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Offbeat

Non-suicidal self-injury: Another effective avenue of intervention?

15 Oct, 14 | by Bridie Scott-Parker

The 10th of October is World Mental Health Day, and here in Australia a variety of activities helped ensure that mental health was openly discussed during Mental Health Week (5-12 October). As a researcher who works with adolescents, I am interested in their mental health, particularly as it can have pervasive implications for their injury prevention. I thought I would share an interesting article regarding non-suicidal self-injury (NSSI), an intentional injury which unfortunately has been found to be associated with a breadth of other injuries including suicide.

As part of a larger study exploring how adolescents cope with emotional problems, Voon, Hasking, and Martin (2014) explored the role of a number of variables in NSSI amongst a sample of 41 Australian high schools (Time 1 n = 2637 students; Time 2: 12 months post-baseline, n = 2328; Time 3: 24 months post-baseline n = 1984). Lifetime prevalence of NSSI increased over time (8.1% – 10.1%), with adolescents engaging in NSSI typically starting the behaviour aged 12-14 years. Experiencing more adverse life events and high psychological distress increased the risk of the first episode of NSSI, consistent with other research findings that adolescents respond to acute life stress and emotional distress through NSSI. This suggests that adolescents in these tumultuous states could benefit from NSSI-targeted interventions which could prevent NSSI include cognitive reappraisal in particular.

The ripple effect of such support for adolescents in particular could indeed offer another effective avenue of intervention for a breadth of injuries during the developmental period of adolescence and young adulthood.

Pedestrian safety video worth watching

6 Oct, 14 | by Barry Pless

Ted Miller, editorial board member and famed for much else, kindly sent a link to an excellent youtube video that I urge you to watch. I do so because I have long cautioned that pedestrian signals can be dangerous if you assume that cars will always respect them. I plead with my friends, family, and former patients (I am now retired) to always establish eye contact with drivers before assuming that a green light means it is safe for you to cross. This is especially true for elderly folk like me. But it seems youth in particular are often impatient at crossing lights and this video presents one way to keep them from jumping the light. It is very clever and I hope the strategy will be widely adopted. Even then, however, I still recommend eye contact with the nearest driver before stepping onto the road. The video is here: https://www.youtube.com/watch?v=SB_0vRnkeOk&feature=share

Let me know what you think. Just copy and paste the link into your browser. Thanks Ted.

Different questions for more answers?

19 Sep, 14 | by Bridie Scott-Parker

This week I have been pondering the larger issue. You may wonder what brought this on?

I live in Queensland, the Australian state with the dubious title of ‘skin cancer capital of the world’. I was a child of the 70’s. We spent hours in the sun covered in all sorts of oil that smelled great (coconut especially) to see who could get the darkest tan in the shortest time possible. Sleepovers often involved mutual peeling of large segments of skin, which ended up being some sort of weird Silence-of-the-Lambs-esque trophy. Slip, slop, slap was new, and for the social misfits only.

Needless to say in an era of increased awareness of the considerable skin cancer risks of too much sun exposure, I am very proud of the fact that my children have never been sunburnt. Well, I can no longer say this.

One day this week my 14 year-old son returned from a school field trip redder than a tomato, despite his protestations that yes indeed he did wear his hat (it kept blowing off in the wind at the beach, according to his urgent explanation to his very cross mother) and yes indeed he did wear sunscreen (apparently of SPF1 as he was red red red!). As a child who wears glasses, I was particularly concerned about a long day in which the sun’s UV rays were concentrated into his eyeballs. He (unconvincingly) claimed that he wore his sunglasses all day. Even worse – his maternal grandmother had a particularly nasty and aggressive skin cancer cut from her face just one week earlier, so sun protection is very high on our family’s radar at the moment!

After a lengthy – and at times loud – discussion about the need to look after his skin particularly in our climate, and that now he is growing up he needs to start taking care of his own health (yes, he did agree that having Mum attend the field trips with him would be embarrassing, and yes, it would definitely harm his reputation with the opposite sex), I started to think about injury prevention more generally.

Initially I had tried to identify the predictors of risk as a way to intervene: what about this field trip contributed to him being sunburnt? Like most injury prevention researchers, we want to know what contributes so we can ameliorate or eliminate it altogether. According to him, hat, check; sunscreen, check; sunglasses, check. Then I started to think about it a different way. What about this field trip helped him be less-sunburnt? What protected his classmates from sunburn (if indeed, as I hope, some managed to avoid the sun’s wrath)?

