To evaluate whether exposure to the United States' discriminatory housing practice of redlining, which occurred in over two-hundred cities in the 1930s, is associated with modern-day, community-level ...incidence of firearm injury.
Firearm violence is a public health epidemic within the United States. Federal policies are crucial in both shaping and reducing the risk of firearm violence; identifying policies that might have contributed to risks also offers potential solutions. We analyzed whether 1930s exposure to the discriminatory housing practices that occurred in over two-hundred U.S. cities was associated with modern-day, community-level incidence of firearm injury.
We performed a nationwide retrospective cohort study between 2014-2018. Urban Zip Code Tabulation Areas (ZCTAs) historically exposed to detrimental redlining (grades C and D) were matched to unexposed ZCTAs based on modern-day population-level demographic characteristics (i.e., age, Gini index, median income, percentage Black population, education level). Incidence of firearm injury was derived from the Gun Violence Archive and aggregated to ZCTA level counts. Our primary outcome was the incidence of firearm injury, modeled using zero inflated negative binomial regression.
When controlling for urban firearm risk factors, neighborhoods with detrimental redlining were associated with 2.6 additional firearm incidents annually, compared to non-redlined areas with similar modern-day risk factors. Over our study period, this accounts for an additional 23,000 firearm injuries.
Historic, discriminatory Federal policy continue to impact modern-day firearm violence. Policies aimed at reversing detrimental redlining may offer an economic means to reduce firearm violence.
Despite the efforts of many traditional lower extremity injury prevention programs (IPP), the incidence of anterior cruciate ligament injuries in young athletes continues to rise. Current best ...practices for IPPs include training lower extremity neuromuscular control and movement quality during cutting, jumping, and pivoting. Emerging evidence indicates neurocognition may contribute to injury incidence and injury risk biomechanics. Therefore, IPP outcomes may improve if clinicians also consider neurocognitive contributions to neuromuscular control and athletic performance. A substantial barrier to neurocognitive challenge integration during injury prevention training in the group setting is the lack of structured neuromuscular and neurocognitive progressions. Therefore, our aim is to provide clinicians with a defined framework and recommendations from clinical experience for how to implement neurocognitive challenges within group IPPs that requires minimal extra time and resources. This clinical commentary proposes a three-phase model adopted from motor learning literature to simultaneously progress neuromuscular and neurocognitive challenges through a structured IPP.
•Integrating Neurocognitive Challenges into Injury Prevention Training: A Clinical Commentary.•Neurocognition can augment injury prevention programs (IPP) to enhance transferability of neuromuscular adaptations to sport.•A three-phase model is proposed paralleling the phases of motor learning with neurocognitive loading.•Neurocognitive loading progresses from single-step reaction and memory to multi-step inference, inhibition and dual tasking.•The framework provides an entry point for integration of neurocognition into IPPs with minimal additional time or risk.•Anecdotally the inclusion of neurocognition improves IPP compliance, creativity and facilitates neuromuscular progression.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•Since entering the US market in 2015, the hoverboard has been a popular recreational device associated with significant injury risk.•Efforts to improve safety associated with hoverboard use have ...increased in recent years, necessitating an updated assessment of injury rates.•Hoverboard-related injuries peaked in 2018 and 2020, and injury rates appear to be decreasing in recent years.•Orthopedic injuries consistently account for the majority of hoverboard-related injuries, with forearm and wrist fractures being most common.
: Hoverboards are a popular means of recreation in the United States and are associated with significant injury risk, leading to recent efforts to improve their safety. Prior studies on hoverboard-related injuries were either conducted prior to implementation of safety regulations, consisted of short study intervals, or did not place a focus on injuries as they pertain to the orthopedic specialist. The purpose of this study is to provide an updated assessment of the epidemiology of orthopedic hoverboard-related injuries presenting to US emergency departments.
: A retrospective analysis from 2015 to 2022 of the National Electronic Injury Surveillance System (NEISS) database was conducted, limited to product codes detailing hoverboard-related injuries leading to emergency department visits. Diagnoses of interest included fractures, dislocations, contusions/abrasions, and strains/sprains. Diagnoses were further broken down to analyze anatomic region affected. National estimates (NE) were calculated using survey methods. One-way ANOVA and chi square tests were used to test for changes over time in injuries, age, and gender.
: 4,718 total hoverboard-related injuries were captured, with a national estimate of 154,121. The majority of patients were under 18 years old (79.6%; P<0.001) and female (52.5%; P=0.038). Orthopedic injuries accounted for 68.6% of the total, with no significant year-by-year change in this proportion (P=0.069). Fractures were the most common orthopedic injury (64.2%), followed by contusions/abrasions (20.2%), strains/sprains (14.6%), and dislocations (1.0%). Most fractures affected the forearm (33.8%) followed by the wrist (29.2%). Injuries peaked in 2018 (NE = 25,192) and 2020 (NE = 24,958), followed by a decline in incidence more recently.
: Hoverboard-related injuries continue to be a common presentation to US emergency departments, though injury rates appear to be decreasing. Orthopedic injuries consistently account for the majority of hoverboard-related injuries reporting to emergency departments, with fractures of the forearm and wrist being most common. Continued efforts toward improving safety measures regarding hoverboard use are warranted.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP