Carlene A. Mayfield

Injury profile of mixed martial arts competitors.

Objective:To provide an updated comprehensive profile of mixed martial arts (MMAs) injuries. Design:Correlational and multivariate analyses were conducted on cross-sectional data to examine injuries sustained during 711 MMA bouts. One physician diagnosed any injuries occurring during the bouts. Setting:Various sports venues in Kansas and Missouri holding MMA competitions. Participants:Male and female and amateur and professional MMA competitors contributing to 1422 fight participations (fight participations = 711 bouts × 2 fighters/bout). Independent Variables:State, level (amateur or professional), gender, number of rounds, and bout outcome (knockout/technical knockout [KO/TKO] vs other outcomes [eg, decision]). Main Outcome Measures:Injuries/fight participations, injury sustained (yes vs no), and fighter referred to emergency room (ER; yes vs no). Results:The overall injury rate was 8.5% of fight participations (121 injuries/1422 fight participations) or 5.6% of rounds (121/2178 rounds). Injury rates were similar between men and women, but a greater percentage of the injuries caused an altered mental state in men. The risk of being injured was significantly greater for bouts held in Kansas, at the professional level, lasting more rounds, and ending in a KO/TKO. Fighters also were more likely to be referred to the ER if they participated in longer bouts ending in a KO/TKO. Conclusions:The observed injury rate was lower than previously reported suggesting recent regulatory changes have made MMA a safer sport. Increased clinical awareness and additional research should be extended to head-related injuries in MMAs especially those associated with KOs/TKOs.

A multi-level analysis showing associations between school neighborhood and child body mass index

Objective:The objective of this study is to examine associations between aspects of the environment in school neighborhoods and childhood body mass index percentile (BMIp).Methods:Trained medical students visited 46 elementary schools in the Kansas City metropolitan area to conduct medical screenings that included the height and weight measurements of 12 118 boys and girls 4–12 years of age in the academic year 2008–2009. For the same time period, aspects of the built environment in a 2-mile radius around each school was obtained from the Walkscore database. Other environmental characteristics (for example, population change) of these areas were also obtained from various sources. Hierarchical linear modeling was used to estimate the associations between neighborhood- and individual-level factors and BMIp.Results:Population size along with the number of fast-food restaurants and grocery stores were positively associated with BMIp, whereas population change along with the number of parks and fitness centers were inversely associated with BMIp.Conclusions:After considering individual-level factors and the random effects of schools, environmental elements of school neighborhoods predict childhood BMIp. This study offers evidence of the health influence of school neighborhoods in a way that can inform neighborhood redevelopment efforts.

Walking During Leisure-Time in Relation to Perceived Neighborhoods

Are researchers correct to assume individuals who walk during leisure-time do so mostly in their neighborhood? To address this question, we examined relationships between leisure-time walking and boundaries of participant- and researcher-defined neighborhoods. Door-to-door interviews were completed with 415 adults residing in a Midwestern, U.S. city. Participants self-reported physical activity and drew on a map their perceived neighborhoods and their typical leisure-time walking routes. We found that 134 participants walked in their neighborhoods at least once during the past week on the route they drew. Routes were used for 82.9% of the leisure-time walks and 67.9% of the route was within perceived neighborhood boundaries. Almost all of the routes (98.2%) were within a straight-line 2,000 m buffer around participants’ homes. The present study suggests leisure-time walking is neighborhood-based and certain researcher-defined areas are adequate when exploring this behavior. Route characteristics described in this study may have implications for initiatives promoting neighborhood walking.

Bicycling Policy Indirectly Associated with Overweight/Obesity

BACKGROUND Policies to enhance bicycling are correlated with health outcomes. Research has yet to provide an adequate, empirically derived explanation for this finding. PURPOSE To examine a comprehensive model of a pathway potentially linking bicycle policies to overweight/obesity. METHODS Data representing multiple years between 2006 and 2012 from CDC, U.S. Census Bureau, U.S. Department of Transportation, and the Alliance for Biking and Walking were subjected to bivariate and multivariate analyses in 2013. A path model was created to explain the relationship between bicycle policies and overweight/obesity in the 48 largest U.S. cities. RESULTS Zero-order correlations were significant between the number of bicycle policies and the percentage of workers bicycling to work and rates of overweight/obesity. These relationships did not remain statistically significant in the multivariate analysis. However, more bicycle policies were associated with a greater number of bicycle infrastructure components (p<0.005). In turn, bicycling infrastructure components were positively related to the percentage of workers bicycling to work (p<0.001), which was inversely associated with overweight/obesity rates (p<0.05). CONCLUSIONS The results of this study suggest that large cities with more policies aimed at promoting bicycling have fewer overweight/obese residents, partially because the policies are related to supportive bicycling infrastructures that promote bicycling to work.

