Mundt, Marlon P; Zakletskaia, Larissa I; Fleming, Michael F
Despite the enormous burden of alcohol-related injuries, the direct connection between college drinking and physical injury has not been well understood. The goal of this study was to assess the connection between alcohol consumption levels and college alcohol-related injury risk. A total of 12,900 college students seeking routine care in 5 college health clinics completed a general Health Screening Survey. Of these, 2,090 students exceeded at-risk alcohol use levels and participated in a face-to-face interview to determine eligibility for a brief alcohol intervention trial. The eligibility interview assessed past 28-day alcohol use and alcohol-related injuries in the past 6 months. Risk of alcohol-related injury was compared across daily drinking quantities and frequencies. Logistic regression analysis and the Bayesian Information Criterion were applied to compute the odds of alcohol-related injury based on daily drinking totals after adjusting for age, race, site, body weight, and sensation seeking. Male college students in the study were 19% more likely (95% CI: 1.12-1.26) to suffer an alcohol-related injury with each additional day of consuming 8 or more drinks. Injury risks among males increased marginally with each day of consuming 5 to 7 drinks (odds ratio = 1.03, 95% CI: 0.94-1.13). Female participants were 10% more likely (95% CI: 1.04-1.16) to suffer an alcohol-related injury with each additional day of drinking 5 or more drinks. Males (OR = 1.69, 95% CI: 1.14-2.50) and females (OR = 1.81, 95% CI: 1.27-2.57) with higher sensation-seeking scores were more likely to suffer alcohol-related injuries. College health clinics may want to focus limited alcohol injury prevention resources on students who frequently engage in extreme drinking, defined in this study as 8+M/5+F drinks per day, and score high on sensation-seeking disposition.
Moure-Rodríguez, Lucía; Caamaño-Isorna, Francisco; Doallo, Sonia; Juan-Salvadores, Pablo; Corral, Montserrat; Rodríguez-Holguín, Socorro; Cadaveira, Fernando
The main objective of this study is to evaluate the effect of heavy drinking on alcohol-related injuries. We carried out an open cohort study among university students in Spain (n=1,382). Heavy drinking and alcohol-related injuries were measured by administrating AUDIT questionnaires to every participant at the ages of 18, 20, 22 and 24. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for consumption of alcohol and cannabis. The response rate at the beginning of the study was 99.6% (1,369 students). The incidence rate of alcohol-related injuries was 3.2 per 100 students year. After adjusting for alcohol consumption and cannabis use, the multivariate model revealed that a high frequency of heavy drinking was a risk factor for alcohol-related injuries (Odds Ratio=3.89 [95%CI: 2.16 - 6.99]). The proportion of alcohol-related injuries in exposed subjects attributable to heavy drinking was 59.78% [95%CI: 32.75 - 75.94] while the population attributable fraction was 45.48% [95%CI: 24.91 - 57.77]. We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
Conclusion: We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern.
There was a significant association between alcohol-related problems and risky sexual behavior. Alcohol-related problems are fairly common in people already infected with HIV/AIDS and are associated with high-risk sexual behavior. Thus, screening and treatment should be part of an effective HIV intervention program.
Caamaño-Isorna, Francisco; Moure-Rodríguez, Lucía; Doallo, Sonia; Corral, Montserrat; Rodriguez Holguín, Socorro; Cadaveira, Fernando
The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration. We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use. The incidence rate of alcohol-related injuries was 0.028year -1 for females and 0.036year -1 for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR]=2.64 and OR=3.68), while being more than 23 is a protective factor (OR=0.34). For males, bivariate analysis also showed HED like risk factor (OR=4.69 and OR=2.51). Finally, the population attributable fraction for HED among females was 37.12%. HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HED. Copyright © 2016 Elsevier Ltd. All rights reserved.
Caviness, Celeste M; Anderson, Bradley J; Stein, Michael D
Energy drink consumption, with or without concurrent alcohol use, is common among young adults. This study sought to clarify risk for negative alcohol outcomes related to the timing of energy drink use. The authors interviewed a community sample of 481 young adults, aged 18-25, who drank alcohol in the last month. Past-30-day energy drink use was operationalized as no-use, use without concurrent alcohol, and concurrent use of energy drinks with alcohol ("within a couple of hours"). Negative alcohol outcomes included past-30-day binge drinking, past-30-day alcohol use disorder, and drinking-related consequences. Just over half (50.5%) reported no use of energy drinks,18.3% reported using energy drinks without concurrent alcohol use, and 31.2% reported concurrent use of energy drinks and alcohol. Relative to those who reported concurrent use of energy drinks with alcohol, and controlling for background characteristics and frequency of alcohol consumption, those who didn't use energy drinks and those who used without concurrent alcohol use had significantly lower binge drinking, negative consequences, and rates of alcohol use disorder (P energy drink without concurrent alcohol groups on any alcohol-related measure (P > .10 for all outcomes). Concurrent energy drink and alcohol use is associated with increased risk for negative alcohol consequences in young adults. Clinicians providing care to young adults could consider asking patients about concurrent energy drink and alcohol use as a way to begin a conversation about risky alcohol consumption while addressing 2 substances commonly used by this population.
Miskulin, Ivan; Peek-Asa, Corinne; Miskulin, Maja
The aim of this study was to describe the alcohol consumption patterns and to identify the association of injury with excess drinking among Croatian students. This cross-sectional study was conducted among 845 university students by the use of the WHO AUDIT questionnaire. A total of 39.9% of the university students reported some level of excess…
McHugh, E E
This paper outlines the preventive health strategic measures that are currently in place and it endeavours to consider how improvements can be made to our national preventive strategy with the goal of reducing alcohol-related facial injuries. It is based on a review of the literature sourced through PubMed, Ovid Medline and the Cochrane database. The main findings are that increased funding, legislative amendment and media involvement are key to improving the work of the health services in their struggle to limit the ever increasing alcohol-related incidents that are experienced by society today.
Brenner, James W; Metz, Stacie M; Entriken, Jack; Brenner, Christina J
Alcohol-related unintentional injury (ARUI) has been an unexamined consequence of alcohol consumption by collegiate athletes. It has a potentially devastating effect on their athletic performances and careers. Awareness of this problem in athletes could have a huge effect on what athletic trainers (ATs) do to recognize, treat, and prevent it in a collegiate athlete population. To examine the experiences and attitudes among collegiate and university ATs about ARUI in the athletes in their care. Cross-sectional study. Web-based survey. A total of 1767 e-mail addresses for collegiate and university ATs within National Athletic Trainers' Association Districts 1, 2, 3, and 9. We calculated frequencies, percentages, and attitudes of ATs regarding ARUI in collegiate athletes during the 2010-2011 academic year. The resulting sample size for the analysis was 459 (26.0%) participants of the initial total sample. More than 56% (n = 260) of the ATs reported that they had evaluated, treated, or referred if needed at least 1 ARUI in a collegiate athlete. On average, these ATs had evaluated, treated, or referred if needed 3 alcohol-related unintentional injuries within the 2010-2011 academic year. About 73% (n = 331) of ATs agreed that ARUI is a serious problem. Nearly 80% (n = 358) indicated they believe ATs should receive more training to identify student-athletes with alcohol-related problems. Alcohol-related unintentional injury is a common and serious consequence of alcohol use among collegiate athletes. Many ATs also view it as a serious problem yet would like more training in how to address it. Alcohol-related unintentional injury may have important negative effects on the careers and athletic performances of athletes. Researchers need to determine how prevalent ARUI is in the collegiate athlete population and what ATs can do to address it.
Hides, Leanne; Limbong, Jesani; Vallmuur, Kirsten; Barker, Ruth; Daglish, Mark; Young, Ross McD
The rate of alcohol-related emergency department (ED) presentations in young people has increased dramatically in recent decades. Injuries are the most common type of youth alcohol-related ED presentation, yet little is known about these injuries in young people. This paper describes the characteristics of alcohol-related ED injury presentations in young people over a 13-year period and determines if they differ by gender and/or age group (adolescents: 12-17 years; young adults: 18-24 years). The Queensland Injury Surveillance Unit (QISU) database collects injury surveillance data at triage in participating EDs throughout Queensland, Australia. A total of 4667 cases of alcohol-related injuries in young people (aged 12-24 years) were identified in the QISU database between January 1999 and December 2011, using an injury surveillance code and nursing triage text-based search strategy. Overall, young people accounted for 38% of all QISU alcohol-related ED injury presentations in patients aged 12 years or over. The majority of young adults presented with injuries due to violence and falls, whereas adolescents presented due to self-harm or intoxication without other injury. Males presented with injuries due to violence, whereas females presented with alcohol-related self-harm and intoxication. There is a need for more effective ways of identifying the degree of alcohol involvement in injuries among young people presenting to EDs. © 2014 Australasian Professional Society on Alcohol and other Drugs.
Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka
A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. We followed a nationally representative sample of 950,158 Finnish adults in 1995-2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976-0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995-2007. However, the rise in the proportion of antidepressant users receiving minimally adequate treatment, possibly
Full Text Available OBJECTIVES: A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. METHODS: We followed a nationally representative sample of 950,158 Finnish adults in 1995-2007 for alcohol-related (n = 2,859 and non-alcohol-related (n = 8,632 suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. RESULTS: The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976-0.998. This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. CONCLUSION: We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995-2007. However, the rise in the proportion of
Howell, Steven M; Barry, Adam E; Pitney, William A
Compared with their nonathlete peers, collegiate athletes consume higher quantities of alcohol, drink with greater frequency, and exhibit an increased propensity to engage in heavy episodic drinking (ie, binge drinking), which often may result in alcohol-related consequences. Moreover, collegiate athletes are also more likely to engage in other maladaptive lifestyle behaviors, such as participating in physical fights and riding with an intoxicated driver, and less likely to engage in protective behaviors, such as wearing a helmet while operating a motorcycle, moped, or bicycle. Taken together, these behaviors clearly pose a health risk for student-athletes and increase the likelihood that they will experience an alcohol-related unintentional injury (ARUI). An ARUI represents a risk not only to the health and well-being of collegiate athletes but also to their athletic performances, collegiate careers, and potential professional opportunities. Therefore, athletic trainers need to be equipped with the knowledge and skills to provide face-to-face brief interventions to student-athletes presenting with ARUIs and to evaluate the effect of their involvement. We address potential action items for implementation by athletic trainers.
Ahmed, Rimsha; Hustad, John T. P.; LaSalle, Linda; Borsari, Brian
Objective: The purpose of this study is to investigate whether pregaming (ie, drinking prior to a social event) is a risk factor for hospitalization. Participants: Participants (N = 516) were undergraduate students with an alcohol-related sanction. Methods: Participants completed a survey about alcohol use, as well as behaviors and experiences,…
Full Text Available Objectives: Drug related mental imagery is proposed to play a central role in addictive behaviour. However, little is known about such cognition or how it is pharmacologically modulated. Here, we test theoretical predictions of the âelaborated intrusionâ theory by comparing neutral with alcohol related mental imagery, and examine the effects of low dose alcohol on phenomenological aspects of this imagery. Methods: Alcohol related and neutral imagery was assessed after at risk drinkers (n=40 consumed alcohol (0.3g/kg or placebo, in a crossover design. Sensory and visuospatial qualities of imagery, along with associated craving, positive affect and âmind wanderingâ were assessed. Results: Alcohol related mental imagery was rated as more vivid and sensorially rich, effects that were larger following the priming dose of alcohol. In addition, mind wandering was substantially lower during alcohol versus neutral imagery, especially after alcohol consumption. First person perspective was more prevalent for alcohol imagery after alcohol, although the DrinkÃImagery type interaction did not reach statistical significance. However, first person imagery was associated with higher levels of craving during alcohol related imagery. Conclusions: Alcohol related mental imagery differs phenomenologically from neutral imagery on a number of dimensions. Priming with alcohol may enable cognitive elaboration by biasing the output of controlled cognitive processing towards enhanced sensory elaboration and increased attention to alcohol related cognition. These feedforward effects may be involved in focusing cognitive and behavioural resources on alcohol acquisition/consumption through the elaboration and rehearsal of relevant goals and plans. Keywords: Mental imagery, Elaborated intrusion theory, Alcohol, Alcohol priming, Craving, Mind wandering
Full Text Available This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016 were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC, pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.
Coomber, Kerri; Mayshak, Richelle; Hyder, Shannon; Droste, Nicolas; Curtis, Ashlee; Pennay, Amy; Gilmore, William; Lam, Tina; Chikritzhs, Tanya; Miller, Peter G
This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews ( n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.
Andreuccetti, Gabriel; Carvalho, Heraclito B.; Ye, Yu; Bond, Jason; Monteiro, Maristela; Borges, Guilherme; Cherpitel, Cheryl J.
Background Previous studies have already substantiated alcohol’s causal role in injuries. Yet the role that alcoholic beverage preferences and the drinking context play in the risk for injury is still under-investigated. In this study a cross-national comparison of the association between alcohol and injury focusing on beverage type preference and the drinking context is reported. Methods Emergency department injured patients were interviewed in eight countries from the Latin American and Caribbean (LAC) region. Data on the type of alcoholic beverage, total alcohol volume, and the place where the injury occurred were obtained from patients who reported any alcohol consumption within 6 hours prior to being injured. Patients who did not drink prior to injury were also asked about their typical drinking pattern and the injury place. Differences within- and between-groups were evaluated regarding patients’ typical drinking and drinking before injury. Results Beer was the most prevalent beverage type usually consumed among injured patients across countries, however, patients who drank before injury had a higher typical consumption of spirits than those not drinking prior to injury. The total alcohol volume typically consumed and drinking in public settings were also found to be positively associated with alcohol-related injury. Conclusions A similar beverage-specific association with alcohol-related injury was found across LAC countries, mainly attributed to beer consumption, and spirits drinkers seem to have a greater chance of becoming involved in injury events. Future prevention strategies should inform the public about harms from drinking associated with the context in which drinking takes place. PMID:24556276
Yoshimoto, Hisashi; Takayashiki, Ayumi; Goto, Ryohei; Saito, Go; Kawaida, Kyoko; Hieda, Rika; Kataoka, Yoshihiro; Aramaki, Maie; Sakamoto, Naoto; Maeno, Tetsuhiro; Kobayashi, Yoshinao; Takemura, Yousuke C
Alcohol-related injuries in college students are a major public health problem worldwide. We clarified the association between excessive drinking and alcohol-related injuries in Japanese college students. This was a cross-sectional study with a self-administered questionnaire. From January to March 2013, we sampled all college students and graduate students aged 20 years or older during annual health examinations at three colleges in Mie Prefecture in Japan. The questionnaire assessed the frequency of alcohol drinking, amount of alcohol consumed per day, binge drinking during the past year, alcohol-related injuries during the past year, and demographic data. Logistic regression analysis was conducted on the association between excessive alcohol use and alcohol-related injuries. A total of 2,842 students underwent health examinations, of whom 2,177 (76.6%) completed the questionnaire. Subjects included 1,219 men (56.0%) and 958 women (44.0%). Eighty-eight men (7.2%) and 93 women (9.7%) were classified as excessive weekly drinkers, while 693 men (56.8%) and 458 women (47.8%) were determined to be binge drinkers. Eighty-one men (6.6%) and 26 women (2.7%) had experienced alcohol-related injuries during the past year. In the logistic regression analysis, binge drinkers (odds ratio 25.6 [8.05-81.4]) and excessive weekly drinkers (odds ratio 3.83 [2.41-6.09]) had a history of significantly more alcohol-related injuries, even after adjusting for age and sex. In conclusion, alcohol-related injuries in college students in Japan were strongly associated with excessive drinking. As a strategy for preventing such injuries in this population, an interventional study is required to identify effective methods for reducing excessive alcohol use.
Ferris, Jason; Killian, Jessica; Lloyd, Belinda
According to the most recent statistics from the World Health Organization, 1.2 million people die or are injured on the world's roads every year. Drink-driving continues to be a major risk factor for road traffic crashes, with 22% of serious road injuries (SRIs) in Victoria involving a blood alcohol concentration (BAC) equal to or above the legal driving limit of 0.05g/mL. Use of police and hospital data to determine alcohol involvement in SRIs is not reliable, with researchers using proxy measures such as high alcohol hours (HAH). This paper examines patterns of alcohol-related SRIs based on reported BAC versus the surrogate HAH measure. Trends over a 10year period (2000-2010) were examined, comparing four different SRI rates (low alcohol hours (LAH), LAH with positive BAC, HAH, HAH with positive BAC). Discontinuities in the data series were also examined. SRI data were drawn from the Road Networks Database of VicRoads containing information on all reported road crashes in Victoria. For the 10year period there were 52,286 reported SRIs relating to the driver. Of the incidents where a driver's reading was recorded, 44% had a recorded BAC exceeding Victoria's legal limit of 0.05% and a further 23% had a BAC below the legal limit. During the period over 17,000 (or 34%) SRIs occurred during HAH. Where a BAC had been recorded during HAH, almost 60% exceeded the legal limit and a further 20% had some positive recording of BAC. Where SRI drivers had a recorded BAC during LAH, 58% had a positive BAC (31% with a BAC over the legal limit). While it is likely that an SRI occurring during HAH will be associated with a positive BAC (80%), of which 60% will be above the legal limit, almost 60% of SRIs during LAH had a positive BAC, with 31% above the legal limit. There was no significant change in overall alcohol-related SRI rates between 2000 and 2010, suggesting that policies and procedures implemented to decrease drink-driving have not reduced alcohol-related SRI rates. In
de Goeij, Moniek C M; Veldhuizen, Eleonore M; Buster, Marcel C A; Kunst, Anton E
The municipality of Amsterdam implemented a new alcohol policy allowing alcohol outlets in two of the five nightlife areas to extend their closing times from 1 April 2009 onwards. We investigated how levels and trends of alcohol-related injuries changed after implementation of this alcohol policy, by comparing areas with extended closing times to those without. A controlled before-and-after evaluation to compare changes in alcohol-related injuries between intervention and control areas. Central district of Amsterdam, The Netherlands. Alcohol-related ambulance attendances for control and intervention areas between 1 April 2006 and 1 April 2009 (respectively, n = 544 and n = 499) and between 1 April 2009 and 1 April 2011 (respectively, n = 357 and n = 480). Alcohol-related injuries were defined as ambulance attendances for people who suffered from direct or indirect consequences of alcohol consumption. Injuries were counted per month in two intervention and three control nightlife areas. We used Poisson regression to assess changes in injuries. After 1 April 2009, intervention areas showed a larger change in the level of alcohol-related injuries than control areas [incidence rate ratio 1.34, 95% confidence interval (CI) = 1.12, 1.61], but trends remained stable in all areas. This increase was only statistically significant for the following subgroups: 2.00-5.59 a.m., weekend days, men, individuals aged 25-34 years, and people transported to a hospital. However, the increase did not differ between subgroups with statistical significance. A 1-hour extension of alcohol outlet closing times in some of Amsterdam's nightlife areas was associated with 34% more alcohol-related injuries. © 2015 Society for the Study of Addiction.
Thush, Carolien; Wiers, Reinout W.; Moerbeek, Mirjam; Ames, Susan L.; Grenard, Jerry L.; Sussman, Steve; Stacy, Alan W.
Both implicit and explicit cognitions play an important role in the development of addictive behavior. This study investigated the influence of a single-session motivational interview (MI) on implicit and explicit alcohol-related cognition and whether this intervention was successful in consequently decreasing alcohol use in at-risk adolescents. Implicit and explicit alcohol-related cognitions were assessed at pretest and one month posttest in 125 Dutch at-risk adolescents ranging in age from 15 to 23 (51 males) with adapted versions of the Implicit Association Test (IAT) and an expectancy questionnaire. Motivation to change, alcohol use and alcohol-related problems were measured with self-report questionnaires, at pretest, at posttest after one month, and at the six-month follow-up. Although the quality of the intervention was rated positively, the results did not yield support for any differential effects of the intervention on drinking behavior or readiness to change at posttest and six-month follow-up. There were indications of changes in implicit and explicit alcohol-related cognitions between pretest and posttest. Our findings raise questions regarding the use of MI in this particular at-risk adolescent population and the mechanisms through which MI is effective. PMID:19290699
Johnson, Patrick B.; And Others
Although research on children of alcoholics indicates that they are at high risk for later problem drinking, the etiological dynamics associated with this heightened risk status are not yet understood. This study compared the alcohol-related beliefs of subjects who possessed close relatives with alcohol problems with alcohol-related beliefs of…
O'Brien, Mary Claire; McCoy, Thomas P; Rhodes, Scott D; Wagoner, Ashley; Wolfson, Mark
The consumption of alcohol mixed with energy drinks (AmED) is popular on college campuses in the United States. Limited research suggests that energy drink consumption lessens subjective intoxication in persons who also have consumed alcohol. This study examines the relationship between energy drink use, high-risk drinking behavior, and alcohol-related consequences. In Fall 2006, a Web-based survey was conducted in a stratified random sample of 4,271 college students from 10 universities in North Carolina. A total of 697 students (24% of past 30-day drinkers) reported consuming AmED in the past 30 days. Students who were male, white, intramural athletes, fraternity or sorority members or pledges, and younger were significantly more likely to consume AmED. In multivariable analyses, consumption of AmED was associated with increased heavy episodic drinking (6.4 days vs. 3.4 days on average; p Students who reported consuming AmED had significantly higher prevalence of alcohol-related consequences, including being taken advantage of sexually, taking advantage of another sexually, riding with an intoxicated driver, being physically hurt or injured, and requiring medical treatment (p student's reported typical alcohol consumption (interaction p = 0.027). Almost one-quarter of college student current drinkers reported mixing alcohol with energy drinks. These students are at increased risk for alcohol-related consequences, even after adjusting for the amount of alcohol consumed. Further research is necessary to understand this association and to develop targeted interventions to reduce risk.
Parks, Kathleen A.; Levonyan-Radloff, Kristine; Dearing, Ronda L.; Hequembourg, Amy; Testa, Maria
Objective Using an iterative process, a series of three video scenarios were developed for use as a standardized measure for assessing women’s perception of risks for alcohol-related sexual assault (SA). The videos included ambiguous and clear behavioral and environmental risk cues. Method Focus group discussions with young, female heavy drinkers (N = 42) were used to develop three videos at different risk levels (low, moderate, and high) in Study 1. Realism, reliability, and validity of the videos were assessed using multiple methods in Studies 2 and 3. One hundred-four women were used to compare differences in risk perception across the video risk level in Study 2. In Study 3 (N = 60), we assessed women’s perceptions of the low and high risk videos under conditions of no alcohol and alcohol. Results The realism and reliability of the videos were good. Women who viewed the low risk video compared to women who viewed the moderate and high risk videos perceived less risk for SA. We found an interaction between alcohol and risk perception such that, women in the alcohol condition were less likely to perceive risk when watching the high risk video. Conclusions As the video risk level increased, women’s perception of risk increased. These findings provide convergent evidence for the validity of the video measure. Given the limited number of standardized scenarios for assessing risk perception for sexual assault, our findings suggest that these videos may provide a needed standardized measure. PMID:27747131
MacKillop, James; Celio, Mark A; Mastroleo, Nadine R; Kahler, Christopher W; Operario, Don; Colby, Suzanne M; Barnett, Nancy P; Monti, Peter M
The discipline of behavioral economics integrates principles from psychology and economics to systematically characterize decision-making preferences. Two forms of behavioral economic decision making are of relevance to HIV risk behavior: delay discounting, reflecting preferences for immediate small rewards relative to larger delayed rewards (i.e., immediate gratification), and probability discounting, reflecting preferences for larger probabilistic rewards relative to smaller guaranteed rewards (i.e., risk sensitivity). This study examined questionnaire-based indices of both types of discounting in relation to sexual risk taking in an emergency department sample of hazardous drinkers who engage in risky sexual behavior. More impulsive delay discounting was significantly associated with increased sexual risk-taking during a drinking episode, but not general sexual risk-taking. Probability discounting was not associated with either form of sexual risk-taking. These findings implicate impulsive delay discounting with sexual risk taking during alcohol intoxication and provide further support for applying this approach to HIV risk behavior.
Rota-Bartelink, Alice; Lipmann, Bryan
For years, community service providers have been frustrated with the lack in availability of long-term, specialized supported accommodation for older people, particularly older homeless people, with severe acquired brain injury (ABI) and challenging behaviors. Although the incidence of ABI (particularly alcohol-related brain injury) is far wider than being confined to the homeless population, it is frequently misdiagnosed and very often misunderstood Wintringham is an independent welfare company in Melbourne, Australia, that provides secure, affordable, long-term accommodation and high quality services to older homeless people. The high incidence of alcohol abuse among the resident population has led us to adapt our model ofcare to accommodate a complexity of need. However, there are some individuals with severely affected behaviors that continue to challenge Wintringham's capacity to provide adequate support. The deficiency in highly specialized, long-term supported accommodation for older people with severe alcohol-related brain injury (ARBI) is the driving force behind this project. We aim to further develop and improve the current Wintringham model of residential care to better support people with these complex care needs. We will report on the synthesis of this project which aims to test a specialized model that can be reproduced or adapted by other service providers to improve the life circumstances of these frequently forgotten people.
Lamis, Dorian A.; Malone, Patrick S.
The relationship among alcohol-related problems, perceived burdensomeness, thwarted belongingness, and suicide proneness in undergraduate college students (N = 996) was examined. As hypothesized, alcohol-related problems, perceived burdensomeness, and thwarted belongingness were all significantly and positively correlated with suicide proneness.…
Two scales were used for data collection: Alcohol Use Disorder Identification Test (AUDIT) and HIV/AIDS Risk Behaviour Questionnaire (HRBQ) and the collected data were subjected to Chi-square goodness of fit test. Two hypotheses were tested in this study. The first hypothesis predicted a significant association between ...
Meyers, Jacquelyn L; Shmulewitz, Dvora; Wall, Melanie M; Keyes, Katherine M; Aharonovich, Efrat; Spivak, Baruch; Weizman, Abraham; Frisch, Amos; Edenberg, Howard J; Gelernter, Joel; Grant, Bridget F; Hasin, Deborah
Childhood adversity and genetic variant ADH1B-rs1229984 have each been shown to influence heavy alcohol consumption and disorders. However, little is known about how these factors jointly influence these outcomes. We assessed the main and additive interactive effects of childhood adversity (abuse, neglect and parental divorce) and the ADH1B-rs1229984 on the quantitative phenotypes 'maximum drinks in a day' (Maxdrinks) and DSM-Alcohol Use Disorder (AUD) severity, adjusting for demographic variables, in an Israeli sample of adult household residents (n = 1143) evaluated between 2007 and 2009. Childhood adversity and absence of the protective ADH1B-rs1229984 A allele were associated with greater mean Maxdrinks (mean differences: 1.50; 1.13, respectively) and AUD severity (mean ratios: 0.71; 0.27, respectively). In addition, childhood adversity moderated the ADH1B-rs1229984 effect on Maxdrinks (P childhood adversity compared with those who had not. ADH1B-rs1229984 impacts alcohol metabolism. Therefore, among those at risk for greater consumption, e.g. those who experienced childhood adversity, ADH1B-rs1229984 appears to have a stronger effect on alcohol consumption and consequently on risk for AUD symptom severity. Evidence for the interaction of genetic vulnerability and early life adversity on alcohol-related phenotypes provides further insight into the complex relationships between genetic and environmental risk factors. © 2013 Society for the Study of Addiction.
Diulio, Andrea R; Dutta, Nicole M; Gauthier, Jami M; Witte, Tracy K; Correia, Christopher J; Angarano, Donna
Hazardous alcohol consumption among medical students appears to occur at a level comparable to the general population; however, among medical students, it has been found that the motivation to use alcohol partially stems from unique stressors related to their professional training. Although veterinary students may also experience psychological distress in association with their training, little work has focused on the way that these students use alcohol to cope with their distress. The current study sought to examine the severity of depressive symptoms and alcohol consumption among veterinary students as well as students' specific motives for drinking alcohol. The majority of our sample reported experiencing at least one depressive symptom, and a significant proportion engaged in high-risk drinking, with men reporting more harmful alcohol use patterns. Drinking motives related to managing internal bodily and emotional states accounted for variance in drinking patterns. Further, drinking to ameliorate negative emotions partially accounted for the relationship between psychological distress and high-risk drinking. The results of this study suggest that depressive symptoms among veterinary students may be related to harmful drinking patterns, due to alcohol being used as a coping mechanism to regulate emotions. The findings from this study can be used to develop targeted interventions to promote psychological well-being among veterinary students.
Des Rosiers, Sabrina E; Schwartz, Seth J; Zamboanga, Byron L; Ham, Lindsay S; Huang, Shi
The present study used a cultural and social cognitive conceptual framework to investigate whether alcohol expectancies and valuations would mediate the associations between specific acculturation orientations and alcohol-related risk behaviors. The sample comprised 1,527 Hispanic students attending colleges and universities in diverse regions of the United States. Respondents completed self-report measures of Hispanic and American cultural practices; alcohol expectancies and valuations; and self-reported frequency of hazardous alcohol use, binge drinking, sexual activity under the influence of alcohol, driving under the influence of alcohol, and riding with a drunk driver. Latent class analysis was used to classify participants into acculturation orientations. Results indicated that acculturation orientations were differentially associated with alcohol-related risk outcomes, with separated bicultural and low bicultural orientations inversely related to all of the alcohol-related risk behaviors except for riding with a drunk driver. Negative expectancy valuations were positively associated with endorsement of binge drinking and drunk driving and negative expectancies were negatively associated with binge drinking, drunk driving, and riding with a drunk driver. With the exception of sexual activity under the influence of alcohol, the associations between acculturation orientations and alcohol-related risk behaviors were partially mediated by positive alcohol expectancies. Our findings provided relevant data that are informative for preventing alcohol and related risk behaviors among Hispanic college students. © 2012 Wiley Periodicals, Inc.
Mies, Gabry W; Verweij, Karin J H; Treur, Jorien L; Ligthart, Lannie; Fedko, Iryna O; Hottenga, Jouke Jan; Willemsen, Gonneke; Bartels, Meike; Boomsma, Dorret I; Vink, Jacqueline M
Genetic and environmental factors contribute about equally to alcohol-related phenotypes in adulthood. In the present study, we examined whether more stress at home or low satisfaction with life might be associated with heavier drinking or more alcohol-related problems in individuals with a high genetic susceptibility to alcohol use. Information on polygenic scores and drinking behavior was available in 6705 adults (65% female; 18-83 years) registered with the Netherlands Twin Register. Polygenic risk scores (PRSs) were constructed for all subjects based on the summary statistics of a large genome-wide association meta-analysis on alcohol consumption (grams per day). Outcome measures were quantity of alcohol consumption and alcohol-related problems assessed with the Alcohol Use Disorders Identification Test (AUDIT). Stress at home and life satisfaction were moderating variables whose significance was tested by Generalized Estimating Equation analyses taking familial relatedness, age and sex into account. PRSs for alcohol were significantly associated with quantity of alcohol consumption and alcohol-related problems in the past year (R 2 =0.11% and 0.10% respectively). Participants who reported to have experienced more stress in the past year and lower life satisfaction, scored higher on alcohol-related problems (R 2 =0.27% and 0.29 respectively), but not on alcohol consumption. Stress and life satisfaction did not moderate the association between PRSs and the alcohol outcome measures. There were significant main effects of polygenic scores and of stress and life satisfaction on drinking behavior, but there was no support for PRS-by-stress or PRS-by-life satisfaction interactions on alcohol consumption and alcohol-related problems. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Williams, Annie; Moore, Simon C; Shovelton, Claire; Moore, Laurence; Murphy, Simon
Alcohol-related violence is associated with licensed premise environments and their management. There is a lack of evidence for effective interventions to address these, and there are significant barriers to implementation. This study aims to understand how development and implementation processes can facilitate intervention reach, fidelity and receipt and therefore provides key process data necessary to interpret the results of the randomised controlled trial conducted in parallel. A process evaluation, embedded within a randomised controlled trial. Intervention development and implementation were assessed via focus groups (n = 2) and semi-structured interviews (n = 22) with Environmental Health Practitioners (EHPs). Reach and fidelity were assessed via routinely collected intervention data, which was was collected from 276 licenced premises across Wales, UK. Case study semi-structured interviews with licensed premises proprietors (n = 30) explored intervention receipt. Intervention co-production with senior EHPs facilitated organisational adoption and implementation. Training events for EHPs played an important role in addressing wider organisational concerns regarding partnership working and the contextual integration of the intervention. EHPs delivered the intervention to 98 % of intervention premises; 35 % of premises should have received a follow up enforcement visit, however EHP confidence in dealing with alcohol risk factors meant only 7 % of premises received one. Premises therefore received a similar intervention dose regardless of baseline risk. Intervention receipt appeared to be greatest in premises with an existing commitment to prevention and those in urban environments. The study suggests that a collaborative approach to the development and diffusion of interventions is associated with high levels of organisational adoption, implementation and reach. However, the lack of enforcement visits represents implementation failure for a key
Full Text Available Abstract Background Alcohol-related violence is associated with licensed premise environments and their management. There is a lack of evidence for effective interventions to address these, and there are significant barriers to implementation. This study aims to understand how development and implementation processes can facilitate intervention reach, fidelity and receipt and therefore provides key process data necessary to interpret the results of the randomised controlled trial conducted in parallel. Methods A process evaluation, embedded within a randomised controlled trial. Intervention development and implementation were assessed via focus groups (n = 2 and semi-structured interviews (n = 22 with Environmental Health Practitioners (EHPs. Reach and fidelity were assessed via routinely collected intervention data, which was was collected from 276 licenced premises across Wales, UK. Case study semi-structured interviews with licensed premises proprietors (n = 30 explored intervention receipt. Results Intervention co-production with senior EHPs facilitated organisational adoption and implementation. Training events for EHPs played an important role in addressing wider organisational concerns regarding partnership working and the contextual integration of the intervention. EHPs delivered the intervention to 98 % of intervention premises; 35 % of premises should have received a follow up enforcement visit, however EHP confidence in dealing with alcohol risk factors meant only 7 % of premises received one. Premises therefore received a similar intervention dose regardless of baseline risk. Intervention receipt appeared to be greatest in premises with an existing commitment to prevention and those in urban environments. Conclusions The study suggests that a collaborative approach to the development and diffusion of interventions is associated with high levels of organisational adoption, implementation and reach. However, the lack
Varvil-Weld, Lindsey; Mallett, Kimberly A; Turrisi, Rob; Cleveland, Michael J; Abar, Caitlin C
Previous research identified a high-risk subgroup of students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). Although they consist of 20% of the population and account for nearly 50% of the consequences, the MRC group has not been the focus of etiological or prevention research. The present study identified pre-college profiles of psychosocial and behavioral characteristics and examined the association between these profiles and membership in the MRC group. The sample consisted of 370 first-year college students (57% female) recruited in the summer before college. Participants reported on typical drinking, alcohol-related risky and protective drinking behaviors, alcohol beliefs, descriptive and injunctive norms, and alcohol-related consequences at three time points over 15 months. Latent profile analysis identified four baseline student profiles: extreme-consequence drinkers, high-risk drinkers, protective drinkers, and nondrinkers. Logistic regression revealed that, when the high-risk drinkers were used as the reference group, both the protective drinkers and the nondrinkers were significantly less likely to be members of the MRC group, whereas the extreme-consequence drinkers were at increased odds of being in the MRC group, even after first-year drinking was controlled for. Student profiles and previously identified parental profiles both had unique main effects on MRC group membership, but there was no significant interaction between parental and student profiles. Findings suggest ways that brief interventions can be tailored for students and parents in relation to the MRC group.
Varvil-Weld, Lindsey; Mallett, Kimberly A.; Turrisi, Rob; Cleveland, Michael J.; Abar, Caitlin C.
Objective: Previous research identified a high-risk subgroup of students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). Although they consist of 20% of the population and account for nearly 50% of the consequences, the MRC group has not been the focus of etiological or prevention research. The present study identified pre-college profiles of psychosocial and behavioral characteristics and examined the association between these profiles and membership in the MRC group. Method: The sample consisted of 370 first-year college students (57% female) recruited in the summer before college. Participants reported on typical drinking, alcohol-related risky and protective drinking behaviors, alcohol beliefs, descriptive and injunctive norms, and alcohol-related consequences at three time points over 15 months. Results: Latent profile analysis identified four baseline student profiles: extreme-consequence drinkers, high-risk drinkers, protective drinkers, and nondrinkers. Logistic regression revealed that, when the high-risk drinkers were used as the reference group, both the protective drinkers and the nondrinkers were significantly less likely to be members of the MRC group, whereas the extreme-consequence drinkers were at increased odds of being in the MRC group, even after first-year drinking was controlled for. Student profiles and previously identified parental profiles both had unique main effects on MRC group membership, but there was no significant interaction between parental and student profiles. Conclusions: Findings suggest ways that brief interventions can be tailored for students and parents in relation to the MRC group. PMID:23739017
Petushek, Erich J.; Ward, Paul; Cokely, Edward T.; Myer, Gregory D.
Background: Simple observational assessment of movement is a potentially low-cost method for anterior cruciate ligament (ACL) injury screening and prevention. Although many individuals utilize some form of observational assessment of movement, there are currently no substantial data on group skill differences in observational screening of ACL injury risk. Purpose/Hypothesis: The purpose of this study was to compare various groups’ abilities to visually assess ACL injury risk as well as the associated strategies and ACL knowledge levels. The hypothesis was that sports medicine professionals would perform better than coaches and exercise science academics/students and that these subgroups would all perform better than parents and other general population members. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 428 individuals, including physicians, physical therapists, athletic trainers, strength and conditioning coaches, exercise science researchers/students, athletes, parents, and members of the general public participated in the study. Participants completed the ACL Injury Risk Estimation Quiz (ACL-IQ) and answered questions related to assessment strategy and ACL knowledge. Results: Strength and conditioning coaches, athletic trainers, physical therapists, and exercise science students exhibited consistently superior ACL injury risk estimation ability (+2 SD) as compared with sport coaches, parents of athletes, and members of the general public. The performance of a substantial number of individuals in the exercise sciences/sports medicines (approximately 40%) was similar to or exceeded clinical instrument-based biomechanical assessment methods (eg, ACL nomogram). Parents, sport coaches, and the general public had lower ACL-IQ, likely due to their lower ACL knowledge and to rating the importance of knee/thigh motion lower and weight and jump height higher. Conclusion: Substantial cross-professional/group differences in visual ACL
Cail, Jessica; LaBrie, Joseph W.
Although peer norms have been found to be a particularly strong correlate of alcohol consumption by college students, research suggests that parents also have a significant impact on the behaviors of their children, even after their child has departed for college. The current study investigated the effect of disparity between the perceived approval of alcohol (injunctive norms) of parents and closest friends on college student drinking and consequences, and explored gender differences in this effect. It found that injunctive disparity was significantly correlated with individual drinking and related consequences over and above the strongest known predictor variables of gender, same-sex descriptive norms and drinks per week. Males experienced significantly greater disparity between the beliefs of their parents and their peers, which was related increased drinking and a greater sense of connection to their same-sex peer group. Among females, greater perceived disparity was associated with greater alcohol-related consequences. These results suggest that it may not be the individual attitudes of parents and peers, but rather the difference between them, that is impacting behavior. Interventions that reduce perceived disparity, either by correcting the over-estimation of peer’s drinking, or by encouraging parents to stay involved in their children’s social lives by promoting socialization with peers whose attitudes more closely match their own, may be beneficial in reducing risky college drinking. PMID:19833444
Mundt, Marlon P.; Zakletskaia, Larissa I.; Brown, David D.; Fleming, Michael F.
Objective An alcohol-induced memory blackout represents an amnesia to recall events but does not involve a loss of consciousness. Memory blackouts are a common occurrence among college drinkers, but it is not clear if a history of memory blackouts is predictive of future alcohol-related injury above and beyond the risk associated with heavy drinking episodes. This analysis sought to determine if baseline memory blackouts can prospectively identify college students with alcohol-related injury in the next 24 months after controlling for heavy drinking days. Methods Data were analyzed from the College Health Intervention Project Study (CHIPS), a randomized controlled trial of screening and brief physician intervention for problem alcohol use among 796 undergraduate and 158 graduate students at four university sites in the US and one in Canada, conducted from 2004 to 2009. Multivariate analyses used generalized estimating equations (GEE) with the logit link. Results The overall 24-month alcohol-related injury rate was 25.6%, with no significant difference between males and females (p=.51). Alcohol-induced memory blackouts at baseline exhibited a significant dose-response on odds of alcohol-related injury during follow-up, increasing from 1.57 (95% CI: 1.13–2.19) for subjects reporting 1–2 memory blackouts at baseline to 2.64 (95% CI: 1.65–4.21) for students acknowledging 6+ memory blackouts at baseline. The link between memory blackouts and injury was mediated by younger age, prior alcohol-related injury, heavy drinking, and sensation-seeking disposition. Conclusions Memory blackouts are a significant predictor of future alcohol-related injury among college drinkers after adjusting for heavy drinking episodes. PMID:21708813
Mies, Gabry W; Verweij, Karin J H; Treur, Jorien L; Ligthart, Lannie; Fedko, Iryna O; Hottenga, Jouke Jan; Willemsen, Gonneke; Bartels, Meike; Boomsma, Dorret I; Vink, Jacqueline M
BACKGROUND: Genetic and environmental factors contribute about equally to alcohol-related phenotypes in adulthood. In the present study, we examined whether more stress at home or low satisfaction with life might be associated with heavier drinking or more alcohol-related problems in individuals
Mies, G.W.; Verweij, K.J.H.; Treur, J.L.; Ligthart, R.S.L.; Fedko, I.O.; Hottenga, J.J.; Willemsen, G.; Bartels, M.; Boomsma, D.I.; Vink, J.M.
Background: Genetic and environmental factors contribute about equally to alcohol-related phenotypes in adulthood. In the present study, we examined whether more stress at home or low satisfaction with life might be associated with heavier drinking or more alcohol-related problems in individuals
Scaglione, Nichole M; Hultgren, Brittney A; Reavy, Racheal; Mallett, Kimberly A; Turrisi, Rob; Cleveland, Michael J; Sell, Nichole M
Recent studies suggest drinking protective behaviors (DPBs) and contextual protective behaviors (CPBs) can uniquely reduce alcohol-related sexual risk in college students. Few studies have examined CPBs independently, and even fewer have utilized theory to examine modifiable psychosocial predictors of students' decisions to use CPBs. The current study used a prospective design to examine (a) rational and reactive pathways and psychosocial constructs predictive of CPB use and (b) how gender might moderate these influences in a sample of college students. Students (n = 508) completed Web-based baseline (mid-Spring semester) and 1- and 6-month follow-up assessments of CPB use; psychosocial constructs (expectancies, normative beliefs, attitudes, and self-concept); and rational and reactive pathways (intentions and willingness). Regression was used to examine rational and reactive influences as proximal predictors of CPB use at the 6-month follow-up. Subsequent path analyses examined the effects of psychosocial constructs, as distal predictors of CPB use, mediated through the rational and reactive pathways. Both rational (intentions to use CPB) and reactive (willingness to use CPB) influences were significantly associated with increased CPB use. The examined distal predictors were found to effect CPB use differentially through the rational and reactive pathways. Gender did not significantly moderate any relationships within in the model. Findings suggest potential entry points for increasing CPB use that include both rational and reactive pathways. Overall, this study demonstrates the mechanisms underlying how to increase the use of CPBs in programs designed to reduce alcohol-related sexual consequences and victimization. (c) 2015 APA, all rights reserved).
Whitcomb, David C.; LaRusch, Jessica; Krasinskas, Alyssa M.; Klei, Lambertus; Smith, Jill P.; Brand, Randall E.; Neoptolemos, John P.; Lerch, Markus M.; Tector, Matt; Sandhu, Bimaljit S.; Guda, Nalini M.; Orlichenko, Lidiya; Alkaade, Samer; Amann, Stephen T.; Anderson, Michelle A.; Baillie, John; Banks, Peter A.; Conwell, Darwin; Coté, Gregory A.; Cotton, Peter B.; DiSario, James; Farrer, Lindsay A.; Forsmark, Chris E.; Johnstone, Marianne; Gardner, Timothy B.; Gelrud, Andres; Greenhalf, William; Haines, Jonathan L.; Hartman, Douglas J.; Hawes, Robert A.; Lawrence, Christopher; Lewis, Michele; Mayerle, Julia; Mayeux, Richard; Melhem, Nadine M.; Money, Mary E.; Muniraj, Thiruvengadam; Papachristou, Georgios I.; Pericak-Vance, Margaret A.; Romagnuolo, Joseph; Schellenberg, Gerard D.; Sherman, Stuart; Simon, Peter; Singh, Vijay K.; Slivka, Adam; Stolz, Donna; Sutton, Robert; Weiss, Frank Ulrich; Wilcox, C. Mel; Zarnescu, Narcis Octavian; Wisniewski, Stephen R.; O'Connell, Michael R.; Kienholz, Michelle L.; Roeder, Kathryn; Barmada, M. Michael; Yadav, Dhiraj; Devlin, Bernie; Albert, Marilyn S.; Albin, Roger L.; Apostolova, Liana G.; Arnold, Steven E.; Baldwin, Clinton T.; Barber, Robert; Barnes, Lisa L.; Beach, Thomas G.; Beecham, Gary W.; Beekly, Duane; Bennett, David A.; Bigio, Eileen H.; Bird, Thomas D.; Blacker, Deborah; Boxer, Adam; Burke, James R.; Buxbaum, Joseph D.; Cairns, Nigel J.; Cantwell, Laura B.; Cao, Chuanhai; Carney, Regina M.; Carroll, Steven L.; Chui, Helena C.; Clark, David G.; Cribbs, David H.; Crocco, Elizabeth A.; Cruchaga, Carlos; DeCarli, Charles; Demirci, F. Yesim; Dick, Malcolm; Dickson, Dennis W.; Duara, Ranjan; Ertekin-Taner, Nilufer; Faber, Kelley M.; Fallon, Kenneth B.; Farlow, Martin R.; Ferris, Steven; Foroud, Tatiana M.; Frosch, Matthew P.; Galasko, Douglas R.; Ganguli, Mary; Gearing, Marla; Geschwind, Daniel H.; Ghetti, Bernardino; Gilbert, John R.; Gilman, Sid; Glass, Jonathan D.; Goate, Alison M.; Graff-Radford, Neill R.; Green, Robert C.; Growdon, John H.; Hakonarson, Hakon; Hamilton-Nelson, Kara L.; Hamilton, Ronald L.; Harrell, Lindy E.; Head, Elizabeth; Honig, Lawrence S.; Hulette, Christine M.; Hyman, Bradley T.; Jicha, Gregory A.; Jin, Lee-Way; Jun, Gyungah; Kamboh, M. Ilyas; Karydas, Anna; Kaye, Jeffrey A.; Kim, Ronald; Koo, Edward H.; Kowall, Neil W.; Kramer, Joel H.; Kramer, Patricia; Kukull, Walter A.; LaFerla, Frank M.; Lah, James J.; Leverenz, James B.; Levey, Allan I.; Li, Ge; Lin, Chiao-Feng; Lieberman, Andrew P.; Lopez, Oscar L.; Lunetta, Kathryn L.; Lyketsos, Constantine G.; Mack, Wendy J.; Marson, Daniel C.; Martin, Eden R.; Martiniuk, Frank; Mash, Deborah C.; Masliah, Eliezer; McKee, Ann C.; Mesulam, Marsel; Miller, Bruce L.; Miller, Carol A.; Miller, Joshua W.; Montine, Thomas J.; Morris, John C.; Murrell, Jill R.; Naj, Adam C.; Olichney, John M.; Parisi, Joseph E.; Peskind, Elaine; Petersen, Ronald C.; Pierce, Aimee; Poon, Wayne W.; Potter, Huntington; Quinn, Joseph F.; Raj, Ashok; Raskind, Murray; Reiman, Eric M.; Reisberg, Barry; Reitz, Christiane; Ringman, John M.; Roberson, Erik D.; Rosen, Howard J.; Rosenberg, Roger N.; Sano, Mary; Saykin, Andrew J.; Schneider, Julie A.; Schneider, Lon S.; Seeley, William W.; Smith, Amanda G.; Sonnen, Joshua A.; Spina, Salvatore; Stern, Robert A.; Tanzi, Rudolph E.; Trojanowski, John Q.; Troncoso, Juan C.; Tsuang, Debby W.; Valladares, Otto; Van Deerlin, Vivianna M.; Van Eldik, Linda J.; Vardarajan, Badri N.; Vinters, Harry V.; Vonsattel, Jean Paul; Wang, Li-San; Weintraub, Sandra; Welsh-Bohmer, Kathleen A.; Williamson, Jennifer; Woltjer, Randall L.; Wright, Clinton B.; Younkin, Steven G.; Yu, Chang-En; Yu, Lei
Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR, and SPINK1 variants were associated with pancreatitis risk. We now report two significant genome-wide associations identified and replicated at PRSS1-PRSS2 (1×10-12) and x-linked CLDN2 (p < 1×10-21) through a two-stage genome-wide study (Stage 1, 676 cases and 4507 controls; Stage 2, 910 cases and 4170 controls). The PRSS1 variant affects susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous (or hemizygous male) CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men – male hemizygous frequency is 0.26, female homozygote is 0.07. PMID:23143602
Bekman, Nicole M.; Cummins, Kevin; Brown, Sandra A.
This study examines whether expectancies about the impact of not drinking or reducing alcohol use and perceptions of peer alcohol use partially mediated risk incurred by sensation seeking for adolescent alcohol involvement. High school drinkers (N = 3,153) completed a survey assessing substance use, sensation seeking, perceived peer alcohol use,…
Newman, Ian M; Ding, Lanyan; Shell, Duane F; Lin, Lida
Alcohol-related facial flushing is a sign of compromised alcohol metabolism and increased risk of certain cancers. This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks. Interviews with Chinese university students identified gender, friendship, and drinking purpose as important variables related to whether someone would encourage a person who flushes when drinking alcohol to stop or reduce their drinking. A questionnaire was developed that incorporated these variables into 24 drinking scenarios in which someone flushed while drinking. Students responded whether they would (a) encourage the flusher to stop or drink less; (b) do nothing while wishing they could; or (c) do nothing because there was no need. Analysis of survey responses from 2912 university students showed a three-way interaction of the variables and implied that the probability students will intervene when a drinker flushes was highest when the flusher was a female, a close friend, and the drinking purpose was for fun and lowest if the flusher was a male, the friendship was general, and the drinking purpose was risky. The results provide important details about the social factors affecting how other people respond to a person who flushes when drinking alcohol. This information is useful for those considering ways to reduce and prevent aerodigestive cancers through education and information programs.
Parkkari, J; Kannus, P; Natri, A; Lapinleimu, I; Palvanen, M; Heiskanen, M; Vuori, I; Järvinen, M
The purpose of this study was to get reliable insight into injury risk in various commuting and lifestyle activities, as well as recreational and competitive sports. A cohort of 3 657 persons was randomly selected from the 15- to 74-year-old Finnish population. Ninety-two percent (n = 3 363) of the subjects accepted to participate the one-year follow-up, record all their physical activities that lasted 15 min or more, and register all acute and overuse injuries that occurred during these activities. To collect the information, the study subjects were interviewed by phone by the trained personnel of the Statistics Finland three times in four-month intervals. The individual injury risk per exposure time was relatively low, ranging from 0.19 to 1.5 per 1 000 hours of participation, in commuting and lifestyle activities including walking and cycling to work, gardening, home repair, hunting and fishing, and, in sports such as golf, dancing, swimming, walking, and rowing. The risk was clearly higher in squash, orienteering, and contact and team sports, such as judo, wrestling, karate, rinkball, floorball, basketball, soccer, ice hockey, volleyball, and Finnish baseball ranging from 6.6 to 18.3 per 1 000 hours of participation. However, the highest absolute number of injuries occurred in low-risk activities, such as gardening, walking, home-repair, and cycling, because they are performed so often. In conclusion, individual injury risk per exposure hours is relatively low in commuting and lifestyle activities compared to many recreational and competitive sports. However, at a population level, these low-to-moderate intensity activities are widely practised producing a rather high absolute number of injuries, and thus, preventive efforts are needed in these activities, too.
LaBrie, Joseph W; Kenney, Shannon R; Napper, Lucy E; Miller, Kevin
The personality trait of impulsivity is predictive of heavy drinking and consequences among college students. The current study examined how impulsivity-measured via positive urgency, negative urgency, and sensation seeking-and a person's beliefs about the role alcohol plays in the college experience relate to drinking and consequences in a sample of 470 college students (mean age=19 years, 61.3% female, 59.8% White). In support of the hypotheses, sensation seeking independently predicted greater drinking, and both positive urgency and negative urgency predicted greater experience of alcohol-related negative consequences after controlling for consumption level. Moreover, alcohol beliefs moderated the relationship between impulsivity types and alcohol outcomes. Among students high (versus low) in sensation seeking, strong beliefs about alcohol's role in college life were related to significantly greater drinking, and among students high (versus low) in negative urgency, endorsing strong beliefs about alcohol's role in college life were related to greater levels of alcohol-related negative consequences. Overall, findings inform college prevention efforts by highlighting the need to distinguish unique facets of impulsivity and examine how they intersect with students' beliefs about alcohol in college. © 2013.
Orchowski, Lindsay M.; Mastroleo, Nadine R.; Borsari, Brian
The prevalence of alcohol-related regretted sex in college students warrants a better understanding of the characteristics of students who report such experiences. Therefore, the present study examined correlates of regretted sexual experiences involving alcohol use among two specific high-risk college student samples: Students mandated to alcohol intervention (N = 522) and volunteer first-year students transitioning to college (N = 481). Results indicated that alcohol-related regretted sex occurred in similar rates in mandated and volunteer students, with approximately 25% of the students reporting at least one occurrence in the past month. Women were more likely to report alcohol-related regretted sex compared to men. The belief that alcohol use would result in “liquid courage” was associated with alcohol-related regretted sex among college students, even after accounting for greater alcohol use and problem alcohol use behaviors. These findings have significant implications for intervention efforts and future research. PMID:22448762
Orchowski, Lindsay M; Mastroleo, Nadine R; Borsari, Brian
The prevalence of alcohol-related regretted sex in college students warrants a better understanding of the characteristics of students who report such experiences. Therefore, the present study examined correlates of regretted sexual experiences involving alcohol use among 2 specific high-risk college student samples: students mandated to alcohol intervention (n = 522) and volunteer 1st-year students transitioning to college (n = 481). Results indicated that alcohol-related regretted sex occurred at similar rates in mandated and volunteer students, with approximately 25% of the students reporting at least 1 occurrence in the past month. Women were more likely to report alcohol-related regretted sex compared with men. The belief that alcohol use would result in "liquid courage" was associated with alcohol-related regretted sex among college students, even after accounting for greater alcohol use and problem alcohol use behaviors. These findings have significant implications for intervention efforts and future research. 2013 APA, all rights reserved
Laing, Anthony J; Sendall, Marguerite C; Barker, Ruth
The study aims to describe the characteristics of patients presenting to EDs within Queensland, Australia with injuries because of assault with a glass implement ('glassing') and to set this within the broader context of presentations because of alcohol-related violence. This is an analysis of prospectively collected ED injury surveillance data collated by the Queensland Injury Surveillance Unit between 1999 and 2011. Cases of injury because of alcohol-related violence were identified and analysed using coded fields supplemented with qualitative data contained within the injury description text. Descriptive statistics were used to assess the characteristics of injury presentations because of alcohol-related violence. Violence included interpersonal violence and aggression (verbal aggression and object violence). A total of 4629 cases were studied. The study population was predominantly men (72%) and aged 18 to 24 (36%), with men in this age group comprising more than a quarter of the study population (28%). Nine per cent of alcohol-related assault injuries were a consequence of 'glassing'. The home was the most common location for alcohol-related violence (31%) and alcohol-related 'glassings' (33%). Overall, the most common glass object involved was a bottle (75%); however, within licensed venues an even mix of a drinking glass (44%) and glass bottle (45%) was identified. Contrary to public perception generated by media, 'glassing' incidents, particularly at licensed venues, constitute a relatively small proportion of all alcohol-related violence. The current study highlights the predominance of young men injured following alcohol-related violence, demonstrating a key focus area within the population for aiming prevention strategies. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Nunn, James; Erdogan, Mete; Green, Robert S
Recurrent admission to a hospital or trauma centre for separate incidents of traumatic injury is known as trauma recidivism. Although use of alcohol is a known risk factor for injury and associated with trauma recidivism, the scale of alcohol-related trauma recidivism has not been well described. The purpose of this review was to search the published literature for studies that evaluated the prevalence of alcohol use among trauma recidivists. Our primary objective was to determine the proportion of trauma recidivism related to alcohol use. The association between alcohol and trauma recidivism was evaluated as a secondary objective. Four electronic databases (MEDLINE, Embase, CINAHL, Web of Science) were searched from inception until December 2015 for all articles that might provide evidence on the proportion of trauma recidivism related to use of alcohol. After removal of duplicates, the search strategy yielded 2470 records for screening. Only primary studies that reported on repeated admissions to a hospital or trauma centre for traumatic injuries specifically related to alcohol use were included. Descriptive statistics were used to assess study characteristics and the prevalence of trauma recidivism related to alcohol use. An aggregate weighted estimate of alcohol-related trauma recidivism was calculated. A total of 12 studies met all inclusion criteria. Studies were published between 1989 and 2014. Overall, there were 3386 trauma recidivists among included studies. The proportion of trauma recidivists with evidence of alcohol use on admission ranged from 26.7% to 76.9% (median 46.4%). The aggregated sample produced a weighted estimate of 41.0% (1388/3386) for alcohol-related trauma recidivism. In four studies, the association between alcohol and trauma recidivism was examined; all four found a positive association between alcohol use and repeated admission for traumatic injury. Studies varied considerably in design, trauma populations, periods for evaluating
Federiuk, C S; Mann, N C
To determine the types of injuries associated with telemark skiing and the effects of ability level, equipment, and terrain. A survey was mailed to a sample of North American telemark skiers. Completed surveys were returned by 548 telemarkers (response rate = 74.5%). The mean age was 42.7 (+/- 9.3) years, and 69% were male. A total of 439 injury events resulted in 494 body injuries, reported by 285 skiers (52%). Lower-extremity injuries (n = 231) were more frequent than upper-extremity injuries (n = 187). Knee injuries were most common with 128 cases, followed by 80 thumb, 66 shoulder, and 44 ankle injuries. Surgery was required in 39 cases. Skiers suffering thumb injuries with sequela lasting greater than 3 months were 10.1 times less likely to have sought medical attention than skiers with other long-term injuries (p boot type and overall knee or ankle injury, but risk of severe ankle injury was increased in leather boots compared to plastic (OR = 8.0, CI = 1.05, 60.59). Release bindings were used by 27.9% of all skiers but were in use in only 18.7% of injury events, suggesting that release plates have a protective effect against injury (OR = 0.59, p knee, thumb, shoulder, and ankle are most frequently injured telemark skiing. Injuries are more likely to occur at lift-served areas than in the backcountry. Thumb injuries are often ignored and may result in long-term sequela. Ankle injuries appear more severe in leather boots. Release bindings appear protective against injury, but they often do not release.
