Youssef, Yassar; Lee, Gyusung; Godinez, Carlos; Sutton, Erica; Klein, Rosemary V; George, Ivan M; Seagull, F Jacob; Park, Adrian
This study compares surgical techniques and surgeon's standing position during laparoscopic cholecystectomy (LC), investigating each with respect to surgeons' learning, performance, and ergonomics. Little homogeneity exists in LC performance and training. Variations in standing position (side-standing technique vs. between-standing technique) and hand technique (one-handed vs. two-handed) exist. Thirty-two LC procedures performed on a virtual reality simulator were video-recorded and analyzed. Each subject performed four different procedures: one-handed/side-standing, one-handed/between-standing, two-handed/side-standing, and two-handed/between-standing. Physical ergonomics were evaluated using Rapid Upper Limb Assessment (RULA). Mental workload assessment was acquired with the National Aeronautics and Space Administration-Task Load Index (NASA-TLX). Virtual reality (VR) simulator-generated performance evaluation and a subjective survey were analyzed. RULA scores were consistently lower (indicating better ergonomics) for the between-standing technique and higher (indicating worse ergonomics) for the side-standing technique, regardless of whether one- or two-handed. Anatomical scores overall showed side-standing to have a detrimental effect on the upper arms and trunk. The NASA-TLX showed significant association between the side-standing position and high physical demand, effort, and frustration (p<0.05). The two-handed technique in the side-standing position required more effort than the one-handed (p<0.05). No difference in operative time or complication rate was demonstrated among the four procedures. The two-handed/between-standing method was chosen as the best procedure to teach and standardize. Laparoscopic cholecystectomy poses a risk of physical injury to the surgeon. As LC is currently commonly performed in the United States, the left side-standing position may lead to increased physical demand and effort, resulting in ergonomically unsound conditions for
... For Consumers Consumer Updates Do Not Use Infant Sleep Positioners Due to the Risk of Suffocation Share ... to top Safety Advice for Putting Babies to Sleep NEVER use infant sleep positioners. Using this type ...
Servomaa, A.; Komppa, T.
X-ray examinations account for about 15 per cent of Finns' radiation exposure and for roughly one out of a hundred deaths from cancer. The risk is small when compared to other risks in life and to the health benefits obtained from the examinations. About 4.1 million x-ray examinations were conducted in Finland in 1995, i.e. an average of 0.8 examinations per inhabitant. The mean effective dose was about 0.67 mSv per examination and about 0.54 mSv per inhabitant. Natural background radiation causes an annual radiation dose of approximately 3 mSv per person. Examinations of bones and soft tissues accounted for the highest number of x-ray images, roughly 2.1 million, of which half were examinations of the extremities. Some 1.3 million x-ray images were taken of the pulmonary organs, most of them being examinations of the lungs. Computed tomography and examinations of the gastrointestinal tract accounted for about 130,000 images each. To assess the radiation risk involved in x-ray examinations, we need knowledge or an estimate of the radiation doses of organs sensitive to radiation. Efficient calculation methods are available for this purpose. (orig.)
A strategy is presented for reducing health risks at sites contaminated with buried transuranic (TRU) wastes by first taking measures to immobilize the contaminants until the second step, final action, becomes cost-effective and poses less risk to the remediation workers. The first step of this strategy does not preclude further action if it is warranted and is in harmony with environmental laws and regulations
Eidsvig, Unni Marie K.; Kristensen, Krister; Vidar Vangelsten, Bjørn
This paper proposes a model for assessing the risk posed by natural hazards to infrastructures, with a focus on the indirect losses and loss of stability for the population relying on the infrastructure. The model prescribes a three-level analysis with increasing level of detail, moving from qualitative to quantitative analysis. The focus is on a methodology for semi-quantitative analyses to be performed at the second level. The purpose of this type of analysis is to perform a screening of the scenarios of natural hazards threatening the infrastructures, identifying the most critical scenarios and investigating the need for further analyses (third level). The proposed semi-quantitative methodology considers the frequency of the natural hazard, different aspects of vulnerability, including the physical vulnerability of the infrastructure itself, and the societal dependency on the infrastructure. An indicator-based approach is applied, ranking the indicators on a relative scale according to pre-defined ranking criteria. The proposed indicators, which characterise conditions that influence the probability of an infrastructure malfunctioning caused by a natural event, are defined as (1) robustness and buffer capacity, (2) level of protection, (3) quality/level of maintenance and renewal, (4) adaptability and quality of operational procedures and (5) transparency/complexity/degree of coupling. Further indicators describe conditions influencing the socio-economic consequences of the infrastructure malfunctioning, such as (1) redundancy and/or substitution, (2) cascading effects and dependencies, (3) preparedness and (4) early warning, emergency response and measures. The aggregated risk estimate is a combination of the semi-quantitative vulnerability indicators, as well as quantitative estimates of the frequency of the natural hazard, the potential duration of the infrastructure malfunctioning (e.g. depending on the required restoration effort) and the number of users of
Durrheim, D N; Leggat, P A
One of South Africa's principal tourist attractions is the opportunity to encounter Africa's large mammals in the wild. Attacks by these mammals can be exceptionally newsworthy with potentially deleterious effects on tourism. Little is known about the risk of injury and death caused by wild mammals to visitors to South Africa's nature reserves. The aim of this study was to determine the incidence of fatal and nonfatal attacks on tourists by wild mammals in South Africa and to ascertain avoidable factors, if any. Commercial press records covering all South African Newspapers archived at the Independent Newspapers' central library were systematically reviewed for a 10-year period, January 1988 to December 1997 inclusive, to identify all deaths and injuries to domestic and international tourists resulting from encounters with wild mammals in South Africa. All of these incidents were analyzed to ascertain avoidable factors. During the review period seven tourists, including two students from Thailand and a German traveler, were killed by wild mammals in South Africa. Three of the four deaths ascribed to lions resulted from tourists carelessly approaching prides on foot in lion reserves. A judicial inquiry found that the management of a KwaZulu-Natal Reserve was culpable for the remaining death. Tourist ignorance of animal behavior and flagrant disregard of rules contributed to the two fatalities involving hippopotami. The unusual behavior manifested by the bull elephant responsible for the final death, resulted from discomfort caused by a dental problem to this pachyderm. During the same period there were 14 nonfatal attacks on tourists, including five by hippo, three by buffalo, two by rhino, and one each by a lion, leopard, zebra and musth elephant. Only the latter occurred while the visitor was in a motor vehicle. Tourist ethological naivete and failure to determine the experience of trail guides prior to travel, resulted in inadvertent agonistic behavior
Petit, Aymeric; Karila, Laurent; Lejoyeux, Michel
Energy drinks designate "any product in the form of a drink or concentrated liquid containing a mixture of ingredients having the property to raise the level of energy and liveliness". Their introduction has raised many reluctance and reserves after numerous cardiovascular and neurological injuries among regular consumers. This article attempts to synthesize the existing literature on energy drinks. The review focuses to show that excessive energy drinks consumption cause many complications. The literature review was conducted from 2001 to 2014, using PubMed, Google Scholar, EMBASE, and PsycInfo, using the following keywords alone or combined: energy drinks, caffeine, taurine, toxicity, dependence, complications. Occasional or moderate consumption of these cans seem to present little risk to healthy adults. However, their repeated consumption in proportions that far exceed the recommendations for recommended use by the manufacturers, combined with the use of alcohol or illicit drugs consumption increases the risk of occurrence of somatic and psychiatric complications, especially among underage, and subjects with cardiovascular and neurological history. Repeated consumption of energy drinks increases the risk of somatic and psychiatric complications. Further studies must be controlled to improve our understanding of other possible negative consequences on health. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Bailey, Matthew R; Rich, Barbara A; Bennett, B Taylor
Among the multitude of crises that US research institutions may face are those caused by animal rights activists. While most activists opposed to animal research use peaceful and lawful means of expressing their opinions, some extremists resort to illegal methods. Arson, break-ins, and theft with significant property damage at US animal research facilities began in the 1980s. The most troubling trend to develop in the past decade is the targeting of individuals associated with animal research, whether directly or indirectly, and the use of violent scare tactics to intimidate researchers and their families. The National Association for Biomedical Research has a 30-year history of monitoring the animal rights movement and assisting member institutions with crisis situations. In this article we discuss attacks on researchers at their homes, cyber crimes, exploitation of new media formats, infiltration of research facilities, and the targeting of external research stakeholders and business partners. We describe the need for a well-conceived crisis management plan and strong leadership to mitigate crisis situations. Institutions with well-informed leaders and crisis management teams ready to take timely action are best equipped to protect staff, laboratory animals, and research programs. They act on early warnings, provide support for targeted staff, seek legal remedies, thoughtfully control access to research facilities, and identify and enlist new research supporters. We underscore the importance of up-to-date crisis planning so that institutions are not only aware of ongoing risks posed by animal rights extremists but also better prepared to take preemptive action and able to manage those risks successfully.
Chen, Wei-Yu; Lin, Chia-Jung; Liao, Chung-Min
Environmental pollution by anti-influenza drugs is increasingly recognized as a threat to aquatic environments. However, little is known about empirical data on risk effects posed by environmentally relevant concentrations of anti-influenza drug based on recently published ecotoxicological researches in Taiwan. Here we linked ecotoxicology models with an epidemiological scheme to assess exposure risks of aquatic organisms and environmental hazards posed by antiviral oseltamivir (Tamiflu) use in Taiwan. Built on published bioassays, we used probabilistic risk assessment model to estimate potential threats of environmentally relevant hazards on algae, daphnid, and zerbrafish. We found that Tamiflu use was unlikely to pose a significant chronic environmental risk to daphnia and zebrafish during seasonal influenza. However, the chronic environmental risk posed by Tamiflu use during pandemic was alarming. We conclude that no significant risk to algal growth was found during seasonal influenza and high pandemic Tamiflu use. -- Highlights: • Environmentally relevant concentrations of anti-influenza drug have ecotoxicologically important effects. • Tamiflu is unlikely to pose a significant chronic environmental risk during seasonal influenza. • Chronic environmental risk posed by Tamiflu during pandemic is alarming. • Tertiary process in sewage treatment plants is crucial in mitigating Tamiflu exposure risk. -- A probabilistic framework can be used for assessing exposure risks posed by environmentally relevant concentrations of anti-influenza drug in aquatic ecosystems
A cellular phone emits radiation very close to a person's head. Any harmful effects that might arise from the use of cellular phones are being studied carefully, but so far no health risks have been determined. However, the phones may interfere with the operation of electrical devices located close-by, such as a cardiac pacemaker. The biological effects of the microwaves emitted by cellular phones might be based on the resultant higher temperatures in the tissues of the head. Since, even in the worst cases, a cellular phone cannot raise the temperature of tissues by more than some tenths of a degree, no health risks based on thermal effects can be attributed to the use of a cellular phone. No reliable theory has been presented for the non-thermal effects of microwaves. Such effects may exist, however. The studies conducted so far have been unable to show that these effects might be harmful to human health. (orig.)
Full Text Available buildings are considered vulnerable to damage by large seismic events, posing safety and financial risks. It is recommended that an earthquake engineer inspect the building stock and review the content and enforcement of building codes. Appropriate training...
Remington, B.C.; Baumert, J.L.; Blom, W.M.; Houben, G.F.; Taylor, S.L.; Kruizinga, A.G.
Background Allergens in food may pose a risk to allergic consumers. While there is EU regulation for allergens present as an ingredient, this is not the case for unintended allergen presence (UAP). Food companies use precautionary allergen labels to inform allergic individuals of a potential risk
Hammer, A.; Schwartzbach, A. L.; Paulev, P. E.
