Lauren A. Petrass

Parent/Caregiver supervision and child injury: a systematic review of critical dimensions for understanding this relationship

This study reviewed the relationship between recognized dimensions of supervision and childrens injuries based on Saluja et als (Injury Control and Safety Promotion. 2004;11:17–22) hierarchal model of supervision strategies. A systematic review of peer-review studies was done with the earliest records available to 2007. There were 112 potentially relevant articles identified; 31 studies met all inclusion criteria. Reported studies were categorized according to the dimensions of supervision they addressed. Studies were not evenly distributed across the dimensions. There was evidence from the study that directly linking dimensions of supervision to child injury risk and outcomes is scarce. Future studies should consider attention, proximity, and continuity of supervision to provide a holistic understanding of the relationship between supervision and injury.

Methodological approaches used to assess the relationship between parental supervision and child injury risk

Objective: To describe and rate the quality of methodological approaches used to measure parental supervision in relation to injury risk in children aged 0–14 years. Design: A systematic review of the literature related to supervision and injury risk. Methods: A comprehensive search of electronic databases from the earliest records available to the end of 2007, and supplemental hand-searching of relevant journals, reference lists of studies identified through database searches, and bibliographies of systematic and non-systematic reviews. A classification scale was used to rate the methodological quality of studies. Results: 30 papers met the inclusion criteria. They varied substantially in quality, and no meta-analyses or randomised controlled trials were identified. Fifteen studies used self-report approaches, asking parents or care givers to report through recording diaries, interviews and questionnaires and were considered of low quality; 11 studies reconstructed injury outcomes retrospectively. Observational studies were conducted in both laboratory and natural settings (n = 6), and these studies were generally of higher quality than self-report methods. Conclusions: The quality of many supervision and child injury risk studies is low to moderate. Further development of methodological approaches is needed to improve studies of the relationship between supervision and child injury risk.

The relationship between ground conditions and injury: What level of evidence do we have?

OBJECTIVES To identify studies which address the relationship between ground conditions and injury, in a sporting context and to evaluate current practice and provide recommendations for future studies that measure ground conditions and injury risk. DESIGN Systematic review. METHODS A comprehensive search of electronic databases from the earliest records available until the end of 2011, and supplemental hand searching was conducted to identify relevant studies. A classification scale was used to rate the methodological quality of studies. RESULTS 79 potentially relevant articles were identified, and 27 met all inclusion criteria. They varied in methodological quality, with analytical observational studies the most common design, although four descriptive observational studies, considered to be of lower quality were also identified. Only five studies objectively measured ground conditions, and of studies that used subjective assessment, only one provided descriptors to explain their classifications. It appears that harder/drier grounds are associated with an increased injury risk but the presence of major limitations necessitates cautious interpretation of many key findings. CONCLUSIONS There is limited high quality evidence of the relationship between injury risk and ground conditions. Further research with high quality designs, and measurement of ground conditions are required to draw more definitive conclusions regarding this relationship.

Preventing adolescent drowning: Understanding water safety knowledge, attitudes and swimming ability. The effect of a short water safety intervention

Worldwide, epidemiological data indicate that children are a high-risk group for drowning and while progress has been made in understanding toddler drownings, there is a lack of empirical evidence regarding the drowning risk and protective factors inherent for adolescents and young adults. This study used a self-report questionnaire to establish swimming and water safety knowledge and attitudes of young adults and objectively measured their actual swimming ability using formal practical testing procedures. Participants then completed a short, 12-week intervention that encompassed swimming, survival and rescue skills, along with water safety knowledge applicable to a range of aquatic environments. Knowledge, attitudes and swimming ability were then re-measured following the intervention to evaluate its effectiveness. The Wilcoxon matched pairs signed ranks test was performed to detect whether there were significant differences between knowledge, attitude and swim ability scores pre-intervention and post-intervention. A total of 135 participants completed the baseline and follow up questionnaire and all practical testing. Results indicated that these young adults had a very low level of water safety knowledge pre-intervention, although the majority had sound swimming and water safety skills and attitudes. Overall, significant improvements were evident in knowledge (p<0.001) and swim ability (p<0.001) post-intervention, although no changes were observed in attitudes (p=0.079). Previous participation in formal swimming lessons and/or swimming within the school curriculum had no significant impact on water safety knowledge, skills or attitudes of these young adults, and there were few significant gender differences. While it is important to conduct further studies to confirm that these findings are consistent with a more representative sample of young adults, our findings are the first to provide empirical evidence of the value of a comprehensive aquatic education program as a drowning prevention strategy for young adults.

Observations of caregiver supervision of children at beaches: identification of factors associated with high supervision

Objective To identify independent factors associated with caregiver supervision levels at beaches. Methods Children (aged 1–14 years) engaged in beach play and their caregivers were observed at Australian beaches during September–April, 2008/09. Caregiver, child, and environmental factor data were collected and recorded on a validated observation instrument. The main outcome of interest was a continuous measure of supervision. After adjusting for potential clustering by beach/state, multivariable linear regression was used to identify independent factors associated with caregiver supervision. Results Four independent predictors of supervision and one interaction effect (child age by the caregiver and child position on beach) were identified. Caregivers who were supervising from a different position to where the child was playing were less likely to provide high supervision, as were older caregivers (>35 years) compared to younger caregivers (≤34 years). Compared to children playing alone, children playing with one, or two or more others were less likely to receive high supervision, and children aged 1–4 years were likely to receive higher supervision than older children. Conclusion This study provides new knowledge about underlying factors associated with the level of caregiver supervision in beach settings. Future studies should continue to explore independent predictors of supervision so that effective programmes, which focus on caregiver supervision, can be targeted to address poor supervision practices.