Tuggy, M L; Ong, R
We performed a population survey of telemark skiers over two ski seasons to determine specific risk factors for injury. The survey inquired about the skier's sex, experience, equipment used, injuries, and number of days skied in each season. The respondents completed the surveys whether or not they were injured while skiing. We received 677 responses from telemark skiing clubs, with 19,962 skier-days of data. The number of self-reported injuries was 178, for an overall self-reported injury rate of 8.9 per 1000 skier-days. Knee injuries (N = 48) were the most common injury (27%), followed by thumb (N = 32, 18%) and shoulder (N = 21, 12%) injuries. Specific risk factors for injury were identified with multivariate regression and survival analysis. The skill level of the skier had a significant injury-sparing effect, as did the use of plastic telemark boots. The protective effect of the plastic boots was likely due to the increased stability they provided compared with traditional leather boots. There were fewer knee injuries with the recently available releasable bindings for telemark skis. Sex and age had no significant impact on injury rates in this study population. As all reported deaths associated with telemark sking were due to environmental hazards, skiers must continue to pay close attention to these hazards in the backcountry.
Schry, Amie R; Maddox, Brenna B; White, Susan W
We sought to examine social anxiety as a risk factor for alcohol-related sexual victimization among college women. Women (Time 1: n = 574; Time 2: n = 88) who reported consuming alcohol at least once during the assessment timeframe participated. Social anxiety, alcohol use, alcohol-related consequences, and sexual victimization were assessed twice, approximately two months apart. Logistic regressions were used to examine social anxiety as a risk factor for alcohol-related sexual victimization at both time points. Longitudinally, women high in social anxiety were approximately three times more likely to endorse unwanted alcohol-related sexual experiences compared to women with low to moderate social anxiety. This study suggests social anxiety, a modifiable construct, increases risk for alcohol-related sexual victimization among college women. Implications for clinicians and risk-reduction program developers are discussed. Published by Elsevier Ltd.
Fuller, Colin W
Because the risk of injury in many sports is high, governing bodies and individuals involved with these sports have a responsibility to manage the risks at acceptable levels. Risk management provides a structured framework within which risks can be identified, evaluated, assessed, and controlled through appropriate mitigation strategies. Exploring inferences obtained from the relationship between risk and the incidence and severity of injury contributes to the understanding and control of risks in sport. Studies related to intrinsic and extrinsic risk factors should be focused on determining which factors cause an athlete's risk level to fall within the high-risk or low-risk regions of the population's risk distribution. Risk values can be used to derive risk contours, which illustrate the interdependence of incidence and severity on the development of effective risk mitigation strategies. The wide variation in the levels of risk across different sports is used to demonstrate the impact that athletes' perception and acceptance of risk have on their choice of sport. Finally, the use of incidence and severity data for predicting the prevalence of injury in a team and for the economic evaluation of intervention programmes is discussed.
Montalva-Iborra, A; Alcanyis-Alberola, M; Grao-Castellote, C; Torralba-Collados, F; Giner-Pascual, M
In the last years, there has been a change in the aetiology of spinal cord injury. There has been an increase in the number of elderly patients with spinal cord injuries caused by diseases or medical procedures. The aim of this study is to investigate the frequency of the occurrence of iatrogenic spinal cord injury in our unit. The secondary aim is to study what variables can be associated with a higher risk of iatrogenesis. A retrospective, descriptive, observational study of patients with acute spinal cord injury admitted from June 2009 to May 2014 was conducted. The information collected included the patient age, aetiology, neurological level and grade of injury when admitted and when discharged, cardiovascular risk factors, a previous history of depression and any prior treatment with anticoagulant or antiplatelet drugs. We applied a logistic regression. The grade of statistical significance was established as Pinjury was the thoracic level (48%). The main aetiology of spinal cord injury caused by iatrogenesis was surgery for degenerative spine disease, in patients under the age of 30 were treated with intrathecal chemotherapy. Iatrogenic spinal cord injury is a frequent complication. A statistically significant association between a patient history of depression and iatrogenic spinal cord injury was found as well as with anticoagulant and antiplatelet drug use prior to iatrogenic spinal cord injury.
Jobski, K; Kollhorst, B; Schink, T; Garbe, Edeltraut
Intoxications involving prescription opioids are a major public health problem in many countries. When taken with opioids, alcohol can enhance the effects of opioids, particularly in the central nervous system. However, data quantifying the impact of alcohol involvement in opioid-related intoxications are limited. Using claims data from the German Pharmacoepidemiological Research Database (GePaRD), we conducted a retrospective cohort study based on users of high-potency opioid (HPO) analgesics during the years 2005-2009. HPO use was classified as extended-release, immediate-release or both. We calculated incidence rates (IRs) for opioid intoxications or related events as well as adjusted IR ratios (aIRR) comparing HPO-treated patients with alcohol-related disorders (ARDs) to those without ARDs overall and within each HPO category. During the study period, 308,268 HPO users were identified with an overall IR of 340.4 per 100,000 person-years [95 % confidence interval (CI) 325.5-355.7]. The risk was highest when patients received concomitant treatment with extended- and immediate-release HPOs (IR 1093.8; 95 % CI 904.6-1310.9). ARDs increased the risk during HPO use by a factor of 1.7 and the highest aIRR was seen when comparing patients simultaneously exposed to extended- and immediate-release HPOs with ARDs to those without ARD also after excluding patients with potential improper/non-medical HPO use. Physicians should be aware of these elevated risks in HPO patients with ARDs. Active patient education by healthcare providers regarding the risk of opioid intoxications or related events due to alcohol in conjunction with HPOs is warranted.
Moore, Isabel S.; Ranson, Craig; Mathema, Prabhat
Background: Within international Rugby Union, only injury rates during the Rugby World Cup have been reported. Therefore, injury rates and types during other international tournaments are unknown. Purpose: To assess the 3-year incidence, severity, nature, and causes of match and training injuries sustained during different international tournaments played by the Welsh national Rugby Union team. Study Design: Descriptive epidemiology study. Methods: Injury data for all players (n = 78) selected for 1 national Rugby Union team over a 3-year period were analyzed using the international consensus statement methods. Player height (cm) and mass (kg) were recorded. Tournaments were grouped for comparisons as: autumn tournaments (2012 and 2013), Rugby World Cup (RWC; 2011), Six Nations (2012, 2013, and 2014), and summer tournaments (2012, 2013, and 2014). Injury incidence (injuries/1000 hours), prevalence (% of players unavailable), and severity (days lost) were calculated for each tournament. Injury location, type, and cause of match and training injuries were analyzed. Results: Match injury incidence was highest during autumn tournaments (262.5/1000 match-hours) and lowest during the RWC (178.6/1000 match-hours). Summer tournaments had the highest training incidence (5.5 injuries/1000 training-hours). Mild injuries were most likely during the RWC (risk ratio [RR], 2.02; 95% CI, 1.26-3.24), while severe injuries were most likely during autumn tournaments (RR, 3.27; 95% CI, 1.70-6.29). Quadriceps hematomas (18.8/1000 match-hours; 95% CI, 11.3-31.1) and concussions (13.8/1000 match-hours; 95% CI, 7.6-24.8) were the most common match injuries, with shoulder dislocations being the most severe (111 mean days lost per injury). Conclusion: Injury rates were considerably higher than those previously reported for multiple teams during RWC tournaments. Further investigation of injury rates and risk factors is recommended to accurately gauge their impact within international Rugby
Østerlund, Anna H; Lander, Flemming; Nielsen, Kent
2.7, 95% CI 1.9-3.9), being distracted by someone (OR 3.1, 95% CI 2.3-4.1), non-routine task (OR 8.2, 95% CI 5.3-12.5), altered surroundings (OR 20.9, 95% CI 12.2-35.8), and broken machinery or materials (OR 20.6, 95% CI 13.5-31.7). The risk of occupational injury did not vary substantially....... In particular, equipment (broken machinery or materials) and work-practice-related factors (non-routine task and altered surroundings) increased the risk of an occupational injury. Elaboration of results in relation to hazard period and information bias is warranted....... risk factors (time pressure, disagreement with someone, feeling sick, being distracted by someone, non-routine task, altered surroundings, and broken machinery and materials) for occupational injuries. In the study, 1693 patients with occupational injuries were recruited from a total of 4002...
Full Text Available There is a substantial amount of evidence from experimental studies to indicate that a variety of individual skills are impaired at blood alcohol concentrations (BACs well below 0.05%. Epidemiological studies indicate that the risk of a crash increases sharply for drivers with BACs below 0.05%. The correlation between drunk driving and the risk of traffic accidents has been established on the individual as well as the aggregate level. The BAC level legally permitted is a public policy decision by legislators, while scientists can present experimental and epidemiological evidence indicating the BAC level at which psychomotor skills deteriorate and accident probabilities increase. There is considerable epidemiological evidence to support the fact that the risk of alcohol impaired drivers being involved in traffic crashes rises with increasing BAC's. By contrast, the evidence on the BAC at which a driver should be regarded as committing an offence has been the subject of much debate and various legislative decisions. Historically, per se laws specify BAC levels which are a compromise figure intended to reflect both the point at which a driver becomes significantly more likely to be involved in an accident than a comparative driver with a zero BAC and that which is politically acceptable, but falls within the BAC region of increased accident liability. Therefore, the per se legislation in most countries has not kept pace with scientific progress. This study suggests that if saving lives on the road is an important issue, then, passing laws that incorporate scientific and epidemiological studies, is necessary.
Ball, Chad G; Ball, Jill E; Kirkpatrick, Andrew W; Mulloy, Robert H
Horseback riding is more dangerous than motorcycle riding, skiing, football, and rugby. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with severe equestrian trauma. All patients with major equestrian injuries (injury severity score > or = 12) admitted between 1995 and 2005 were reviewed. A 46-question survey outlining potential rider, animal, and environmental risk factors was administered. Among 7941 trauma patients, 151 (2%) were injured on horseback (mean injury severity score, 20; mortality rate, 7%). Injuries included the chest (54%), head (48%), abdomen (22%), and extremities (17%). Forty-five percent required surgery. Survey results (55%) indicated that riders and horses were well trained, with a 47% recidivism rate. Only 9% of patients wore helmets, however, 64% believed the accident was preventable. Chest trauma previously has been underappreciated. This injury pattern may be a result of significant rider experience. Helmet and vest use will be targeted in future injury prevention strategies.
The characteristics of dementia relating to excessive alcohol use have received increased research interest in recent times. In this paper, the neuropathology, nosology, epidemiology, clinical features, and neuropsychology of alcohol-related dementia (ARD) and alcohol-induced persisting amnestic syndrome (Wernicke-Korsakoff syndrome, or WKS) are reviewed. Neuropathological and imaging studies suggest that excessive and prolonged use of alcohol may lead to structural and functional damage that is permanent in nature; however, there is debate about the relative contributions of the direct toxic effect of alcohol (neurotoxicity hypothesis), and the impact of thiamine deficiency, to lasting damage. Investigation of alcohol-related cognitive impairment has been further complicated by differing definitions of patterns of alcohol use and associated lifestyle factors related to the abuse of alcohol. Present diagnostic systems identify two main syndromes of alcohol-related cognitive impairment: ARD and WKS. However, 'alcohol-related brain damage' is increasingly used as an umbrella term to encompass the heterogeneity of these disorders. It is unclear what level of drinking may pose a risk for the development of brain damage or, in fact, whether lower levels of alcohol may protect against other forms of dementia. Epidemiological studies suggest that individuals with ARD typically have a younger age of onset than those with other forms of dementia, are more likely to be male, and often are socially isolated. The cognitive profile of ARD appears to involve both cortical and subcortical pathology, and deficits are most frequently observed on tasks of visuospatial function as well as memory and higher-order (executive) tasks. The WKS appears more heterogeneous in nature than originally documented, and deficits on executive tasks commonly are reported in conjunction with characteristic memory deficits. Individuals with alcohol-related disorders have the potential to at least
Herschl, Laura C; McChargue, Dennis E; MacKillop, James; Stoltenberg, Scott F; Highland, Krista B
Positive alcohol outcome expectancies and behavioral economic indices of alcohol consumption are related to binge drinking among college students and may reflect explicit and implicit motivations that are differentially associated with this behavior. The present study hypothesized that implicit (alcohol purchase task) and explicit (positive expectancy for alcohol's effects) motivations for drinking would not be correlated. It was also hypothesized that greater implicit and explicit motivations would predict alcohol-related risk. Participants were 297 college student binge drinkers (54% female; 88% European-American; Alcohol Use Disorders Identification Test: M = 9.53, SD = 5.04). Three indices from the alcohol purchase task (APT) were modeled as a latent implicit alcohol-related motivations variable. Explicit alcohol-related motivations were measured using a global positive expectancy subscale from the Comprehensive Effects of Alcohol Questionnaire. Alcohol Use Disorders Identification Test total, Rutgers Alcohol Problem Index total, and age of drinking onset were modeled as a latent alcohol-related risk variable. Structural equation modeling was used to examine associations amongst implicit motivations, explicit motivations, and alcohol-related risk. Implicit and explicit motivations were not correlated. Partially consistent with the second hypothesis, greater implicit motivations were associated with greater alcohol-related risk. Relations between explicit motivations and alcohol-related risk were marginally significant. Implicit and explicit drinking motivations are differentially associated with problem drinking behaviors. Future research should examine the underlying neurobiological mechanisms associated with these factors.
Kraus, Ludwig; Baumeister, Sebastian E; Pabst, Alexander; Orth, Boris
The present study investigates the combined effect of average volume and binge drinking in predicting alcohol-related social problems and estimates the proportion of alcohol-related harms related to specific drinking patterns that could be prevented if transferred to a low-risk drinking group. Data came from the 1997 and 2000 German Epidemiological Survey of Substance Abuse (ESA) (age: 18-59 years; response rate: 65% and 51%, respectively). The pooled sample consisted of 12,668 current drinkers. By using nine categories of average daily intake and three groups of binge drinking, individuals were grouped into 22 mutual exclusive groups. Social problems were defined as the occurrence of 'repeated family quarrels', 'concern of family members or friends', 'loss of partner or friend' or 'physical fight or injury' in relation to alcohol. The effect of average daily intake is modified by binge drinking frequency such that the association was strongest in those with four or more binge drinking occasions during the last 30 days. Within each binge drinking group, adjusted relative risks (aRR) increased with alcohol intake up to a certain threshold and decreased thereafter. Overall, compared to the reference group (alcohol-related social problems than volume. Alcohol-related social harms especially among drinkers with moderate volume per day may be reduced by targeting prevention strategies towards episodic heavy drinkers.
Kenborg, Line; Rugbjerg, Kathrine; Lee, Pei-Chen
OBJECTIVE: To examine the association between head injuries throughout life and the risk for Parkinson disease (PD) in an interview-based case-control study. METHODS: We identified 1,705 patients diagnosed with PD at 10 neurologic centers in Denmark in 1996-2009 and verified their diagnoses...
No African-based studies have reported the prevalence or severity of injuries, risk factors associated with injuries or return-to-play (RTP) time. Objectives: To determine the prevalence of injuries and associated risk factors, as well as severity of injuries sustained by professional male MMA athletes competing at the Extreme ...
Tripp, Jessica C; Meshesha, Lidia Z; Teeters, Jenni B; Pickover, Alison M; McDevitt-Murphy, Meghan E; Murphy, James G
Posttraumatic stress (PTS) symptoms are associated with alcohol-related consequences, but there is a need to understand mediators that may help explain the reasons for this relationship. Individuals with PTS may experience elevated craving and alcohol reward value (demand), which may contribute to risk for alcohol-related consequences. We examined relationships between PTS status, craving, alcohol demand, and alcohol-related consequences in PTS-positive (n = 64) and PTS-negative (n = 200) college students (M age = 21.7; 77% women; 54% Caucasian; 34% African American) who endorsed past-month alcohol use. We tested craving and alcohol demand as mediators of the relation between PTS status and alcohol-related consequences. Craving (B = .04, SE = .02, 95% CI [.01, .10]), demand intensity (B = .02, SE = .02, 95% CI [.001, .07]), and demand elasticity (B = .05, SE = .03, 95% CI [.006, .12]) significantly mediated the association between PTS symptoms and alcohol-related consequences. Craving remained a significant mediator in a multiple mediators model (B = .08, SE = .04, 95% CI [.03, .19]). Craving and alcohol demand may partially explain the relation between PTS status and alcohol-related consequences. Craving may be especially salient for individuals with PTS symptoms, as it may lead to more severe alcohol-related consequences even in the absence of elevated alcohol consumption. (c) 2015 APA, all rights reserved).
Weaver, Ashley A; Talton, Jennifer W; Barnard, Ryan T; Schoell, Samantha L; Swett, Katrina R; Stitzel, Joel D
Injury risk curves estimate motor vehicle crash (MVC) occupant injury risk from vehicle, crash, and/or occupant factors. Many vehicles are equipped with event data recorders (EDRs) that collect data including the crash speed and restraint status during a MVC. This study's goal was to use regulation-required data elements for EDRs to compute occupant injury risk for (1) specific injuries and (2) specific body regions in frontal MVCs from weighted NASS-CDS data. Logistic regression analysis of NASS-CDS single-impact frontal MVCs involving front seat occupants with frontal airbag deployment was used to produce 23 risk curves for specific injuries and 17 risk curves for Abbreviated Injury Scale (AIS) 2+ to 5+ body region injuries. Risk curves were produced for the following body regions: head and thorax (AIS 2+, 3+, 4+, 5+), face (AIS 2+), abdomen, spine, upper extremity, and lower extremity (AIS 2+, 3+). Injury risk with 95% confidence intervals was estimated for 15-105 km/h longitudinal delta-Vs and belt status was adjusted for as a covariate. Overall, belted occupants had lower estimated risks compared to unbelted occupants and the risk of injury increased as longitudinal delta-V increased. Belt status was a significant predictor for 13 specific injuries and all body region injuries with the exception of AIS 2+ and 3+ spine injuries. Specific injuries and body region injuries that occurred more frequently in NASS-CDS also tended to carry higher risks when evaluated at a 56 km/h longitudinal delta-V. In the belted population, injury risks that ranked in the top 33% included 4 upper extremity fractures (ulna, radius, clavicle, carpus/metacarpus), 2 lower extremity fractures (fibula, metatarsal/tarsal), and a knee sprain (2.4-4.6% risk). Unbelted injury risks ranked in the top 33% included 4 lower extremity fractures (femur, fibula, metatarsal/tarsal, patella), 2 head injuries with less than one hour or unspecified prior unconsciousness, and a lung contusion (4
Alicia M. Montalvo, Hilary Shaefer, Belinda Rodriguez, Tan Li, Katrina Epnere, Gregory D. Myer
The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently ...
Schwebel, David C; Gaines, Joanna
Unintentional injury is the leading cause of death for children and adolescents between the ages of 1 and 18 in the United States, accounting for more deaths than the next 20 causes of mortality combined. It is estimated that pediatric injury accounts for more than $50 billion in annual losses from medical care costs, future wages, and quality of life. Despite these numbers, much remains to be learned about the behavioral risks for pediatric unintentional injury. This article reviews behavioral risk factors for pediatric unintentional injury risk, with a particular focus on four broad areas. First, we discuss the effects of demographic risk factors, including gender, socioeconomic status, and ethnicity. Second, we present information about child-specific risk factors, including temperament, personality, psychopathology, and cognitive development. Third, we discuss the influence of parents and other primary caregivers on childhood injury risk, with a particular focus on the effects of supervision and parenting quality and style. Finally, we discuss the role of peers on child injury risk. We conclude with a discussion of the ways in which the material reviewed has been translated into injury prevention techniques, with a focus on how pediatricians might use knowledge about etiological risk to prioritize safety counseling topics. We also present thoughts on four priorities for future research: injury risk in diverse nations and cultures; developmental effects of injury; the influence of multiple risk factors together on injury risk; and translation of knowledge about risk for injury into intervention and prevention techniques.
Whitaker, Lydia; Brown, Stephen L; Young, Bridget; Fereday, Richard; Coyne, Sarah M; Qualter, Pamela
Laboratory studies of alcohol-inexperienced adolescents show that aggression can be primed by alcohol-related stimuli, suggesting that alcohol-related aggression is partly socially learned. Script theory proposes that alcohol-related aggression 'scripts' for social behaviors are culturally-available and learned by individuals. The purpose of the study was to understand the content and origins of alcohol-related aggression scripts learned by adolescents. This qualitative focus group study of 40 adolescents (ages 14-16 years) examined alcohol-related aggression scripts. Participants believed aggression and severe injury to be pervasive when young people drink. Viewed through a biological lens, participants described aggression as an 'instinctive' and 'hard-wired' male trait facilitated by intoxication. As such, alcohol-related aggression was not seen as intended or personally controllable and participants did not see it in moral terms. Females were largely viewed as either bystanders of inter-male aggression or potential victims of male sexual aggression. Participants attributed their views on the frequency and nature of alcohol-related aggression to current affairs and reality television, which they felt portrayed a reality of which they had little experience. The origins of the explicitly biological frameworks that participants used seemed to lie in pre-existing beliefs about the nature of gender differences. Perceptions of the pervasiveness of male alcohol-related aggression, and the consequent failure to view alcohol-related aggression in moral terms, could dispose some young people to alcohol-related aggression. Interventions could target (1) the beliefs that alcohol-related aggression is pervasive and uncontrollable in males, and (2) participants' dysfunctional views of masculinity that underpin those beliefs.
Strotmeyer, Stephen; Lystad, Reidar P.
Background Muay Thai is a style of kickboxing that allows full-contact blows to an unprotected head, torso and legs, and, as in any combat sport, there is an inherent risk of injury. Previous observational studies have shown there is a substantial risk of injury in competitive kickboxing. None of these studies, however, have investigated the potential role of psychological risk factors and, consequently, little is known about the perception of injury risk among these athletes. Notwithstanding...
Sørensen, Holger J; Mortensen, Erik Lykke; Reinisch, June M
OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...... of early weaning was 1.47. Elevated relative risks were also associated with maternal smoking during pregnancy (1.52) and unwanted pregnancy status (1.59). Other independent predictors were male gender, maternal psychiatric hospitalization with alcohol-related diagnosis, and low parental social status....... CONCLUSIONS: Independent of a number of other risk factors for alcoholism, a significant association between early weaning and elevated risk of hospitalization with alcohol-related diagnoses was observed....
Månsdotter, Anna; Backhans, Mona; Hallqvist, Johan
In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120). A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978-1979) and full-time work for mothers (1980). The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981-2001). Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood.
The objective of this review is to identify the available research regarding the risk factors and prevention of injuries in high school athletes (ages 14 to 18 years). Relevant manuscripts were identified by searching six electronic databases with a combination of key words and medical subject headings (high school, adolescent, athletic injury, sports injury, risk factors, prevention, and prospective). Original research that reported prospective data on high school athletes (ages 14 to 18), reported injury and exposure data, and used data collected throughout the entire sport season or school year. Twenty-nine studies that identified injury risk factors or injury prevention strategies were reviewed and summarized. Data extracted from the studies included a) sport(s) or injuries studied, b) year of publication, c) lead author, d) description of the subjects, e) sample-size calculation, f) variables studied (baseline demographic or performance variables), g) whether multivariate analyses were used, h) data reported (injury rates, risk ratios, and 95% CI), and i) results. Studies that introduced an intervention were characterized by the same data as well as the type of intervention employed and randomization procedures used. The quality of each injury-risk and injury-prevention study was assessed, and the results were summarized. The risk factors for injury in several specific sports such as soccer, American football, and basketball have been documented. Other sports are less well represented in the current literature. The risk factors for injuries to the ankle, head, and knee have been identified, to a limited degree. Upper-extremity injury risk factors are less well known. There is a need for high-quality prospective studies to further identify injury risk factors and injury-prevention strategies for high school athletes.
Amie R Schry
Full Text Available BACKGROUND AND OBJECTIVES: Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. METHODS: In the present study, 573 undergraduate students (M(age = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role. Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. RESULTS: After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. DISCUSSION AND CONCLUSIONS: These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. SCIENTIFIC SIGNIFICANCE: This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences.
Schry, Amie R.; Norberg, Melissa M.; Maddox, Brenna B.; White, Susan W.
Background and Objectives Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. Methods In the present study, 573 undergraduate students (M age = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. Results After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. Discussion and Conclusions These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. Scientific Significance This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences. PMID:25541722
Hatzenbuehler, Mark L; Corbin, William R; Fromme, Kim
Discrimination is a risk factor for health-risk behaviors, including alcohol abuse. Far less is known about the mechanisms through which discrimination leads to alcohol-related problems, particularly during high-risk developmental periods such as young adulthood. The present study tested a mediation model using prospective data from a large, diverse sample of 1539 college students. This model hypothesized that discrimination would be associated with established cognitive (positive alcohol expectancies) and affective (negative affect and coping motives) risk factors for alcohol-related problems, which would account for the prospective association between discrimination and alcohol problems. Structural equation modeling indicated that discrimination was associated cross-sectionally with negative affect and more coping motives for drinking, but not with greater alcohol expectancies. Coping motives mediated the prospective relationship between discrimination and alcohol-related problems. Additionally, results indicated significant indirect effects from discrimination to alcohol-related problems through negative affect and coping motives. These associations were evident for multiple groups confronting status-based discrimination, including women, racial/ethnic minorities, and lesbian/gay/bisexual individuals. This study identified potential affective mechanisms linking discrimination to alcohol-related problems. Results suggest several avenues for prevention and intervention efforts with individuals from socially disadvantaged groups. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Haxhiu, Bekim; Murtezani, Ardiana; Zahiti, Bedri; Shalaj, Ismet; Sllamniku, Sabit
The aim of this study was to identify risk factors related to the occurrence of injuries in football players. The study included 216 football players from 12 teams in the elite football league. Football-related injury data were collected prospectively during the 2012/2013 competitive season. At baseline the following information was collected for the players: anthropometric measurements (weight, height, BMI, subcutaneous skinfolds), playing experience, injury history, physical fitness performance test (agility run), peak oxygen uptake. The incidence, type and severity of injuries and training and game exposure times were prospectively documented for each player. Most of the players (n = 155, 71.7%) sustained the injures during the study period. The overall injury incidence during the regular season was 6.3 injuries per 1000 athlete-exposures (95% confidence interval, 4.31-9.67). Multivariate logistic regression analysis showed that playing experience (odds ratio [OR] = 0.44; 95% CI = 0.32-0.61, p injuries. Body mass index was not associated with risk of injury. Strains (34.19%) and sprains (25.81%) were the major injury types. Twenty-seven percent of injured players were absent from football for more than 1 month, with knee injuries (25.42%) being the most severe type. The risk factors that increase injury rates in football players were previous injury, higher age and years of playing. Future research should include adequate rehabilitation program to reduce the risk of injuries.
Strotmeyer, Stephen; Lystad, Reidar P
Muay Thai is a style of kickboxing that allows full-contact blows to an unprotected head, torso and legs, and, as in any combat sport, there is an inherent risk of injury. Previous observational studies have shown there is a substantial risk of injury in competitive kickboxing. None of these studies, however, have investigated the potential role of psychological risk factors and, consequently, little is known about the perception of injury risk among these athletes. Notwithstanding the important role risk perception may play in the occurrence and prevention of sports injuries, there is very limited empirical data pertaining to athletes in full-contact combat sports such as Muay Thai. Because the development and successful implementation of effective injury prevention policies for combat sports are likely to benefit from an increased understanding of the perception of injury risk and sport safety attitudes and behavior of its participants, further study is warranted. Muay Thai fighters were invited to complete an online survey in which they rated the perceived risk of injury in a range of different sports, including Muay Thai kickboxing. Perceived comparative risk was obtained indirectly by subtracting perceived risk of injury to oneself from perceived risk of injury to a peer. Data were analyzed using descriptive statistics, comparison of means, and ordinal logistic regression. Contrary to the best available epidemiological evidence, Muay Thai fighters perceived the risk of injury in their own sport to be average and significantly lower than that in other collision and contact sports, including popular combat sports such as boxing and mixed martial arts. On average, Muay Thai fighters perceived their own risk injury to be significantly lower compared to their peers (p injury risk perception and actual risk among Muay Thai fighters. Moreover, these athletes also exhibit a slight degree comparative optimism or unrealistic optimism. Because behavior is determined by
Neumann, W. Patrick; Winkel, Jørgen; Palmerud, Gunnar
Engineering innovations in car disassembly systems are studied for affects on system operatorsâ€™ risk of repetitive strain injury (RSI). Objective instrumented measures of injury risk factors with synchronised video-based task analyses were used to examine changes in operatorsâ€™ RSI risk during...
Lewis, Melissa A; Patrick, Megan E; Litt, Dana M; Atkins, David C; Kim, Theresa; Blayney, Jessica A; Norris, Jeanette; George, William H; Larimer, Mary E
The purpose of this study was to evaluate the efficacy of personalized normative feedback (PNF) on college student alcohol-related risky sexual behavior (RSB). In a randomized controlled trial, 480 (57.6% female) sexually active college students were stratified by gender and level of drinking and randomly assigned to an alcohol-only intervention, an alcohol-related RSB-only intervention, a combined alcohol and alcohol-related RSB intervention, or control. All assessment and intervention procedures were Web-based. Results indicated a significant reduction in drinking outcomes for the alcohol only and the combined alcohol and alcohol-related RSB interventions relative to control. Findings further demonstrated a significant reduction in alcohol-related RSB outcomes for the alcohol-related RSB only and the combined alcohol and alcohol-related RSB interventions relative to control. There were no significant intervention effects on alcohol-related negative consequences. These findings demonstrate that the combined alcohol and alcohol-related RSB intervention was the only intervention successful at reducing both drinking and alcohol-related RSB outcomes relative to control. There were no significant differences when comparing the combined alcohol and alcohol-related RSB intervention to the alcohol-only intervention or the alcohol-related RSB-only intervention. Finally, results suggested that the intervention effects on high-risk behaviors were mediated by reductions in descriptive normative perceptions. These findings demonstrate that PNF specific to drinking in sexual situations was needed to reduce alcohol-related RSB. Furthermore, this study highlights the potential utility of a brief intervention that can be delivered via the Internet to reduce high-risk drinking and alcohol-related RSB among college students. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Niebuhr, Tobias; Junge, Mirko; Achmus, Stefanie
Assessment of the effectiveness of advanced driver assistance systems (ADAS) plays a crucial role in accident research. A common way to evaluate the effectiveness of new systems is to determine the potentials for injury severity reduction. Because injury risk functions describe the probability of an injury of a given severity conditional on a technical accident severity (closing speed, delta V, barrier equivalent speed, etc.), they are predestined for such evaluations. Recent work has stated an approach on how to model the pedestrian injury risk in pedestrian-to-passenger car accidents as a family of functions. This approach gave explicit and easily interpretable formulae for the injury risk conditional on the closing speed of the car. These results are extended to injury risk functions for pedestrian body regions. Starting with a double-checked German In-depth Accident Study (GIDAS) pedestrian-to-car accident data set (N = 444) and a functional-anatomical definition of the body regions, investigations on the influence of specific body regions on the overall injury severity will be presented. As the measure of injury severity, the ISSx, a rescaled version of the well-known Injury Severity Score (ISS), was used. Though traditional ISS is computed by summation of the squares of the 3 most severe injured body regions, ISSx is computed by the summation of the exponentials of the Abbreviated Injury Scale (AIS) severities of the 3 most severely injured body regions. The exponentials used are scaled to fit the ISS range of values between 0 and 75. Three body regions (head/face/neck, thorax, hip/legs) clearly dominated abdominal and upper extremity injuries; that is, the latter 2 body regions had no influence at all on the overall injury risk over the range of technical accident severities. Thus, the ISSx is well described by use of the injury codes from the same body regions for any pedestrian injury severity. As a mathematical consequence, the ISSx becomes explicitly
Nguyen, Rita; Téllez Zenteno, José F.
Currently, there is intense clinical research into various aspects of the medical risks relating to epilepsy, including total and cause-specific mortality, accidents and injuries in patients with epilepsy and mortality related with seizures. Seizures occurring in precarious situations and resulting in injuries are still an important concern for patients with epilepsy, their employers and their caregivers. Submersion injuries, motor vehicle accidents, burns, and head injuries are among the mo...
McBeth, Paul B; Ball, Chad G; Mulloy, Robert H; Kirkpatrick, Andrew W
Alpine skiing and snowboarding are popular winter sports in Canada. Every year participation in these activities results in traumatic injury. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with ski and snowboarding injuries. A comprehensive 10-year retrospective review of Alpine ski and snowboarding injuries from 1996 to 2006 was conducted. The Alberta Trauma Registry was used as the primary source of data. A total of 196 patients (56.6% skiers, 43.4% snowboarders) were identified as having major traumatic injuries (Injury Severity Score, >or=12). Forty-three patients required intensive care unit support. The majority of injuries were related to falls and collisions with natural objects. Head injuries were most common, followed by chest, spinal, and extremity trauma. Seventy-nine patients required emergency surgery. Skiing and snowboarding represent activities with high potential for traumatic injury. Safety initiatives should be developed to target this population.
Dong, Xiuwen Sue; Ringen, Knut; Welch, Laura; Dement, John
Estimates of occupational risk are typically computed on an annual basis. In contrast, this article provides estimates of lifetime risks for fatal and nonfatal injuries among construction workers. A companion paper presents lifetime risks for occupational illnesses. Using 2003-2007 data from three large data sources, lifetime risk was computed based on the number of fatal and nonfatal injuries per 100 FTEs for a working lifespan of 45 years. For a working life in construction, the risk of fatal injuries were approximately one death per 200 FTE, and the leading causes were falls and transportation incidents. For nonfatal injuries resulting in days away from work, the adjusted lifetime risk was approximately 78 per 100 FTEs, and the leading causes were contact with objects/equipment, overexertion, and falls to a lower level. Lifetime risk estimates help inform both workers and policymakers. Despite improvements over the past decades, risks in construction remain high. © 2014 Wiley Periodicals, Inc.
Koziol-McLain, J.; Brand, D.; Morgan, D.; Leff, M.; Lowenstein, S.
Background—Recently (1996–98), Colorado added 15 questions pertaining to injury related risks and behaviors to the behavioral risk factor surveillance system (BRFSS). Questions addressed bicycle helmet use, traffic crashes, exposure to violence, suicidal behavior, and gun storage.
Virk, Jasveer; Li, Jiong; Lauritsen, Jens
The aim of this study was to assess the risk of injuries among children exposed to a stressful life exposure (defined as bereavement) before conception or during fetal life.......The aim of this study was to assess the risk of injuries among children exposed to a stressful life exposure (defined as bereavement) before conception or during fetal life....
Prasanna J. Gamage
Full Text Available Understanding how junior athletes perceive injury risks when participating in sport and the environment they play in is an important component of injury prevention. This study investigates how Sri Lankan junior cricketers (n = 365, aged 11–14 years, boys perceive injury risks associated with playing cricket. The study used a Sri Lankan modification of an Australian junior cricket injury risk perception survey that considered playing cricket versus other sports, different cricket playing positions and roles, and different ground conditions. The risk of playing cricket was considered to be greater than that for cycling, but lower than that for rugby and soccer. Fast-bowlers, batters facing fast-bowlers, fielding close in the field, and wicket-keeping without a helmet were perceived to pose greater risks of injury than other scenarios. Playing on hard, bumpy and/or wet ground conditions were perceived to have a high risk opposed to playing on a grass field. Fielding in the outfield and wicket-keeping to fast-bowlers whilst wearing a helmet were perceived as low risk actions. The risk perceptions of junior cricketers identified in this study, do not necessarily reflect the true injury risk in some instances. This information will inform the development of injury prevention education interventions to address these risk perceptions in junior cricketers.
Amaia M Erdozain
Full Text Available Chronic excessive alcohol intoxications evoke cumulative damage to tissues and organs. We examined prefrontal cortex (Brodmann's area (BA 9 from 20 human alcoholics and 20 age, gender, and postmortem delay matched control subjects. H & E staining and light microscopy of prefrontal cortex tissue revealed a reduction in the levels of cytoskeleton surrounding the nuclei of cortical and subcortical neurons, and a disruption of subcortical neuron patterning in alcoholic subjects. BA 9 tissue homogenisation and one dimensional polyacrylamide gel electrophoresis (PAGE proteomics of cytosolic proteins identified dramatic reductions in the protein levels of spectrin β II, and α- and β-tubulins in alcoholics, and these were validated and quantitated by Western blotting. We detected a significant increase in α-tubulin acetylation in alcoholics, a non-significant increase in isoaspartate protein damage, but a significant increase in protein isoaspartyl methyltransferase protein levels, the enzyme that triggers isoaspartate damage repair in vivo. There was also a significant reduction in proteasome activity in alcoholics. One dimensional PAGE of membrane-enriched fractions detected a reduction in β-spectrin protein levels, and a significant increase in transmembranous α3 (catalytic subunit of the Na+,K+-ATPase in alcoholic subjects. However, control subjects retained stable oligomeric forms of α-subunit that were diminished in alcoholics. In alcoholics, significant loss of cytosolic α- and β-tubulins were also seen in caudate nucleus, hippocampus and cerebellum, but to different levels, indicative of brain regional susceptibility to alcohol-related damage. Collectively, these protein changes provide a molecular basis for some of the neuronal and behavioural abnormalities attributed to alcoholics.
Knapik Joseph J
Full Text Available Abstract Background A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI new agent training. Methods Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy. Results A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men = 1.3, 95% confidence interval = 0.9-1.7. The activities most commonly associated with injuries (% of total were defensive tactics training (58%, physical fitness training (20%, physical fitness testing (5%, and firearms training (3%. Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT, lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity. Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents.
... MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.237 Other alcohol-related conduct. (a) No operator shall... 49 Transportation 3 2010-10-01 2010-10-01 false Other alcohol-related conduct. 199.237 Section 199...
... 49 Transportation 5 2010-10-01 2010-10-01 false Other alcohol-related conduct. 382.505 Section 382... SUBSTANCES AND ALCOHOL USE AND TESTING Consequences for Drivers Engaging in Substance Use-Related Conduct § 382.505 Other alcohol-related conduct. (a) No driver tested under the provisions of subpart C of this...
Nordahl Christensen, Helene; Diderichsen, Finn; Hvidtfeldt, Ulla Arthur
.001).Conclusions: High alcohol consumption is associated with a higher risk of alcohol-related medical events among those with low compared with high education. This interaction may be explained by differences in vulnerability and drinking patterns across educational groups. See video abstract at, http......Background: Alcohol-related mortality is more pronounced in lower than in higher socioeconomic groups in Western countries. Part of the explanation is differences in drinking patterns. However, differences in vulnerability to health consequences of alcohol consumption across socioeconomic groups...... may also play a role. We investigated the joint effect of alcohol consumption and educational level on the rate of alcohol-related medical events.Methods: We pooled seven prospective cohorts from Denmark that enrolled 74,278 men and women age 30–70 years (study period, 1981 to 2009). We measured...
Koefoed Petersen, Rasmus; Benzon Larsen, Signe; Jensen, Ditte Marie
Alcohol is a risk factor for postmenopausal breast cancer. One of several proposed mechanisms is that alcohol-related breast cancer is caused by increased sex hormone levels. PPARγ inhibits aromatase transcription in breast adipocytes. We reproduced previously found allele-specific effects...... of the wildtype Pro-allele of PPARG Pro12Ala in alcohol related breast cancer. In transiently transfected cells, transcriptional activation by PPARγ and the PPARγ-PGC-1α complex was inhibited by ethanol. PPARγ 12Ala-mediated transcription activation was not enhanced by PGC-1α, resulting in allele......-specific transcription activation by the PPARγ 12Pro-PGC-1α complex. Our results suggest that PPARγ and PGC-1α activity is an important determinant of alcohol related breast cancer....
Jacobsson, Jenny; Timpka, Toomas; Kowalski, Jan; Nilsson, Sverker; Ekberg, Joakim; Dahlström, Örjan; Renström, Per A
To estimate the incidence, type and severity of musculoskeletal injuries in youth and adult elite athletics athletes and to explore risk factors for sustaining injuries. Prospective cohort study conducted during a 52-week period. Male and female youth and adult athletics athletes ranked in the top 10 in Sweden (n=292). 199 (68%) athletes reported an injury during the study season. Ninety-six per cent of the reported injuries were non-traumatic (associated with overuse). Most injuries (51%) were severe, causing a period of absence from normal training exceeding 3 weeks. Log-rank tests revealed risk differences with regard to athlete category (p=0.046), recent previous injury (>3 weeks time-loss; p=0.039) and training load rank index (TLRI; p=0.019). Cox proportional hazards regression analyses showed that athletes in the third (HR 1.79; 95% CI 1.54 to 2.78) and fourth TLRI quartiles (HR 1.79; 95% CI 1.16 to 2.74) had almost a twofold increased risk of injury compared with their peers in the first quartile and interaction effects between athlete category and previous injury; youth male athletes with a previous serious injury had more than a fourfold increased risk of injury (HR=4.39; 95% CI 2.20 to 8.77) compared with youth females with no previous injury. The injury incidence among both youth and adult elite athletics athletes is high. A training load index combing hours and intensity and a history of severe injury the previous year were predictors for injury. Further studies on measures to quantify training content and protocols for safe return to athletics are warranted.
Juth, Vanessa; Smyth, Joshua M.; Thompson, Kevin; Nodes, Jennifer
Research on alcohol consumption among college students is often limited by self-reported outcomes and a narrow focus of predictor factors. This study examined both traditional risk factors for alcohol use as well as broader factors (e.g., weather, seasons) in predicting objective negative outcomes of alcohol use--alcohol-related legal infractions…
de Haan, Hein A.; Joosten, Evelien A.G.; de Haan, Lydia; Schellekens, Arnt F.A.; Buitelaar, Jan K.; van der Palen, Jacobus Adrianus Maria; de Jong, Cor A.J.
Objectives Previous research identified alexithymia as a potential risk factor for substance use disorders (SUD). More insight into the relation between alexithymia and SUD is needed in order to treat SUD effectively. Therefore, we investigated whether a familial vulnerability to alcoholism relates
Porell, Frank W; Carter, Mary W
To evaluate the effects of unintentional injuries on the risks of nursing home institutionalization and mortality in older adults. A retrospective analysis of data from the Medicare Current Beneficiary Survey, a nationally representative survey of Medicare beneficiaries. Noninstitutionalized community residents. Older adult panel members (N = 12,031) with continuous Medicare eligibility not enrolled in managed care in a cohort starting between 1998 and 2001. Cox regression and competing risk survival models were estimated using time-varying injury-status dummy variables and control variables for outcomes measured as time until death and institutionalization, respectively. Almost 4% of persons were institutionalized, 15% died, 14% had a sentinel injury, and 3% had two or more minor nonsentinel injuries within 1-year period. Persons hospitalized for sentinel injury had elevated institutionalization and mortality risks during an injury episode and after the episode ended. Persons receiving outpatient treatment for sentinel injuries had elevated institutionalization risk during injury episodes (subhazard ratio [SHR] = 6.78, 95% confidence interval [CI] = 3.72-12.37) and elevated mortality risk after episodes (hazard ratio [HR] = 1.60, 95% CI = 1.28-2.00). Persons with multiple minor nonsentinel injuries within a year also had elevated mortality (HR = 1.56, 95% CI = 1.15-2.11) and institutionalization (SHR = 3.55, 95% CI = 2.25-5.67) risks. Mortality and institutionalization risks extend well beyond the acute episode of treatment for sentinel and repeated minor injuries. More research is needed on longer-term health outcomes of injury survivors to inform development of evidence-based quality-of-care indicators. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
Miller, Peter; Droste, Nicolas; Baker, Tim; Gervis, Cathreena
The present study summarises the methodology and findings of a pilot project designed to measure the sources and locations of alcohol-related harm by implementing anonymised 'last drinks' questions in the ED of a rural community. 'Last drinks' questions were added to computerised triage systems at South West Healthcare ED in rural Warrnambool, Victoria, from 1 November 2013 to 3 July 2014. For all injury presentations aged 15 years or older, attendees were asked whether alcohol was consumed in the 12 h prior to injury, how many standard drinks were consumed, where they purchased most of the alcohol and where they consumed the last alcoholic drink. From 3692 injury attendances, 10.8% (n = 399) reported consuming alcohol in the 12 h prior to injury. 'Last drinks' data collection was 100% complete for participants who reported alcohol use prior to injury. Approximately two-thirds (60.2%) of all alcohol-related presentations had purchased their alcohol at packaged liquor outlets. During high-alcohol hours, alcohol-related injuries accounted for 36.1% (n = 101) of all ED injury presentations, and in total 41.7% of alcohol-related attendances during these hours reported consuming last drinks at identifiable hotels, bars, nightclubs or restaurants, or identifiable public areas/events. This pilot demonstrates the feasibility and reliability of implementing sustainable 'last drinks' data collection methods in the ED, and the ability to effectively map the source of alcohol-related ED attendances in a rural community. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Graham, J. W.; Tatterson, J. W.; Roberts, M. M.; Johnston, S. E.
The Alcohol-related Harm Prevention (AHP) program is a normative education and skill-acquisition program designed to reduce serious, long-term alcohol-related harm in college students. Without admonishing students not to drink, which is likely to fail in many student populations, the AHP program attempts to give students the necessary perceptions,…
Malisoux, Laurent; Frisch, Anne; Urhausen, Axel; Seil, Romain; Theisen, Daniel
Careful modulation of training characteristics in high-level sports optimizes performance and avoids inappropriate workloads and associated sports injury risk. The aims of this study were to compare sport participation characteristics in different youth sport categories and to investigate their relationship with injury. Prospective cohort follow-up. Young (12-19 years) high-level athletes (n=154) from a regional sport school were followed during 41 weeks regarding sport participation characteristics and traumatic and overuse sports injuries (time-loss definition). All data were self-recorded by the athletes in an electronic system "TIPPS" (Training and Injury Prevention Platform for Sports) and subject to a systematic data quality control. Volume and intensity (self-rated perceived exertion) of each sport session were used to compute weekly load, monotony and strain. Sport categories were defined as team, racket, and individual sports. All sport participation characteristics were dependent on sport category (psports were associated with lower injury risk (HR=0.37 and 0.34, p=0.001 and psports. Average sport participation characteristics were not related to injury according to the survival analysis. However, intensity during the week prior to injury was significantly higher (psport participation pattern and injury risk in young athletes. The monitoring method was sensitive to variations according to pertinent variables and might help identify athletes with increased sports injury risk. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
de Rome, Liz; Boufous, Soufiane; Georgeson, Thomas; Senserrick, Teresa; Ivers, Rebecca
A majority of cyclists' hospital presentations involve relatively minor soft tissue injuries. This study investigated the role of clothing in reducing the risk of cyclists' injuries in crashes. Adult cyclists were recruited and interviewed through hospital emergency departments in the Australian Capital Territory. This paper focuses on 202 who had crashed in transport related areas. Eligible participants were interviewed and their self-reported injuries corroborated with medical records. The association between clothing worn and injury was examined using logistic regression while controlling for potential confounders of injury. A high proportion of participants were wearing helmets (89%) and full cover footwear (93%). Fewer wore long sleeved tops (43%), long pants (33%), full cover gloves (14%) or conspicuity aids (34%). The primary cause of injury for the majority of participants (76%) was impact with the ground. Increased likelihood of arm injuries (Adj. OR=2.06, 95%CI: 1.02-4.18, p=0.05) and leg injuries (Adj. OR=3.37, 95%CI: 1.42-7.96, p=0.01) were associated with wearing short rather than long sleeves and pants. Open footwear was associated with increased risk of foot or ankle injuries (Adj. OR=6.21, 95%CI: 1.58-23.56, p=0.01) compared to enclosed shoes. Bare hands were associated with increased likelihood of cuts, lacerations or abrasion injuries (Adj. OR=4.62, 95%CI: 1.23-17.43, p=0.02) compared to wearing full cover gloves. There were no significant differences by fabric types such as Lycra/synthetic, natural fiber or leather. Clothing that fully covers a cyclist's body substantially reduced the risk of injuries in a crash. Coverage of skin was more important than fabric type. Further work is necessary to determine if targeted campaigns can improve cyclists' clothing choices and whether impact protection can further reduce injury risk. Copyright © 2014 Elsevier Ltd. All rights reserved.
Alcohol related violence is a troubling backdrop to the social lives and relationships of many young people in post-industrial societies. The development of the night-time economy where young people are encouraged to drink heavily in entertainment precincts has increased the risk of violence. This paper reports on 60 individual structured in-depth interviews about the drinking biographies of young people (aged 20-24) living in Victoria, Australia. Twenty-six males and 34 females participated in the research. The participants discussed their experiences with alcohol over their life course to date. The material on alcohol related violence is analysed in this paper. Just over half of the participants (33/60) recounted negative experiences with alcohol related violence. The findings demonstrate the continuing gendered nature of experiences of perpetration and victimization. Participants reported that aggression and violence perpetrated by some men was fuelled by alcohol consumption and required ongoing management. Experiences of violence were also spatialized. Men were more likely to report managing and avoiding violence in particular public settings whilst more women than men discussed managing violence in domestic settings. The central argument of this paper is that incidents of alcohol related violence and reactions to it are specific gender performances that occur in specific socio-cultural contexts. In contrast to research which has found some young people enjoy the adventure and excitement of alcohol related violence the mainstream participants in this study saw violence as a negative force to be managed and preferably avoided. Understanding violence as a dynamic gender performance complicates the development of policy measures designed to minimize harm but also offers a more holistic approach to developing effective policy in this domain. There is a need for greater acknowledgement that alcohol related violence in public venues and in families is primarily about
Hogan, Catherine M; Weaver, Nancy L; Cioni, Claire; Fry, Jessica; Hamilton, Alyssa; Thompson, Samantha
More than 9,000 children die annually from various causes of unintentional injury. Of all the pediatric unintentional injuries occurring in the United States, 8.7 million are treated in emergency departments, and 225,000 require hospitalization annually. Health education programs are available to address these injuries. The objective of this research was to examine the distribution of self-reported high priority injury risks in an urban Midwestern pediatric level 1 trauma center and investigate the relationship between parental perceptions and injury-prevention behaviors. Prevalence rates for 3 data sources are compared. Missouri Information for Community Assessment (MICA) was categorized to mirror variables corresponding with risks of injury presented in the Safe 'n' Sound (SNS) program. Level 1 trauma center data were examined to determine how the variables were distributed compared with MICA data and with the parent-reported levels. A total of 429 SNS surveys were compared with ED data and MICA data. For SNS users, car crashes were identified as the highest risk, specifically due to the use of incorrect car seats. The injuries seen most often in the emergency department were falls, and falls were also the most prevalent injury captured by MICA. Controlling for demographics, parental perceptions predicted several risks for injury. Because parental perceptions are significantly related to risks of injury, prevention programs aiming to decrease injuries could focus on the perceptions. Not only can perceptions be used to tailor health communication materials, these perceptions can be the targets of change. Further work might investigate the extent to which changes in perceptions result in increased adoption of safety practices. Copyright © 2017 Elsevier Inc. All rights reserved.
Koziol-McLain, J; Brand, D; Morgan, D; Leff, M; Lowenstein, S R
Recently (1996-98), Colorado added 15 questions pertaining to injury related risks and behaviors to the behavioral risk factor surveillance system (BRFSS). Questions addressed bicycle helmet use, traffic crashes, exposure to violence, suicidal behavior, and gun storage. To measure the test-retest reliability of these injury related questions. Of 330 BRFSS participants, 229 (69%) were called a second time and reasked nine selected injury questions. Retests were completed 7-28 days after the original interview. Test-retest agreement was very high (kappa >0.80) for bicycle helmet use, domestic police visits, and gun ownership. All other injury risk questions had substantial agreement (kappa >0.60). The injury related questions added to the Colorado BRFSS have high test-retest reliability.
Tognon, Ilaria Desirée
The aim of the work has been to evaluate the risk of injuries connected to the use of machinery and work tools in the footwear industry. The analysis of the data related to injuries in the footwear industry, deduced from the registers of injuries collected in the investigated factories, shows that most accidents arise from the contact of the operator's hands with tools and machinery parts during their use. Risk factors generally include the inherent specific danger of some work tools and machines, the lack or inadequacy of safety devices, the obsolescence of the equipment, the imprudence and underestimation of risk.
Niebuhr, Tobias; Junge, Mirko; Rosén, Erik
Older adults and pedestrians both represent especially vulnerable groups in traffic. In the literature, hazards are usually described by the corresponding injury risks of a collision. This paper investigates the MAIS3+F risk (the risk of sustaining at least one injury of AIS 3 severity or higher, or fatal injury) for pedestrians in full-frontal pedestrian-to-passenger car collisions. Using some assumptions, a model-based approach to injury risk, allowing for the specification of individual injury risk parameters for individuals, is presented. To balance model accuracy and sample size, the GIDAS (German In-depth Accident Study) data set is divided into three age groups; children (0-14); adults (15-60); and older adults (older than 60). For each group, individual risk curves are computed. Afterwards, the curves are re-aggregated to the overall risk function. The derived model addresses the influence of age on the outcome of pedestrian-to-car accidents. The results show that older people compared with younger people have a higher MAIS3+F injury risk at all collision speeds. The injury risk for children behaves surprisingly. Compared to other age groups, their MAIS3+F injury risk is lower at lower collision speeds, but substantially higher once a threshold has been exceeded. The resulting injury risk curve obtained by re-aggregation looks surprisingly similar to the frequently used logistic regression function computed for the overall injury risk. However, for homogenous subgroups - such as the three age groups - logistic regression describes the typical risk behavior less accurately than the introduced model-based approach. Since the effect of demographic change on traffic safety is greater nowadays, there is a need to incorporate age into established models. Thus far, this is one of the first studies incorporating traffic participant age to an explicit risk function. The presented approach can be especially useful for the modeling and prediction of risks, and for the
Ward, Cynthia W.
Youth participation in sports has increased greatly over the past 20 years. Consequently, there has been a rise in the number of sports injuries. A study was conducted to determine teen's level of physical activity, knowledge about risk factors for sports injuries, use of protective equipment, and parental involvement. Two groups of teens, one of…
Hendriks, Hanneke; Gebhardt, Winifred A; van den Putte, Bas
Many young people place alcohol-related posts on social networking sites (SNS) which can result in undesirable effects. Although several recent studies have investigated the occurrence of alcohol-related SNS use, it is neither clear (a) what type of alcohol posts are placed on SNS, (b) the motivations to place alcohol posts, nor (c) which young people are most likely to place alcohol posts. This study addressed these three goals. A large cross-sectional study among young participants (12-30 years; N = 561) assessed the posting of different types of alcohol posts, the motivations to (not) post these posts, and potential differences in posting between subgroups (i.e., in terms of age, gender, and religion). Participants reported that they most often placed moderate, instead of more extreme, alcohol posts, in particular, when alcohol was present in the post "by chance". Furthermore, they indicated to post alcohol-related content mostly for entertainment reasons. Finally, we found differences in self-reported posting and motivations to post according to age, gender, and religion. These findings provide relevant implications for future interventions aiming to decrease alcohol posts, for example, by making participants aware of their posting behavior and by targeting specific at risk groups. Future research should explore the effectiveness of such intervention strategies and should investigate whether alcohol posts lead to an underestimation of alcohol-related risks.
Full Text Available Currently, there is intense clinical research into various aspects of the medical risks relating to epilepsy, including total and cause-specific mortality, accidents and injuries in patients with epilepsy and mortality related with seizures. Seizures occurring in precarious situations and resulting in injuries are still an important concern for patients with epilepsy, their employers and their caregivers. Submersion injuries, motor vehicle accidents, burns, and head injuries are among the most feared epilepsy-related injuries. These concerns seem valid because the hallmark of epilepsy, episodic impairment of consciousness and motor control, may occur during interictal EEG epileptiform discharges, even in the absence of a clinical seizure. In addition, psychomotor comorbidity and side effects of antiepileptic drugs may contribute to the risk of injuries in patients with epilepsy. Published risk factors for injuries include the number of antiepileptic drugs, history of generalized seizures, and seizure frequency. In general, epidemiological information about incidence of injuries has been conflicting and sparse. In general, studies focusing on populations with more severe forms of epilepsy tend to report substantially higher risks of injuries than those involving less selected populations. On the other hand, studies based on non-selected populations of people with epilepsy have not shown an increased frequency of injuries in people with epilepsy compared with the general population. Some studies have shown that patients with epilepsy are more frequently admitted to the hospital following an injury. Possible explanations include: more cautious attitude of clinicians toward injuries occurring in the setting of seizures; hospitalization required because of seizures and not to the injuries themselves; and hospitalization driven by other issues, such as comorbidities, which are highly prevalent in patients with epilepsy. Potentially the high rate of
Green, Brady; Pizzari, Tania
To systematically review the literature to identify risk factors for calf strain injury, and to direct future research into calf muscle injuries. Systematic review DATA SOURCES: Database searches conducted for Medline, CINAHL, EMBASE, AMED, AUSPORT, SportDiscus, PEDro and Cochrane Library. Manual reference checks, ahead of press searches, citation tracking. From inception to June 2016. Studies evaluating and presenting data related to intrinsic or extrinsic risk factors for sustaining future calf injury. Ten studies were obtained for review. Subjects across football, Australian football, rugby union, basketball and triathlon were reported on, representing 5397 athletes and 518 calf/ lower leg muscle injuries. Best evidence synthesis highlights chronological age and previous history of calf strain are the strongest risk factors for future calf muscle injury. Previous lower limb injuries (hamstring, quadriceps, adductor, knee) show some limited evidence for an association. Numerous factors lack evidence of an association, including height, weight, gender and side dominance. Increasing age and previous calf strain injury are the most predictive of future calf injury. The overall paucity of evidence and the trend for studies of a high risk of bias show that further research needs to be undertaken. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Jaques, M L; Weaver, T L; Weaver, N L; Willoughby, L
Unintentional injuries are the leading cause of death in children ages 1-18 years. Many of these injuries to young children occur in their own homes. Although research has explored injury risk prevention strategies, historically, much of this research has focused on environmental changes and teaching safety practices. Currently, there appears to be a gap in current research exploring how parenting influences children's risk of injury. Mothers (n = 119) of children 5 years and younger were recruited from a paediatric clinic as a part of a larger study and completed measures of parenting challenges, developmentally sensitive parenting, child neglect, parental efficacy, and risk of potential injury situations. Hierarchical logistic regression was used to explore the extent to which developmentally insensitive parenting behaviours put parents at higher risk for behaviours that lead to unintentional injury in children and whether developmentally sensitive parenting behaviours protects children from injury. The association between demographic characteristics and injury risk behaviours was also examined. Parents who reported more frequent insensitive parenting behaviours (i.e., yelling, spanking, and putting child in time out) were more likely to report putting their child in an incorrect car seat or taking their child out of a car seat while the car is still moving. In addition, younger parents were at greater risk of storing cleaners and medications unsafely. Results from this study highlight the importance of supporting younger mothers and educating parents on effective parenting strategies when trying to prevent unintentional injury risks. © 2017 John Wiley & Sons Ltd.
