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Biomedical subjects

D MacAuley

Publications and source records attributed to D MacAuley.

At least 19 recordsLinked to original sources
PubMed2003

Impact of school sports injury.

BACKGROUND: Most injuries in school occur during sport. OBJECTIVES: To explore the impact of sports injury in supervised school sport. METHOD: A prospective study of sports injury in children of secondary school age presenting to the accident and emergency department. Each patient was identified on registration, matched with medical records after discharge, and contacted later by telephone to complete a structured interview. Patients were only included if their injury was sustained during supervised school sport. RESULTS: During the study period, 194 patients aged 11-18 attended the accident and emergency department with an injury, 51% of which occurred during school sport. Injuries occurred most commonly in rugby (43%), followed by physical education and games together (17.5%). Most injuries were x rayed (72%). Just over 12% of pupils lost no time from sport, most (71%) were back to sport within three weeks, and 2.7% were injured for more than eight weeks. Almost a third of parents needed to take time off from work to deal with the injured child. CONCLUSION: School sports injuries are important. They account for just over half of all injuries in secondary school children. They cause significant disruption to school and sport and have important implications for the wider family.

Adolescent↗
PubMed2003

Immediate care of school sport injury.

School sport is a major cause of injury in the post-primary age group. The importance of primary prevention in sport has been identified; however secondary prevention of school related sport injury has not been described in Ireland. A random sample of 450 schools in Northern Ireland and the Republic of Ireland was studied using a postal questionnaire. Current management of sport injury, with particular interest in the expertise and training of teachers and coaches, was explored. Replies were received from 333 (74%) schools. There was no physical education teacher with up to date first aid training in 37% schools. Immediate care in terms of mechanisms and equipment to deal with injury was available in 35%-81% of schools responding. Correct response ranged from 65%-90% to four scenarios: commonly presenting yet potentially serious management problems. This study demonstrated deficiencies in sport injury care. In addition to concern about current training, a need for basic life support training is highlighted. These findings have implications for the prevention of school sports injuries.

Adolescent↗
PubMed2002

The quality of research in sports journals.

OBJECTIVE: To examine the evidence base of sports medicine research. METHODS: A sample of four major journals that present core research in sport and exercise medicine (British Journal of Sports Medicine, Medicine and Science in Sports and Exercise, Journal of Sports Medicine and Physical Fitness, and Physical Therapy) was examined using assessment criteria taken from the READER method. RESULTS: Randomised controlled trials comprised 10% or less of all original research articles. Observational/descriptive studies were the most commonly published study design. There was a highly significant difference (p<0.0001) in the contents of the four journals but when they were compared by categorising the better quality methods together (randomised control trial, case-control, and cohort studies), the difference was not significant (p = 0.09). CONCLUSIONS: The overall pattern of publication type seems remarkably stable over medical journals, indicating that the quality of sports medicine research is comparable to that in other specialities.

Clinical Trials as Topic↗
PubMed2002

Sports medicine and the accident and emergency medicine specialist.

BACKGROUND: Sport and exercise related injuries are responsible for about 5% of the workload in the accident and emergency (A&E) department, yet training in sports medicine is not a compulsory part of the curriculum for Higher Specialist Training. AIM: To determine how A&E medicine consultants and specialist trainees view their role and skill requirements in relation to sports medicine. METHOD: A modified Delphi study, consisting of two rounds of a postal questionnaire. Participants were invited to rate the importance of statements relating to the role and training of the A&E specialist in relation to sports injuries (six statements) and the need for knowledge and understanding of defined skills of importance in sports medicine (16 statements). VALUE OF RESEARCH: This provides a consensus of opinion on issues in sport and exercise medicine that have educational implications for A&E specialists, and should be considered in the curriculum for Higher Specialist Training. There is also the potential for improving the health care provision of A&E departments, to the exercising and sporting population.

Athletic Injuries↗
PubMed2001

Sterilization and disinfection in general practice within university health services.

A postal questionnaire on 'sterilization and disinfection' was sent to all 144 nurse members of the British Association of Health Services in Higher Education (BAHSHE). Forty-nine (34%) completed valid questionnaires were returned. Despite the majority of practices performing minor surgical procedures such as cervical cytology (N= 40, 82%), ear syringing (N= 44, 90%) and wound dressing (N= 49, 100%), only 11 (22%) had access to a sterile supply department (SSD), and the definitions of sterilization and disinfection were only identified by 23 (52%) and 14 (32%) of the respondents, respectively. Forty-one (84%) respondents had a benchtop sterilizer (30 had a benchtop sterilizer, 11 a vacuum sterilizer and two had both), although there was considerable confusion on their appropriate use and maintenance. Just over half had written procedures for sterilizer use, no practice changed the sterilizer water on a daily basis as recommended by the Medical Devices Agency (MDA), few kept a sterilizer logbook and even fewer had read the MDA Device Bulletin on benchtop sterilizers. The majority of respondents voiced an interest in attending a workshop on sterilization and disinfection. We conclude that despite the location of the general practices within an academic environment, the concept of infection control is clearly not understood by university health service staff. As the implications of a failure to implement proper infection control procedures are potentially serious, the need for adequate education and training of staff is of critical importance.

Clinical Competence↗
PubMed2001

Do textbooks agree on their advice on ice?

