Background: Examining factors unique to major head injury (HI) etiogenesis can help reduce the burden of injury by identifying factors amenable to prevention. Objectives: To describe the epidemiology of HI in Nova Scotia. Risk and protective factors unique to HI were also examined specific to falls and Motor Vehicle Collision (MVC) injuries. Methods: Descriptive analyses and regression models were used to examine the socio-demographic profile of HI and associated risk factors using data from the Nova Scotia Trauma Registry. Results: Regression analyses for MVC-related injury found age, injury place, vehicle type and lack of safety restraint to be independently associated with an increased risk of HI. For falls-related injuries, age, time of trauma, injury mechanism and place were significant factors for a HI event. Conclusion: While HI share many similar characteristics to other major injuries, prevention programs must be aware of both common and unique risk factors for head injuries.

Burn injuries are one of the most painful and potentially debilitating traumatic injuries that a person can suffer. Every reader is likely to have, at some point in their life, suffered a burn injury, no matter how minor and therefore can have some comprehension of the pain and suffering associated with significant burn injury. Traumatic injury is the leading cause of death and disability in children and young adults. Although much has been done to optimise pre-hospital care and emergent treatment of injuries in recent times, the mainstay of managing death and disability from traumatic injury must lie in preventing these injuries where at all possible. To enable effective preventative strategies to be put in place it is important to define the demographics of those injured and the mechanisms of injury for any given population. Only then can we ensure that strategies are targeted in the areas where they are most needed at the mechanisms that are occurring most commonly. This study has combined a number of data sources namely burns service, fire service, coroners' service and accident and emergency department in an attempt to define the epidemiology and aetiology of burn injury in Greater Manchester. Data from the different sources was pooled and underwent a process of data-linkage to remove duplicate records. Rates have been calculated and compared according to age group, sex group and deprivation status. Poisson regression modelling was used to calculate the rate ratios amongst the different groups. Postcode data was used to allow geographical mapping of injuries across the county to allow rates to be calculated for different areas of the city. Where rates have been calculated for small area geographies Bayesian modelling was used to predict injury rates for those areas. Maps have been produced that show the areas with the highest rates of injury. The results show that in children it is the under five age group that have the highest rates of injury, particularly the under 2's. In adults, those over 75 years of age have the highest rates of injury. For all age groups males were more likely to be injured than females. In both children and adults higher rates of injury were seen in those areas where there were increased levels of deprivation. Key mechanisms of injury for individual age groups have been highlighted. The maps of Greater Manchester and its constituent local authorities show those areas with the highest rates of injury. The definition of target demographic groups and geographical areas within Greater Manchester will be used to allow development of targeted prevention strategies in those areas.

A prospective cohort study of 412 professional rugby union players registered with the English Premiership clubs was conducted during the 2002-2003 season. Injuries were diagnosed and reported by the club medics and the training practices by the club strength and conditioners. A total of 1,090 club injuries (match: 818; training: 260; unidentifiable onset: 12) and 145 international injuries (match: 97; training: 48) were reported. The incidence and risk of club match injuries was 97 injuries and 1,480 days absence per 1,000 player-hours, and the incidence and risk of international match injuries was 218 injuries and 3,076 days absence per 1,000 player-hours. The highest incidence of match injuries occurred to the thigh, however, injuries to the knee were of highest risk. The incidence of club and international training injuries was 3.1 and 6.1 injuries per 1,000 player-hours, respectively. When intrinsic risk factors were assessed, the youngest players (<21 years old) had the highest incidence and a significantly higher risk of injury. Playing position appeared to be the most influential determinate of injury profile, rather than intrinsic anthropometric risk factors alone. The match injury with the second highest incidence and risk was hamstring muscle injuries and a number of risk factors and protective training factors were identified. Results presented from this study have provided the most comprehensive study of injury incidence, aetiology and risk factors in professional rugby union to date. The data provide objective evidence on which to base both preventative interventions to reduce the probability of sustaining an injury and therapeutic interventions to reduce the severity of an injury and thereby reduce the overall risk associated with injuries.