Four case histories out of 75 significant trampoline injuries (from a total of 198 injuries re-examined) plus two recent accidents (1979) are presented, illustrating that the trampoline is posing an undue risk of serious injury. It is argued that the only single factor capable of preventing trampoline injuries is a trampoline ban. This is imperative in schools. Trampoline clubs are advised to reconsider the risk factors involved. Images p27-a p27-b p27-c Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 PMID:7066612
Guo, Guanghui; Song, Bo; Xia, Deshang; Yang, Zijie; Wang, Fopeng
Intense mining, smelting, and tailing activities of polymetallic ore deposits have affected the environment in Nandan County, Guangxi, China. Samples of particulates with aerodynamic diameters low or equal 10 μm (PM 10 ) were collected in Nandan County to investigate the concentrations of and health risks posed by 17 metals and metalloids in the PM 10 . The metal and metalloid concentrations were lower than those found in other industrial cities. The mean Cr concentration was 7.48 ng/m 3 . Significant higher metal and metalloid concentrations were found in PM 10 from mining areas (Dachang and Chehe) than from the control area (Liuzhai) (p metalloids in PM 10 at all the sites were low, but the non-carcinogenic risks posed to children by all the metals and metalloids together exceeded the safe level (i.e., risk value > 1). The carcinogenic risks posed by Cd, Ni, and Pb were negligible at all sites, while As, Co, and Cr posed potential carcinogenic risks to the residents.
... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Coal tar hair dyes posing a risk of cancer. 740.18... (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements § 740.18 Coal tar hair dyes... coal tar hair dye containing any ingredient listed in paragraph (b) of this section shall bear, in...
Bledsoe, Gregory H; Li, Guohu; Levy, Fred
Although a popular endeavor, boxing has fallen under increased scrutiny because of its association with traumatic brain injury. However, few studies have investigated the overall epidemiology of boxing injuries from representative samples, and no study has ever documented the incidence of injuries in female boxers. This study is a review of professional boxing data from the state of Nevada from September 2001 through March 2003. Medical and outcome data for all professional boxing matches occurring in Nevada between September 2001 and March 2003 (n = 524 matches) were analyzed on the basis of a pair-matched, case-control design. Cases were boxers who received an injury during the boxing matches. Boxers who were not injured served as control subjects. Both conditional and unconditional logistic regression models were used to assess risk factors for injury. The overall incidence rate of injury was 17.1 per 100 boxer-matches, or 3.4 per 100 boxer-rounds. Facial laceration accounted for 51% of all injuries, followed by hand injury (17%), eye injury (14%), and nose injury (5%). Male boxers were significantly more likely than female boxers to receive injuries (3.6 versus 1.2 per 100 boxer-rounds, P = 0.01). Male boxing matches also ended in knockouts and technical knockouts more often than did female matches (P boxing matches is high, particularly among male boxers. Superficial facial lacerations are the most common injury reported. Male boxers have a higher rate of knockout and technical knockouts than female boxers. Further research is necessary to determine the outcomes of injury, particularly the long-term neurologic outcome differences between sexes.
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.
Chang, Chia-Ling; Liao, Chung-Sheng
The objective of this study is to assess the risk of insufficient water supply posed by high-turbidity water. Several phenomena can pose risks to the sufficiency of a water supply; this study concerns risks to water treatment plants from particular properties of rainfall and raw water turbidity. High-turbidity water can impede water treatment plant operations; rainfall properties can influence the degree of soil erosion. Thus, water turbidity relates to rainfall characteristics. Exceedance probabilities are presented for different rainfall intensities and turbidities of water. When the turbidity of raw water is higher than 5,000 NTU, it can cause operational problems for a water treatment plant. Calculations show that the turbidity of raw water at the Ban-Sin water treatment plant will be higher than 5,000 NTU if the rainfall intensity is larger than 165 mm/day. The exceedance probability of high turbidity (turbidity >5,000 NTU) in the Ban-Sin water treatment plant is larger than 10%. When any water treatment plant cannot work regularly, its ability to supply water to its customers is at risk.
Cheng, Yi-Hsien; Lin, Yi-Jun; You, Shu-Han; Yang, Ying-Fei; How, Chun Ming; Tseng, Yi-Ting; Chen, Wei-Yu; Liao, Chung-Min
Waterborne and dietborne exposures of freshwater fish to mercury (Hg) in the forms of inorganic (Hg(II)) and organic (methylmercury or MeHg) affect their growth, development, and reproduction. However, an integrated mechanistic risk model framework to predict the impact of Hg(II)/MeHg on freshwater fish is lacking. Here, we integrated biokinetic, physiological and biogeographic data to calibrate and then establish key risk indices-hazardous quotient and exceedance risk-for freshwater tilapia species across geographic ranges of several major rivers in Taiwan. We found that Hg(II) burden was highest in kidney followed by gill, intestine, liver, blood, and muscle. Our results showed that Hg was less likely to pose mortality risk (mortality rate less than 5 %) for freshwater tilapia species. However, Hg is likely to pose the potential hazard to aquatic environments constrained by safety levels for aquatic organisms. Sensitivity analysis showed that amount of Hg accumulated in tilapia was most influenced by sediment uptake rate. Our approach opens up new possibilities for predicting future fish population health with the impacts of continued Hg exposure to provide information on which fish are deemed safe for human consumption.
Tiede, K.; Westerhoff, P.; Hansen, Steffen Foss
an estimate of the amount of exposure to a range of ENPs from drinking water as well as a relative qualitative risk of exposure to ENPs from drinking water compared to other routes. A range of metal, metal oxide and organic-based ENPs were identified that have the potential to contaminate drinking waters...... drinking waters. In order to address these concerns, the U.K. Drinking Water Inspectorate (DWI) has published a "Review of the risks posed to drinking water by man-made nanoparticles"(DWI 70/2/246). The study, which was funded by the Department for Food and Rural Affairs (Defra), was undertaken by the Food...... (such as ENPs that are produced in large quantities or are used in a free form) were identified and categorised. The classification was based on a categorisation framework to aid exposure assessment of nanomaterials in consumer products. A conservative approach was then used to estimate worst case...
Johnson, Andrew C; Donnachie, Rachel L; Sumpter, John P; Jürgens, Monika D; Moeckel, Claudia; Pereira, M Gloria
This work presents a new and unbiased method of risk ranking chemicals based on the threat they pose to the aquatic environment. The study ranked 12 metals, 23 pesticides, 11 other persistent organic pollutants (POPs), 13 pharmaceuticals, 10 surfactants and similar compounds and 2 nanoparticles (total of 71) of concern against one another by comparing their median UK river water and median ecotoxicity effect concentrations. To complement this, by giving an assessment on potential wildlife impacts, risk ranking was also carried out by comparing the lowest 10th percentile of the effects data with the highest 90th percentile of the exposure data. In other words, risk was pared down to just toxicity versus exposure. Further modifications included incorporating bioconcentration factors, using only recent water measurements and excluding either lethal or sub-lethal effects. The top ten chemicals, based on the medians, which emerged as having the highest risk to organisms in UK surface waters using all the ecotoxicity data were copper, aluminium, zinc, ethinylestradiol (EE2), linear alkylbenzene sulfonate (LAS), triclosan, manganese, iron, methomyl and chlorpyrifos. By way of contrast, using current UK environmental quality standards as the comparator to median UK river water concentrations would have selected 6 different chemicals in the top ten. This approach revealed big differences in relative risk; for example, zinc presented a million times greater risk then metoprolol and LAS 550 times greater risk than nanosilver. With the exception of EE2, most pharmaceuticals were ranked as having a relatively low risk. Copyright © 2017 Elsevier B.V. All rights reserved.
Jonathan E. Suk
Full Text Available Infectious diseases can constitute public health emergencies of international concern when a pathogen arises, acquires new characteristics, or is deliberately released, leading to the potential for loss of human lives as well as societal disruption. A wide range of risk drivers are now known to lead to and/or exacerbate the emergence and spread of infectious disease, including global trade and travel, the overuse of antibiotics, intensive agriculture, climate change, high population densities, and inadequate infrastructures, such as water treatment facilities. Where multiple risk drivers interact, the potential impact of a disease outbreak is amplified. The varying temporal and geographic frequency with which infectious disease events occur adds yet another layer of complexity to the issue. Mitigating the emergence and spread of infectious disease necessitates mapping and prioritising the interdependencies between public health and other sectors. Conversely, during an international public health emergency, significant disruption occurs not only to healthcare systems but also to a potentially wide range of sectors, including trade, tourism, energy, civil protection, transport, agriculture, and so on. At the same time, dealing with a disease outbreak may require a range of critical sectors for support. There is a need to move beyond narrow models of risk to better account for the interdependencies between health and other sectors so as to be able to better mitigate and respond to the risks posed by emerging infectious disease.
Warming, Marlies; Hansen, Mette G.; Holm, Peter E.; Magid, Jakob; Hansen, Thomas H.; Trapp, Stefan
This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured. Concentrations (mg/kg dw) of As were 0.002–0.21, Cd 0.03–0.25, Cr < 0.09–0.38, Cu 1.8–8.7, Ni < 0.23–0.62, Pb 0.05–1.56, and Zn 10–86. Generally, elemental concentrations in the crops do not reflect soil concentrations, nor exceed legal standards for Cd and Pb in food. Hazard quotients (HQs) were calculated from soil ingestion, vegetable consumption, measured trace element concentrations and tolerable intake levels. The HQs for As, Cd, Cr, Cu, Ni, and Zn do not indicate a health risk through urban gardening in Copenhagen. Exposure to Pb contaminated sites may lead to unacceptable risk not caused by vegetable consumption but by unintentional soil ingestion. - Highlights: • We measured trace metal concentrations in urban soil and vegetables. • We calculated hazard quotients (HQs) to determine the human health risk. • Consumption of urban vegetables does not result in HQs exceeding unity. • Unintentional ingestion of contaminated soil causes a risk to the human health. - Consumption of vegetables grown in Copenhagen does not pose a risk to the human health, while unintentional ingestion of contaminated soil remains a risk factor with respect to lead
Østerlund, Anna H; Lander, Flemming; Nielsen, Kent
Objectives The objectives of this study were to (i) identify transient risk factors of occupational injuries and (ii) determine if the risk varies with age, injury severity, job task, and industry risk level. Method A case-crossover design was used to examine the effect of seven specific transient...... 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...... in relation to sex, age, job task, industry risk level, or injury severity. Conclusion Use of a case-crossover design identified several worker-related transient risk factors (time pressure, feeling sick, being distracted by someone) that led to significantly increased risks for occupational injuries...
