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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 If its appearance is outdated, no one will look at your information because there will be the assumption (correct or not) that what is on the site is also likely outdated. People may believe you and/or your organization are outdated, or worse yet, irrelevant.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.

 

 

“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”! 🙂

Children in virtual traffic testing situations – can we approximate real traffic situations?

20 Aug, 15 | by Klara Johansson

Young children are developmentally very bad at traffic safety. This was early demonstrated by Swedish researcher Stina Sandels in the 1960’s. In her groundbreaking studies where she studied children’s behaviour in traffic situations, she came to the conclusion that children under the age of 12 are developmentally unable to handle traffic in a safe way. She stated that ‘even the best road safety education cannot adapt a child to modern traffic, so that traffic has got to be adapted to the child.’

Since then, research has repeatedly shown this to be true. For instance, children before the age of eleven are usually not able to think from another perspective, and thus often fail to understand that a curve, hill or parked car may obstruct their view.

But in order to adapt traffic to children, we still need to study the choices children make in various traffic situations. And nowadays, when we’re aware of the high injury risk, we need to do such studies “in vitro”, in perfectly safe conditions.

How can we do that?

Well, nowadays there are technical options never before seen. An article in our current issue of Injury Prevention is using and further developing virtual reality to study if children crossing a street adjust their walking speed to avoid oncoming traffic. The technology is obviously still at an early stage, but Morrongiello, Corbett, Milanovic, Pyne & Vierich is building on previous research but with the improvement that they use a system that allows children to physically walk across a street in a virtual environment (while actually walking in an empty room, supervised by researchers).

The virtual environment used in the study (picture courtesy of Barbara A Morrongiello)

The virtual environment used in the study (picture courtesy of Barbara A Morrongiello)

The study shows that children’s average walking speed is a bad proxy for how fast they walk under the threat of oncoming traffic. This finding emphasizes the importance of using a VR testing environment where children can actually move around themselves instead of controlling an avatar that corresponds to their average normal walking speed, which has been used in previous studies.

Incidentally, I just read a long feature in Time about how far virtual reality has developed. The full article is unfortunately only available to subscribers, but there is a brief version here. To give a very short summary: virtual reality tec has come further than we think, but many headsets and graphics on the market are still fairly clunky (but new tec is set to reach the market within 18 months). The article also points out that VR can be useful for a wide range of purposes, including conference meetings, treatment of phobias, empathy training, and research. They don’t mention traffic safety research, but that just goes to show that each of us nerds in the world have our own specific interest to bring to the table.

One major differentiating feature of VR systems seems to be whether one would explore the virtual worlds by walking around or sitting on the couch. Well, for traffic safety research, the article by Morrongiello et al shows the value of one that lets the subject walk around.

Or cycle around – that seems easier to accomplish, using a training bike that responds to the virtual environment. For adults, studies using car driving simulators has been available for more than 20 years, but of course, that doesn’t require a VR headset.

The next technological step that VR geeks dream of is apparently “enhanced reality” – a headset that superimposes virtual holograms onto your real field of vision. From what I understand, this is more difficult technologically, but if accomplished, I imagine it could be a gold mine for safety research and training.

 

Home safety and the prevention of falls

17 Aug, 15 | by Bridie Scott-Parker

The Royal Children’s Hospital (RCH) Safety Centre has created a new online resource to tackle the number one cause of injury to children in Victoria, Australia – falls.

Targeting parents of children aged from birth to 14 years old, the site details simple steps parents and caregivers can take to prevent common injuries by age group, such as

* changing a baby’s nappy on the floor rather than on an elevated change table, and

* wearing protective gear, including mouth guards, when playing contact sports.

RCH Trauma Service Manager Helen Jowett says the frequency of under 14-year-olds requiring a hospital admission following a fall has increased by 29 per cent since 1998, at an annual cost of $18.6 million.

Most of those injuries occur in the home and behind those statistics are children like Ella, who had a tough lesson in gravity when she fell from a tree she was climbing in her back garden. The eight-year-old, from country Victoria, landed head-first when she fell, and was rushed to her local hospital where she was assessed as having a significant head injury.

Ella was promptly sent to The Royal Children’s Hospital by air ambulance for emergency surgery. After discharge, she spent several weeks resting and was unable to play contact sport for three months.