Although the benefits of exercise are well documented, the risk of injury as a result of exercise is also documented. The undertaking of exercise in the form of sport or dance carries a risk of injury. This risk is increased in the professional ranks where increased intensity of exercise coupled with greater exposure periods are noted. Two published systematic reviews of the literature pertaining to musculoskeletal injuries and pain in dancers (up to 2008) indicated that there are still major scientific limitations and biases in the literature reviewed and indicated the need for explicit criteria on injury definition and methods of injury reporting. The reviews did comment on the evidence that musculoskeletal injury is an important issue for all dancers and that there is preliminary evidence that comprehensive injury prevention and management strategies may reduce injuries. The purpose of this single cohort observational study was to document injury incidence and severity in professional ballet dancers over three years including any changes as a result of changes within their medical management. While it is recognised that a randomised control trial would be advocated for an interventional study, due to the demands of this high performance environment this was not feasible. As such, steps were taken to improve the reporting of findings through the utilisation of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. To date there are two publications in peer reviewed journals as a result of the data collected in this study. In the absence of international consensus on injury data collection in dance the methodology employed in this study was consistent with the International Consensus Statements on injury data collection from sport. Although the incidence of injuries in Year 1 was lower than that in other sports, the results were higher than other studies that have been reported in dance. The reason for this may be due to the use of a more encompassing injury definition. In response to the data and details obtained through the injury audit process changes in the comprehensive medical management of the dancers were implemented. The pre-participation screening was extended and the individual conditioning programmes were structured using the developed Hybrid Intervention Model. The result of the injury auditing indicated a significant reduction in injury incidence in the Year 2, with a further reduction in Year 3. These findings support the results of the systematic reviews in that there is growing evidence that comprehensive injury prevention and management strategies may reduce injuries in dance and that in the absence of stronger evidence there is a strong recommendation for those charged with caring for professional dancers to implement comprehensive medical management programmes.

Background: The multiplicities of factors, which may contribute to injury from sporting activity, and the complexity of the relations among them, indicate that identifying causal mechanisms poses a challenge to epidemiologists. The identification of risk factors associated with the effect of the injury on subsequent participation may be as important in understanding how to reduce the burden of injuries on sports participants, as identifying factors associated with the injury incidence rate. Aim: The aim of this study was to develop a biomechanical, antbropometrical, physical, motor and injury epidemiology profile for elite U/19 rugby players. Design: A prospective cohort study. Subiects: In this study 77 elite rugby players were used during the first testing episode (October 2005). These players had just completed their school career and were selected to form part of the Rugby Institute of the University of North West. The U/19 first team members were (n = 31) tested again in July 2006. Two different profiles were established. Method: Once approval had been granted by both the players and by the Rugby Institute of the North West University, the players were submitted to a test battery. Anthropometric, Physical and Motor tests were done at the beginning of the season and the players re-tested at the end of the season. A Biomechanical and Postural Evaluation was done once-off at the beginning of the season. The necessary steps were taken to address existing shortcomings identified in the test subjects. After the results had been analysed, individual programmes were formulated, explained and implemented. The aim was to minimize the possible risk areas indicated by screening. Results: The results were statistically processed, recorded and compared with previous literature studies, according to both the total group and the different player positions - these are the tight five, the loose forwards, the halfbacks and the backs. The Anthropometrical, Physical and Motor testings showed a low or nil practical significant difference for the total group after a season of professional training and coaching, with slight differences between the player groups. The Biomechanical and Postural Evaluation proved the group to be dynamically overloaded with poor regional stability and musculature as far as the upper and lower limbs were concerned, with asymmetry and weak core stability of the spinal and pelvic region. A total of 184 injuries were reported over the season, with the lower limbs (58%) and upper limbs (23%) as the most commonly injured body parts; and sprains (22%) and strains (17%) the type of injury which occurred most often. The tight five (32%) had the highest injury rate, with the flanker (13%) the least injured player position. Conclusion: A profile for elite U/19 rugby players has been determined. This profile can be implemented in conjunction with similar findings in existing literature for future guidelines by coaches and the management to select a better team, to ensure a higher quality of performance and to prevent injuries. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2007.

Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2007.