Berchialla, Paola; Bellussi, Luisa; Castella, Annalisa; Snidero, Silvia; Passali, Desiderio; Gregori, Dario
The entry of a small item into the respiratory or digestive tract is still one of the leading causes of injuries in children up to 14 years old. The aim of the paper is to provide a quantitative risk assessment analysis for identifying consumer product features which contribute to increase the risk of sustaining a severe injury. Data on foreign body injuries were collected in 28 European countries and one Pakistani hospital. A total of 7296 cases were classified according to ICD-9CM 931-935. Information about injuries included age and gender of the injured child, circumstances of the accident and foreign body features. A classification tree was set up in order to analyze the impact of the item features like volume shape and rigidity on the severity of the injury. Males are involved in severe injuries more often than females. Most severe injuries when the foreign body is localized in the ears were due to objects with volume lesser than 49 mm(3). Volume cut-off is slightly higher for foreign bodies that have been found in the nose (55 mm(3)). Objects with conforming rigidity pose children to higher risk of severe injury. The presence and supervision of an adult is crucial in reducing the risk for severe injuries both in pharynx and laryhnx and in mouth. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Avčin, Bojana Avguštin; Kučina, Andrea Užmah; Sarotar, Brigita Novak; Radovanović, Mirjana; Plesničar, Blanka Kores
The global financial and economic crisis starting in 2007 led to a deterioration of several socio-economic determinants of mental health. The aim of this cross-sectional study was to examine the impact of the present economic crisis on the depression and anxiety levels of the employed in the private and public sector in Slovenia. Altogether 1592 employees completed an internet based self-reported questionnaire. Data about perceived impact of the economic crisis, several socio-demographic, socioeconomic, and health parameters were collected. Depression symptoms were assessed by the Center for Epidemiological Studies-Depression Scale and anxiety symptoms by the Spielberger State-Inventory. Regression models were used 1) to explore the associations of the economic crisis with the level of depression and anxiety symptoms while controlling for some sociodemographic and work characteristic variables, and 2) to understand the relationship between some potentially important socioeconomic variables and the perception of the economic crisis. Depressive and anxiety scores were significantly increased among 590 (46.6%) employees being affected by the economic crisis. The level of depressive symptoms was significantly associated with perceived impact by the crisis, recent sick leave, reported injuries sustained at work, benzodiazepine and analgesic use, the lack of emotional support, and trust in crisis telephone lines. The level of anxiety symptoms yielded the robust association with the level of depression symptoms, reported injuries sustained on the way to work and education. The economic crisis poses an additional risk factor for mental health problems which clinicians should internalize and become more aware of them. Symptoms of depression and anxiety can be masked in high-utilizers of medical care with physical complaints or psychoactive drug use.
Liu, Yu Y; Shen, Ya X; Liu, Cheng; Liu, Hao F
The present study aims to investigate the influence of human activity on heavy metals in a typical arid urban area of China and assess human health risks posed by heavy metals in PM 1 (particles <1.0 μm in diameter) for different people. In this paper, Changji (Xinjiang, China) was selected as the study area, and samples were collected from March 2014 to March 2015. A total 14 elements in PM 1 were quantified using ICP-MS. An enrichment factor (EF) was used to assess the influence of human activity on the contamination of these metals. The results indicated that Mn was not enriched; Co, Cu, Cr, Ni, Tl, and V were slightly enriched; Mo, Pb, and Sb were moderately enriched; and Ag, As, and Cd were strongly enriched. To assess the health risks associated with inhaling PM 1 , the risk assessment code and loss in life expectancy based on the individual metals were calculated. The results showed that the elements Ag, Cu, Mo, Pb, Sb, Tl, and V in PM 1 posed low levels of non-carcinogenic risks, but these metals may still pose risks to certain susceptible populations. In addition, the results also showed that As, Co, and Cr posed an appreciable carcinogenic risk, while Cd and Ni posed low levels of carcinogenic risk. The total predicted loss of life expectancy caused by the three metals As, Co, and Ni was 63.67 d for the elderly, 30.95 d for adult males, 26.62 d for adult females, and 48.22 d for children. Therefore, the safety of the elderly and children exposed to PM 1 should be given more attention than the safety of adults. The results from this study demonstrate that the health risks posed by heavy metals in PM 1 in Changji, Xinjiang, China should be examined.
Smith, Kristopher M; Apicella, Coren L
A contribution to a special issue on Hormones and Human Competition. The effect of postural power displays (i.e. power poses) on hormone levels and decision-making has recently been challenged. While Carney et al. (2010) found that holding brief postural displays of power leads to increased testosterone, decreased cortisol and greater economic risk taking, this failed to replicate in a recent high-powered study (Ranehill et al. 2015). It has been put forward that subtle differences in social context may account for the differences in results. Power displays naturally occur within the context of competitions, as do changes in hormones, and researchers have yet to examine the effects of poses within this ecologically relevant context. Using a large sample of 247 male participants, natural winners and losers of a physical competition were randomly assigned to hold a low, neutral or high-power postural display. We found no main effect of pose type on testosterone, cortisol, risk or feelings of power. Winners assigned to a high-power pose had a relative, albeit small, rise in testosterone compared to winners who held neutral or low-power poses. For losers, we found little evidence that high-power poses lead to increased testosterone relative to those holding neutral or low-powered poses. If anything, the reverse was observed - losers had a reduction in testosterone after holding high-power poses. To the extent that changes in testosterone modulate social behaviors adaptively, it is possible that the relative reduction in testosterone observed in losers taking high-powered poses is designed to inhibit further "winner-like" behavior that could result in continued defeat and harm. Still, effects were small, multiple comparisons were made, and the results ran counter to our predictions. We thus treat these conclusions as preliminary. Copyright © 2016 Elsevier Inc. All rights reserved.
Dodd, Roger Y; Hackett, John; Linnen, Jeffrey M; Dorsey, Kerri; Wu, Yanyun; Zou, Shimian; Qiu, Xiaoxing; Swanson, Priscilla; Schochetman, Gerald; Gao, Kui; Carrick, James M; Krysztof, David E; Stramer, Susan L
When xenotropic murine leukemia virus-related virus (XMRV) was first reported in association with chronic fatigue syndrome, it was suggested that it might offer a risk to blood safety. Thus, the prevalence of the virus among blood donors and, if present, its transmissibility by transfusion need to be defined. Two populations of routine blood donor samples (1435 and 13,399) were obtained for prevalence evaluations; samples from a linked donor-recipient repository were also evaluated. Samples were tested for the presence of antibodies to XMRV-related recombinant antigens and/or for XMRV RNA, using validated, high-throughput systems. The presence of antibodies to XMRV could not be confirmed among a total of 17,249 blood donors or recipients (0%; 95% confidence interval [CI], 0%-0.017%); 1763 tested samples were nonreactive for XMRV RNA (0%; 95% CI, 0%-0.17%). Evidence of infection was absent from 109 recipients and 830 evaluable blood samples tested after transfusion of a total of 3741 blood components. XMRV and related murine leukemia virus (MLV) markers are not present among a large population of blood donors and evidence of transfusion transmission could not be detected. Thus, these viruses do not currently pose a threat to blood recipient safety and further actions relating to XMRV and MLV are not justified. © 2012 American Association of Blood Banks.
Full Text Available Bufadienolide-type cardiac glycosides have a worldwide distribution and are mainly synthesized by plants, but there are also animal sources. In South Africa, members of three genera of the Crassulaceae (Cotyledon, Tylecodon and Kalanchoe cause a unique chronic form of cardiac glycoside poisoning, predominantly in small stock. This paretic/paralytic condition is referred to as “krimpsiekte”, cotyledonosis or “nenta”. “Krimpsiekte” is a plant poisoning only reported from South Africa and is regarded as the most important plant poisoning of small stock in the semi-arid Little Karoo and southern fringes of the Great Karoo. The toxicosis is caused by cumulative bufadienolides which have neurotoxic properties. Four types of cumulative neurotoxic bufadienolides, namely cotyledoside, and the tyledosides, orbicusides and lanceotoxins, have been isolated. Based on the structure activity relationships and certain toxicokinetic parameters possible reasons for their accumulation are presented. Consumption of edible tissues from animals that have ingested these plants poses a potential risk to humans.
Eidson, M; Lybarger, J A; Parsons, J E; MacCormack, J N; Freeman, J I
Tornadoes in North and South Carolina on 28 March 1984 caused 252 people to be injured seriously enough to require hospitalization and 59 to be killed. To evaluate risk factors, we gathered information on 238 (94%) of those hospitalized and 46 (78%) of those killed. Those hospitalized or deceased had statistically significantly more deep cuts, concussions, unconsciousness and broken bones than those with them at the time of the tornado who were not hospitalized or killed. People living in mobile homes were more likely to be hospitalized or die than people occupying conventional houses. Other risk factors for hospitalization or death included advanced age (60+ years), no physical protection (not having been covered with a blanket or other object), having been struck by broken window glass or other falling objects, home lifted off its foundation, collapsed ceiling or floor, or walls blown away. More awareness of the tornado risk before it strikes and better adherence to tornado protection guidelines could reduce injuries and deaths in the future.
Richard, J-B; Thélot, B; Beck, F
Whatever the type of injury considered, prevention requires an improvement in health services' awareness of risk factors. The Health Barometer is a general population survey conducted in France since 1992 to contribute to surveillance in this field. The survey's statistical power and the numerous health topics included in the questionnaire provide accurate information for healthcare professionals and decision-makers. The Health Barometer 2010 was a nationwide telephone survey of 9110 persons representative of the 15-85-year-old population. One part of the questionnaire detailed injuries which had occurred during the past year. The numerous variables recorded enabled application of logistic regression models to explore risk factors related to different types of injury by age group. The findings were compared with the Health Barometer 2005 data to search for temporal trends of injury prevalence. The data analysis showed that 10.3% of the 15-85-year-olds reported an injury during the past year. This rate was higher than recorded in 2005; the increase was mainly due to domestic accidents and injuries occurring during recreational activities. Both type of injury and risk factors exhibited age-related variability. Domestic accidents and injuries occurring during recreational activities predominated in the older population and were associated with physical or mental health problems (chronic disease, diability, sleep disorders). For younger people, injuries were related to cannabis use, drunkedness, and insufficient sleep. Risk factors were also depended on type of injury: occupational accident-related injuries were linked with social disadvantage (manual worker population) whereas sports injuries were more common in the socially advantaged population. This survey confirms established knowledge and highlights, at different stages of life, new risk factors that contribute to injuries in France. These findings should be helpful for the development of adapted injury
Hernandez, Sonia M; Peters, Valerie E; Weygandt, P Logan; Jimenez, Carlos; Villegas, Pedro; O'Connor, Barry; Yabsley, Michael J; Garcia, Maricarmen; Riblet, Sylva M; Carroll, C Ron
Shade-grown coffee plantations are often promoted as a conservation strategy for wild birds. However, these agro-ecosystems are actively managed for food production, which may alter bird behaviors or interactions that could change bird health, compared to natural forest. To examine whether there is a difference between the health parameters of wild birds inhabiting shade-grown coffee plantations and natural forest, we evaluated birds in Costa Rica for (1) their general body condition, (2) antibodies to pathogens, (paramyxovirus and Mycoplasma spp.), and (3) the prevalence and diversity of endo-, ecto-, and hemoparasites. We measured exposure to Mycoplasma spp. and paramyxovirus because these are pathogens that could have been introduced with domestic poultry, one mechanism by which these landscapes could be detrimental to wild birds. We captured 1,561 birds representing 75 species. Although seasonal factors influenced body condition, we did not find bird general body condition to be different. A total of 556 birds of 31 species were tested for antibodies against paramyxovirus-1. Of these, five birds tested positive, four of which were from shade coffee. Out of 461 other tests for pathogens (for antibodies and nucleotide detection), none were positive. Pterolichus obtusus, the feather mite of chickens, was found on 15 birds representing two species and all were from shade-coffee plantations. Larvated eggs of Syngamus trachea, a nematode typically associated with chickens, were found in four birds captured in shade coffee and one captured in forest. For hemoparasites, a total of 1,121 blood smears from 68 bird species were examined, and only one species showed a higher prevalence of infection in shade coffee. Our results indicate that shade-coffee plantations do not pose a significant health risk to forest birds, but at least two groups of pathogens may deserve further attention: Haemoproteus spp. and the diversity and identity of endoparasites.