Maybe as injury prevention researchers we should be spending more time considering what helps to minimise risk, not only what increases risk. I think these ‘different questions’ will lead to more answers in the long term. Think big picture!

Engagement appears the key

25 Aug, 14 | by Bridie Scott-Parker

Regular readers of the Injury Prevention blog will be well aware with my obsession with engagement. Traditionally, injury prevention – such as in road safety – focuses on the “Three E’s” of Engineering, Enforcement, and Education. I think that Engagement is the fourth, often-forgotten, essential “E”, albeit it can be very tricky to actually manage, and manage effectively.

I was interested to read the engagement experiences of a team of Australian colleagues who trialled an online injury surveillance program in 78 community sports clubs in five football leagues (see http://www.injepijournal.com/content/1/1/19). I have previously blogged regarding injuries in sports such as football, and in particular related to concussion, and this and similar contact sports continue to be of interest to injury prevention researchers, practitioners, and policy-makers. As such, community-based injury surveillance can help everyone from persons in injury prevention to those actually on the sports field. While Ekegren et al note that 44% of the 78 clubs targeted for the intervention actually adopted the program, overall only 23% of the clubs implemented the program by recording injuries in the online program in 2012, and 9% maintained the program by recording injuries in 2013.

Barriers included personal factors like a lack of importance being placed on injury surveillance; socio-contextual factors such as staff shortages/changes, injury underreporting, lack of leadership/support for reporting injuries; and system factors included technical issues, data requirements, time to input data, and adjusting to a new online reporting system. Notwithstanding these barriers, facilitators include recognition that injury surveillance is important and is part of the trainer’s role (personal factors); association with a simultaneous injury prevention program (socio-contextual factors); and ease of use (system factors).

Engagement to reduce barriers and maximise benefits appears essential, and expertise and guidance in engagement appears to be a definite need in the realm of injury prevention across all domains of injury. In my own area of young driver road safety, I and others struggle to engage one key partner: parents. Perhaps learnings from one domain can help other domains, and information sharing is vital.

Domestic violence

4 Aug, 14 | by Bridie Scott-Parker

Blog readers are well aware of my passion for conferences – the immeasurable benefits that can arise from presenting, networking, developing and maintaining collaborations, and sparking ideas, just to name a few. So today I won’t talk at length about the wonderful experiences I had last month as I spoke at a conference in Paris, then at another conference in Krakow. I will talk, however, about domestic violence.

Whilst in Europe, I had no idea that a verdict had been handed down in a local murder trial which has grabbed our attention since the victim’s disappearance more than two years ago (see http://www.brisbanetimes.com.au/queensland/gerard-badenclay-found-guilty-of-murdering-wife-allison-badenclay-20140715-ztdon.html). I also had no idea of the insidious nature of the domestic violence, inflicted upon the victim, which emerged during the trial and has insipired a variety of responses including efforts to start a dialogue around the unacceptability of domestic violence  (eg., see http://www.couriermail.com.au/news/queensland/tragedy-of-allison-badenclay-inspires-cousin-to-set-up-online-antidomestic-violence-site/story-fnihsrf2-1227006310512?nk=e46ae81c51bf6c72de6319e37bb46706).

It is easy to lay blame and cast judgement in such circumstances. Some will lay blame at the perpetrator’s feet. Others will lay blame at the victim’s feet. Hindsight is frequently 20/20, and laying blame may not help those in a similar situation. Rather, is there a way we can break the victim/perpetrator dynamic by understanding the victim’s perspective, with the ultimate goal of supporting the victim to extricate themselves from this situation?

A recent article by Taket, O’Doherty, Valpied, and Hegarty (see http://www.ncbi.nlm.nih.gov/pubmed/24925714) summarised the interview responses of 254 women who had experienced intimate partner violence. Interestingly, as noted by the authors, “The sample of women was extremely diverse in terms of their experience of abuse, including those still actively working to improve the relationship; those who were staying in the relationship and could not see how it could change; those working to stay safe in the relationship while they worked out how to leave; those in the process of ending the relationship and sorting out finances, housing, and custody of children (if applicable); and those who had ended the relationship but were still experiencing abuse and/or were dealing with the physical or psychological effects of abuse.” Participants shared a range of experiences and advice relating to what they value – and do not value – from their family and friends, including instrumental, informational, emotional and companionship support.

I was particularly touched by their concluding statement: “Notably, women value both support that is directly related to abuse and support related to other areas of life.” How can I help?

Injury prevention and the musician

16 Jun, 14 | by Bridie Scott-Parker

It doesn’t seem right that something so beautiful as music can cause terrible, enduring pain for the creator.