Ground condition as a risk factor in sports injury aetiology studies: the level of concordance between objective and subjective measures

BackgroundIt is well known that the condition and type of sporting ground influences the risk of sports injury. However, the lack of evidence on the relationship between subjective and objective sporting ground condition assessments in sports injury aetiology studies has implications for the development of effective injury prevention strategies. This paper aims to examine concordance between subjectively rated and objective ground hardness and moisture measurements to inform data collection methods for future sports injury aetiology studies.MethodsSubjective, observational assessments of ground hardness and soil moisture were recorded on 36 occasions during an Australian football season using two four-point scales of ‘very soft’ to ‘very hard’ and ‘very wet’ to ‘very dry’, respectively. Independent, objectively measured hardness and soil moisture were also undertaken at nine locations on the same grounds. The maximum and minimum ground values and the computed average of ground hardness and soil moisture were analysed. Somer’s d statistic was calculated to measure the level of concordance between the subjective and objective measures.ResultsA significant, moderate to substantial level of agreement was found between the subjective ratings and the average objective hardness values (d = 0.467, p <0.001), but there was perfect agreement on just less than half of the occasions. The level of concordance between the subjective and objective moisture ratings was low to moderate or trivial for all moisture measures (0.002 < d <0.264, p >0.05).ConclusionsCompared to objective measures, the subjective assessments were more accurate for ground hardness than for soil moisture levels and raters were just as likely to underestimate or overestimate the condition under review. This has implications for future sports injury aetiology studies that include ground condition assessments and particularly the use of subjective measures to underpin the development of future injury prevention strategies.

Adapting an established measure of supervision for beach settings. Is the parent supervision attributes profile questionnaire reliable

The Parent Supervision Attributes Profile Questionnaire (PSAPQ), developed to measure aspects of caregiver supervision and protectiveness and previously applied within playgrounds and in the home, was modified for implementation in a beach setting. To assess the test–retest reliability of the PSAPQ beach modification (PSAPQ-BEACH), 20 caregivers completed the PSAPQ-BEACH twice, over a mean interval of 18 days (range 10–24). The test–retest reliability and internal consistency of the PSAPQ-BEACH scores were compared to those of the PSAPQ. All scores on the PSAPQ-BEACH were higher than the PSAPQ, providing evidence that the questionnaire remains reliable after its adaptation to beach settings.

Comparison of surface temperatures of different synthetic turf systems and natural grass: Have advances in synthetic turf technology made a difference

Few studies have considered surface temperatures on the most recent synthetic turf products, and no empirical evidence is available on the more technologically advanced cool climate synthetic products which claim to reduce surface temperature. This article compared surface temperatures of typical third-generation synthetic turf with a cool climate product and also compared the synthetic turf products to natural grass to determine whether synthetic turf reacts differently to environmental factors and hence may increase heat-related health risks for participants. Surface temperatures were significantly associated with ambient temperature (F3,376 = 116.02, p < 0.001), relative humidity (F1,376 = 10.15, p = 0.028), and wind (F1,376 = 1.45, p = 0.004) having smaller effects. After adjustment for covariates, mean surface temperatures were significantly lower (40.79 °C) on a cool climate field compared to a typical third-generation field (44.91 °C), although both synthetic fields were considerably warmer than natural grass at the same venue (by 12.46 °C at the metropolitan venue and 22.15 °C at the regional venue). These findings provide initial insight into the potential value of cool climate products and will aid both design and development of synthetic turf products for the future.

One, two, three or four: Does the number of Clegg hammer drops alter ground hardness readings on natural grass?

The Clegg hammer is currently used to measure hardness of natural turf surfaces to inform performance and safety decisions. However, the number of Clegg hammer drops reported in natural grass testing varies from one to four drops, and the impact of the choice of the number of drops is unknown. The aim of this article is to determine whether significant differences exist between the four Clegg hammer drops on natural grass across a variety of conditions. Hardness readings (using a 2.25 kg Clegg hammer), soil moisture and botanical composition were recorded at nine different sites on seven football fields during an 18-week playing season. A total of 1255 hardness readings were collected for each of four consecutive Clegg hammer drops. Overall, there were significant differences between drop 1 and the other three consecutive drops, on all fields and on all sites. Deep soil moisture was the only factor that significantly influenced the hardness readings. The results of this study demonstrate that the decision regarding the number of drops recorded needs careful consideration as conclusions drawn on playability of a ground or the association with injury risk may vary considerably depending on the number of drops.

Drowning deaths among anglers: Are waders a contributing factor?

Recreational fishing has been a popular activity for Australians over at least the past two centuries. While the use of waders for recreational fishing is widely adopted by participants, there is considerable speculation as to whether waders are contributing to fishing-related drowning deaths. This study involved a comprehensive search of peer-reviewed and grey literature to identify relevant information and a pilot investigation in a swimming pool to understand the accuracy of the currently available information. Extensive searching indicated that there is no published peer-reviewed evidence on the contribution of waders to drowning deaths, although the grey literature and personal communication with fishers offer a range of opinions, some that aim to discredit the claim that waders contribute to drowning, and others that support it. Improved understanding of the actual effect of waders based on biomechanical buoyancy principles and a pilot study of submersion in controlled conditions contributes to enhanced safety of fishers who choose to wear waders, dispels current myths and informs future studies of fishers wearing waders.