Background: An increased load on the European elite football players is seen; both physically, with more matches with the national teams and the club teams, but also mentally. To play football on the highest level induce a high injury risk with injury incidences very high, both in the national team and in the club teams. Objective: To investigate the injury risk among elite football players in UEFA Champions League when playing in their clubs compared to international matches with their national team respectively. Further the objective also was to study the injury incidence and injury pattern differences between national team players and non national team players. Materials and methods: In this study 3233 player seasons were registered for 6141 injuries from 134 UEFA Champions League team seasons, during the seasons 2001/2002 to 2009/2010. Existing data from UEFA research group consisted of injuries, exposure, anthropometric data etc. The author collected data regarding national team exposure. Definitions of injury severity, injury categorization, injury incidence are standard definitions and the definition of being national team player or not were given by the author. Results: The baseline data showed that the national team players played more matches, had more match injuries, had a higher match exposure and were younger. No large differences are seen in injury incidence in the type of injuries. Some specific injuries as Achilles tendon, low back pain and ACL are more common in matches whit the non national team players, while knee MCL injuries are more common among the national team players. The non national team players had more absence from injuries. When comparing the both groups in injury incidence in total, there were no differences. Discussion: The results of this study can be compared to other similar studies, because of the same procedure regarding injury incidence etc. as consensus. The figures in this study show the same figures as other studies in the same subject. Conclusions: The injury incidence and injury pattern do not diverge from one another or from earlier studies on the same topic. The noteworthy finding is that the players who play for the national team have not a higher injury incidence than the players who do not play for the national team.

Assisting smokers to quit and stay quit is the most important intervention clinicians can undertake to improve the length and quality of life of patients who use tobacco. The chronic, relapsing nature of tobacco dependence complicates tobacco treatment. Tobacco treatment counseling programs provide on-going support to help patients avoid relapse. Assistance with a referral increases the likelihood that patients will participate in counseling, but few clinicians regularly assist with referrals to tobacco treatment programs. This dissertation examined health system processes and clinician attitudes that influence the likelihood that clinicians will refer their patients for tobacco treatment counseling. Three papers examined health system processes, clinician attitudes, and frequency of referrals. A systematic review of the literature was conducted to evaluate strategies to increase the frequency of clinician referrals and effects on quit rates in primary care. The most effective strategies were those that combined clinician education with integrated referral systems. Integrated referral systems include non-clinician staff and clinician and staff prompts with algorithms or protocols for referrals. The second paper reports the findings of a pilot study using qualitative methods to explore experiences and strategies used for tobacco treatment by clinician champions practicing in independent primary care practices. Tobacco champions (N = 11) described experiences counseling patients but not assistance with referrals. Themes identified were: sources of knowledge and experience, understanding dependence, role perception, and treatment strategies. The final paper reports the findings of a cross- sectional, non-experimental study to examine clinician attitudes toward counseling, health system processes that facilitate referrals, and referrals to tobacco treatment counseling. Attitudes about the efficacy of tobacco counseling and the presence of processes that facilitate referrals predicted referrals. Clinicians sampled in these studies held favorable attitudes toward tobacco treatment but lacked confidence in the efficacy of community-based counseling for tobacco treatment. These findings have implications for health care policies to improve integration of processes that facilitate referrals and clinician education that includes information about counseling resources to improve chronic care for the treatment of tobacco dependence.

Objectives: The concept of clinical champions has been widely promoted, yet empirically underdeveloped in health services literature. The objectives of this study are to investigate the role of the clinical champion and how it contributes to effective patient safety change. Methods: Case study design was used to examine the role of champions in the implementation of rapid response teams in two hospitals. Central themes were derived through qualitative analysis of semi-structured interviews with key informants. Results: Analysis revealed a typology of champions: clinical, managerial, and executive. Champions engaged in five core activities: disseminating knowledge, advocating, building relationships, navigating boundaries, and facilitating consensus. Individuals became champions by informal emergence or by formal appointment combined with informal emergence. Conclusions: This study furthered understanding of patient safety champions by revealing types, activities, and modes of emergence. Findings will allow health care professionals to use an evidence-based approach to identifying and supporting champions.

Objectives: The concept of clinical champions has been widely promoted, yet empirically underdeveloped in health services literature. The objectives of this study are to investigate the role of the clinical champion and how it contributes to effective patient safety change. Methods: Case study design was used to examine the role of champions in the implementation of rapid response teams in two hospitals. Central themes were derived through qualitative analysis of semi-structured interviews with key informants. Results: Analysis revealed a typology of champions: clinical, managerial, and executive. Champions engaged in five core activities: disseminating knowledge, advocating, building relationships, navigating boundaries, and facilitating consensus. Individuals became champions by informal emergence or by formal appointment combined with informal emergence. Conclusions: This study furthered understanding of patient safety champions by revealing types, activities, and modes of emergence. Findings will allow health care professionals to use an evidence-based approach to identifying and supporting champions.