Miss Imogen Scott-Parker preparing for a concert

Miss Imogen Scott-Parker preparing for a concert

Sharing my home with an aspiring concert pianist (a busy young lady who has also spent years studying violin, harp, and classical voice) means I have seen first hand just what can happen through overuse, incorrect practice, or simply through not knowing what the consequences may be. She has also shared stories of the pain experienced by fellow musicians as they commit themselves – quite vigorously at times – to perfecting their craft. Such injuries can have devastating, long-term consequences, with permanent conditions meaning a change in career may not be a choice, rather the only option.

My daughter commenced her tertiary studies this year, and pleasingly one of her classes covered how to practice ‘smart’, so that less time was spent fixing more problems, thus minimising exposure to potential injury. If injured, the students were advised to cease practice immediately and to notify teachers of any discomfort and pain in particular. Students were also provided with contact details for a physiotherapist who specialises in music-related injury management.

Consistent with this advice, my daughter mentioned to her instrumental teacher that she was experiencing pain whilst practising certain pieces of music for lengthy periods. Her teacher strongly counselled her to immediately cease all practice, including typing (which is fundamentally the same movements as playing a piano), and allow her wrists, her thumbs, and her little fingers time to recuperate. Her teacher is mindful that she has relatively small, young hands (she is 15 years old) and is playing quite challenging repertoire.

Given my first-hand exposure to the realm of injury in music, I had a look through some recent publications. If you are interested, here are some interesting papers: Rickert, Barrett and Ackermann have produced a two-part series exploring injury in the orchestral environment (see http://www.ncbi.nlm.nih.gov/pubmed/24337034 ; http://www.ncbi.nlm.nih.gov/pubmed/24925177); Chan, Driscoll, & Ackermann examined the usefulness of triage services for professional orchestral musicians (http://www.ncbi.nlm.nih.gov/pubmed/23506482); and the reframing of the injury-prevention issue of likening musicians to athletes was an interesting read (http://www.ncbi.nlm.nih.gov/pubmed/24225525).

Connecting, coordination and coverage is crucial: my experiences with Fatality Free Friday

2 Jun, 14 | by Bridie Scott-Parker

Dr Bridie Scott-Parker (University of the Sunshine Coast Accident Research), Councillor Rick Baberowski, Ms Megan Cawkwell (Sunshine Coast Council) [Photo courtesy Ms Vanessa Clarke]

Dr Bridie Scott-Parker (University of the Sunshine Coast Accident Research), Councillor Rick Baberowski, Ms Megan Cawkwell (Sunshine Coast Council) [Photo courtesy Ms Vanessa Clarke]

Last Friday, May 28, was Fatality Free Friday (see http://www.fatalityfreefriday.com/)  here in Australia. The aim of the event is Not a single road death in Australia for just one day. Just one Fatality Free Friday.

The Fatality Free Friday website states:

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.

Whilst as an evidence-based practitioner and methodologically-rigorous researcher I realise that this is not necessarily the most effective manner in which to prevent injury on the road, I was delighted to participate in my the Fatality Free Friday events of my local region for the three reasons listed in the title:

1. Connecting: Injury prevention professionals need to connect – simply espousing what the evidence suggests should be done is not enough. At a fundamental level we humans are social beings, and making the connection (the fifth ‘E’ of engagement) is often the key to making any inroads in injury prevention. We need to connect with policy-makers, we need to connect with those whom we are trying to protect, and we need to connect with our colleagues-in-arms. Connecting can be as simple as speaking to one person about how they can prevent injury (for example, at the local event), translating what the research means in real words for real people (such as in my University lecture later that morning), and giving tips regarding how to stay safe to those who may not be sure what to do (like during drive-time radio).

2. Coordination: The event was organised by Sunshine Coast Council, and attending stakeholders included Transport and Main Roads, Queensland Police, Maurice Blackburn lawyers, Coastwide Driving School, motorcycle champion Chris Vermeulen, and parents and friends of those lost to road crashes in addition to myself. We all play a part in road safety, so it is important we are coordinated in our efforts whenever we can have the opportunity.

3. Coverage: I can conduct all the research I want; however if I can’t translate this into practice through connecting, coordinating and coverage, how is this going to advance the world of injury prevention? We need our research translated into the real world, and coverage is essential.

How can you be active in injury prevention?

 

Look for injury prevention ideas everywhere

26 May, 14 | by Bridie Scott-Parker

Conferences – I’m a huge fan! Regular readers of the blog will know I have shared my thoughts about the benefits of conference attendance/presentation/participation etc. Today I continue my sharing by telling you about one of the best ideas I heard at the most recent conference within which I had the great fortune to participate.

