Category Archives: Injury Prevention
A recent report from the Institute of Medicine found that young athletes in the United States face a "culture of resistance" to reporting when they might have a concussion and to complying with treatment decisions. That culture can result in students heading back to school too quickly—when they should be resting their brains to prevent short- and long-term complications.
"The findings of our report justify the concerns about sports concussions in young people," said Robert Graham, chair of the committee and director of the national program office for Aligning Forces for Quality, at George Washington University, Washington, D.C. (Aligning Forces is a program of the Robert Wood Johnson Foundation.) "However,” says Graham, “there are numerous areas in which we need more and better data. Until we have that information, we urge parents, schools, athletic departments, and the public to examine carefully what we do know, as with any decision regarding risk, so they can make more informed decisions about young athletes playing sports."
Recently, Righttime Medical Care, a chain of urgent care centers in Maryland, opened a number of HeadFirst sports injury and concussion centers in the state, staffed with health professionals who can assess injuries for concussions as well as evaluate students for return to play—in consolation with a team of experts who work with HeadFirst staff. HeadFirst will this year be presenting and publishing data on the more than 10,000 youth it has examined and treated for concussion in just the past two years.
NewPublicHealth recently spoke with Robert Graw, MD, head of Righttime and HeadFirst, about the need for better prevention, evaluation and treatment of concussions to prevent long-term health problems and disability.
NewPublicHealth: Why did Righttime add concussion care to the services provided?
Robert Graw: My son is an orthopedic surgeon and talked to me about the number of injuries he was seeing. We decided a few years ago that we’d learn as much as we could about preventing head injury and the consequences of head injury, and then promote that information through Righttime’s call center and through the visits that people made to our sites.
In the process of learning as much as we could we realized that the knowledge base of how people evaluate and manage concussions had changed drastically in the last five years as people have done more research. So, we then gathered together a group of consultant physicians and neuropsychologists to determine best practices. We met with them frequently, and then had them train our provider staff so that all of them became much more informed about what a concussion really is, the best way to evaluate them and the guidelines for management going forward.
Decrease in Pediatric Antibiotic Leveling Off
The number of children taking antibiotics has decreased over the past decade, but that decrease has stalled in recent years in certain age groups and geographic locations, according to a study in Pediatrics. Researchers reviewed pharmacy and outpatient claims over a 10-year period (2000 to 2010) in three health plans located in three different geographic locations to determine the number of antibiotics dispensed each year for children ages 3 months to 18 years. Although the overall antibiotic-dispensing rate in each age group and health plan was lower in 2009-2010 than in 2000-2001, the rate of decline in antibiotic use has slowed. The highest rate of antibiotic use was in children age 3 months to less than 24 months of age in all years of the study.
The study authors say the previous downward trend in antibiotic use in children may have reached a plateau, and continued improvements in judicious antibiotic dispensing are needed. Read more on pediatrics.
NHTSA Gives Okay for Vehicle to Vehicle Communication to Help Prevent Crashes
The National Highway Traffic Safety Administration has announced that it will begin taking steps to allow vehicle-to-vehicle (V2V) communication technology for light vehicles, which will allow vehicles to "talk" to each other and ultimately avoid many crashes by exchanging basic safety data, such as speed and position, ten times per second.
The safety applications currently being developed provide warnings to drivers so that they can prevent imminent collisions, but do not automatically operate any vehicle systems, such as braking or steering, although NHTSA is also considering future actions on active safety technologies that rely on on-board sensors.
V2V communications can provide the vehicle and driver with 360-degree situational awareness to address additional crash situations — including those, for example, in which a driver needs to decide if it is safe to pass on a two-lane road (potential head-on collision), make a left turn across the path of oncoming traffic, or in which a vehicle approaching at an intersection appears to be on a collision course. In those situations, V2V communications can detect threats hundreds of yards from other vehicles that cannot be seen, often in situations in which on-board sensors alone cannot detect the threat. Read more on transportation.
Many Hospital ICUs Don't Follow Infection Prevention Rules
While most hospitals have evidence-based guidelines in place to prevent health care-associated infections in intensive care units (ICUs), clinicians often fail to follow them according to new research from the Columbia University School of Nursing published in the American Journal of Infection Control. The study, on over 1600 ICUs, found lax compliance in intensive care units where patients are more likely to be treated with devices linked to preventable infections – such as central lines, urinary catheters and ventilators.