Zhang, Yanli; Wu, Junrong; Feng, Xiaoli; Wang, Ruolan; Chen, Aijie; Shao, Longquan
With the broad use of nanotechnology, the number and variety of nanoparticles that humans can be exposed to has further increased. Consequently, there is growing concern about the potential effect of maternal exposure to various nanoparticles during pregnancy on a fetus. However, the nature of this risk is not fully known. Areas covered: In this review, materno-fetal transfer of nanoparticles through the placenta is described. Both prenatal and postnatal adverse effects, such as fetal resorption, malformation and injury to various organs in mice exposed to nanoparticles are reviewed. The potential mechanisms of toxicity are also discussed. Expert opinion: The toxicology and safe application of recently developed nanoparticles has attracted much attention in the past few years. Although many studies have demonstrated the toxicology of nanoparticles in various species, only a small number of studies have examined the effect on a fetus after maternal exposure to nanoparticles. This is particularly important, because the developing fetus is especially vulnerable to the toxic effects of nanoparticles during fetal development due to the unique physical stage of the fetus. Nanoparticles may directly or indirectly impair fetal development and growth after maternal exposure to nanoparticles.
To describe and critically analyse the thinking that led to the concept of an association between incontinence, care dependence and elder abuse. Coercive or abusive continence care practices include chastising a person for their incontinence and overriding their attempts to resist continence care. Neglect in continence care is characterised by withholding or delaying responding to requests for help to maintain continence or to manage incontinence, and restricting a person's access to toileting assistance, incontinence aids or hygiene care. Contemporary biomedical understandings about incontinence and influencing concepts from the fields of sociology, psychology and nursing were analysed to inform the design of a conceptual model that elucidates possible associations between incontinence, care dependence and elder abuse. Ideas generated from an analysis of the concepts led to the development of a model termed the "Model of Attributes to Abuse of Dependent Elders in Continence Care" (MADE-CC). The MADE-CC theorises factors that cause and contribute to abuse in continence care. Carer factors include physical and emotional exhaustion, frustration related to the inability to control or predict incontinence, resentment associated with constraints imposed by care dependence, disgust associated with physical contact with urine/faeces, limited knowledge and skills about incontinence and ethical conflicts concerning care. Care recipient factors include frequent and severe incontinence, cognitive impairment and a history of physical or psychological trauma. Social factors that are theorised include the stigmatised nature of incontinence, social taboos and cultural norms and the private nature of continence care. The MADE-CC illuminates the potential risk of elder abuse posed by incontinence and care dependence. It should be used to improve ethical care of older people and stimulate debate about everyday ethics in the care of older people who are care dependent and to optimise
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.
Anderson, W. B.; Seager, R.; Cane, M. A.; Baethgen, W.
The El Niño Southern Oscillation (ENSO) is a major source of interannual climate variability, particularly in the Pacific Basin. ENSO life-cycles tend to evolve over multiple years, as do the associated trans-Pacific ENSO teleconnections. This analysis, however, represents the first attempt to characterize the structure of the risk posed by ENSO to wheat, maize and soybean production across the Pacific Basin. Our results indicate that most ENSO teleconnections relevant for crop flowering seasons are the result of a single trans-Pacific circulation anomaly that develops in boreal summer and persists through the spring. During the late summer and early fall of a developing ENSO event, the tropical Pacific forces an atmospheric anomaly in the midlatitudes that spans the Pacific Basin. This teleconnection directly links the soybean and maize growing seasons of the US, Mexico and China. It also connects the wheat growing seasons of Argentina, southern Brazil and Australia. The ENSO event peaks in boreal winter, when the atmospheric circulation anomalies intensify and affect maize and soybeans in southeast South America. As the event decays, the ENSO-induced circulation anomalies persist through the wheat flowering seasons in China and the US. While the prospect of ENSO forcing simultaneous droughts in major food producing regions seems disastrous, there may be a silver lining from the perspective of global food security: trans-Pacific ENSO teleconnections to yields are often offsetting between major producing regions in the eastern and western portions of the Pacific Basin. El Niños tend to create good maize and soybean growing conditions in the US and southeast South America, but poor growing conditions in China, Mexico and northeast Brazil. The opposite is true during La Niña. Wheat growing conditions in southeast South America generally have the opposite sign of those in Australia. Finally, we investigate how trade networks interact with this structure of ENSO
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.
André Lincoln Barroso de Magalhães
, P. reticulata, and Amatitlania nigrofasciata can potentially invade the Todos os Santos River. Six recommendations are suggested to reduce the invasion risk of non-native fish on the rivers surveyed posed by aquarium trade.Um modelo foi desenvolvido para avaliar o risco de invasão de peixes ornamentais não-nativos em seis rios do estado de Minas Gerais, sudeste do Brasil, com foco na popularidade das espécies. Trinta e nove lojas de aquário em seis cidades foram visitadas mensalmente de janeiro a dezembro de 2007. Em cada cidade, as espécies foram identificadas e suas biologias e histórias de invasão foram obtidas da literatura. Calculou-se a frequência de ocorrência anual e quantidade média mensal de exemplares disponíveis nas lojas. Foram obtidas temperaturas trimestrais da água e dados de oxigênio dissolvido de 1997 a 2007 dos rios Velhas, Muriaé, Uberabinha, Sapucaí-Mirim, Doce e Todos os Santos a partir de bases de dados públicas. O risco de invasão de cada espécie foi avaliado através de um modelo composto por nove parâmetros agrupados em quatro variáveis: (i Invasividade (limite de alcance térmico/oxigênio dissolvido, dieta, cuidado parental ou fecundidade, (ii Histórico de invasões (estabelecimento, (iii Pressão de propágulos (sucesso comercial, composto pela frequência de ocorrência anual e número de exemplares disponíveis mensalmente nas lojas, e (iv Invasibilidade (temperatura da água/oxigênio dissolvido dos rios compatível com o limite de alcance térmico/ oxigênio dissolvido das espécies. Das 345 espécies de peixes ornamentais para venda, 332 são não-nativos para Minas Gerais (n = 151 ou Brasil (n = 194. Com base nos valores de corte propostos, cinco espécies de peixes ornamentais não-nativos (Cyprinus rubrofuscus, Carassius auratus, Xiphophorus hellerii, Poecilia reticulata e P. latipinna podem potencialmente invadir os rios Velhas e Muriaé, quatro espécies (C. rubrofuscus, C. auratus, X. helleri, P
This diploma thesis concentrates on problem posing from the students' point of view. Problem posing can be either seen as a teaching method which can be used in the class, or it can be used as a tool for researchers or teachers to assess the level of students' understanding of the topic. In my research, I compare three classes, one mathematics specialist class and two generalist classes, in their ability of problem posing. As an assessment tool it seemed that mathemathics specialists were abl...
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.
Bosso, Luciano; De Conno, Carmelina; Russo, Danilo
We generated a risk map to forecast the potential effects of the spreading of zebra mussels Dreissena polymorpha across the Italian territory. We assessed the invader's potential impact on rivers, lakes, watersheds and dams at a fine-grained scale and detected those more at risk that should be targeted with appropriate monitoring. We developed a MaxEnt model and employed weighted overlay analyses to detect the species' potential distribution and generate risk maps for Italy. D. polymorpha has a greater probability of occurring at low to medium altitudes in areas characterised by fluviatile deposits of major streams. Northern and central Italy appear more at risk. Some hydroelectric power dams are at high risk, while most dams for irrigation, drinkable water reservoirs and other dam types are at medium to low risk. The lakes and rivers reaches (representing likely expansion pathways) at medium-high or high risk mostly occur in northern and central Italy. We highlight the importance of modelling potential invasions on a country scale to achieve the sufficient resolution needed to develop appropriate monitoring plans and prevent the invader's harmful effects. Further high-resolution risk maps are needed for other regions partly or not yet colonised by the zebra mussel.
Bosso, Luciano; De Conno, Carmelina; Russo, Danilo
We generated a risk map to forecast the potential effects of the spreading of zebra mussels Dreissena polymorpha across the Italian territory. We assessed the invader's potential impact on rivers, lakes, watersheds and dams at a fine-grained scale and detected those more at risk that should be targeted with appropriate monitoring. We developed a MaxEnt model and employed weighted overlay analyses to detect the species' potential distribution and generate risk maps for Italy. D. polymorpha has a greater probability of occurring at low to medium altitudes in areas characterised by fluviatile deposits of major streams. Northern and central Italy appear more at risk. Some hydroelectric power dams are at high risk, while most dams for irrigation, drinkable water reservoirs and other dam types are at medium to low risk. The lakes and rivers reaches (representing likely expansion pathways) at medium-high or high risk mostly occur in northern and central Italy. We highlight the importance of modelling potential invasions on a country scale to achieve the sufficient resolution needed to develop appropriate monitoring plans and prevent the invader's harmful effects. Further high-resolution risk maps are needed for other regions partly or not yet colonised by the zebra mussel.
Full Text Available are incorporating the risks of seismicity in their disaster management plans, and Johannesburg is urged to do likewise. Some buildings are considered vulnerable to damage by large seismic events, posing safety and financial risks....
Andricevic, Nino; Junge, Mirko; Krampe, Jonas
The objective of this article was the construction of injury risk functions (IRFs) for front row occupants in oblique frontal crashes and a comparison to IRF of nonoblique frontal crashes from the same data set. Crashes of modern vehicles from GIDAS (German In-Depth Accident Study) were used as the basis for the construction of a logistic injury risk model. Static deformation, measured via displaced voxels on the postcrash vehicles, was used to calculate the energy dissipated in the crash. This measure of accident severity was termed objective equivalent speed (oEES) because it does not depend on the accident reconstruction and thus eliminates reconstruction biases like impact direction and vehicle model year. Imputation from property damage cases was used to describe underrepresented low-severity crashes-a known shortcoming of GIDAS. Binary logistic regression was used to relate the stimuli (oEES) to the binary outcome variable (injured or not injured). IRFs for the oblique frontal impact and nonoblique frontal impact were computed for the Maximum Abbreviated Injury Scale (MAIS) 2+ and 3+ levels for adults (18-64 years). For a given stimulus, the probability of injury for a belted driver was higher in oblique crashes than in nonoblique frontal crashes. For the 25% injury risk at MAIS 2+ level, the corresponding stimulus for oblique crashes was 40 km/h but it was 64 km/h for nonoblique frontal crashes. The risk of obtaining MAIS 2+ injuries is significantly higher in oblique crashes than in nonoblique crashes. In the real world, most MAIS 2+ injuries occur in an oEES range from 30 to 60 km/h.
Full Text Available Higher demands of food production for human consumption increased uses of fertilizers and other chemicals that arise in a major public problem and heavy-metal pollution. Levels of Aluminum and Nickel which affect mankind health in exact doses, were determined in fresh and dried samples of Jumbo Cot, Tom Cot, Gold Strike, Gold Bar, Bergeron, Bergarouge, Sweet Cot, Yellow cot and Zebra apricot cultivars to assess possible health risk of apricot (Prunus armeniaca L. consumption. Highest content of Al and Ni among all cultivars, where 9.71 and 2.14 mg/kg of dehydrated apricot samples. Fresh fruit samples maximally contain 2.9 and 0.425 mg/kg of Aluminum and Nickel respectively. Data analysis showed significant differences between cultivars for Al and Ni. Furthermore, to reveal the health-risk possibility of dried and fresh fruit consumption daily intake of elements and health-risk index were calculated and compared.