First, some background. I am a post-doctoral researcher, focusing upon improving young driver road safety. Over the years I have attended, presented at, and/or participated in a wide variety of conferences, including those more generally addressing road safety and injury prevention, and more specifically addressing particular risk factors such as adolescent psychological distress and learning-to-drive. I have found each and every one of these conferences to be an invaluable source not only of education, but, most importantly, inspiration and engagement.

Second, having said that, conferences are what you make of them. You need to listen to different ideas (and you may not necessarily agree with these, which is often the best source of inspiration), and you need to speak with others, whether they presented themselves or simply attended due to a burning interest. The sky is the limit.

Third, and my point for today – I learnt something very important at this conference. Attend conferences (and other networking/learning/engaging opportunities) outside your ‘area of interest’, and you might be surprised by what you learn, who you meet, and the range and breadth of inspired collaborative projects which may emerge. In my own case, as a trained psychologist and scientist, I had never considered attending, for example, an engineering conference. However, this makes sense. For example, civil engineers create the roads upon which all my young drivers travel; automotive engineers create the vehicles within which all my young drivers travel; computer engineers create the computer systems in the vehicles in which all my young drivers travel. Do civil engineers, automotive engineers, and computer engineers think about the young drivers who will be travelling on, through, and within their creations? I don’t know, but I will find out!

I hope I have encouraged you to ‘think outside the box’.

 

From evidence to policy and practice

13 May, 14 | by Bridie Scott-Parker

Regular readers of the Injury Prevention blog will be quite familiar with my obsession for getting our rigorous research translated into policy and practice. I regularly hear from individuals in industry and government, not to mention the general community, that researchers are great at communicating with other researchers, and not so great at communicating with ‘normal people’. Upon hearing this I have decided to create one-page summaries of my journal articles and conference papers, in plain English, summarising for the ‘normal person’ what I did, what I found, and what it means for them.

So you can understand my delight at reading an article published in a recent edition of Social Science & Medicine (see http://www.ncbi.nlm.nih.gov/pubmed/24632115). Zardo, Collie and Livingstone decided to wrangle with the twofold problem of getting research translated into policy and practice: “identify external factors that affect policy and program decision-making, and use this evidence to inform targeting of interventions aimed at increasing research use (in the context of injury prevention and rehabilitation compensation in Victoria, Australia)”.

Interestingly the interviews with employees from two state government agencies revealed that the following stakeholders were most influential, suggesting that researchers need to target these stakeholders if they are to be influential in  government policy and practice.

* the Minister and the government,

* lawyers, and

* agency stakeholders, including health providers, trade unions, and employer groups.

I love the idea of working smarter, not harder!

Poorly-fitted child seats an injury waiting to happen

24 Apr, 14 | by Bridie Scott-Parker

Thinking about the recalls yesterday, particularly those related to child seats, reminded me of a recent story I read recently. A 2013 survey of over 10,000 child seats in England, Wales and Scotland revealed that 60% of the child seats were poorly-fitted (see http://www.express.co.uk/news/uk/470156/Millions-of-infants-at-risk-60-per-cent-of-all-child-seats-not-fitted-safely). One poorly-fitted child seat is a problem, let alone 6,000 in a sample of 10,000. This statistic is alarming.

Why is this an issue? According to Kevin Clinton, head of Road Safety at the Royal Society for Prevention of Accidents in the United Kingdom,

“The importance of properly fitting a child seat cannot be overstated. Make sure it is compatible with the car and remember to seek expert help on fitting. We encourage parents to check that the seat is fitted correctly before every journey, esp­ecially if they are regularly taking it in and out of the car.”

He urged the public to “avoid purchasing second-hand car seats as they might not comply with the latest standards, the fitting instructions may be missing and you cannot be sure of their history, such as whether they have been in an accident.”

So why isn’t the message getting through to parents? As a parent myself, I cannot imagine another parent willingly installing a child seat in an unsafe manner, deliberately putting their child in harm’s way. How do stakeholders important in injury prevention get the message across?

Timely action is particularly important when we consider that our most vulnerable could be travelling at 110km/hr, with parents mistakenly believing that their child is as safe as possible. Timely action is also especially important when we realise that this has been an issue for some time (eg., a 2011 story reporting similar statistics: http://www.theguardian.com/money/2011/sep/17/child-car-seats-motoring).

It will continue to be an issue unless more is done, and sooner rather than later.

 

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