The study focused on three of the most common preventable infections — central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections and determined that despite decades of research, establishing best practices for prevention of these infections, approximately one in 10 hospitals lack checklists to prevent bloodstream infections, and one in four lack checklists to help avoid pneumonia in ventilator patients, and that in hospitals with checklists, they are followed only about half of the time.
Health care-associated infections kill an estimated 100,000 Americans a year and result in over $30 billion in excess medical costs, according to the Centers for Disease Control and Prevention. Read more on injury prevention.
NIH, Industry and Non-profits Form Partnership to Speed Drug Development
The National Institutes of Health (NIH), 10 biopharmaceutical companies and several non-profit organizations have launched the Accelerating Medicines Partnership (AMP) to identify and validate the most promising biological for several diseases. The first set of disease targets will be Alzheimer’s disease, type 2 diabetes, rheumatoid arthritis and lupus. Through the foundation for the NIH, AMP partners will invest more than $230 million over five years in the first drug projects. Read more on partnerships.
CDC: Child passenger Deaths Decrease 43 Percent from 2002-2011
While car crash deaths among children age 12 and younger dropped by 43 percent from 2002 to 2011, more than 9,000 children died in crashes during that time period, according to a new Vital Signs report from the U.S. Centers for Disease Control and Prevention. The report found that 45 percent of black children and 46 percent of Hispanic children who died in crashes were not buckled up, compared to 26 percent of white children. Read more on injury prevention.
New Survey Finds Skepticism about Health Law Continues for Many Adults
Analysis of a new Health Reform Monitoring Survey, funded in part by the Robert Wood Johnson Foundation, finds that more and better outreach is needed to educate uninsured people about free or low-cost health insurance through expanded Medicaid programs or subsidies to help them purchase health insurance in the new marketplaces. Among the survey findings:
- On seven measures of health care quality, access, and cost, the majority of adults expect to be neither better-off nor worse-off in 2014 than in 2013, but of those expecting a change in 2014; more expect to be worse-off than better-off.
- Adults are more pessimistic about health-related costs in 2014 than about health care quality and access.
- Compared with insured adults, a higher share of the uninsured—expects to be better-off in 2014.
- Younger adults tend to be more optimistic than older adults about overall health care quality, access, and cost.
In an effort to help more people seek out health insurance coverage, Enroll America in partnership with the Ad Council, just launched “Take Care, People,” a national multimedia public service advertising (PSA) campaign to raise awareness, educate and motivate uninsured Americans to get health insurance for themselves and their families under the Affordable Care Act (ACA).
The campaign uses pets to tell people it’s time to take care of themselves, with a particular focus on women ages 18 to 34. Research by Enroll America finds that that women are more likely than men to do investigate health insurance options, enroll and encourage others to seek out information. Enroll America research also shows that 81 percent of people who are uninsured are unaware of the March 31 deadline to enroll in coverage for 2014 and 69 percent don’t know that financial assistance is available to help pay for their coverage. The PSAs were produced in both English and Spanish. Read more on the Affordable Care Act.
Recommended Reading: As 2014 Begins, the Stanford Football Team is an Exercise Model for the Rest of Us
As the new year begins, the United States is awash in millions of people resolved to go to the gym, run many miles every day, blow the dust off the treadmill in the basement and park yards away from the office front door. But a recent article in The New York Times on the exercise regimen of the Stanford University football team finds that slow and steady, rather than extreme, may be the effective approach toward injury-reduced, successful exercise.
While Stanford lost its Rose Bowl game against Michigan State yesterday, the team’s players have ended the season ahead of many of their competitors in injuries avoided and games missed. What’s different at Stanford is a training regimen by Conditioning Coach Sean Turley, which focuses on each player’s abilities and the muscles and strength they need most to prevent injuries, as well as get their own jobs done on the football field.
The Times reports that from 2006, the year before Turley arrived at Stanford, through last season, the number of games missed because of injury dropped by 87 percent. In 2012, only two players required season-ending or postseason surgical repair, and this year only one did. “For the subtle art of injury prevention, the [Stanford football players] stretch and stretch and stretch. They stretch before and after lifts and before and after practice. They stretch for fun.”
And think again if you think that’s just a regimen needed for elite football players. “These are things that you do for Grandma and Grandpa,” says a Stanford yoga instructor who helps train the team.