McClure, Meredith L; Burdett, Christopher L; Farnsworth, Matthew L; Sweeney, Steven J; Miller, Ryan S
In the midst of Earth's sixth mass extinction event, non-native species are a driving factor in many imperiled species' declines. One of the most widespread and destructive alien invasive species in the world, wild pigs (Sus scrofa) threaten native species through predation, habitat destruction, competition, and disease transmission. We show that wild pigs co-occur with up to 87.2% of imperiled species in the contiguous U.S. identified as susceptible to their direct impacts, and we project increases in both the number of species at risk and the geographic extent of risks by 2025. Wild pigs may therefore present a severe threat to U.S. imperiled species, with serious implications for management of at-risk species throughout wild pigs' global distribution. We offer guidance for efficient allocation of research effort and conservation resources across species and regions using a simple approach that can be applied to wild pigs and other alien invasive species globally.
Warming, Marlies; Hansen, Mette G.; Holm, Peter E.
This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured. Concentra......This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured...
Warming, Marlies; Hansen, Mette G; Holm, Peter E; Magid, Jakob; Hansen, Thomas H; Trapp, Stefan
This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured. Concentrations (mg/kg dw) of As were 0.002-0.21, Cd 0.03-0.25, Cr gardening in Copenhagen. Exposure to Pb contaminated sites may lead to unacceptable risk not caused by vegetable consumption but by unintentional soil ingestion. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gann, Gretchen L; Powell, Cleveland H; Chumchal, Matthew M; Drenner, Ray W
Methylmercury (MeHg) is an environmental contaminant that can have adverse effects on wildlife. Because MeHg is produced by bacteria in aquatic ecosystems, studies of MeHg contamination of food webs historically have focused on aquatic organisms. However, recent studies have shown that terrestrial organisms such as songbirds can be contaminated with MeHg by feeding on MeHg-contaminated spiders. In the present study, the authors examined the risk that MeHg-contaminated terrestrial long-jawed orb weaver spiders (Tetragnatha sp.) pose to songbirds at Caddo Lake (Texas/Louisiana, USA). Methylmercury concentrations in spiders were significantly different in river, wetland, and open-water habitats. The authors calculated spider-based wildlife values (the minimum spider MeHg concentrations causing physiologically significant doses in consumers) to assess exposure risks for arachnivorous birds. Methylmercury concentrations in spiders exceeded wildlife values for Carolina chickadee (Poecile carolinensis) nestlings, with the highest risk in the river habitat. The present study indicates that MeHg concentrations in terrestrial spiders vary with habitat and can pose a threat to small-bodied nestling birds that consume large amounts of spiders at Caddo Lake. This MeHg threat to songbirds may not be unique to Caddo Lake and may extend throughout the southeastern United States. © 2014 SETAC.
Ciriello, V.; Lauriola, I.; Bonvicini, S.; Cozzani, V.; Di Federico, V.; Tartakovsky, Daniel M.
Ubiquitous hydrogeological uncertainty undermines the veracity of quantitative predictions of soil and groundwater contamination due to accidental hydrocarbon spills from onshore pipelines. Such predictions, therefore, must be accompanied by quantification of predictive uncertainty, especially when they are used for environmental risk assessment. We quantify the impact of parametric uncertainty on quantitative forecasting of temporal evolution of two key risk indices, volumes of unsaturated and saturated soil contaminated by a surface spill of light nonaqueous-phase liquids. This is accomplished by treating the relevant uncertain parameters as random variables and deploying two alternative probabilistic models to estimate their effect on predictive uncertainty. A physics-based model is solved with a stochastic collocation method and is supplemented by a global sensitivity analysis. A second model represents the quantities of interest as polynomials of random inputs and has a virtually negligible computational cost, which enables one to explore any number of risk-related contamination scenarios. For a typical oil-spill scenario, our method can be used to identify key flow and transport parameters affecting the risk indices, to elucidate texture-dependent behavior of different soils, and to evaluate, with a degree of confidence specified by the decision-maker, the extent of contamination and the correspondent remediation costs.
Wilkinson, R. Allen; Behringer, Robert P.; Jenkins, James T.; Louge, Michel Y.
Working with soil, sand, powders, ores, cement and sintered bricks, excavating, grading construction sites, driving off-road, transporting granules in chutes and pipes, sifting gravel, separating solids from gases, and using hoppers are so routine that it seems straightforward to do it on the Moon and Mars as we do it on Earth. This paper brings to the fore how little these processes are understood and the millennia-long trial-and-error practices that lead to today's massive over-design, high failure rate, and extensive incremental scaling up of industrial processes because of the inadequate predictive tools for design. We present a number of pragmatic scenarios where granular materials play a role, the risks involved, and what understanding is needed to greatly reduce the risks.
the ingestion of contaminated sediment and food items that have accumulated MC in their tissues. Because MCs are poorly accumulated in fish and...explosives have been extensively used by the DoD. Contamination of terrestrial sites by MC has occurred largely due to (1) explosive manufacturing ...varied widely across a diversity of MC and species. For most aquatic sites, MC contamination in sediment and in the water- column presents low risk to
Bradley, F. [Canadian Electricity Association (Canada)
The proliferation of sophisticated illegal indoor multi-plant marihuana cultivation operations is discussed, focusing primarily on public health and safety issues. Public health issues arise from the high level of molds and pollens caused by high humidity, which can cause asthma, respiratory conditions and allergies, particularly among children, and the likelihood of deadly levels of carbon monoxide build-up resulting from faulty rerouting of the residence's ventilation system. Safety issues discussed are: fires and electrocutions associated with the use of electrical diversions or bipasses to circumvent utility meters, the chemical and electrical hazards involved in investigating and dismantling growing operations, the significant dangers to utility crews who must repair illegal electrical bypasses, injuries by the booby-traps planted to protect the operation from other criminals or law enforcement agents, and the physical danger from the violence, including homicide and assaults, carried out by operators to exert control over production and distribution. Although in general, there is a relaxed attitude towards marihuana use in Canada. there is growing evidence of increasing public concern over large-scale growing operations. Nevertheless, to date operators of grow-ops have been dealt with lightly by the justice system. For example, in British Columbia 11,733 cases have come to the attention of police during the 1997 to 2000 period. Of these about half were dealt with informally (i.e. 'no case' seizures) and 2,255 cases led to at least one offender being convicted. The majority of convictions did not result in custodial dispositions. Only 18 per cent of the cases resulted in prison sentences, the average term being only 4.5 months.
Full Text Available Higher demands of food production for human consumption increased uses of fertilizers and other chemicals that arise in a major public problem and heavy-metal pollution. Levels of Aluminum and Nickel which affect mankind health in exact doses, were determined in fresh and dried samples of �Jumbo Cot�, �Tom Cot�, �Gold Strike�, �Gold Bar�, Bergeron�, �Bergarouge�, �Sweet Cot�, �Yellow cot� and �Zebra� apricot cultivars to assess possible health risk of apricot (Prunus armeniaca L. consumption. Highest content of Al and Ni among all cultivars, where 9.71 and 2.14 mg/kg of dehydrated apricot samples. Fresh fruit samples maximally contain 2.9 and 0.425 mg/kg of Aluminum and Nickel respectively. Data analysis showed significant differences between cultivars for Al and Ni. Furthermore, to reveal the health-risk possibility of dried and fresh fruit consumption daily intake of elements and health-risk index were calculated and compared.
Louden, Emily; Marcotte, Michael; Mehlman, Charles; Lippert, William; Huang, Bin; Paulson, Andrea
Over the course of decades, the incidence of brachial plexus birth injury (BPBI) has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations. The odds of BPBI were 2.5 times higher when oxytocin was used and 3.7 times higher when tachysystole occurred. The odds of BPBI injury are increased when tachysystole and oxytocin occur during the mother’s labor. Logistic regression identified a higher risk for BPBI when more than three of the following variables (>30 lbs gained during the pregnancy, stage 2 labor >61.5 min, mother’s age >26.4 years, tachysystole, or fetal malpresentation) were present in any combination. PMID:29596309
Full Text Available Over the course of decades, the incidence of brachial plexus birth injury (BPBI has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations. The odds of BPBI were 2.5 times higher when oxytocin was used and 3.7 times higher when tachysystole occurred. The odds of BPBI injury are increased when tachysystole and oxytocin occur during the mother’s labor. Logistic regression identified a higher risk for BPBI when more than three of the following variables (>30 lbs gained during the pregnancy, stage 2 labor >61.5 min, mother’s age >26.4 years, tachysystole, or fetal malpresentation were present in any combination.
Girasek, Deborah C; Marschall, Joy S; Pope, Dov
To analyse patterns of departure from a popular hiking trail in Yosemite National Park, at sites where fatal drownings have occurred in the past. This study employed direct observation. For 32 days throughout the summer of 2013, study team members observed hikers who entered areas that brought them in close proximity to hazardous sections of the Merced River. Subject and environmental data were recorded for 1417 such approaches. In 81% of our observation hours, subjects entered 'risk zones.' The median number of hikers seen near/in the river was eight per hour at the Vernal Fall footbridge, and three at the top of the waterfall. A regression analysis found that air temperature and later hike starts were positively associated, and water level was negatively associated, with the rate of river approach. Means of river access were also identified. Males, teens and people who were alone were significantly more likely to be observed entering particularly dangerous areas. It is common for hikers to approach water sources during summer months, particularly as air temperatures rise. By analysing how behaviour and environmental factors co-vary, safety advocates can tailor risk reduction measures to specific settings and visitor populations. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: email@example.com.
Leerkes, Esther M; Su, Jinni; Calkins, Susan D; O'Brien, Marion; Supple, Andrew J
The extent to which indices of maternal physiological arousal (skin conductance augmentation) and regulation (vagal withdrawal) while parenting predict infant attachment disorganization and behavior problems directly or indirectly via maternal sensitivity was examined in a sample of 259 mothers and their infants. Two covariates, maternal self-reported emotional risk and Adult Attachment Interview attachment coherence were assessed prenatally. Mothers' physiological arousal and regulation were measured during parenting tasks when infants were 6 months old. Maternal sensitivity was observed during distress-eliciting tasks when infants were 6 and 14 months old, and an average sensitivity score was calculated. Attachment disorganization was observed during the Strange Situation when infants were 14 months old, and mothers reported on infants' behavior problems when infants were 27 months old. Over and above covariates, mothers' arousal and regulation while parenting interacted to predict infant attachment disorganization and behavior problems such that maternal arousal was associated with higher attachment disorganization and behavior problems when maternal regulation was low but not when maternal regulation was high. This effect was direct and not explained by maternal sensitivity. The results suggest that maternal physiological dysregulation while parenting places infants at risk for psychopathology.
Full Text Available The United Nations Environment Programme (UNEP has been focusing on actions with regard to lead and cadmium since 2001 when the work of the Partnership for Clean Fuels and Vehicles (PCFV was initiated. The development and finalization of the reviews of scientific information on lead and cadmium facilitated discussions among Governments in relation to the need for global action with regard to these heavy metals. UNEP continues to address priority areas for focusing to reduce risks posed by lead and cadmium. The Global Alliance to Eliminate Lead Paint (GAELP is a clear example for addressing those risks; however more work is expected to be done in relation to these key issues.
Sudsandee, Suntorn; Tantrakarnapa, Kraichat; Tharnpoophasiam, Prapin; Limpanont, Yanin; Mingkhwan, Ratchaneekorn; Worakhunpiset, Suwalee
There is global concern about heavy metal contamination in the environment. Adverse health effects can be caused by heavy metals in contaminated food and water. Therefore, environmental monitoring studies and risk assessments should be conducted periodically. In this study, we measured levels of Cd, Cr, Cu, Hg, Mn, Ni, Pb, and Zn in blood cockles (Anadara granosa) collected from three locations in the Upper Gulf of Thailand. Hazard quotients and hazard indices were calculated to evaluate the health risks posed by heavy metals in consumed blood cockles. Heavy metal concentrations in all of the blood cockle samples were lower than the relevant food standards. The hazard quotients and hazard indices were heavy metals in blood cockles over a human lifetime.