Sran, R; Djerboua, M; Romanow, N; Mitra, T; Russell, K; White, K; Goulet, C; Emery, C; Hagel, B
The objective of our study was to evaluate incidence rates and profile of school program ski and snowboard-related injuries by school grade group using a historical cohort design. Injuries were identified via Accident Report Forms completed by ski patrollers. Severe injury was defined as those with ambulance evacuation or recommending patient transport to hospital. Poisson regression analysis was used to examine the school grade group-specific injury rates adjusting for risk factors (sex, activity, ability, and socioeconomic status) and accounting for the effect of clustering by school. Forty of 107 (37%) injuries reported were severe. Adolescents (grades 7-12) had higher crude injury rates (91 of 10 000 student-days) than children (grades 1-3: 25 of 10 000 student-days; grades 4-6: 65 of 10 000 student-days). Those in grades 1-3 had no severe injuries. Although the rate of injury was lower in grades 1-3, there were no statistically significant grade group differences in adjusted analyses. Snowboarders had a higher rate of injury compared with skiers, while higher ability level was protective. Participants in grades 1-3 had the lowest crude and adjusted injury rates. Students in grades 7-12 had the highest rate of overall and severe injuries. These results will inform evidence-based guidelines for school ski/snowboard program participation by school-aged children. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Brennan, Iain R
This study identifies the individual, situational, and alcohol-related factors associated with reporting violent victimization to the police. Factors positively associated with reporting included older age and incident severity (the assailant's use of a weapon, incurring injury that required attendance at an emergency department). Factors negatively associated with reporting included higher educational qualifications, assault in the nighttime economy (NTE), and drinking more than two alcoholic drinks immediately prior to victimization. It is possible that drinkers engage in "moratorium" on reporting violence in the NTE. Recognizing and reducing the acceptability of violence in the NTE may help reduce incidence of alcohol-related violence. Organizations that use police records of violence to inform practice and policy should account for uneven distributions in reporting behavior when analyzing trends in violence.
Montalvo, Alicia M; Shaefer, Hilary; Rodriguez, Belinda; Li, Tan; Epnere, Katrina; Myer, Gregory D
The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002) and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce the increase risk of injury during CrossFit.
Bushman, Timothy T; Grier, Tyson L; Canham-Chervak, Michelle C; Anderson, Morgan K; North, William J; Jones, Bruce H
The Functional Movement Screen (FMS) is a tool intended to evaluate limitations or asymmetries of movement to detect individuals at risk for exercise- and sports-related injury. The purpose was to determine the association and predictive value of specific FMS tests with injury risk in physically active men. Soldiers aged 18-57 years completed the FMS (n = 2,476). Demographic and fitness data were collected by survey. Medical record data for any, overuse, and traumatic injury 6 months after the assessment were obtained. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated along with receiver operator characteristics to determine area under the curve (AUC). Risks, risk ratios, odds ratios (ORs), and 95% confidence intervals were calculated to assess injury risks. Multivariate logistic regression identified that pain on 5 of the 7 tests was associated with greater risk for any injury (OR = 1.50-3.51): deep squat, hurdle step, in-line lunge, trunk stability push-up, and rotary stability. However, FMS registered low sensitivity, PPV, and AUC for all 7 tests for the 3 injury types (2-24% sensitivity, 16-74% PPV, and 50-58% AUC). Although the presence of pain was associated with a higher risk of injury on 5 tests, a low sensitivity, PPV, and AUC were displayed. Therefore, caution is advised when implementing the FMS as a screening tool in an Army or similarly active population as it could lead to prevention and treatment resources being directed toward individuals who are not at greater risk for injury.
Voogt, C.V.; Otten, R.; Kleinjan, M.; Engels, R.C.M.E.; Kuntsche, E.N.
Background: Limited research is available on children's alcohol-related knowledge and alcohol-related norms, yet a better comprehension of these factors may be crucial in explaining alcohol use later in life. This study provides insights into alcohol-related knowledge and alcohol-related norms in
Voogt, Carmen; Otten, Roy; Kleinjan, Marloes; Engels, Rutger; Kuntsche, Emmanuel
BACKGROUND: Limited research is available on children's alcohol-related knowledge and alcohol-related norms, yet a better comprehension of these factors may be crucial in explaining alcohol use later in life. This study provides insights into alcohol-related knowledge and alcohol-related norms in 4-
Full Text Available The paper gives an overview of employment in coal mining, levels of extraction and injuries among the coal mine operators in Poland over a span of time from 1954 through to 2010. The injury indicators, such as the incidence rate, severity and the generalized loss index, have been assessed for a period of coal mining sector restructuring from 1993 to 2010. Diverging trends have been revealed, resulting in a need to extend the time span of the analysis. Analysis of records from 1954 to 2010 has shown a multiple cyclicity of trends of change in the values used to derive coefficients. The definition of the Injury Risk has been justified, along with a new way for its representation and its interpretation as a new method with account of the previous studies. Based on this method the injuries at the coal mines of Poland during a period of their restructuring have been investigated with analyzed database expansion to include records from 1954 to 2010.As a result a new dependency, namely the injury risk hysteresis, has been identified. A proposed new method for assessing the injury risk is universal and can be applied not only to the coal mines, but to any facility of any sector within the country and even at the inter-state level. The method can be used to analyze data on the injury incidence rate per 1000 people and the injury severity rate over any span of time.
Austin, Laurel Cecelia; Fischhoff, Baruch
Individuals' decisions and behaviour can play a critical role in determining both the probability and severity of injury. Behavioural decision research studies peoples' decision-making processes in terms comparable to scientific models of optimal choices, providing a basis for focusing...... interventions on the most critical opportunities to reduce risks. That research often seeks to identify the ‘mental models’ that underlie individuals' interpretations of their circumstances and the outcomes of possible actions. In the context of injury prevention, a mental models approach would ask why people...... and uses examples to discuss how the approach can be used to develop scientifically validated context-sensitive injury risk communications....
Elliott, Michael R; Margulies, Susan S; Maltese, Matthew R; Arbogast, Kristy B
There has been recent dramatic increase in the use of sensors affixed to the heads or helmets of athletes to measure the biomechanics of head impacts that lead to concussion. The relationship between injury and linear or rotational head acceleration measured by such sensors can be quantified with an injury risk curve. The utility of the injury risk curve relies on the accuracy of both the clinical diagnosis and the biomechanical measure. The focus of our analysis was to demonstrate the influence of three sources of error on the shape and interpretation of concussion injury risk curves: sampling variability associated with a rare event, concussion under-reporting, and sensor measurement error. We utilized Bayesian statistical methods to generate synthetic data from previously published concussion injury risk curves developed using data from helmet-based sensors on collegiate football players and assessed the effect of the three sources of error on the risk relationship. Accounting for sampling variability adds uncertainty or width to the injury risk curve. Assuming a variety of rates of unreported concussions in the non-concussed group, we found that accounting for under-reporting lowers the rotational acceleration required for a given concussion risk. Lastly, after accounting for sensor error, we find strengthened relationships between rotational acceleration and injury risk, further lowering the magnitude of rotational acceleration needed for a given risk of concussion. As more accurate sensors are designed and more sensitive and specific clinical diagnostic tools are introduced, our analysis provides guidance for the future development of comprehensive concussion risk curves. Copyright © 2015 Elsevier Ltd. All rights reserved.
Traditionally, balance training has been used as part of the rehabilitation programme for ankle injuries. More recently, balance training has been adopted to try and prevent injuries to the ankle and knee joints during sport. The purpose of this review is to synthesise current knowledge in the area of balance ability, training and injury risk, highlight the findings and identify any future research needs. A number of studies have found that poor balance ability is significantly related to an increased risk of ankle injuries in different activities. This relationship appears to be more common in males than females. Multifaceted intervention studies that have included balance training along with jumping, landing and agility exercises have resulted in a significant decrease in ankle or knee injuries in team handball, volleyball and recreational athletes. It is unknown which component of the multifaceted intervention was most effective and whether the effects are additive. As a single intervention, balance training has been shown to significantly reduce the recurrence of ankle ligament injuries in soccer, volleyball and recreational athletes; however, it has not been clearly shown to reduce ankle injuries in athletes without a prior ankle injury. Balance training on its own has also been shown to significantly reduce anterior cruciate ligament injuries in male soccer players. Surprisingly, it was also found to be significantly associated with an increased risk of major knee injuries in female soccer players and overuse knee injuries in male and female volleyball players. The studies with the contrasting findings differed in aspects of their balance training programmes. It would appear that balance training, as a single intervention, is not as effective as when it is part of a multifaceted intervention. Research is required to determine the relative contribution of balance training to a multifaceted intervention so as to generate an effective and efficient preventative
Bhamkar, Rahul; Seth, Bageshree; Setia, Maninder Singh
To study the profile and various risk factors associated with unintentional injuries in children. The study is a cross sectional analysis of data collected from 351 children presenting with unintentional injury to a tertiary care hospital in Navi Mumbai, India. Data were collected about variables based on Haddon Phase Factor Matrix - host, environment and agent factors. Proportions for categorical variables across various groups were compared using Chi square test or Fisher's exact test. Logistic regression model was used to evaluate the factors. Falls (36 %) were the most common injuries followed by bites (23 %). Majority of children were school going children (38 %) followed by preschool children (29 %). Forty-seven percent were from lower socioeconomic class. Commonest place of injury was home (48 %) and the commonest time was evening (49 %). Though there was male predominance in injuries, the difference across gender did not vary significantly (p = 0.15). Poisonings were significantly more common in infants and toddlers and in rural population (p Injuries from rural area and lower socioeconomic class were more serious, requiring hospitalization; they were also more likely to present late to the hospital (p injuries varies widely as per the variations in agent, host and environmental factors. Socio-environmental, economic conditions and infancy-toddler age groups are predisposing risk factors for bites and poisoning. Although rural areas and lower socioeconomic class population are more vulnerable to serious types of injuries, they still lack essential basic medical care.
Benzon Larsen, Signe; Vogel, Ulla Birgitte; Christensen, Jane
, Cancer and Health study. Among variant allele carriers of ADH1C Arg(272)Gln, alcohol intake increased the risk of breast cancer with 14% (95% CI: 1.04-1.24) per 10g alcohol/day, but not among homozygous wild type carriers (p for interaction=0.06). Thus, slow oxidation of ethanol seemed to be associated...
Alicia M. Montalvo, Hilary Shaefer, Belinda Rodriguez, Tan Li, Katrina Epnere, Gregory D. Myer
Full Text Available The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002 and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p < 0.001 than non-competitors. Athletes who reported injury also reported significantly higher values for the following risk factors: years of participation (2.7 ± 1.8 v 1.8 ± 1.5, p = 0.001, weekly athlete training hours (7.3 ± 3.8 v 4.9 ± 2.1, p = 0.020, weekly athlete-exposures (6.4 ± 3.8 v 4.7 ± 2.1, p = 0.003, height (1.72 ± 0.09 m v 1.68 ± 0.01 m, p = 0.011, and body mass (78.24 ± 16.86 kg v 72.91 ± 14.77 kg, p = 0.037. Injury rates during CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce
Cui, M J; Chen, Y; Li, Y; Hu, J; Zhang, X J
Objective: To examine the risk factors for road traffic injury in agricultural vehicle drivers. Methods: A total of 103 drivers (who had suffered agricultural vehicle road traffic injury within the past year based on the road traffic injury registrar from the Traffic Management Bureau) who were involved in the annual agricultural vehicle inspection from December 2014 to January 2015 were randomly sampled from the Yixing Agricultural Vehicle Station as the case group for this study. Based on a 1∶2 assignment ratio and matched for sex, age, and education, a total of 206 drivers who had not suffered any agricultural vehicle road traffic injury within the past year were selected as the control group. The general information, vehicle information, driving information, driving behavior, and accident details of the agricultural vehicle drivers were analyzed. Results: The incidence rate of road traffic injury was 7.24% given the 103 agricultural vehicle drivers who had suffered agricultural vehicle road traffic injury in the past year. Univariate logistic regression analysis showed that drinking, debt, pressure, history of car accident, history of drunk driving, smoking and phone use during driving, fatigue driving, and driving with illness were the risk factors for road traffic injury in agricultural vehicle drivers ( OR =2.332, 2.429, 19.778, 5.589, 8.517, 2.125, 3.203, 10.249 and 5.639, respectively) . Multivariate logistic regression analysis also demonstrated that pressure, history of car accident, history of drunk driving, fatigue driving, and driving with illness were the risk factors for road traffic injury in agricultural vehicle drivers ( OR =12.139, 11.184, 6.729, 5.939, and 6.544, respectively) . Conclusion: Pressure, history of car accident, history of drunk driving, fatigue driving, and driving with illness are the major risk factors for road traffic injury in agricultural vehicle drivers.
Theisen, Daniel; Frisch, Anne; Malisoux, Laurent; Urhausen, Axel; Croisier, Jean-Louis; Seil, Romain
This study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries. Prospective cohort follow-up. Pupils from a public sports school (12-19 years) were recruited over two separate school years (2008-2009: 42 weeks, n=199 athletes; 2009-2010: 40 weeks, n=89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire. Injury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000h, respectively), as a result of a higher incidence of both traumatic (RR=2.17; CI95%=1.75-2.70; pteam sports participation had a hazard ratio of 2.00 (CI95%=1.49-2.68; pteam sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR=1.072; CI95% [1.033; 1.113]; pTeam sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Tupler, Larry A; Zapp, Daniel; DeJong, William; Ali, Maryam; O'Rourke, Sarah; Looney, John; Swartzwelder, H Scott
Many transgender college students struggle with identity formation and other emotional, social, and developmental challenges associated with emerging adulthood. A potential maladaptive coping strategy employed by such students is heavy drinking. Prior literature has suggested greater consumption and negative alcohol-related consequences (ARCs) in transgender students compared with their cisgender peers, but little is known about their differing experiences with alcohol-related blackouts (ARBs). We examined the level of alcohol consumption, the frequency of ARBs and other ARCs, and motivations for drinking reported by the largest sample of transgender college students to date. A Web survey from an alcohol-prevention program, AlcoholEdu for College™, assessed student demographics and drinking-related behaviors, experiences, and motivations of newly matriculating first-year college students. A self-reported drinking calendar was used to examine each of the following measures over the previous 14 days: number of drinking days, total number of drinks, and maximum number of drinks on any single day. A 7-point Likert scale was used to measure ARCs, ARBs, and drinking motivations. Transgender students of both sexes were compared with their cisgender peers. A total of 989 of 422,906 students (0.2%) identified as transgender. Over a 14-day period, transgender compared with cisgender students were more likely to consume alcohol over more days, more total drinks, and a greater number of maximum drinks on a single day. Transgender students (36%) were more likely to report an ARB than cisgender students (25%) as well as more negative academic, confrontation-related, social, and sexual ARCs. Transgender respondents more often cited stress reduction, social anxiety, self-esteem issues, and the inherent properties of alcohol as motivations for drinking. For nearly all measures, higher values were yielded by male-to-female than female-to-male transgender students. Transgender
Sytema, Renee; Dekker, Rienk; Dijkstra, Pieter U; ten Duis, Hendrik J; van der Sluis, Corry K
To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Retrospective cohort study. An emergency department of a large European level I trauma center. A total of 25 120 patients with a simple sports injury, attending during 1990-2005. Independent variables used to assess risk factors were extracted from a local database. These include age, sex, type of injury, site and side of the injury, type of sport, injury mechanism, and data on admission. Main outcome measure was the relation of various risk factors to the occurrence of either upper or lower extremity injury. Logistic regression analysis was used to identify predictors for upper extremity injury. Thirty-five percent upper and 53% lower extremity injuries were recorded. Most injuries were sustained when playing soccer (36%). Fractures were more frequently diagnosed in the upper than in the lower extremities (44% and 14%, respectively), especially in children. Falling was the main cause of upper extremity injury. Further risk factors were young age and playing individual sports, no-contact sports, or no-ball sports. Women were at risk in speed skating, inline skating, and basketball, whereas men mostly got injured during skiing and snowboarding. A high percentage of sports injuries are sustained to the upper extremity. Different risk factors were identified for both sexes. These risk factors should be taken into account when designing preventive measures.
Sytema, Renee; Dekker, Rienk; Dijkstra, Pieter U.; ten Duis, Hendrik J.; van der Sluis, Corry K.
Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting: An emergency department of a large European level I trauma center. Patients: A total of 25 120 patients with a simple sports injury, attending during 1990-2005. Assessment of Risk Factors: Independ...
Yau, Rebecca K; Strotmeyer, Elsa S; Resnick, Helaine E; Sellmeyer, Deborah E; Feingold, Kenneth R; Cauley, Jane A; Vittinghoff, Eric; De Rekeneire, Nathalie; Harris, Tamara B; Nevitt, Michael C; Cummings, Steven R; Shorr, Ronald I; Schwartz, Ann V
To determine whether older adults with diabetes are at increased risk of an injurious fall requiring hospitalization. The longitudinal Health, Aging, and Body Composition Study included 3,075 adults aged 70-79 years at baseline. Hospitalizations that included ICD-9-Clinical Modification codes for a fall and an injury were identified. The effect of diabetes with and without insulin use on the rate of first fall-related injury hospitalization was assessed using proportional hazards models. At baseline, 719 participants had diabetes, and 117 of them were using insulin. Of the 293 participants who were hospitalized for a fall-related injury, 71 had diabetes, and 16 were using insulin. Diabetes was associated with a higher rate of injurious fall requiring hospitalization (hazard ratio [HR] 1.48 [95% CI 1.12-1.95]) in models adjusted for age, race, sex, BMI, and education. In those participants using insulin, compared with participants without diabetes, the HR was 3.00 (1.78-5.07). Additional adjustment for potential intermediaries, such as fainting in the past year, standing balance score, cystatin C level, and number of prescription medications, accounted for some of the increased risk associated with diabetes (1.41 [1.05-1.88]) and insulin-treated diabetes (2.24 [1.24-4.03]). Among participants with diabetes, a history of falling, poor standing balance score, and A1C level ≥8% were risk factors for an injurious fall requiring hospitalization. Older adults with diabetes, in particular those using insulin, are at greater risk of an injurious fall requiring hospitalization than those without diabetes. Among those with diabetes, poor glycemic control may increase the risk of an injurious fall.
Czech, Suzanne; Shakeshaft, Anthony P; Byrnes, Joshua M; Doran, Christopher M
Existing studies have identified that, although to a lesser extent than individual factors such as males and young people, rural (compared to urban) communities represent a disproportionately high-risk of alcohol-related traffic crashes (ARTCs). To date, however, few studies have attempted to apply different costs to alcohol crashes of different severity, to provide more precise, and practically useful, data on which to base public health policy and intervention decisions. The aim of this study is to quantify the per capita prevalence and differential costs of alcohol crashes of different levels of severity to determine the extent to which urban and rural geographical areas may differ in the costs attributable to ARTCs. A cross-sectional analysis of alcohol-related traffic crash and costs data from 2001 to 2007. Data from New South Wales, Australia. Modified routinely collected traffic accident data to which costs relevant to alcohol crashes of different severity are applied. Although the rate per 10,000 population of alcohol-related crashes is 1.5 times higher in rural, relative to urban, communities, the attributable cost is four times higher, which largely reflects that rural alcohol-fatalities are seven to eight times more prevalent and costly. Given that per capita alcohol-related fatal crashes in rural areas account for a disproportionately large proportion of the harms and costs associated with alcohol-related traffic crashes, the cost-effectiveness of public health interventions and public policy initiatives should consider the relative extent of ARTC-harm in rural versus urban communities. Copyright 2010 Elsevier Ltd. All rights reserved.
Conclusion: Elderly Taiwanese inpatients with existing intrinsic conditions of cancer, vertigo, and lower leg weakness were at high risk of falling, resulting in severe injuries. Additional research including controlled trials is necessary to further identify treatable, causal intrinsic risk factors for this elderly group.
Brett, Emma I; Leavens, Eleanor L; Miller, Mary Beth; Lombardi, Nathaniel; Leffingwell, Thad R
College students in the U.S. continue to drink in hazardous ways and experience a range of alcohol-related consequences. Personalized feedback interventions (PFIs), which often include normative components comparing personal drinking to that of similar peers, have been effective in reducing alcohol outcomes among college students. Though normative perceptions of the quantity and frequency of alcohol use have been examined in many studies, norms for alcohol-related consequences have received less attention. The current study examined self-other discrepancies (SODs) for alcohol-related consequences among college students. Participants overestimated how often alcohol-related consequences are experienced by other same-sex students on campus and rated consequences as more acceptable for others to experience than themselves. No differences in SODs were found between those who did and did not report alcohol use. Future studies should examine the efficacy of PFIs that incorporate normative feedback on alcohol-related consequences. Copyright © 2016 Elsevier Ltd. All rights reserved.
Razvodovsky, Yury E
Alcohol abuse has numerous adverse health and social consequences. The consumer response to changes in alcohol affordability is an important issue on alcohol policy debates. Studies from many countries have shown an inverse relationship between alcohol prices and alcohol consumption in the population. There are, however, suggestions that increasing the price of alcohol by rising taxes may have limited effect on alcohol-related problems, associated with long-term heavy drinking. The aim of the present study was to evaluate the relationship between alcohol affordability and alcohol-related mortality rates in post-Soviet Belarus. For this purpose trends in alcohol-related mortality rates (mortality from liver cirrhosis, pancreatitis, alcoholism and alcohol psychoses) and affordability of vodka between 1990 and 2010 were compared. The time series analysis revealed that 1% increase in vodka affordability is associated with an increase in liver cirrhosis mortality of 0,77%, an increase in pancreatitis mortality of 0.53%, an increase in mortality from alcoholism and alcohol psychoses of 0,70%. The major conclusion emerging from this study is that affordability of alcohol is one of the most important predictor of alcohol-related problems in a population. These findings provide additional evidence that decreasing in affordability of alcohol is an effective strategy for reducing alcohol consumption and alcohol-related harm.
Møller, Martin Nue; Sørensen, Christian Hjort
% of the cases in whom two of them had the nerve sacrificed for oncologic reasons during the operation. In 18 patients with parotic cancer the corresponding permanent frequency of MMN paralysis was 11.1%. In 46 patients with neck dissection in level II A but not in level I B, no paresis of the MMN was registered....... Recognition of the MMN during the operation, pre- or postoperative radiation therapy, re-operation for deep hemorrhage, age, gender or postoperative infection did not have any statistically significant influence on the frequency of MMN injury. In conclusion we found a moderate risk of injury to the MMN after......The immediate and permanent frequency of injury to the marginal mandibular branch of the facial nerve (MMN) after neck dissection has only scarcely been addressed in the medical literature. We investigated the risk of injury in 159 consecutive patients after neck dissection for various reasons...
Brussoni, Mariana; Brunelle, Sara; Pike, Ian; Sandseter, Ellen Beate Hansen; Herrington, Susan; Turner, Heather; Belair, Scott; Logan, Louise; Fuselli, Pamela; Ball, David J
To reflect on the role of risk-taking and risky play in child development and consider recommendations for the injury prevention field, a symposium was held prior to the November 2013 Canadian Injury Prevention and Safety Promotion Conference. Delegates heard from Canadian and international researchers, practitioners and play safety experts on child development, play space design and playground safety, provision of recreation, and legal and societal perceptions of risk and hazard. The presenters provided multidisciplinary evidence and perspectives indicating the potential negative effect on children's development of approaches to injury prevention that prioritise safety and limit children's opportunities for risky play. Delegates considered the state of the field of injury prevention and whether alternative approaches were warranted. Each presenter prepared a discussion paper to provide the opportunity for dialogue beyond attendees at the symposium. The resulting discussion papers provide a unique opportunity to consider and learn from multiple perspectives in order to develop a path forward. PMID:25535208
Heck, J F; Weis, M P; Gartland, J M; Weis, C R
Although catastrophic head and neck injuries in football occur infrequently, their occurrence is almost always followed by litigation. The athletic trainer has to be sure he/she has adequate liability insurance to cover the costs of a defense and a possible judgment. General claims filed against athletic staffs usually deal with instruction, equipment, matching of participants, supervision, and/or postinjury care. The defenses to these claims include: statutory immunity, assumption of risk, releases or waivers, and the reckless disregard standard. The athletic trainer plays a key role in head and neck injury prevention and care, and must be aware of litigation possibilities, along with methods of risk management. We present recommendations aimed at minimizing the risk of head and neck injuries and the risk of liability. The areas covered are: preparing for head and neck lawsuits, preventing head and neck injuries, and postcatastrophic injury care. We base these recommendations on principles that the athletic trainer can easily apply to other areas, broadening the risk management concept presented.
Sytema, Renee; Dekker, Rienk; Dijkstra, Pieter U.; ten Duis, Hendrik J.; van der Sluis, Corry K.
Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:
Taylor, Aileen E; Kemp, Simon; Trewartha, Grant; Stokes, Keith A
To assess and evaluate the injury risk associated with the scrum in English professional rugby union in the 2011-2012 season. Prospective, cohort. Players at English Premiership rugby union clubs. Frequency of team scrum-events per match; incidence (injuries per 1000 player-hours; propensity (injuries/1000 events); risk (days absence per 1000 player-hours and days absence per 1000 events). 31% of scrums in competitive matches resulted in collapse. Injury incidence associated with collapsed scrum-events (incidence: 8.6 injuries/1000 scrum-events) was significantly higher than those scrums that did not collapse (incidence: 4.1/1000 scrum-events). The injury risk associated with collapsed scrum supports the continued focus on reducing scrum collapse through changes in, and strict application of, the laws surrounding the scrum. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Clarke, S; McCann, C
The purpose of this study was to determine the immediate effects the prevent injury enhance performance programme (PEP) had on lower extremity biomechanics in relation to anterior cruciate ligament (ACL) risk factors compared to when it was not performed. 8 healthy males were required to perform a number of drop rebound jumps as a task that mimicked the sudden deceleration seen during ACL injuries. The PEP significantly (p
Conclusions: Given the selected studies we were not able to introduce general conclusions regarding the connection between various injury risk factors, since all studies partially differ from each other, regarding age range of study participants, geographical sampling, selected injury risk factors, and different injury definitions. It can be concluded that a higher level of physical/sports activity brings a higher risk of injury.
Nilsson, Martin; Eriksson, Joel; Larsson, Berit; Odén, Anders; Johansson, Helena; Lorentzon, Mattias
To investigate the role of a fall risk assessment, using the Downton Fall Risk Index (DFRI), in predicting fall-related injury, fall-related head injury and hip fracture, and death, in a large cohort of older women and men residing in Sweden. Cross sectional observational study. Sweden. Older adults (mean age 82.4 ± 7.8) who had a fall risk assessment using the DFRI at baseline (N = 128,596). Information on all fall-related injuries, all fall-related head injuries and hip fractures, and all-cause mortality was collected from the Swedish Patient Register and Cause of Death Register. The predictive role of DFRI was calculated using Poisson regression models with age, sex, height, weight, and comorbidities as covariates, taking time to outcome or end of study into account. During a median follow-up of 253 days (interquartile range 90-402 days) (>80,000 patient-years), 15,299 participants had a fall-related injury, 2,864 a head injury, and 2,557 a hip fracture, and 23,307 died. High fall risk (DFRI ≥3) independently predicted fall-related injury (hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 1.39-1.49), hip fracture (HR = 1.51, 95% CI =1.38-1.66), head injury (HR = 1.12, 95% CI = 1.03-1.22), and all-cause mortality (HR = 1.39, 95% CI = 1.35-1.43). DFRI more strongly predicted head injury (HR = 1.29, 95% CI = 1.21-1.36 vs HR = 1.08, 95% CI = 1.04-1.11) and hip fracture (HR = 1.41, 95% CI = 1.30-1.53 vs HR = 1.08, 95% CI = 1.05-1.11) in 70-year old men than in 90-year old women (P Fall risk assessment using DFRI independently predicts fall-related injury, fall-related head injury and hip fracture, and all-cause mortality in older men and women, indicating its clinical usefulness to identify individuals who would benefit from interventions. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.
Eirale, Cristiano; Tol, Johannes L; Smiley, Faten; Farooq, Abdulaziz; Chalabi, Hakim
To investigate whether fasting during Ramadan influences injury incidence in professional Muslim and non-Muslim footballers. Prospective cohort study. Professional First Division League of Qatar. About 527 male football players (462 Muslim and 65 non-Muslim) from 7 league clubs (first year of data collection) and 8 clubs (second and third years). Daily collection of training and match exposure from August 2008 until April 2011 by club medical staff. Injuries during training and match play were recorded on standardized injury cards. Injury incidence was calculated as number of injuries per hour exposed to risk, and expressed as rate per 1000 hours. The probability of injury for different Arabic months between Muslims and non-Muslims was calculated using Generalized Estimating Equations (GEEs). There was no significant difference in total, match, and training injury incidence between the Ramadan and non-Ramadan periods. Non-Muslim footballers had a significantly higher injury incidence rate than Muslim footballers both during Ramadan (8.5 vs 4.0 injuries/1000 hours, P = 0.009) and non Ramadan (6.6 vs 4.9 injuries/1000 hours, P = 0.004) periods. The GEE analysis revealed that after adjusting for age and random factors (month and club), the probability of match injury among non-Muslims was the highest in Ramadan and the 2 consecutive following months (adjusted odds ratio of injury among non-Muslims compared with Muslims was 3.7 [95% confidence interval (CI), 1.7-7.9], P = 0.001 during Ramadan (ninth) month; 2.4 (95% CI, 1.1-4.9), P = 0.021 during 10th month; and 2.7 (95% CI, 1.2-5.8), P = 0.013 during 11th month). Finally, there was no change in injury patterns over the months of the Islamic calendar. Ramadan does not impact injury incidence for Muslim footballers in Qatar, suggesting the current adjustments and scheduling of football activities during Ramadan are sufficient. The increased match injury among non-Muslims during and 2 months post-Ramadan may suggest less
Pedersen, Eric R.; Skidmore, Jessica R.; Aresi, Giovanni
Objective: Study abroad students are at risk for increased and problematic drinking behavior. As few efforts have been made to examine this at-risk population, the authors predicted drinking and alcohol-related consequences abroad from predeparture and site-specific factors. Participants: The sample consisted of 339 students completing study…
Demorest, Rebecca A; Koutures, Chris
The martial arts can provide children and adolescents with vigorous levels of physical exercise that can improve overall physical fitness. The various types of martial arts encompass noncontact basic forms and techniques that may have a lower relative risk of injury. Contact-based sparring with competitive training and bouts have a higher risk of injury. This clinical report describes important techniques and movement patterns in several types of martial arts and reviews frequently reported injuries encountered in each discipline, with focused discussions of higher risk activities. Some of these higher risk activities include blows to the head and choking or submission movements that may cause concussions or significant head injuries. The roles of rule changes, documented benefits of protective equipment, and changes in training recommendations in attempts to reduce injury are critically assessed. This information is intended to help pediatric health care providers counsel patients and families in encouraging safe participation in martial arts. Copyright © 2016 by the American Academy of Pediatrics.
Lv, Li-Quan; Hou, Li-Jun; Yu, Ming-Kun; Qi, Xiang-Qian; Chen, Huai-Rui; Chen, Ju-Xiang; Hu, Guo-Han; Luo, Chun; Lu, Yi-Cheng
Dysautonomia after severe traumatic brain injury (TBI) is a clinical syndrome affecting a subgroup of survivors and is characterized by episodes of autonomic dysregulation and muscle overactivity. The purpose of this study was to determine the incidence of dysautonomia after severe TBI in an intensive care unit setting and analyze the risk factors for developing dysautonomia. A consecutive series of 101 patients with severe TBI admitted in a major trauma hospital during a 2-year period were prospectively observed to determine the effects of age, sex, mode of injury, hypertension history, admission systolic blood pressure, fracture, lung injury, admission Glasgow Coma Scale (GCS) score, injury severity score, emergency craniotomy, sedation or analgesia, diffuse axonal injury (DAI), magnetic resonance imaging (MRI) scales, and hydrocephalus on the development of dysautonomia. Risk factors for dysautonomia were evaluated by using logistic regression analysis. Seventy-nine of the 101 patients met inclusion criteria, and dysautonomia was observed in 16 (20.3%) of these patients. Univariate analysis revealed significant correlations between the occurrence of dysautonomia and patient age, admission GCS score, DAI, MRI scales, and hydrocephalus. Sex, mode of injury, hypertension history, admission systolic blood pressure, fracture, lung injury, injury severity score, sedation or analgesia, and emergency craniotomy did not influence the development of dysautonomia. Multivariate logistic regression revealed that patient age and DAI were two independent predictors of dysautonomia. There was no independent association between dysautonomia and admission GCS score, MRI scales, or hydrocephalus. Dysautonomia frequently occurs in patients with severe TBI. A younger age and DAI could be risk factors for facilitating the development of dysautonomia.
Sanchez-Ramirez, Diana C; Voaklander, Donald
Evidence supports the expectation that changes in time of alcohol sales associate with changes in alcohol-related harm in both directions. However, to the best of our knowledge, no comprehensive systematic reviews had examined the effect of policies restricting time of alcohol trading on specific alcohol-related harms. To compile existing evidence related to the impact of policies regulating alcohol trading hours/days of on specific harm outcomes such as: assault/violence, motor vehicle crashes/fatalities, injury, visits to the emergency department/hospital, murder/homicides and crime. Systematic review of literature studying the impact of policies regulation alcohol trading times in alcohol-related harm, published between January 2000 and October 2016 in English language. Results support the premise that policies regulating times of alcohol trading and consumption can contribute to reduce injuries, alcohol-related hospitalisations/emergency department visits, homicides and crime. Although the impact of alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is also positive, these associations seem to be more complex and require further study. Evidence suggests a potential direct effect of policies that regulate alcohol trading times in the prevention of injuries, alcohol-related hospitalisations, homicides and crime. The impact of these alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is less compelling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Full Text Available In adolescents and young adults, acute consequences like injuries account for a substantial proportion of alcohol-related harm, especially in risky single-occasion (RSO drinkers. The primary aim of the study was to characterize different drinking profiles in RSO drinkers according to drinking locations and their relationship to negative, alcohol-related consequences. The sample consisted of 2746 young men from the Cohort Study on Substance Use Risk Factors (C-SURF who had reported drinking 6 or more drinks on a single occasion at least monthly over the preceding 12 months. Principal component analysis on the frequency and amount of drinking at 11 different locations was conducted, and two distinguishable components emerged: a non-party-dimension (loading high on theatre/cinema, sport clubs, other clubs/societies, restaurants, and sport events and a party-dimension (loading high on someone else’s home, pubs/bars, discos/nightclubs, outdoor public places, special events, and home. Differential impacts of drinking location profiles were observed on severe negative alcohol-related consequences (SAC. Relative to those classified as low or intermediate in both dimensions, no significant difference experiencing SAC was found among those who were classified as high in the non-party-dimension only. However, those who were classified as high in the party-dimension alone or in both dimensions were more likely to experience SAC. These differential effects remained after adjusting for alcohol consumption (volume and RSOD, personality traits, and peer-influence (adjusted OR=0.83 [0.68-1.02], 1.57 [1.27-1.96] and 1.72 [1.23-2.41], respectively, indicating independent effects of drinking location on SAC. The inclusion of sociodemographic factors did not alter this association. The fact that this cluster of party-dimension locations seems to predispose young men to experiencing SAC has important implications for alcohol control policies.
Full Text Available Aim: The aim of this study is to characterize the clinical profile of patients with alcohol related seizures (ARS and to identify the prevalence of idiopathic generalized epilepsy (IGE in the same. Materials and Methods: 100 consecutive male patients presenting to a tertiary care center in South India with new onset ARS were analyzed with alcohol use disorders identification test (AUDIT score. All underwent 19 channel digital scalp electroencephalography (EEG and at least computed tomography (CT scan. Results: A total of 27 patients (27% who had cortical atrophy on CT had a mean duration of alcohol intake of 23.62 years compared with 14.55 years in patients with no cortical atrophy (P < 0.001. Twenty-two patients (22% had clustering in the current episode of whom 18 had cortical atrophy. Nearly, 88% patients had generalized tonic clonic seizures while 12% who had partial seizures underwent magnetic resonance imaging (MRI, which identified frontal focal cortical dysplasia in one. Mean lifetime duration of alcohol intake in patients presenting with seizures within 6 hours (6H-gp of intake of alcohol was significantly lower (P = 0.029. One patient in the 6H-gp with no withdrawal symptoms had EEG evidence for IGE and had a lower AUDIT score compared with the rest. Conclusion: CT evidence of cortical atrophy is related to the duration of alcohol intake and portends an increased risk for clustering. Partial seizures can be a presenting feature of ARS and those patients may benefit from MRI to identify underlying symptomatic localization related epilepsy (8.3% of partial seizures. IGE is more likely in patients presenting with ARS within first 6 hours especially if they do not have alcohol withdrawal symptoms and scalp EEG is helpful to identify this small subgroup (~1% who may require long-term anti-epileptic medication.
Inness, C M; Morgan, K L
Polo, one of the world's oldest sports, is unique in merging human skill and balance with animal agility and performance in a contact sport. These modern-day 'centaurs' offer medical, dental and veterinary scientists an unrivalled, if quirky, opportunity to collaborate. Collection of epidemiological data on injuries to UK polo riders and ponies is the first step. To measure the reported risk and risk factors for injuries to UK polo ponies, their perception and mitigation by player-owners. A retrospective cohort design and telephone interviews were used. Data on equine injuries, preseason training and risk perception were collected from a random sample of player-owners using a structured questionnaire. Injuries were defined as requiring veterinary treatment. Frequencies were represented as percentages and 95% confidence intervals (CIs). Risk factors for injuries were identified by univariable and multivariable analyses. The cumulative incidence of player-owner-reported injury was 10.6% (95% CI 8.4-12.7). Tendon injuries were most common (4.3%; 95% CI 2.9-5.7), followed by wounds and splints. The only risk factor was stabling all season (odds ratio 4.79; 95% CI 1.46-15.73). Tendon injuries were perceived as the major risk and hard ground the most important risk factor. Risk mitigation practices were bandaging before exercise (45.7%; 95% CI 34.8-56.5), checking tendons (84.0%; 95% CI 76.0-91.9), cold hosing (40.7%; 95% CI 30.0-51.4), bandaging (38.3%; 95% CI 27.7-48.9) and using clays and coolants after exercise (24.7%; 15.3-34.1). Cuts and wounds were considered most frequent by only 2.5% (95% CI 0.0-3.6) of players but were the second most common injury, accounting for 21.6% of veterinary treatments. Splints accounted for 12.5% of injuries. The risk of injury to polo ponies is similar to that in the general horse population; musculoskeletal injuries, particularly tendon injuries, are most common, followed by wounds and splints. The association between stabling and
Morrongiello, B A; Howard, A W; Rothman, L; Sandomierski, M
To compare risk perceptions of parents whose child sustained a medically attended playground injury (cases) with those of parents whose child had not (controls) to address two questions. Does having a child experience a medically attended injury: (1) sensitise parents to children's injury vulnerability and severity; (2) influence parents' appraisal of the injury mechanism (child's behaviour), attributions for injuries or beliefs about strategies for prevention? Each case-control parent dyad was assigned to one of two conditions: (1) being presented with 10 common injury-risk playground behaviours specific to the equipment on which their child had been hurt, and asked to appraise injury vulnerability and severity; or (2) being presented with scenarios about playground injuries that varied in severity but were all based on the same child behaviour, and asked questions about this behaviour, attributions for injury and strategies for prevention. The results support the occurrence of a sensitisation process. Compared with control parents, case parents showed higher ratings of injury severity and children's vulnerability to injury, made fewer attributions for injuries to bad luck, and endorsed a greater diversity of prevention strategies, including parent (closer supervision), child (teaching rules about safe play on playgrounds) and environmental (modifications to playgrounds). A child's medically attended injury can create a "teachable moment" for the parent. Linking injury-prevention programming to this teachable moment may increase the likelihood of evoking changes in parental supervisory behaviour and their setting of rules limiting their child's risk behaviours to reduce the occurrence of childhood injury.
Hoffman, Eric W; Pinkleton, Bruce E; Weintraub Austin, Erica; Reyes-Velázquez, Wanda
Alcohol marketers have increasingly moved their advertising efforts into digital and social media venues. As a result, the purpose of this study is to investigate associations between students' use of social media, their exposure to alcohol marketing messages through social media, and their alcohol-related beliefs and behaviors. Public and private university students (N = 637) participated November and December 2011 and April 2012. College students completed online surveys to measure their exposure to social and online media generally, as well as their alcohol-related digital media use and alcohol use. Use of social media related to alcohol marketing predicted alcohol consumption and engaging in risky behaviors, whereas the use of social media more generally did not. Students' use of alcohol-related social media-marketing content associates with their problem drinking. Results have implications for alcohol abuse reduction efforts targeted at college students and suggest the importance of considering social, cultural, and cognitive factors in campaign planning and design.
Kenny, Sarah J; Palacios-Derflingher, Luz; Shi, Qian; Whittaker, Jackie L; Emery, Carolyn A
To determine the prevalence of self-reported 1-year injury history and examine its association with preparticipation evaluation components aimed at predicting future injury risk (PPE-IP) among preprofessional ballet and contemporary dancers. Cross-sectional study. Preprofessional ballet school, university contemporary dance program. Full-time preprofessional ballet and contemporary dancers. Preparticipation evaluation consisted of the Athletic Coping Skills Inventory-28, body mass index, total bone mineral density, ankle range of motion, active standing turnout, lumbopelvic control, unipedal dynamic balance, and Y-Balance test. Self-reported 1-year history of dance-related medical attention and/or time-loss injury. A total of 155 ballet [n = 90, 80 females, median age 15 years (range 11-19)] and contemporary [n = 65, 63 females, median age 20 years (range 17-30)] dancers participated. Forty-six percent (95% confidence interval (CI), 38.4-54.6) reported a 1-year injury history. Self-reported injury history was not associated with any PPE-IP, however, an influence of age and psychological coping skills on the relationship between 1-year injury history and PPE-IP was identified. Multivariable analyses revealed that prevalence of 1-year injury history did not differ by age [referent group 18 years: OR 0.69 (95% CI, 0.30-1.56)], or level of psychological coping skills [OR 1.35 (95% CI, 0.61-2.94)]. The prevalence of self-reported 1-year injury history among preprofessional ballet and contemporary dancers is high. Although measures of PPE-IP did not differ based on injury history, it is important that age and psychological coping skills are considered in future dance injury prevention and prediction research. Level 3 evidence.
Griffin, Russell L; Davis, Gregory G; Levitan, Emily B; MacLennan, Paul A; Redden, David T; McGwin, Gerald
Research has reported that a strong risk factor for traumatic injury is having a previous injury (i.e., recidivism). To date, the only study examining the relationship between recidivism and homicide reported strong associations, but was limited by possible selection bias. The current matched case-control study utilized coroner's data from 2004 to 2008. Subjects were linked to trauma registry data to determine whether the person had a previous traumatic injury. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between homicide and recidivism. Homicide risk was increased for those having a previous traumatic injury (OR 1.81, 95% CI 1.09-2.99) or a previous intentional injury (OR 2.53, 95% CI 1.24-5.17). These results suggest an association between homicide and injury recidivism, and that trauma centers may be an effective setting for screening individuals for secondary prevention efforts of homicide through violence prevention programs. © 2014 American Academy of Forensic Sciences.
Schwebel, David C; Roth, David L; Elliott, Marc N; Chien, Alyna T; Mrug, Sylvie; Shipp, Eva; Dittus, Patricia; Zlomke, Kimberly; Schuster, Mark A
Injuries are the leading cause of morbidity and mortality for American children. Marital conflict has been associated with a range of negative health outcomes, but little is known about how marital conflict may influence risk of injury among children. We hypothesized marital conflict would be related to increased youth injury risk after controlling for relevant demographic and parenting covariates. A community sample of 3218 fifth-graders recruited from three US locales was utilized. Ordinal logistic regression models were used to predict the frequency of unintentional injuries from marital conflict while adjusting for demographics, parenting factors (nurturance, communication, involvement with youth), and family cohesion. Higher levels of marital conflict were associated with higher rates of injury that required professional medical attention (OR=1.20, 95% CI 1.06, 1.35 per standard deviation). The same association held after inclusion of all covariates in a multivariate ordinal logistic regression model. Parental marital conflict is associated with higher rates of injuries requiring professional medical attention in preadolescent children. Copyright Â© 2012 Elsevier Ltd. All rights reserved.
Full Text Available At the last World Conference on Sport and Physical Therapy celebrated in Bern (Switzerland, 2015, it was confirmed that the functional skills of an athlete are a very important variable to be considered in the recovery of an injury. On the other hand, its use as a predictive risk tool still lacks solid evidence. The purpose of this study was to determine whether a battery of functional tests (FPT could be used as a preliminary measure for the season in order to identify the injury risk in a professional soccer team in the Spanish Second Division B League. Fifty-two soccer players (ages of 25.3 ± 4.6 years, 10.33% ± 0.9% fat were functionally assessed during two seasons (2012–2013 and 2013–2014 and analyzed from an injury perspective. A total of 125 injuries were recorded. The sample was grouped based on the number of injuries and the required absence days. Except for the bipodal vertical jump (CMJ, none of the functional tests revealed differences among the groups. The correlation study between the functional condition and the suffered injuries did not show any significant results.
Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M
OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...... conducted in a sample of 6,562 men and women, all of whom were born in Copenhagen, Denmark, between October 1959 and December 1961. The sample was divided into two categories based on duration of breast-feeding, as assessed by a physician interview with mothers at a 1-year examination. Psychiatric...... hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy...
Rugbjerg, Kathrine; Ritz, Beate; Korbo, Lise
OBJECTIVE: To determine whether a hospital contact for a head injury increases the risk of subsequently developing Parkinson's disease. DESIGN: Population based case-control study. SETTING: Denmark. PARTICIPANTS: 13 695 patients with a primary diagnosis of Parkinson's disease in the Danish national...... of history of head injury. RESULTS: An overall 50% increase in prevalence of hospital contacts for head injury was seen before the first registration of Parkinson's disease in this population (odds ratio 1.5, 95% confidence interval 1.4 to 1.7). The observed association was, however, due almost entirely...... to injuries that occurred during the three months before the first record of Parkinson's disease (odds ratio 8.0, 5.6 to 11.6), and no association was found between the two events when they occurred 10 or more years apart (1.1, 0.9 to 1.3). CONCLUSIONS: The steeply increased frequency of hospital contacts...
Søndergaard, Grethe; Osler, Merete; Andersen, Anne-Marie Nybo
AIMS: To estimate the association between educational status and alcohol-related somatic and non-somatic morbidity and mortality among full siblings in comparison with non-related individuals. DESIGN: Cohort study. SETTING: Denmark. PARTICIPANTS: Approximately 1.4 million full siblings born in De...
Walvoort, S.J.; Wester, A.J.; Doorakkers, M.C.; Kessels, R.P.C.; Egger, J.I.
BACKGROUND: It is evident from the dsm-iv-tr that alcohol-related impairment is extremely difficult to classify accurately. As a result, cognitive deficits can easily be overlooked. The dsm-5, however, incorporates a new category, namely 'neurocognitive disorders', which may lead to significant
Shuler, Kristrina A.; Schroeder, Hannes
Alcohol Related Birth Defects (ARBD) are yet undocumented among past communities, although alcohol is the leading cause of non-heritable birth defects in the US today. We evaluate potential ARBD at Newton Plantation, Barbados (ca. 1660-1820), where earlier studies suggest frequent, community-wide...
Mallett, Kimberly A; Varvil-Weld, Lindsey; Borsari, Brian; Read, Jennifer P; Neighbors, Clayton; White, Helene R
The objective of this review is to provide an update on existing research examining alcohol-related consequences among college students with relevance for individual-based interventions. While alcohol-related consequences have been a focus of study for several decades, the literature has evolved into an increasingly nuanced understanding of individual and environmental circumstances that contribute to risk of experiencing consequences. A number of risk factors for experiencing alcohol-related consequences have been identified, including belonging to specific student subgroups (e.g., Greek organizations) or drinking during high-risk periods, such as spring break. In addition, the relationship between students' evaluations of both negative and positive consequences and their future drinking behavior has become a focus of research. The current review provides an overview of high-risk student subpopulations, high-risk windows and activities, and college students' subjective evaluations of alcohol-related consequences. Future directions for research are discussed and include determining how students' orientations toward consequences change over time, identifying predictors of membership in high-risk consequence subgroups and refining existing measures of consequences to address evolving research questions. Copyright © 2012 by the Research Society on Alcoholism.
Garg, Amit X; Kurz, Andrea; Sessler, Daniel I
IMPORTANCE: Acute kidney injury, a common complication of surgery, is associated with poor outcomes and high health care costs. Some studies suggest aspirin or clonidine administered during the perioperative period reduces the risk of acute kidney injury; however, these effects are uncertain...... and each intervention has the potential for harm. OBJECTIVE: To determine whether aspirin compared with placebo, and clonidine compared with placebo, alters the risk of perioperative acute kidney injury. DESIGN, SETTING, AND PARTICIPANTS: A 2 × 2 factorial randomized, blinded, clinical trial of 6905...... patients undergoing noncardiac surgery from 88 centers in 22 countries with consecutive patients enrolled between January 2011 and December 2013. INTERVENTIONS: Patients were assigned to take aspirin (200 mg) or placebo 2 to 4 hours before surgery and then aspirin (100 mg) or placebo daily up to 30 days...
Webb, Timothy S; Wells, Timothy S
With the advent of electronic records, the opportunity to conduct research on workplace-related injuries and musculoskeletal disorders has increased dramatically. The purpose of this study was to examine the United States Air Force Civil Engineering career field to determine if they are negatively impacted by their work environment. Specifically, the objective of this study was to determine if enlisted Civil Engineering Airmen (n = 25,385) were at increased risk for injury or injury-related musculoskeletal disorders compared to enlisted Information Management/Communications Airmen (n = 28,947). Using an historical prospective design, electronic data were assembled and analyzed using Cox's proportional hazards modeling. Models were stratified by gender and adjusted for race/ethnicity, marital status, birth year, and deployment status. Male Civil Engineers were observed to be at greater risk for both inpatient injury-related musculoskeletal disorders (HR = 1.86; 95% CI = 1.54-2.26) and injuries (HR = 1.77; 95% CI = 1.48-2.11), while female Civil Engineers were more than double the risk for both inpatient injury-related musculoskeletal disorders (HR = 2.18; 95% CI = 1.28-3.73) and injuries (HR = 2.22; 95% CI = 1.27-3.88) compared to Information Management/Communications Airmen. Although analyses do not allow exploration of specific causes, they highlight the utility of using electronic data to identify occupations for further evaluation. Based on these results, additional resources were allocated to survey Civil Engineers on their physical work demands and job requirements to identify key problem areas for further study and mitigation. Copyright © 2010 Wiley-Liss, Inc.
Hels, Tove; Lyckegaard, Allan; Bernhoft, Inger Marie
approximated by odds ratios and calculated by logistic regression. The estimates were adjusted for age, gender and country. The highest risk of the driver being severely injured was associated with driving positive for high concentrations of alcohol (≥0.8 g/L), alone or in combination with other psychoactive......Driving with alcohol and other psychoactive substances imposes an increased risk of severe injury accidents. In a population-based case-control design, the relative risks of severe driver injury (MAIS ≥ 2) by driving with ten substance groups were approximated by odds ratios (alcohol, amphetamines...... (N = 2490) were collected from severely injured drivers of passenger cars or vans in selected hospitals in various regions of the countries. Control samples (N = 15,832) were sampled in a uniform sampling scheme stratified according to country, time, road type and season. Relative risks were...
Clausen, M B; Tang, L; Zebis, M K
as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P
The risks of gastrointestinal injury due to ingested magnetic beads. S Cox, R Brown, A Millar, A Numanoglu, A Alexander, A Theron. Abstract. Accidental ingestion of foreign bodies is a common problem in children. Magnetic bead toys are hazardous, having potentially lethal consequences if ingested. These magnets ...
Kemper, G. L. J.; van der Sluis, A.; Brink, M. S.; Visscher, C.; Frencken, W. G. P.; Elferink-Gemser, M. T.
The aim of the study was to investigate whether an increased risk of injury occurrence can be determined through frequent anthropometric measurements in elite-standard youth soccer players. Over the course of one season, we followed 101 male elite-standard youth soccer players between 11 and 19
StGeorge, Jennifer; Fletcher, Richard; Freeman, Emily; Paquette, Daniel; Dumont, Caroline
Unintentional injury is an important cause of infant and child hospitalisation and parents play a key role in reducing children's risk-taking behaviour. Studies show that maternal and paternal parenting and supervision of children differ, but there is little research showing how fathers' parenting may influence children's tendency to engage in…
Beijsterveldt, A.M.C. van; Port, L.G.L. van de; Vereijken, A.J.; Backx, F.J.C.
Hamstring injuries are common injuries in soccer players. In view of the high incidence and the serious consequences, identifying risk factors related to hamstring injuries is essential. The aim of this systematic review was therefore to identify risk factors for hamstring injuries in male adult
Dallinga, J.; Benjaminse, A.; Gokeler, A.; Otten, Egbert; Lemmink, K.
BACKGROUND: Anterior cruciate ligament (ACL) injury prevention programs have shown mixed results, which may be in part due to suboptimal training components. OBJECTIVE: Determine effects of a prevention program with external and internal focus of attention on (potential) biomechanical risk factors
Hoffman, Eric W.; Pinkleton, Bruce E.; Weintraub Austin, Erica; Reyes-Velázquez, Wanda
Objective: Alcohol marketers have increasingly moved their advertising efforts into digital and social media venues. As a result, the purpose of this study is to investigate associations between students' use of social media, their exposure to alcohol marketing messages through social media, and their alcohol-related beliefs and behaviors.…
Nesi, Jacqueline; Rothenberg, W Andrew; Hussong, Andrea M; Jackson, Kristina M
Adolescents' increased use of social networking sites (SNS) coincides with a developmental period of heightened risk for alcohol use initiation. However, little is known regarding associations between adolescents' SNS use and drinking initiation nor the mechanisms of this association. This study examined longitudinal associations among adolescents' exposure to friends' alcohol-related SNS postings, alcohol-favorable peer injunctive norms, and initiation of drinking behaviors. Participants were 658 high-school students who reported on posting of alcohol-related SNS content by self and friends, alcohol-related injunctive norms, and other developmental risk factors for alcohol use at two time points, 1 year apart. Participants also reported on initiation of three drinking behaviors: consuming a full drink, becoming drunk, and heavy episodic drinking (three or more drinks per occasion). Probit regression analyses were used to predict initiation of drinking behaviors from exposure to alcohol-related SNS content. Path analyses examined mediation of this association by peer injunctive norms. Exposure to friends' alcohol-related SNS content predicted adolescents' initiation of drinking and heavy episodic drinking 1 year later, controlling for demographic and known developmental risk factors for alcohol use (i.e., parental monitoring and peer orientation). In addition, alcohol-favorable peer injunctive norms statistically mediated the relationship between alcohol-related SNS exposure and each drinking milestone. Results suggest that social media plays a unique role in contributing to peer influence processes surrounding alcohol use and highlight the need for future investigative and preventive efforts to account for adolescents' changing social environments. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Daily physical activity ist a predictive factor for cardio-vascular disease and for obesity. In military, police and firefighter service duty sport is used to increase and to keep a work specifical physical fitness. Till today no study data with direct data acquisition exists for a risk assessment of the injury rates in duty sport. In this one-year study in a German Armed Forces armoured brigade with 22 companies, every sport-related injury on duty and the following sick days were recorded. Apart from the sport type, the duration of the athletic activity and the number of soldiers that took part in it were monitored. 275 sport injuries were recorded. Soccer was the sport with the highest risk of injuries. Team sports proved to be more dangerous than individual physical activity. The author has demonstrated a reduction of the total injury rate by 39 %, of sick days by 50 %, and of the days with partial unfitness for duty by 42 % when team sports are reduced in favour to other physical activities. © Georg Thieme Verlag KG Stuttgart · New York.
Rita de Cassia Almeida Vieira
Full Text Available Abstract Diffuse axonal injury (DAI, a type of traumatic injury, is known for its severe consequences. However, there are few studies describing the outcomes of DAI and the risk factors associated with it. This study aimed to describe the outcome for patients with a primary diagnosis of DAI six months after trauma and to identify sociodemographic and clinical factors associated with mortality and dependence at this time point. Seventy-eight patients with DAI were recruited from July 2013 to February 2014 in a prospective cohort study. Patient outcome was analyzed using the Extended Glasgow Outcome Scale (GOS-E within six months of the traumatic injury. The mean Injury Severity Score was 35.0 (SD = 11.9, and the mean New Injury Severity Score (NISS was 46.2 (SD = 15.9. Mild DAI was observed in 44.9% of the patients and severe DAI in 35.9%. Six months after trauma, 30.8% of the patients had died, and 45.1% had shown full recovery according to the GOS-E. In the logistic regression model, the severity variables—DAI with hypoxia, as measured by peripheral oxygen saturation, and hypotension with NISS value—had a statistically significant association with patient mortality; on the other hand, severity of DAI and length of hospital stay were the only significant predictors for dependence. Therefore, severity of DAI emerged as a risk factor for both mortality and dependence.