Addressing obesity with pediatric patients and their families in a primary care office.

Pediatric obesity is a prevalent condition that has devastating health consequences for children. If left untreated, it can result in adult obesity and related chronic health conditions. Special considerations need to be made for treatment in the pediatric population including an adjustment of treatment goals (weight maintenance vs weight loss) and treatment methodologies. Special emphasis needs to be made to support a childs development of healthy behavior choices. The use of medications should be avoided when possible because long-term health effects of pharmacotherapy treatment in children are unknown.

Relations between Perceptions of Environmental Features and Physical Activity

Studies have examined associations between environmental features and physical activity, but there has been no exploration of adult perceptions about the influence environmental features have on physical activity. This study assessed associations between perceptions of environmental features and physical activity. 305 women and 229 men (18–91 years of age) were interviewed in their homes. Questions elicited self-report data on physical activities they performed in their neighborhood (sidewalks near home) and perceptions about neighborhood environmental features. Women (86.4%) were more likely than men (79.3%) to be active in their neighborhoods and view the features as influential. The influences features were perceived to have on physical activity were associated with activity performed in the neighborhood, but perceptions of the conditions of features were not. Interviewers of adults about relationships between environmental features and physical activity should consider perceptions about the influence the feature exerts on activity levels.

Playground safety is associated with playground, park, and neighborhood characteristics

BACKGROUND More than 200,000 children each year are treated at emergency departments for injuries occurring on playgrounds. Empirically derived data are needed to elucidate factors associated with playground safety and reduce injury rates. OBJECTIVE Determine if neighborhood, park and playground characteristics are significantly associated with playground safety. METHODS A 24-item report card developed by the National Program for Playground Safety was used to assess playground safety at 41 public parks in a small to midsized, Midwestern city. Trained assessors evaluated the parks and playgrounds in June/July and used a standardized method to count the numbers of users. Data from the 2010 U.S. Census were used to describe the neighborhoods surrounding the parks. RESULTS The average safety score for all playgrounds was 77.4% which denotes acceptable safety levels. However, 17.1% of the playgrounds were potentially hazardous and in need of corrective measures. Playgrounds were safer in neighborhoods with more youth (< 18 years of age) and educated adults and in parks with better quality features. Playgrounds with fewer amenities were relatively less safe. CONCLUSIONS Park safety levels need to be improved to reduce the risk of physical injuries. Future studies examining cause-effect associations between environmental features and playground safety are warranted.

Community Development Corporations Could Potentially Improve Research on Causal Associations Between Environmental Features and Physical Activity

BACKGROUND Community development corporations (CDC) are worldwide entities that create environments facilitating physical activity. At the same time, researchers face challenges conducting cost-effective, longitudinal studies on how environmental changes affect physical activity. OBJECTIVE To provide evidence suggesting that CDC initiatives could potentially be integrated into a research framework for examining the influence of environmental improvements on physical activity. METHODS Quality of Life Plans (QLP) developed by a CDC and stakeholders from 6 lower-income neighborhoods were systematically reviewed to obtain data about environmental features targeted for change and the strategies used to bring about those changes. Strategies were deemed pro-physical activity if previous studies suggested they have the potential to affect physical activity. RESULTS A total of 348 strategies were proposed of which 164 were pro-physical activity. Six environmental features were targeted including crime (57 strategies), aesthetics (39), facilities (30), walkability (17), destinations (14), and programs (5). Strategies involved implementing (90 strategies), planning (33), assessing (26), and securing funding (13). Progress reports indicated that 37.4% of the pro-physical activity strategies were implemented 1 year following the development of the QLPs. CONCLUSIONS These results suggest that activities of CDCs could potentially be systematically integrated into the scientific study of environmental influences on physical activity.