Full Text Available Presently, water contamination issues are of great concern worldwide. Mexico has not escaped this environmental problem, which negatively affects aquifers, water bodies and biodiversity; but most of all, public health. The objective was to determine the level of water contamination in six tributaries of the Conchos River and to relate their levels to human health risks. Bimonthly samples were obtained from each location during 2005 and 2006. Physical-chemical variables (temperature, pH, electrical conductivity (EC, Total solids and total nitrogen as well as heavy metals (As, Cr, Cu, Fe, Mn, Ni, V, Zn, and Li were determined. The statistical analysis considered yearly, monthly, and location effects, and their interactions. Temperatures differed only as a function of the sampling month (P < 0.001 and the pH was different for years (P = 0.006, months (P < 0.001 and the interaction years x months (P = 0.018. The EC was different for each location (P < 0.001, total solids did not change and total nitrogen was different for years (P < 0.001, months (P < 0.001 and the interaction years x months (P < 0.001. The As concentration was different for months (P = 0.008 and the highest concentration was detected in February samples with 0.11 mg L-1. The Cr was different for months (P < 0.001 and the interaction years x months (P < 0.001, noting the highest value of 0.25 mg L-1. The Cu, Fe, Mn, Va and Zn were different for years, months, and their interaction. The highest value of Cu was 2.50 mg L-1; forFe, it was 16.36 mg L-1; forMn it was 1.66 mg L-1; V was 0.55 mg L-1; and Zn was 0.53 mg L-1. For Ni, there were differences for years (P = 0.030, months (P < 0.001, and locations (P = 0.050, with the highest Ni value being 0.47 mg L-1. The Li level was the same for sampling month (P < 0.001. This information can help prevent potential health risks in the communities established along the river watershed who use this natural resource for swimming and fishing
He, Guizhen; Zhang, Lei; Mol, Arthur P.J.; Wang, Tieyu; Lu, Yonglong
In China, rural chemical SMEs are often believed to still largely operate below the sustainability radar. This paper investigates to what extent and how chemical SMEs are already experiencing pressure to improve their environmental performance, using an in-depth case study in Jasmine County, Hebei province. The results show that local residents had rather low trust in the environmental improvement promises made by the enterprises and the local government, and disagreed with the proposed improvement plans. Although the power of local residents to influence decision making remained limited, the chemical SMEs started to feel increasing pressures to clean up their business, from governments, local communities and civil society, and international value chain stakeholders. Notwithstanding these mounting pressures chemical SME's environmental behavior and performance has not changed radically for the better. The strong economic ties between local county governments and chemical SMEs continue to be a major barrier for stringent environmental regulation. -- Highlights: • Rural chemical SMEs are often below the sustainability radar in China. • Close local government-SMEs tie remained as a barrier for effective environmental enforcement. • Rural communities proved unable to collectively raise their voice. • National government must adopt environment-oriented political incentives. -- The paper provides a major understanding of how and why the large number of existing chemical SMEs in rural China still form major chemical risks
Langford, Katherine H; Øxnevad, Sigurd; Schøyen, Merete; Thomas, Kevin V
Aquaculture production is an important industry in many countries and there has been a growth in the use of medicines to ensure the health and cost effectiveness of the industry. This study focused on the inputs of sea lice medication to the marine environment. Diflubenzuron, teflubenzuron, emamectin benzoate, cypermethrin, and deltamethrin were measured in water, sediment, and biota samples in the vicinity of five aquaculture locations along the Norwegian coast. Deltamethrin and cypermethrin were not detected above the limits of detection in any samples. Diflubenzuron, teflubenzuron, and emamectin benzoate were detected, and the data was compared the UK Environmental Quality Standards. The concentrations of emamectin benzoate detected in sediments exceed the environmental quality standard (EQS) on 5 occasions in this study. The EQS for teflubenzuron in sediment was exceeded in 67% of the samples and exceeded for diflubenzuron in 40% of the water samples collected. A crude assessment of the concentrations detected in the shrimp collected from one location and the levels at which chronic effects are seen in shrimp would suggest that there is a potential risk to shrimp. It would also be reasonable to extrapolate this to any species that undergoes moulting during its life cycle.
Nicol, Sam; Chadès, Iadine
Environmental impact assessment (EIA) is used globally to manage the impacts of development projects on the environment, so there is an imperative to demonstrate that it can effectively identify risky projects. However, despite the widespread use of quantitative predictive risk models in areas such as toxicology, ecosystem modelling and water quality, the use of predictive risk tools to assess the overall expected environmental impacts of major construction and development proposals is comparatively rare. A risk-based approach has many potential advantages, including improved prediction and attribution of cause and effect; sensitivity analysis; continual learning; and optimal resource allocation. In this paper we investigate the feasibility of using a Bayesian belief network (BBN) to quantify the likelihood and consequence of non-compliance of new projects based on the occurrence probabilities of a set of expert-defined features. The BBN incorporates expert knowledge and continually improves its predictions based on new data as it is collected. We use simulation to explore the trade-off between the number of data points and the prediction accuracy of the BBN, and find that the BBN could predict risk with 90% accuracy using approximately 1000 data points. Although a further pilot test with real project data is required, our results suggest that a BBN is a promising method to monitor overall risks posed by development within an existing EIA process given a modest investment in data collection.
Full Text Available Environmental impact assessment (EIA is used globally to manage the impacts of development projects on the environment, so there is an imperative to demonstrate that it can effectively identify risky projects. However, despite the widespread use of quantitative predictive risk models in areas such as toxicology, ecosystem modelling and water quality, the use of predictive risk tools to assess the overall expected environmental impacts of major construction and development proposals is comparatively rare. A risk-based approach has many potential advantages, including improved prediction and attribution of cause and effect; sensitivity analysis; continual learning; and optimal resource allocation. In this paper we investigate the feasibility of using a Bayesian belief network (BBN to quantify the likelihood and consequence of non-compliance of new projects based on the occurrence probabilities of a set of expert-defined features. The BBN incorporates expert knowledge and continually improves its predictions based on new data as it is collected. We use simulation to explore the trade-off between the number of data points and the prediction accuracy of the BBN, and find that the BBN could predict risk with 90% accuracy using approximately 1000 data points. Although a further pilot test with real project data is required, our results suggest that a BBN is a promising method to monitor overall risks posed by development within an existing EIA process given a modest investment in data collection.
Recently, awareness has developed of the environmental consequences of drug waste and disposal. These residues are identified as coming from either diffuse sources, the most significant of which is via the discharge of these residues in urine and feces, and thus the sewage system and water contains these drug remnants and their metabolites, or from point sources, sometimes with very high levels of concentration in waste from chemical and pharmaceutical industries, health care settings, but also from intensive livestock farming and aquaculture. Depending on their physical chemistry properties, these substances are more or less naturally biodegradable and easily treated in sewage purification plants. The effectiveness of these treatment processes is highly random and unpredictable, but is overall around 60%, nevertheless with variations of 2-99% according to the molecules. The silt from these treatment plants, sometimes very rich in lipophilic substances is on occasion reused for agricultural application as fertilizer, paving the way for a possible contamination of crops. Furthermore, the use of veterinary drugs in animals can lead to soil contamination either directly or through manure and slurry. The contamination can equally reach and affect surface water, groundwater and sometimes the water intended for human consumption. The National academy of Pharmacy has established some general recommendations on the proper use of drugs, environmental monitoring and surveillance, risk assessment for humans and the environment, prevention and the need for prevention. Several categories of drugs are more worrying: cancer treatments, antibiotics as well as transfers of anti-bio-resistance, and hormonal derivatives which has been previously demonstrated to contribute, along with other molecules, to detrimental effects on endocrines.
Kim, Kyu Rang; Oh, Jae-Won; Woo, Su-Young; Seo, Yun Am; Choi, Young-Jin; Kim, Hyun Seok; Lee, Wi Young; Kim, Baek-Jo
Oak pollen is a major respiratory allergen in Korea, and the distribution of oak trees is expected to increase by ecological succession and climate change. One of the drivers of climate change is increasing CO2, which is also known to amplify the allergy risk of weed pollen by inducing elevated allergenic protein content. However, the impact of CO2 concentration on tree pollen is not clearly understood due to the experimental difficulties in carrying out extended CO2 treatment. To study the response of pollen production of sawtooth oak trees (Quercus acutissima) to elevated levels of ambient CO2, three open-top chambers at the National Institute of Forest Science in Suwon, Korea were utilized with daytime (8 am-6 pm) CO2 concentrations of ambient (× 1.0, 400 ppm), × 1.4 ( 560 ppm), and × 1.8 ( 720 ppm) treatments. Each chamber had three sawtooth oak trees planted in September 2009. One or two trees per chamber matured to bloom in 2016. Five to six catkins were selected per tree and polyethylene bags were attached to collect pollen grains. The total number of catkins per tree was counted and the number and weight of pollen grains per catkin were measured. Oak allergen—Que a 1 (Allergon Co., Uppsala, Sweden)—was extracted and purified to make an ELISA kit by which the antigen levels in the pollen samples were quantified. Total pollen counts per tree of the × 1.4 and × 1.8 treatments showed significant increase of 353 and 1299%, respectively, from the × 1.0 treatment (p < 0.001). Allergenic protein contents at the × 1.4 and × 1.8 treatments also showed significant increase of 12 and 11%, respectively (p = 0.011). The × 1.8 treatment induced significant difference from the × 1.0 treatment in terms of pollen production and allergenic protein content, whereas the × 1.4 treatment showed mixed significance. In summary, the oak trees under the elevated CO2 levels, which are expected in the changing climate, produced significantly higher amount of pollen and
James W. Stoutenborough
Full Text Available One of the most difficult aspects of persuading the public to support climate change policy is the lack of recognition that climate change will likely have a direct impact on an individual’s life. Anecdotal evidence and arguments within the media suggest that those who are skeptical of climate change are more likely to believe that the negative externalities associated with climate change will be experienced by others, and, therefore, are not a concern to that individual. This project examines public perceptions of the health risk posed by climate change. Using a large national public opinion survey of adults in the United States, respondents were asked to evaluate the health risk for themselves, their community, the United States, and the world. The results suggest that individuals evaluate the risk for each of these contexts differently. Statistical analyses are estimated to identify the determinants of each risk perception to identify their respective differences. The implications of these findings on support for climate change policy are discussed.
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 ...
Neuparth, T; Moreira, S; Santos, M M; Reis-Henriques, M A
Increases in the maritime transportation of Hazardous and Noxious Substances (HNS), alongside the need for an effective response to HNS spills have led environmental managers and the scientific community to focus attention on HNS spill preparedness and responsiveness. In the context of the ARCOPOL project, a weight-of-evidence approach was developed aimed at prioritizing HNS that pose major environmental risks to European waters. This approach takes into consideration the occurrence probability of HNS spills in European Atlantic waters and the severity of exposure associated with their physico-chemical properties and toxicity to marine organisms. Additionally, a screening analysis of the toxicological information available for the prioritization of HNS was performed. Here we discuss the need for a prioritization methodology to select HNS that are likely to cause severe marine environmental effects as an essential step towards the establishment of a more effective preparedness and response to HNS incidents. Copyright Â© 2010 Elsevier Ltd. All rights reserved.
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.