OBJECTIVE: To study ice therapy guidance in sports medicine textbooks. DATA SOURCES: A systematic search of a convenience sample of textbooks. STUDY SELECTION: 45 general sports medicine texts were included in the study. DATA EXTRACTION: The indices and chapter headings of each text were searched using key words "ice," "cryotherapy," "soft tissue injury," "muscle," and "bruise." DATA SYNTHESIS: In 17 of the textbooks, there was no guidance on the duration, frequency, or length of ice treatment or on the use of barriers between ice and the skin. Advice on treatment duration was given in 28 texts but recommendations differed depending on the particular ice therapy, injury location, or severity. There was considerable variation in the recommended duration and frequency of advised treatments. CONCLUSION: There was little guidance in the standard textbooks on ice application, and the advice varied greatly. There is a need for evidence-based sport and exercise medicine with a consensus on the appropriate use of ice in acute soft tissue injury.

Athletic Injuries↗
PubMed2000

Sport and exercise medicine: building the foundations of a new discipline.

New disciplines emerge as medicine evolves. But, to be recognised as a clinical discipline we must be prepared to measure ourselves against established criteria; there should be consensus on the core content of the discipline and an identifiable body of knowledge to allow us to deal with common clinical problems. At this developmental stage in our evolution we have general agreement on what defines sport and exercise medicine but, as most of our clinical skills developed empirically, research is relatively underdeveloped. The volume and quality of this research does not yet reflect a vibrant research culture. The validity of our clinical method is supported by research evaluating the sensitivity and specificity of clinical tests but the evidence supporting other areas of clinical practice is uncertain. Some aspects of prevention have become integrated into clinical practice without sufficient evidence and, screening has been introduced without critical evaluation. To ensure the future success of our discipline and achieve recognition of its value in the wider medical community, we must nurture an evaluative culture and ensure that clinical practice is built on firm foundations of research evidence.

Athletic Injuries↗
PubMed2000

Hospitals do not inform GPs about medication that should be monitored.

BACKGROUND: General practitioners are now asked to prescribe drugs that, due to possible risks and side effects, had previously been prescribed almost exclusively at hospital. OBJECTIVE: To assess the quality of hospital letters as the key communication between hospitals and GPs. METHOD: Hospital letters examined using a predetermined protocol. RESULTS: Of 224 patients identified who were taking drugs that required regular monitoring, 173 were commenced in hospital. Fewer than one in five (30; 17%) hospital letters indicated that there was a risk associated with the drug or that it should be routinely monitored. Monitoring frequency was identified on only 14 occasions and the majority of letters (129; 74. 6%) did not state who was to be responsible for ongoing monitoring (either GP or hospital). Information was slow to arrive at the practice and, in 12% of cases, the hospital letter had not arrived within 14 days of commencement of medication. CONCLUSION: The information provided in hospital letters is insufficient to allow GPs to put structures in place to monitor drug therapy.

Adverse Drug Reaction Reporting Systems↗
PubMed1999

Sterilization and disinfection in general practice in Northern Ireland.

In view of the recent trend towards more minor surgery being carried out in general practice we decided to conduct a postal survey to assess the level of knowledge of sterilization and disinfection and the use of benchtop sterilizers in general practice in Northern Ireland. The survey, of all 366 practices in the Province, was carried out in January/March 1998. One hundred and eleven (30%) completed questionnaires were returned. All practices performed at least one of a range of procedures requiring sterilization or disinfection, e.g., minor surgery 95%, cervical smear taking 98%, syringing of ears 98%. Only 76% of practices had a benchtop sterilizer and 39% did not have access to a sterile supply department (SSD); 32% of the latter had no desire to utilize such a service. Only 25% and 34% correctly identified the Medical Devices Agency (MDA) definitions of sterilization and disinfection respectively. The MDA Device Bulletin on benchtop sterilizers had been read by only 26% of respondents. There was an 86% interest in attending a workshop on sterilization and disinfection. The concepts and practice of sterilization and disinfection appear not to be clearly understood. We conclude that resources must be identified to provide appropriate education in this important area for primary care staff.

Ambulatory Surgical Procedures↗
PubMed1999

Critical appraisal using the READER method: a workshop-based controlled trial.

BACKGROUND: Critical reading is an important skill for those trying to practice evidence-based medicine. There are a number of recognized structures for critical reading, including the READER model. These methods should be subjected to high-quality studies. OBJECTIVES: We aimed to evaluate the READER method in a practical teaching setting using the highest quality research methodology. METHODS: We carried out a modified randomized controlled trial. Two groups of GP trainers were invited to appraise critically the two articles using either the READER acronym or a semi-structured free appraisal. RESULTS: Of 99 participants in the workshop, 92 completed the study. One-third of participants (33.7%) read more than five articles per month and those who had been in practice the longest read fewer articles (P<0.05). Both groups attributed the lowest score to paper 2. The median total scores were higher using the READER method, although only significant for paper 2 (P<0.05). The median score attributed to the methodology was lower using the READER method than the free appraisal, although this difference was only significant for paper 1 (P<0.05). Overall, 51% (70% of the READER group) believed that taking part in the exercise would encourage them to be more critical of published articles in the future. CONCLUSION: Those using the READER method attributed a higher total score, but were more critical of the methodology than those using a free appraisal. Participants found the study useful and believed that it would be of help in future critical appraisal. The study raises interesting questions about the relative importance to GPs of methodological rigour compared with other factors when evaluating research papers.

Education, Medical, Continuing↗
PubMed1999

Ankle injuries: same joint, different sports.

Specific information on the incidence of ankle injury is not easy to establish, and studies use variable methodology and recording systems. There are problems in recording injury in many sports injury studies (23) as we often cannot calculate the relative risks without denominator data. Although we can estimate that ankle injuries make up about 10-15% of sports-related injury and that soccer and rugby are responsible for most sports-related injury in the United Kingdom, it is difficult to be more specific. Prevention and treatment strategies are also different, and taping and strapping is not widely practiced. Soccer has a particular injury pattern with some injuries particularly associated with the sport.

Ankle Injuries↗
PubMed1999

Vision or heresy.

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Accreditation↗