VeiligheidNL

ABSTRACT Background Noise-induced hearing loss is both irreversible and preventable. However, only a minority of adolescents and young adults engage in hearing protective behaviors (HPBs) that reduce their exposure to noise, such as wearing earplugs at music venues. To promote HPBs it is imperative to know the most influential, and potentially modifiable, psychological factors that in this age group stimulate or hinder these protective behaviors. Objective The present study aims to offer a systematic literature overview of psychological correlates of HPBs in persons aged 12 to 25 years, and identify the correlates with most potential as behavioral intervention targets. Conclusions A total of 82 studies were included in the present review, of which data of 24 studies could be used to assess the strength of the association between one or more psychological factors and HPB. Heterogeneity between studies hindered synthesis. In particular, psychological constructs and HPBs were rarely defined and measured in a uniform manner. Studies were further characterized by a lack of research on psychological factors related to other HPBs than earplug use, such as sound volume control (e.g. the use of a volume limiter). Due to this relative absence of data, associations could not be assessed for specific HPB, and HPBs were aggregated in one variable. Taking into account both the strength of their associations with HPB and their univariate distributions, five psychological factors possessed the greatest potential as behavioral intervention targets: attitude toward recreational noise, perceived barriers, capacity, perceived norms, and perceived threat susceptibility. These results can help the development of new interventions. Additional research is however needed.

De juridische boodschap achter het rapport van de Onderzoeksraad voor Veiligheid Het rapport ‘Aanpak coronacrisis – Deel 1’ van de Onderzoeksraad voor Veiligheid (OvV) analyseert de aanpak van de COVID-19-crisis tot 1 september 2020. Deze bijdrage analyseert de juridische dimensies van de pandemische paraatheid, de formele crisisstructuur en kwetsbare ouderen en doet enige suggesties ter versterking van onder meer de Wet publieke gezondheid (Wpg).

BackgroundDifferences in health care utilization by educational level can contribute to inequalities in health. Understanding health care utilization and health-related quality of life (HRQoL) of educational groups may provide important insights into the presence of these inequalities. Therefore, we assessed characteristics, health care utilization and HRQoL of injury patients by educational level.MethodData for this registry based cohort study were extracted from the Dutch Injury Surveillance System. At 6-month follow-up, a stratified sample of patients (≥25 years) with an unintentional injury reported their health care utilization since discharge and completed the EQ-5-Dimension, 5-Level (EQ-5D-5L) and visual analogue scale (EQ VAS). Logistic regression analyses, adjusting for patient and injury characteristics, were performed to investigate the association between educational level and health care utilization. Descriptive statistics were used to analyse HRQoL scores by educational level, for hospitalized and non-hospitalized patients.ResultsThis study included 2606 patients; 47.9% had a low, 24.4% a middle level, and 27.7% a high level of education. Patients with low education were more often female, were older, had more comorbidities, and lived more often alone compared to patients with high education (p < 0.001). Patients with high education were more likely to visit a general practitioner (OR: 1.38; CI: 1.11–1.72) but less likely to be hospitalized (OR: 0.79; CI: 0.63–1.00) and to have nursing care at home (OR: 0.66; CI: 0.49–0.90) compared to their low educated counterparts. For both hospitalized an non-hospitalized persons, those with low educational level reported lower HRQoL and more problems on all dimensions than those with a higher educational level.ConclusionPost-discharge, level of education was associated with visiting the general practitioner and nursing care at home, but not significantly with use of other health care services in the 6 months post-injury. Additionally, patients with a low educational level had a poorer HRQoL. However, other factors including age and sex may also explain a part of these differences between educational groups. It is important that patients are aware of potential consequences of their trauma and when and why they should consult a specific health care service after ED or hospital discharge.

