Athletes in team sports have to quickly visually perceive actions of opponents and teammates while executing their own movements. These continuous actions are performed under time pressure and may contribute to a non-contact ACL injury. However, ACL injury screening and prevention programmes are primarily based on standardised movements in a predictable environment. The sports environment provides much greater cognitive demand because athletes must attend their attention to numerous external stimuli and inhibit impulsive actions. Any deficit or delay in attentional processing may contribute to an inability to correct potential errors in complex coordination, resulting in knee positions that increase the ACL injury risk. In this viewpoint, we advocate that ACL injury screening should include the sports specific neurocognitive demands.
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The seventh ACL Research Retreat was held March 19–21, 2015, in Greensboro, North Carolina. The retreat brought together clinicians and researchers to present and discuss the most recent advances in anterior cruciate ligament (ACL) injury epidemiology, risk factor identification, and injury risk screening and prevention strategies. Subsequently, our goal was to identify important unknowns and future research directions. The ACL Research Retreat VII was attended by 64 clinicians and researchers from Australia, Canada, India, Ireland, the Netherlands, South Africa, the United States, and the United Kingdom. The meeting featured 3 keynote and 29 podium presentations highlighting recent research. Keynotes were delivered by Bruce Beynnon, PhD (Univer- sity of Vermont), Charles ‘‘Buz’’ Swanik, PhD, ATC (University of Delaware), and Mark Paterno, PhD, PT, ATC, SCS (Cincinnati Children’s Hospital Medical Cen- ter), addressing their ongoing work related to sex-specific multivariate risk factor models for ACL injury,1 the role of the brain in noncontact ACL injury,2 and the incidence and predictors of a second ACL injury after primary ACL reconstruction and return to sport,3 respectively. Podium and poster presentations were organized into thematic sessions of prospective and case-control risk factor studies, anatomical and hormonal risk factors, neuromuscular and biomechanical risk factors, injury risk assessment after ACL injury, and injury-prevention strategies. Time was provided for group discussion throughout the conference. At the end of the meeting, attendees participated in 1 of 3 breakout sessions on the topics of genetic, hormonal, and anatomical risk factors; neuromechanical contributions to ACL injury; and risk factor screening and prevention. From these discussions, we updated the 2012 consensus state- ment4 to reflect the most recent advances in the field and to revise the important unknowns and future directions necessary to enhance our understanding of ACL injury. Following are the updated consensus statement, keynote presentation summaries, and free communication abstracts organized by topic and presentation order.
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Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.
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