The new website shows that, unlike Ella’s hospital stay, safety around the home doesn’t need to be expensive, emotionally draining, complicated, or time-consuming.

Importantly for injury prevention around the world, the website is an easy-to-access repository for information regarding, and links to, useful tips and advice that can be applied in any home anywhere, anytime. For example, falls-prevention safety pertaining to furniture, and to bunk beds specifically, may have helped prevent my nephew from breaking his arm as a young boy.

Risky opinions

29 Jul, 15 | by Sheree Bekker

“If you are a parent, you know that kids love to keep making circles” ~ Takaharu Tezuka

This charming Ted Talk from architect Takaharu Tezuka captured my imagination. It beautifully illustrates how architecture can positively influence physical activity levels – and we all have heard that sitting is the new smoking – however, I could not help but notice the take-away message that we are left with:

“My point is don’t control them, don’t protect them too much, and they need to tumble sometimes. They need to get some injury. And that makes them learn how to live in this world. I think architecture is capable of changing this world, and people’s lives. And this is one of the attempts to change the lives of children”

So, can child injury prevention include healthy risk promotion? A special feature in Injury Prevention explored this very question. This piece takes the reader on an interesting journey from the developmental benefits of risky play (via parenting and societal perceptions of risk, playground safety standards and children’s play space design, bubble-wrapped recreation, the public policy perspective, risk-benefit assessment, the state of the evidence) through towards calling for a culture of reasonableness: 

“The challenge is to broaden the focus and commit to a child-centric approach—one that includes not only the mitigation of injury but also optimal child development, which necessitates exposure to competence-appropriate risky play in a hazard-free play space”

This has been an ongoing conversation (as hinted at in the Ted Talk): Are our school playgrounds being wrapped in cotton wool?

Of course, there are varying stances on risk within the injury prevention world. Recently, Barry Pless posted his own opinion right here on the Injury Prevention blog in The Safety Hysteric Speaks Again, stating that:

“In some circles I am regarded as an injury prevention fascist, safety hysteric, protect the children fanatic, a wuss, or worse. This has come about because I consistently push for more prevention and less risk taking. I am not at all convinced that risk-taking is good for child development, as some would have us believe. Nor am I convinced that having a serious injury with possible life-long (if not life-threatening) consequences builds character, or whatever”

It seems that this topic is a can of worms, and one which many researchers are (rightly?) wary of engaging in outside of carefully crafted research papers. Our opinions are carefully kept out of the public eye – however social media is rapidly has changed this. A large element of the advocacy that I wrote about last week applies here: why allow others to own the conversation that we, as injury prevention researchers, have all the tools to constructively address?

Our opinions can, and should, be fluid and in flux – and certainly differing too – this is the very nature of advancing our life’s work. Fostering an open and ongoing conversation remains necessary to that very nature of our work, and is one which I believe we should all be partaking in more often.

So, any thoughts?

 

More background on our blogging team

19 Jun, 15 | by Bridie Scott-Parker

Blog 3: So today I wanted to share some more background on our blogging team. As an applied social psychologist, I find this information very interesting indeed!

What excites you about being part of the Injury Prevention social media editorial team?  

Sheree Bekker: The invaluable conversation that has sprung up around scholarly work through the collaborative power of social media and blogs inspires me to no end. I tend to find more relevant scholarly content through Twitter than through traditional platforms, and Injury Prevention has played a big part in that. As researchers, I believe that we should own our voice on social media, and constructively add value to this conversation.

David Bui: Through my studies in medical school I have seen the costs of injuries to society and individuals worldwide.  This is a great opportunity to harness the underutilised power of Social Media in health promotion and Injury Prevention, across multiple disciplines and multiple borders.

Angy El-Khatib: Being a part of the Injury Prevention social media editorial team is a great opportunity personally and collectively. By being a part of the social media editorial team, I am able to stay up to date on various topics within the realm of Injury Prevention while acquiring different perspectives from individuals from different backgrounds, disciplines, and locations. I’m also excited to be able to potentially increase readership and engage readers to create a conversation around the latest Injury Prevention research and ideas.

Klara Johansson: I am very interested to explore ways to share and disseminate knowledge and research results, outside the “old-school”, regular channels. I look forward to learning from my new co-editors, who all seem to be great communicators.