BackgroundFalls and fall-related injuries among older adults are a serious threat to the quality of life and result in high healthcare and societal costs. Despite evidence that falls can be prevented by fall prevention programmes, practical barriers may challenge the implementation of these programmes. In this study, we will investigate the effectiveness and cost-effectiveness of In Balance, a fourteen-week, low-cost group fall prevention intervention, that is widely implemented in community-dwelling older adults with an increased fall risk in the Netherlands. Moreover, we will be the first to include cost-effectiveness for this intervention. Based on previous evidence of the In Balance intervention in pre-frail older adults, we expect this intervention to be (cost-)effective after implementation-related adjustments on the target population and duration of the intervention.MethodsThis study is a single-blinded, multicenter randomized controlled trial. The target sample will consist of 256 community-dwelling non-frail and pre-frail adults of 65 years or older with an increased risk of falls. The intervention group receives the In Balance intervention as it is currently widely implemented in Dutch healthcare, which includes an educational component and physical exercises. The physical exercises are based on Tai Chi principles and focus on balance and strength. The control group receives general written physical activity recommendations. Primary outcomes are the number of falls and fall-related injuries over 12 months follow-up. Secondary outcomes consist of physical performance measures, physical activity, confidence, health status, quality of life, process evaluation and societal costs. Mixed model analyses will be conducted for both primary and secondary outcomes and will be stratified for non-frail and pre-frail adults.DiscussionThis trial will provide insight into the clinical and societal impact of an implemented Dutch fall prevention intervention and will have major benefits for older adults, society and health insurance companies. In addition, results of this study will inform healthcare professionals and policy makers about timely and (cost-)effective prevention of falls in older adults.Trial registrationNetherlands Trial Register: NL9248 (registered February 13, 2021).

The aim of this study was to determine the association between bicycle helmet use in adults (16 years and older) and traumatic brain injury (TBI) in emergency departments (EDs) in the Netherlands.The conducted research was a retrospective case-control study in patients aged 16 years and older who sustained a bicycle accident and therefore visited the EDs of participating hospitals throughout 2016. Cases were patients with TBI; controls were patients without TBI but with other trauma. Exposure was defined as helmet wearing during the accident. In total, 2133 patients were included in the study, 361 case patients and 1772 controls. Within the TBI group (cases) 3.9% of patients wore a helmet compared with 7.7% of patients in the control (non-head injury) group (odds ratio [OR] 0.49, 95% confidence interval [CI]: 0.28-0.86). No difference in helmet wearing was observed in patients who sustained accidents that involved motorized vehicles (OR 0.91; 95% CI: 0.29-2.83). In conclusion, adult patients (≥16 years of age) with TBI had a significantly lower odds of wearing a bicycle helmet than adult patients with other trauma, adding more evidence that wearing a bicycle helmet effectively protects against TBI.

Abstract Background In addition to the beneficial health effects of being active, running is also associated with a risk of sustaining injuries. The online intervention Runfitcheck was developed to stimulate injury-preventive behaviour among adult novice runners. The objective of this study was to evaluate the effectiveness of Runfitcheck on injury-preventive behaviour among adult novice runners. Design Randomised controlled trial Methods A randomised controlled trial with a follow-up period of five months was conducted among adult novice runners. The intervention group had access to the Runfitcheck intervention, while the control group performed their running activities as usual. One, three, and five months after enrolment, participants reported retrospectively what they had done regarding injury-preventive behaviour (operationalised as (i) using a (personalised) training schedule; (ii) performing strength and technique exercises; and (iii) performing a warm-up routine prior to running). Relative Risks ((RR) and 95% Confidence Interval (95%CI)) were used to analyse behavioural change among runners who were not performing the favourable behaviour at enrolment. Results A total of 1,411 novice runners (72.6% female, mean age 38.1 years) were included in this study and assigned to the intervention group (n=715) or control group (n=696). Runners in the intervention group searched more often for information about a warm-up routine (55.6% versus 44.9%; RR 1.211 (95%CI 1.080-1.357); Table 2), and added more often strength exercises to their warm-up routine (49.3% versus 38.2%; RR 1.228 (95%CI 1.092-1.380)). Runners in the intervention group performed more often running technique exercises compared to runners in the control group (58.6% versus 51.5%; RR 1.134 (95%CI 1.015-1.267)), but less often strength exercises (71.9% versus 77.9%; RR 0.865 (95%CI 0.752-0.995)). Within the group of runners that did not perform any warm-up routine at enrolment (n=272; 69.5% female, mean age 35.8 years (SD 9.3), runners in the intervention group performed a regular warm-up routine more often than runners in the control group (47.1% versus 28.4%; n=196; RR 1.461 (95%CI 1.084-1.968)) No significant results were found for using a training schedule. Conclusions The online intervention Runfitcheck was effective in stimulating aspects of injury-preventive behaviour in adult novice runners, mostly related to a warm-up routine.