The primary aim of this study was to evaluate the effectiveness of an injury prevention and training programme for elite cricketers in regard to biomechanical, physical and motor and anthropometric variables over a period of six cricketing off-seasons (1998/1999-2003/2004). A secondary aim was to investigate the injury epidemiology of elite cricket players over a six-season period (1998/1999 – 2003/2004). A total of 93 cricket players, who were part of the North-West professional cricket squad, were evaluated over a six-season period stretching from the 1998/1999 cricket season to 2003/2004 cricket season. The players were all evaluated at the end of the off-season (middle September) of the commencing season and the injury lists were compiled throughout each playing season. This included all players who needed medical attention due to injury sustained while representing the North-West cricket team in a cricket match. An analysis was done of literature sources by making use of electronic media, library search and sports medicine journals. Databases such as Pubmed, EbscoHost (Academic Search Elite), Sciencedirect, Medline, Eric, Health Source - Consumer Edition, Health Source: Nursing/Academic Edition and SPORTDiscus were used. Special consideration was given to cricket injury epidemiology, injury prevention strategies in cricket, biomechanics in cricket and general injury prevention strategies. The recorded data were statistically processed and the practical significances were calculated. Three different protocols were followed to evaluate the effectiveness of the injury prevention and training programme. The recorded data were analysed for the six off-season periods (1998/1999-2003/2004, protocol 1) of the study for the biomechanical, physical and motor and anthropometric evaluations, as well as for the injury epidemiology. The players were then divided into four exposure times (protocol 2) in the study for the biomechanical, physical and motor and anthropometric evaluations. Then the players were divided into two groups (protocol 3), with each group consisting of the same players, and over a three off-season period each evaluated for the biomechanical, physical and motor and anthropometric variables. Lastly, the results for the last three seasons of protocol 1 were compared with the result of the last three seasons of protocol 3 (group 2) for the biomechanical, physical and motor and anthropometric evaluations, as well as for the injury epidemiology. The results for this study indicate that the injury prevention and training programme was successful in improving and maintaining the biomechanical, physical and motor and anthropometric profile of the cricketers over the six off-season periods (1998/1999-2003/2004). Although all injuries could not be prevented, injuries resulting from structural vulnerability did decrease. Injuries resulting from structural vulnerability (mechanism of injury) decreased from the 1998/1999 season (67,67% of the total injuries suffered during the 1998/1999 season) to the 2003/2004 season (10% of the total injuries suffered during the 2003/2004 season), indicating that the training and prevention programme played a role in the prevention of these injuries. Injury incidence per 10 000 hours of play was 5,82 injuries for the six-season period (1998/1999- 2003/2004). The injury prevention and training programme used in this study can be utilised to improve the biomechanical, physical and motor and anthropometric profile of cricketers. The biomechanical, physical and motor and anthropometric evaluations can also be used as injury prevention strategies by identifying possible injury risk factors as a result of poor biomechanical, physical and motor and anthropometric profiles. / Thesis (Ph.D. (Education))--North-West University, Potchefstroom Campus, 2005.

Traffic-related injuries represent a global public health problem, and contribute largely to mortality and years lived with disability worldwide. Over the course of the last decades, improvements to road traffic safety and injury surveillance systems have resulted in a shift in focus from the prevention of motor vehicle accidents to the control of injury events involving vulnerable road users (VRUs), such as cyclists and moped riders. There have been calls for improvements to the evaluation of safety interventions due to methodological problems associated with the most commonly used study designs. The purpose of this licentiate thesis was to assess the strengths and limitations of the interrupted time series (ITS) design, which has gained some attention for its ability to provide valid effect estimates. Two national road safety interventions involving VRUs were selected as cases: the Swedish bicycle helmet law for children under the age 15, and the tightening of licensing rules for Class 1 mopeds. The empirical results suggest that both interventions were effective in improving the safety of VRUs. Unless other concurrent events affect the treatment population at the exact time of intervention, the effect estimates should be internally valid. One of the main limitations of the study design is the inability to identify why the interventions were successful, especially if they are complex and multifaceted. A lack of reliable exposure data can also pose a further threat to studies of interventions involving VRUs if the intervention can affect the exposure itself. It may also be difficult to generalize the exact effect estimates to other regions and populations. Future studies should consider the use of the ITS design to enhance the internal validity of before-after measurements. / Traffic-related injuries represent a global public health problem, and contribute largely to mortality and years lived with disability. Over the course of the last decades, improvements to road traffic safety and injury surveillance systems have resulted in a shift in focus from motor vehicle accidents to injury events involving vulnerable road users (VRUs), such as cyclists and moped riders. There have been calls for improvements to the evaluation of safety interventions due to methodological problems associated with the most commonly used study designs. The purpose of this licentiate thesis was to assess the strengths and limitations of the interrupted time series (ITS) design, which has gained some attention for its ability to provide valid effect estimates while accounting for secular trends. Two national interventions involving VRUs were selected as cases: the Swedish bicycle helmet law for children under the age 15, and the tightening of licensing rules for Class 1 mopeds. The empirical results suggest that both interventions were effective. These results are discussed in the light of some methodological considerations regarding internal and external validity, data quality and the ability to fully understand key causal mechanisms behind complex interventions.