Joseph Magoola: The opportunity to work and collaborate with a variety of scholars on the injury prevention platform is nothing short of exciting. It also excites and inspires me to have an opportunity to represent Africa since low and medium income countries bear the brunt of the injury burden.

Julian Santaella-Tenorio: It is really exciting to be part of this team and to have a space to communicate and express ideas on ways to improve injury prevention, and to discuss about new studies and topics relevant to this field. I am very motivated to learn more and continue growing as a researcher as I walk through this experience.

What are you passionate about?

Sheree Bekker: Intersectional issues drive my life’s work, and my aim is that my research is, and always will be, an extension of that.

David Bui: Passionate about bringing people and ideas together.

Angy El-Khatib: I am passionate about translating scientific evidence and research into public health action. My goal is to improve the health and wellbeing of myself as well as my community. Outside of my work, I am passionate about health, fitness, and wellness.

Klara Johansson: Open discussions and innovative research in collaborative teams with high scientific ambition + high levels of tolerance and kindness; I also enjoy making difficult subjects understandable to students and the general population. Passions on my free time: nature, gardening, books, movies, writing fiction, playing music (clarinet, harmonium, piano, accordion).

Joseph Magoola: Writing on my social media accounts (facebook, twitter and my blog) as a way of reaching out to the masses. I am also interested travelling a lot, especially by road and as such, ensuring road safety is part and parcel of my aims to contribute towards reducing the carnage of our roads.

Julian Santaella-Tenorio: I am passionate about things that can make people have a better, healthier and happier life. I am inspired by ideas challenging previous knowledge, creative thinking finding answers from different angles, and the power of multidisciplinary groups. That is why I am passionate about public health research.

 

I hope you are looking forward to hearing from our bloggers, starting next month!

More background on our new blogging team

18 Jun, 15 | by Bridie Scott-Parker

Today I will share more about our blogging team members.

Blog 2: Explain your injury prevention research and interests.

Sheree Bekker: My research investigates safety promotion and injury prevention policy and practice within community sport in Australia. I have a particular interest in dissemination and social marketing. The overall purpose of my research is to allow people to be safe, as well as feel safe, whilst participating in sport or physical activity.

David Bui: Undertaking a number of different projects currently; my injury prevention research focuses on Hip fracture and Falls Prevention research, working with Neuroscience Research Australia. I am also looking into Social Media and its utility in healthcare and civilian settings, and I believe that it represents a powerful new medium in health promotion and injury prevention.

Angy El-Khatib: I am interested in integrating public health approaches with athletic training practice. Athletic training has traditionally focused on the individual but may be able to maximize the effectiveness of prevention efforts by using population-level approaches to improve health and wellness.

Klara Johansson: I am not currently doing research on injury/safety. But I am interested in social difference in injury risk – and also how perceived risk of injuries affects people’s daily lives, mobility, fears and physical activity; and how perceived and real injury risks interrelate with each other and with gender and socioeconomics. Main focus on adolescent safety; real and perceived. Also interested in open data and availability/accessibility of injury statistics globally.

Joseph Magoola: My research interests center around prevention of injury, especially through generation of data for evidence-based decision making and policy action. I am also interested in the use of media to disseminate research findings and for advocacy.

Julian Santaella-Tenorio: At the moment I conduct research on policy evaluation, specifically on policies that impact injury-related outcomes. I am interested in looking at substance use policies and firearm-related legislation and their effects on the health of populations.

Tomorrow: Learn about their passions!

Injury prevention and Indigenous Australians

11 Apr, 15 | by Bridie Scott-Parker

Yesterday I came across a report which estimated the fatal burden of disease and injury for Indigenous Australians. Included were estimates of the magnitude of the fatal burden ‘gap’ between Indigenous and non-Indigenous Australians.

The Burden of Disease Study: Fatal burden of disease in Aboriginal and Torres Strait Islander people 2010 report includes fatal burden calculations in terms of years of life lost (YLL). Noteworthy findings include

Injuries and cardiovascular diseases contributed the most fatal burden for Indigenous Australians (22% and 21% respectively), followed by cancer (17%), infant and congenital conditions (10%), gastrointestinal diseases (6%) and endocrine disorders (which includes diabetes) (5%). These disease groups accounted for 82% of all Indigenous YLL in 2010.