Carey, David L; Blanch, Peter; Ong, Kok-Leong; Crossley, Kay M; Crow, Justin; Morris, Meg E
(1) To investigate whether a daily acute:chronic workload ratio informs injury risk in Australian football players; (2) to identify which combination of workload variable, acute and chronic time window best explains injury likelihood. Workload and injury data were collected from 53 athletes over 2 seasons in a professional Australian football club. Acute:chronic workload ratios were calculated daily for each athlete, and modelled against non-contact injury likelihood using a quadratic relationship. 6 workload variables, 8 acute time windows (2-9 days) and 7 chronic time windows (14-35 days) were considered (336 combinations). Each parameter combination was compared for injury likelihood fit (using R 2 ). The ratio of moderate speed running workload (18-24 km/h) in the previous 3 days (acute time window) compared with the previous 21 days (chronic time window) best explained the injury likelihood in matches (R 2 =0.79) and in the immediate 2 or 5 days following matches (R 2 =0.76-0.82). The 3:21 acute:chronic workload ratio discriminated between high-risk and low-risk athletes (relative risk=1.98-2.43). Using the previous 6 days to calculate the acute workload time window yielded similar results. The choice of acute time window significantly influenced model performance and appeared to reflect the competition and training schedule. Daily workload ratios can inform injury risk in Australian football. Clinicians and conditioning coaches should consider the sport-specific schedule of competition and training when choosing acute and chronic time windows. For Australian football, the ratio of moderate speed running in a 3-day or 6-day acute time window and a 21-day chronic time window best explained injury risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Full Text Available In some occupational contexts overweight and obesity have been identified as risk factors for injury. The purpose of this study was to examine this hypothesis within farm work environments and then to identify specific opportunities for environmental modification as a preventive strategy. Data on farm-related injuries, height and weight used to calculate body mass index (BMI, and demographic characteristics were from the Phase 2 baseline survey of the Saskatchewan Farm Injury Cohort; a large cross-sectional mail-based survey conducted in Saskatchewan, Canada from January through May 2013. Multivariable logistic regression was used to examine associations between BMI and injury. Injury narratives were explored qualitatively. Findings were inconsistent and differed according to gender. Among women (n = 927, having overweight (adjusted OR: 2.94; 95% CI: 1.29 to 6.70 but not obesity (1.10; 95% CI: 0.35 to 3.43 was associated with an increased odds of incurring a farm-related injury. No strong or statistically significant effects were observed for men (n = 1406 with overweight or obesity. While injury-related challenges associated with obesity have been addressed in other occupational settings via modification of the worksite, such strategies are challenging to implement in farm settings because of the diversity of work tasks and associated hazards. We conclude that the acute effects of overweight in terms of injury do require consideration in agricultural populations, but these should also be viewed with a differentiation based on gender.
Klimek, Peter Michael; Juen, David; Stranzinger, Enno; Wolf, Rainer; Slongo, Theddy
Backyard trampolines are immensely popular among children, but are associated with an increase of trampoline-related injuries. The aim of this study was to evaluate radiographs of children with trampoline related injuries and to determine the risk factors. Between 2003 and 2009, 286 children under the age of 16 with backyard trampoline injuries were included in the study. The number of injuries increased from 13 patients in 2003 to 86 in 2009. The median age of the 286 patients was 7 years (range: 1-15 years). Totally 140 (49%) patients were males, and 146 (51%) females. Medical records and all available diagnostic imaging were reviewed. A questionnaire was sent to the parents to evaluate the circumstances of each injury, the type of trampoline, the protection equipment and the experience of the children using the trampoline. The study was approved by the Institutional Ethics Committee of the University Hospital of Bern. The questionnaires and radiographs of the 104 patients were available for evaluation. A fracture was sustained in 51 of the 104 patients. More than 75% of all patients sustaining injuries and in 90% of patients with fractures were jumping on the trampoline with other children at the time of the accident. The most common fractures were supracondylar humeral fractures (29%) and forearm fractures (25%). Fractures of the proximal tibia occurred especially in younger children between 2-5 years of age. Children younger than 5 years old are at risk for specific proximal tibia fractures ("Trampoline Fracture"). A child jumping simultaneously with other children has a higher risk of suffering from a fracture.
Ariel V. Dowling; Gregory D. Myer; Timothy E. Hewett; Anne Benjaminse; James A. Onate; Alli Gokeler; Avery Faigenbaum; Kevin R. Ford; Bert Otten
Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence is still high, making it imperative to continue to improve cur- rent prevention strategies. A potential limitation of current ACL
Benjaminse, Anne; Gokeler, Alli; Dowling, Ariel V.; Faigenbaum, Avery; Ford, Kevin R.; Hewett, Timothy E.; Onate, James A.; Otten, Bert; Myer, Gregory D.
SYNOPSIS: Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence-is still high, making it imperative to continue to improve current prevention strategies. A potential limitation of current
Chang, Jeffrey S; Hsiao, Jenn-Ren; Chen, Che-Hong
The occurrence of more than 200 diseases, including cancer, can be attributed to alcohol drinking. The global cancer deaths attributed to alcohol-consumption rose from 243,000 in 1990 to 337,400 in 2010. In 2010, cancer deaths due to alcohol consumption accounted for 4.2% of all cancer deaths. Strong epidemiological evidence has established the causal role of alcohol in the development of various cancers, including esophageal cancer, head and neck cancer, liver cancer, breast cancer, and colorectal cancer. The evidence for the association between alcohol and other cancers is inconclusive. Because of the high prevalence of ALDH2*2 allele among East Asian populations, East Asians may be more susceptible to the carcinogenic effect of alcohol, with most evidence coming from studies of esophageal cancer and head and neck cancer, while data for other cancers are more limited. The high prevalence of ALDH2*2 allele in East Asian populations may have important public health implications and may be utilized to reduce the occurrence of alcohol-related cancers among East Asians, including: 1) Identification of individuals at high risk of developing alcohol-related cancers by screening for ALDH2 polymorphism; 2) Incorporation of ALDH2 polymorphism screening into behavioral intervention program for promoting alcohol abstinence or reducing alcohol consumption; 3) Using ALDH2 polymorphism as a prognostic indicator for alcohol-related cancers; 4) Targeting ALDH2 for chemoprevention; and 5) Setting guidelines for alcohol consumption among ALDH2 deficient individuals. Future studies should evaluate whether these strategies are effective for preventing the occurrence of alcohol-related cancers.
Larsen, Ann D.; Hannerz, Harald; Møller, Simone V.
Objectives: The aims of this study were to (i) investigate the association between night work or long work weeks and the risk of accidental injuries and (ii) test if the association is affected by age, sex or socioeconomic status. Methods: The study population was drawn from the Danish version...... of the European Labour Force Survey from 1999-2013. The current study was based on 150 438 participants (53% men and 47% women). Data on accidental injuries were obtained at individual level from national health registers. We included all 20-59-year-old employees working ≥32 hours a week at the time...
Jango, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne
To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women.......To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women....
Smith, P M; Berecki-Gisolf, J
Interest in the relationship between age and serious work injury is increasing, given the ageing of the workforce in many industrialized economies. To examine if the relationship between age and risk of serious musculoskeletal injury differs when the physical demands of work are higher from those when they are lower. A secondary analysis of workers' compensation claims in the State of Victoria, Australia, combined with estimates of the insured labour force. We focused on musculoskeletal claims, which required 10 days of absence or health care expenditures beyond a pecuniary threshold. Regression models examined the relationship between age and claim-risk across workers with different occupational demands, as well as the relationship between occupational demands and musculoskeletal claim-risk across different age groups. Older age and greater physical demands at work were associated with an increased risk of musculoskeletal claims. In models stratified by occupational demands, we observed the relationship between age and claim-risk was steeper when occupational demands were higher. We also observed that the relationship between occupational demands and risk of work injury claim peaked among workers aged 25-44, attenuating among those aged 45 and older. This study's results suggest that although older workers and occupations with higher demands should be the targets of primary preventive efforts related to serious musculoskeletal injuries, there may also be gains in targeting middle-aged workers in the most physically demanding occupations. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Knapik, Joseph J; Graham, Bria; Cobbs, Jacketta; Thompson, Diane; Steelman, Ryan; Jones, Bruce H
United States Army military police (MP) training is a 19-week course designed to introduce new recruits to basic soldiering skills, Army values and lifestyle, and law enforcement skills and knowledge. The present investigation examined injury rates and injury risk factors in MP training. At the start of training, 1,838 male and 553 female MP recruits were administered a questionnaire containing items on date of birth, height, weight, tobacco use, prior physical activity, injury history, and menstrual history. Injuries during training were obtained from electronic medical records and the training units provided data on student graduation and attrition. Successfully graduating from the course were 94.3% of the men and 83.7% of the women. Experiencing at least one injury during training were 34.2% of the men and 66.7% of the women (risk ratio (women/men) = 1.95, 95% confidence interval = 1.79-2.13). Recruits were at higher injury risk if they reported that they were older, had smoked in the past, or had performed less frequent exercise or sports prior to MP training. Men were at higher injury risk if they reported a prior injury and women were at higher risk if they reported missing at least six menstrual cycles in the last year or had previously been pregnant. The present investigation was the first to identify injury rates and identify specific factors increasing injury risk during MP training.
Morgan, Jessica Kelley; Brown, Janice; Bray, Robert M
Due to the current prolonged conflicts in Iraq and Afghanistan, members of the United States National Guard and Reserve have shifted from a historically support-based role to an integral segment of combat efforts. Clinical and epidemiological research studies conducted on both civilian and military populations have documented high rates of comorbidity of stress disorders and substance use disorders. It is widely understood that excessive alcohol use is an issue among military personnel. The aim of this paper is to describe risk factors for alcohol-related serious consequences in a study of Army National Guard service members, as well as the role of resilience in protecting against these risks. Members of the National Guard (N=320) participated in the survey. We conducted a multiple regression to predict alcohol-related serious consequences and a simple moderation analysis was performed. After controlling for race, education, and deployment history, several variables emerged as significant predictors of alcohol-related consequences. Higher stressors, lower resilience, younger age, being unmarried and not living as married, being male, and identifying as non-Hispanic were associated with higher levels of serious alcohol-related consequences. Results revealed that resilience significantly moderated the relationship between stress and alcohol-related consequences. This study furthers our understanding of the alcohol-stress relationship by contextualizing it in terms of behaviors related to alcohol, as opposed to measuring consumption only. Most importantly, our work extends prior research in its examination of resilience as a moderator of the relationship between stress and serious alcohol-related consequences. Copyright © 2018 Elsevier Ltd. All rights reserved.
Orlovska, Sonja; Pedersen, Michael Skaarup; Benros, Michael Eriksen
. METHOD: The authors used linkable Danish nationwide population-based registers to investigate the incidence of schizophrenia spectrum disorders, unipolar depression, bipolar disorder, and organic mental disorders in 113,906 persons who had suffered head injuries. Data were analyzed by survival analysis.......55-1.75), depression (IRR=1.59 95% CI=1.53-1.65), bipolar disorder (IRR=1.28, 95% CI=1.10-1.48), and organic mental disorders (IRR=4.39, 95% CI=3.86-4.99). This effect was larger than that of fractures not involving the skull or spine for schizophrenia, depression, and organic mental disorders, which suggests...... that the results were not merely due to accident proneness. Head injury between ages 11 and 15 years was the strongest predictor for subsequent development of schizophrenia, depression, and bipolar disorder. The added risk of mental illness following head injury did not differ between individuals with and without...
Frisch, Anne; Croisier, Jean-Louis; Urhausen, Axel; Seil, Romain; Theisen, Daniel
Sports injuries in young athletes are a public health issue which deserves special attention. Effective prevention can be achieved with training programmes originating from the field of physical therapy and medicine. A systematic literature search on injury prevention in youth sport was performed in the MEDLINE database. For prevention programmes to reduce sports injuries, critical factors must be considered, such as training content, duration and frequency, as well as athlete compliance. Home-based programmes could be inferior to supervised training, but are efficient if compliance is high. So far prevention programmes have focused on team sports and their efficiency in individual sports remains to be proven. Active prevention programmes focusing specifically on the upper extremity are scarce. Initiatives enhancing the awareness of trainers, athletes and therapists about risk factors and systematic prevention measures should be encouraged.
Erhardt, Taryn; Rice, Thomas; Troszak, Lara; Zhu, Motao
The use of novelty motorcycle helmets is often prompted by beliefs that wearing a standard helmet can contribute to neck injury during traffic collisions. The goal of this analysis was to examine the association between helmet type and neck injury risk and the association between helmet type and head injury. Data were collected during the investigation of motorcycle collisions of any injury severity by the California Highway Patrol (CHP) and 83 local law enforcement agencies in California between June 2012 and July 2013. We estimated head injury and neck injury risk ratios from data on 7051 collision-involved motorcyclists using log-binomial regression. Helmet type was strongly associated with head injury occurrence but was not associated with the occurrence of neck injury. Rider age, rider alcohol use, and motorcycle speed were strong, positive predictors of both head and neck injury. Interventions to improve motorcycle helmet choice and to counteract misplaced concerns surrounding neck injury risk are likely to lead to reductions in head injury, brain injury, and death. Copyright © 2015 Elsevier Ltd. All rights reserved.
Junge, Tina; Runge, Lisbeth; Juul-Kristensen, Birgit
.14). For overuse knee injuries, intrinsic risk factors were sex (girls OR 1.38), and previous knee injury (OR 1.78), while participation in soccer (OR 1.64), handball (OR 1.95), basket (OR 2.07), rhythmic (OR 1.98), and tumbling gymnastics (OR 1.74) were additional risk factors. For both injury types, sport...... and participation in soccer, handball, basket, rhythmic and tumbling gymnastics. Further risk factors for both types of injury were participation in sports above two times/week. Although growth-related overuse knee injuries are a self-limiting condition, a major part of children are affected by these injuries......INTRODUCTION: Knee injuries are frequent in children, with most studies reporting traumatic knee injuries. Evidence of risk factors for knee injuries in children is sparse. The purpose of this study was to report the extent of traumatic and overuse knee injuries in children and to evaluate...
Full Text Available Background and aims :Prevalence of musculoskeletal disorders (MSDs is high among office workers. Long time seated posture, working with computer, repetitive movements and inappropriate environmental conditions may have causal effects in these disorders. High prevalence rate of MSDs makes ergonomics assessment and working conditions improvement necessary. Designing an assessment checklist and calculating ergonomics indices can be useful in this evaluation. This study was conducted with the objectives of determination of prevalence rate, ergonomics assessment of working conditions and determination of factors associated with MSDs among office workers. Methods:In this study 400 randomly selected office workers participated. Nordic musculoskeletal disorders questionnaire was applied to determine prevalence rate of MSDs. Working conditions were assessed by the designed ergonomics checklist and ergonomic risk factors were identified. Data were analyzed using statistical tests including t-test, Chi-square and test of proportion by SPSS software (Version 12.0. Results:The highest prevalence rates of MSDs were reported in lower back and neck regions (49% and 47%, respectively. Statistical analysis revealed that there were significant association between occurrence of MSDs and calculated ergonomics indices (P<0.05. The mean of ergonomics index among those suffered from MSDs were less than other healthy workers indicating inappropriate ergonomics conditions. Calculation of OR also revealed that ergonomics conditions was associated with MSDs occurrence among workers (P<0.05. Totally, 53.3% of the office workers studied had poor working conditions. Awkward working posture and inappropriate workstation design were recognized as the main risk factors in the office workplace. Conclusion:Most ergonomics problems were originated from bad postures and inappropriate design of workstation. Any interventional program for working conditions improvement should
Gabrielle T Goodlin
Full Text Available Recent studies have identified genetic markers associated with risk for certain sports-related injuries and performance-related conditions, with the hope that these markers could be used by individual athletes to personalize their training and diet regimens. We found that we could greatly expand the knowledge base of sports genetic information by using published data originally found in health and disease studies. For example, the results from large genome-wide association studies for low bone mineral density in elderly women can be re-purposed for low bone mineral density in young endurance athletes. In total, we found 124 single-nucleotide polymorphisms associated with: anterior cruciate ligament tear, Achilles tendon injury, low bone mineral density and stress fracture, osteoarthritis, vitamin/mineral deficiencies, and sickle cell trait. Of these single nucleotide polymorphisms, 91% have not previously been used in sports genetics. We conducted a pilot program on fourteen triathletes using this expanded knowledge base of genetic variants associated with sports injury. These athletes were genotyped and educated about how their individual genetic make-up affected their personal risk profile during an hour-long personal consultation. Overall, participants were favorable of the program, found it informative, and most acted upon their genetic results. This pilot program shows that recent genetic research provides valuable information to help reduce sports injuries and to optimize nutrition. There are many genetic studies for health and disease that can be mined to provide useful information to athletes about their individual risk for relevant injuries.
Junge, Tina; Runge, Lisbeth; Juul-Kristensen, Birgit; Wedderkopp, Niels
Knee injuries are frequent in children, with most studies reporting traumatic knee injuries. Evidence of risk factors for knee injuries in children is sparse. The purpose of this study was to report the extent of traumatic and overuse knee injuries in children and to evaluate intrinsic and extrinsic factors for risk of these injuries. Weekly musculoskeletal pain, sport participation, and sports type were reported by 1326 school children (8-15 yr). Knee injuries were classified as traumatic or overuse. Multinomial logistic regression was used for analyses. During the study period, 952 (15% traumatic and 85% overuse) knee injuries were diagnosed. Period prevalence for traumatic and overuse knee injuries were 0.8/1000 and 5.4/1000 sport participations, respectively. Participation in tumbling gymnastics was a risk factor for traumatic knee injuries (OR, 2.14). For overuse knee injuries, intrinsic risk factors were sex (girls OR, 1.38) and previous knee injury (OR, 1.78), whereas participation in soccer (OR, 1.64), handball (OR, 1.95), basket (OR, 2.07), rhythmic (OR, 1.98), and tumbling gymnastics (OR, 1.74) were additional risk factors. For both injury types, sport participation above two times per week increased odds (OR, 1.46-2.40). Overuse knee injuries were the most frequent injury type. For traumatic knee injuries, participation in tumbling gymnastics was a risk factor. Risk factors for overuse knee injuries were being a girl; previous knee injury; and participation in soccer, handball, basket, and rhythmic and tumbling gymnastics. Further risk factors for both types of injury were participation in sports above two times per week. Although growth-related overuse knee injuries are a self-limiting condition, a major part of children are affected by these injuries with unknown short- and long-term consequences.
Lam, Carlos; Kang, Jiunn-Horng; Lin, Hsiao-Yu; Huang, Hung-Chang; Wu, Chia-Chieh; Chen, Ping-Ling
Recurrent falls not only have risk factors different from those of single falls but also have less favorable outcomes. The aim of our study was to determine the association between the injury characteristics of a first fall and the likelihood of recurrent injurious falls in a cohort of hospitalized patients. We designed a nationwide retrospective cohort study and selected hospitalized patients who had injurious falls between 2001 and 2010. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of recurrent injurious falls requiring hospitalization in the following year on the basis of the patients' demographic characteristics, comorbidities, and the characteristics of injuries from the first injurious fall requiring hospitalization. Among the 504 512 patients hospitalized for injurious falls, 19 442 experienced recurrent injurious falls requiring hospitalization. The 1-year incidence of recurrent injurious falls requiring hospitalization was 3.85%. The incidence density was the highest within the 3-month period after the first injurious fall. The risk of recurrent injurious falls among patients aged 40 to 64, 65 to 74, and ≥ 75 years increased progressively (HR: 2.11, 95% confidence interval [CI]: 1.90-2.34; HR: 2.80, 95% CI: 2.51-3.11; and HR: 3.80, 95% CI: 3.42-4.23, respectively). The length of hospitalization (LOH) ≥ 15 or ≥ 31 days (HR: 1.39, 95% CI: 1.30-1.48; and HR: 1.59, 95% CI: 1.43-1.77, respectively) and injury to the head (HR: 1.59, 95% CI: 1.53-1.65) or spine (HR: 1.66, 95% CI: 1.59-1.74) were also found to be major risk factors. Our findings show that the LOH and head and spine injuries are associated with an increased risk of recurrent injurious falls leading to hospitalization. The risk of recurrent injurious falls requiring hospitalization increased significantly among adults older than 40 years. We suggest further research on the effects of injury characteristics associated with the first injurious fall requiring
Full Text Available Recurrent falls not only have risk factors different from those of single falls but also have less favorable outcomes. The aim of our study was to determine the association between the injury characteristics of a first fall and the likelihood of recurrent injurious falls in a cohort of hospitalized patients.We designed a nationwide retrospective cohort study and selected hospitalized patients who had injurious falls between 2001 and 2010. Cox proportional hazards models were used to estimate the hazard ratios (HRs of recurrent injurious falls requiring hospitalization in the following year on the basis of the patients' demographic characteristics, comorbidities, and the characteristics of injuries from the first injurious fall requiring hospitalization.Among the 504 512 patients hospitalized for injurious falls, 19 442 experienced recurrent injurious falls requiring hospitalization. The 1-year incidence of recurrent injurious falls requiring hospitalization was 3.85%. The incidence density was the highest within the 3-month period after the first injurious fall. The risk of recurrent injurious falls among patients aged 40 to 64, 65 to 74, and ≥ 75 years increased progressively (HR: 2.11, 95% confidence interval [CI]: 1.90-2.34; HR: 2.80, 95% CI: 2.51-3.11; and HR: 3.80, 95% CI: 3.42-4.23, respectively. The length of hospitalization (LOH ≥ 15 or ≥ 31 days (HR: 1.39, 95% CI: 1.30-1.48; and HR: 1.59, 95% CI: 1.43-1.77, respectively and injury to the head (HR: 1.59, 95% CI: 1.53-1.65 or spine (HR: 1.66, 95% CI: 1.59-1.74 were also found to be major risk factors.Our findings show that the LOH and head and spine injuries are associated with an increased risk of recurrent injurious falls leading to hospitalization. The risk of recurrent injurious falls requiring hospitalization increased significantly among adults older than 40 years. We suggest further research on the effects of injury characteristics associated with the first injurious fall
Full Text Available Abstract Background Cutting and piercing injuries are among the leading causes of unintentional injury morbidity in developed countries. In New Zealand, cutting and piercing are second only to falls as the most frequent cause of unintentional home injuries resulting in admissions to hospital among people aged 20 to 64 years. Alcohol intake is known to be associated with many other types of injury. We used a case-crossover study to investigate the role of acute alcohol use (i.e., drinking during the previous 6 h in unintentional cutting or piercing injuries at home. Methods A population-based case-crossover study was conducted. We identified all people aged 20 to 64 years, resident in one of three regions of the country (Greater Auckland, Waikato and Otago, who were admitted to public hospital within 48 h of an unintentional non-occupational cutting or piercing injury sustained at home (theirs or another's from August 2008 to December 2009. The main exposure of interest was use of alcohol in the 6-hour period before the injury occurred and the corresponding time intervals 24 h before, and 1 week before, the injury. Other information was collected on known and potential confounders. Information was obtained during face-to-face interviews with cases, and through review of their medical charts. Results Of the 356 participants, 71% were male, and a third sustained injuries from contact with glass. After adjustment for other paired exposures, the odds ratio for injury after consuming 1 to 3 standard drinks of alcohol during the 6-hour period before the injury (compared to the day before, compared to none, was 1.77 (95% confidence interval 0.84 to 3.74, and for four or more drinks was 8.68 (95% confidence interval 3.11 to 24.3. Smokers had higher alcohol-related risks than non-smokers. Conclusions Alcohol consumption increases the odds of unintentional cutting or piercing injury occurring at home and this risk increases with higher levels of drinking.
McKay, Damien; Broderick, Carolyn; Steinbeck, Katharine
With the advent of long-term athlete development programs and early sport specialization, the training of elite athletes now spans the period of adolescence. Adolescence represents a period of physical, psychosocial and cognitive development, but also a time of physical and psychological vulnerability. Changes in skeletal and physiological attributes coincide with an increased risk of sport related injury. A window of vulnerability is shaped by the properties of the musculoskeletal system, the influence of pubertal hormones and the lag time between physical and cognitive development. This article aims to challenge the assumption of adolescence as a time of increased vigor alone, by highlighting the presence of specific vulnerabilities, and proposing that the hormonal, musculoskeletal, and neurocognitive changes of adolescence may represent intrinsic risk factors for sport related injury.
Nahon, Pierre; Nault, Jean-Charles
Exploration of the constitutional genetics of hepatocellular carcinoma (HCC) has identified numerous variants associated with a higher risk of liver cancer in alcoholic cirrhotic patients. Although Genome-Wide Association studies have not been carried out in the field of alcohol-related HCC, common single nucleotide polymorphisms conferring a small increase in the risk of liver cancer risk have been identified and shown to modulate ethanol metabolism, inflammation, oxidative stress, iron or lipid metabolism. Specific patterns of gene mutations including CTNNB1, TERT, ARID1A and SMARCA2 exist in alcohol-related HCC. Moreover, a specific mutational process observed at the nucleotide level by next generation sequencing has revealed cooperation between alcohol and tobacco in the development of HCC. Combining this genetic information with epidemiological and clinical data that might define specific HCC risk classes and refine surveillance strategies needs to be assessed in large prospective cohorts of patients with alcoholic cirrhosis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
tobacco has no effect on reaction time.89-91 It is possible that the increased risk of injury associated with smokeless tobacco use could be...Grabiner M. Smokeless tobacco, reaction time, and strength in athletes. Medicine and Science in Sports and Exercise, 1998; 30: 1548- 1551. 92...Candau R, Belli A, Millet GY, George D, Barbier B, Rouillon JD. Energy cost and running mechanics during a treadmill run to voluntary exhaustion in
Feng, Xun Yi Jasmine; Nah, Shireen Anne; Lee, York Tien; Lin, Yea-Chyi; Chiang, Li Wei
This study evaluates the demographics of paediatric pedestrian injuries with the aim of identifying the group of children who is most vulnerable and the risk factors for major trauma (MT). Data was extracted from the integrated trauma system of a regional paediatric referral hospital. All paediatric cases involving road traffic accidents from January 2011 to December 2013 were studied. Demographics, injury mechanism, treatment and outcome were evaluated. Patients were categorised as MT or non-MT (NMT) based on their Injury Severity Score, admission to the intensive care unit, type of surgery (e.g. life/limb-saving) and death. Data analysis was done using nonparametric tests and Fisher's exact test. A total of 261 children were admitted for pedestrian injuries during the study period. The median age was ten years (range 14 months-16 years) and the median weight was 42.4 (range 8.6-93.7) kg. Half (i.e. 50.2%) of the children were primary-schoolers. The majority of the accidents occurred on roads (i.e. 83.1%), between 12 pm and 6 pm (i.e. 52.8%). Among the 261 children, 177 (67.8%) were unaccompanied by an adult at the time of the accident; 17 (6.5%) children sustained MT, while 244 (93.5%) suffered NMT. MT patients were more likely to have lost consciousness (p injuries involved primary-schoolers walking home from school unaccompanied by adults. This information should inform future road safety campaigns. Being flung and loss of consciousness predicted MT in children who sustained pedestrian injuries.
Pearson, Matthew R; D'Lima, Gabrielle M; Kelley, Michelle L
Alcohol misuse among college students is a large public health concern, thus, it is imperative to identify factors that reduce this risk. One risk factor associated with developing alcohol-related problems is meeting criteria for being an adult child of an alcoholic (ACOA). Conversely, self-regulation has been identified as a protective factor that is inversely associated with drinking-related outcomes. The purpose of the present study was to examine whether self-regulation buffers the risk associated with ACOA status on alcohol use and alcohol-related consequences. In a sample of 195 first-year college students, we found that ACOA status had a unique effect on both alcohol consumption and alcohol-related consequences. Self-regulation was unrelated to alcohol use but inversely associated with alcohol-related consequences. Notably, self-regulation moderated the effect of ACOA status on alcohol-related problems (but not alcohol consumption) such that self-regulation was most strongly related to alcohol-related problems among ACOAs. Our results suggest that self-regulation helps explain the resilience of many ACOAs. Copyright © 2011 Elsevier Ltd. All rights reserved.
Preventive Medicine THE PARACHUTE ANKLE BRACE: ENTANGLEMENTS AND INJURIES AFTER CONTROLLING FOR EXTRINSIC RISK...Amoroso P.J. (2005). Effectiveness of an external ankle brace in reducing parachute-related ankle injuries . Injury Prevention . 11: 163- 168. 25...M. (1994). The efficacy of a semirigid ankle stabilizer to reduce acute ankle injury in basketball . American Journal of Sports Medicine. 22:
Borland, Meredith L; Dalziel, Stuart R; Phillips, Natalie; Dalton, Sarah; Lyttle, Mark D; Bressan, Silvia; Oakley, Ed; Hearps, Stephen J C; Kochar, Amit; Furyk, Jeremy; Cheek, John A; Neutze, Jocelyn; Babl, Franz E
To determine the prevalence of traumatic brain injuries in children who vomit after head injury and identify variables from published clinical decision rules (CDRs) that predict increased risk. Secondary analysis of the Australasian Paediatric Head Injury Rule Study. Vomiting characteristics were assessed and correlated with CDR predictors and the presence of clinically important traumatic brain injury (ciTBI) or traumatic brain injury on computed tomography (TBI-CT). Isolated vomiting was defined as vomiting without other CDR predictors. Of the 19 920 children enrolled, 3389 (17.0%) had any vomiting, with 2446 (72.2%) >2 years of age. In 172 patients with ciTBI, 76 had vomiting (44.2%; 95% confidence interval [CI] 36.9%-51.7%), and in 285 with TBI-CT, 123 had vomiting (43.2%; 95% CI 37.5%-49.0%). With isolated vomiting, only 1 (0.3%; 95% CI 0.0%-0.9%) had ciTBI and 2 (0.6%; 95% CI 0.0%-1.4%) had TBI-CT. Predictors of increased risk of ciTBI with vomiting by using multivariate regression were as follows: signs of skull fracture (odds ratio [OR] 80.1; 95% CI 43.4-148.0), altered mental status (OR 2.4; 95% CI 1.0-5.5), headache (OR 2.3; 95% CI 1.3-4.1), and acting abnormally (OR 1.86; 95% CI 1.0-3.4). Additional features predicting TBI-CT were as follows: skull fracture (OR 112.96; 95% CI 66.76-191.14), nonaccidental injury concern (OR 6.75; 95% CI 1.54-29.69), headache (OR 2.55; 95% CI 1.52-4.27), and acting abnormally (OR 1.83; 95% CI 1.10-3.06). TBI-CT and ciTBI are uncommon in children presenting with head injury with isolated vomiting, and a management strategy of observation without immediate computed tomography appears appropriate. Copyright © 2018 by the American Academy of Pediatrics.
Rickert, Dale L; Barrett, Margaret S; Ackermann, Bronwen J
That orchestral musicians are exposed to a high risk of playing-related injury is well established, but despite this, little is known about how work organisation and psychosocial factors may contribute to this risk. Lack of research in this area is surprising considering the importance of these factors in managing occupational health risks in a wide range of other working populations. To address this, we conducted a qualitative study with the following aims: to investigate orchestral musicians' and managers' perceptions of those workplace environmental factors that contribute to injury, and to investigate the potential influence of work organisation and psychosocial factors on injury risk for orchestral musicians. Using a qualitative case-study methodology, in-depth, semi-structured interviews were undertaken with 10 professional orchestral cellists (2 casual and 8 full-time members) from a single Australian orchestra. After initial data analysis, further interviews were undertaken with a set of 5 orchestral management staff as a means of data triangulation. All data were analysed using a "themes-based" analysis of narrative approach. The findings indicate that musicians perceive that stress in the orchestral environment increases injury risk. The perceived stressors were divided into two broad categories: psychosocial injury risks, which included performance stress and interpersonal relationships, and combined psychosocial/physical injury risks such as work organisation and lack of control. This article evaluates the findings in terms of existing literature and makes recommendations for better management of environmental injury risk for orchestral musicians.
Dudding, Thomas C; Vaizey, Carolynne J; Kamm, Michael A
Obstetric sphincter damage is the most common cause of fecal incontinence in women. This review aimed to survey the literature, and reach a consensus, on its incidence, risk factors, and management. This systematic review identified relevant studies from the following sources: Medline, Cochrane database, cross referencing from identified articles, conference abstracts and proceedings, and guidelines published by the National Institute of Clinical Excellence (United Kingdom), Royal College of Obstetricians and Gynaecologists (United Kingdom), and American College of Obstetricians and Gynecologists. A total of 451 articles and abstracts were reviewed. There was a wide variation in the reported incidence of anal sphincter muscle injury from childbirth, with the true incidence likely to be approximately 11% of postpartum women. Risk factors for injury included instrumental delivery, prolonged second stage of labor, birth weight greater than 4 kg, fetal occipitoposterior presentation, and episiotomy. First vaginal delivery, induction of labor, epidural anesthesia, early pushing, and active restraint of the fetal head during delivery may be associated with an increased risk of sphincter trauma. The majority of sphincter tears can be identified clinically by a suitably trained clinician. In those with recognized tears at the time of delivery repair should be performed using long-term absorbable sutures. Patients presenting later with fecal incontinence may be managed successfully using antidiarrheal drugs and biofeedback. In those who fail conservative treatment, and who have a substantial sphincter disruption, elective repair may be attempted. The results of primary and elective repair may deteriorate with time. Sacral nerve stimulation may be an appropriate alternative treatment modality. Obstetric anal sphincter damage, and related fecal incontinence, are common. Risk factors for such trauma are well recognized, and should allow for reduction of injury by proactive
Hamilton, G M; Meeuwisse, W H; Emery, C A; Shrier, I
A secondary data analysis of a prospective cohort study was conducted to explore how different definitions of injury affect the results of risk factor analyses. Modern circus artists (n=1281) were followed for 828,547 performances over a period of 49 months (2004-2008). A univariate risk factor analysis (age, sex, nationality, artist role) estimating incidence rate ratios (IRR) with 95% confidence intervals (95% CI) was conducted using three injury definitions: (1) medical attention injuries, (2) time-loss injuries resulting in ≥1 missed performances (TL-1) and (3) time-loss injuries resulting in >15 missed performances (TL-15). Results of the risk factor analysis were dependent on the injury definition. Sex (females to male; IRR=1.13, 95% CI; 1.02-1.25) and age over 30 (30 years; IRR=1.37, 95% CI; 1.07-1.79) were risk factors for medical attention injuries only. Risk of injury for Europeans compared with North Americans was higher for TL-1 and TL-15 injuries compared with medical attention injuries. Finally, non-sudden load artists (low-impact acts) were less likely than sudden load artists (high-impact acts) to have TL-1 injuries, but the risk of medical attention injuries was similar. The choice of injury definition can have effects on the magnitude and direction of risk factor analyses. © 2010 John Wiley & Sons A/S.
Sarah A. Richmond
Full Text Available Objectives. To examine body mass index (BMI and waist circumference (WC as risk factors for sport injury in adolescents. Design. A secondary analysis of prospectively collected data from a pilot cluster randomized controlled trial. Methods. Adolescents (n=1,040 at the ages of 11–15 years from two Calgary junior high schools were included. BMI (kg/m2 and WC (cm were measured from direct measures at baseline assessment. Categories (overweight/obese were created using validated international (BMI and national (WC cut-off points. A Poisson regression analysis controlling for relevant covariates (sex, previous injury, sport participation, intervention group, and aerobic fitness level estimated the risk of sport injury [incidence rate ratios (IRR with 95% confidence intervals (CI]. Results. There was an increased risk of time loss injury (IRR = 2.82, 95% CI: 1.01–8.04 and knee injury (IRR = 2.07, 95% CI: 1.00–6.94 in adolescents that were overweight/obese; however, increases in injury risk for all injury and lower extremity injury were not statistically significant. Estimates suggested a greater risk of time loss injury [IRR = 1.63 (95% CI: 0.93–2.47] in adolescents with high measures of WC. Conclusions. There is an increased risk of time loss injury and knee injury in overweight/obese adolescents. Sport injury prevention training programs should include strategies that target all known risk factors for injury.
Wiersma, Jacquelyn D; Fischer, Judith L
This study examines the association between young adult drinking partnerships (ages 18-26 years) and later alcohol-related problems and consequences, alcohol use, relationship quality, and relationship dissolution in adult relationships (ages 26-35). Data came from the National Longitudinal Study of Adolescent Health (Add Health; Waves III and IV) with 1,347 young adults and their partners at Wave III, including dating, cohabiting, and married couples, and individual adult behaviors at Wave IV, 6 years later. Drinking partnerships were based on alcohol use frequency, quantity, heavy episodic drinking, and getting drunk. Four clusters included (a) congruent light and infrequent, (b) discrepant male heavy and frequent, (c) discrepant female heavy and frequent, and (d) congruent heavy and frequent drinkers. Young adult discrepant partnerships reported more alcohol-related problems and consequences 6 years later. Young adults in the congruent heavy drinking partnership indicated more separation/divorce and alcohol use as adults. Young adult married men who drank discrepantly and higher compared to their wives reported higher rates of adult drinking and problems than other men. There were a number of negative effects from congruent heavy drinking, especially for women. These findings demonstrated that there are multiple types of young adult drinking partnerships based on couples' alcohol use behaviors. Men may be at risk for serious alcohol-related problems later in adulthood, especially when paired with discrepant drinking partners and congruent heavy drinking partners. Women are at risk when in congruent, heavy and frequent drinking partnerships. Studying romantic relationships and drinking has implications for broad aspects of young adult and adult development.
Nexøe, Jørgen; Wilche, Julie Præst; Niclasen, Birgit
Aims: The aim of this study was to describe emergency admissions in Greenland's healthcare system, and the extent to which admissions were associated with alcohol abuse or violence. Furthermore, we aimed to test whether data on emergencies in Greenland could be registered in a reliable way......). Conclusions: This study confirms that violence- and alcohol-related emergencies put a considerable strain on Greenland's healthcare system. Due to the short observation period, we have not been able to describe the actual extent of the problem in detail, nor was it possible to estimate whether this problem...
João B. Fonseca
Full Text Available Coprophagia and entomophagia are two phenomena not commonly reported in the medical literature and their occurrence is usually associated with mental disorders. We present the case of a 59-year-old man with a history of alcohol abuse who was evaluated due to cognitive deterioration and disturbed eating habits including feces and living insects. Organic causes were ruled out and an important cognitive impairment became evident on neuropsychological formal test. The behavior remitted after antipsychotic pharmacologic therapy and alcohol detoxification, leaving the diagnostic impression of alcohol related dementia. This report shows a rare association of these two conditions in a patient with dementia.
Rishiraj, N; Lloyd-Smith, R; Lorenz, T; Niven, B; Michel, M
The aim of this study was to determine the injury rates of a Men's Varsity Ice Hockey team over six-years. Data on ice hockey injury rates and profile continue to increase in the hope of assisting with injury prevention. The University of British Columbia Men's Varsity team has been followed prospectively over a six-year period. All student-athletes completed a preseason medical examinations and physiological assessments. The team physician evaluated each injury and the team therapist completed the injury report forms and the attendance records for each player. A total of 46215 player exposures were recorded. The combined injury rate was 3.70 injuries/1000 player game and practice exposures. A statistically significantly higher risk of injury was observed during games and the greatest risk of injury was observed during the second period. Forwards sustained greater percentage of injuries compared to defensemen and goalies. Sprains and strains accounted for 40% of all injuries, followed by concussions (13%). Non-contact injuries were most common, while the anatomy sustaining the most injuries was the head/neck/face region. A high percentage of the recorded injuries required less than seven days to return to full activity. The risk of injury for university ice hockey players is greater during games and is dependant on playing position. Players are prone to sprains and strains, which may not involve any contact. Concussion and knee joint injury rates continue to cause concern.
Wang, Xin; Wang, Pei-shan; Zhou, Wei
To assess the incidence, types and risk factors of military training-related injuries in recruits of Chinese People's Armed Police Forces (CPAPF). A cohort study was made on the risk factors of injuries in 805 male recruits during the military training from December 25, 1999 to December 25, 2000. A total of 111 recruits (14%) experienced one or more injuries, and the cumulative incidence was 16.1 injuries per 100 soldiers in a year. And 77.7% of the injuries belonged to overuse injuries of the skeletal and muscular systems, the most common type of which was stress fractures. Most injuries occurred in the 3rd month of training. Univariate analysis and logistic regression analysis of possible risk factors for overuse injuries were carried out, and a number of risk factors were identified: history of agricultural labor, history of lower limb injury, flatfoot and less running exercise before entry into the army. But a suitable body mass index (BMI) was a protective factor. Examination of age, body height, smoking, body flexibility and frequency of 2-mile running revealed no significant association with the injuries. History of agricultural labor, history of lower limb injury, flatfoot, less running exercise before entry into the army and lower BMI were risk factors of the overuse injuries. In order to decrease the incidence of overuse injuries, the young people with good physical ability and shapely body type should be selected during conscription. During the training, nutrition should be improved so as to decrease the incidence of injuries.
Nanjundappa S. Harshavardhana
Full Text Available Blunt cerebrovascular injuries (i.e. involvement of carotid and vertebral arteries are increasingly being recognized in setting of cervical spine trauma/fractures and are associated with high incidence of stroke/morbidity and mortality. The incidence of vertebral artery injuries (VAI is more common than previously thought and regular screening is seldom performed. However there exists no screening criteria and conflicting reports exists between spine and trauma literature. Many clinicians do not routinely screen/evaluate patients presenting with cervical spine trauma for potential VAI. This article provides a brief summary of existing evidence regarding the incidence of VAI in the background of cervical trauma/fractures. The type and fracture pattern that is associated with a high risk of VAI warranting mandatory screening/further work-up is discussed. A brief overview of diagnostic modalities and their respective sensitivity/specificity along with available treatment options is also summarized.
Runge, Lisbeth; Kristensen, Peter Lund; Junge, Tina
for overuse injuries in the foot region (IRR=1.65), as did good performance in core stability tests and shuttle run, especially for knee injuries (IRR=1.07-1.18). CONCLUSIONS: Poor balance (sway) performance was a consistent predictor of traumatic injuries, in particular for traumatic ankle injuries. Good......PURPOSE: Physical activity related injuries in children constitute a costly public health matter. The influence of motor performance on injury risk is unclear. The purpose was to examine if motor performance was a risk factor of traumatic and overuse lower extremity injuries in a normal population...... for distance, core stability tests, vertical jump, shuttle run, and a cardiorespiratory fitness test. Lower extremity injuries were registered by clinicians by weekly questionnaires and classified according to the ICD-10 system. RESULTS: Poor balance increased risk for traumatic injury in the foot region (IRR...
Cronin, Robert M; VanHouten, Jacob P; Siew, Edward D; Eden, Svetlana K; Fihn, Stephan D; Nielson, Christopher D; Peterson, Josh F; Baker, Clifton R; Ikizler, T Alp; Speroff, Theodore; Matheny, Michael E
Objective Hospital-acquired acute kidney injury (HA-AKI) is a potentially preventable cause of morbidity and mortality. Identifying high-risk patients prior to the onset of kidney injury is a key step towards AKI prevention.
Read, Paul J.; Oliver, Jon L.; De Ste Croix, Mark B. A.; Myer, Gregory D.; Lloyd, Rhodri S.
Injuries reported in male youth soccer players most commonly occur in the lower extremities, and include a high proportion of ligament sprains at the ankle and knee with a lower proportion of overuse injuries. There is currently a paucity of available literature that examines age-and sex-specific injury risk factors for such injuries within youth soccer players. Epidemiological data have reported movements that lead to non-contact ligament injury include running, twisting and turning, over-re...
Zahr, Natalie M; Kaufman, Kimberley L; Harper, Clive G
One of the sequelae of chronic alcohol abuse is malnutrition. Importantly, a deficiency in thiamine (vitamin B(1)) can result in the acute, potentially reversible neurological disorder Wernicke encephalopathy (WE). When WE is recognized, thiamine treatment can elicit a rapid clinical recovery. If WE is left untreated, however, patients can develop Korsakoff syndrome (KS), a severe neurological disorder characterized by anterograde amnesia. Alcohol-related brain damage (ARBD) describes the effects of chronic alcohol consumption on human brain structure and function in the absence of more discrete and well-characterized neurological concomitants of alcoholism such as WE and KS. Through knowledge of both the well-described changes in brain structure and function that are evident in alcohol-related disorders such as WE and KS and the clinical outcomes associated with these changes, researchers have begun to gain a better understanding of ARBD. This Review examines ARBD from the perspective of WE and KS, exploring the clinical presentations, postmortem brain pathology, in vivo MRI findings and potential molecular mechanisms associated with these conditions. An awareness of the consequences of chronic alcohol consumption on human behavior and brain structure can enable clinicians to improve detection and treatment of ARBD.
Young, Chelsie M; DiBello, Angelo M; Traylor, Zachary K; Zvolensky, Michael J; Neighbors, Clayton
The current study evaluated the roles of drinking motives and shyness in predicting problem alcohol use over 2 years. First-year college student drinkers (n = 818) completed assessments of alcohol use and related problems, shyness, and drinking motives every 6 months over a 2-year period. Generalized linear mixed models indicated that shyness was associated with less drinking, but more alcohol-related problems. Further, shyness was associated with coping, conformity, and enhancement drinking motives, but was not associated with social drinking motives. However, when examining coping motives, moderation analyses revealed that social drinking motives were more strongly associated with coping motives among individuals higher in shyness. In addition, coping, conformity, and enhancement motives, but not social motives, mediated associations between shyness and alcohol-related problems over time. Finally, coping motives mediated the association between the interaction of shyness and social motives and alcohol-related problems. Together, the results suggest that shy individuals may drink to reduce negative affect, increase positive affect, and fit in with others in social situations, which may then contribute to greater risk for subsequent alcohol-related problems. Copyright © 2015 by the Research Society on Alcoholism.
Worp, M.P. van der
Running is a popular sport worldwide and has a positive effect on health and well-being. However, the rate of running-related injuries and the associated costs are high. Van der Worp performed a systematic review to examine which factors increase the risk of running injuries, and whether this is the
Bae, Dong-Hyeon; Choi, Kyu-Sun; Yi, Hyeong-Joong; Chun, Hyoung-Joon; Ko, Yong; Bak, Koang Hum
Objective Post-traumatic cerebral infarction (PTCI) is one of the most severe secondary insults after traumatic brain injury (TBI), and is known to be associated with poor outcome and high mortality rate. We assessed the practical incidence and risk factors for the development of PTCI. Methods We conducted retrospective study on 986 consecutive patients with TBI from the period May 2005 to November 2012 at our institution. The definition of PTCI was made on non-enhanced CT scan based on a wel...
Bell, Alison F; Steele, Julie R
This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers.
van Heumen, Moniek; Tol, Johannes L; de Vos, Robert-Jan; Moen, Maarten H; Weir, Adam; Orchard, John; Reurink, Gustaaf
A challenge for sports physicians is to estimate the risk of a hamstring re-injury, but the current evidence for MRI variables as a risk factor is unknown. To systematically review the literature on the prognostic value of MRI findings at index injury and/or return to play for acute hamstring re-injuries. Databases of PubMed, Embase, MEDLINE, Scopus, CINAHL, Google Scholar, Web of Science, LILACS, SciELO, ScienceDirect, ProQuest, SPORTDiscus and Cochrane Library were searched until 20 June 2016. Studies evaluating MRI as a prognostic tool for determining the risk of re-injury for athletes with acute hamstring injuries were eligible for inclusion. Two authors independently screened the search results and assessed risk of bias using standardised criteria from a consensus statement. A best-evidence synthesis was used to identify the level of evidence. Post hoc analysis included correction for insufficient sample size. Of the 11 studies included, 7 had a low and 4 had a high risk of bias. No strong evidence for any MRI finding as a risk factor for hamstring re-injury was found. There was moderate evidence that intratendinous injuries were associated with increased re-injury risk. Post hoc analysis showed moderate evidence that injury to the biceps femoris was a moderate to strong risk factor for re-injury. There is currently no strong evidence for any MRI finding in predicting hamstring re-injury risk. Intratendinous injuries and biceps femoris injuries showed moderate evidence for association with a higher re-injury risk. Registration in the PROSPERO International prospective register of systematic reviews was performed prior to study initiation (registration number CRD42015024620). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Hewett, Timothy E.; Myer, Gregory D.; Ford, Kevin R.; Paterno, Mark V.; Quatman, Carmen E.
Economic and societal pressures influence modern medical practice to develop and implement prevention strategies. Anterior cruciate ligament (ACL) injury devastates the knee joint leading to short term disability and long term sequelae. Due to the high risk of long term osteoarthritis in all treatment populations following ACL injury, prevention is the only effective intervention for this life-altering disruption in knee health. The “Sequence of Prevention” Model provides a framework to monitor progress towards the ultimate goal of preventing ACL injuries. Utilizing this model, our multidisciplinary collaborative research team has spent the last decade working to delineate injury mechanisms, identify injury risk factors, predict which athletes are at-risk for injury, and develop ACL injury prevention programs. Within this model of injury prevention, modifiable factors (biomechanical and neuromuscular) related to injury mechanisms likely provide the best opportunity for intervention strategies aimed to decrease the risk of ACL injury, particularly in female athletes. Knowledge advancements have led to the development of potential solutions that allow athletes to compete with lowered risk of ACL injury. Design and integration of personalized clinical assessment tools and targeted prevention strategies for athletes at high risk for ACL injury may transform current prevention practices and ultimately significantly reduce ACL injury incidence. This 2016 OREF Clinical Research Award focuses on the authors' work and contributions to the field. The author's acknowledge the many research groups who have contributed to the current state of knowledge in the fields of ACL injury mechanisms, injury risk screening and injury prevention strategies. PMID:27612195
Full Text Available Context: Alcohol dependence is on rise world over, especially in developing countries such as India. According to the World Health Organization, about 30% of Indians consume alcohol, out of which 4%–13% are daily consumers and up to 50% of them, fall under the category of hazardous drinking. Another worrying trend from India is that the average age of initiation of alcohol use has reduced from 28 years during the 1980s to 17 years in 2007. In India, alcohol abuse also amounts to huge annual losses due to alcohol-related problems in workplaces. This was a cross-sectional, noninterventional study which was carried out at the Department of Psychiatry, Sri Venkateswara Ramnaraian Ruia Government General Hospital (SVRRGGH, Tirupati, Andhra Pradesh. Aim: The aim of this study was to determine the frequency and nature of psychiatric morbidity in spouses of patients with alcohol-related disorders (ARDs. Methods: Study design - Hospital-based cross-sectional study. Study setting - Psychiatry Department of SVRRGGH, Sri Venkateswara Medical College, Tirupati. Study period - October 1, 2014 to September 30, 2015. Study units - the spouses of adult patients attending the Department of Psychiatry, with a diagnosis of ARDs. After the ethical clearance from the Institutional Ethical Committee, the spouses of adult patients attending the Department of Psychiatry with a diagnosis of ARDs according to the International Classification of Diseases-10 classification of mental and behavioral disorders constitute the population for the investigation. After obtaining written informed consent from each of the concerned subjects, demographic details and history of psychiatric illness were noted as per the structured pro forma. Results: The age of the alcohol-dependent men and spouses of men with ADS ranged from 23 to 67 years (mean ± standard deviation [SD] 41.24 ± 10.101 and 21–60 years (mean ± SD 35.04 ± 8.98, respectively. Among the study population, 36.6% of
Yoganandan, Narayan; Banerjee, Anjishnu; Hsu, Fang-Chi; Bass, Cameron R; Voo, Liming; Pintar, Frank A; Gayzik, F Scott
Injury risk curves from biomechanical experimental data analysis are used in automotive studies to improve crashworthiness and advance occupant safety. Metrics such as acceleration and deflection coupled with outcomes such as fractures and anatomical disruptions from impact tests are used in simple binary regression models. As an improvement, the International Standards Organization suggested a different approach. It was based on survival analysis. While probability curves for side-impact-induced thorax and abdominal injuries and frontal impact-induced foot-ankle-leg injuries are developed using this approach, deficiencies are apparent. The objective of this study is to present an improved, robust and generalizable methodology in an attempt to resolve these issues. It includes: (a) statistical identification of the most appropriate independent variable (metric) from a pool of candidate metrics, measured and or derived during experimentation and analysis processes, based on the highest area under the receiver operator curve, (b) quantitative determination of the most optimal probability distribution based on the lowest Akaike information criterion, (c) supplementing the qualitative/visual inspection method for comparing the selected distribution with a non-parametric distribution with objective measures, (d) identification of overly influential observations using different methods, and (e) estimation of confidence intervals using techniques more appropriate to the underlying survival statistical model. These clear and quantified details can be easily implemented with commercial/open source packages. They can be used in retrospective analysis and prospective design of experiments, and in applications to different loading scenarios such as underbody blast events. The feasibility of the methodology is demonstrated using post mortem human subject experiments and 24 metrics associated with thoracic/abdominal injuries in side-impacts. Published by Elsevier Ltd.
Abar, Caitlin C
The present study sought to examine parenting influences on student alcohol use through the use of a holistic, person-centered approach in order to accomplish three distinct research aims: (a) identify groups of college students with unique profiles of perceived parenting characteristics, (b) identify groups of college students with unique profiles of alcohol-related correlates, and (c) examine the extent to which profiles of perceived parenting characteristics are associated with profiles of college alcohol-related risk. A sample of 1,153 first-year university students (17-20 years-of-age) was assessed on a host of perceived parenting and self-reported alcohol-related items. Four profiles of perceived parenting (High Quality, High Monitoring, Anti-Alcohol, Pro-Alcohol) were found using latent profile analysis (LPA). Five profiles of student alcohol-related characteristics (Abstainers, Past Drinkers, Light Drinkers, High Risk Drinkers, Extreme Risk Drinkers) were also found using LPA. Latent transition analysis illustrated that students who perceived their parents as belonging to the Pro-Alcohol profile had much higher probabilities of belonging in the High Risk Drinker or Extreme Risk Drinker profiles than students in all other perceived parenting profiles. In addition to alcohol-specific parenting characteristics, aspects of parent-teen relationship quality may also be integral in the prevention of college alcohol misuse. Finally, this study observed complex patterns of parenting and alcohol behaviors, such that the profiles could be interpreted as qualitatively distinct types of individuals. These unique profiles suggest that a targeted approach reflecting the profiles found in the current study might greatly enhance prevention program efficacy. PsycINFO Database Record (c) 2012 APA, all rights reserved.
Yau, Rebecca K; Casteel, Carri; Nocera, Maryalice; Bishop, Stephanie F; Peek-Asa, Corinne
Retail business robberies can lead to employee and customer injury. Previous work demonstrates that employee resistance increases employee injury risk; limited research has investigated customer injuries. This study examines associations between employee resistance against perpetrators and the risk of customer injury. Retail and service robbery reports were obtained from a metropolitan police department. Generalized estimating equations estimated risk ratios and 95% confidence intervals (CIs). Customers were injured in 75 out of 697 robberies. Employees resisted the perpetrator in 32 out of 697 robberies. Customers had higher injury risk when employees resisted the perpetrator, compared with robberies where employees did not resist (adjusted risk ratio [95% CI], 2.6 [1.5 to 4.5]). Employee resistance against a perpetrator during a robbery increased customer injury risk. Businesses can train employees to not resist during a robbery, providing benefits for both customers and the business itself.
Io, Aro; Yoshimoto, Hisashi
Japan passed the national law "Basic Act on Measures against Alcohol-related Health Harm" on December 2013. This law is expected to prevent inappropriate drinking that leads to alcohol-related problems such as physical and mental disorder, drunk driving, suicide, domestic violence, child abuse, and poor work performance. The physician's responsibilities under this law are described as follows: i) to provide high quality and appropriate medical care concerning alcohol-related health harm; ii) to reduce or eliminate the consumption of alcohol, thus preventing the progression of alcohol-related health harm; and iii) to coordinate these efforts amongst medical institutions. Based on this law, we believe that Japanese physicians will have essential roles in achieving the goals of this law and that we can fulfill our responsibilities by observing the following aspects: a) changing our message to the patients from "drink sensibly and moderately" to "low-risk drinking; but any drinking has a risk of harm and low-risk drinking is not risk-free"; b) encouraging the spread and use of Screening, Brief Intervention, and Referral to Treatment (SBIRT); and c) establishing community healthcare systems for alcohol-related problems, including dementia in the elderly and during alcohol emergencies.