Hunter, Peter D; Hanley, Nick; Czajkowski, Mikołaj; Mearns, Kathryn; Tyler, Andrew N; Carvalho, Laurence; Codd, Geoffrey A
Mass populations of toxin-producing cyanobacteria are an increasingly common occurrence in inland and coastal waters used for recreational purposes. These mass populations pose serious risks to human and animal health and impose potentially significant economic costs on society. In this study, we used contingent valuation (CV) methods to elicit public willingness to pay (WTP) for reductions in the morbidity risks posed by blooms of toxin-producing cyanobacteria in Loch Leven, Scotland. We found that 55% of respondents (68% excluding protest voters) were willing to pay for a reduction in the number of days per year (from 90, to either 45 or 0 days) that cyanobacteria pose a risk to human health at Loch Leven. The mean WTP for a risk reduction was UK£9.99-12.23/household/year estimated using a logistic spike model. In addition, using the spike model and a simultaneous equations model to control for endogeneity bias, we found the respondents' WTP was strongly dependent on socio-demographic characteristics, economic status and usage of the waterbody, but also individual-specific attitudes and perceptions towards health risks. This study demonstrates that anticipated health risk reductions are an important nonmarket benefit of improving water quality in recreational waters and should be accounted for in future cost-benefit analyses such as those being undertaken under the auspices of the European Union's Water Framework Directive, but also that such values depend on subjective perceptions of water-related health risks and general attitudes towards the environment. Copyright © 2012 Elsevier B.V. All rights reserved.
McMurry, Timothy L; Poplin, Gerald S
We address 4 frequently misunderstood and important statistical ideas in the construction of injury risk functions. These include the similarities of survival analysis and logistic regression, the correct scale on which to construct pointwise confidence intervals for injury risk, the ability to discern which form of injury risk function is optimal, and the handling of repeated tests on the same subject. The statistical models are explored through simulation and examination of the underlying mathematics. We provide recommendations for the statistically valid construction and correct interpretation of single-predictor injury risk functions. This article aims to provide useful and understandable statistical guidance to improve the practice in constructing injury risk functions.
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.
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...
Kenborg, Line; Rugbjerg, Kathrine; Lee, Pei-Chen
in medical records. Patients were matched to 1,785 controls randomly selected from the Danish Central Population Register on sex and year of birth. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. RESULTS: We observed no association between any head......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...
Prasad, Priya; Mertz, Harold J; Dalmotas, Danius J; Augenstein, Jeffrey S; Diggs, Kennerly
An evaluation of the four injury risk curves proposed in the NHTSA NCAP for estimating the risk of AIS>= 3 injuries to the head, neck, chest and AIS>=2 injury to the Knee-Thigh-Hip (KTH) complex has been conducted. The predicted injury risk to the four body regions based on driver dummy responses in over 300 frontal NCAP tests were compared against those to drivers involved in real-world crashes of similar severity as represented in the NASS. The results of the study show that the predicted injury risks to the head and chest were slightly below those in NASS, and the predicted risk for the knee-thigh-hip complex was substantially below that observed in the NASS. The predicted risk for the neck by the Nij curve was greater than the observed risk in NASS by an order of magnitude due to the Nij risk curve predicting a non-zero risk when Nij = 0. An alternative and published Nte risk curve produced a risk estimate consistent with the NASS estimate of neck injury. Similarly, an alternative and published chest injury risk curve produced a risk estimate that was within the bounds of the NASS estimates. No published risk curve for femur compressive load could be found that would give risk estimates consistent with the range of the NASS estimates. Additional work on developing a femur compressive load risk curve is recommended.
Lehr, M E; Plisky, P J; Butler, R J; Fink, M L; Kiesel, K B; Underwood, F B
In athletics, efficient screening tools are sought to curb the rising number of noncontact injuries and associated health care costs. The authors hypothesized that an injury prediction algorithm that incorporates movement screening performance, demographic information, and injury history can accurately categorize risk of noncontact lower extremity (LE) injury. One hundred eighty-three collegiate athletes were screened during the preseason. The test scores and demographic information were entered into an injury prediction algorithm that weighted the evidence-based risk factors. Athletes were then prospectively followed for noncontact LE injury. Subsequent analysis collapsed the groupings into two risk categories: Low (normal and slight) and High (moderate and substantial). Using these groups and noncontact LE injuries, relative risk (RR), sensitivity, specificity, and likelihood ratios were calculated. Forty-two subjects sustained a noncontact LE injury over the course of the study. Athletes identified as High Risk (n = 63) were at a greater risk of noncontact LE injury (27/63) during the season [RR: 3.4 95% confidence interval 2.0 to 6.0]. These results suggest that an injury prediction algorithm composed of performance on efficient, low-cost, field-ready tests can help identify individuals at elevated risk of noncontact LE injury. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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
Bazarian, Jeffrey J; Fisher, Susan Gross; Flesher, William; Lillis, Robert; Knox, Kerry L; Pearson, Thomas A
We determine the relative risk and severity of traumatic brain injury among occupants of lateral impacts compared with occupants of nonlateral impacts. This was a secondary analysis of the National Highway Traffic Safety Administration's National Automotive Sampling System, Crashworthiness Data Systems for 2000. Analysis was restricted to occupants of vehicles in which at least 1 person experienced an injury with Abbreviated Injury Scale score greater than 2. Traumatic brain injury was defined as an injury to the head or skull with an Abbreviated Injury Scale score greater than 2. Outcomes were analyzed using the chi2 test and multivariate logistic regression, with adjustment of variance to account for weighted probability sampling. Of the 1,115 occupants available for analysis, impact direction was lateral for 230 (18.42%) occupants and nonlateral for 885 (81.58%) occupants. One hundred eighty-seven (16.07%) occupants experienced a traumatic brain injury, 14.63% after lateral and 16.39% after nonlateral impact. The unadjusted relative risk of traumatic brain injury after lateral impact was 0.89 (95% confidence interval [CI] 0.51 to 1.56). After adjusting for several important crash-related variables, the relative risk of traumatic brain injury was 2.60 (95% CI 1.1 to 6.0). Traumatic brain injuries were more severe after lateral impact according to Abbreviated Injury Scale and Glasgow Coma Scale scores. The proportion of fatal or critical crash-related traumatic brain injuries attributable to lateral impact was 23.5%. Lateral impact is an important independent risk factor for the development of traumatic brain injury after a serious motor vehicle crash. Traumatic brain injuries incurred after lateral impact are more severe than those resulting from nonlateral impact. Vehicle modifications that increase head protection could reduce crash-related severe traumatic brain injuries by up to 61% and prevent up to 2,230 fatal or critical traumatic brain injuries each year
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
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.
Alemany, Joseph A; Bushman, Timothy T; Grier, Tyson; Anderson, Morgan K; Canham-Chervak, Michelle; North, William J; Jones, Bruce H
The Functional Movement Screen (FMS™) has been used as a screening tool to determine musculoskeletal injury risk using composite scores based on movement quality and/or pain. However, no direct comparisons between movement quality and pain have been quantified. Retrospective injury data analysis. Male Soldiers (n=2154, 25.0±1.3years; 26.2±.7kg/m 2 ) completed the FMS (scored from 0 points (pain) to 3 points (no pain and perfect movement quality)) with injury data over the following six months. The FMS is seven movements. Injury data were collected six months after FMS completion. Sensitivity, specificity, receiver operator characteristics and positive and negative predictive values were calculated for pain occurrence and low (≤14 points) composite score. Risk, risk ratios (RR) and 95% confidence intervals were calculated for injury risk. Pain was associated with slightly higher injury risk (RR=1.62) than a composite score of ≤14 points (RR=1.58). When comparing injury risk between those who scored a 1, 2 or 3 on each individual movement, no differences were found (except deep squat). However, Soldiers who experienced pain on any movement had a greater injury risk than those who scored 3 points for that movement (pmovements in which pain occurrence increased, so did injury risk (p<0.01). Pain occurrence may be a stronger indicator of injury risk than a low composite score and provides a simpler method of evaluating injury risk compared to the full FMS. Published by Elsevier Ltd.
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....
H.M. de Visser (H.); M. Reijman (Max); M.P. Heijboer (Rien); P.K. Bos (Koen)
textabstractBackground Although recurrent hamstring injury is a frequent problem with a significant impact on athletes, data on factors determining the risk for a recurrent hamstring injury are scarce. Objective To systematically review the literature and provide an overview of risk factors for
Paller, M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Blas, S. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)
The upper portion of Lower Three Runs includes several ponds, reservoirs, and canals that were formerly used as a cooling system for nuclear production reactors. This area was divided into nine exposure areas (EAs) for the assessment of environmental contamination resulting from past reactor operations and other industrial processes. A tiered screening process identified several contaminants of potential concern including aluminum, cyanide, lead, manganese, mercury, DDD, DDE, and DDT. Risks posed by these contaminants to ecological receptors (river otter, belted kingfisher, raccoon, and blue heron) were assessed using contaminant exposure models that estimated contaminant intake resulting from ingestion of food, water, and sediment/ soil and compared these intakes with toxicity reference values (TRVs). The contaminant exposure models showed that the TRVs were not exceeded in the otter model, exceeded by aluminum in EA 7 (Pond 2 and associated canals) in the raccoon model, and exceeded by mercury in EAs 2, 3 (Pond B), 6 (Par Pond), and 8 (Ponds 4 and 5 and Canal to Pond C) in both the kingfisher and blue heron models. Hazard quotients (total exposure dose divided by the TRV) were 2.8 for aluminum and 1.7- 3.6 for mercury. The primary route of exposure for aluminum was the ingestion of soil, and the primary route of exposure for mercury was the ingestion of mercury contaminated fish. Elevated levels of mercury in fish were at least partly the result of the aerial deposition of mercury onto Lower Three Runs and its watershed. The atmospheric deposition of mercury creates pervasive contamination in fish throughout the Savannah River basin. Another possible source of mercury was the discharge of mercury contaminated Savannah River water into the Lower Three Runs cooling ponds and canals during previous years of reactor operation. This contamination originated from industries located upstream of the SRS. The aluminum exceedance for the raccoon was likely the result of
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. PMID:22166096
Foot blisters: Though not a musculoskeletal injury , past studies and reviews have described foot blisters as one of the most common marching... injuries were the highest among all activities in these studies, ranging from 36 to 69 limited duty days per injury .23, 24 The top three most common ...Knapik, and J.J. 1994. Exercise, training and injuries . Sports Med 18(3): 202-1. 35. APHC (Prov) Blister Prevention Factsheet. 2015. Available at
Neumann, W. Patrick; Winkel, Jørgen; Palmerud, Gunnar
to control injury hazards as part of the development and design process. These cases suggest how failure to manage RSI hazards in the innovation process may allow increases of injury risks that can compromise operational performance. This â€˜innovation pitfallâ€™ has implications for operator health...... increased movement speeds and reduced muscular recovery opportunities, implying increased RSI risk. This case study reveals a mechanism by which innovation may increase RSI risks for operators. Managers responsible for engineering innovation should ensure their teams have the tools and mandate necessary......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...
Girgin, Sadullah; Gedik, Ercan; Uysal, Ersin; Taçyildiz, Ibrahim Halil
The present study explored the factors effective on colon-related morbidity in patients with penetrating injury of the colon. The medical records of 196 patients were reviewed for variables including age, gender, factor of trauma, time between injury and operation, shock, duration of operation, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), site of colon injury, Colon Injury Score, fecal contamination, number of associated intra- and extraabdominal organ injuries, units of transfused blood within the first 24 hours, and type of surgery. In order to determine the independent risk factors, multivariate logistic regression analysis was performed. Gunshot wounds, interval between injury and operation > or =6 hours, shock, duration of the operation > or =6 hours, PATI > or =25, ISS > or =20, Colon Injury Score > or = grade 3, major fecal contamination, number of associated intraabdominal organ injuries >2, number of associated extraabdominal organ injuries >2, multiple blood transfusions, and diversion were significantly associated with morbidity. Multivariate logistic regression analysis showed diversion and transfusion of > or =4 units in the first 24 hours as independent risk factors affecting colon-related morbidity. Diversion and transfusion of > or =4 units in the first 24 hours were determined to be independent risk factors for colon-related morbidity.