>>Bonus Link: Read a U.S. Food and Drug Administration update reminding consumers that, despite advertising they may have seen, dietary supplements cannot prevent concussions.
Help for Keeping Those New Year’s Resolutions from the Federal Government
Losing weight, helping others and quitting smoking are among the top New Year’s resolutions of the American people, according to the General Services Administration (GSA), the agency that oversees the business of the federal government. Links on the GSA site offer strategies, websites and help lines for 2014 resolutions. Click on the quit smoking link on the GSA resolution list for example, and you’ll find yourself at smokefree.gov, which offers tools you can access immediately, even before 2014 begins. Read more on community health.
NIH to Fund Research on Workforce Diversity Programs
The National Institutes of Health (NIH) will establish a national consortium to develop, implement and evaluate approaches to encourage individuals of all backgrounds to start and stay in biomedical research careers. “There is a compelling need to promote diversity in the biomedical research workforce,” said NIH Director Francis S. Collins MD, PhD. “A lack of diversity jeopardizes our ability to carry out the NIH mission because innovation and problem solving require diverse perspectives. The future of biomedical research rests on engaging highly talented researchers from all groups and preparing them to be successful in the NIH-funded workforce.” Read a new JAMA study that finds that minority physicians care for the majority of underserved patients in the United States. Read more on health disparities.
Twenty Percent of Drivers Admit They Often Drive Too Fast
A recent survey by the National Highway Traffic Safety Administration (NHTSA) finds that twenty percent of drivers say they “try to get where I am going as fast as I can." According to NHTSA, speeding-related deaths nationwide account for nearly a third of all traffic fatalities each year, taking close to 10,000 lives. And despite acknowledging the safety benefits of speed limits and reasons drivers should follow them, more than a quarter of those surveyed admitted "speeding is something I do without thinking" and "I enjoy the feeling of driving fast." And sixteen percent felt that "driving over the speed limit is not dangerous for skilled drivers." Most alarming, drivers with the least experience behind the wheel—those 16-20 years old—admitted to speeding more frequently than any other age group. And more than one in ten drivers ages 16-20 reported at least one speeding-related crash in the past five years, compared to 4 percent for the population as a whole. Read more on injury prevention.
Many Still Have Signup Options for Health Insurance Coverage under the Affordable Care Act
Although the December 23 signup deadline for health insurance coverage beginning January 1 has passed, the White House announced on Christmas Eve that signup has been extended for several days for anyone who was unable to complete their online application because of heavy traffic on the site. States and insurers may impose their own deadlines, however, so people not enrolled should reach out to their state insurance hotlines by calling 800-318-2596. Additional information options include clicking the “what is the marketplace in my state” or “live chat” features on the healthcare.gov home page.
The absolute deadline to sign up for 2014 coverage with no financial penalty is March 31, 2014, but signup after Jan 1, 2014 will generally result in coverage beginning a little later in the year. However there is no deadline for people signing up for Medicaid or the Children’s Health Insurance Program. Enrollment for those coverage options, for those that qualify, is open throughout the year, with no penalties assessed.
Professional Truck Drivers Offer Safety Tips for Holiday Travel
America's Road Team Captains, members of the American Trucking Associations who are elite professional truck drivers with millions of accident-free miles, have advice on how to navigate through highway traffic and winter driving conditions during the busy holiday driving season. Their tips include:
- Prepare your vehicle for long distance travel: Check your wipers and fluids. Have your radiator and cooling system serviced. Simple maintenance can prevent many of the problems that strand motorists on the side of the road before you leave your home.
- Plan ahead: Before you get on a highway, know your exit by name and number, and watch the signs as you near the off-ramp. Drivers making unexpected lane changes to exit often cause accidents.
- Do not cut in front of large trucks: Remember that trucks are heavier and take longer to make a complete stop, so avoid cutting quickly in front of them.
- Be aware of truck blind spots: When sharing the road with large trucks, be aware of their blind spots. If you can't see the truck driver in his or her mirrors, then the truck driver can't see you.
- Pack your emergency kit: Contents should include a battery-powered radio, flashlight, blanket, jumper cables, fire extinguisher, first aid kit, bottled water, non-perishable foods, maps, tire repair kit and flares.
- Check the weather: Be aware of changes in weather during your travel even if it’s just a trip of a few hours. Temperatures can drop and rain and fog can develop since you got started on the road. Check weather conditions before you leave and each time you stop.