Fillo, Jennifer; Rodriguez, Lindsey M; Anthenien, Amber M; Neighbors, Clayton; Lee, Christine M
Twenty-first birthdays are associated with heavier drinking and more negative consequences than any other high-risk drinking event. Friends are the strongest social influence on young adult drinking; however, previous research on college students' drinking has often only examined individuals' perceptions of "friends" generally. Unfortunately, this may obscure the positive influence of some friends and the negative influence of others. Using data drawn from a larger intervention study aimed at reducing 21st birthday drinking, this research examined how specific friends (N = 166) who were present at 21st birthday celebrations may have exacerbated or mitigated celebrants' (N = 166) experience of alcohol-related consequences, as well as how characteristics of that friendship moderate these effects. Controlling for sex, alcohol consumption, and friend prointoxication intentions for the celebrants' 21st birthday drinking, higher friend prosafety/support intentions predicted the celebrants experiencing fewer alcohol-related consequences. Higher prosafety/support intentions also buffered participants from the negative influence of friend prointoxication intentions. Furthermore, the closeness of the friendship moderated this effect. At high levels of closeness, having a friend with lower prosafety/support intentions was associated with more alcohol-related consequences for the celebrant. Post hoc analyses revealed that this effect may have been driven by discrepancies between celebrants' and friends' reports of friendship closeness; celebrants' perception of closeness that was higher than the friends' perception was associated with the celebrant experiencing more alcohol-related consequences. Results demonstrate the ways that specific friends can both mitigate and exacerbate 21st birthday alcohol-related consequences. The implications of the present findings for incorporating specific friends into drinking-related interventions are discussed. (PsycINFO Database Record (c
Fortenbaugh, Dave; Fleisig, Glenn S; Andrews, James R
Baseball pitching kinematics, kinetics, ball velocity, and injuries at the shoulder and elbow are related. PubMed and Sport Discus were searched for original studies published between 1994 and 2008. Relevant references in these studies were retrieved. Inferential studies that tested relationships between kinematics and kinetics were included, as were studies that tested relationships between kinematics and ball velocity. Descriptive studies that simply quantified kinematics and/or kinetics were excluded. SEVERAL KINEMATIC PARAMETERS AT THE INSTANT OF FOOT CONTACT WERE ASSOCIATED WITH INCREASED UPPER EXTREMITY KINETICS: front foot position, front foot orientation, shoulder abduction, and shoulder horizontal adduction. The timing of shoulder external rotation, pelvis rotation, and upper trunk rotation was associated with increased kinetics and decreased ball velocity. Low braking force of the lead leg and a short stride were associated with decreased ball velocity. Decreased maximum shoulder external rotation, shoulder abduction, knee extension, and trunk tilt were also associated with decreased ball velocity. As pitchers develop, kinematic values remain similar, their variability reduces, and kinetic values gradually increase. Slight kinematic variations were seen among pitch types, although the kinetics of fastballs and curveballs were relatively the same; changeup kinetics were the lowest. As pitchers fatigued, kinetic values remained constant, but increases in arm pain were reported. Several kinematic parameters were related to joint kinetics and ball velocity. To enhance performance and reduce injury risk, pitchers need to learn proper fastball mechanics at an early age. A changeup is recommended as a safe secondary pitch to complement the fastball; the curveball can be added after fastball and changeup mechanics are mastered. Avoiding overuse and pitching while fatigued is necessary to minimize the risk of arm injury.
Heinz, Adrienne J; Beck, Anne; Meyer-Lindenberg, Andreas; Sterzer, Philipp; Heinz, Andreas
Alcohol-related violence is a serious and common social problem. Moreover, violent behaviour is much more common in alcohol-dependent individuals. Animal experiments and human studies have provided insights into the acute effect of alcohol on aggressive behaviour and into common factors underlying acute and chronic alcohol intake and aggression. These studies have shown that environmental factors, such as early-life stress, interact with genetic variations in serotonin-related genes that affect serotonergic and GABAergic neurotransmission. This leads to increased amygdala activity and impaired prefrontal function that, together, predispose to both increased alcohol intake and impulsive aggression. In addition, acute and chronic alcohol intake can further impair executive control and thereby facilitate aggressive behaviour.
Wells, Melissa; Morrongiello, Barbara A.; Kane, Alexa
Objective: Research on children's risk of injury reveals that parent and child factors are often interrelated. This study examined relations between children's risk taking, parent appraisal of this risk taking, and children's rate of injury in youth 8 and 9 years old. Methods: Responses to questionnaires and laboratory tasks were used to examine…
Rodríguez, Eva; Soler, María J.; Rap, Oana; Barrios, Clara; Orfila, María A.; Pascual, Julio
Background Acute kidney injury (AKI) is a life-threatening complication of severe rhabdomyolysis. This study was conducted to assess risk factors for AKI and to develop a risk score for early prediction. Methods Retrospective observational cohort study with a 9-year follow-up, carried out in an acute-care teaching-affiliated hospital. A total of 126 patients with severe rhabdomyolysis defined as serum creatine kinase (CK) > 5,000 IU/L fulfilled the inclusion criteria. Univariate and logistic regression analyses were performed to determine risk factors for AKI. Based on the values obtained for each variable, a risk score and prognostic probabilities were estimated to establish the risk for developing AKI. Results The incidence of AKI was 58%. Death during hospitalization was significantly higher among patients with AKI, compared to patients without AKI (19.2% vs 3.6%, p = 0.008). The following variables were independently associated with AKI: peak CK (odds ratio [OR] 4.9, 95%CI 1.4-16.8), hypoalbuminemia (rhabdomyolysis may be useful in clinical practice, particularly to implement early preventive measures. PMID:24367578
Humble, Stephen S; Wilson, Laura D; McKenna, John W; Leath, Taylor C; Song, Yanna; Davidson, Mario A; Ehrenfeld, Jesse M; Guillamondegui, Oscar D; Pandharipande, Pratik P; Patel, Mayur B
To determine risk factors associated with tracheostomy placement after severe traumatic brain injury (TBI) and subsequent outcomes among those who did and did not receive a tracheostomy. This retrospective cohort study compared adult trauma patients with severe TBI (n = 583) who did and did not receive tracheostomy. A multivariable logistic regression model assessed the associations between age, sex, race, insurance status, admission GCS, AIS (Head, Face, Chest) and tracheostomy placement. Ordinal logistic regression models assessed tracheostomy's influence on ventilator days and ICU LOS. To limit immortal time bias, Cox proportional hazards models assessed mortality at 1, 3 and 12-months. In this multivariable model, younger age and private insurance were associated with increased probability of tracheostomy. AIS, ISS, GCS, race and sex were not risk factors for tracheostomy placement. Age showed a non-linear relationship with tracheostomy placement; likelihood peaked in the fourth decade and declined with age. Compared to uninsured patients, privately insured patients had an increased probability of receiving a tracheostomy (OR = 1.89 [95% CI = 1.09-3.23]). Mortality was higher in those without tracheostomy placement (HR = 4.92 [95% CI = 3.49-6.93]). Abbreviated injury scale-Head was an independent factor for time to death (HR = 2.53 [95% CI = 2.00-3.19]), but age, gender and insurance were not. Age and insurance status are independently associated with tracheostomy placement, but not with mortality after severe TBI. Tracheostomy placement is associated with increased survival after severe TBI.
Nauta, Joske; Martin-Diener, Eva; Martin, Brian W; van Mechelen, Willem; Verhagen, Evert
The current focus on a physically active lifestyle in children puts children at increased physical activity-related injury risk. To summarise, in a systematic review, the evidence for the injury risk of several physical activity behaviours in 6- to 12-year-old children. An electronic search was performed in three databases (Embase, PubMed and SPORTDiscus). Inclusion criteria were: age 6-12 years; report on injuries related to overall physical activity, active commuting, unorganised leisure time physical activity, physical education and/or organised sports; incidence rates expressed as injuries per hours of physical activity; and published after January 1st 2000. Risk of bias was assessed for all studies included. Eight studies were included. The risk of bias assessment resulted in two studies with a score that was higher than 75 %; risk bias of those two studies was considered low. The medically treated, injury incidence rate was reported to be between 0.15 and 0.27 injuries per 1,000 h of physical activity. The absolute number of injuries related to unorganised leisure time physical activity was higher than the absolute number of injuries reported in organised sports. The respective injury incidence rate expressed per 1,000 h exposure was, however, generally lower during unorganised leisure time than during organised sports. Reported injury incidence rates related to active commuting were comparable to those for unorganised leisure time physical activity. Conflicting injury incidence rates were reported for physical education. Subgroup analysis suggested that girls and children with low habitual levels of physical activity are at increased injury risk. A limitation of the review is that no standard bias assessment was available for this specific context. Children are at an inherent injury risk while participating in physical activities. Most injury prevention efforts have focussed on the sports setting, but our results suggest that many children sustain an injury
Howe, L D; Huttly, S R A; Abramsky, T
To assess the occurrence of child injury in four developing country settings and to explore potential risk factors for injury. Injury occurrence was studied in cohorts of 2000 children of age 6-17 months at enrolment, in each of Ethiopia, Peru, Vietnam and India (Andhra Pradesh). Generalized estimating equation models were used to explore potential risk factors for child injury. Occurrence of child injury was high in all countries. Caregiver depression emerged as a consistent risk factor for all types of injury measured (burns, serious falls, broken bones and near-fatal injury) across all countries. Other risk factors also showed consistent associations, including long-term child health problems, region of residence and the regular care of the child by a non-household member. This report provides further evidence of the importance of childhood injury in developing countries and emphasizes the importance of including infants in injury research and prevention strategies. It provides strong evidence of an association between caregiver mental health and child injury risk and contributes to the limited knowledge base on risk factors for child injury in developing countries.
Peralta, Robert L; Barr, Peter B
We examine weight control behavior used to (a) compensate for caloric content of heavy alcohol use; and (b) enhance the psychoactive effects of alcohol among college students. We evaluate the role of gender orientation and sex. Participants completed an online survey (N = 651; 59.9% women; 40.1% men). Weight control behavior was assessed via the Compensatory-Eating-and-Behaviors-in Response-to-Alcohol-Consumption-Scale. Control variables included sex, race/ethnicity, age, and depressive symptoms. Gender orientation was measured by the Bem Sex Role Inventory. The prevalence and probability of alcohol-related weight control behavior using ordinal logistic regression are reported. Men and women do not significantly differ in compensatory-weight-control-behavior. However, regression models suggest that recent binge drinking, other substance use, and masculine orientation are positively associated with alcohol-related weight control behavior. Sex was not a robust predictor of weight control behavior. Masculine orientation should be considered a possible risk factor for these behaviors and considered when designing prevention and intervention strategies.
Adewuya, Abiodun O
The study aimed to estimate the prevalence of major depressive disorder (MDD) among Nigerian college students with alcohol-related problems (ARP) and compare the estimated prevalence with their counterparts without ARP. A cross-sectional survey of a representative sample of students (n=2658) in six colleges in Osun state, Western Nigeria. The students were independently assessed for ARP and MDD with the Mini International Neuropsychiatric Interview (MINI). The current (2 weeks) prevalence of MDD in college students with alcohol dependence is 23.8%; alcohol abuse 17.2% and hazardous use 12.4%. Compared with total abstainers, major depressive disorder is significantly more likely to be associated with diagnosis of alcohol dependence (OR 3.14, 95% CI 1.42-6.96), alcohol abuse (OR 2.27, 95% CI 1.38-3.72) and hazardous use (OR 1.64, 95% CI 1.12-2.38), but less associated with alcohol users without ARP (OR 0.93, 95% CI 0.69-1.25). Nigerian college students with ARP are significantly more at risk of depressive disorders than those without ARP. Early recognition and treatment of depression are important considerations when planning preventive strategies for alcohol-related problems in college students.
Bushman, Timothy T; Grier, Tyson L; Canham-Chervak, Michelle; Anderson, Morgan K; North, William J; Jones, Bruce H
The Functional Movement Screen (FMS) is a series of 7 tests used to assess the injury risk in active populations. To determine the association of the FMS with the injury risk, assess predictive values, and identify optimal cut points using 3 injury types. Cohort study; Level of evidence, 2. Physically active male soldiers aged 18 to 57 years (N = 2476) completed the FMS. Demographic and fitness data were collected by survey. Medical record data for overuse injuries, traumatic injuries, and any injury 6 months after the FMS assessment were obtained. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated along with the receiver operating characteristic (ROC) to determine the area under the curve (AUC) and identify optimal cut points for the risk assessment. Risks, risk ratios (RRs), odds ratios (ORs), and 95% CIs were calculated to assess injury risks. Soldiers who scored ≤14 were at a greater risk for injuries compared with those who scored >14 using the composite score for overuse injuries (RR, 1.84; 95% CI, 1.63-2.09), traumatic injuries (RR, 1.26; 95% CI, 1.03-1.54), and any injury (RR, 1.60; 95% CI, 1.45-1.77). When controlling for other known injury risk factors, multivariate logistic regression analysis identified poor FMS performance (OR [score ≤14/19-21], 2.00; 95% CI, 1.42-2.81) as an independent risk factor for injuries. A cut point of ≤14 registered low measures of predictive value for all 3 injury types (sensitivity, 28%-37%; PPV, 19%-52%; AUC, 54%-61%). Shifting the injury risk cut point of ≤14 to the optimal cut points indicated by the ROC did not appreciably improve sensitivity or the PPV. Although poor FMS performance was associated with a higher risk of injuries, it displayed low sensitivity, PPV, and AUC. On the basis of these findings, the use of the FMS to screen for the injury risk is not recommended in this population because of the low predictive value and misclassification of the
Cantley, Linda F; Galusha, Deron; Cullen, Mark R; Dixon-Ernst, Christine; Rabinowitz, Peter M; Neitzel, Richard L
This study aimed to examine the associations between acute workplace injury risk, ambient noise exposure, and hearing acuity, adjusting for reported hearing protection use. In a cohort of 9220 aluminum manufacturing workers studied over six years (33 300 person-years, 13 323 person-jobs), multivariate mixed effects models were used to estimate relative risk (RR) of all injuries as well as serious injuries by noise exposure category and hearing threshold level (HTL) adjusting for recognized and potential confounders. Compared to noise exposure was associated with elevated risk in a monotonic and statistically significant exposure-response pattern for all injuries and serious injuries with higher risk estimates observed for serious injuries [82-84.99 dBA: RR 1.26, 95% confidence interval (95% CI) 0.96-1.64; 85-87.99 dBA: RR 1.39, 95% CI 1.05-1.85; ≥88 dBA: RR 2.29, 95% CI 1.52-3.47]. Hearing loss was associated with increased risk for all injuries, but was not a significant predictor of risk for the subset of more serious injuries. Compared to those without hearing loss, workers with HTL ≥25 dB had 21% increased all injury risk (RR 1.21, 95% CI 1.09-1.33) while those with HTL 10-24.99 dB had 6% increased risk (RR 1.06, 95% CI 1.00-1.13). Reported hearing protection type did not predict injury risk. Noise exposure levels as low as 85 dBA may increase workplace injury risk. HTL was associated with increased risk for all, but not the subset of serious, injuries. Additional study is needed both to confirm the observed associations and explore causal pathways.
Nauta, J; Jespersen, E; Verhagen, E; van Mechelen, W; Wedderkopp, N
Although injuries to the upper extremity are most costly, the picture of the upper extremity injury problem remains incomplete. This study is the first to describe the etiology and mechanisms of upper extremity injuries in Danish children. A 2.5-year observational prospective cohort study was conducted to record upper extremity injuries in 1048 children. Data were weekly collected by sending a text message. A total of 176 upper extremity injuries were reported (128 acute injuries). Of the acute upper extremity injuries, 55% were sprains, 47% occurred in the hand/wrist, and 53% of cases were caused by a fall. When corrected for exposure to physical activity, this resulted in an acute upper extremity injury incidence density of 0.18 per 1000 h of physical activity. The odds of sustaining an upper extremity injury was higher in the older children (HR: 1.84, 95% CI: 1.10-3.09), a tendency was found suggesting that girls are at increased acute upper extremity risk compared to boys (HR: 1.40 95% CI: 0.97-2.04). The findings that most injuries occur after a fall, that injury risk increases over age and that girls seem to be at increased injury risk provides essential information to guide future childhood injury prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
... term includes not only the concept of “grievous bodily injury,” defined at § 1115.12(d), but also any... injury or death. 1115.6 Section 1115.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER... Reporting of unreasonable risk of serious injury or death. (a) General provision. Every manufacturer...
Nauta, J.; van Mechelen, W.; Otten, R.H.J.; Verhagen, E.A.L.M.
Objectives: To review existing literature on the effectiveness of community-based and school-based physical activity related injury prevention programmes implemented to increase safety behaviour and decrease injury risk in 8-12 year old children, considering the methodological quality of the
O'Kane, John W; Neradilek, Moni; Polissar, Nayak; Sabado, Lori; Tencer, Allan; Schiff, Melissa A
Youth soccer injuries are common and of increasing concern, with sport specialization occurring at younger ages. Limited research is available regarding overuse injuries and risk factors in young female athletes. To identify the number and rate of overuse injuries in female soccer players (ages 12-15 years), describe the anatomic location and type of injury, and evaluate contributing risk factors. Case-control study; Level of evidence, 3. A total of 351 female youth soccer players, ages 12 to 15 years, from Washington State were evaluated from 2008 to 2012. Players with lower extremity overuse injuries were identified through weekly emails and were interviewed by telephone to obtain data on injury type and body region. We evaluated the association between overuse injuries and preseason risk factors, including joint hypermobility, hip and knee muscle strength, and jump biomechanics, using Poisson regression to estimate relative risk (RR) and 95% CIs. The incidence rate for first-time lower extremity overuse injuries was 1.7 per 1000 athlete-exposure hours (AEH; 95% CI, 1.4-2.2), and that for repeat injuries was 3.4 per 1000 AEH (95% CI, 2.1-5.6). Knee injuries accounted for 47% of overuse injuries. Increased valgus was associated with a 3.2-fold increased risk (95% CI, 1.52-6.71) for knee injury. A 1-standard deviation (SD) increase in hamstring strength was associated with a 35% decreased risk (RR, 0.65; 95% CI, 0.46-0.91) for overuse knee injuries, and a 1-SD increase in quadriceps strength was associated with a 30% decreased risk (RR, 0.70; 95% CI, 0.50-0.98). A 1-SD increase in hip flexor strength was associated with a 28% decreased risk (RR, 0.72; 95% CI, 0.51-1.00) for overuse knee injuries, and a 1-SD increase in external rotation strength was associated with a 35% decreased risk (RR, 0.65; 95% CI, 0.46-0.91). Playing on more than 1 soccer team was associated with a 2.5-fold increased risk (95% CI, 1.08-5.35) for overuse knee injuries, and participating in
Ali, Nicholas; Rouhi, Gholamreza
High incidences of non-contact anterior cruciate ligament (ACL) injury, frequent requirements for ACL reconstruction, and limited understanding of ACL mechanics have engendered considerable interest in quantifying the ACL loading mechanisms. Although some progress has been made to better understand non-contact ACL injuries, information on how and why non-contact ACL injuries occur is still largely unavailable. In other words, research is yet to yield consensus on injury mechanisms and risk fa...
Moller, M.; Attermann, J.; Myklebust, G.
% illustrating the promise of the SMS system as a tool in injury surveillance. Of 448 reported injuries, 165 injuries (37%) were overuse injuries and 283 (63%) traumatic injuries. Knee (19%) and ankle (29%) were the most common traumatic injuries. The injury incidence during match play was 23.5 (95% CI 17...... absence from handball for more than 4 weeks increased the risk of new injury in the u-16 group (IRR: 1.79 (95% CI 1.03 to 3.11)-2.23 (95% CI 1.22 to 4.10)). Conclusion The incidence of time-loss injuries in elite handball was higher during match play than previously reported in recreational handball...
Mirsafaei Rizi, Rezvan; Yeung, Simon S; Stewart, Nathan J; Yeung, Ella W
To investigate injury incidence and the influence of physical fitness parameters on the risk of severe injuries in players on rugby sevens university teams. Prospective cohort study. Rugby players from three universities (N=104; 90M:14F; 20.6±1.9years) were recruited before the beginning of the season. Players underwent pre-season assessments of power, strength, speed, agility, endurance, stability, and flexibility. Throughout the season, rugby-related injury and exposure data were collected. Potential predictor variables were analyzed using Cox proportional regression model to identify risk factors associated with severe injuries (time loss>28days). Thirty-one injuries occurred during the rugby season. The match and training injury incidence rates were 59.3 injuries and 3.3 injuries per 1000 player-hours, respectively. Lower limb injuries were most common and most severe. The ankle joint was the most prevalent site of injury, and ligamentous injury was most common (48.4%). Nine severe injuries were sustained resulting in an average time loss of 51.3±14.6days. Female (hazard ratio [HR]=8.35; 95% confidence intervals [CI]=2.01-34.8), slower (HR=3.51; 95% CI=1.17-10.5), and less agile (HR=2.22; 95% CI=1.26-3.92) players as well as those with hip flexors tightness (HR=1.12; 95% CI=1.00-1.25) were at significantly greater risk for sustaining severe injuries. Limited studies are available on risk factors associated with amateur rugby players in the Sevens version. The development of gender-specific injury prevention measures that emphasize speed and agility training, and improve hip flexor extensibility may be important to reduce the risk of severe injuries. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
It is perceived by the man in the street that low-level radiation from a nuclear facility is more dangerous than that from other practices. The radiation protection system, in particular the ALARA principle, leads to concerns that even the smallest exposure to radiation is abnormal and dangerous. Public perception of the radiation risk leads to fear in the minds of the public. A consequence of this fear itself may be damage to health in the form of psychological damage or nervous shock. The paper draws attention to the liability for damages by radiation, in particular under the common law of the UK and US, and how liability, determined by the court, is not necessarily influenced by scientific rationality. A natural conclusion may be that a claimant suffering injury of the type caused by radiation and who had been exposed to radiation, no matter how small a dose, that could be shown to come from a nuclear installation would be awarded damages against the licensee of the site of the installation unless it could be shown that the injury was predominantly caused by another source (radioactive or otherwise)
Schöffl, Volker; Morrison, Audry; Schwarz, Ulrich; Schöffl, Isabelle; Küpper, Thomas
Rock and ice climbing are widely considered to be 'high-risk' sporting activities that are associated with a high incidence of severe injury and even death, compared with more mainstream sports. However, objective scientific data to support this perception are questionable. Accordingly, >400 sport-specific injury studies were analysed and compared by quantifying the injury incidence and objectively grading the injury severity (using the National Advisory Committee for Aeronautics score) per 1000 hours of sporting participation. Fatalities were also analysed. The analysis revealed that fatalities occurred in all sports, but it was not always clear whether the sport itself or pre-existing health conditions contributed or caused the deaths. Bouldering (ropeless climbing to low heights), sport climbing (mostly bolt protected lead climbing with little objective danger) and indoor climbing (climbing indoors on artificial rock structures), showed a small injury rate, minor injury severity and few fatalities. As more objective/external dangers exist for alpine and ice climbing, the injury rate, injury severity and fatality were all higher. Overall, climbing sports had a lower injury incidence and severity score than many popular sports, including basketball, sailing or soccer; indoor climbing ranked the lowest in terms of injuries of all sports assessed. Nevertheless, a fatality risk remains, especially in alpine and ice climbing. In the absence of a standard definition for a 'high-risk' sport, categorizing climbing as a high-risk sport was found to be either subjective or dependent on the definition used. In conclusion, this analysis showed that retrospective data on sport-specific injuries and fatalities are not reported in a standardized manner. To improve preventative injury measures for climbing sports, it is recommended that a standardized, robust and comprehensive sport-specific scoring model should be developed to report and fully evaluate the injury risk, severity
Reynolds, K; Williams, J; Miller, C; Mathis, A; Dettori, J
This study determined the incidence of and risk factors for injuries among 356 Marines during a winter mountain training exercise. Marines received a podiatry screening and completed a questionnaire on race, education, tobacco use, height, weight, and fitness (4.8-km run, sit-ups, pull-ups). Forty-five Marines (12.6%) reported at least one injury each, 68.9% of which were traumatic injuries. Total injuries resulted in 114 days of limited duty time. A final foot examination (N = 141) revealed 118 injuries (82.2% blisters and abrasions, 11.9% frostnip). White ethnicity was a risk factor for overall injuries, and forefoot varus alignment was a risk factor for traumatic injuries. Lower education and rank and smokeless tobacco use were associated with foot injuries. The Marine ski-march leather boot and smoking were related to foot cold injuries. Military winter training is associated with injuries and lost training time. Risk factors were identified, suggesting that these injuries may be preventable.
Engström, Karin; Diderichsen, Finn; Laflamme, Lucie
in the household (1- or 2-parent home), receipt of welfare benefits, parental country of birth, and population density as exposures and compiled relative risks and population-attributable risks (PARs) for self-inflicted and interpersonal violence-related injury. RESULTS: For both genders and for both injury types......, receipt of welfare benefits showed the largest crude and net relative risks and the highest PARs. The socioeconomic status-related PAR for self-inflicted injury and the PAR related to number of parents in the household for interpersonal violence-related injury also were high. CONCLUSIONS: Intentional...
Lauridsen, Eva Fejerskov; Hermann, Nuno Vibe; Gerds, Thomas Alexander
The reported risk of pulp necrosis (PN) is generally low in teeth with subluxation injuries. A concomitant crown fracture may increase the risk of PN in such teeth. Aim: To analyse the influence of a concomitant trauma-related infraction, enamel-, enamel–dentin- or enamel–dentin–pulp fracture...... on the risk of PN in permanent teeth with subluxation injury. Material and Methods: The study included 404 permanent incisors with subluxation injury from 289 patients (188 male, 101 female). Of these teeth, 137 had also suffered a concomitant crown fracture. All the teeth were examined and treated according...... age, crown fracture type, mobility and response to an electric pulp test (EPT) at the initial examination. Results: Teeth with immature root development: The risk of PN was increased in teeth with a concomitant enamel fracture (log-rank test: P = 0.002), enamel–dentin fracture (log-rank test: P
Corrao, G.; Bagnardi, V.; Vittadini, G.; Favilli, S.
STUDY OBJECTIVE—To investigate the utility of capture-recapture methods to estimate prevalence of subjects with alcohol related disorders using multiple incomplete lists. DESIGN—This was a cross sectional study of alcohol related disorders in a large community. SETTING—During 1997 identified cases with known alcohol related disorders were independently flagged by four sources (self help volunteering groups; psychiatric ambulatory; public alcohology service; hospital discharges). PATIENTS—381 ...
Full Text Available Whiplash, a common injury following motor vehicle crashes, is associated with high costs and a prognosis that is variable and difficult to predict. In this paper, we review findings from the Quebec cohort epidemiological study on predictive factors of recovery from whiplash injury after a motor vehicle crash. We formed a population-based incident cohort of all 4,759 individuals who sustained a whiplash injury resulting from a motor vehicle crash in the province of Québec, Canada, in 1987, and followed these patients for up to seven years. The data were obtained from the universal automobile insurance plan (SAAQ that covers all seven million residents of the Province for all vehicular-related injuries. From this cohort, we formed the cohort of 3,014 for whom a police report was completed. For this cohort, we obtained data on crash-related factors directly from the police report. We also formed the cohort of 2,627 subjects who had strictly a whiplash injury, without associated injuries. For this cohort, the data on signs and symptoms were obtained from the medical charts kept by the SAAQ. For both cohorts, data on the outcome, the recovery time from whiplash, was obtained from the SAAQ databases. The crash-related cohort study found that socio-demographic factors associated with a longer recovery from whiplash include older age, female sex, having dependents and not being employed full time and that each decreases the rate of recovery by 14 to 16 per cent. Factors related to the crash conditions indicate that being in a truck or bus, with a decrease of 52% in the rate of recovery, being a passenger in the vehicle (15%, colliding with a moving vehicle (16%, and a side or frontal collision (15% all decrease the rate of recovery. We introduce a combined risk score that predicts longer recovery. In the cohort of subjects with signs and symptoms, the median recovery time was 32 days and 12% of subjects had still not recovered after 6 months. The signs
van Beijsterveldt, A M C; van de Port, I G L; Vereijken, A J; Backx, F J G
Hamstring injuries are common injuries in soccer players. In view of the high incidence and the serious consequences, identifying risk factors related to hamstring injuries is essential. The aim of this systematic review was therefore to identify risk factors for hamstring injuries in male adult soccer players. PubMed, Embase/Medline, Cumulative Index to Nursing and Allied Health Literature, and SPORTDiscus were systematically searched, and prospective studies investigating risk factors for hamstring injuries in adult male soccer players were included. The methodological quality of the included articles was assessed using a standardized set of predefined criteria. Seven of the 11 studies identified, involving a total of 1775 players and 344 hamstring injuries, met the inclusion criteria. All but one of the included studies met at least five of nine methodological criteria, causing them to be qualified as 'high quality'. The included studies used univariate as well as multivariate analyses to identify risk factors for hamstring injury. The results from the multivariate analyses suggest that previous hamstring injury is most strongly related to hamstring injury. Conflicting evidence is found for age and hamstring length or flexibility as risk factors for the occurrence of hamstring injuries. © 2012 John Wiley & Sons A/S.
Wyss, T; Von Vigier, R O; Frey, F; Mäder, U
The aim of this study was to quantify the discriminative power of physical performance tests to recognize conscripts with enhanced risk of acute and overuse injuries in specific, physically demanding occupational specialties of the Swiss Army. The five performance tests investigated represent the Swiss Army Physical Fitness Test Battery. Physical fitness performances were assessed during recruitment procedures prior to military service, and injury occurrences were assessed during 18 weeks of boot camp. Complete fitness and injury data of 459 volunteers from four military occupational specialties were collected. Discriminative power of volunteers' aerobic endurance capacity, trunk muscle fitness, muscle power of upper and lower extremities, and balance for predicting risk of acute injuries and for predicting risk of overuse injuries was calculated using receiver operating characteristic curve analysis. The presented fitness tests had no discriminative power for predicting the risk of acute injuries. However, the trunk muscle fitness test was discriminative in predicting overuse injuries in all four military occupational specialties, progressive endurance run in three, balance test in two, and standing long jump in one. Only the seated shot put had no significant power for predicting overuse injuries in all four study groups. However, for different occupational specialties, different fitness parameters were discriminative to predict overuse injuries. It is possible to conclude that the fitness tests used allow detection of conscripts with enhanced overuse injury risk in physically demanding occupational specialties and therefore provide an indicator to select suitable personnel for physically demanding jobs in a military organization.
Grenard, Jerry L; Dent, Clyde W; Stacy, Alan W
This study used prospective data to test the hypothesis that exposure to alcohol advertising contributes to an increase in underage drinking and that an increase in underage drinking then leads to problems associated with drinking alcohol. A total of 3890 students were surveyed once per year across 4 years from the 7th through the 10th grades. Assessments included several measures of exposure to alcohol advertising, alcohol use, problems related to alcohol use, and a range of covariates, such as age, drinking by peers, drinking by close adults, playing sports, general TV watching, acculturation, parents' jobs, and parents' education. Structural equation modeling of alcohol consumption showed that exposure to alcohol ads and/or liking of those ads in seventh grade were predictive of the latent growth factors for alcohol use (past 30 days and past 6 months) after controlling for covariates. In addition, there was a significant total effect for boys and a significant mediated effect for girls of exposure to alcohol ads and liking of those ads in 7th grade through latent growth factors for alcohol use on alcohol-related problems in 10th grade. Younger adolescents appear to be susceptible to the persuasive messages contained in alcohol commercials broadcast on TV, which sometimes results in a positive affective reaction to the ads. Alcohol ad exposure and the affective reaction to those ads influence some youth to drink more and experience drinking-related problems later in adolescence.
van der Sluis, Alien
Talented athletes having their growth spurt have an increased injury risk Young talented athletes that mature have an increased injury risk. Human movement scientist Alien van der Sluis studied soccer players of the talent development program of FC Groningen and tennis players of the talented
Rasmussen, Christina Haugaard; Nielsen, Rasmus Østergaard; Juul, Martin Serup
PURPOSEBACKGROUND: The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race.......PURPOSEBACKGROUND: The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race....
Rasmussen, Christina Haugaard; Nielsen, R.O.; Juul, Martin Serup
The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race.......The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race....
Nauta, J.; Martin-Diener, E.; Martin, B.W.; van Mechelen, W.; Verhagen, E.A.L.M.
Results: Eight studies were included. The risk of bias assessment resulted in two studies with a score that was higher than 75 %; risk bias of those two studies was considered low. The medically treated, injury incidence rate was reported to be between 0.15 and 0.27 injuries per 1,000 h of physical
van Heumen, Moniek; Tol, Johannes L.; de Vos, Robert-Jan; Moen, Maarten H.; Weir, Adam; Orchard, John; Reurink, Gustaaf
A challenge for sports physicians is to estimate the risk of a hamstring re-injury, but the current evidence for MRI variables as a risk factor is unknown. To systematically review the literature on the prognostic value of MRI findings at index injury and/or return to play for acute hamstring
Niebuhr, Tobias; Junge, Mirko; Achmus, Stefanie
Injury risk assessment plays a pivotal role in the assessment of the effectiveness of Advanced Driver Assistance Systems (ADAS) as they specify the injury reduction potential of the system. The usual way to describe injury risks is by use of injury risk functions, i.e. specifying the probability of an injury of a given severity occurring at a specific technical accident severity (collision speed). A method for the generation of a family of risk functions for different levels of injury severity is developed. The injury severity levels are determined by use of a rescaled version of the Injury Severity Score (ISS) namely the ISSx. The injury risk curves for each collision speed is then obtained by fixing the boundary conditions and use of a case-by-case validated GIDAS subset of pedestrian-car accidents (N=852). The resultant functions are of exponential form as opposed to the frequently used logistic regression form. The exponential approach in combination with the critical speed value creates a new injury risk pattern better fitting for high speed/high energy crashes. Presented is a family of pedestrian injury risk functions for an arbitrary injury severity. Thus, the effectiveness of an ADAS can be assessed for mitigation of different injury severities using the same injury risk function and relying on the internal soundness of the risk function with regard to different injury severity levels. For the assessment of emergency braking ADAS, a Zone of Effective Endangerment Increase (ZEEI), the speed interval in which a one percent speed increase results at least in a one percent of injury risk increase, is defined. The methodology presented is kept in such general terms that a direct adaption to other accident configurations is easily done.
Opar, David A; Serpell, Benjamin G
Hamstring strain injuries (HSIs) are the most prevalent injury in a number of sports, and while anterior cruciate ligament (ACL) injuries are less common, they are far more severe and have long-term implications, such as an increased risk of developing osteoarthritis later in life. Given the high incidence and severity of these injuries, they are key targets of injury preventive programs in elite sport. Evidence has shown that a previous severe knee injury (including ACL injury) increases the risk of HSI; however, whether the functional deficits that occur after HSI result in an increased risk of ACL injury has yet to be considered. In this clinical commentary, we present evidence that suggests that the link between previous HSI and increased risk of ACL injury requires further investigation by drawing parallels between deficits in hamstring function after HSI and in women athletes, who are more prone to ACL injury than men athletes. Comparisons between the neuromuscular function of the male and female hamstring has shown that women display lower hamstring-to-quadriceps strength ratios during isokinetic knee flexion and extension, increased activation of the quadriceps compared with the hamstrings during a stop-jump landing task, a greater time required to reach maximal isokinetic hamstring torque, and lower integrated myoelectrical hamstring activity during a sidestep cutting maneuver. Somewhat similarly, in athletes with a history of HSI, the previously injured limb, compared with the uninjured limb, displays lower eccentric knee flexor strength, a lower hamstrings-to-quadriceps strength ratio, lower voluntary myoelectrical activity during maximal knee flexor eccentric contraction, a lower knee flexor eccentric rate of torque development, and lower voluntary myoelectrical activity during the initial portion of eccentric contraction. Given that the medial and lateral hamstrings have different actions at the knee joint in the coronal plane, which hamstring head is
Measuring the effectiveness of in-hospital and on-base Prevent Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y. programs on reducing alcohol related harms in naval trainees: P.A.R.T.Y. Defence study protocol
Full Text Available Abstract Background Reducing alcohol related harms in Australian Defence Force (ADF trainees has been identified as a priority, but there are few evidence-based prevention programs available for the military setting. The study aims to test whether the P.A.R.T.Y. program delivered in-hospital or on-base, can reduce harmful alcohol consumption among ADF trainees. Methods/design The study is a 3-arm randomized controlled trial, involving 953 Royal Australian Navy trainees from a single base. Trainees, aged 18 to 30 years, will be randomly assigned to the study arms: i. in-hospital P.A.R.T.Y.; ii. On-base P.A.R.T.Y.; and iii. Control group. All groups will receive the routine ADF annual alcohol awareness training. The primary outcome is the proportion of participants reporting an Alcohol Use Disorders Identification Test (AUDIT score of 8 or above at 12 months’ post-intervention. The secondary outcome is the number of alcohol related incidents reported to the Royal Australian Navy (RAN in the 12 months’ post-intervention. Discussion This is the first trial of the use of the P.A.R.T.Y. program in the military. If the proposed intervention proves efficacious, it may be a useful program in the early education of RAN trainees. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR: ACTRN12614001332617 , date of registration: 18/12/2014 ‘retrospectively registered’.
Rowe, Shelley C; Wiggers, John; Wolfenden, Luke; Francis, J Lynn; Freund, Megan
Licensed premises are associated with a considerable level of alcohol-related harm. This study examined the effectiveness of an educational policing strategy, implemented as routine policing practice, to reduce the number of patrons of licensed premises involved in police-recorded incidents of violence, disorder and motor vehicle crashes. The educational policing strategy targeted on-licensed premises registered as operating in 2003. The strategy was delivered by police and was overseen by the research team. The intervention was conducted in 21 non-metropolitan New South Wales Police Force commands. On the basis of routinely collected and recorded police data, premises received one of three levels of police response on three separate occasions from December 2002 to July 2003. The police responses were letters, incident reports, covert audits and feedback meetings. The rate of patrons who had last consumed alcohol on licensed premises before being involved in police-recorded incidents decreased from 1.24 per premises in the 4-month baseline period to 1.11 in the 4-month follow-up period (p=0.08). There was a significant reduction, from 7.08 to 5.65 patrons (p=0.03), in such a rate for high-risk premises that received the most intensive police response. High-risk premises also recorded a significant reduction in the rate of intoxicated patrons involved in such incidents, from 5.50 to 4.40 (p=0.05). The findings suggest a potential benefit of an educational policing strategy in reducing alcohol-related harm associated with licensed premises. Further implementation of this strategy concurrent with rigorous evaluation is warranted.
Lauridsen, Eva Fejerskov; Hermann, Nuno Vibe; Gerds, Thomas Alexander
The reported risk of pulp necrosis (PN) is low in teeth with concussion injuries. A concomitant crown fracture may affect the risk of PN. Aim: To analyze the influence of a crown fracture (with and without pulp exposure) on the risk of PN in teeth with concussion injury. Material: The study...... included 469 permanent incisors with concussion from 358 patients (226 male, 132 female). Among these, 292 had a concomitant crown fracture (70 with and 222 without pulp exposure). All teeth were examined and treated according to standardized protocol. Statistical analysis: The risk of PN was analyzed...... by the Kaplan–Meier method and Cox regression. Risk factors included in the analysis: gender, age, stage of root development, type of crown fracture, and response to electric pulp test (EPT) at the initial examination. The level of significance was set at 5%. Results: The risk of PN was low in teeth...
Jayaraj, Rama; Whitty, Megan; Thomas, Mahiban; Kavangh, David; Palmer, Didier; Thomson, Valerie; Griffin, Carolyn; Mayo, Luke; D'Abbs, Peter; Nagel, Tricia
Globally, alcohol-related injuries cause millions of deaths and huge economic loss each year . The incidence of facial (jawbone) fractures in the Northern Territory of Australia is second only to Greenland, due to a strong involvement of alcohol in its aetiology, and high levels of alcohol consumption. The highest incidences of alcohol-related trauma in the Territory are observed amongst patients in the Maxillofacial Surgery Unit of the Royal Darwin Hospital. Accordingly, this project aims to introduce screening and brief interventions into this unit, with the aims of changing health service provider practice, improving access to care, and improving patient outcomes. Establishment of Project Governance: The project governance team includes a project manager, project leader, an Indigenous Reference Group (IRG) and an Expert Reference Group (ERG).Development of a best practice pathway: PACT project researchers collaborate with clinical staff to develop a best practice pathway suited to the setting of the surgical unit. The pathway provides clear guidelines for screening, assessment, intervention and referral. The developed pathway is introduced to the unit through staff training workshops and associate resources and adapted in response to staff feedback. File audits, post workshop questionnaires and semi-structured interviews are administered. This project allows direct transfer of research findings into clinical practice and can inform future hospital-based injury prevention strategies.
Full Text Available Abstract Background Globally, alcohol-related injuries cause millions of deaths and huge economic loss each year . The incidence of facial (jawbone fractures in the Northern Territory of Australia is second only to Greenland, due to a strong involvement of alcohol in its aetiology, and high levels of alcohol consumption. The highest incidences of alcohol-related trauma in the Territory are observed amongst patients in the Maxillofacial Surgery Unit of the Royal Darwin Hospital. Accordingly, this project aims to introduce screening and brief interventions into this unit, with the aims of changing health service provider practice, improving access to care, and improving patient outcomes. Methods Establishment of Project Governance: The project governance team includes a project manager, project leader, an Indigenous Reference Group (IRG and an Expert Reference Group (ERG. Development of a best practice pathway: PACT project researchers collaborate with clinical staff to develop a best practice pathway suited to the setting of the surgical unit. The pathway provides clear guidelines for screening, assessment, intervention and referral. Implementation: The developed pathway is introduced to the unit through staff training workshops and associate resources and adapted in response to staff feedback. Evaluation: File audits, post workshop questionnaires and semi-structured interviews are administered. Discussion This project allows direct transfer of research findings into clinical practice and can inform future hospital-based injury prevention strategies.
Background Globally, alcohol-related injuries cause millions of deaths and huge economic loss each year . The incidence of facial (jawbone) fractures in the Northern Territory of Australia is second only to Greenland, due to a strong involvement of alcohol in its aetiology, and high levels of alcohol consumption. The highest incidences of alcohol-related trauma in the Territory are observed amongst patients in the Maxillofacial Surgery Unit of the Royal Darwin Hospital. Accordingly, this project aims to introduce screening and brief interventions into this unit, with the aims of changing health service provider practice, improving access to care, and improving patient outcomes. Methods Establishment of Project Governance: The project governance team includes a project manager, project leader, an Indigenous Reference Group (IRG) and an Expert Reference Group (ERG). Development of a best practice pathway: PACT project researchers collaborate with clinical staff to develop a best practice pathway suited to the setting of the surgical unit. The pathway provides clear guidelines for screening, assessment, intervention and referral. Implementation: The developed pathway is introduced to the unit through staff training workshops and associate resources and adapted in response to staff feedback. Evaluation: File audits, post workshop questionnaires and semi-structured interviews are administered. Discussion This project allows direct transfer of research findings into clinical practice and can inform future hospital-based injury prevention strategies. PMID:23331868
Maistros, Alexander; Schneider, William H; Savolainen, Peter T
Alcohol related crashes have accounted for approximately 35% of fatal crashes per year since 1994 nationwide, with approximately 30% involving impairment over the legal blood alcohol content limit of 0.08%. Educational campaigns and law enforcement efforts are two components of multi-faceted programs aimed toward reducing impaired driving. It is crucial that further research be conducted to guide the implementation of enforcement and educational programs. This research attempts to provide such guidance by examining differences in alcohol-involved crashes involving motorcycles and passenger cars. Prior safety research has shown that motorcyclists follow a significantly different culture than the average passenger car operator. These cultural differences may be reflected by differences in the contributing factors affecting crashes and the severity of the resulting injuries sustained by the driver or motorcyclist. This research is focused on single-vehicle crashes only, in order to isolate modal effects from the contribution of additional vehicles. The crash data provided for this study are from the Ohio Department of Public Safety from 2009 through 2012. The injury severity data are analysed through the development of two mixed logit models, one for motorcyclists and one for passenger car drivers. The models quantify the effects of various factors, including horizontal curves, speeds, seatbelt use, and helmet use, which indicate that the required motor skills and balance needed for proper motorcycle operation compounded with a lack of mechanical protection make motorcyclists more prone to severe injuries, particularly on curves and in collisions with roadside objects. The findings of this study have been incorporated into combined motorcycle and sober driving educational safety campaigns. The results have shown to be favorable in supporting national campaign messages with local justification and backing. Copyright © 2014 Elsevier Ltd. All rights reserved.
Cantley, Linda F; Taiwo, Oyebode A; Galusha, Deron; Barbour, Russell; Slade, Martin D; Tessier-Sherman, Baylah; Cullen, Mark R
This study aimed to examine the effect of an ergonomic hazard control (HC) initiative, undertaken as part of a company ergonomics standard, on worker injury risk. Using the company's ergonomic hazards database to identify jobs with and without ergonomic HC implementation and linking to individual job and injury histories, injury risk among person-jobs with HC implementation (the HC group) was compared to those without HC (NoHC group) using random coefficient models. Further analysis of the HC group was conducted to determine the effect of additional ergonomic hazards controlled on injury risk. Among 123 jobs at 17 plant locations, 347 ergonomic hazards were quantitatively identified during the study period. HC were implemented for 204 quantified ergonomic hazards in 84 jobs, impacting 10 385 persons (12 967 person-jobs). No HC were implemented for quantified ergonomic hazards in the remaining 39 jobs affecting 4155 persons (5046 person-jobs). Adjusting for age, sex, plant origin, and year to control for any temporal trend in injury risk, the relative risk (RR) for musculoskeletal disorder (MSD) was 0.85 and the RR for any injury or MSD was 0.92 in the HC compared to NoHC group. Among the HC group, each ergonomic hazard controlled was associated with risk reduction for MSD and acute injury outcomes (RR 0.93). Systematic ergonomic HC through participatory ergonomics, as part of a mandatory company ergonomics standard, is associated with MSD and injury risk reduction among workers in jobs with HC implemented.
Objectives. I examined workplace injury risk over time and across racial/ethnic and gender groups to observe patterns of change and to understand how occupational characteristics and job mobility influence these changes. Methods. I used hierarchical generalized linear models to estimate individual workplace injury and illness risk over time (“trajectories”) for a cohort of American workers who participated in the National Longitudinal Survey of Youth (1988–1998). Results. Significant temporal variation in injury risk was observed across racial/ethnic and gender groups. At baseline, White men had a high risk of injury relative to the other groups and experienced the greatest decline over time. Latino men demonstrated a pattern of lower injury risk across time compared with White men. Among both Latinos and non-Latino Whites, women had lower odds of injury than did men. Non-Latino Black women's injury risk was similar to Black men's and greater than that for both Latino and non-Latino White women. Occupational characteristics and job mobility partly explained these differences. Conclusions. Disparities between racial/ethnic and gender groups were dynamic and changed over time. Workplace injury risk was associated with job dimensions such as work schedule, union representation, health insurance, job hours, occupational racial segregation, and occupational environmental hazards. PMID:18235072
Berdahl, Terceira A
I examined workplace injury risk over time and across racial/ethnic and gender groups to observe patterns of change and to understand how occupational characteristics and job mobility influence these changes. I used hierarchical generalized linear models to estimate individual workplace injury and illness risk over time ("trajectories") for a cohort of American workers who participated in the National Longitudinal Survey of Youth (1988-1998). Significant temporal variation in injury risk was observed across racial/ethnic and gender groups. At baseline, White men had a high risk of injury relative to the other groups and experienced the greatest decline over time. Latino men demonstrated a pattern of lower injury risk across time compared with White men. Among both Latinos and non-Latino Whites, women had lower odds of injury than did men. Non-Latino Black women's injury risk was similar to Black men's and greater than that for both Latino and non-Latino White women. Occupational characteristics and job mobility partly explained these differences. Disparities between racial/ethnic and gender groups were dynamic and changed over time. Workplace injury risk was associated with job dimensions such as work schedule, union representation, health insurance, job hours, occupational racial segregation, and occupational environmental hazards.
Bae, Dong-Hyeon; Choi, Kyu-Sun; Yi, Hyeong-Joong; Chun, Hyoung-Joon; Ko, Yong; Bak, Koang Hum
Post-traumatic cerebral infarction (PTCI) is one of the most severe secondary insults after traumatic brain injury (TBI), and is known to be associated with poor outcome and high mortality rate. We assessed the practical incidence and risk factors for the development of PTCI. We conducted retrospective study on 986 consecutive patients with TBI from the period May 2005 to November 2012 at our institution. The definition of PTCI was made on non-enhanced CT scan based on a well-demarcated or fairly discernible region of low attenuation following specific vascular territory with normal initial CT. Clinical and radiological findings that related to patients' outcome were reviewed and statistically compared. PTCI was observed in 21 (2.1%) patients. Of various parameters, age (p=0.037), initial Glasgow coma scale score (paccident and PTCI, patterns of TBI and vascular territory of PTCI were not specific. The mortality rates were significantly higher in patients with PTCI than without PTCI. The development of PTCI is rare after TBI, but it usually results in serious outcome and high mortality. Early recognition for risks and aggressive managements is mandatory to prevent PTCI.
Emad E Ghobrial
Full Text Available Acute kidney injury (AKI in the newborn is a common problem in the neonatal intensive care unit with many underlying factors such as asphyxia, respiratory distress syndrome (RDS, and urogenital anomalies. The aim of this study is to highlight possible risk factors and profile of neonates developing AKI in the Neonatal Intensive Care Unit (NICU of Cairo University Pediatric Hospital. The study was carried out on 90 neonates (30 patients and 60 controls, among neonates admitted to NICU. The study was done over two months, from January 2015 to March 2015. Our study showed that sepsis was detected in 53.3%, prematurity in 46.67%, RDS in 43.3%, congenital heart disease in 20%, and hypoxic-ischemic encephalopathy in 6.67% of patients. Maternal illness and low body temperature were both significant risk factors of AKI in neonates. History of maternal illness, low body temperature, sepsis, prematurity, and respiratory distress can contribute to the development of AKI in neonates.
Read, Paul J; Oliver, Jon L; De Ste Croix, Mark B A; Myer, Gregory D; Lloyd, Rhodri S
Injuries reported in male youth soccer players most commonly occur in the lower extremities, and include a high proportion of ligament sprains at the ankle and knee with a lower proportion of overuse injuries. There is currently a paucity of available literature that examines age- and sex-specific injury risk factors for such injuries within youth soccer players. Epidemiological data have reported movements that lead to non-contact ligament injury include running, twisting and turning, over-reaching and landing. Altered neuromuscular control during these actions has been suggested as a key mechanism in females and adult populations; however, data available in male soccer players is sparse. The focus of this article is to review the available literature and elucidate prevalent risk factors pertaining to male youth soccer players which may contribute to their relative risk of injury.
Full Text Available Abstract Background Injuries affect all age groups but have a particular impact on young people. To evaluate the incidence of non-fatal, unintentional, injuries among undergraduates in Wenzhou, China, assess the burden caused by these injuries, and explore the associated risk factors for unintentional injuries among these undergraduates, we conducted a college-based cross-sectional study. Methods Participants were selected by a multi-stage random sampling method, and 2,287 students were asked whether they had had an injury in the last 12 months; the location, cause, and consequences of the event. The questionnaire included demographic and socioeconomic characteristics, lifestyle habits, and the scale of type A behaviour pattern (TABP. Multivariate logistic regression models were used; crude odds ratios (ORs, adjusted ORs and their 95% confidence intervals (CIs were estimated, with students having no injuries as the reference group. Results The incidence of injuries among undergraduates in Wenzhou was 18.71 injuries per 100 person-years (95%CI: 17.12~20.31 injuries per 100 person-years. Falls were the leading cause of injury, followed by traffic injuries, and animal/insect bites. Male students were more likely to be injured than female students. Risk factors associated with unintentional injuries among undergraduates were: students majoring in non-medicine (adjusted OR: 1.53; 95% CI: 1.19-1.96; type A behaviour pattern (adjusted OR: 2.99; 95% CI: 1.45-6.14; liking sports (adjusted OR: 1.86; 95% CI: 1.41-2.45. Conclusions Injuries have become a public health problem among undergraduates. Falls were the major cause of non-fatal injury. Therefore, individuals, families, schools and governments should promptly adopt preventive measures aimed at preventing and controlling morbidity due to non-fatal injury, especially among students identified to be at high-risk; such as male students with type A behaviour pattern who like sports.
Shi, Hongying; Yang, Xinjun; Huang, Chenping; Zhou, Zumu; Zhou, Qiang; Chu, Maoping
Injuries affect all age groups but have a particular impact on young people. To evaluate the incidence of non-fatal, unintentional, injuries among undergraduates in Wenzhou, China, assess the burden caused by these injuries, and explore the associated risk factors for unintentional injuries among these undergraduates, we conducted a college-based cross-sectional study. Participants were selected by a multi-stage random sampling method, and 2,287 students were asked whether they had had an injury in the last 12 months; the location, cause, and consequences of the event. The questionnaire included demographic and socioeconomic characteristics, lifestyle habits, and the scale of type A behaviour pattern (TABP). Multivariate logistic regression models were used; crude odds ratios (ORs), adjusted ORs and their 95% confidence intervals (CIs) were estimated, with students having no injuries as the reference group. The incidence of injuries among undergraduates in Wenzhou was 18.71 injuries per 100 person-years (95%CI: 17.12~20.31 injuries per 100 person-years). Falls were the leading cause of injury, followed by traffic injuries, and animal/insect bites. Male students were more likely to be injured than female students. Risk factors associated with unintentional injuries among undergraduates were: students majoring in non-medicine (adjusted OR: 1.53; 95% CI: 1.19-1.96); type A behaviour pattern (adjusted OR: 2.99; 95% CI: 1.45-6.14); liking sports (adjusted OR: 1.86; 95% CI: 1.41-2.45). Injuries have become a public health problem among undergraduates. Falls were the major cause of non-fatal injury. Therefore, individuals, families, schools and governments should promptly adopt preventive measures aimed at preventing and controlling morbidity due to non-fatal injury, especially among students identified to be at high-risk; such as male students with type A behaviour pattern who like sports.
Full Text Available Anterior cruciate ligament (ACL injuries are common in soccer. Understanding ACL loading mechanisms and risk factors for ACL injury is critical for designing effective prevention programs. The purpose of this review is to summarize the relevant literature on ACL loading mechanisms, ACL injury risk factors, and current ACL injury prevention programs for soccer players. Literature has shown that tibial anterior translation due to shear force at the proximal end of tibia is the primary ACL loading mechanism. No evidence has been found showing that knee valgus moment is the primary ACL loading mechanism. ACL loading mechanisms are largely ignored in previous studies on risk factors for ACL injury. Identified risk factors have little connections to ACL loading mechanisms. The results of studies on ACL injury prevention programs for soccer players are inconsistent. Current ACL injury prevention programs for soccer players are clinically ineffective due to low compliance. Future studies are urgently needed to identify risk factors for ACL injury in soccer that are connected to ACL loading mechanisms and have cause-and-effect relationships with injury rate, and to develop new prevention programs to improve compliance.
Westland, Rik; Kurvers, Roel A J; van Wijk, Joanna A E; Schreuder, Michiel F
The hyperfiltration hypothesis implies that children with a solitary functioning kidney are at risk to develop hypertension, proteinuria, and chronic kidney disease. We sought to determine the presenting age of renal injury and identify risk factors for children with a solitary functioning kidney. We evaluated 407 patients for signs of renal injury, defined as hypertension, proteinuria, an impaired glomerular filtration rate, and/or the use of renoprotective medication. Patients were subdivided on the basis of type of solitary functioning kidney and the presence of ipsilateral congenital anomalies of the kidney and urinary tract (CAKUT). The development of renal injury was analyzed with Kaplan-Meier analysis. Risk factors were identified by using logistic regression models. Renal injury was found in 37% of all children. Development of renal injury increased by presence of ipsilateral CAKUT (odds ratio [OR] 1.66; P = .04) and age (OR 1.09; P Renal length was inversely associated with the risk to develop renal injury (OR 0.91; P = .04). In all patients, the median time to renal injury was 14.8 years (95% confidence interval 13.7-16.0 years). This was significantly shortened for patients with ipsilateral CAKUT (12.8 years, 95% confidence interval 10.6-15.1 years). Our study determines independent risk factors for renal injury in children with a solitary functioning kidney. Because many children develop renal injury, we emphasize the need for clinical follow-up in these patients starting at birth.
Nguyen, Edward; Grubor, Dragan; Chandu, Arun
The purpose of this study was to assess the incidence of and risk factors for permanent neurologic injuries to the inferior alveolar nerve (IAN) or lingual nerve (LN) after the removal of third molars. This report also describes the use of a Clinical Incident Review (CIR) process, allowing close monitoring of all patients with neurologic injuries as a result of dentoalveolar surgery. A database associated with a CIR process at the Royal Dental Hospital of Melbourne from January 2006 through December 2009 was assessed. Factors assessed included gender, age, operator class, method of anesthesia, spacial relation, depth of impaction, ramus relation, proximity of the IAN on orthopantomogram, cone-beam computed tomographic usage, and side of injury. During this 4-year period, 11,599 lower third molars were removed in 6,803 patients. The incidence of an IAN injury was 0.68%, and the incidence of an LN injury was 0.15%. Important risk factors for permanent IAN injury were increasing age, surgery performed by staff dentists, type of anesthesia, and mesioangular impactions. The mean time of complete resolution was 4.3 months. No factors were found to statistically increase the risk of LN injury, although most injuries were seen in patients with a distoangular impaction. The overall incidences of IAN and LN injuries were low. Some risk factors for permanent IAN nerve injury were identified. Important risk factors for permanent IAN injury were increasing age (≥25 yr old), surgery performed by staff dentists, surgery under general anesthesia, and mesioangular impaction. No factors were found to statistically increase the risk of LN injury. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Decloe, Melissa D; Meeuwisse, Willem H; Hagel, Brent E; Emery, Carolyn A
The objectives of this cohort study were to examine the rate, types, mechanisms and risk factors for injury in female youth (ages 9-17) ice hockey players in the Girls Hockey Calgary Association. The main outcome was ice hockey injury, defined as any injury occurring during the 2008/2009 season that required medical attention, and/or removal from a session and/or missing a subsequent session. Potential risk factors included age group, level of play, previous injury, ice hockey experience, physical activity level, weight, height, position of play and menarche. Incidence rate ratios (IRR) were estimated with Poisson Regression adjusted for cluster (team). Exposure data were collected for every session for each participating player. Twenty-eight teams (n=324) from Atom (ages 9-10), PeeWee (11-12), Bantam (13-14) and Midget (15-17) participated with 53 reported injuries. The overall injury rate was 1.9 injuries/1000 player-hours (95% CI 1.4 to 2.7). Previous injury (IRR=2.7, 95% CI 1.7 to 4.3), games (IRR=2.1, 95% CI 1.1 to 4.2), menarche (PeeWee) (IRR=4.1, 95% CI 1.0 to 16.8) were significant risk factors. In Midget, the more elite divisions were associated with a lower injury risk (A-IRR=0.2, 95% CI 0.1 to 0.5) (AAA-IRR=0.5, 95% CI 0.2 to 0.9). Injury rates were lower in this study than previously found in male youth and women's ice hockey populations. Previous injury and game play as risk factors are consistent with the literature. Menarche as a risk factor is a new finding in this study. This research will inform future studies of the development of injury prevention strategies in this population.
