Objective. To study the prevalence, nature and determinants of aggression among inpatients with acquired brain injury. Background. Patients with acquired brain injury often have difficulty in controlling their aggressive impulses. Design. A prospective observational study design. Methods. By means of the Staff Observation Aggression Scale-Revised, the prevalence, nature and severity of aggressive behaviour of inpatients with acquired brain injury was assessed on a neuropsychiatric treatment ward with 45 beds. Additional data on patient-related variables were gathered from the patients’ files. Results. In total, 388 aggressive incidents were recorded over 17 weeks. Of a total of 57 patients included, 24 (42%) patients had engaged in aggressive behaviour on one or more occasions. A relatively small proportion of patients (n = 8; 14%) was found to be responsible for the majority of incidents (n = 332; 86%). The vast majority of aggression incidents (n = 270; 70%) were directly preceded by interactions between patients and nursing staff. In line with this, most incidents occurred at times of high contact intensity. Aggressive behaviour was associated with male gender, length of stay at the ward, legal status and hypoxia as the cause of brain injury. Conclusion. Aggression was found to be highly prevalent among inpatients with acquired brain injury. The results suggest that for the prevention of aggression on the ward, it may be highly effective to develop individually tailored interventions for the subgroup with serious aggression problems. Relevance to clinical practice. Insight into the frequency, nature and determinants of aggressive behaviour in inpatients with acquired brain injury provides nurses with tools for the prevention and treatment of aggressive behaviour.
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Benjaminse, A, Nijmeijer, EM, Gokeler, A, Broekhaar, DC, and Cortes, N. Motivation unraveled: giving choice to football players to improve anterior cruciate ligament injury prevention. J Strength Cond Res 38(12): e735–e743, 2024—Providing athletes some control over a training session facilitates motor skill acquisition. This is a promising concept to use in anterior cruciate ligament (ACL) injury prevention, as the key for risk reduction is to improve quality of movement. The goal of this study was to better understand why improved motor learning occurred when football players had the opportunity to choose when to receive feedback when practicing sidestep cutting (SSC) movements. Healthy male recreational football players (n 5 22, 22.9 6 1.7 years, 185.5 6 7.2 cm, 79.3 6 9.2 kg) were included and assigned to the self-control (SC) or the yoked (YK) group. The players performed anticipated and unanticipated SSC. They received video instructions and were instructed to “copy the movement of the model to the best of their ability.” During the training blocks, the SC group could ask for feedback, whereas the YK group could not. Cutting movement assessment scores (CMAS) were measured to test quality of movement and the Intrinsic Motivation Inventory was administered to measure constructs of motivation. In the anticipated condition, SC group showed better scores in immediate post and the retention test compared with pretest (p, 0.001), whereas the YK group showed worse scores in the retention test compared with immediate posttest (p 5 0.001). Perceived competence (p 5 0.017) and self-efficacy (p 5 0.032) were consistent factors that correlated with improved CMAS in the SC group. This has given us innovative insights into underlying mechanisms optimizing the quality of movement, necessary to improve current ACL injury prevention approaches.
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The demanding environment that contemporary dance students are exposed to could result in high stress levels, which can influence injury susceptibility. Therefore, this study aims to investigate the association between stress and injuries. In the period between September 2016 and March 2020, four cohorts of first-year dance students (N = 186; mean age 19.21 ± 1.35 years) were followed for one academic year. Each month, general stress was assessed on a 0-100 visual analogous scale. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used on a monthly basis to monitor injuries. Injuries were defined as "all injuries" (i.e., any physical complaint irrespective of the need for medical attention or time-loss from dance) and "substantial injuries" (i.e., leading to moderate/severe/complete reductions in training volume or performance). Mann-Whitney tests were performed to measure differences in general stress levels between injured and injury-free students, while repeated-measures ANOVA were performed to investigate whether general stress scores increased before and during injury occurrence. The overall average monthly general stress score over all cohorts for all students was 39.81. The monthly general stress scores ranged from 31.75 to 49.16. Overall, injured and substantially injured students reported higher stress scores than injury-free students, with significant differences in 3 out of the 9 months for all injuries (September, October, March, p < 0.05), and in 5 months for substantial injuries (September, October, November, December, April, p < 0.05). Within the 3-month period before and during injury occurrence, a (marginally) significant linear effect of general stress across the time periods was found for all injuries [F(1.87,216.49) = 3.10, p = 0.051] and substantial injuries [F(2,138) = 4.16, p = 0.018]. The results indicate an association between general stress and injuries. Future research should focus on effects of varying stress levels on injury risk using higher sampling frequency, for instance by measuring weekly since stress levels are likely to fluctuate daily. Practically, strategies aiming at stress reduction might have the potential to reduce the burden of dance injuries and may have positive outcomes for dancers, teachers, schools, and companies.
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