Submitted by Kenia Bernini (kenia.bernini@ufpel.edu.br) on 2018-10-23T20:54:38Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Vinicius_Cardoso_Nunes_Dissertação.pdf: 1701098 bytes, checksum: dd2afd21984827a300e3cd09d937cdf6 (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2018-11-06T18:54:48Z (GMT) No. of bitstreams: 2 Vinicius_Cardoso_Nunes_Dissertação.pdf: 1701098 bytes, checksum: dd2afd21984827a300e3cd09d937cdf6 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2018-11-06T18:54:59Z (GMT) No. of bitstreams: 2 Vinicius_Cardoso_Nunes_Dissertação.pdf: 1701098 bytes, checksum: dd2afd21984827a300e3cd09d937cdf6 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-11-06T18:55:07Z (GMT). No. of bitstreams: 2 Vinicius_Cardoso_Nunes_Dissertação.pdf: 1701098 bytes, checksum: dd2afd21984827a300e3cd09d937cdf6 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-11-24 / Sem bolsa / Esta dissertação tem como objetivo analisar as relações entre escravos-senhores e a população livre, no período entre 1850-1870 na vila de Piratini.Tendo em vista que muitos dos processos-crimes investigados e analisados decorreram de crimes à propriedade privada, no caso de furto e roubo. O ponto de partida para essas análises são os escravos campeiros que foram acusados de serem os responsáveis por estes crimes. Homicídios a pessoas livres não estavam dentro da lógica senhor/escravo, e a tentativa de Insurreição por parte dos escravos se enquadra na perturbação de ordem pública do ponto de vista senhorial; analisarei também as redes que formavam estes escravos, assim como seus senhores e as pessoas livres que aparecem no decorrer da pesquisa. Como objetivos específicos busca-se compreender quais motivações levaram os cativos à prática de homicídio; entender as motivações que levaram os escravos a praticarem roubos e furtos; investigar o que levou à insurreição de escravos, além de estudar quem eram os senhores e os escravos envolvidos nos processos-crimes. / This dissertation aims at the relations between slaves-lords and the free population, in the period between 1850-1870. Considering that many of the crimes-cases investigated and analyzed went from crimes to private property in the event of theft and robbery. The starting point for these analyzes is the guiding slaves who were accused of being responsible for these crimes. Homicides to free people were not within the lord / slave logic, and the attempt of insurrection on the part of the slaves fits into the disturbance of public order from the point of view of manor; I will also analyze the networks that formed these slaves, as well as their masters and the free people that appear during the analysis. Specific objectives are to understand what motivations led the captives to the practice of homicide in the village; understand the motivations that led the slaves to commit robberies and robberies; to investigate what led to the insurrection of slaves in the then Vila de Piratini, besides studying who were the masters and the slaves involved in the criminal processes.

BACKGROUND: Champions are widely recognized as playing a key role in the successful implementation of evidence-based interventions within the healthcare sector; however, little is known about which characteristics and skills enable them to play that role. Furthermore, previous studies have measured only individual champion’s responses to personal attributes without incorporating input from other observers. A mixed methods study was conducted to 1) identify, analyze, and group the characteristics of champions who have successfully promoted adoption of new initiatives within the healthcare delivery system, 2) understand when and how champion-like characteristics emerge during the implementation process, and 3) describe how these characteristics are developed to more quickly advance champions within the healthcare setting. METHODS: Data were collected and analyzed from healthcare champions (n=30) and their colleagues (n=58) from eleven countries using a survey. Every champion and a subset of colleagues (n=14) also participated in in-depth interviews. Correlation coefficients and descriptive statistics were used to explore the relationship between responses to survey items; Chi-squared tests and Kruskal-Wallis tests were used to compare the differences. Thematic content analysis of qualitative data explored champion-like characteristics, their emergence, and how their skills were developed. Once results emerged, characteristics of champions were categorized using the Transformational Leadership Theory framework. RESULTS: Champions tend to inspire their clinical teams to adopt new interventions within healthcare using a leadership style that naturally facilitates trust, as well as motivation to work towards common goals. This leadership style is similar to what is exhibited by transformational leaders; therefore, champions can be identified, categorized, and developed using transformational leadership theory. Champion emergence within the implementation process is facilitated by supportive leadership and high levels of autonomy. Additionally, there was a high proportion of agreement between champion and colleague survey responses; however, champions were more likely to underrate their skills and abilities to instigate change. CONCLUSION: Champions exhibit the same characteristics as transformational leaders; therefore, transformational leadership theory — its frameworks and associated tools — is useful for identifying and developing champions. Future work should focus on how organizational leaders can facilitate the growth of emerging champions, as this enabling environment determines the fate of both the champion and the evidence-based intervention.