Ekberg, Joakim; Timpka, Toomas; Ramel, Henrik; Valter, Lars
The aim of this study was to examine injury events and risk-factors among Swedish adult eventing athletes. A cross-sectional study design with retrospective recording of 1-year sports-specific exposure and injury data was used. The invited study population consisted of all members of the Swedish Equestrian Federation with eventing as their primary discipline (n = 513). The participation rate was 70.0%. The total 1-year injury prevalence was 26.6%; the specific 1-year prevalence of traumatic injury was 19.3% and of overuse injury 10.9%. The incidence of traumatic injury events was 0.54 injury events/1000 eventing hours (95% confidence interval (CI), 0.35-0.73 injury events/1000 eventing hours) for novices and 0.35 injury events/1000 eventing hours for qualified riders (95% CI, 0.21-0.49 injury events/1000 eventing hours). A total of 27.9% of the traumatic injury events led to severe injuries (causing more than 3 weeks absence from riding). Attitude to risk-taking was the only factor predicting an athlete becoming injured (p = 0.023), and qualification level was the only risk factor for additional injuries among injured riders (p = 0.003). Our results suggest that injury prevention programs in eventing should also give attention to overuse injuries and that care should be taken when eventing athletes are licensed into higher qualification groups.
Hannan, Susan M; Orcutt, Holly K; Miron, Lynsey R; Thompson, Kristen L
The current study sought to examine whether symptoms of posttraumatic stress disorder (PTSD), adolescent sexual assault (ASA), and drinking motivations (e.g., drinking to regulate emotional experiences) mediate the relationship between a history of childhood sexual abuse (CSA) and subsequent alcohol-related problems among college women. Participants were 579 female students at a Midwestern university. Participants were recruited as part of a larger longitudinal study that investigated risk and resiliency factors related to sexual revictimization. Using a serial mediation model, the current study found that the proposed constructs mediated the relationship between CSA and subsequent alcohol-related problems via two separate paths. In one path, CSA was associated with PTSD, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. In the second path, CSA was related to ASA, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. These results suggest that individuals with a history of CSA are more likely to experience both revictimization in adolescence and PTSD symptoms in adulthood, which may lead to alcohol-related problems via drinking to regulate emotional experiences. These findings suggest the importance of incorporating skills training in adaptive emotion regulation strategies into treatment for individuals with a history of CSA and ASA. © The Author(s) 2015.
Rhonda M. Brand
Full Text Available Alcoholics suffer from immune dysfunction that can impede vaccine efficacy. If ethanol (EtOH-induced immune impairment is in part a result of direct exposure of immune cells to EtOH, then reduced levels of exposure could result in less immune dysfunction. As alcohol ingestion results in lower alcohol levels in skin than blood, we hypothesized that the skin immune network may be relatively preserved, enabling skin-targeted immunizations to obviate the immune inhibitory effects of alcohol consumption on conventional vaccines. We employed the two most common chronic EtOH mouse feeding models, the liver-damaging Lieber-DeCarli (LD and liver-sparing Meadows-Cook (MC diets, to examine the roles of EtOH and/or EtOH-induced liver dysfunction on alcohol related immunosuppression. Pair-fed mice were immunized against the model antigen ovalbumin (OVA by DNA immunization or against flu by administering the protein-based influenza vaccine either systemically (IV, IM, directly to liver (hydrodynamic, or cutaneously (biolistic, ID. We measured resulting tissue EtOH levels, liver stress, regulatory T cell (Treg, and myeloid-derived suppressor cell (MDSC populations. We compared immune responsiveness by measuring delayed-type hypersensitivity (DTH, antigen-specific cytotoxic T lymphocyte (CTL, and antibody induction as a function of delivery route and feeding model. We found that, as expected, and independent of the feeding model, EtOH ingestion inhibits DTH, CTL lysis, and antigen-specific total IgG induced by traditional systemic vaccines. On the other hand, skin-targeted vaccines were equally immunogenic in alcohol-exposed and non-exposed subjects, suggesting that cutaneous immunization may result in more efficacious vaccination in alcohol-ingesting subjects.
Brand, Rhonda M; Stottlemyer, John Mark; Cline, Rachel A; Donahue, Cara; Behari, Jaideep; Falo, Louis D
Alcoholics suffer from immune dysfunction that can impede vaccine efficacy. If ethanol (EtOH)-induced immune impairment is in part a result of direct exposure of immune cells to EtOH, then reduced levels of exposure could result in less immune dysfunction. As alcohol ingestion results in lower alcohol levels in skin than blood, we hypothesized that the skin immune network may be relatively preserved, enabling skin-targeted immunizations to obviate the immune inhibitory effects of alcohol consumption on conventional vaccines. We employed the two most common chronic EtOH mouse feeding models, the liver-damaging Lieber-DeCarli (LD) and liver-sparing Meadows-Cook (MC) diets, to examine the roles of EtOH and/or EtOH-induced liver dysfunction on alcohol related immunosuppression. Pair-fed mice were immunized against the model antigen ovalbumin (OVA) by DNA immunization or against flu by administering the protein-based influenza vaccine either systemically (IV, IM), directly to liver (hydrodynamic), or cutaneously (biolistic, ID). We measured resulting tissue EtOH levels, liver stress, regulatory T cell (Treg), and myeloid-derived suppressor cell (MDSC) populations. We compared immune responsiveness by measuring delayed-type hypersensitivity (DTH), antigen-specific cytotoxic T lymphocyte (CTL), and antibody induction as a function of delivery route and feeding model. We found that, as expected, and independent of the feeding model, EtOH ingestion inhibits DTH, CTL lysis, and antigen-specific total IgG induced by traditional systemic vaccines. On the other hand, skin-targeted vaccines were equally immunogenic in alcohol-exposed and non-exposed subjects, suggesting that cutaneous immunization may result in more efficacious vaccination in alcohol-ingesting subjects.
LaBrie, Joseph; Pedersen, Eric R.; Neighbors, Clayton; Hummer, Justin F.
Heavy drinking among college students is a well-established national concern. An in-depth look at the characteristics and traits of heavy drinking students is an essential precursor to the development of successful targeted interventions with at-risk students. The current study examines the role self-consciousness (private, public, social anxiety) plays in the experience of alcohol-related consequences among a sample of 1,168 student members of campus organizations. Male gender predicted drinking in the sample, while both private self-consciousness and social anxiety predicted less drinking. Public self-consciousness predicted alcohol-related consequences over and above the variance explained by drinking for both males and females. Additionally, both gender and social anxiety moderated the effect of drinking on problems. Heavier drinking female students and heavier drinking students high in social anxiety appear more susceptible to the experience of negative consequences. These results highlight the direct and indirect impact that self-consciousness and gender have on college students’ experience of alcohol-related negative consequences. PMID:18258376
Gauffin, Karl; Hjern, Anders; Vinnerljung, Bo; Björkenstam, Emma
The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD) on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973-82 (n = 872,912), which was followed from age 18 to 29-40 years. Cox regression analyses were used to calculate hazard ratios (HR) for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP) was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7-2.5], two CHD indicators 5.6 [4.4-7.1], three or more indicators 9.4 [7.1-12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks-those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9-14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4-1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.
Full Text Available The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973-82 (n = 872,912, which was followed from age 18 to 29-40 years. Cox regression analyses were used to calculate hazard ratios (HR for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7-2.5], two CHD indicators 5.6 [4.4-7.1], three or more indicators 9.4 [7.1-12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks-those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9-14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4-1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.
Leavens, Eleanor L.; Leffingwell, Thad R.; Miller, Mary Beth; Brett, Emma I.; Lombardi, Nathaniel
Objective: Research suggests college students rate some alcohol-related consequences less negatively than others, yet it is unclear how or when these differences in perception develop. The current study compared college students' subjective evaluations of alcohol-related consequences that they had and had not experienced in order to test the…
Doumas, Diana M.
This study examined drinking motives as predictors of alcohol-related consequences among student athletes and nonathletes. Results indicated that the highest level of alcohol-related consequences was reported by student athletes with high levels of both coping and conformity motives. (Contains 2 tables and 2 figures.)
McIntosh, A S; McCrory, P; Finch, C F; Wolfe, R
In this study, the incidence of head, neck and facial injuries in youth rugby was determined, and the associated risk factors were assessed. Data were extracted from a cluster randomised controlled trial of headgear with the football teams as the unit of randomisation. No effect was observed for headgear use on injury rates, and the data were pooled. General school and club-based community competitive youth rugby in the 2002 and 2003 seasons. Young male rugby union football players participating in under-13, under 15, under 18 and under 21 years competitions. Eighty-two teams participated in year 1 and 87 in year 2. Injury rates for all body regions combined, head, neck and face calculated for game and missed game injuries. 554 head, face and neck injuries were recorded within a total of 28 902 h of rugby game exposure. Level of play and player position were related to injury risk. Younger players had the lowest rates of injury; forwards, especially the front row had the highest rate of neck injury; and inside backs had the highest rate of injuries causing the player to miss a game. Contact events, including the scrum and tackle, were the main events leading to injury. Injury prevention must focus on the tackle and scrum elements of a youth rugby game.
Nilstad, Agnethe; Andersen, Thor Einar; Bahr, Roald; Holme, Ingar; Steffen, Kathrin
The incidence of lower extremity injuries in female soccer players is high, but the risk factors for injuries are unknown. To investigate risk factors for lower extremity injuries in elite female soccer players. Cohort study; Level of evidence, 3. Players in the Norwegian elite female soccer league (N = 12 teams) participated in baseline screening tests before the 2009 competitive soccer season. The screening included tests assessing maximal lower extremity strength, dynamic balance, knee valgus angles in a drop-jump landing, knee joint laxity, generalized joint laxity, and foot pronation. Also included was a questionnaire to collect information on demographic data, elite-level experience, and injury history. Time-loss injuries and exposure in training and matches were recorded prospectively in the subsequent soccer season using weekly text messaging. Players reporting an injury were contacted to collect data regarding injury circumstances. Univariate and multivariate regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for ±1 standard deviation of change. In total, 173 players underwent complete screening tests and registration of injuries and exposure throughout the season. A total of 171 injuries in 107 players (62%) were recorded; ligament and muscle injuries were the most frequent. Multivariate analyses showed that a greater body mass index (BMI) (OR, 1.51; 95% CI, 1.21-1.90; P = .001) was the only factor significantly associated with new lower extremity injuries. A greater BMI was associated with new thigh injuries (OR, 1.51; 95% CI, 1.08-2.11; P = .01), a lower knee valgus angle in a drop-jump landing was associated with new ankle injuries (OR, 0.64; 95% CI, 0.41-1.00; P = .04), and a previous knee injury was associated with new lower leg and foot injuries (OR, 3.57; 95% CI, 1.27-9.99; P = .02), whereas none of the factors investigated influenced the risk of new knee injuries. A greater BMI was associated with
Lin, Zhen-Bin; Ji, Yan-Hu; Xiao, Qing-Yu; Luo, Li-Bo; Li, Li-Ping; Choi, Bernard
Bicycle injuries are a leading cause of accidental death among children in the world, and bicycle-related injuries are also very common in China, thus to find out bicycle injury risk factors is imperative. This study aims to identify the cyclist-, bicycle- and road-related risk factors of bicycle injury, to develop health education programs as an intervention and to provide a scientific basis for establishing policies against bicycle injury. We selected two middle schools randomly among seven schools in Chaoshan rural areas,where the main means of transportation for students from home to school was bicycle. The subjects were middle school students from 7th to 9th grades from Gucuo Middle School and Hefeng Middle School. Cyclists were surveyed through questionnaires about bicycle injury in the past 12 months. Multivariable logistic analysis showed that compared with a combination-type road、 motor lane and a non-intact road were both risk factors of bicycle injuries. This was followed by riding with fatigue, non-motor lane and inattentive riding. Bicycle injuries are frequent in China. Three risk factors on bicycle traffic injury among middle school students in Chaoshan rural areas of China were identified. This study provides important data to develop intervention strategies for China and other developing countries.
Roe, Mark; Malone, Shane; Blake, Catherine; Collins, Kieran; Gissane, Conor; Büttner, Fionn; Murphy, John C; Delahunt, Eamonn
Managing injury risk is important for maximising athlete availability and performance. Although athletes are inherently predisposed to musculoskeletal injuries by participating in sports, etiology models have illustrated how susceptibility is influenced by repeat interactions between the athlete (i.e. intrinsic factors) and environmental stimuli (i.e. extrinsic factors). Such models also reveal that the likelihood of an injury emerging across time is related to the interconnectedness of multiple factors cumulating in a pattern of either positive (i.e. increased fitness) or negative adaptation (i.e. injury).The process of repeatedly exposing athletes to workloads in order to promote positive adaptations whilst minimising injury risk can be difficult to manage. Etiology models have highlighted that preventing injuries in sport, as opposed to reducing injury risk, is likely impossible given our inability to appreciate the interactions of the factors at play. Given these uncertainties, practitioners need to be able to design, deliver, and monitor risk management strategies that ensure a low susceptibility to injury is maintained during pursuits to enhance performance. The current article discusses previous etiology and injury prevention models before proposing a new operational framework.
Ristolainen, L; Kettunen, J A; Waller, B; Heinonen, A; Kujala, U M
The purpose of this study was to clarify training-related risk factors for overuse injuries. This was twelve-month retrospective study which was done by self-reported postal questionnaire. The study group consisted of 446 men and women top-level Finnish athletes representing three different endurance sports (cross-country skiing, swimming, long-distance running) between the ages of 15-35. Self-reported anthropometric and training-related variables (such as starting age of training, years of active training, hours trained yearly, competition hours and weekly resting days) and occurrence of overuse injuries. Athletes with less than 2 rest days per week during the training season had 5.2-fold risk (95% confidence intervals [CI] 1.89-14.06, P=0.001) for an overuse injury, and athletes who trained more than 700 hours during a year had 2.1-fold risk (95% CI 1.21-3.61, P=0.008) for an overuse injury compared to the others. Athletes who reported a tendon injury were on average two years older than athletes without such an injury (Ptraining are training-related risk factors for overuse injuries in top-level endurance athletes. The higher number of tendon overuse injuries in older than younger athletes may indicate that age-related degeneration plays an important role in the etiology of tendon injuries. These findings should be taken into account when planning exercise programs for endurance athletes.
Buzzetti, Elena; Kalafateli, Maria; Thorburn, Douglas
Background: Alcohol-related liver disease is due to excessive alcohol consumption. It includes a spectrum of liver diseases such as alcohol-related fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. Mortality associated with alcoholic hepatitis is high. The optimal pharmacological treatment...... of alcoholic hepatitis and other alcohol-related liver disease remains controversial. Objectives: To assess the comparative benefits and harms of different pharmacological interventions in the management of alcohol-related liver disease through a network meta-analysis and to generate rankings of the available...... Citation Index Expanded, World Health Organization International Clinical Trials Registry Platform and randomised controlled trials registers until February 2017 to identify randomised clinical trials on pharmacological treatments for alcohol-related liver diseases. Selection criteria: Randomised clinical...
Full Text Available Muge Bozkurt,1 Cuneyt Evren,1 Gokhan Umut,1 Bilge Evren2 1Research, Treatment and Training Center for Alcohol and Substance Dependence, Bakirkoy Prof Dr Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 2Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey Purpose: Attention-deficit/hyperactivity disorder (ADHD has been shown to be related to a higher risk of developing psychiatric problems such as depressive disorders, substance use disorder, and impulsivity. Adults who have comorbid ADHD and alcohol use disorder (AUD are at greater risk of negative outcomes. Thus, it is important to evaluate the relationship of ADHD symptoms and the severity of alcohol-related problems among patients with AUD. The aim of the present study was to evaluate the effect of ADHD symptoms on severity of alcohol-related problems, while controlling the effects of depression and impulsivity in a sample of inpatients with AUD. Patients and methods: Participants (n=190 were evaluated with the Beck Depression Inventory, the Short Form Barratt Impulsiveness Scale, the Michigan Alcohol Screening Test, and the Adult ADHD Self-Report Scale. Results: Severity of the scale scores was positively correlated with each other. Although severity of depression and impulsivity (particularly non-planning impulsivity predicted the severity of alcohol-related problems in a linear regression model, when severity of ADHD symptoms was included in the analysis, the inattentive subscale score, in particular, predicted the severity of alcohol-related problems together with non-planning impulsivity, whereas depression was no longer a predictor. Conclusion: These findings suggest that, together with non-planning impulsivity, symptoms of ADHD (particularly inattentive factor are an important factor that predict alcohol-related problems, while controlling the severity of depressive symptoms among inpatients
Dec 16, 2015 ... As part of the Safe and Inclusive Cities initiative, IDRC-supported researchers in South Africa are evaluating the impact of liquor control laws and urban upgrades on violence and injury. University of Cape Town researchers are collaborating with the Violence Prevention through Urban Upgrading program ...
Bere, Tone; Kruczynski, Jacek; Veintimilla, Nadège; Hamu, Yuichiro; Bahr, Roald
Background Little is known about the rate and pattern of injuries in international volleyball competition. Objective To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). Methods The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior). Results The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions. Conclusions Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder. PMID:26194501
Bere, Tone; Kruczynski, Jacek; Veintimilla, Nadège; Hamu, Yuichiro; Bahr, Roald
Little is known about the rate and pattern of injuries in international volleyball competition. To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior). The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions. Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Erevik, Eilin K; Torsheim, Torbjørn; Vedaa, Øystein; Andreassen, Cecilie S; Pallesen, Ståle
The present study aimed to explore students' reports of their sharing of alcohol-related content on different social networking sites (i.e., frequency of sharing and connotations of alcohol-related posts), and to identify indicators of such posting. Students at the four largest institutions for higher education in Bergen, Norway, were invited to participate in an Internet-based survey. The sample size was 11,236 (a 39.4% response rate). The survey included questions about disclosure of alcohol-related content on social networking sites, alcohol use (using the Alcohol Use Disorders Identification Test), personality factors (using the Mini-IPIP), and demographic characteristics. Binary logistic regressions were used to analyze indicators of frequent sharing of alcohol-related content depicting positive and negative aspects of alcohol use. A majority of the students had posted alcohol-related content (71.0%), although few reported having done so frequently. Positive aspects of alcohol use (e.g., enjoyment or social community) were most frequently shared. Young, single, and extroverted students with high alcohol consumption were more likely to report frequent sharing of alcohol-related content. Positive attitudes toward posting alcohol-related content and reports of exposure to such content particularly increased the likelihood of one's own posting of alcohol-related content. Positive aspects of alcohol use seem to be emphasized on social networking sites. Sharing of alcohol-related content is associated with heightened alcohol use, which implies that such sites can be relevant for prevention agents. Social influence from social networking sites, such as exposure to others' alcohol-related content, is associated with one's own sharing of similar content.
Jennissen, Charles A; Koos, Maggie; Denning, Gerene
The purpose of this study was to better understand the factors associated with playground slide-related injuries in preschool children and to test the hypothesis that riding on laps increases the likelihood of lower extremity injuries. Playground slide-related injuries (product code 1242) in children ≤5 years of age treated in emergency departments from 2002 to 2015 were identified (N = 12,686) using the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS). Descriptive and comparative analyses, including chi-square testing and binary logistic regression, were performed. Based on NEISS stratified national sampling estimates, over 350,000 children ≤5 years of age were injured on slides from 2002 to 2015. Overall, 59% of the children were male, and 65% were white. Almost 60% of injuries occurred in parks or other public areas. The most frequent diagnosis was a fracture (36%); lacerations were 19% of the injuries. A higher proportion of musculoskeletal injuries were seen in toddlers < 3 years old as compared to those 3-5 years of age (p < 0.001). Injuries to the lower extremities increased in frequency as age decreased, whereas injuries to the upper extremities and head/neck/face were more common in older preschoolers. Children < 3 years of age were 12 times more likely to be identified from narratives as being on another person's lap at the time of injury. Children identified as being on a lap had an increased odds of injury to the lower extremity than to other body parts (OR 43.0, 95% confidence interval (CI) 32.0-58.0), and of lower leg/ankle fracture than fractures elsewhere (OR 49.5, 95% CI 31.7-77.4). Decreasing age was associated with a higher likelihood of being identified as sliding down on another person's lap and a higher likelihood of lower extremity injuries. Healthcare providers should be mindful of the potential for these slide-related injuries as they can result in a toddler's fracture of
Cantu, Robert C
This article focuses on the issues related to recurrent athletic head injuries; specifically, when cumulative exponential injury or the second impact syndrome may be anticipated. Case histories and research studies are used to illustrate the salient points. A signs-and-symptoms checklist for use in concussion evaluation and management is included. Finally, the topic of when to retire after repeated athletic head injuries is discussed and illustrated with a case study.
Full Text Available Objectives: Extensive literature exists about military trauma as opposed to the very limited literature regarding terror-related civilian trauma. However, terror-related vascular trauma (VT, as a unique type of injury, is yet to be addressed.Methods: A retrospective analysis of the Israeli National Trauma Registry was performed. All patients in the registry from 09/2000 to 12/2005 were included. The subgroup of patients with documented vascular trauma (VT (N=1,545 was analyzedand further subdivided into those suffering from Terror-related Vascular Trauma (TVT and Non-Terror related Vascular Trauma (NTVT. Both groups were analyzed according to mechanism of trauma, type and severity of injury and treatment.Results: Out of 2,446 terror related trauma admissions 243 sustained TVT (9.9% compared to 1302 VT patients from Non Terror trauma (1.1%. TVT injuries tend to be more complex and most patients were operated on. ICU admissions and hospitallength of stay was higher in the TVT group. Penetrating trauma was the prominent cause of injury among the TVT group. TVT group had a higher proportion of patients with severe injuries (ISS>16 and mortality. Thorax injuries were more frequent in the TVT group. Extremity injuries were the most prevalent vascular injuries in both groups; however NTVT group had more upper extremity injuries, while the TVT group had significantly more lower extremity injuries.Conclusion: Vascular injuries are remarkably more common among terror attack victims than among non-terror trauma victims and the injuries of terror casualties tend to be more complex. The presence of a vascular surgeon will ensure a comprehensive clinical care.
Somers, Jeffrey T.; Newby, Nate; Wells, Jessica
A panel of experts was convened in 2010 to help define acceptable injury risk levels for space vehicle launches, landings, and abort scenarios. Classifications of spaceflight-relevant injuries were defined using four categories ranging from minor to severe injury. Limits for each injury category were agreed to, dependent on the expected number of crew exposures in a given vehicle and on whether the flight was considered nominal or off-nominal. Somers et al. captured the findings of this summit in a NASA technical memorandum. This panel was recently re-convened (December 1, 2014) to determine whether the previous recommended injury limits were applicable to newly-designed commercial space flight vehicles. In particular, previous limits were based in part on the number of crew exposures per vehicle and also were sensitive to a definition of nominal and off-nominal vehicle performance. Reconsideration of these aspects led to a new consensus on a definition of injury risk.
Moran, Sebastian; Booker, Harry; Staines, Jacob; Williams, Sean
CrossFitTM is a strength and conditioning program that has gained widespread popularity since its inception approximately 15 years ago. However, at present little is known about the level of injury risk associated with this form of training. Movement competency, assessed using the Functional Movement ScreenTM (FMS), has been identified as a risk factor for injury in numerous athletic populations, but its role in CrossFit participants is currently unclear. The aim of this study was to evaluate the level of injury risk associated with CrossFit training, and examine the influence of a number of potential risk factors (including movement competency). A cohort of 117 CrossFit participants were followed prospectively for 12 weeks. Participants' characteristics, previous injury history and training experience were recorded at baseline, and an FMS assessment was conducted. The overall injury incidence rate was 2.10 per 1000 training hours (90% confidence limits: 1.32-3.33). A multivariate Poisson regression model identified males (rate ratio [RR]: 4.44 ×/÷ 3.30, very likely harmful) and those with previous injuries (RR: 2.35 ×/÷ 2.37, likely harmful) as having a higher injury risk. Inferences relating to FMS variables were unclear in the multivariate model, although number of asymmetries was a clear risk factor in a univariate model (RR per two additional asymmetries: 2.62 ×/÷ 1.53, likely harmful). The injury incidence rate associated with CrossFit training was low, and comparable to other forms of recreational fitness activities. Previous injury and gender were identified as risk factors for injury, whilst the role of movement competency in this setting warrants further investigation.
Ali, Nicholas; Rouhi, Gholamreza
High incidences of non-contact anterior cruciate ligament (ACL) injury, frequent requirements for ACL reconstruction, and limited understanding of ACL mechanics have engendered considerable interest in quantifying the ACL loading mechanisms. Although some progress has been made to better understand non-contact ACL injuries, information on how and why non-contact ACL injuries occur is still largely unavailable. In other words, research is yet to yield consensus on injury mechanisms and risk factors. Biomechanics, video analysis, and related study approaches have elucidated to some extent how ACL injuries occur. However, these approaches are limited because they provide estimates, rather than precise measurements of knee - and more specifically ACL - kinematics at the time of injury. These study approaches are also limited in their inability to simultaneously capture many of the contributing factors to injury.This paper aims at elucidating and summarizing the key challenges that confound our understanding in predicting the mechanisms and subsequently identifying risk factors of non-contact ACL injury. This work also appraise the methodological rigor of existing study approaches, review testing protocols employed in published studies, as well as presents a possible coupled approach to better understand injury mechanisms and risk factors of non-contact ACL injury. Three comprehensive electronic databases and hand search of journal papers, covering numerous full text published English articles were utilized to find studies on the association between ACL and injury mechanisms, ACL and risk factors, as well as, ACL and investigative approaches. This review unveils that new research modalities and/or coupled research methods are required to better understand how and why the ACL gets injured. Only by achieving a better understanding of ACL loading mechanisms and the associated contributing factors, one will be able to develop robust prevention strategies and exercise
Keough, Matthew T; Battista, Susan R; O'Connor, Roisin M; Sherry, Simon B; Stewart, Sherry H
Predrinking (or pregaming) is common among undergraduates and has been linked with problem alcohol use. While many students predrink to save money, evidence suggests that some students predrink to cope with social anxiety (SA). Tension reduction and cognitive theories predict that those high in SA may predrink to reduce anticipatory anxiety before attending social events and their predrinking may be done alone rather than in normative social contexts. Available data suggest that, relative to social drinking, solitary drinking elevates risk for alcohol use and related problems. Informed by this evidence, we speculated that context for predrinking may be an important mechanism by which SA-risk for alcohol use unfolds. Specifically, we offered the novel hypothesis that those high in SA would engage frequently in solitary predrinking and this in turn would be associated with elevated alcohol use and related problems. Undergraduate drinkers (N=293; 70% women) completed self-reports of social anxiety, predrinking context (social, solitary), alcohol use, and alcohol-related problems. In partial support of our hypotheses, SA was a positive predictor of solitary predrinking, which in turn predicted elevated alcohol-related problems, but not alcohol use. While not hypothesized, we also found that SA was a negative predictor of social predrinking, which in turn reduced risk for alcohol use and related problems. Our study is the first in the literature to show that solitary predrinking helps explain the well-documented association between SA and alcohol-related problems. These findings may inform etiological models and clinical interventions, suggesting that SA-risk for problem drinking begins even before the party starts. Copyright © 2015 Elsevier Ltd. All rights reserved.
Schwab, Charles V; Mosher, Gretchen A; Ryan, Saxon J
Keeping workers safe is a continuing challenge in agricultural production. Risk assessment methodologies have been used widely in other industries to better understand systems and enhance decision making, yet their use in production agriculture has been limited. This article describes the considerations and the approach taken to measure the difference in worker injury risks between two agricultural production systems. A model was developed specifically for the comparison of worker injury risk between corn and biofuel switchgrass production systems. The model is composed of injury and exposure values that were used in a Monte Carlo simulation. The output of this risk assessment shows that approximately 99% of the values from the Monte Carlo simulation rank corn production as a greater worker injury risk than biofuel switchgrass production. Furthermore, the greatest contributing factors for each production system were identified as harvest, and that finding aligns with current literature. Copyright© by the American Society of Agricultural Engineers.
Leiter, Michael P; Zanaletti, William; Argentero, Piergiorgio
This study examined occupational risk perception in relation to safety training and injuries. In a printing industry, 350 workers from 6 departments completed a survey. Data analysis showed significant differences in risk perceptions among departments. Differences in risk perception reflected the type of work and the injury incidents in the departments. A structural equation analysis confirmed a model of risk perception on the basis of employees' evaluation of the prevalence and lethalness of hazards as well as the control over hazards they gain from training. The number of injuries sustained was positively related to the perception of risk exposure and negatively related to evaluations about the safety training. The results highlight the importance of training interventions in increasing workers' adoption of safety procedures and prevention of injuries.
Roberts, Simon P; Trewartha, Grant; England, Mike; Stokes, Keith A
To establish the propensity for specific contact events to cause injury in rugby union. Medical staff at participating English community-level rugby clubs reported any injury resulting in the absence for one match or more from the day of the injury during the 2009/2010 (n=46), 2010/2011 (n=67) and 2011/2012 (n=76) seasons. Injury severity was defined as the number of matches missed. Thirty community rugby matches were filmed and the number of contact events (tackles, collision tackles, rucks, mauls, lineouts and scrums) recorded. Of 370 (95% CI 364 to 378) contact events per match, 141 (137 to 145) were tackles, 115 (111 to 119) were rucks and 32 (30 to 33) were scrums. Tackles resulted in the greatest propensity for injury (2.3 (2.2 to 2.4) injuries/1000 events) and the greatest severity (16 (15 to 17) weeks missed/1000 events). Collision tackles (illegal tackles involving a shoulder charge) had a propensity for injury of 15 (12.4 to 18.3) injuries/1000 events and severity was 92 (75 to 112) weeks missed/1000 events, both of which were higher than any other event. Additional scrum analysis showed that only 5% of all scrums collapsed, but the propensity for injury was four times higher (2.9 (1.5 to 5.4) injuries/1000 events) and the severity was six times greater (22 (12 to 42) weeks missed/1000 events) than for non-collapsed scrums. Injury prevention in the tackle should focus on technique with strict enforcement of existing laws for illegal collision tackles. The scrum is a relatively controllable event and further attempts should be made to reduce the frequency of scrum collapse. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Ehrhardt, Jennifer; Xu, Yingying; Khoury, Jane; Yolton, Kimberly; Lanphear, Bruce; Phelan, Kieran
Residential injury is a leading cause of morbidity and mortality in US children. Rates and types of injury vary by child age but little is known about injury risk based on child cognitive and motor abilities. The objective of this study was to determine whether cognitive or motor development in young children is associated with residential injury. We employed data from Health Outcomes and Measures of the Environment (HOME) Study. Parent report of medically attended injury was obtained at regular intervals from 0 to 42 months. Child development was assessed at 12, 24 and 36 months using Bayley Scales of Infant and Toddler Development, 2nd edition, which generates both mental developmental index (MDI) and a psychomotor developmental index (PDI). Injury risk was modelled using multivariable logistic regression as function of child's MDI or PDI. Effects of MDI and PDI on injury risk were examined separately and jointly, adjusting for important covariates. Children with cognitive delay (MDI children without cognitive delay (OR=3.7, 95% CI 1.4 to 10.5, p=0.012). There was no significant association of PDI with injury. There was, however, significant interaction of MDI and PDI (p=0.02); children with cognitive delay but normal motor development were at significantly higher risk of injury than children with normal cognitive and motor development (OR=9.6, 95% CI 2.6 to 35.8, p=0.001). Children with cognitive delays, especially those with normal motor development, are at elevated risk for residential injuries. Injury prevention efforts should target children with developmental delays. NCT00129324; post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Nauta, J.; Jespersen, Eva; Verhagen, Evert
was found suggesting that girls are at increased acute upper extremity risk compared to boys (HR: 1.40 95% CI: 0.97–2.04). The findings that most injuries occur after a fall, that injury risk increases over age and that girls seem to be at increased injury risk provides essential information to guide future...... caused by a fall. When corrected for exposure to physical activity, this resulted in an acute upper extremity injury incidence density of 0.18 per 1000 h of physical activity. The odds of sustaining an upper extremity injury was higher in the older children (HR: 1.84, 95% CI: 1.10–3.09), a tendency...
Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne
BACKGROUND: Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether recurrence of obstetric anal sphincter injury affects the risk of anal- and fecal...... incontinence at long term follow up. OBJECTIVE: To evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal- and fecal incontinence more than 5 years after the second vaginal delivery. STUDY DESIGN: We performed a secondary analysis of data from a postal questionnaire study...... in women with obstetric anal sphincter injury in the first delivery and one subsequent vaginal delivery. The questionnaire was sent to all Danish women who fulfilled inclusion criteria and had two vaginal deliveries 1997 -2005. We performed uni- and multivariable analyses to assess how recurrent obstetric...
Engström, Karin; Diderichsen, Finn; Laflamme, Lucie
OBJECTIVES: We investigated the effect of family social and economic circumstances on intentional injury among adolescents. METHODS: We conducted a cross-sectional register study of youths aged 10 to 19 years who lived in Sweden between 1990 and 1994. We used socioeconomic status, number of parents...... in the household (1- or 2-parent home), receipt of welfare benefits, parental country of birth, and population density as exposures and compiled relative risks and population-attributable risks (PARs) for self-inflicted and interpersonal violence-related injury. RESULTS: For both genders and for both injury types......, receipt of welfare benefits showed the largest crude and net relative risks and the highest PARs. The socioeconomic status-related PAR for self-inflicted injury and the PAR related to number of parents in the household for interpersonal violence-related injury also were high. CONCLUSIONS: Intentional...
Gomberg, Edith S Lisansky
For the subgroups indicated, a few questions/issues are relevant to all three (women, elderly, minorities): 1. Heterogeneity of the special populations, for example, Hispanic-Americans are from different countries with different cultures. Women and the elderly vary by age, education, income, social class, health status, etc., to say nothing of ethnicity/color/religion. 2. Of therapy modalities, professional and indigenous, which are more efficacious? 3. Are group-specific therapies needed, or will sensitivity to a particular group work as well? WOMEN: Stereotypes and myths have prevailed, for example, the long-standing belief that women have poorer prognoses than male alcoholics. When female and male alcoholics are compared, women report more positive family history, a later onset of drinking and problems, more marital disruption, more comorbidity, etc. The review of treatment outcomes (Vannicelli, 1986) showed few significant gender differences in outcomes. Research recommendations include biological and genetic studies, women's view of and use of therapeutic modalities, and outcome studies of different modalities, including all female facilities. ELDERLY: Medications are used more by older patients, and such patients are more likely to experience adverse drug reactions. In the moderate social use of alcohol, there are conflicting reports and the extent of elderly use awaits decisive study. The etiology of problem drinking by older persons is studied rarely. An attempt has been made to explain onset later in life (vs. earlier onset) based on the stresses of aging (loss, loneliness, health problems, etc.); research results have not been supportive. Consequences of older persons' heavy drinking seems to be most often alcohol-related medical disorders, although there are often familial and social consequences. Atkinson (1995) recommended the development of elder-specific outcome measures, study of the efficacy of different treatment modalities, and study of the
Roemer, Audra; Stockwell, Tim
The present study is a systematic review of the literature examining the relationship between alcohol mixed with energy drinks (AmED) and injury. The study provides a summary and critical analysis of the current literature. The review was conducted using PRISMA guidelines for systematic reviews. Studies included in the review were those that quantified the relationship between AmED use and injury risk relative to alcohol only. Records were considered along the following theme areas: controlled for drinking behaviors, controlled for impulsivity or risk-taking propensity, examined sex differences, and self-reported injury outcomes for (a) AmED versus alcohol consumers and (b) AmED versus alcohol sessions. The results support the association between AmED and increased risk of injury; however, substantial variability in harm outcomes and methodology makes it difficult to determine the extent of this risk. There is significant need for further examination of the role of AmED use in the risk of injury. A better understanding of the relationship between AmED use and injury and of the potential underlying mechanisms is crucial for informing effective preventive intervention strategies. This review can be used to inform the public and health practitioners of the risks associated with AmED use. Further, translating this knowledge to policy makers could inform regulations on the availability of AmED, with the goal of reducing injury-related outcomes.
Laugsand, Lars Erik; Strand, Linn B; Vatten, Lars J; Janszky, Imre; Bjørngaard, Johan Håkon
To assess the association between insomnia symptoms and risk of fatal unintentional injuries. Population-based prospective cohort study with a mean follow-up of 14 y, linking health survey data with information on insomnia symptoms to the National Cause of Death Registry. Nord-Trøndelag County, Norway. A total of 54,399 men and women 20-89 y of age who participated in the Nord-Trøndelag Health Study between 1995 and 1997. N/A. There were 277 unintentional fatal injuries, including 57 fatal motor vehicle injuries during follow-up. There was a dose-dependent association between the number of insomnia symptoms and risk of unintentional fatal injuries (P for trend 0.001) and fatal motor vehicle injuries (P for trend 0.023), respectively. The proportion of unintentional fatal injuries cases that could have been prevented in the absence of difficulties initiating sleep, difficulties maintaining sleep, and having a feeling of nonrestorative sleep were 8%, 9%, and 8%, respectively. The corresponding estimates for motor vehicle injuries were 34%, 11%, and 10%. Insomnia is a major contributor to both unintentional fatal injuries in general as well as fatal motor vehicle injuries. Increasing public health awareness about insomnia and identifying persons with insomnia may be important in preventing unintentional fatal injuries.
Colby, Marcus J; Dawson, Brian; Heasman, Jarryd; Rogalski, Brent; Gabbett, Tim J
The purpose of this study was to investigate the relationship between overall physical workload (global positioning systems [GPS]/accelerometer) measures and injury risk in elite Australian football players (n = 46) during a season. Workload data and (intrinsic) injury incidence were monitored across preseason and in-season (18 matches) phases. Multiple regression was used to compare cumulative (1-, 2-, 3-, and 4-weekly loads) and absolute change (from previous-to-current week) in workloads between injured and uninjured players for all GPS/accelerometer-derived variables: total distance, V1 distance (total distance above individual's aerobic threshold speed), sprint distance, force load, velocity load, and relative velocity change. Odds ratios (ORs) were calculated to determine the relative injury risk. Cumulative loads showed the strongest relationship with greater intrinsic injury risk. During preseason, 3-weekly distance (OR = 5.489, p = 0.008) and 3-weekly sprint distance (OR = 3.667, p = 0.074) were most indicative of greater injury risk. During in-season, 3-weekly force load (OR = 2.530, p = 0.031) and 4-weekly relative velocity change (OR = 2.244, p = 0.035) were associated with greater injury risk. No differences in injury risk between years of Australian Football League system experience and GPS/accelerometer data were seen. From an injury risk (prevention) perspective, these findings support consideration of several GPS/accelerometer running load variables in Australian football players. In particular, cumulative weekly loads should be closely monitored, with 3-weekly loads most indicative of a greater injury risk across both seasonal phases.
Zamboanga, Byron L; Pesigan, Ivan Jacob Agaloos; Tomaso, Cara C; Schwartz, Seth J; Ham, Lindsay S; Bersamin, Melina; Kim, Su Yeong; Cano, Miguel A; Castillo, Linda G; Forthun, Larry F; Whitbourne, Susan Krauss; Hurley, Eric A
A drinking game (DG) is a high-risk, social drinking activity that consists of certain rules (i.e., when to drink and how much to consume) designed to promote inebriation and that requires each player to perform a cognitive and/or motor task (Zamboanga et al., 2013). Research suggests that non-White or female students who play DGs are at an increased risk of experiencing alcohol-related problems. Thus, this study examined whether the associations between DG participation and alcohol-related problems were similar for men and women and across ethnic groups. College students (N=7409; 73% women; 64% White, 8% Black, 14% Hispanic, 14% Asian) from 30 U.S. colleges/universities completed self-report questionnaires. Controlling for age, site, Greek membership (i.e., membership in a fraternity or sorority), and typical alcohol consumption, results indicated that the association between DG participation and alcohol-related problems was stronger for men compared to women. With respect to ethnicity, the association between these variables was stronger among Black women than Black men. Findings from this large-scale study highlight the need to closely investigate how gender and ethnicity moderate the associations between DG participation and alcohol-related problems. College intervention efforts designed to address high-risk drinking behaviors such as DG participation might consider paying close attention to ethnic minority populations, perhaps particularly Black women. Copyright © 2014 Elsevier Ltd. All rights reserved.
Wilkerson, Gary B; Gupta, Ashish; Colston, Marisa A
Sport injuries restrict participation, impose a substantial economic burden, and can have persisting adverse effects on health-related quality of life. The effective use of Internet of Things (IoT), when combined with analytics approaches, can improve player safety through identification of injury risk factors that can be addressed by targeted risk reduction training activities. Use of IoT devices can facilitate highly efficient quantification of relevant functional capabilities prior to sport participation, which could substantially advance the prevailing sport injury management paradigm. This study introduces a framework for using sensor-derived IoT data to supplement other data for objective estimation of each individual college football player's level of injury risk, which is an approach to injury prevention that has not been previously reported. A cohort of 45 NCAA Division I-FCS college players provided data in the form of self-ratings of persisting effects of previous injuries and single-leg postural stability test. Instantaneous change in body mass acceleration (jerk) during the test was quantified by a smartphone accelerometer, with data wirelessly transmitted to a secure cloud server. Injuries sustained from the beginning of practice sessions until the end of the 13-game season were documented, along with the number of games played by each athlete over the course of a 13-game season. Results demonstrate a strong prediction model. Our approach may have strong relevance to the estimation of injury risk for other physically demanding activities. Clearly, there is great potential for improvement of injury prevention initiatives through identification of individual athletes who possess elevated injury risk and targeted interventions. © 2018 Society for Risk Analysis.
John W. Orchard
Conclusion: Fast bowlers suffer more hamstring injuries than other playing roles in cricket, particularly in First Class (multi-day cricket. Batsmen are more likely to get injured in 50-over (one day cricket. Playing in Australia (compared to overseas venues leads to increased risk of hamstring injury.
Whiteside-Mansell, Leanne; Johnson, Danya; Aitken, Mary M.; Bokony, Patti A.; Conners-Burrow, Nicola; McKelvey, Lorraine
Much is known about how to provide safe environments for preschool children (3-5 years-of-age); however, many preschool children still experience preventable injuries--particularly children living in poverty. This study examined the use of an assessment tool used to identify children at risk for unintended injury in two large, federally funded…
Boele van Hensbroek, P.; Mulder, S.; Luitse, J. S. K.; van Ooijen, M. R.; Goslings, J. C.
Introduction: Few data are available about the epidemiology and injury characteristics in staircase falls. The available literature mainly concerns children and autopsy studies. Objective: To describe the epidemiology and injury characteristics of staircase falls, and to identify high-risk groups
Duerden, Emma G.; Oatley, Hannah K.; Mak-Fan, Kathleen M.; McGrath, Patricia A.; Taylor, Margot J.; Szatmari, Peter; Roberts, S. Wendy
While self-injurious behaviors (SIB) can cause significant morbidity for children with autism spectrum disorders (ASD), little is known about its associated risk factors. We assessed 7 factors that may influence self-injury in a large cohort of children with ASD: (a) atypical sensory processing; (b) impaired cognitive ability; (c) abnormal…
Carrivick, P J; Lee, A H; Yau, K K
To describe the formation of a consultative team to assess the risk of manual handling in the workplace that started in October 1992 within the cleaning services department of a 600 bed hospital, and to evaluate the effectiveness of its recommendations in reducing the rate and severity (time lost and cost) of workers' compensation injury. The consultative team identified, assessed, and recommended controls for manual handling and other injury risks. Data on injuries counted before and after implementation of the team's recommendations were obtained for the cleaning services study group, an orderly services comparison group, as well as cleaners from a peer hospital and for the State of Western Australia. Evaluation of the four groups was undertaken 3 years after the end of the study period, to allow maturation of the costs of the claims (adjusted to July 1998 consumer price index) and hours lost from work. Statistical analysis showed that implementation of the recommendations significantly reduced numbers and rates of injury, but not the severity of injury, in the cleaning services study group. There was no difference in numbers or severity of injuries for the comparison groups before and after implementation of the recommendations. The recommendation of the consultative team can produce a meaningful and sustained reduction in rates of injury within an at risk population. The results support a consultative approach to reducing workplace injuries from manual handling. The team process has potential for application to occupational groups at risk of exposure to other types of hazards.
Full Text Available This paper deals with the subject of injury in alpine skiing and snowboarding and the aim was to define the characteristics of injuries and the risk factors as the basis for establishing preventive measures. The types of injuries and risk factors were analyzed by examining previous papers. During the last thirty years, the number of injuries has generally decreased by 50-70%. The changes were recorded in the types of injuries, and the number of certain injuries increased. It was found that there was a mutual difference in the number and structure of the injuries of skiers and snowboarders. Injuries can be classified topologically and according to risk factors. The risk factors may be manifold: the characteristics of the equipment, the characteristics of the trail and snow surface, protective equipment, age, gender, physical fitness, risky behaviours, time of day, skiing discipline, climate factors, the presence of other skiers and others. By the analysis of these factors it was concluded that there were three entities in the implementation of security measures: the state that stipulates laws (relevant ministries, owners or organizers who provide services in skiing (ski centres, ski services, ski schools, clubs and skiers and snowboarders themselves.
Yamakawa, H; Murase, S; Sakai, H; Iwama, T; Katada, M; Niikawa, S; Sumi, Y; Nishimura, Y; Sakai, N
The purpose of this study was to clarify the occurrence rate and characteristics of spinal injuries caused by snowboarding that were sustained at the Okumino skiing area in Gifu Prefecture, Japan, from 1988 to 2000. This study was a retrospective review of 13,490 cases of snowboard- or ski-related injury treated at Sumi Memorial Hospital over this period. A total of 7,188 patients sustained snowboard-related injuries, and 238 of these had spinal injuries caused by snowboarding (3.3%), whereas 6,302 patients sustained ski-related injuries, and 86 of these had spinal injuries caused by skiing (1.4%). Although there were no significant differences in the difficulty of slope, location of vertebral fracture, or spinal cord injury between snowboarders and skiers, the incidence of transverse process fractures was significantly higher in snowboard-related than in skiing-related injury (p jumping than beginners (p skiing resulted from a simple fall. Spinal injuries sustained while snowboarding are increasing considerably in incidence and are characterized as complex injuries. We must educate young snowboarders of the risk of this sport, to prevent these serious injuries.
Lopes, Camila Mendonça de Moraes; Haas, Vanderlei José; Dantas, Rosana Aparecida Spadoti; Oliveira, Cheila Gonçalves de; Galvão, Cristina Maria
to build and validate a scale to assess the risk of surgical positioning injuries in adult patients. methodological research, conducted in two phases: construction and face and content validation of the scale and field research, involving 115 patients. the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning contains seven items, each of which presents five subitems. The scale score ranges between seven and 35 points in which, the higher the score, the higher the patient's risk. The Content Validity Index of the scale corresponded to 0.88. The application of Student's t-test for equality of means revealed the concurrent criterion validity between the scores on the Braden scale and the constructed scale. To assess the predictive criterion validity, the association was tested between the presence of pain deriving from surgical positioning and the development of pressure ulcer, using the score on the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning (pescala de avaliação de risco para lesões decorrentes do posicionamento cirúrgico em pacientes adultos. pesquisa metodológica, conduzida em duas etapas: construção e validação de face e de conteúdo da escala e pesquisa de campo, com a participação de 115 pacientes. a Escala de Avaliação de Risco para o Desenvolvimento de Lesões Decorrentes do Posicionamento Cirúrgico contém sete itens, sendo que cada um apresenta cinco subitens. A pontuação dessa escala varia de sete a 35 pontos, quanto maior o escore maior o risco do paciente. O Índice de Validade de Conteúdo da escala foi de 0,88. Por meio da aplicação do teste t de Student, para igualdade de médias, constatou-se validade de critério concorrente entre os escores da escala de Braden e da escala construída. Para avaliar a validade de critério preditiva testou-se a associação da presença de dor decorrente do posicionamento cirúrgico e o desenvolvimento de úlcera por pressão com o
Whittaker, Jackie L; Small, Claire; Maffey, Lorrie; Emery, Carolyn A
The identification of risk factors for groin injury in sport is important to develop and implement injury prevention strategies. To identify and evaluate the evidence examining risk factors for groin injury in sport. Nine electronic databases were systematically searched to June 2014. Studies selected met the following criteria: original data; analytic design; investigated a risk factor(s); included outcomes for groin injury sustained during sport participation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed and two independent authors assessed the quality and level of evidence with the Downs and Black (DB) criteria and Oxford Centre of Evidence-Based Medicine model, respectively. Of 2521 potentially relevant studies, 29 were included and scored. Heterogeneity in methodology and injury definition precluded meta-analyses. The most common risk factors investigated included age, hip range of motion, hip adductor strength and height. The median DB score across studies was 11/33 (range 6-20). The majority of studies represented level 2 evidence (cohort studies) however few considered the inter-relationships between risk factors. There is level 1 and 2 evidence that previous groin injury, higher-level of play, reduced hip adductor (absolute and relative to the hip abductors) strength and lower levels of sport-specific training are associated with increased risk of groin injury in sport. We recommended that investigators focus on developing and evaluating preparticipation screening and groin injury prevention programmes through high-quality randomised controlled trials targeting athletes at greater risk of injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Pedro José Labronici
Full Text Available OBJECTIVE: To ascertain whether the number of screws or pins placed in the calcaneus might increase the risk of injury when three different techniques for treating calcaneal fractures. METHOD: 126 radiographs of patients who suffered displaced calcaneal fractures were retrospectively analyzed. Three surgical techniques were analyzed on an interobserver basis: 31 radiographs of patients treated using plates that were not specific for the calcaneus, 48 using specific plates and 47 using an external fixator. The risk of injury to the anatomical structures in relation to each Kirschner wire or screw was determined using a graded system in accordance with the Licht classification. The total risk of injury to the anatomical structures through placement of more than one wire/screw was quantified using the additive law of probabilities for the product, for independent events. RESULTS: All of the models presented high explanatory power for the risk evaluated, since the coefficient of determination values (R2 were greater than 98.6 for all the models. Therefore, the set of variables studied explained more than 98.6% of the variations in the risks of injury to arteries, veins or nerves and can be classified as excellent models for prevention of injuries. CONCLUSION: The risk of injury to arteries, veins or nerves is not defined by the total number of pins/screws. The region and the number of pins/screws in each region define and determine the best distribution of the risk.
Witbrodt, Jane; Mulia, Nina; Zemore, Sarah E; Kerr, William C
While prior studies have reported racial/ethnic disparities in alcohol-related problems at a given level of heavy drinking (HD), particularly lower levels, it is unclear whether these occur in both genders and are an artifact of racial/ethnic differences in drink alcohol content. Such information is important to understanding disparities and developing specific, targeted interventions. This study addresses these questions and examines disparities in specific types of alcohol problems across racial-gender groups. Using 2005 and 2010 National Alcohol Survey data (N = 7,249 current drinkers), gender-stratified regression analyses were conducted to assess black-white and Hispanic-white disparities in alcohol dependence and negative drinking consequences at equivalent levels of HD. HD was measured using a gender-specific, composite drinking-patterns variable derived through factor analysis. Analyses were replicated using adjusted-alcohol consumption variables that account for group differences in drink alcohol content based on race/ethnicity, gender, age, and alcoholic beverage. Compared with white men, black and Hispanic men had higher rates of injuries/accidents/health and social consequences, and marginally greater work/legal consequences (p racial/ethnic disparities. Interventions focused on reducing HD might not address disparities in alcohol-related problems that exist at low levels of HD. Future research should consider the potential role of environmental and genetic factors in these disparities. Copyright © 2014 by the Research Society on Alcoholism.
Marshall, Robert N; McNair, Peter J
Knee injuries in golf comprise approximately 8% of all injuries, and are considered to result from overuse, technical faults or a combination of those factors. This review examines factors involved in injury, including the structure of the knee joint, kinematics and kinetics of the golf swing, forces sustained by knee joint structures and the potential for joint injury as well as injury prevention strategies. The golf swing generates forces and torques which tend to cause internal or external rotation of the tibia on the femur, and these are resisted by the knee ligaments and menisci. Research has shown that both maximum muscle forces and the forces sustained during a golf swing are less than that required to cause damage to the ligaments. However, the complex motion of the golf swing, involving both substantial forces and ranges of rotational movement, demands good technique if the player is to avoid injuring their knee joint. Most knee injury in golf is likely related to joint laxity, previous injuries or arthritis, and such damage may be exacerbated by problems in technique or overuse. In addition to appropriate coaching, strategies to remedy discomfort include specific exercise programmes, external bracing, orthotics and equipment choices.
Stavrinos, Despina; Byington, Katherine W; Schwebel, David C
Early adolescents are using cell phones with increasing frequency. Cell phones are known to distract motor vehicle drivers to the point that their safety is jeopardized, but it is unclear if cell phones might also distract child pedestrians. This study was designed to examine the influence of talking on a cell phone for pediatric pedestrian injury risk. Seventy-seven children aged 10 to 11 years old completed simulated road crossings in an immersive, interactive virtual pedestrian environment. In a within-subjects design, children crossed the virtual street 6 times while undistracted and 6 times while distracted by a cell phone conversation with an unfamiliar research assistant. Participants also completed several other experimental tasks hypothesized to predict the impact of distraction while crossing the street and talking on a cell phone. Children's pedestrian safety was compromised when distracted by a cell phone conversation. While distracted, children were less attentive to traffic; left less safe time between their crossing and the next arriving vehicle; experienced more collisions and close calls with oncoming traffic; and waited longer before beginning to cross the street. Analyses testing experience using a cell phone and experience as a pedestrian yielded few significant results, suggesting that distraction on the cell phone might affect children's pedestrian safety no matter what their experience level. There was some indication that younger children and children who are less attentive and more oppositional may be slightly more susceptible to distraction while talking on the cell phone than older, more attentive, and less oppositional children. Our results suggest that cell phones distract preadolescent children while crossing streets.
Stavrinos, Despina; Byington, Katherine W; Schwebel, David C
Distraction on cell phones jeopardizes motor-vehicle driver safety, but few studies examine distracted walking. At particular risk are college students, who walk frequently in and near traffic, have increased pedestrian injury rates compared to other age groups, and frequently use cell phones. Using an interactive and immersive virtual environment, two experiments studied the effect of cell phone conversation on distraction of college student pedestrians. In the first, we examined whether pedestrians would display riskier behavior when distracted by a naturalistic cell phone conversation than when undistracted. We also considered whether individual difference factors would moderate the effect of the distraction. In a second experiment, we examined the impact of three forms of distraction on pedestrian safety: (a) engaging in a cell phone conversation, (b) engaging in a cognitively challenging spatial task by phone, and (c) engaging in a cognitively challenging mental arithmetic task by phone. Results revealed that cell phone conversations distracted college pedestrians considerably across all pedestrian safety variables measured, with just one exception. Attention to traffic was not affected by the naturalistic phone conversation in Experiment 1, but was altered by the cognitively-demanding content of some types of conversation in Experiment 2. The content of the conversation did not play a major role in distraction across other variables; both mundane and cognitively complex conversations distracted participants. Moreover, no significant associations between individual difference factors and susceptibility to distraction emerged. Results may inform researchers, policy makers, and pedestrians themselves. Educational campaigns might discourage telephone conversations in pedestrian environments. Copyright © 2011 Elsevier Ltd. All rights reserved.
van Seters, Christine; van Rijn, Rogier M; van Middelkoop, Marienke; Stubbe, Janine H
OBJECTIVE: To determine whether student characteristics, lower-extremity kinematics, and strength are risk factors for sustaining lower-extremity injuries in preprofessional contemporary dancers. DESIGN: Prospective cohort study. SETTING: Codarts University of the Arts. PATIENTS: Forty-five
Knapik, Joseph J; Spiess, Anita; Darakjy, Salima; Grier, Tyson; Manning, Fred; Livingston, Elaine; Swedler, David; Amoroso, Paul; Jones, Bruce H
...) of the Defense Safety Oversight Council (DSOC) to evaluate the parachute ankle brace (PAB). Information provided by the questionnaire identified potential injury risk factors and comments on the PAB...
Engdahl, Barbro; Ramstedt, Mats
A question that has not been addressed in the literature is whether the population level association between alcohol and harm differs between men and women. The main aim of this article is to fill this gap by analysing recently collected time series data of male and female self-reported drinking in relation to gender-specific harm indicators in Sweden. Male and female per capita and risk consumption was estimated on the basis of self-reported data from monthly alcohol surveys for the period 2002-07. Overall per capita consumption including recorded sales and estimates of unrecorded consumption were also collected for the same period. Alcohol-related hospitalizations were used as indicators of alcohol-related harm. Data were aggregated into quarterly observations and analysed by means of time series analyses (ARIMA-modelling). Overall per capita consumption was significantly related to both male and female alcohol-related hospitalizations. Male per capita consumption and risk consumption were also significantly related to alcohol-related hospitalizations among men. Female per capita consumption and risk consumption had also a positive association with alcohol-related hospitalizations but statistical significance was only reached for alcohol poisonings where the association was even stronger than for men. Changes in alcohol consumption in Sweden was associated with changes in male and female alcohol-related hospitalizations also in analyses based on gender-specific consumption measures. There was no clear evidence that the population level association between alcohol and harm differed between men and women.