Deaths in infants contributed the most to Indigenous YLL. The fatal burden in Indigenous infants was largely due to infant and congenital conditions, which includes causes such as pre-term birth complications, birth trauma and congenital defects.

‘Injuries were the leading cause of fatal burden among Indigenous persons aged 1- 34, after which cardiovascular diseases and cancer were most prominent,’ said Australian Institute of Health and Welfare spokesperson Dr Fadwa Al-Yaman.

YLL rates for injuries and cardiovascular diseases were almost 3 times as high in the Indigenous population.

Clearly we need to reduce the injury-related burden for all persons, and for indigenous persons in particular. It is important that we use this information to more forward to achieve that outcome – but, just how do we do this? What are the next steps? How do we start the ball rolling, and then maintain its momentum? I would argue that this is the greatest challenge facing injury prevention researchers and practitioners around the world.

World Health Day 2015

7 Apr, 15 | by Bridie Scott-Parker

In case you didn’t know, today, the 7th of April, is World Health Day 2015. As can be read on the World Health Organization website, WHO hopes to highlight

the challenges and opportunities associated with food safety under the slogan “From farm to plate, make food safe.”

“Food production has been industrialized and its trade and distribution have been globalized,” says WHO Director-General Dr Margaret Chan. “These changes introduce multiple new opportunities for food to become contaminated with harmful bacteria, viruses, parasites, or chemicals.”

Dr Chan adds: “A local food safety problem can rapidly become an international emergency. Investigation of an outbreak of foodborne disease is vastly more complicated when a single plate or package of food contains ingredients from multiple countries.”

My husband experienced first hand the consequences of poor food handling practices, experiencing severe gastrointestinal upset which started showing itself half way through a 16-hour cross-Pacific flight. The extremely unpleasant side-effects lasted for several days, and he will not be eating airport lounge fast-food any time soon!

I myself had a number of blood tests earlier this year after persistent ill health – thankfully I returned negative results, unlike other Australians who similarly had eaten contaminated berries imported from overseas. This latest scare has prompted a call for clearer packaging, and improved safety standards in Australia and overseas.

Our immediate experiences cannot compare with those of individuals who have lost their lives due to foodborne illnesses, however. The WHO has released its preliminary findings regarding the global burden of foodborne diseases, with additional findings expected later this year. I look forward to seeing further results in this important injury prevention domain.

 

 

Drowning in injury prevention

6 Apr, 15 | by Bridie Scott-Parker

Living in the Sunshine State, water safety has always been important to our family. I remember learning how to rescue someone, and how to swim safely out of an ocean rip, as a young child. I grew up in a farming community, and my brothers and I always knew if we went near the dam we would be in for it. I have also seen how resuscitation after drowning may not always the best option.

Given it is school holidays, and given how popular our state is at this time of year, unfortunately we have seen some near misses – thank goodness they reached these struggling swimmers in time. The difference between drowning and surviving can be just seconds.

Children are particularly vulnerable – during the last couple of weeks, a 15-month old drowned in the family pool; a four-year old boy drowned in the neighbour’s pool; a two-year-old boy drowned in the family dam…. figures showed five drownings in pools, seven in dams and two in waterways among children under eight since July 2014.

As an injury prevention researcher I firmly believe in preventing drownings and near-miss drownings is the best course of action we can take, and any research findings which help us take a holistic approach to preventing drownings spark my interest. In November 2014, the World Health Organization released its first Global report on drowning: preventing a leading killer. with the World Conference on Drowning Prevention to be held in Malaysia in November. The April edition of Injury Prevention features a paper by Karimi, Beiki, and Mohammadi, highlighting the increased drowning risk for boys with a foreign background; an article by Tian, Shaw, Zack, Kobau, Dyckstra, and Covington in the the March edition of Epilepsy & Behavior highlighting the increased risk of death due to drowning for children and young adults with epilepsy; and the February edition of PLoS One featuring an article by Wallis, Watt, Franklin, Nixon, and Kimble highlighting the considerable burden of drowning and near-drowning among children aged 0-19 years in Queensland.

Clearly we have much progress to make, and publishing research findings such as these are vital to prevent water-related deaths in persons of all ages.

 

 

 

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