Context: The Western Cape Province's Department of Health, South Africa, implemented a complex intervention aimed at changing organisational culture across health facilities in the province called the C²AIR² club challenge, in phases, starting from August 2013 and was still ongoing in 2016 at the time of the research. A group of front-line staff from each participating health facility called C²AIR² club champions were capacitated to implement the intervention in their respective facilities. This study aimed to explored the process of introduction, diffusion, adoption and implementation of the C²AIR² club challenge in one of the primary health facilities where the challenge was implemented, using a diffusion of innovation lens. Methods: We examined the process of implementing the C²AIR² club and the contextual and other factors that constrained and enabled this process. Working in one primary health care facility selected as a representative case, we explored the experiences of the champions and other staff members of the C²AIR² club. Our methods included 21 in-depth interviews, informal conversations, document review, and non-participant observation. Results: Innovation-fit, leadership, champions, adopters' characteristics, and contextual issues were the main factors that influenced the spread of the C²AIR² club. Contextual issues particularly those related to resource constraints played a central role in determining the successful spread of the complex organisational culture change intervention. Sufficiently trained champions could successfully spread the intervention without onsite external change consultants' facilitation, however this took time and caution should be taken not to evaluate implementation success too early. Involvement of not only top leadership but of all other multi-levels and multi-disciplines facilitated the spread of the intervention. Conclusions: When introducing an innovation like the C²AIR² club challenge the impact of which is not immediate neither tangible, in an organisation where there are tangible problems such as lack of working space, staff shortages and shortages in working equipment, it is important that efforts are made to address these immediate challenges and where they cannot be addressed that this is openly acknowledged by the implementers and management. If this is not considered, organisational members are likely to acknowledge the innovation as a good initiative but one that they would not actively rally around as it does not speak to their problems.

Studien undersöker och jämför hur Dagens Nyheter och Aftonbladet skrivit om damfotboll kontra herrfotboll, säsongerna 2015/16 och 2020/21. Utgångspunkten för studien har varit att undersöka Champions League. Studien har en kvantitativ del, en kvalitativ del och även en kortare del där intervjuer gjorts. Syftet med den kvantitativa delen har varit att i siffror och diagram kunna se på hur mycket det skrivits om de två könen inom Champions League och ta fram skillnader mellan Dagens Nyheter och Aftonbladet. Den kvalitativa delen har i stället använts för att besvara frågor kring hur det skrivs om manliga kontra kvinnliga spelare i Champions League. Intervjudelen har haft som syfte att få två aktiva journalister att ge sin syn på de frågor vi ställt och bidra med andra perspektiv. Vårt teoretiska ramverk är uppbyggt på teorier som gestaltningsteorin, genusteorin, bildanalys och kommersialiseringsteorin. De fyra teorier har vi valt ut för att på bästa sätt kunna besvara våra frågor på ett djupgående sätt. Resultatet i den kvantitativa delen var att det både skrivs mer av och om män än vad det skrivs av eller om kvinnor. Vi kunde se en ökning under säsongen 2020/21 jämfört med säsongen 2015/16 i antalet artiklar om damfotboll. Däremot kunde vi också se att det både i Dagens Nyheter och Aftonbladet skrevs fler artiklar av kvinnor säsongen 2015/16 än vad det gjordes 2020/21. I vår kvalitativa del blev resultatet att det inte skiljer sig speciellt mycket i hur det skrivs om kvinnliga fotbollsspelare jämfört med manliga, men att typen av artiklar skiljer sig. Intervjuerna förstärker de resultat vi i vår studie fått fram där båda intervjupersonerna nämner att det under deras tid som journalister skett en förbättring.

The effectiveness of champions in increasing the use of innovations and improving outcomes across health care contexts is not well synthesized in the literature. A systematic review was conducted using the JBI systematic review method. A total of 35 studies (37 articles) were included in the review. The use of champions was related to improvements in system/facility use of innovations. However, the evidence pertaining to causal relationships between use of champions and use of innovations or outcomes is currently inconclusive according to the findings of systematic review. Key limitations of the included primary studies were the use of observational study designs (n = 28) and the lack of detailed description of the champion strategy (n = 26). Future studies that evaluate the effectiveness champions should:1) clearly describe the champion strategy in detail, 2) use experimental design in conjunction to process evaluation, 3) and evaluate the cost-effectiveness of deploying champions.

BACKGROUND: Several groups have instituted helmet initiatives with varying success across the world. Helmet use has been well documented to prevent traumatic brain injury. Despite the known benefits, many people, including university students, refuse to utilize helmets when riding bikes, mopeds, or motorcycles. We recognized a need within our community regarding the lack of helmet use at University of Florida and developed a program to institute change. METHODOLOGY: We identified community champions and hosted weekly round table discussion initiatives. Through these round table discussions we identified events already going on within the community and developed new opportunities to promote helmet use. We had stories from survivors and parents, utilized school administration support, and partnered with local bike shops. RESULTS: The pilot initiative was successful in increasing awareness across the city and got stakeholders excited in the process. It also spearheaded more data driven initiatives that will look at reduction of traumatic brain injuries in the clinical setting. CONCLUSION: This project highlights the University of Florida Helmet Initiative that has already generated renewed interest in safety and traumatic brain injury prevention. The school of nursing has implemented safety protocols and further support is being garnered by the administration across campus. Most importantly we have identified community champions that will carry the work forward.