BackgroundIn addition to beneficial health effects, running is associated with a risk of sustaining injuries. The online intervention Runfitcheck was developed to stimulate injury-preventive behaviour among adult novice runners.ObjectiveTo evaluate the effectiveness of Runfitcheck on injury-preventive behaviour among adult novice runners.DesignRandomized controlled trial.SettingParticipants were recruited via Dutch social media networks. Participants were asked to fill in four online questionnaires.ParticipantsThe group of participants consisted of adult novice runners.Interventions (or assessment of risk factors)The intervention group had access to the Runfitcheck intervention, while the control group performed their running activities as usual.Main outcome measurementsInjury-preventive behaviour: (i) using a (personalised) training schedule; (ii) performing strength and technique exercises; and (iii) performing a warm-up routine prior to running. Relative Risks ((RR) and 95% Confidence Interval (95%CI)) were used to analyse behavioural change among runners who were not performing the favourable behaviour at enrolment.ResultsA total of 1,411 novice runners (72.6% female, mean age 38.1 years) were included. Runners in the intervention group searched more often for information about a warm-up routine (53.6% versus 33.6%; n=194; RR 1.444 (95%CI 1.098–1.901)), performed a regular warm-up routine more often (47.1% versus 28.4%; n=196; RR 1.461 (95%CI 1.084–1.968), and added strength exercises to their warm-up routine more often than runners in the control group (32.6% versus 17.4%; n=192; RR 1.504 (95%CI 1.039–2.179)). Runners in the intervention group performed strength exercises less often at other points of time during the week (other than during their warm-up routine) than runners in the control group (36.6% versus 50.0%; n=426; RR 0.790 (95%CI 0.669–0.932)). No significant results were found for using a training schedule and running technique exercises.ConclusionsThe online intervention Runfitcheck was effective in stimulating aspects of injury-preventive behaviour in adult novice runners related to a warm-up routine, but did not succeed in stimulating other aspects of injury-preventive behaviour.

Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. The effects of epidemiological changes such as ageing of the population and increased traffic safety on the incidence of TBI are unknown. The objective of this study was to evaluate trends in TBI-related emergency department (ED) visits, hospitalization and mortality in the Netherlands between 1998 and 2012. This was a retrospective observational, longitudinal study. The main outcome measures were TBI-related ED visits, hospitalization and mortality. Between 1998 and 2012, there were 500 000 TBI-related ED visits in the Netherlands. In the same period, there were 222 000 TBI-related admissions and 17 000 TBI-related deaths. During this period, there was a 75% increase in ED visits for TBI and a 95% increase for TBI-related hospitalization; overall mortality because of TBI did not change significantly. Despite the overall increase in TBI-related ED visits, this increase was not evenly distributed among age groups or trauma mechanisms. In patients younger than 65 years, a declining trend in ED visits for TBI caused by road traffic accidents was observed. Among patients 65 years or older, ED visits for TBI caused by a fall increased markedly. TBI-related mortality shifted from mainly young (67%) and middle-aged individuals (<65 years) to mainly elderly (63%) individuals (≥65 years) between 1998 and 2012. The conclusions of this study did not change when adjusting for changes in age, sex and overall population growth. The incidence of TBI-related ED visits and hospitalization increased markedly between 1998 and 2012 in the Netherlands. TBI-related mortality occurred at an older age. These observations are probably the result of a change in aetiology of TBI, specifically a decrease in traffic accidents and an increase in falls in the ageing population. This hypothesis is supported by our data. However, ageing of the population is not the only cause of the changes observed; the observed changes remained significant when correcting for age and sex. The higher incidence of TBI with a relatively stable mortality rate highlights the importance of clinical decision rules to identify patients with a high risk of poor outcome after TBI.

ABSTRACTObjectives: Training errors are suggested to be an important cause of running-related injuries (RRIs). As most runners train individually, digital coaching using running applications is becoming increasingly popular. However, the quality of these applications is unknown. The aim of the present cross-sectional study was to evaluate the relationship between the use of running applications and RRIs.Methods: An online questionnaire was used to collect data on running activities of 1,029 runners, their injuries, and the association between the use of running applications and RRIs. Parametric and non-parametric tests for independent samples were used to analyze the baseline characteristics of the participants. Univariate logistic regression analyses and multiple logistic regression analysis (Enter procedure) were used to determine the association between the use of running applications and RRIs, while adjusting for confounding effects.Results: Of all the 1,029 runners included in this study, 31% (n = 319) got injured and 44% (n = 453) used an application in the previous 12 months. Multiple logistic regression analysis showed no statistically significant association between the use of running applications and RRIs.Conclusions: Based on this study, the use of running applications was not associated with an increased or decreased risk of RRIs. Running applications can be used by runners without any further implications to guide their training activities. However, runners should be aware that the use of predefined running schemes is associated with RRI risk. It is important that following a previous RRI, athletes should be fully recovered before resuming their training sessions as hindrance from a previous RRI is highly associated with the occurrence of a new RRI.