- Keep your eyes on the road: Distracted driving is a major cause of traffic accidents. Even just two seconds of distraction time doubles the chances of an accident. Use your cell phone when stopped and never text while driving.
Read more on transportation.
CPSC Recommends Checking to See if Winter Gear, Gifts, Have Been Recalled
As you pull out winter clothes or start to use holiday gifts, the Consumer Product Safety Commission (CPSC) recommends you first check to see if anything you or your family will be using was recalled for a safety hazard. Items recalled in 2013 include children’s clothing with appliques and toys with small pieces that can pose choking risks. Read more on injury prevention.
We hate to be the bearers of buzz kill, but folks should think about adding “safety” to their holiday wish lists this year. Researchers at the Consumer Product Safety Commission say there are about 250 injuries a day during the holiday season. Last year the most frequently reported holiday accidents seen in emergency departments involved falls (34%), lacerations (11%) and back strains (10%). And from 2009 through 2011, fire departments nationwide responded to an average of 200 fires in which the Christmas tree was the first item ignited—resulting in 10 deaths, 20 injuries and $16 million in property loss for those years. Candle-related fires during holidays between 2009 and 2011 resulted in an estimated 70 deaths, 680 injuries and $308 million in property loss.
Best tips for avoiding Holiday fires: discard sets of holiday lights with evidence of damage such as broken sockets and bare wires; water Christmas trees frequently; and always extinguish candles before leaving a room.
Here are our top five safety tips for the holidays culled from the websites of the Consumer Product Safety Commission, the American Academy of Pediatrics, the Centers for Disease Control and Prevention and the Food and Drug Administration:
FDA Proposes New Rules for Proving Effectiveness, Safety of Antibacterial Soaps
A new proposed rule from the U.S. Food and Drug Administration (FDA) would require manufacturers of antibacterial hand soaps and body washes to prove not only that their products are more effective than normal soap when it comes to preventing illness and infections, but that they are also safe for daily long-term use. Products that can’t meet these standards would need to be reworked before coming to market. The regulatory move comes as research suggests that not only are antibacterial products not helpful, but they could also be harmful in the long term, leading to bacterial resistance and hormonal problems. Hand sanitizers, wipes and other antibacterial products used in health care settings would not fall under the new regulations. “Antibacterial soaps and body washes are used widely and frequently by consumers in everyday home, work, school, and public settings, where the risk of infection is relatively low,” said Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research (CDER). “Due to consumers’ extensive exposure to the ingredients in antibacterial soaps, we believe there should be a clearly demonstrated benefit from using antibacterial soap to balance any potential risk.” Read more on infectious disease.
NIH, NFL to Research Ways to Diagnose, Treat Traumatic Brain Injuries
New research projects from the U.S. National Institutes of Health (NIH) will explore methods to diagnose and treat chronic traumatic encephalopathy, or CTE, in football players and others who experience head injuries and concussions. Current science only allows health care professionals to diagnose the traumatic brain injuries after death. "This is a public health problem," said Walter Koroshetz, deputy director of the NIH's National Institute of Neurological Disorders and Stroke. "We don't know the mechanics of the head injuries that lead to this, the number and severity that is required to get this. We don't know whether certain people based on their genes are more susceptible or not. There are a lot of questions to be answered." The National Football League will cover $12 million of the $14 million in research costs. Earlier this year the league agreed to pay as much as $765 million to former players who accused the league of covering up and downplaying the risks of brain injury. Read more on mental health.
Studies: Multivitamins, Supplements Don’t Improve Overall Wellness
Daily multivitamins and mineral supplements don’t prevent heart problems or memory loss, and are also not linked to longer lives, according to three new studies in the journal Annals of Internal Medicine. The researchers said the findings indicate that U.S. consumers should stop taking the dietary supplements, which are part of a multibillion-dollar U.S. industry. "We believe that it's clear that vitamins are not working," said Eliseo Guallar, MD, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, adding “"The probability of a meaningful effect is so small that it's not worth doing study after study and spending research dollars on these questions." Read more on nutrition.
Telehealth Technology Could Help Obese Youth Get Better Treatment, Lose Weight
Telehealth technology—a secure computer system that enables patients to speak “face-to-face” with doctors who are far away—could be an effective strategy to help obese youth who are trying to lose weight, according to new research from UCLA. With a multidisciplinary approach often the prescribed for treating obesity, telehealth services would reduce travel time while giving patients access to expertise that might not be available in their area. This would be especially helpful for low-income families. The UCLA study linked UCLA health care providers with patients at their local health clinics, finding that 80 percent of the 45 study subjects were happy with the technology and would use it again. "One surprise was how natural it was to talk with each other through the telehealth system, even though we never met the patients in person," said lead author Wendy Slusser, MD, medical director of the Fit for Healthy Weight program at Mattel Children's Hospital UCLA and director of pediatric wellness programs at the Venice Family Clinic. "The interaction was very much like being in the same room together. Some kids even thought it was fun to see themselves on the screen." Read more on access to health care.
Study: Psychiatrists Less Likely than Other Doctors to Accept Insurance
Psychiatrists are less likely than other doctors to accept private insurance, according to a new study in JAMA Psychiatry. Researchers analyzed government data from 2005 to 2010, which surveyed approximately 1,250 doctors each year, finding that from 2005 to 2010 the percentage of psychiatrists who accepted private insurance dropped from 72 percent to 55 percent. In comparison, over that same time the rate for doctors in other areas only dropped from 93 percent to 89 percent. While the study does not explain the vast difference, Jeffrey Lieberman, MD, president of the American Psychiatric Association, said reimbursement is a major concern, according to Reuters. "Many doctors can't afford to accept insurance because (insurance companies) don't pay them for the time," he said. "It involves taking more time with the patient and often treating them with psychotherapy.” Read more on mental health.
Even Mild Hits to the Head Can Cause Brain Damage
Even mild hits to the head that don’t cause concussion can still lead to problems with memory and thinking, according to a new study in the journal Neurology. Researchers equipped 80 football and ice hockey players with special helmets that gathered data on mild hits; while none of the players were diagnosed with a concussion, they still showed signs of deficits in thinking after the season. "This suggests that concussion is not the only thing we need to pay attention to," said Tom McAllister, MD, chairman of the department of psychiatry at the Indiana University School of Medicine. "These athletes didn't have a concussion diagnosis in the year we studied them ... and there is a subsample of them who are perhaps more vulnerable to impact. We need to learn more about how long these changes last and whether the changes are permanent." Read more on injury prevention.
HealthCare.gov: After Fixes, More Enroll in First Two Days of December than Did in All of October
The five weeks spent working on many of the problems of the HealthCare.gov website seem to have been time well spent, with more people signing up for the new health insurance in the first two days of December than were able to enroll in all of October. About 29,000 signed up for the insurance, made possible by the Affordable Care Act, on Sunday and Monday; only about 27,000 people signed up in October when the site first went live. While the final numbers have not been released, about 100,000 are estimated to have signed up via the site in November. The website is used in 36 states, with fourteen states and Washington, D.C. running their own sites. Read more on the Affordable Care Act.
Boston Adds Rentable Bicycle Helmets to Bikeshare System
Boston is working to improve the safety of people who use Hubway, the city’s popular bikeshare system, by installing the first vending machine for renting bicycle helmets. The HelmetHub street kiosk will be located at the Boylston Street and Massachusetts Avenue Hubway Station. Riders will be able to rent a helmet for 24 hours for $2, or purchase one to keep for $20; they will be sanitized and inspected after each use. The city intends for this test kiosk to be the first of many throughout Boston. Read more on safety.
Study: Social Ties, More than Biology, Responsible for Changes in Teen Sleep Times
Social ties—especially with parents and friends—may be more responsible than biology for whether a teenager gets enough sleep. While past studies have linked biological development factors to why children tend to sleep less as they age into teenagers, a new study in the Journal of Health and Social Behavior ties the trend more closely to the quality of the teen’s social ties. In an analysis of data on almost 1,000 kids ages 12 to 15—during with the average sleep time drops from 9 hours per school night to 8 hours—researchers concluded that teens who felt that they were a part of school, who were close to their friends and especially who had parents who were active in their life were more likely to get more sleep. "Research shows that parents who keep tabs on their kids are less likely to see them get into trouble or use drugs and alcohol," said David Maume, a sociology professor at the University of Cincinnati. "My findings suggest a similar dynamic with sleep. Parents who monitor their children's behavior are more likely to have kids that get adequate rest. Given that children generally get less sleep as they become teenagers, parents should be ever more vigilant at this stage.” Read more on pediatrics.