The primary aim of this study was to evaluate the effectiveness of an injury prevention and training programme for elite cricketers in regard to biomechanical, physical and motor and anthropometric variables over a period of six cricketing off-seasons (1998/1999-2003/2004). A secondary aim was to investigate the injury epidemiology of elite cricket players over a six-season period (1998/1999 – 2003/2004). A total of 93 cricket players, who were part of the North-West professional cricket squad, were evaluated over a six-season period stretching from the 1998/1999 cricket season to 2003/2004 cricket season. The players were all evaluated at the end of the off-season (middle September) of the commencing season and the injury lists were compiled throughout each playing season. This included all players who needed medical attention due to injury sustained while representing the North-West cricket team in a cricket match. An analysis was done of literature sources by making use of electronic media, library search and sports medicine journals. Databases such as Pubmed, EbscoHost (Academic Search Elite), Sciencedirect, Medline, Eric, Health Source - Consumer Edition, Health Source: Nursing/Academic Edition and SPORTDiscus were used. Special consideration was given to cricket injury epidemiology, injury prevention strategies in cricket, biomechanics in cricket and general injury prevention strategies. The recorded data were statistically processed and the practical significances were calculated. Three different protocols were followed to evaluate the effectiveness of the injury prevention and training programme. The recorded data were analysed for the six off-season periods (1998/1999-2003/2004, protocol 1) of the study for the biomechanical, physical and motor and anthropometric evaluations, as well as for the injury epidemiology. The players were then divided into four exposure times (protocol 2) in the study for the biomechanical, physical and motor and anthropometric evaluations. Then the players were divided into two groups (protocol 3), with each group consisting of the same players, and over a three off-season period each evaluated for the biomechanical, physical and motor and anthropometric variables. Lastly, the results for the last three seasons of protocol 1 were compared with the result of the last three seasons of protocol 3 (group 2) for the biomechanical, physical and motor and anthropometric evaluations, as well as for the injury epidemiology. The results for this study indicate that the injury prevention and training programme was successful in improving and maintaining the biomechanical, physical and motor and anthropometric profile of the cricketers over the six off-season periods (1998/1999-2003/2004). Although all injuries could not be prevented, injuries resulting from structural vulnerability did decrease. Injuries resulting from structural vulnerability (mechanism of injury) decreased from the 1998/1999 season (67,67% of the total injuries suffered during the 1998/1999 season) to the 2003/2004 season (10% of the total injuries suffered during the 2003/2004 season), indicating that the training and prevention programme played a role in the prevention of these injuries. Injury incidence per 10 000 hours of play was 5,82 injuries for the six-season period (1998/1999- 2003/2004). The injury prevention and training programme used in this study can be utilised to improve the biomechanical, physical and motor and anthropometric profile of cricketers. The biomechanical, physical and motor and anthropometric evaluations can also be used as injury prevention strategies by identifying possible injury risk factors as a result of poor biomechanical, physical and motor and anthropometric profiles. / Thesis (Ph.D. (Education))--North-West University, Potchefstroom Campus, 2005.

Background: The multiplicities of factors, which may contribute to injury from sporting activity, and the complexity of the relations among them, indicate that identifying causal mechanisms poses a challenge to epidemiologists. The identification of risk factors associated with the effect of the injury on subsequent participation may be as important in understanding how to reduce the burden of injuries on sports participants, as identifying factors associated with the injury incidence rate. Aim: The aim of this study was to develop a biomechanical, antbropometrical, physical, motor and injury epidemiology profile for elite U/19 rugby players. Design: A prospective cohort study. Subiects: In this study 77 elite rugby players were used during the first testing episode (October 2005). These players had just completed their school career and were selected to form part of the Rugby Institute of the University of North West. The U/19 first team members were (n = 31) tested again in July 2006. Two different profiles were established. Method: Once approval had been granted by both the players and by the Rugby Institute of the North West University, the players were submitted to a test battery. Anthropometric, Physical and Motor tests were done at the beginning of the season and the players re-tested at the end of the season. A Biomechanical and Postural Evaluation was done once-off at the beginning of the season. The necessary steps were taken to address existing shortcomings identified in the test subjects. After the results had been analysed, individual programmes were formulated, explained and implemented. The aim was to minimize the possible risk areas indicated by screening. Results: The results were statistically processed, recorded and compared with previous literature studies, according to both the total group and the different player positions - these are the tight five, the loose forwards, the halfbacks and the backs. The Anthropometrical, Physical and Motor testings showed a low or nil practical significant difference for the total group after a season of professional training and coaching, with slight differences between the player groups. The Biomechanical and Postural Evaluation proved the group to be dynamically overloaded with poor regional stability and musculature as far as the upper and lower limbs were concerned, with asymmetry and weak core stability of the spinal and pelvic region. A total of 184 injuries were reported over the season, with the lower limbs (58%) and upper limbs (23%) as the most commonly injured body parts; and sprains (22%) and strains (17%) the type of injury which occurred most often. The tight five (32%) had the highest injury rate, with the flanker (13%) the least injured player position. Conclusion: A profile for elite U/19 rugby players has been determined. This profile can be implemented in conjunction with similar findings in existing literature for future guidelines by coaches and the management to select a better team, to ensure a higher quality of performance and to prevent injuries. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2007.