Robinson, Mark; Siddall, Andrew; Bilzon, James; Thompson, Dylan; Greeves, Julie; Izard, Rachel; Stokes, Keith
Injuries sustained by military recruits during initial training impede training progression and military readiness while increasing financial costs. This study investigated training-related injuries and injury risk factors among British Army infantry recruits. Recruits starting infantry training at the British Army Infantry Training Centre between September 2008 and March 2010 were eligible to take part. Information regarding lifestyle behaviours and injury history was collected using the Military Pre-training Questionnaire. Sociodemographic, anthropometric, physical fitness and injury (lower limb and lower back) data were obtained from Army databases. Univariable and multivariable Cox regression models were used to explore the association between time to first training injury and potential risk factors. 58% (95% CI 55% to 60%) of 1810 recruits sustained at least 1 injury during training. Overuse injuries were more common than traumatic injuries (65% and 35%, respectively). The lower leg accounted for 81% of all injuries, and non-specific soft tissue damage was the leading diagnosis (55% of all injuries). Injuries resulted in 122 (118 to 126) training days lost per 1000 person-days. Slower 2.4 km run time, low body mass, past injury and shin pain were independently associated with higher risk of any injury. There was a high incidence of overuse injuries in British Army recruits undertaking infantry training. Recruits with lower pretraining fitness levels, low body mass and past injuries were at higher risk. Faster 2.4 km run time performance and minimal body mass standards should be considered for physical entry criteria.
von Rosen, P; Frohm, A; Kottorp, A; Fridén, C; Heijne, A
Many risk factors for injury are presented in the literature, few of those are however consistent and the majority is associated with adult and not adolescent elite athletes. The aim was to identify risk factors for injury in adolescent elite athletes, by applying a biopsychosocial approach. A total of 496 adolescent elite athletes (age range 15-19), participating in 16 different sports, were monitored repeatedly over 52 weeks using a valid questionnaire about injuries, training exposure, sleep, stress, nutrition, and competence-based self-esteem. Univariate and multiple Cox regression analyses were used to calculate hazard ratios (HR) for risk factors for first reported injury. The main finding was that an increase in training load, training intensity, and at the same time decreasing the sleep volume resulted in a higher risk for injury compared to no change in these variables (HR 2.25, 95% CI, 1.46-3.45, Pself-esteem increased the hazard for injury with 1.02 (HR 95% CI, 1.00-1.04, P=.01). Based on the multiple Cox regression analysis, an athlete having the identified risk factors (Risk Index, competence-based self-esteem), with an average competence-based self-esteem score, had more than a threefold increased risk for injury (HR 3.35), compared to an athlete with a low competence-based self-esteem and no change in sleep or training volume. Our findings confirm injury occurrence as a result of multiple risk factors interacting in complex ways. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Moran, Sebastian; Booker, Harry; Staines, Jacob; Williams, Sean
BACKGROUNDː CrossFit is a strength and conditioning programme that has gained widespread popularity since its inception approximately 15 years ago. However, at present little is known about the level of injury risk associated with this form of training. Movement competency, assessed using the Functional Movement Screen (FMS), has been identified as a risk factor for injury in numerous athletic populations, but its role in CrossFit participants is currently unclear. The aim of this study was t...
Premji, Stephanie; Smith, Peter M
To examine the association between education-to-job mismatch and work injury. Cross-sectional data from the 2003 and 2005 Canadian Community Health Surveys (n=63,462) were used to examine the relationship between having an educational level that is incongruent with occupational skills requirements and the risk of sustaining a work injury requiring medical attention or a work-related repetitive movement injury (RMI). The effect on injury of the interaction of overeducation with recent immigrant status was also examined. Models were stratified by sex and adjusted for possible confounders. Occupational physical demands were conceptualised as a potential mediating variable. After adjustment for covariates, over-education was associated with work injury and RMI for both sexes. Adjustment for occupational demands attenuated the impact on work injury but did not eliminate the effect on RMI among men. The interaction of over-education and recent immigrant status resulted among men in a fourfold increase in the odds of work injury compared with non-recent immigrants who were not over-educated. After adjustment for occupational demands, over-educated recent immigrant men still had more than a twofold increase in the odds of injury. The risk of sustaining a work injury is higher among those whose education exceeds that of job requirements. These findings highlight the need to address barriers to suitable employment, particularly among recent immigrants.
Fagher, Kristina; Forsberg, Anna; Jacobsson, Jenny; Timpka, Toomas; Dahlström, Örjan; Lexell, Jan
Our knowledge of sports-related injuries in para-sport is limited and there are no data on how Paralympic athletes themselves perceive an injury. The aim of this qualitative study was to explore Paralympic athletes' perceptions of their experiences of sports-related injuries, risk factors and preventive possibilities. Eighteen Swedish Paralympic athletes with vision impairment, intellectual impairment, spinal cord injury, cerebral palsy, myelomeningocele, dysplasia and neuromuscular disorder, representing 10 different para-sports, were interviewed. The qualitative phenomenographic method was used to interpret the data. The analysis revealed nine categories of perceptions of experiences. The athletes perceived that their impairments were involved in the cause and consequential chains associated with a sports-related injury. Other categories that denoted and described these injuries were: sport overuse, risk behaviour, functional limitations, psychological stressors, the normalised pain, health hazards, individual possibilities to prevent sports-related injuries and unequal prerequisites. This qualitative study revealed that Paralympic athletes' perceptions of their experiences of sports-related injuries are complex and multifactorial, and in several ways differ from able-bodied athletes. This needs to be considered in the sports health and safety work within the Paralympic Movement as well as in the design of future injury surveillance systems and preventive programmes.
Rice, Thomas M; Troszak, Lara; Ouellet, James V; Erhardt, Taryn; Smith, Gordon S; Tsai, Bor-Wen
Most studies find strong evidence that motorcycle helmets protect against injury, but a small number of controversial studies have reported a positive association between helmet use and neck injury. The most commonly cited paper is that of Goldstein (1986). Goldstein obtained and reanalyzed data from the Hurt Study, a prospective, on-scene investigation of 900 motorcycle collisions in the city of Los Angeles. The Goldstein results have been adopted by the anti-helmet community to justify resistance to compulsory motorcycle helmet use on the grounds that helmets may cause neck injuries due to their mass. In the current study, we replicated Goldstein's models to understand how he obtained his unexpected results, and we then applied modern statistical methods to estimate the association of motorcycle helmet use with head injury, fatal injury, and neck injury among collision-involved motorcyclists. We found Goldstein's analysis to be critically flawed due to improper data imputation, modeling of extremely sparse data, and misinterpretation of model coefficients. Our new analysis showed that motorcycle helmets were associated with markedly lower risk of head injury (RR 0.40, 95% CI 0.31-0.52) and fatal injury (RR 0.44, 95% CI 0.26-0.74) and with moderately lower but statistically significant risk of neck injury (RR 0.63, 95% CI 0.40-0.99), after controlling for multiple potential confounders. Copyright © 2016 Elsevier Ltd. All rights reserved.
Franettovich Smith, Melinda M; Bonacci, Jason; Mendis, M Dilani; Christie, Craig; Rotstein, Andrew; Hides, Julie A
To investigate if size and activation of the gluteal muscles is a risk factor for hamstring injuries in elite AFL players. Prospective cohort study. Twenty-six elite male footballers from a professional Australian Football League (AFL) club participated in the study. At the beginning of the season bilateral gluteus medius (GMED) and gluteus maximus (GMAX) muscle volume was measured from magnetic resonance images and electromyographic recordings of the same muscles were obtained during running. History of hamstring injury in the pre-season and incidence of hamstring injury during the season were determined from club medical data. Nine players (35%) incurred a hamstring injury during the season. History of hamstring injury was comparable between those players who incurred a season hamstring injury (2/9 players; 22%) and those who did not (3/17 players; 18%). Higher GMED muscle activity during running was a risk factor for hamstring injury (p=0.03, effect sizes 1.1-1.5). There were no statistically significant differences observed for GMED volume, GMAX volume and GMAX activation (P>0.05). This study identified higher activation of the GMED muscle during running in players who sustained a season hamstring injury. Whilst further research is required to understand the mechanism of altered muscle control, the results of this study contribute to the developing body of evidence that the lumbo-pelvic muscles may be important to consider in hamstring injury prevention and management. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Whittaker, Jackie L; Booysen, Nadine; de la Motte, Sarah; Dennett, Liz; Lewis, Cara L; Wilson, Dave; McKay, Carly; Warner, Martin; Padua, Darin; Emery, Carolyn A; Stokes, Maria
Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. 5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model). Of 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3-15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. Future research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted
Lin, Jiun-Nong; Lin, Cheng-Li; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Kao, Chia-Hung
Abstract The spleen is a crucial organ in humans. Little is known about the association between stroke and splenic injury or splenectomy. The aim of this study was to determine the risk of stroke in patients with splenic injury and splenectomy. A nationwide cohort study was conducted by analyzing the National Health Insurance Research Database in Taiwan. For comparison, control patients were selected and matched with splenic injury patients in a ratio of 4:1 according to age, sex, and the year of hospitalization. We analyzed the risks of stroke using a Cox proportional-hazards regression analysis. A total of 11,273 splenic injury patients, including 5294 splenectomized and 5979 nonsplenectomized patients, and 45,092 control patients were included in this study. The incidence rates of stroke were 8.05, 6.53, and 4.25 per 1000 person-years in splenic injury patients with splenectomy, those without splenectomy, and the control cohort, respectively. Compared with the control cohort, splenic injury patients with splenectomy exhibited a 2.05-fold increased risk of stroke (95% confidence interval [CI] 1.8–2.34), whereas those without splenectomy exhibited a 1.74-fold increased risk (95% CI 1.51–2). Splenectomy entailed an additional 1.21-fold increased risk of stroke compared with nonsplenectomy in patients with splenic injury. This study revealed that splenic injury and splenectomy were significantly associated with an increased risk of hemorrhagic and ischemic strokes. The results of this study may alert physicians and patients to the complications of splenic injury and splenectomy. PMID:26334909
Bradshaw, Elizabeth J; Hume, Patria A
Targeted injury prevention strategies, based on biomechanical analyses, have the potential to help reduce the incidence and severity of gymnastics injuries. This review outlines the potential benefits of biomechanics research to contribute to injury prevention strategies for women's artistic gymnastics by identification of mechanisms of injury and quantification of the effects of injury risk factors. One hundred and twenty-three articles were retained for review after searching electronic databases using key words, including 'gymnastic', 'biomech*', and 'inj*', and delimiting by language and relevance to the paper aim. Impact load can be measured biomechanically by the use of instrumented equipment (e.g. beatboard), instrumentation on the gymnast (accelerometers), or by landings on force plates. We need further information on injury mechanisms and risk factors in gymnastics and practical methods of monitoring training loads. We have not yet shown, beyond a theoretical approach, how biomechanical analysis of gymnastics can help reduce injury risk through injury prevention interventions. Given the high magnitude of impact load, both acute and accumulative, coaches should monitor impact loads per training session, taking into consideration training quality and quantity such as the control of rotation and the height from which the landings are executed.
Full Text Available Many workers worldwide experience fatality and disability caused by occupational injuries. This study examined the relationship between noise exposure and occupational injuries at factories in Korea. A total of 1790 factories located in northern Gyeonggi Province, Korea was evaluated. The time-weighted average levels of dust and noise exposure were taken from Workplace Exposure Assessment data. Apart occupational injuries, sports events, traffic accidents, and other accidents occurring outside workplaces were excluded. The incidences of occupational injury in each factory were calculated by data from the Korea Workers′ Compensation and Welfare Services. Workplaces were classified according to the incidence of any occupational injuries (incident or nonincident workplaces, respectively. Workplace dust exposure was classified as 90 dB. Workplaces with high noise exposure were significantly associated with being incident workplaces, whereas workplaces with high dust exposure were not. The odds ratios (95% confidence intervals derived from a logistic regression model were 1.68 (1.27-2.24 and 3.42 (2.26-5.17 at 80-89 dB and ≥90 dB versus <80 dB. These associations remained significant when in a separate analysis according to high or low dust exposure level. Noise exposure increases the risk of occupational injury in the workplace. Furthermore, the risk of occupational injury increases with noise exposure level in a dose-response relationship. Therefore, strategies for reducing noise exposure level are required to decrease the risk of occupational injury.
Laursen, Bjarne; Nielsen, Jeppe W
children for specific injury mechanisms and involved products. METHODS: Information on injuries in 173 504 children treated at emergency departments was recorded for the period 1998-2003. The information was linked to data including parents' education and income and family type, and the results were...... compared with those for a random sample of the population. RESULTS: A total of 50 561 injuries were analysed. The risk was 1.5 (1.5-1.6) for children with mothers having only primary education compared to tertiary education, and 1.5 (1.4-1.6) for children in families with the lowest vs. the highest income......BACKGROUND: While social differences in childhood injuries are recognized, less is known about how social and demographic differences relate to injury mechanism. The purpose of the study was to reveal how sociodemographic factors affect the incidence of unintentional home injuries in Danish...
Sharir, Raihana; Rafeeuddin, Radin; Staes, Filip; Dingenen, Bart; George, Keith; Vanrenterghem, Jos; Robinson, Mark A
Whilst many studies measure large numbers of biomechanical parameters and associate these to anterior cruciate ligament injury risk, they cannot be considered as anterior cruciate ligament injury risk factors without evidence from prospective studies. A review was conducted to systematically assess the in vivo biomechanical literature to identify biomechanical risk factors for non-contact anterior cruciate ligament injury during dynamic sports tasks; and to critically evaluate the research trends from retrospective and associative studies investigating non-contact anterior cruciate ligament injury risk. An electronic literature search was undertaken on studies examining in vivo biomechanical risk factors associated with non-contact anterior cruciate ligament injury. The relevant studies were assessed by classification; level 1 - a prospective cohort study, level 2 - a retrospective study or level 3 - an associative study. An initial search revealed 812 studies but this was reduced to 1 level 1 evidence study, 20 level 2 evidence studies and 175 level 3 evidence studies that met all inclusion criteria. Level 1 evidence showed that the knee abduction angle, knee abduction moment and ground reaction force were biomechanical risk factors. Nine level 2 studies and eighty-three level 3 studies used these to assess risk factors in their study. Inconsistencies in results and methods were observed in level 2 and 3 studies. There is a lack of high quality, prospective level 1 evidence related to biomechanical risk factors for non-contact anterior cruciate ligament injury. More prospective cohort studies are required to determine risk factors and provide improved prognostic capability. Copyright © 2016 Elsevier Ltd. All rights reserved.
Langran, Mike; Selvaraj, Sivasubramaniam
Inexperience predisposes skiers, snowboarders, and skiboarders to a higher risk of injury. Individuals on their very 1st day's experience of skiing, snowboarding, or skiboarding are at greater risk of injury. Case control study. All individuals injured at the three largest ski areas in Scotland during the three winter seasons 1999-2000 through 2001-2002 were included. First-day participants were identified. Individual demographic details and snow sports-related parameters were recorded. Control data were collected from uninjured individuals. Factors associated with injury were explored in univariate and multivariate analyses. First-day participants were overrepresented in the injured population by a factor of 2.2. Participant age younger than 17 years or older than 26 years, snowboarding, taking professional instruction, and the use of rented or borrowed gear were all independently associated with increased injury risk among 1st-day participants. First-day participants are at increased risk of injury. Several independent risk factors for injury have been identified. First-day participants should be targeted in any future educational programs with emphasis on gear selection, use of protective gear, and the risks of exceeding the limits of their ability.
Cantley, Linda F; Galusha, Deron; Cullen, Mark R; Dixon-Ernst, Christine; Tessier-Sherman, Baylah; Slade, Martin D; Rabinowitz, Peter M; Neitzel, Richard L
To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of 0.5, 1, 2, 3 kHz; PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz; PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk. Retrospective analysis. The study considered 9920 workers employed during 2003 to 2008. The cohort consisted of 8818 workers (89%) whose complete records were available. Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk. These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs.
unintentional injury to intentional injury in the home and school, alcohol-related injury and, finally the psycho-social impact of trauma and violence. The chapters are authored ... The discussion on intentional injury is subdivided into child maltreatment, sexual violence, bullying, violence in schools, gang involvement, children ...
Hunt, Kenneth J; George, Elizabeth; Harris, Alex H S; Dragoo, Jason L
To describe the incidence and risk factors for high ankle sprains (ie, syndesmosis injuries) among National Collegiate Athletic Association (NCAA) football players. Descriptive epidemiologic study. Data were examined from the NCAA's Injury Surveillance System (ISS) for 5 football seasons (from 2004-2005 to 2008-2009). All NCAA men's football programs participating in the ISS. No additional risk factors were introduced as a result of this analysis. For partial and complete syndesmosis injuries, outcome measures included incidence, time lost from participation, and requirement for surgical repair. The overall incidence of high ankle sprains in NCAA football players was 0.24 per 1000 athlete exposures, accounting for 24.6% of all ankle sprains. Athletes were nearly 14 times more likely to sustain the injury during games compared with practice; complete syndesmosis injuries resulted in significantly greater time lost compared with partial injuries (31.3 vs 15.8 days). Less than 3% of syndesmosis injuries required surgical intervention. There was a significantly higher injury incidence on artificial surfaces compared with natural grass. The majority of injuries (75.2%) occurred during contact with another player. Our data suggest a significantly higher incidence of syndesmosis injuries during games, during running plays, and to running backs and interior defensive linemen. The wide range in time lost from participation for complete syndesmosis injuries underscores the need for improved understanding of injury mechanism and classification of injury severity such that prevention, safe return to play protocols, and outcomes can be further improved.
Xiong, Lili; Zhu, Yao; Li, Liping
Background Motorcycle vehicles are frequent in China, especially in the small and medium sized cities. Road traffic collisions involving motorcycles often result in severe injuries. We aimed to identify risk factors for severe injuries in inpatients sustaining motorcycle collisions. Methods Patients with road traffic injuries involving motorcycles who presented to the neurosurgery and orthopedic departments of three major comprehensive hospitals in Shantou city were reviewed from October 2012 to June 2013. Data from 349 patients was investigated. Crash and injury characteristics were documented by interviewing patients, their family members, and their doctors. Binary logistic regression was used to determine risk factors for severe injuries. Results There were 253 males (72.49%) and 96 females (27.51%), with a male to female ratio of 2.64:1. The mean age was 38.21±17.32 years. One-hundred and fifty patients were in the severe injury group with a mean injury severity score (ISS) of 15.34±9.13. The simple and multiple logistic model showed that males, lack of safeguards, morning and night hours, non-urban areas, collision of a motorcycle with a cycle, ambulance transportation to hospital, admission to a neurosurgery department, lack of traffic control, unobstructed traffic, and poor visibility were all the risk factors. Conclusions This research highlights some problems: less helmet wearing in motorcyclists and cyclists, rural injuries being more serious than urban ones, and head injuries being the main diagnosis in severe injuries. The result of this research is predictable. If the safety equipment is required to be used, such as helmets, and the traffic environment is improved, such as traffic flow, medical resources to injuries and deaths is seasonable, then traffic safety will be improved and accidents will be reduced. PMID:29546203
Zech, Astrid; Wellmann, Kai
Current approaches regarding injury prevention focus on the transfer of evidence into daily practice. One promising approach is to influence attitudes and beliefs of players. The objective of this study was to record player’s perceptions on injury prevention. A survey was performed among players of one German high-level football (soccer) club. 139 professional and youth players between age 13 and 35 years completed a standardized questionnaire (response rate = 98%). It included categories with (1) history of lower extremity injuries, (2) perceptions regarding risk factors and (3) regularly used prevention strategies. The majority of players (84.2%) had a previous injury. 47.5% of respondents believe that contact with other players is a risk factor, followed by fatigue (38.1%) and environmental factors (25.9%). The relevance of previous injuries as a risk factor is differently perceived between injured (25%) and uninjured players (0.0%). Nearly all players (91.5%) perform stretching to prevent injuries, followed by neuromuscular warm up exercises (54.0%). Taping is used by 40.2% of previously injured players and 13.6% of players without a history of injuries. In conclusion, the perception of risk factors and performed preventive strategies are inconsistent with scientific evidence. Future transfer strategies should incorporate the players beliefs and attitudes. PMID:28459845
Full Text Available Current approaches regarding injury prevention focus on the transfer of evidence into daily practice. One promising approach is to influence attitudes and beliefs of players. The objective of this study was to record player's perceptions on injury prevention. A survey was performed among players of one German high-level football (soccer club. 139 professional and youth players between age 13 and 35 years completed a standardized questionnaire (response rate = 98%. It included categories with (1 history of lower extremity injuries, (2 perceptions regarding risk factors and (3 regularly used prevention strategies. The majority of players (84.2% had a previous injury. 47.5% of respondents believe that contact with other players is a risk factor, followed by fatigue (38.1% and environmental factors (25.9%. The relevance of previous injuries as a risk factor is differently perceived between injured (25% and uninjured players (0.0%. Nearly all players (91.5% perform stretching to prevent injuries, followed by neuromuscular warm up exercises (54.0%. Taping is used by 40.2% of previously injured players and 13.6% of players without a history of injuries. In conclusion, the perception of risk factors and performed preventive strategies are inconsistent with scientific evidence. Future transfer strategies should incorporate the players beliefs and attitudes.
Chorba, Rita S; Chorba, David J; Bouillon, Lucinda E; Overmyer, Corey A; Landis, James A
Athletes often utilize compensatory movement strategies to achieve high performance. However, these inefficient movement strategies may reinforce poor biomechanical movement patterns during typical activities, resulting in injury. This study sought to determine if compensatory movement patterns predispose female collegiate athletes to injury, and if a functional movement screening (FMS™) tool can be used to predict injuries in this population. Scores on the FMS™, comprised of seven movement tests, were calculated for 38 NCAA Division II female collegiate athletes before the start of their respective fall and winter sport seasons (soccer, volleyball, and basketball). Seven athletes reported a previous history of anterior cruciate ligament reconstruction (ACLR). Injuries sustained while participating in sport activities were recorded throughout the seasons. The mean FMS™ score and standard deviation for all subjects was 14.3±1.77 (maximum score of 21). Eighteen injuries (17 lower extremity, 1 lower back) were recorded during this study. A score of 14/21 or less was significantly associated with injury (P=0.0496). Sixty-nine percent of athletes scoring 14 or less sustained an injury. Odds ratios were 3.85 with inclusion of all subjects, and 4.58 with exclusion of ACLR subjects. Sensitivity and specificity were 0.58 and 0.74 for all subjects, respectively. A significant correlation was found between low-scoring athletes and injury (P=0.0214, r=0.76). A score of 14 or less on the FMS™ tool resulted in a 4-fold increase in risk of lower extremity injury in female collegiate athletes participating in fall and winter sports. The screening tool was able to predict injury in female athletes without a history of major musculoskeletal injury such as ACLR. Compensatory fundamental movement patterns can increase the risk of injury in female collegiate athletes, and can be identified by using a functional movement screening tool.
Howell, David R; Lynall, Robert C; Buckley, Thomas A; Herman, Daniel C
An emerging area of research has identified that an increased risk of musculoskeletal injury may exist upon returning to sports after a sport-related concussion. The mechanisms underlying this recently discovered phenomenon, however, remain unknown. One theorized reason for this increased injury risk includes residual neuromuscular control deficits that remain impaired despite clinical recovery. Thus, the objectives of this review were: (1) to summarize the literature examining the relationship between concussion and risk of subsequent injury and (2) to summarize the literature for one mechanism with a theorized association with this increased injury risk, i.e., neuromuscular control deficits observed during gait after concussion under dual-task conditions. Two separate reviews were conducted consistent with both specified objectives. Studies published before 9 December, 2016 were identified using PubMed, Web of Science, and Academic Search Premier (EBSCOhost). Inclusion for the objective 1 search included dependent variables of quantitative measurements of musculoskeletal injury after concussion. Inclusion criteria for the objective 2 search included dependent variables pertaining to gait, dynamic balance control, and dual-task function. A total of 32 studies were included in the two reviews (objective 1 n = 10, objective 2 n = 22). According to a variety of study designs, athletes appear to have an increased risk of sustaining a musculoskeletal injury following a concussion. Furthermore, dual-task neuromuscular control deficits may continue to exist after patients report resolution of concussion symptoms, or perform normally on other clinical concussion tests. Therefore, musculoskeletal injury risk appears to increase following a concussion and persistent motor system and attentional deficits also seem to exist after a concussion. While not yet experimentally tested, these motor system and attentional deficits may contribute to the risk of sustaining a
Tolouei, Reza; Maher, Mike; Titheridge, Helena
This paper introduces a novel methodology based on disaggregate analysis of two-car crash data to estimate the partial effects of mass, through the velocity change, on absolute driver injury risk in each of the vehicles involved in the crash when absolute injury risk is defined as the probability of injury when the vehicle is involved in a two-car crash. The novel aspect of the introduced methodology is in providing a solution to the issue of lack of data on the speed of vehicles prior to the crash, which is required to calculate the velocity change, as well as a solution to the issue of lack of information on non-injury two-car crashes in national accident data. These issues have often led to focussing on relative measures of injury risk that are not independent of risk in the colliding cars. Furthermore, the introduced methodology is used to investigate whether there is any effect of vehicle size above and beyond that of mass ratio, and whether there are any effects associated with the gender and age of the drivers. The methodology was used to analyse two-car crashes to investigate the partial effects of vehicle mass and size on absolute driver injury risk. The results confirmed that in a two-car collision, vehicle mass has a protective effect on its own driver injury risk and an aggressive effect on the driver injury risk of the colliding vehicle. The results also confirmed that there is a protective effect of vehicle size above and beyond that of vehicle mass for frontal and front to side collisions. Copyright © 2012 Elsevier Ltd. All rights reserved.
Merrill, R M; Thygerson, S M; Palmer, C A
We identify the risk of selected types of injuries among patients with ADHD or ADHD and comorbid mental illness. We also assess whether selected medications used by patients with ADHD increase the risk of comorbid mental illness or influence the association between ADHD and injury. A retrospective cohort study design was conducted using medical claims data from the Deseret Mutual Benefit Administrators (DMBA). ADHD diagnosis, injury, medication, and demographic data were extracted from claims files during 2001-2013. Rate ratios were adjusted for age, sex, and calendar year. Patients with ADHD were 7.9 (95% CI 7.6-8.2) times more likely to have psychosis, 5.5 (3.9-7.8) times more likely to have alcohol- or drug-induced psychosis, and 6.0 (5.9-6.2) times more likely to have neurotic or personality disorder. Therapy with amphetamine was positively associated with neurotic or personality disorder (rate ratio=1.08, 1.02-1.15); methylphenidate was negatively associated with neurotic or personality disorder (0.90, 0.84-0.97); and atomoxetine was positively associated with psychosis (1.33, 1.21-1.46), alcohol- or drug-induced psychosis (2.38, 1.04-5.43), and neurotic or personality disorder (2.38, 1.04-5.43). ADHD was associated with an increased risk of injury, with ADHD and comorbid mental illness having a stronger increased risk of injury. Psychostimulants ameliorated the increased risk of injury for patients with ADHD. Patients with ADHD have an increased risk of injury, significantly more so for those with ADHD and comorbid mental illness. Psychostimulants can lower the risk of injury among patients with ADHD. © Georg Thieme Verlag KG Stuttgart · New York.
Onate, James A; Everhart, Joshua S; Clifton, Daniel R; Best, Thomas M; Borchers, James R; Chaudhari, Ajit M W
A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk in a prospective setting, and (2) critically assess the methodological quality of prospective lower extremity risk assessment studies that use these tools. A systematic search was performed in PubMed, CINAHL, UptoDate, Google Scholar, Cochrane Reviews, and SportDiscus. Inclusion criteria were prospective injury risk assessment studies involving athletes primarily ages 13 to 19 that used screening methods that did not require highly specialized equipment. Methodological quality was evaluated with a modified physiotherapy evidence database (PEDro) scale. Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5-6.1; P < 0.05) and physical maturation status (P < 0.05) were predictive of overall injury risk, knee hyperextension was predictive of anterior cruciate ligament injury (OR, 5.0; CI, 1.2-18.4; P < 0.05), hip external:internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle sprain (r = -0.339, P = 0.008). Minimal prospective evidence supports or refutes the use of the functional musculoskeletal exam portion of the current PPE to assess lower extremity injury risk in high school athletes. Limited evidence does support inclusion of multidirectional balance assessment and physical maturation status in a musculoskeletal exam as both are generalizable risk factors for lower extremity injury.
Li, Hongmei; Moreland, Jennifer J; Peek-Asa, Corinne; Yang, Jingzhen
Psychological risk factors are increasingly recognized as important in sport-related injury prevention. Understanding how these psychological factors may affect the risk of injuries could help design effective prevention programs. To determine the effect of reported preseason anxiety and depressive symptoms on the risk of injuries during a prospective season in a cohort of collegiate athletes. Cohort study; Level of evidence, 2. Collegiate athletes participating in 4 men's sports and 5 women's sports from 2 National Collegiate Athletic Association (NCAA) Division I universities were enrolled and prospectively followed during the 2007-2011 seasons. Preseason anxiety and depressive symptoms were measured at enrollment. Injuries occurring during the season were reported by certified athletic trainers. The injury incidence rate was calculated as the total number of injuries divided by the total number of athlete-exposures (ie, games and practices). Of 958 enrolled athletes (response rate of 90.3%), 389 (40.6%) athletes sustained a total of 597 injuries. At preseason, 276 (28.8%) athletes reported anxiety symptoms, and 208 (21.7%) reported depressive symptoms. Among athletes reporting any of these symptoms, 48.5% (n = 158) reported having both anxiety and depressive symptoms. Athletes with preseason anxiety symptoms had a significantly higher injury incidence rate compared with athletes without anxiety symptoms (rate ratio [RR], 2.3; 95% CI, 2.0-2.6), adjusting for age, race, body mass index, history of injuries 12 months before baseline, and university attended, and this was observed for both male and female athletes. Only male athletes who reported co-occurring preseason depressive and anxiety symptoms had a significantly increased injury risk (RR, 2.1; 95% CI, 1.6-2.6) compared with male athletes who reported no co-occurring symptoms. However, no such increase in the injury risk was observed among female athletes or male athletes who reported preseason depressive
Vitale, Jacopo A; Bassani, Tito; Galbusera, Fabio; Bianchi, Alberto; Martinelli, Nicolò
Previous studies attempted to identify possible risk factors for acute and overuse injuries in several sports disciplines such as running, gymnastics or team sports. Given the lack of scientific works focused on risk factors for lower limb injuries in martial arts, the present study was aimed to investigate foot anatomy, anthropometric measures, and other background information as possible risk factors of injury in barefoot athletes practicing judo, karate, kung fu, thai boxe, or aikido. In addition, the injury rates were evaluated in relation with the different martial art styles. One group of 130 martial artists was retrospectively evaluated. Data of three foot morphological variables were collected: navicular height (NH), navicular drop (ND) and the rear foot (RF). In addition, each participant filled an interview questionnaire providing the following information: age, sex, body weight, height, BMI, hours of training per week, the kind of injury occurred to the lower limbs in the preceding year. Of 130 subjects, 70 (53.8%) did not sustain injuries, 35 (27.0%) suffered an acute injury and the remaining 25 (19.2%) reported an overuse injury. No significant differences were observed in the injury rates in relation to style and kind of martial art. Age, training volume and BMI were found as significant predictors of injury, while NH, ND and RF were not able to predict acute or overuse injury at lower limbs. The injury rates were similar in karate, judo, kung fu, aikido, and thai boxe. The foot morphology variables were not related with the presence or absence of acute and overuse injuries. Conversely, older and heavier martial artists, performing more hours of barefoot training, are at higher risk of acute and overuse injury. Athletic trainers should strongly take into account the present information in order to develop more accurate and specific injury prevention programs for martial artists.
This project developed methods to more accurately identify alcohol-related crash hot spots, ultimately allowing for more effective and efficient enforcement and safety campaigns. Advancements in accuracy came from improving the calculation of spatial...
Richardson, E.A.; Hill, S.E.; Mitchell, R.; Pearce, J.; Shortt, N.K.
Alcohol consumption may be influenced by the local alcohol retailing environment. This study is the first to examine neighbourhood alcohol outlet availability (on- and off-sales outlets) and alcohol-related health outcomes in Scotland. Alcohol-related hospitalisations and deaths were significantly higher in neighbourhoods with higher outlet densities, and off-sales outlets were more important than on-sales outlets. The relationships held for most age groups, including those under the legal minimum drinking age, although were not significant for the youngest legal drinkers (18–25 years). Alcohol-related deaths and hospitalisations were higher in more income-deprived neighbourhoods, and the gradient in deaths (but not hospitalisations) was marginally larger in neighbourhoods with higher off-sales outlet densities. Efforts to reduce alcohol-related harm should consider the potentially important role of the alcohol retail environment. PMID:25840352
Kedir, Abdu; Berg-Beckhoff, Gabriele; Stock, Christiane
Background: This study examined the associations between distance from residence to the nearest alcohol outlet with alcohol consumption as well as with alcohol-related harm. Methods: Data on alcohol consumption, alcohol-related harm and sociodemographics were obtained from the 2011 Danish Drug...... and Alcohol Survey (n=5133) with respondents aged 15–79 years. The information on distances from residence to the nearest alcohol outlets was obtained from Statistics Denmark. Multiple logistic and linear regressions were used to examine the association between distances to outlets and alcohol consumption...... whereas alcohol-related harm was analysed using negative binomial regression. Results: Among women it was found that those living closer to alcohol outlets were more likely to report alcohol-related harm (p
Brumbelow, Matthew L; Teoh, Eric R
A 2009 study by the Insurance Institute for Highway Safety found that midsize SUVs with stronger roofs, as measured in quasi-static tests, had lower risk of ejection and lower risk of injury for nonejected drivers. The objective of the present study was to determine whether a similar association exists for other vehicle groups. Twelve small passenger cars were evaluated according to Federal Motor Vehicle Safety Standard 216 test conditions. Crash databases in 14 states provided more than 20,000 single-vehicle rollover crashes involving these vehicles. Logistic regression analyses were used to evaluate the effect of roof strength on the rate of driver injury while assessing and controlling for the effects of driver age, vehicle stability, state, and other factors where necessary. Small cars with stronger roofs had lower overall rates of serious injury, lower rates of ejection, and lower rates of injury for nonejected drivers. Although the effect on ejection was somewhat smaller for cars than for SUVs, the overall pattern of injury results was consistent. For roof strength-to-weight ratio measured within 5 in. (SWR(5)), a one-unit increase (e.g., from 2.0 to 3.0) was associated with a 22 percent reduction in risk of incapacitating or fatal driver injury in single-vehicle rollovers. This compares with a 24 percent reduction estimated for a similar change in roof strength among midsize SUVs. The association between vehicle roof strength and occupant injury risk in rollover crashes appears robust across different vehicle groups and across roof SWR(5) values, varying from just more than 1.5 to just less than 4.0. If roofs were to increase in strength by one SWR(5), a 20-25 percent reduction in risk of serious injury in rollovers would be expected. Still, even if all vehicle roofs were as strong as the strongest roof measured, many rollover injuries still would occur, indicating the need for additional research and countermeasures.
Reiter Randy B
Full Text Available Abstract Background In recent years, national and global mortality data have been characterized in terms of well-established risk factors. In this regard, alcohol consumption has been called the third leading "actual cause of death" (modifiable behavioral risk factor in the United States, after tobacco use and the combination of poor diet and physical inactivity. Globally and in various regions of the world, alcohol use has been established as a leading contributor to the overall burden of disease and as a major determinant of health disparities, but, to our knowledge, no one has characterized alcohol-related harm in such broad terms at the local level. We asked how alcohol-related premature mortality in San Francisco, measured in years of life lost (YLLs, compares with other well-known causes of premature mortality, such as ischemic heart disease or HIV/AIDS. Methods We applied sex- and cause-specific population-attributable fractions (PAFs of years of life lost (YLLs from the Global Burden of Disease Study to 17 comparable outcomes among San Francisco males and females during 2004-2007. We did this in three ways: Method 1 assumed that all San Franciscans drink like populations in developed economies. These estimates were limited to alcohol-related harm. Method 2 modified these estimates by including several beneficial effects. Method 3 assumed that Latino and Asian San Franciscans drink alcohol like populations in the global regions related to their ethnicity. Results By any of these three methods, alcohol-related premature mortality accounts for roughly a tenth of all YLLs among males. Alcohol-related YLLs among males are comparable to YLLs for leading causes such as ischemic heart disease and HIV/AIDS, in some instances exceeding them. Latino and black males bear a disproportionate burden of harm. Among females, for whom estimates differed more by method and were smaller than those for males, alcohol-related YLLs are comparable to leading
Teyhen, Deydre S; Shaffer, Scott W; Butler, Robert J; Goffar, Stephen L; Kiesel, Kyle B; Rhon, Daniel I; Williamson, Jared N; Plisky, Phillip J
Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy. Understanding intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskeletal injury and maintaining operational military readiness. Findings from this population may also be useful as hypothesis-generating work for particular civilian settings such as law enforcement officers (SWAT teams), firefighters (smoke jumpers), or others in physically demanding professions. The purposes of this study were (1) to examine whether using baseline measures of self-report and physical performance can identify musculoskeletal injury risk; and (2) to determine whether a combination of predictors would enhance the accuracy for determining future musculoskeletal injury risk in US Army Rangers. Our study was a planned secondary analysis from a prospective cohort examining how baseline factors predict musculoskeletal injury. Baseline predictors associated with musculoskeletal injury were collected using surveys and physical performance measures. Survey data included demographic variables, injury history, and biopsychosocial questions. Physical performance measures included ankle dorsiflexion, Functional Movement Screen, lower and upper quarter Y-balance test, hop testing, pain provocation, and the Army Physical Fitness Test (consisting of a 2-mile run and 2 minutes of sit-ups and push-ups). A total of 320 Rangers were invited to enroll and 211 participated (66%). Occurrence of musculoskeletal injury was tracked for 1 year using monthly injury surveillance surveys, medical record reviews, and a query of the Department of Defense healthcare utilization database. Injury surveillance data were available on 100% of the subjects. Receiver operator characteristic curves and accuracy statistics were calculated to identify predictors of interest. A logistic regression equation was then calculated to find the most pertinent
Foster, Dawn W.; Neighbors, Clayton; Prokhorov, Alexander
The current study seeks to evaluate relationships between drinking motives and alcohol-related ambivalence in the prediction of problem drinking. We expected that: 1) main effects would emerge such that alcohol-related ambivalence would be positively associated with peak drinking and problems; drinking motives would be positively associated with drinking and problems, and 2) interactions would emerge between motives and ambivalence in predicting problematic drinking such that drinking motives...
Woud, M.L.; Hutschemaekers, M.H.M.; Rinck, M.; Becker, E.S.
Background and objectives: There is a large body of evidence demonstrating that alcohol abuse and misuse is characterized by alcohol-related interpretation biases (IBs). The present study tested whether alcohol-related IBs can be trained, and whether this has an effect on alcohol-related
von Heideken, Johan; Svensson, Tobias; Iversen, Maura; Ekbom, Anders; Janarv, Per-Mats
Background: A child who suffers a fracture or a soft-tissue injury at a young age faces an increased risk of subsequent injuries during childhood. This risk could be related to personal and family characteristics or to lower-than-average bone-mineral density. The purpose of this nationwide cohort study was to estimate the association between a femur shaft fracture at a young age and the subsequent risk of hospitalization for injuries during childhood. Methods: We compared the subsequent risk ...
Pek, Simon; Turner, Nick; Tucker, Sean; Kelloway, E Kevin; Morrish, Jayne
Injunctive safety norms (ISNs) refer to perceptions of others' expectations of one's safety-related conduct. Drawing on a sample of Canadian young workers (n=11,986;M age=17.90years; 55% males), we study the relationships among four sources of non-work-related (i.e., parents, siblings, friends, teachers), two sources of work-related (i.e., supervisors, co-workers) ISNs, young workers' self-reported work-related risk-taking behaviors, and workplace injuries. Structural equation modeling suggests that ISNs from parents, supervisors, and co-workers were related to less frequent work-related risk-taking behaviors, and with fewer workplace injuries via less frequent work-related risk-taking behaviors. In addition, ISNs from supervisors were directly associated with fewer workplace injuries. In contrast, ISNs from teachers and siblings were not associated with work-related risk-taking behaviors, but ISNs from siblings were associated with fewer work injuries. Finally, ISNs from friends were associated with more frequent work-related risk-taking and more frequent work injuries via more frequent work-related risk-taking. This study draws attention to the relative roles of non-work sources of social influence and provides some evidence of how ISNs might be related to young workers' work-related risk-taking behaviors and their workplace injuries. It also contributes to practice by suggesting specific interventions that parents, supervisors, and co-workers could undertake to reduce young workers' work-related risk-taking and workplace injuries, namely encouraging youth to be safe at work. Copyright © 2017 Elsevier Ltd. All rights reserved.
Dvorak, Robert D; Sargent, Emily M; Kilwein, Tess M; Stevenson, Brittany L; Kuvaas, Nicholas J; Williams, Thomas J
Understanding factors associated with alcohol-related consequences is an important area of research. Emotional functioning has been associated with alcohol-related consequences but there is less research examining a comprehensive underlying model of emotional regulation. The Difficulties in Emotion Regulation Scale (DERS) is a recent measure developed to assess six facets of emotion regulation difficulties that contribute to overall emotional functioning. The current study examines associations between these six facets of emotion regulation difficulties and problematic alcohol use. Participants (n = 1758 college students) were recruited as part of a larger study and were asked to complete online questionnaires assessing demographics, alcohol use and problems, and emotion regulation difficulties. Negative binomial hurdle models for alcohol use and alcohol-related consequences were estimated. Impulse control difficulties were positively related to the number of drinks consumed during the week among active drinkers. Non-acceptance of emotional responses, impulse control difficulties, lack of emotional clarity, and difficulties engaging in goal-directed behavior were all positively associated with number of consequences endorsed. Difficulty engaging in goal-directed behavior was also positively associated with the likelihood of experiencing any alcohol-related consequences. The findings support previous research indicating that emotion-regulation difficulties are broadly associated with alcohol-related consequences. Results suggest exposure and/or mindfulness based prevention/interventions with emotion focused psychoeducation may offer one path to reducing alcohol-related consequences among college students.
O'Brien, Kerry S; Forrest, Walter; Greenlees, Iain; Rhind, Daniel; Jowett, Sophia; Pinsky, Ilana; Espelt, Albert; Bosque-Prous, Marina; Sonderlund, Anders Larrabee; Vergani, Matteo; Iqbal, Muhammad
There is no research examining alcohol-related aggression and anti-social behaviour in UK or European sportspeople (athletes), and no research has examined relationships between masculinity, alcohol consumption, and alcohol-related aggression and antisocial behaviour in sportspeople (athletes). This study addresses this gap. Cross-sectional. A sample (N=2048; women=892, 44%) of in season sportspeople enrolled at UK universities (response 83%), completed measures of masculinity, alcohol consumption, within-sport (on-field) violence, and having been the perpetrator and/or victim of alcohol-related violent/aggressive and antisocial behaviour (e.g., hit/assaulted, vandalism, sexual assault). Logistic regressions examined predictors of alcohol-related violence/aggression and anti-social behaviours. Significant bivariate relationships between masculinity, within-sport violence, alcohol consumption, and alcohol-related aggression and anti-social behaviour were found for both men and women (p'smasculinity and alcohol consumption in men and women were related to an increased odds of having conducted an aggressive, violent and/or anti-social act in the past 12 months when intoxicated. Odds ratios were largest for relationships between masculinity, alcohol consumption, within-sport violence, and interpersonal violence/aggression (p'smasculinity and excessive drinking. Interventions that reduce excessive alcohol consumption, masculine norms and associated within-sport violence, could be effective in reducing alcohol-related aggression and antisocial behaviour in UK sportspeople. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Mainwaring, Lynda M; Finney, Caitlin
Historically, dance medicine and science has focused on the physical aspects rather than the psychological aspects of dance injury. Psychological variables, however, have been shown to influence the occurrence of injury and post-injury outcomes. The purpose of this review was to examine the dance psychology literature and determine the specific psychological factors reported to be associated with the incidence, frequency, and outcome of dance injuries. A systematic literature search was conducted using SPORTDiscus, MEDLINE, CINAHL, and PsycINFO. All retrieved articles were screened based on criteria developed a priori, and selected articles were subsequently assessed for quality. Thirteen studies met the inclusion and quality assessment criteria. Psychological factors associated with both risk and outcome of dance injury included the following: stress, psychological distress, disordered eating, and coping. Factors associated only with risk of injury were sleep, personality, and social support. The results suggest that psychological variables can affect both the incidence and outcome of dance injury among dancers. Therefore, it is critical to gain a well-rounded, thorough understanding of all the factors, including psychological, that have a negative impact on dancers with respect to dance injury. The findings are discussed in terms of the utility of including psychological assessment and intervention, such as cognitive behavioral therapy, when implementing preventative and treatment measures in dance schools and companies.
Full Text Available Intracranial hemorrhage (ICH after traumatic brain injury (TBI commonly increases in size and coagulopathy has been implicated in such progression. Our aim is to perform a meta-analysis to assess their relationship. Cochrane library, PubMed, and EMBASE were searched for literatures. Pooled effect sizes and 95% confidential intervals (CIs were calculated using random-effects model. We included six studies, involving 1700 participants with 540 progressive hemorrhagic injuries (PHIs. Our findings indicate that PT, D-dimer level, and INR value are positively associated with the risk of PHI. Higher level of PLT and Fg seemed to suggest a lower risk of PHI. Among these parameters, higher D-dimer level and INR value would possess more powerful strength in predicting PHI.
Hu, Jia; Xia, Qinghua; Jiang, Yu; Zhou, Peng; Li, Yuhua
The aims of the study were to explore the characteristics and the potential risk factors of indoor fall injuries in community-dwelling older women, and to provide evidence for the future intervention strategy. A prospective cohort of 3043 women aged 60 years old and above from 3 selected counties in Shanghai was followed up on the outcomes of indoor fall injuries for up to 1 year. Demographic and health data were collected during admission; the physical function, balance ability and home-living environment were examined by a structured questionnaire when admitted. The outcome of indoor fall injury was investigated by a visit in month 3, month 6 and month 12 after baseline survey. Univariate analysis and Multiple Logistic Regression Model were used to examine the associations between potential risk factors and outcomes of indoor fall injuries. Two hundred and thirty-one of the 3043 women (7.6%) eventually suffered indoor fall injuries at least once during the 1-year follow-up. The injurious falls of women were significantly associated with age, educational level, marital status, health status, balance ability, physical activity and home-living environment in the univariate analyses. Women who worried about falls and restrained activities for it were more likely to suffer fall injury. Younger women, with less chronic disease, with good balance ability and living in good corridor environment, were less likely to receive fall injury in multiple logistic regression analyses. Multidimensional factors were associated with indoor fall injuries for community-dwelling older women. Proper clinical treatment of chronic disease and improvement of women's balance ability, as well as reducing the risk factor of indoor environment, which will play vital roles in preventing indoor fall injuries, should be prioritized for the intervention strategy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
June T Spector
Full Text Available Recent research suggests that heat exposure may increase the risk of traumatic injuries. Published heat-related epidemiological studies have relied upon exposure data from individual weather stations.To evaluate the association between heat exposure and traumatic injuries in outdoor agricultural workers exposed to ambient heat and internal heat generated by physical activity using modeled ambient exposure data.A case-crossover study using time-stratified referent selection among 12,213 outdoor agricultural workers with new Washington State Fund workers' compensation traumatic injury claims between 2000 and 2012 was conducted. Maximum daily Humidex exposures, derived from modeled meteorological data, were assigned to latitudes and longitudes of injury locations on injury and referent dates. Conditional logistic regression was used to estimate odds ratios of injury for a priori daily maximum Humidex categories.The mean of within-stratum (injury day and corresponding referent days standard deviations of daily maximum Humidex was 4.8. The traumatic injury odds ratio was 1.14 (95% confidence interval 1.06, 1.22, 1.15 (95% confidence interval 1.06, 1.25, and 1.10 (95% confidence interval 1.01, 1.20 for daily maximum Humidex of 25-29, 30-33, and ≥34, respectively, compared to < 25, adjusted for self-reported duration of employment. Stronger associations were observed during cherry harvest duties in the June and July time period, compared to all duties over the entire study period.Agricultural workers laboring in warm conditions are at risk for heat-related traumatic injuries. Combined heat-related illness and injury prevention efforts should be considered in high-risk populations exposed to warm ambient conditions in the setting of physical exertion.
Kochi, Masato; Hori, Shigeaki
The authors conducted a retrospective analysis of the risk factors of intracranial traumatic lesions in elderly patients with minor head injury. Sixty-nine elderly patients with Glasgow Coma Scale (GCS) scores of 13-15 after head injury who had presented within 24 hours of trauma and admitted to hospital were included in this study. The indications for admission were a GCS score of 13 or 14 on presentation, loss of consciousness, retrograde or posttraumatic amnesia, local neurological deficit, severe headache and vomiting, dangerous mechanism of injury, skull fracture and abnormal CT findings. The relationship between the clinical findings and intracranial traumatic lesions was analized by univariate and multivariate analysis. The relationship between the clinical findings and surgical intervention was also analized by the same methods in those who had intracranial traumatic lesions. The mean and median age of patients were 81.1 and 83 years, respectively. Of 69 patients, 41 had intracranial traumatic lesions present on their CT scan. Of these, 6 needed surgical intervention. Multivariable logistic regression analysis showed that a Glasgow Coma Scale score of 13 and a loss of consciousness at injury were identified as independent risk factors of intracranial traumatic lesions in elderly patients with minor head injury and a dangerous mechanism of injury was identified as an independent risk factor of surgical intervention in those who had traumatic intracranial lesions. Our results offer useful information for evaluating patients with minor head injury in Japan's aging society. (author)
Rauh, Mitchell J
Prospective cohort. To examine the relationship between summer training practices and risk of injury during the first month of a high school interscholastic cross-country season. Several prospective studies have reported a high incidence of injury in adolescent cross-country runners. However, limited reports exist on the role of summer training practices and risk of injury among these runners. Four hundred twenty-one athletes (186 girls, 235 boys) who competed in interscholastic cross-country were followed during a cross-country season. At the start of the season, all participants completed a questionnaire regarding summer training routines. Time-loss, running-related injuries were tracked during the subsequent season. Logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of initial injury during the first month of the season associated with summer training variables. Sixty-seven runners (15.9%) had a confirmed injury during the first month of the season, with a higher percent among girls (19.4%) than boys (13.2%) (P = .06). Overall, 60.1% of the participants ran during the summer prior to the season, with a significantly higher percent among girls (71.5%) than boys (51.1%) (Ptraining. Running 8 weeks or fewer (P = .03), not frequently alternating mileage on different days (P = .01), and running a higher percentage of time on predominantly hill (P = .001) and irregular terrains (P = .004) were associated with increased risk of injury for girls. These findings suggest that injuries during the first month of the high school cross-country season may be reduced if runners who participate in summer training activities run a greater number of weeks and frequently vary their daily running mileage during the summer. For girls, training programs that reduce mileage on hills and irregular terrains may help to minimize the occurrence of running-related injury. Prognosis, level 1b-.
Hagel, Brent E; Romanow, Nicole T R; Enns, Nancy; Williamson, Jacqueline; Rowe, Brian H
Bicycling is the most common cause of sports and recreation injury in children and adolescents; yet, there is limited evidence on the factors associated with severe bicycling injuries in youth. Case-control study of injured bicyclists less than 18 years old seen in seven emergency departments (EDs) from May 2008 to October 2010. Cases were bicyclists hospitalized after their ED visit (severe injury). Controls were bicyclists seen and discharged from the ED (non-severe injury). Personal, environmental, and crash characteristics were collected by interview. Injury data were collected from medical charts. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression were used to estimate the odds of hospitalization associated with risk factors. Multiple imputation techniques were employed to address missing data. There were 1470 participants including 119 cases. Those ages 13-17 had the highest proportion (23%) of severe injuries resulting from motor vehicle [MV] collision. In models including age, sex and MV collision, being male (OR: 2.02; 95% CI: 1.21-3.38), not wearing a helmet (OR: 2.18; 95% CI: 1.43-3.31) and MV collision (OR: 3.91; 95% CI: 2.26-6.78) were significant risk factors for severe injury. Riding on a paved surface (OR: 0.63; 95% CI: 0.41-0.97) and utilitarian (school, work) bicycling (OR: 0.44; 95% CI: 0.2-0.94) decreased injury risk. Results were similar, apart from utilitarian bicycling (OR: 0.49; 95% CI: 0.22-1.06), after imputation for missing data. Bicycle-MV collisions increase severe injury risk in youth, and adolescents are often injured in these events. This suggests separating bicyclists from MVs or traffic calming strategies could improve safety. Copyright © 2015 Elsevier Ltd. All rights reserved.
Lin, Jiun-Nong; Chen, Hsuan-Ju; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Kao, Chia-Hung
The spleen is a crucial organ in humans. However, little is known about the association of venous thromboembolism (VTE) with splenic injury and splenectomy in trauma patients. The aim of this study was to determine the subsequent risk of VTE following splenic injury and splenectomy. A nationwide retrospective cohort study was conducted by analysing data from the National Health Insurance Research Database in Taiwan. We included 6,162 splenic injury patients (3,033 splenectomised and 3,129 nonsplenectomised patients) and 24,648 comparison patients who were selected by frequency match based on sex, age, and the index year during 2000-2006. All patients were followed until the occurrence of VTE, 31 December, 2011, death, or withdrawal from the insurance program. The age of patients with splenic injury was 41.93 ± 16.44 years. The incidence rates of VTE were 11.81, 8.46, and 5.21 per 10,000 person-years in the splenic injury patients with splenectomy, splenic injury patients without splenectomy, and comparison patients, respectively. Compared with the comparison cohort, splenic injury patients with splenectomy exhibited a 2.21-fold risk of VTE (95% confidence interval [CI], 1.43-3.43), whereas those without splenectomy exhibited a 1.71-fold risk of VTE (95% CI, 1.05-2.80). The overall incidence rate of VTE was 1.97-fold higher in the splenic injury cohort than the comparison cohort (95% CI, 1.38-2.81). Although splenectomy increased the risk of VTE 1.35-fold compared with no splenectomy, the difference was not statistically significant (95% CI, 0.74-2.45). These results may alert physicians and patients to the complications of splenic injury and splenectomy.
Balazs, George C; Pavey, Gabriel J; Brelin, Alaina M; Pickett, Adam; Keblish, David J; Rue, John-Paul H
The effect of synthetic playing surfaces on the risk of injury in athletes is frequently debated in the orthopaedic literature. Biomechanical studies have identified increased frictional force at the shoe-surface interface, theoretically increasing the risk of injury relative to natural grass. This increase in frictional force is potentially relevant for the risk of anterior cruciate ligament (ACL) rupture, where noncontact mechanisms are frequent. However, clinical studies examining this issue have shown mixed results. The purpose of this study was to systematically review the available literature on risk of ACL rupture on natural grass versus artificial turf. We hypothesized that the risk of ACL rupture on synthetic playing surfaces would not be higher than that of natural grass playing surfaces. Systematic review. A systematic keyword search was performed of OVID, EMBASE, the Cochrane Library of Systematic Reviews, and the PROSPERO International Prospective Register of Systematic Reviews. Candidate articles were included if they reported the risk ratio of ACL rupture on natural grass versus synthetic playing surfaces, were of level 3 evidence or better, and included only ACL injuries sustained during organized athletic events. Exclusion criteria included a study with non-field-related sports and the use of historical cohorts for calculating risk ratios. A total of 10 studies with 963 ACL injuries met criteria for inclusion, all of which reported on soccer and football cohorts. Among these, 4 studies (753 ACL injuries) found an increased risk of ACL injury on artificial playing surfaces. All 4 of these articles were conducted using American football cohorts, and they included both earlier-generation surfaces (AstroTurf) and modern, 3rd-generation surfaces. Only 1 study in football players found a reduced risk of ACL injury on synthetic playing surfaces. No soccer cohort found an increased risk of ACL injury on synthetic surfaces. High-quality studies support an
van Beijsterveldt, A M C Anne-Marie; Stubbe, J H; Schmikli, S L; van de Port, I G L; Backx, F J G
To compare the incidence and characteristics of injuries between Dutch amateur and professional male soccer players during one entire competition season. A prospective two-cohort design. During the 2009-2010 season, 456 Dutch male amateur soccer players and 217 professional players were prospectively followed. Information on injuries and individual exposure to all soccer activities were recorded in both cohorts. Injuries were recorded using the time-loss definition. In total, 424 injuries were recorded among 274 of the amateur players (60.1% injured players) and 286 injuries were sustained by 136 (62.7% injured players) of the professional players (p=0.52). Compared to the professionals, the injury incidence during training sessions was higher among amateurs (p=0.01), but the injury incidence among professionals was higher during matches (pamateurs (all pamateurs reported more recurrent injuries (pamateur and professional players in the Netherlands might be explained by the difference in the level at which they play, since factors like the availability of medical support and/or the team size may influence the injury risk and characteristics. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Glassman, Tavis; Werch, Chudley E.; Jobli, Edessa; Bian, Hui
High-risk drinking on game day represents a unique public health challenge. Objective: The authors examined the drinking behavior of college football fans and assessed the support for related interventions. Participants: The authors randomly selected 762 football fans, including college students, alumni, and other college football fans, to…
Grier, Tyson L; Canham-Chervak, Michelle; Bushman, Timothy T; Anderson, Morgan K; North, William J; Jones, Bruce H
Grier, TL, Canham-Chervak, M, Bushman, TT, Anderson, MK, North, WJ, and Jones, BH. Evaluating injury risk and gender performance on health- and skill-related fitness assessments. J Strength Cond Res 31(4): 971-980, 2017-The purpose of this analysis was to investigate the association of injury risk and gender performance on health- and skill-related fitness assessments. A survey was used to collect personal characteristics and Army Physical Fitness Test scores (2-mile run, push-ups, and sit-ups). Within the same day, 9 physical fitness assessments were performed. Percent body fat was estimated using height, weight, age, and sex. All fitness assessment data were categorized into tertiles of high, moderate and low performance. To investigate potential injury risk predicted by fitness assessment performance, injury risk ratios, odds ratios (ORs), and 95% confidence intervals (CIs) were calculated using medical record data. A total of 3,264 soldiers completed surveys and physical fitness assessments. Tertiles of fitness performance with men and women combined showed that on an average, 14% of women and 70% of men were in the moderate- and high-performance groups. Among men, higher injury risk was independently associated with low performance on a 2-mile run (ORslow/fast = 1.51, 95% CI 1.18-1.94) and low performance on a weighted 300-yard shuttle run (ORslow/fast = 1.36, 95% CI 1.06-1.74). For women, a higher risk of injury was associated with low performance on the 2-mile run (ORslow/fast = 2.38, 95% CI 1.04-5.74). Therefore, out of the 13 fitness assessments, the 2-mile run and weighted 300-yard shuttle run can also (in addition to measuring performance) be utilized to identify soldiers or athletes who are at a higher risk of experiencing an injury.
Amelia R Turagabeci
Full Text Available BACKGROUND: Bullying and violence are problems of aggression in schools among adolescents. Basic daily healthy practices including nutritious diet, hygiene and physical activity are common approaches in comprehensive health promotion programs in school settings, however thier relationship to these aggressive behaviours is vague. We attempted to show the advantages of these healthy lifestyle behaviours in 9 developing countries by examining the association with being frequently bullied, violence and injury. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional cross-national survey of 9 countries using the WHO Global School Based Student Health Survey dataset was used. Measurements included experiences of "being frequently bullied" in the preceding 30 days and violence/injury in the past 12 months. Association of risk behaviours (smoking, alcohol, sexual behaviour and healthy lifestyle (nutrition, hygiene practices, physical activity to being bullied, and violence/injury were assessed using multivariate logistic regression. Hygiene behaviour showed lower risks of being frequently bullied [male: RR = 0.7 (97.5CI: 0.5, 0.9; female: RR = 0.6 (0.5, 0.8], and lower risk of experiences of violence/injury [RR = 0.7 (0.5, 0.9 for males], after controlling for risk behaviours, age, education, poverty, and country. CONCLUSION/SIGNIFICANCE: Healthy lifestyle showed an association to decreased relative risk of being frequently bullied and violence/injury in developing countries. A comprehensive approach to risk and health promoting behaviours reducing bullying and violence is encouraged at school settings.
McDaniel, Larry W.; Rasche, Adrienna; Gaudet, Laura; Jackson, Allen
The Anterior Cruciate Ligament (ACL) is located behind the kneecap (patella) and connects the thigh bone (femur) to the shin bone (tibia). Stabilizing the knee joint is the primary responsibility of the ACL. Injuries that affect the ACL are three to five times more common in females than males. This is a result of anatomical, biomechanical,…
Eirale, Cristiano; Tol, Johannes L.; Smiley, Faten; Farooq, Abdulaziz; Chalabi, Hakim
To investigate whether fasting during Ramadan influences injury incidence in professional Muslim and non-Muslim footballers. Prospective cohort study. Professional First Division League of Qatar. About 527 male football players (462 Muslim and 65 non-Muslim) from 7 league clubs (first year of data
However, the published research reviewed provides important information on injury causality and theories to direct future studies. Further research should be directed towards younger populations using valid testing protocols applicable to real life scenarios. South African Journal of Sports Medicine Vol. 18 (1) 2006: pp.
Wiggins, Amelia J.; Grandhi, Ravi K.; Schneider, Daniel K.; Stanfield, Denver; Webster, Kate E.; Myer, Gregory D.
Background Injury to the ipsilateral graft used for reconstruction of the anterior cruciate ligament (ACL) or a new injury to the contralateral ACL are disastrous outcomes after successful ACL reconstruction (ACLR), rehabilitation, and return to activity. Studies reporting ACL reinjury rates in younger active populations are emerging in the literature, but these data have not yet been comprehensively synthesized. Purpose To provide a current review of the literature to evaluate age and activity level as the primary risk factors in reinjury after ACLR. Study Design Systematic review and meta-analysis. Methods A systematic review of the literature was conducted via searches in PubMed (1966 to July 2015) and EBSCO host (CINAHL, Medline, SPORTDiscus [1987 to July 2015]). After the search and consultation with experts and rating of study quality, 19 articles met inclusion for review and aggregation. Population demographic data and total reinjury (ipsilateral and contralateral) rate data were recorded from each individual study and combined using random-effects meta-analyses. Separate meta-analyses were conducted for the total population data as well as the following subsets: young age, return to sport, and young age + return to sport. Results Overall, the total second ACL reinjury rate was 15%, with an ipsilateral reinjury rate of 7% and contralateral injury rate of 8%. The secondary ACL injury rate (ipsilateral + contralateral) for patients younger than 25 years was 21%. The secondary ACL injury rate for athletes who return to a sport was also 20%. Combining these risk factors, athletes younger than 25 years who return to sport have a secondary ACL injury rate of 23%. Conclusion This systematic review and meta-analysis demonstrates that younger age and a return to high level of activity are salient factors associated with secondary ACL injury. These combined data indicate that nearly 1 in 4 young athletic patients who sustain an ACL injury and return to high-risk sport
Full Text Available Registered offenders are known to have a higher mortality rate, but given the high proportion of offenders with drug-addiction, particularly among offenders with a custodial sentence, higher mortality is expected. While the level of overall mortality compared to the non-criminal population is of interest in itself, we also estimate the risk of death by criminal records related to substance abuse and other types of criminal acts, and separate between those who receive a prison sentence or not.Age-adjusted relative risks of death for 2000-2008 were studied in a population based dataset. Our dataset comprise the total Norwegian population of 2.9 million individuals aged 15-69 years old in 1999, of whom 10% had a criminal record in the 1992-1999 period.Individuals with a criminal record have twice the relative risk (RR of death of the control group (non-offenders. Males with a record of use/possession of drugs and a prison record have an 11.9 RR (females, 15.6; males with a drug record but no prison record have a 6.9 RR (females 10.5. Males imprisoned for driving under the influence of substances have a 4.4 RR (females 5.6; males with a record of driving under the influence but no prison sentence have a 3.2 RR (females 6.5. Other male offenders with a prison record have a 2.8 RR (females 3.7; other male offenders with no prison record have a 1.7 RR (females 2.3.Significantly higher mortality was found for people with a criminal record, also for those without any record of drug use. Mortality is much higher for those convicted of substance-related crimes: more so for drug- than for alcohol-related crimes and for women.
Skardhamar, Torbjørn; Skirbekk, Vegard
Registered offenders are known to have a higher mortality rate, but given the high proportion of offenders with drug-addiction, particularly among offenders with a custodial sentence, higher mortality is expected. While the level of overall mortality compared to the non-criminal population is of interest in itself, we also estimate the risk of death by criminal records related to substance abuse and other types of criminal acts, and separate between those who receive a prison sentence or not. Age-adjusted relative risks of death for 2000-2008 were studied in a population based dataset. Our dataset comprise the total Norwegian population of 2.9 million individuals aged 15-69 years old in 1999, of whom 10% had a criminal record in the 1992-1999 period. Individuals with a criminal record have twice the relative risk (RR) of death of the control group (non-offenders). Males with a record of use/possession of drugs and a prison record have an 11.9 RR (females, 15.6); males with a drug record but no prison record have a 6.9 RR (females 10.5). Males imprisoned for driving under the influence of substances have a 4.4 RR (females 5.6); males with a record of driving under the influence but no prison sentence have a 3.2 RR (females 6.5). Other male offenders with a prison record have a 2.8 RR (females 3.7); other male offenders with no prison record have a 1.7 RR (females 2.3). Significantly higher mortality was found for people with a criminal record, also for those without any record of drug use. Mortality is much higher for those convicted of substance-related crimes: more so for drug- than for alcohol-related crimes and for women.
Van der Sluis, A; Brink, M S; Pluim, B; Verhagen, E A; Elferink-Gemser, M T; Visscher, C
Overuse injuries are a serious problem in junior tennis. Gaining insight in age-specific risk factors can contribute to prevention. The developmental cognitive processes that take place during adolescence make talented players more inclined to take risks. This may be even more pronounced in the high
Westland, R.; Kurvers, R.A.; Wijk, J.A. van; Schreuder, M.F.
OBJECTIVE: The hyperfiltration hypothesis implies that children with a solitary functioning kidney are at risk to develop hypertension, proteinuria, and chronic kidney disease. We sought to determine the presenting age of renal injury and identify risk factors for children with a solitary
Full Text Available Previous study has shown a likely link between increased shoe- surface traction and risk of knee Anterior Cruciate Ligament (ACL injury. Portable natural grass systems are being used more often in sport, but no study to date has investigated their relative safety. By their nature, they must have high resistance to falling apart and therefore newly laid systems may be at risk of creating excessive shoe-surface traction. This study describes two clusters of knee injuries (particularly non-contact ACL injuries, each occurring to players of one professional football team at single venue, using portable grass, in a short space of time. The first series included two ACL injuries, one posterolateral complex disruption and one lateral ligament tear occurring in two rugby league games on a portable bermudagrass surface in Brisbane, Australia. The second series included four non-contact ACL injuries over a period of ten weeks in professional soccer games on a portable Kentucky bluegrass/perennial ryegrass surface in Barcelona, Spain. Possible intrinsic risk factors are discussed but there was no common risk shared by the players. Although no measures of traction were made at the Brisbane venue, average rotational traction was measured towards the end of the injury cluster at Camp Nou, Barcelona, to be 48 Nm. Chance undoubtedly had a part to play in these clusters, but the only obvious common risk factor was play on a portable natural grass surface soon after it was laid. Further study is required to determine whether portable natural grass systems may exhibit high shoe-surface traction soon after being laid and whether this could be a risk factor for knee injury
Iwamoto, Derek Kenji; Kaya, Aylin; Grivel, Margaux; Clinton, Lauren
, traditional norms that may directly pertain to hyperfemininzed Asian-American women, including modesty and sexual fidelity, may protect against heavy episodic drinking (Young et al. 2005). Conversely, the risk for heavy episodic drinking may be enhanced in men who strive to demonstrate traditional notions of masculinity through risk-taking and endorsement of playboy norms (Iwamoto et al. 2010). Although this review has illustrated the contemporary state of research on alcohol use among Asian Americans, it also highlights the significant limitations in this literature. Many of the studies reviewed here have used cross-sectional data, which do not allow researchers to infer causality between the various sociocultural factors and problematic alcohol use. One way of addressing this gap in the existing literature may be to implement longitudinal designs to further understand how the temporal relationship between sociocultural factors, including acculturation and gender norms, may impact alcohol use and alcohol-related problem trajectories. There also is a pressing need to develop greater understanding of within-group differences among U.S.-born and foreign-born Asian Americans as well as among as specific ethnic groups. To date, epidemiological research has largely neglected to examine these significant discrepancies. Given the growing prevalence of alcohol use and alcohol-related problems among Asian-American women (Grant et al. 2004; Iwamoto et al. 2010), studies also should focus on this group and explore how the intersection of gender and culture may influence alcohol use. Finally, the majority of research on this population has been conducted in college samples; therefore, it is important to also examine community samples, including U.S.-born young adults who are not attending college and older adult Asian-American populations.
Bliekendaal, S; Goossens, L; Stubbe, J H
Injuries can have a major impact on the physical performance and academic career of physical education teacher education (PETE) students. To investigate the injury problem, risk factors, and the impact of injuries on academic success, 252 PETE students were followed during their first semester. Risk factor analysis was conducted by means of logistic regression analysis with a differentiation for upper body, lower body, acute, overuse, and severe injuries. An incidence of 1.26 injuries/student/semester was found. Most injuries involved the lower body (61%), were new injuries (76%), occurred acutely (66%), and were sustained during curricular gymnastics (25%) or extracurricular soccer (28%). Significant risk factors for lower body acute injuries were age (OR=2.14; P=.01), previous injury (OR=2.23; P=.01), and an injury at the start of the year (OR=2.56; P=.02). For lower body overuse injuries, gender (OR=2.85; P=.02) and the interval shuttle run test score (OR=2.44; P=.04) were significant risk factors. Previous injury (OR=2.59; P=.04) and injury at the start of the year (upper body: OR=4.57; P=.02; lower body: OR=3.75; Pacademic success (r=.20; P=.02) and success in theoretical courses (r=.24; P=academic success for sport courses. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Chalmers, David J; Samaranayaka, Ari; Gulliver, Pauline; McNoe, Bronwen
To identify risk factors for injury in amateur club rugby. Prospective cohort design; with follow-up over the 2004 season. Amateur club rugby in New Zealand. Participants Seven hundred and four male rugby players, aged 13 years and over. Assessment of risk factors The study investigated the independent effect on injury incidence of age, ethnicity, rugby experience, height, weight, body mass index, physical activity, cigarette smoking, previous injury, playing while injured, grade, position, training, time of season, warm-up, foul play, weather conditions, ground conditions and protective equipment. Generalised Poisson regression was used to estimate the effect of each factor after adjusting for all other factors. Game injury, defined as 'any event that resulted in an injury requiring medical attention or causing a player to miss at least one scheduled game or team practice'. A total of 704 players, representing 6263 player-games, contributed information on injury and exposure. Evidence was obtained of the effect on injury incidence of increasing age, Pacific Island versus Maori ethnicity (injury rate ratio (IRR)=1.48, 1.03-2.13), ≥40 h strenuous physical activity per week (IRR=1.54, 1.11-2.15), playing while injured (IRR=1.46, 1.20-1.79), very hard ground condition (IRR=1.50, 1.13-2.00), foul-play (IRR=1.87, 1.54-2.27) and use of headgear (IRR=1.23, 1.00-1.50). Opportunities for injury prevention might include promoting injury-prevention measures more vigorously among players of Pacific Island ethnicity, ensuring injured players are fully rehabilitated before returning to play, reducing the effects of ground hardness through ground preparation and stricter enforcement of the laws relating to foul play.
Haney, Suzanne B; Starling, Suzanne P; Heisler, Kurt W; Okwara, Leonore
Although many studies have shown that short falls by children rarely result in serious injury, no recent study in the United States has assessed the prevalence and the characteristics of such falls. Because the history of a short fall often is given in the instance of suspected child abuse, data addressing the characteristics, the frequency, and the severity of such falls would assist in abuse investigations. Anonymous questionnaires were distributed at primary care offices to parents of children younger than 5 years. Parents answered a series of questions regarding any falls their children had sustained before the age of 2 years. Information gathered included the age of the child at the time of the fall, the details about the fall, the medical attention sought, and any injuries sustained. We received a total of 307 eligible surveys. There were 209 falls reported for 122 children. Only 24% of those children sustained any injury as a result of the fall. Most (85%) of the children who sustained injuries had a bruise or a bump. Of the 20% (40 children) who were brought for medical care, only 13 children received medical treatment. The most severe injuries were in 2 children who sustained concussions; only 4 children had permanent injury (cutaneous scars). Children who fell on a hard surface were 6 times more likely to have an injury compared with children who fell on a soft surface (P = 0.001) In addition, for every 1 unit increase in fall height, risk of injury increased by a factor of 2.3. In short falls, ground surface and fall height were significant predictors of injury risk. The results of this study also support the opinion that short falls rarely cause injury. Therefore, a history of a short fall in a seriously injured child should raise the suspicion of child abuse.
McCall, B P; Horwitz, I B; Taylor, O A
Occupational eye injuries are a significant source of injury in the workplace. Little population-based research in the area has been conducted, and is necessary for developing and prioritizing effective interventions. Workers' compensation data from the state of Kentucky for the years 1994-2003 were analysed by demographics, injury nature and cause, cost, and occupational and industrial characteristics. The US Bureau of Labor Statistics' Current Population Survey was utilised to compute injury rates for demographic and occupational groups. There were 10,545 claims of ocular injury, representing 6.29 claims per 10,000 workers on average annually. A substantial drop in the claim rate was found after the state passed monetary penalties for injuries caused by employer negligence or OSHA violations. Claims by men were over three times more likely than those by women to have associated claim costs (OR 0.52; 95% CI 0.32 to 0.85; p = 0.009). The highest eye injury rates per 10,000 of 13.46 (95% CI 12.86 to 14.07) were found for the helpers/labourers occupation, and of 19.95 (95% CI 18.73 to 21.17) for the construction industry. The total cost of claim payments over the period was over $3,480,000, and average cost per claim approximated $331. Eye injuries remain a significant risk to worker health, especially among men in jobs requiring intensive manual labour. Evidence showed that increased legislative regulation led to a decline in eye injuries, which was consistent with other recent findings in the area. Additionally, targeting groups most at risk, increasing worker training, providing effective eye protection equipment, and developing workplace safety cultures may together reduce occupational eye injuries.
Medina, G I S; Jesus, C L M; Ferreira, D M; Pacheco, E M B; Beraldo, G L; de Franca Urquiza, F; Cliquet, A
A retrospective cohort. To report the incidence rates of shoulder injuries diagnosed with magnetic resonance imaging (MRI) in tetraplegic athletes and sedentary tetraplegic individuals. To evaluate whether sport practice increases the risk of shoulder injuries in tetraplegic individuals. Campinas, Sao Paulo, Brazil. Ten tetraplegic athletes with traumatic spinal cord injury were selected among quad rugby athletes and had both the shoulders evaluated by MRI. They were compared with 10 sedentary tetraplegic individuals who were submitted to the same radiological protocol. All athletes were male with a mean age of 32.1 years (range 25-44 years, s.d.=6.44). Time since injury ranged from 6 to 17 years, with a mean value of 9.7 years and s.d. of 3.1 years. All sedentary individuals were male with a mean age of 35.9 years (range 22-47 years, s.d.=8.36). Statistical analysis showed a protective effect of sport in the development of shoulder injuries, with a weak correlation for infraspinatus and subscapularis tendinopathy (P=0.09 and P=0.08, respectively) and muscle atrophy (P=0.08). There was a strong correlation for acromioclavicular joint (ACJ) and labrum injuries (P=0.04), with sedentary individuals at a higher risk for these injuries. Tetraplegic athletes and sedentary individuals have a high incidence of supraspinatus tendinosis, bursitis and ACJ degeneration. Statistical analysis showed that there is a possible protective effect of sport in the development of shoulder injuries. Weak evidence was encountered for infraspinatus and subscapularis tendinopathy and muscle atrophy (P=0.09, P=0.08 and P=0.08, respectively). Strong evidence with P=0.04 suggests that sedentary tetraplegic individuals are at a greater risk for ACJ and labrum injuries.
Siew, Edward D; Fissell, William H; Tripp, Christina M; Blume, Jeffrey D; Wilson, Matthew D; Clark, Amanda J; Vincz, Andrew J; Ely, E Wesley; Pandharipande, Pratik P; Girard, Timothy D
Acute kidney injury may contribute to distant organ dysfunction. Few studies have examined kidney injury as a risk factor for delirium and coma. To examine whether acute kidney injury is associated with delirium and coma in critically ill adults. In a prospective cohort study of intensive care unit patients with respiratory failure and/or shock, we examined the association between acute kidney injury and daily mental status using multinomial transition models adjusting for demographics, nonrenal organ failure, sepsis, prior mental status, and sedative exposure. Acute kidney injury was characterized daily using the difference between baseline and peak serum creatinine and staged according to Kidney Disease Improving Global Outcomes criteria. Mental status (normal vs. delirium vs. coma) was assessed daily with the Confusion Assessment Method for the ICU and Richmond Agitation-Sedation Scale. Among 466 patients, stage 2 acute kidney injury was a risk factor for delirium (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.07-2.26) and coma (OR, 2.04; 95% CI, 1.25-3.34) as was stage 3 injury (OR for delirium, 2.56; 95% CI, 1.57-4.16) (OR for coma, 3.34; 95% CI, 1.85-6.03). Daily peak serum creatinine (adjusted for baseline) values were also associated with delirium (OR, 1.35; 95% CI, 1.18-1.55) and coma (OR, 1.44; 95% CI, 1.20-1.74). Renal replacement therapy modified the association between stage 3 acute kidney injury and daily peak serum creatinine and both delirium and coma. Acute kidney injury is a risk factor for delirium and coma during critical illness.
Alentorn-Geli, Eduard; Mendiguchía, Jurdan; Samuelsson, Kristian; Musahl, Volker; Karlsson, Jon; Cugat, Ramon; Myer, Gregory D
The purpose of this study was to report a comprehensive literature review on the risk factors for anterior cruciate ligament (ACL) injuries in male athletes. All abstracts were read and articles of potential interest were reviewed in detail to determine on inclusion status for systematic review. Information regarding risk factors for ACL injuries in male athletes was extracted from all included studies in systematic fashion and classified as environmental, anatomical, hormonal, neuromuscular, or biomechanical. Data extraction involved general characteristics of the included studies (type of study, characteristics of the sample, type of sport), methodological aspects (for quality assessment), and the principal results for each type of risk factor. The principal findings of this systematic review related to the risk factors for ACL injury in male athletes are: (1) most of the evidence is related to environmental and anatomical risk factors; (2) dry weather conditions may increase the risk of non-contact ACL injuries in male athletes; (3) artificial turf may increase the risk of non-contact ACL injuries in male athletes; (4) higher posterior tibial slope of the lateral tibial plateau may increase the risk of non-contact ACL injuries in male athletes. Anterior cruciate ligament injury in male athletes likely has a multi-factorial aetiology. There is a lack of evidence regarding neuromuscular and biomechanical risk factors for ACL injury in male athletes. Future research in male populations is warranted to provide adequate prevention strategies aimed to decrease the risk of this serious injury in these populations.
Tucker, Ross; Raftery, Martin; Kemp, Simon; Brown, James; Fuller, Gordon; Hester, Ben; Cross, Matthew; Quarrie, Ken
The tackle is responsible for the majority of head injuries during rugby union. In order to address head injury risk, risk factors during the tackle must first be identified. This study analysed tackle characteristics in the professional game in order to inform potential interventions. 464 tackles resulting in a head injury assessment (HIA) were analysed in detail, with tackle type, direction, speed, acceleration, nature of head contact and player body position the characteristics of interest. Propensity to cause an HIA was significantly greater for active shoulder tackles, front-on tackles, high speeder tackles and an accelerating tackler. Head contact between a tackler's head and ball carrier's head or shoulder was significantly more likely to cause an HIA than contact below the level of the shoulder (incident rate ratio (IRR) 4.25, 95%-CI 3.38 to 5.35). The tackler experiences the majority (78%) of HIAs when head-to-head contact occurs. An upright tackler was 1.5 times more likely to experience an HIA than a bent at the waist tackler (IRR 1.44, 95% CI 1.18 to 1.76). This study confirms that energy transfer in the tackle is a risk factor for head injury, since direction, type and speed all influence HIA propensity. The study provides evidence that body position and the height of tackles should be a focus for interventions, since lowering height and adopting a bent at the waist body position is associated with reduced risk for both tacklers and ball carriers. To this end, World Rugby has implemented law change based on the present data. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Etman, A.; Wijlhuizen, G.J.; van Heuvelen, M.J.G.; Chorus, A.M.J.; Hopman-Rock, M.
Background: up till now, the risk of falls has been expressed as falls incidence (i.e. the number of falls or fallers per 100 person-years). However, the risk of an accident or injury is the probability of having an accident or injury per unit of exposure. The FARE (Falls risk by Exposure) is a
Etman, A.; Wijlhuizen, G.J.; Heuvelen, M.J.G. van; Chorus, A.; Hopman-Rock, M.
Background: up till now, the risk of falls has been expressed as falls incidence (i.e. the number of falls or fallers per 100 person-years). However, the risk of an accident or injury is the probability of having an accident or injury per unit of exposure. The FARE (Falls risk by Exposure) is a
Etman, Astrid; Wijlhuizen, Gert Jan; van Heuvelen, Marieke J. G.; Chorus, Astrid; Hopman-Rock, Marijke
Background: up till now, the risk of falls has been expressed as falls incidence (i.e. the number of falls or fallers per 100 person-years). However, the risk of an accident or injury is the probability of having an accident or injury per unit of exposure. The FARE ( Falls risk by Exposure) is a
Grier, Tyson; Canham-Chervak, Michelle; Bushman, Timothy; Anderson, Morgan; North, William; Jones, Bruce H
Minimalist running shoes (MRS) are lightweight, are extremely flexible, and have little to no cushioning. It has been thought that MRS will enhance running performance and decrease injury risk. To compare physical characteristics, fitness performance, and injury risks associated with soldiers wearing MRS and those wearing traditional running shoes (TRS). Case series; Level of evidence, 4. Participants were men in a United States Army brigade (N = 1332). Physical characteristics and Army Physical Fitness Test data were obtained by survey. Fitness performance testing was administered at the brigade, and the types of footwear worn were identified by visual inspection. Shoe types were categorized into 2 groups: TRS (stability, cushioning, and motion control) and MRS. Injuries from the previous 12 months were obtained from the Defense Medical Surveillance System. A t test was used to determine mean differences between personal characteristics, training, and fitness performance metrics by shoe type. Hazard ratios and 95% CIs were calculated to determine injury risk by shoe type, controlling for other risk factors. A majority of soldiers wore cushioning shoes (57%), followed by stability shoes (24%), MRS (17%), and motion control shoes (2%). Soldiers wearing MRS were slightly younger than those wearing TRS (P shoe type between soldiers wearing MRS compared with TRS. Soldiers who chose to wear MRS were younger and had higher physical performance scores compared with soldiers wearing TRS. When these differences are controlled, use of MRS does not appear to be associated with higher or lower injury risk in this population. © 2016 The Author(s).
Henry, Thomas; Evans, Karrin; Snodgrass, Suzanne J; Miller, Andrew; Callister, Robin
To determine whether nonmodifiable and modifiable risk factors [ankle dorsiflexion range of motion (ROM), lower limb power output, and balance], as identified in preseason screening, predict the risk of sustaining a noncontact ankle injury in amateur male soccer players during the training and competitive season. Prospective cohort study. Amateur soccer competition (club and area representative teams). Amateur soccer players (n = 210) aged ≥15 years. Height, weight, ankle dorsiflexion ROM, power (vertical jump) and balance (time of double-leg balanced stance on an electronic wobble board, maximum 20 seconds) measured in preseason screening. Incidence of noncontact ankle injury and exposure to both training and games, monitored during the competitive season following baseline measurement. Noncontact ankle injury was defined as any ankle injury not caused by a collision (with another player or object) resulting in a participant missing at least 1 game or training session. Fourteen of the 210 participants (6.7%) sustained a noncontact ankle injury yielding an injury rate of 0.484 injuries per 1000 player hours. Lower limb power output scores soccer players. These deficits can potentially be identified by screening, providing opportunities to investigate prevention strategies.
Chong, Shu-Ling; Tyebally, Arif; Chew, Su Yah; Lim, Yang Chern; Feng, Xun Yi; Chin, Sock Teng; Lee, Lois K
Pediatric road traffic injuries remain a significant cause of death and disability in many countries in Asia, despite the implementation of road traffic safety laws. We aim to describe the injuries, the use of restraints among road users, and risk factors associated with severe injuries for children in Singapore. We performed a retrospective chart review of road traffic injuries presenting to the only two pediatric tertiary care hospitals in Singapore, from January 2012 to April 2016. We included children road injuries involved motor vehicle occupants (1483/2468). Most bicyclist/motorcyclists were not wearing helmets (70.0%, 245/350) and 51.1% of motor vehicle passengers (758/1483) were not restrained. Compared to motor vehicle passengers, pedestrians (adjusted OR 2.38, 95% CI 1.41-3.99), bicyclists (adjusted OR 2.12, 95% CI 1.04-4.32) and motorcyclists (adjusted OR 6.09, 95% CI 2.04-18.24) were more likely to sustain severe injuries. Child pedestrians, bicyclists and motorcyclists are especially vulnerable for severe injures. Further injury prevention efforts must focus on the enforcement of legislation to protect these high-risk groups. Copyright © 2017 Elsevier Ltd. All rights reserved.
Larsen, Ann D; Hannerz, Harald; Møller, Simone V; Dyreborg, Johnny; Bonde, Jens Peter; Hansen, Johnni; Kolstad, Henrik A; Hansen, Åse Marie; Garde, Anne Helene
Objectives The aims of this study were to (i) investigate the association between night work or long work weeks and the risk of accidental injuries and (ii) test if the association is affected by age, sex or socioeconomic status. Methods The study population was drawn from the Danish version of the European Labour Force Survey from 1999-2013. The current study was based on 150 438 participants (53% men and 47% women). Data on accidental injuries were obtained at individual level from national health registers. We included all 20-59-year-old employees working ≥32 hours a week at the time of the interview. We used Poisson regression to estimate the relative rates (RR) of accidental injuries as a function of night work or long work weeks (>40 hours per week) adjusted for year of interview, sex, age, socioeconomic status (SES), industry, and weekly working hours or night work. Age, sex and SES were included as two-way interactions. Results We observed 23 495 cases of accidental injuries based on 273 700 person years at risk. Exposure to night work was statistically significantly associated with accidental injuries (RR 1.11, 99% CI 1.06-1.17) compared to participants with no recent night work. No associations were found between long work weeks (>40 hours) and accidental injuries. Conclusion We found a modest increased risk of accidental injuries when reporting night work. No associations between long work weeks and risk of accidental injuries were observed. Age, sex and SES showed no trends when included as two-way interactions.
Perone, Christian S.
This study describes the experimental application of Machine Learning techniques to build prediction models that can assess the injury risk associated with traffic accidents. This work uses an freely available data set of traffic accident records that took place in the city of Porto Alegre/RS (Brazil) during the year of 2013. This study also provides an analysis of the most important attributes of a traffic accident that could produce an outcome of injury to the people involved in the accident.
Injuries and Illnesses of Vietnam War POWs Revisited: IV. Air Force Risk Factors LT Saima Raza, MSC, USN, Jeffrey L. Moore, John P. Albano, and A...Fred Wells Operation Homecoming (O/H), the negotiated release of 566 US Servicemen held as prisoners of war (POWs) in Vietnam for as long as...M. (1977a). Injuries and illnesses of Vietnam War POWs. I. Navy POWs. Military Medicine, 142, 514-518. 2. Berg, S.W. & Richlin, M. (1977b
Ek, Stina; Rizzuto, Debora; Fratiglioni, Laura; Johnell, Kristina; Xu, Weili; Welmer, Anna-Karin
Although falls in older adults are related to multiple risk factors, these factors have commonly been studied individually. We aimed to identify risk profiles for injurious falls in older adults by detecting clusters of established risk factors and quantifying their impact on fall risk. Participants were 2,566 people, aged 60 years and older, from the population-based Swedish National Study on Aging and Care in Kungsholmen. Injurious falls was defined as hospitalization for or receipt of outpatient care because a fall. Cluster analysis was used to identify aggregation of possible risk factors including chronic diseases, fall-risk increasing drugs (FRIDs), physical and cognitive impairments, and lifestyle-related factors. Associations between the clusters and injurious falls over 3, 5, and 10 years were estimated using flexible parametric survival models. Five clusters were identified including: a "healthy", a "well-functioning with multimorbidity", a "well-functioning, with multimorbidity and high FRID consumption", a "physically and cognitively impaired", and a "disabled" cluster. The risk of injurious falls for all groups was significantly higher than for the first cluster of healthy individuals in the reference category. Hazard ratios (95% confidence intervals) ranged from 1.71 (1.02-2.66) for the second cluster to 12.67 (7.38-21.75) for the last cluster over 3 years of follow-up. The highest risk was observed in the last two clusters with high burden of physical and cognitive impairments. Risk factors for injurious fall tend to aggregate, representing different levels of risk for falls. Our findings can be useful to tailor and prioritize clinical and public health interventions.
Full Text Available Introduction: Homicide is the second leading cause of death among youth aged 15–24. Prior crosssectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury. However, longitudinal cohort studies have not been performed to evaluate the temporal or predictive relationship between these risk factors and emergency department (ED visits for injuries among at-risk youth. The objective was to assess whether self-reported exposure to violence risk factors in young adults can be used to predict future ED visits for injuries over a 1-year period. Methods: This prospective cohort study was performed in the ED of a Southeastern US Level I trauma center. Eligible participants were patients aged 18–24, presenting for any chief complaint. We excluded patients if they were critically ill, incarcerated, or could not read English. Initial recruitment occurred over a 6-month period, by a research assistant in the ED for 3–5 days per week, with shifts scheduled such that they included weekends and weekdays, over the hours from 8AM-8PM. At the time of initial contact in the ED, patients were asked to complete a written questionnaire, consisting of previously validated instruments measuring the following risk factors: a aggression, b perceived likelihood of violence, c recent violent behavior, d peer behavior, e community exposure to violence, and f positive future outlook. At 12 months following the initial ED visit, the participants’ medical records were reviewed to identify any subsequent ED visits for injury-related complaints. We analyzed data with chisquare and logistic regression analyses. Results: Three hundred thirty-two patients were approached, of whom 300 patients consented. Participants’ average age was 21.1 years, with 60.1% female, 86.0% African American. After controlling for participant gender, ethnicity, or injury complaint at time of first
Khashaba, E; El-Helaly, M; El-Gilany, A H; Motawei, S M; Foda, S
Substance abuse is a serious problem, because it affects both workers and young people. Prevalence and consequences of cannabis abuse among construction workers in particular are not well studied in Egypt. To determine the association between non-fatal occupational injuries among construction workers and their demographic and occupational factors and to assess the frequency of cannabis abuse and its relationship to injury severity and workdays lost. A case-control study was conducted at Mansoura Emergency Hospital. Cases were 100 acutely injured male workers. A control group of 90 healthy age-matched workers was selected from 8 construction sites. Workers were interviewed, and a questionnaire was completed that included socio-demographic data, full occupational history, and causes and type of injury. Injury outcome measures included lost workdays and the injury severity score (ISS). Cannabis abuse in injured workers was monitored by preliminary testing of urine and confirmatory testing of blood. Logistic regression analysis revealed that the independent predictors of occupational injuries were rural residence, being a carpenter or painter and past history of injuries. The most common accidents were slipping falls (62%). Confirmed cannabis test was positive in 51.1% of the injured workers. Median days away from work were greater among cannabis users than non-users. The ISS was significantly higher among users compared to non-users ( p abuse can increase injury severity and prolong workdays lost. Drug testing is recommended for at-risk construction workers with inadequate safety measures.
Full Text Available Methylprednisolone is a synthetic glucocorticoid with a potent and long-acting anti-inflammatory, antiallergic and immunosuppressant. Its mechanism of action of methylprednisolone is the result of many cellular changes. Methylprednisolone is used in many diseases, such as rheumatic diseases, autoimmune diseases, allergic, anaphylactic shock, asthma. Methylprednisolone was also used in patients with spinal cord injury, in order to minimize neurological damage. While in the above mentioned fields of medicine is undeniable role of methylprednisolone, whereas its use in the treatment of traumatic spinal cord injury within the last few years raises a lot of controversy, and in most cases, the side effects of its use outweigh the potential benefits.
Weaver, Emma R; Horyniak, Danielle R; Jenkinson, Rebecca; Dietze, Paul
Background Smartphone applications (“apps”) offer a number of possibilities for health promotion activities. However, young people may also be exposed to apps with incorrect or poor quality information, since, like the Internet, apps are mostly unregulated. Little is known about the quality of alcohol-related apps or what influence they may have on young people’s behavior. Objective To critically review popular alcohol-related smartphone apps and to explore young people’s opinions of these apps, their acceptability, and use for alcohol-related health promotion. Methods First, a content analysis of 500 smartphone apps available via Apple iTunes and Android Google Play stores was conducted. Second, all available blood alcohol concentration (BAC) apps were tested against four individual case profiles of known BAC from a previous study. Third, two focus group discussions explored how young people use alcohol-related apps, particularly BAC apps. Results 384 apps were included; 50% (192) were entertainment apps, 39% (148) were BAC apps, and 11% (44) were health promotion and/or stop drinking–related apps. When testing the BAC apps, there was wide variation in results, with apps tending to overestimate BAC scores compared with recorded scores. Participants were skeptical of the accuracy of BAC apps, and there was an overall concern that these apps would be used as a form of entertainment, further encouraging young people to drink, rather than reduce their drinking and risk taking. Conclusions The majority of popular alcohol-related apps encouraged alcohol consumption. Apps estimating blood alcohol concentration were widely available but were highly unreliable. Health departments and prominent health organizations need to endorse alcohol smartphone apps that are accurate and evidence-based to give specific apps credibility in the ever-expanding market of unregulated apps. PMID:25100681
Eum, Regina S; Brown, Allen W; Watanabe, Thomas K; Zasler, Nathan D; Goldstein, Richard; Seel, Ronald T; Roth, Elliot J; Zafonte, Ross D; Glenn, Mel B
To create a profile of individuals with traumatic brain injury (TBI) who received inpatient rehabilitation and were discharged to an institutional setting using characteristics measured at rehabilitation discharge. The Traumatic Brain Injury Model Systems National Database is a prospective, multicenter, longitudinal database for people with moderate to severe TBI. We analyzed data for participants enrolled from January 2002 to June 2012 who had lived in a private residence before TBI. This cross-sectional study used logistic regression analyses to identify sociodemographic factors, lengths of stay, and cognitive and physical functioning levels that differentiated patients discharged to institutional versus private settings. Older age, living alone before TBI, and lower levels of function at rehabilitation discharge (independence in locomotion, bladder management, comprehension, and social interaction) were significantly associated with higher institutionalization rates and provided the best models identifying factors associated with institutionalization. Institutionalization was also associated with decreased independence in bed-chair-wheelchair transfers and increased duration of posttraumatic amnesia. Individuals institutionalized after inpatient rehabilitation for TBI were older, lived alone before injury, had longer posttraumatic amnesia durations, and were less independent in specific functional characteristics. Research evaluating the effect of increasing postdischarge support and improving treatment effectiveness in these functional areas is recommended.
Korkmaz, Y T; Kayıpmaz, S; Senel, F C; Atasoy, K T; Gumrukcu, Z
The objectives of this study were to evaluate the efficacy of additional cone beam computed tomography (CBCT) imaging on decreasing the risk of inferior alveolar nerve (IAN) injury during third molar removal in patients at high risk and to assess the surgical outcomes. The study sample included patients considered at high risk for IAN injury based on panoramic radiography (PAN) evaluation. The primary predictor was the type of imaging method (PAN only or with additional CBCT). The other variables were demographic and anatomical/radiographic factors. The primary outcome variable was IAN injury. The secondary outcome variables were the preoperative surgical plan and surgical results including IAN exposure and duration of surgery. The sample comprised 122 patients (139 teeth) aged 18-48 years. Postoperative temporary IAN injury was present in three (4.2%) cases in the CBCT group and 11 (16.4%) in the PAN group at 7 days after surgery. However, none of the patients had a permanent IAN injury at the 6-month follow-up. Additional CBCT imaging was not superior to PAN in reducing IAN injury after third molar surgery during long-term follow-up. Nonetheless, CBCT may decrease the prevalence of temporary IAN injury and improve the surgical outcomes in high-risk patients. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Mackenbach, Johan P; Kulhánová, Ivana; Bopp, Matthias; Borrell, Carme; Deboosere, Patrick; Kovács, Katalin; Looman, Caspar W N; Leinsalu, Mall; Mäkelä, Pia; Martikainen, Pekka; Menvielle, Gwenn; Rodríguez-Sanz, Maica; Rychtaříková, Jitka; de Gelder, Rianne
Socioeconomic inequalities in alcohol-related mortality have been documented in several European countries, but it is unknown whether the magnitude of these inequalities differs between countries and whether these inequalities increase or decrease over time. We collected and harmonized data on mortality from four alcohol-related causes (alcoholic psychosis, dependence, and abuse; alcoholic cardiomyopathy; alcoholic liver cirrhosis; and accidental poisoning by alcohol) by age, sex, education level, and occupational class in 20 European populations from 17 different countries, both for a recent period and for previous points in time, using data from mortality registers. Mortality was age-standardized using the European Standard Population, and measures for both relative and absolute inequality between low and high socioeconomic groups (as measured by educational level and occupational class) were calculated. Rates of alcohol-related mortality are higher in lower educational and occupational groups in all countries. Both relative and absolute inequalities are largest in Eastern Europe, and Finland and Denmark also have very large absolute inequalities in alcohol-related mortality. For example, for educational inequality among Finnish men, the relative index of inequality is 3.6 (95% CI 3.3-4.0) and the slope index of inequality is 112.5 (95% CI 106.2-118.8) deaths per 100,000 person-years. Over time, the relative inequality in alcohol-related mortality has increased in many countries, but the main change is a strong rise of absolute inequality in several countries in Eastern Europe (Hungary, Lithuania, Estonia) and Northern Europe (Finland, Denmark) because of a rapid rise in alcohol-related mortality in lower socioeconomic groups. In some of these countries, alcohol-related causes now account for 10% or more of the socioeconomic inequality in total mortality. Because our study relies on routinely collected underlying causes of death, it is likely that our results
Woollings, Kaikanani Y; McKay, Carly D; Emery, Carolyn A
Rock climbing is an increasingly popular sport worldwide, as a recreational activity and a competitive sport. Several disciplines including sport climbing and bouldering have developed, each employing specific movements and techniques, leading to specific injuries. To examine risk factors and prevention measures for injury in sport climbing and bouldering, and to assess the methodological quality of existing studies. 12 electronic databases and several other sources were searched systematically using predetermined inclusion and exclusion criteria. Eligible articles were peer-reviewed, based on primary research using original data; outcome measures included injury, morbidity or mortality in rock climbing, and included one or more potential risk factor or injury prevention strategy. Two independent reviewers assessed the methodology of research in each study using the Downs and Black Quality Index. The data extracted is summarised, and appraisals of the articles are presented with respect to the quality of evidence presented. 19 studies met the inclusion criteria, and introduced 35 possible risk factors or injury prevention measures in climbing. Age, increasing years of climbing experience, highest climbing grade achieved (skill level), high climbing intensity score (CIS) and participating in lead climbing are potential risk factors. Results regarding injury prevention measures remain inconclusive. This field is relatively new and, as such, the data are not as robust as for more established sports with a larger research foundation. The key need is establishing modifiable risk factors using prospective studies and high quality methodology, such that injury prevention strategies can be developed. The CIS may be a useful measure in this field of research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Full Text Available Abstract Background Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care. Method All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735. Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication. Results Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care. Conclusions While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree.
Cabral, Felipe Cezar; Ramos Garcia, Pedro Celiny; Mattiello, Rita; Dresser, Daiane; Fiori, Humberto Holmer; Korb, Cecilia; Dalcin, Tiago Chagas; Piva, Jefferson Pedro
To evaluate the predictive value of the pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease criteria for disease course severity in patients with or without acute kidney injury admitted to a PICU. Retrospective cohort study. A 12-bed PICU at a tertiary referral center in Southern Brazil. All patients admitted to the study unit over a 1-year period. A database of all eligible patients was analyzed retrospectively. Patients were classified by pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease score at admission and worst pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease score during PICU hospitalization. The outcomes of interest were length of PICU stay, duration of mechanical ventilation, duration of vasoactive drug therapy, and mortality. The Pediatric Index of Mortality 2 was used to assess overall disease severity at the time of PICU admission. Of 375 patients, 169 (45%) presented acute kidney injury at the time of admission and 37 developed acute kidney injury during PICU stay, for a total of 206 of 375 patients (55%) diagnosed with acute kidney injury during the study period. The median Pediatric Index of Mortality 2 score predicted a mortality rate of 9% among non-acute kidney injury patients versus a mortality rate of 16% among acute kidney injury patients (p = 0.006). The mortality of patients classified as pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease F was double that predicted by Pediatric Index of Mortality 2 (7 vs 3.2). Patients classified as having severe acute kidney injury (pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease I + F) exhibited higher mortality (14.1%; p = 0.001) and prolonged PICU length of stay (median, 7 d; p = 0.001) when compared with other patients. Acute kidney injury is a very frequent occurrence among patients admitted to PICUs. The degree of acute kidney injury severity, as assessed by the pediatric-modified Risk
Acheson, Ashley; Richard, Dawn M; Mathias, Charles W; Dougherty, Donald M
Previous studies have found individuals with family histories of alcohol use disorders are more impulsive on some but not all laboratory behavioral measures, suggesting deficits on specific forms of impulse control. However, drawing conclusions is tenuous because these different measures have not been administered together in the same group of participants. In the present study, we compared healthy 21-35 year old adults with family histories of alcohol related problems (FHAP+) or without such histories (FHAP-) on behavioral measures of response inhibition, response initiation, and consequence sensitivity impulsivity. FHAP+ (n=36) and FHAP- (n=36) participants were compared on performance on the Immediate Memory Task (IMT, response initiation), GoStop Impulsivity Paradigm (GoStop, response inhibition), Two Choice Impulsivity Paradigm (TCIP, consequence sensitivity) and Single Key Impulsivity Paradigm (SKIP, consequence sensitivity). FHAP+ individuals were more impulsive on the IMT and GoStop but not on the TCIP or SKIP. These results suggest that response initiation and response inhibition impulsivity are increased in individuals with family histories of alcohol related problems despite not having alcohol or drug use disorders themselves. In contrast, increased consequence sensitivity impulsivity may be associated with additional risk factors such as more severe family histories of alcohol use disorders, or it may be increased as a consequence of heavy drug or alcohol use. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Strauss, Jillian; Miranda-Moreno, Luis F; Morency, Patrick
This study proposes a two-equation Bayesian modelling approach to simultaneously study cyclist injury occurrence and bicycle activity at signalized intersections as joint outcomes. This approach deals with the potential presence of endogeneity and unobserved heterogeneities and is used to identify factors associated with both cyclist injuries and volumes. Its application to identify high-risk corridors is also illustrated. Montreal, Quebec, Canada is the application environment, using an extensive inventory of a large sample of signalized intersections containing disaggregate motor-vehicle traffic volumes and bicycle flows, geometric design, traffic control and built environment characteristics in the vicinity of the intersections. Cyclist injury data for the period of 2003-2008 is used in this study. Also, manual bicycle counts were standardized using temporal and weather adjustment factors to obtain average annual daily volumes. Results confirm and quantify the effects of both bicycle and motor-vehicle flows on cyclist injury occurrence. Accordingly, more cyclists at an intersection translate into more cyclist injuries but lower injury rates due to the non-linear association between bicycle volume and injury occurrence. Furthermore, the results emphasize the importance of turning motor-vehicle movements. The presence of bus stops and total crosswalk length increase cyclist injury occurrence whereas the presence of a raised median has the opposite effect. Bicycle activity through intersections was found to increase as employment, number of metro stations, land use mix, area of commercial land use type, length of bicycle facilities and the presence of schools within 50-800 m of the intersection increase. Intersections with three approaches are expected to have fewer cyclists than those with four. Using Bayesian analysis, expected injury frequency and injury rates were estimated for each intersection and used to rank corridors. Corridors with high bicycle volumes
Iguchi, Junta; Watanabe, Yuya; Kimura, Misaka; Fujisawa, Yoshihiko; Hojo, Tatsuya; Yuasa, Yasuhiro; Higashi, Shinsuke; Kuzuhara, Kenji
Iguchi, J, Watanabe, Y, Kimura, M, Fujisawa, Y, Hojo, T, Yuasa, Y, Higashi, S, and Kuzuhara, K. Risk factors for injury among Japanese collegiate players of American football based on performance test results. J Strength Cond Res 30(12): 3405-3411, 2016-The purpose of this study was to identify how risk factors for injury during American football are related to players' physical strength as determined using typical performance tests. One hundred 53 Japanese collegiate players of American football were recruited for this study. Eight potential risk factors were evaluated: position (skill vs. lineman), body mass index, back squat one-repetition maximum, vertical jump height, power, height, body weight, and previous injury. Using multivariate Cox regression, we examined how these factors were associated with knee sprain, ankle sprain, and hamstring strain. We recorded 63 injuries (17 knee sprains, 23 ankle sprains, and 23 hamstring strains). Players with higher power were at significantly greater risk for knee sprains (p = 0.04), those with low power had a significantly higher incidence of ankle sprain (p = 0.01), and vertical jump height was a significant predictor of hamstring strain (p = 0.02). We identified several independent predictors of injuries associated with American football. Our findings may contribute to the development of effective screening tests and prevention exercises.
Saunders, Natasha R; Lee, Hannah; Macpherson, Alison; Guan, Jun; Guttmann, Astrid
Firearm injuries contribute to substantial morbidity and mortality. The immigrant paradox suggests that, despite being more socially disadvantaged, immigrants are less likely than nonimmigrants to have poor outcomes. We tested the association of immigrant characteristics with firearm injuries among children and youth. We conducted a population-based cohort study involving residents of Ontario aged 24 years and younger from 2008-2012 using health and administrative databases. We estimated rate ratios of unintentional and assault-related firearm injuries by immigrant status using Poisson regression models with Generalized Estimating Equations. We included 15 866 954 nonimmigrant and 4 551 291 immigrant person-years in our analysis. Nonimmigrant males had 1032 unintentional (12.4 per 100 000, 95% confidence interval [CI] 11.7-13.2) and 304 assault-related (3.6 per 100 000, 95% CI 3.2-4.0) firearm injuries. Immigrant males had 148 unintentional (7.2 per 100 000, 95% CI 6.1-8.5) and 113 assault-related (5.5 per 100 000, 95% CI 4.5-6.6) firearm injuries. Compared with nonimmigrants, immigrants had a lower rate of unintentional firearm injury (adjusted rate ratio 0.5, 95% CI 0.4-0.6) but a similar rate of assault-related firearm injury. Among immigrants, refugees had a 43% higher risk of assault-related firearm injury compared with nonrefugees (adjusted rate ratio 1.4, 95% CI 1.0-2.0). Immigrants from Central America and Africa accounted for 68% of immigrants with assault-related firearm injuries. Compared with nonimmigrants, immigrant children and youth had a lower risk of unintentional firearm injury, although the risk of assault-related firearm injury was higher among refugees and immigrants from Central America and Africa. The results suggest that prevention strategies for firearm safety should target nonimmigrant youth as well as these newly identified high-risk immigrant populations. © 2017 Canadian Medical Association or its licensors.
Emery, Carolyn; Kang, Jian; Shrier, Ian; Goulet, Claude; Hagel, Brent; Benson, Brian; Nettel-Aguirre, Alberto; McAllister, Jenelle; Meeuwisse, Willem
Background: In a previous prospective study, the risk of concussion and all injury was more than threefold higher among Pee Wee ice hockey players (ages 11–12 years) in a league that allows bodychecking than among those in a league that does not. We examined whether two years of bodychecking experience in Pee Wee influenced the risk of concussion and other injury among players in a Bantam league (ages 13–14) compared with Bantam players introduced to bodychecking for the first time at age 13. Methods: We conducted a prospective cohort study involving hockey players aged 13–14 years in the top 30% of divisions of play in their leagues. Sixty-eight teams from the province of Alberta (n = 995), whose players had two years of bodychecking experience in Pee Wee, and 62 teams from the province of Quebec (n = 976), whose players had no bodychecking experience in Pee Wee, participated. We estimated incidence rate ratios (IRRs) for injury and for concussion. Results: There were 272 injuries (51 concussions) among the Bantam hockey players who had bodychecking experience in Pee Wee and 244 injuries (49 concussions) among those without such experience. The adjusted IRRs for game-related injuries and concussion overall between players with bodychecking experience in Pee Wee and those without it were as follows: injury overall 0.85 (95% confidence interval [CI] 0.63 to 1.16); concussion overall 0.84 (95% CI 0.48 to 1.48); and injury resulting in more than seven days of time loss (i.e., time between injury and return to play) 0.67 (95% CI 0.46 to 0.99). The unadjusted IRR for concussion resulting in more than 10 days of time loss was 0.60 (95% CI 0.26 to 1.41). Interpretation: The risk of injury resulting in more than seven days of time loss from play was reduced by 33% among Bantam hockey players in a league where bodychecking was allowed two years earlier in Pee Wee compared with Bantam players introduced to bodychecking for the first time at age 13. In light of the
Jennifer H. Olson-Madden
Full Text Available Traumatic brain injury (TBI and substance use disorders (SUDs frequently co-occur. Individuals with histories of alcohol or other drug use are at greater risk for sustaining TBI, and individuals with TBI frequently misuse substances before and after injury. Further, a growing body of literature supports the relationship between comorbid histories of mild TBI (mTBI and SUDs and negative outcomes. Alcohol and other drug use are strongly associated with risk taking. Disinhibition, impaired executive function, and/or impulsivity as a result of mTBI also contribute to an individual’s proclivity towards risk-taking. Risk-taking behavior may therefore, be a direct result of SUD and/or history of mTBI, and risky behaviors may predispose individuals for subsequent injury or continued use of substances. Based on these findings, evaluation of risk-taking behavior associated with the co-occurrence of SUD and mTBI should be a standard clinical practice. Interventions aimed at reducing risky behavior among members of this population may assist in decreasing negative outcomes. A novel intervention (Substance Use and Traumatic Brain Injury Risk Reduction and Prevention (STRRP for reducing and preventing risky behaviors among individuals with co-occurring mTBI and SUD is presented. Areas for further research are discussed.
Na, Hye-Kyung; Lee, Ja Young
Many meta-analysis, large cohort studies, and experimental studies suggest that chronic alcohol consumption increases the risk of gastric and colon cancer. Ethanol is metabolized by alcohol dehydrogenases (ADH), catalase or cytochrome P450 2E1 (CYP2E1) to acetaldehyde, which is then further oxidized to acetate by aldehyde dehydrogenase (ALDH). Acetaldehyde has been classified by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen to humans. The acetaldehyde level in the stomach and colon is locally influenced by gastric colonization by Helicobacter pylori or colonic microbes, as well as polymorphisms in the genes encoding tissue alcohol metabolizing enzymes, especially ALDH2. Alcohol stimulates the uptake of carcinogens and their metabolism and also changes the composition of enteric microbes in a way to enhance the aldehyde level. Alcohol also undergoes chemical coupling to membrane phospholipids and disrupts organization of tight junctions, leading to nuclear translocation of β-catenin and ZONAB, which may contributes to regulation of genes involved in proliferation, invasion and metastasis. Alcohol also generates reactive oxygen species (ROS) by suppressing the expression of antioxidant and cytoprotective enzymes and inducing expression of CYP2E1 which contribute to the metabolic activation of chemical carcinogens. Besides exerting genotoxic effects by directly damaging DNA, ROS can activates signaling molecules involved in inflammation, metastasis and angiogenesis. In addition, alcohol consumption induces folate deficiency, which may result in aberrant DNA methylation profiles, thereby influencing cancer-related gene expression.
Rice, Hannah; Nunns, Michael; House, Carol; Fallowfield, Joanne; Allsopp, Adrian; Dixon, Sharon
Ankle inversion injuries are one of the most common and burdensome injuries in athletic populations. Research that prospectively identifies characteristics associated with this injury is lacking. This prospective study compared baseline anthropometric and biomechanical gait characteristics of military recruits who sustained an ankle inversion injury during training, with those who remained injury-free. Bilateral plantar pressure and three-dimensional lower limb kinematics were recorded in 1065 male, injury-free military recruits, during barefoot running. Injuries that occurred during the 32-week recruit training programme were subsequently recorded. Data were compared between recruits who sustained an ankle inversion injury during training (n=27) and a sample (n=120) of those who completed training injury-free. A logistic regression analysis was used to identify risk factors for this injury. A narrower bimalleolar width and an earlier peak pressure under the fifth metatarsal were predictors of ankle inversion injury. Those who sustained an ankle inversion injury also had a lower body mass, body mass index, and a smaller calf girth than those who completed training injury-free. Anthropometric and dynamic gait characteristics have been identified that may predispose recruits to an ankle inversion injury during Royal Marine recruit training, allowing identification of recruits at higher risk at the start of training. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.
Crompton, Joseph G; Bone, Curt; Oyetunji, Tolulope; Pollack, Keshia M; Bolorunduro, Oluwaseyi; Villegas, Cassandra; Stevens, Kent; Cornwell, Edward E; Efron, David T; Haut, Elliott R; Haider, Adil H
There has been a repeal of the universal helmet law in several states despite definitive evidence that helmets reduce mortality, traumatic brain injury, and hospital expenditures. Opponents of the universal helmet law have successfully claimed that helmets should not be required because of greater torque on the neck, which is thought to increase the likelihood of a cervical spine injury. There is currently insufficient evidence to counter claims that helmets do not increase the risk of cervical spine injury after a motorcycle collision. The objective of this study was to determine the impact of motorcycle helmets on the likelihood of developing a cervical spine injury after a motorcycle collision. We reviewed cases in the National Trauma Databank (NTDB) v7.0 involving motorcycle collisions. Multiple logistic regression was used to analyze the independent effect of helmets on cervical spine injury. Cases were adjusted for age, race, sex, insurance status, anatomic (Injury Severity Score) and physiologic injury severity (systolic blood pressure 3). Between 2002 and 2006, 62,840 cases of motorcycle collision were entered into the NTDB; 40,588 had complete data and were included in the adjusted analysis. Helmeted riders had a lower adjusted odds (0.80 [CI 0.72 to 0.90]) and a lower proportion of cervical spine injury (3.5% vs 4.4%, p Helmeted motorcyclists are less likely to suffer a cervical spine injury after a motorcycle collision. This finding challenges a long-standing objection to mandatory helmet use that claims helmets are associated with cervical spine injury. Re-enactment of the universal helmet law should be considered in states where it has been repealed. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Sulsky, Sandra I; Bulzacchelli, Maria T; Zhu, Lei; Karlsson, Lee; McKinnon, Craig J; Hill, Owen T; Kardouni, Joseph R
Injuries during basic combat training (BCT) impact military health and readiness in the U.S. Army. Identifying risk factors is crucial for injury prevention, but few Army-wide studies to identify risk factors for injury during BCT have been completed to date. This study examines associations between individual and training-related characteristics and injuries during Army BCT. Using administrative data from the Total Army Injury and Health Outcomes Database (TAIHOD), we identified individuals who apparently entered BCT for the first time between 1 January 2002 and 30 September 2007, based on review of administrative records. Injuries were identified and categorized based on coded medical encounter data. When combined with dates of medical services, we could count injuries per person, identify unique injuries, and identify the quantity and type of medical care delivered. Regression models produced odds ratios (ORs) and 95% confidence intervals (CIs) to identify risk factors for injury during BCT (yes/no), adjusted for potential confounders. Of the 278,045 (83.4%) men and 55,302 (16.6%) women who were apparently first-time trainees, 39.5% (n = 109,760) of men and 60.9% (n = 33,699) of women were injured during training based on over 2 million recorded medical encounters entries. The large cohort yielded statistically significant, small magnitude associations between injury and all individual and training-related covariates for men, and all but medical accession waivers and weight for women. After adjustment, largest magnitude effects among men were due to age > 25 yr vs. 17-18 yr (OR = 1.83, 95% CI: 1.75, 1.91); having been married in the past vs. being single (OR = 1.36, 95% CI: 1.24, 1.49); rank E4-E7 vs. E1 (OR = 0.56, 95% CI: 0.53. 0.59); training at Ft. Jackson (OR = 0.66, 95% CI: 0.64, 0.69), Ft. Leonard Wood (OR = 0.67, 95% CI: 0.65, 0.70), or Ft. Knox (OR = 0.69, 95% CI: 066, 0.72) vs. Ft. Benning. Odds of injury were highest during 2005, 2006, and 2007. After
Morrongiello, Barbara A.; Zdzieborski, Daniel; Normand, Jackie
This study compared reactions of mothers and fathers to the risk taking behavior of sons and daughters. Mother-father pairs (N = 52) imagined their 2-year-old boy or girl behaving in risky ways in common home situations that could, and did, result in injury. Emotional and parenting reactions to the behaviors were assessed before and after injury.…
increase aerobic capacity and minimize injury risk through a balance of aerobic endurance and mobility exercises. Establishment of surveillance...Connolly, I. King, and S. Mickelson. 2002. Participatory ergonomics : determining injury control" buy-in" of US Army cadre. Work, 18(2):191-203. Bohnker