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 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.
Roy, Tanja C; Songer, Thomas; Ye, Feifei; LaPorte, Ronald; Grier, Tyson; Anderson, Morgan; Chervak, Michelle
Musculoskeletal injuries (MSIs) result in the most medical encounters, lost duty days, and permanent disability. Women are at greater risk of injury than men and physical training is the leading cause of injury. The purpose of this study was to investigate the demographic, body composition, fitness, and physical training risk factors for injuries in female Soldiers serving in garrison Army units over the past 12 months. Self-report survey was collected from 625 women. The ankle was the most frequently injured body region, 13%. Running was the activity most often associated with injury, 34%. In univariate analysis lower rank, older age, history of deployment, no unit runs, weekly frequency of personal resistance training, and history of injury were all associated with injury. In multivariate analysis rank, history of injury, weekly frequency of unit runs, and weekly frequency of personal resistance training were the best combination of predictors of injury. Running once or twice a week with the unit protected against MSIs, whereas participating in personal resistance training sessions once or twice a week increased the risk of MSIs. With more emphasis on running and resistance training, the U.S. Army could reduce injuries and save billions of dollars in training and health care costs. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
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.
In-Fun Li; Yvonne Hsiung; Hui-Fen Hsing; Mei-Yu Lee; Te-Hsin Chang; Ming-Yuan Huang
Background: As a vital issue in geriatric research, risk factors for falls were concluded to be multifactorial, and prevention has been mostly aimed at decreasing situational and environmental risks that cause and aggravate fall-related injuries, particularly within the institutions. While knowledge is limited about older patients' intrinsic determinants, the purpose of this study was to explore elderly Taiwanese's intrinsic risk factors associated with severe fall-related injuries. Method...
Holcroft, Christina A; Punnett, Laura
The reported injury rate for wood product manufacturing in Maine, 1987-2004, was almost twice the state-wide average for all jobs. A case-control study was conducted in wood processing plants to determine preventable risk factors for injury. A total of 157 cases with injuries reported to workers' compensation and 251 controls were interviewed. In multivariable analyses, variables associated with injury risk were high physical workload, machine-paced work or inability to take a break, lack of training, absence of a lockout/tagout program, low seniority, and male gender. Different subsets of these variables were significant when acute incidents and overexertions were analyzed separately and when all injuries were stratified by industry sub-sector. Generalizability may be limited somewhat by non-representative participation of workplaces and individuals. Nevertheless, these findings provide evidence that many workplace injuries occurring in wood processing could be prevented by application of ergonomics principles and improved work organization.
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
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
Bernardes, Rodrigo Cupertino; Barbosa, Wagner Faria; Martins, Gustavo Ferreira; Lima, Maria Augusta Pereira
Large-scale pesticide application poses a major threat to bee biodiversity by causing a decline in bee populations that, in turn, compromises ecosystem maintenance and agricultural productivity. Biopesticides are considered an alternative to synthetic pesticides with a focus on reducing potential detrimental effects to beneficial organisms such as bees. The production of healthy queen stingless bees is essential for the survival and reproduction of hives, although it remains unknown whether biopesticides influence stingless bee reproduction. In the present study, we investigated the effects of the biopesticide azadirachtin on the survival, behavior, morphology, development, and reproduction of queens of the stingless bee Partamona helleri (Friese, 1900). The neonicotinoid imidacloprid was used as a toxic reference standard. Queens were orally exposed in vitro to a contaminated diet (containing azadirachtin and imidacloprid) during development. Azadirachtin resulted in reduced survival, similarly to imidacloprid, altered development time, caused deformations, and reduced the size of the queens' reproductive organs. All of these factors could potentially compromise colony survival. Results from the present study showed azadirachtin posed a toxicological hazard to P. helleri queens. Copyright © 2018 Elsevier Ltd. All rights reserved.
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.
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.
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.
Shetty, Teena; Nguyen, Joseph T; Sasaki, Mayu; Wu, Anita; Bogner, Eric; Burge, Alissa; Cogsil, Taylor; Dalal, Aashka; Halvorsen, Kristin; Cummings, Kelianne; Su, Edwin P; Lyman, Stephen
In this we study identified potential risk factors for post-total knee arthroplasty (TKA) nerve injury, a catastrophic complication with a reported incidence of 0.3%-1.3%. Patients who developed post-TKA nerve injury from 1998 to 2013 were identified, and each was matched with 2 controls. A multivariable logistic regression model was built to calculate odds ratios (ORs). Sixty-five nerve injury cases were identified in 39,990 TKAs (0.16%). Females (OR 3.28, P = 0.003) and patients with history of lumbar pathology (OR 6.12, P = 0.026) were associated with increased risk of nerve injury. Tourniquet pressure nerve injury was unexpected and requires further investigation. Muscle Nerve 57: 946-950, 2018. © 2017 Wiley Periodicals, Inc.
Zazryn, Tsharni R; McCrory, Paul R; Cameron, Peter A
To determine injury rates and risk factors for injury in a cohort of professional boxers. Retrospective cohort design reporting on data collected for a fight statistics database maintained by the Professional Boxing and Combat Sports Board of Victoria, Australia. Data were extracted for the years January 1997 through June 2005. Victoria, Australia. 545 professional boxers (age, 18 to 43 years) who participated in a total of 907 fights over the study period. Independent variables under investigation included age, gender, weight, bout exposure, and location of the bout (within or outside of the State of Victoria). Physician-reported acute boxing injuries occurring during bouts of any region or nature. 214 injuries were sustained over the 8.5 years, corresponding to an injury rate of 23.6 per 100 professional fights. The majority of these injuries were lacerations to the head and face. An increasing age and an increasing number of fights were both significant predictors of injury. Injury reduction strategies for professional boxing might include restrictions of eligibility to fight based on age and boxing bout exposure. Future research using prospective cohort designs and standardized injury definitions are needed to confirm these results. Greater mechanistic detail and more complete data entry are necessary to ensure that optimal injury prevention strategies can be developed and implemented. Upon confirmation of the results of this study, the Professional Boxing and Combat Sports Board of Victoria may consider different criteria upon which to sanction a fight.
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
Wagner, W.B.; Nijskens, R.G.M.
A main cause of the crisis of 2007–2009 is the various ways through which banks have transferred credit risk in the financial system. We study the systematic risk of banks before the crisis, using two samples of banks respectively trading Credit Default Swaps (CDS) and issuing Collateralized Loan
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
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 risk of bites compared to urban (p Profile of 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.
Van Middelkoop, M; Kolkman, J; Van Ochten, J; Bierma-Zeinstra, S M A; Koes, B W
The aim of this study is to identify risk factors for lower extremity injuries in male marathon runners. A random sample of 1500 recreational male marathon runners was drawn. Possible risk factors were obtained from a baseline questionnaire 1 month before the start of the marathon. Information on injuries sustained shortly before or during the marathon was obtained using a post-race questionnaire. Of the 694 male runners who responded to the baseline and post-race questionnaire, 28% suffered a self-reported running injury on the lower extremities in the month before or during the marathon run. More than six times race participation in the previous 12 months [odds ratio (OR) 1.66; confidence interval (CI) 1.08-2.56], a history of running injuries (OR 2.62; CI 1.82-3.78), high education level (OR 0.73; CI 0.51-1.04) and daily smoking (OR 0.23; CI 0.05-1.01) were associated with the occurrence of lower extremity injuries. Among the modifiable risk factor studies, a training distance training is a strong protective factor for knee injuries. Other training characteristics appear to have little or no effect on future injuries.
Transgenic Bt rice expressing the protoxin proteins derived from Bacillus thuringiensis Berliner (Bt) have been developed since 1989. Their ecological risks toward non-target organisms have been investigated. However, these studies were conducted individually, yielding inconsistent conclusions and u...
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.
Daniel N. Qekwana
Full Text Available In African societies, traditional slaughter is linked to celebrations like weddings or births, as well as funerals and ancestor veneration. Participants in traditional slaughter of goats are at risk of exposure to hazards during slaughter, food preparation and consumption of goat meat. For risk mitigation strategies to be implemented, identification of the population at risk is required. This study is based on the premise that the demographic profile of people involved in traditional slaughter of goats is important for risk communication. Both structured and informal interviews were recorded and analysed using a thematic analysis. A total of 105 people were interviewed at taxi ranks in Tshwane, Gauteng. Of these, 48 were women and 57 men. The median age of women and men was 40.6 years and 44.3 years, respectively. The majority of respondents (61.9%, n = 65 interviewed were from the Gauteng Province. Sixty percent (n = 63 of respondents had a secondary education, whilst less than 4.81% (n = 5 of respondents had no formal education. This study demonstrated that interviewing commuters at taxi ranks gave access to a cross section of gender, age, language and origin. It was found that both genders were involved in traditional slaughter of goats. Risk communication strategies should thus target women as well as men. Communication strategies to mitigate the risks of traditional slaughter of goats should take into consideration the dynamic nature of demographic and cultural norms. In light of the wide demographic profile of the respondents, it was concluded that it should be possible to use taxi ranks for successful dissemination of food safety and occupational health risk mitigation messages.
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.
Mark R. McNeill
Full Text Available Soil frequently occurs as a contaminant on numerous sea, land and air transport pathways. It can carry unwanted invasive species, is widely recognized as a biosecurity risk, and is usually strictly regulated by biosecurity authorities. However, little is known about relative risk levels between pathways, thus authorities have limited capability to identify and target the riskiest soil pathways for management. We conducted a an experiment to test the hypotheses that biosecurity risks from soil organisms will increase both with declining transport duration and with increasing protection from environmental extremes. Soil was collected from two sites, a native forest remnant and an orchard, and stored on, in and under sea containers, or in cupboards, and assayed after 0, 3, 6 and 12 months for bacteria, fungi, nematodes and seeds. Results showed that viability of Pseudomonas spp., bacteria, nematodes and plants declined over 12 months, irrespective of soil source. Also, mortality of most biota was higher when exposed to sunlight, moisture and desiccation than when protected. However, bacterial and fungal numbers were higher in exposed environments, possibly due to ongoing colonization of exposed soil by airborne propagules. The results were consistent with our observations of organisms in soil intercepted from airports and sea ports, and indicated there is potential to rank risks from transported soils based partly on transport duration and environmental exposure. This would help authorities to optimally allocate management resources according to pathway-specific risks.
Narasimhan, Harikrishna; Ferlisi, Settimio; Cascini, Leonardo
) (Nathwani et al. in Affordable safety by choice: the life quality method. University of Waterloo, Waterloo, 1997; Nathwani et al. in Engineering decisions for life quality: how safe is safe enough? Springer, London, 2009). A case study involving the cost–benefit analysis of selected packages of measures......Decisions associated with life safety risk management of natural hazards can involve significant potential consequences for public safety. Given possible limitations to available societal resources, it is therefore necessary to establish a clear and rational basis for the allocation of resources...... towards risk management. A viable approach for utilising life safety risk assessment in public safety decisions that are aimed at improving the welfare of the public and other stakeholders is described in this paper. This approach is conceptually based on the principles of the Life Quality Index (LQI...
Carey, David L; Blanch, Peter; Ong, Kok-Leong; Crossley, Kay M; Crow, Justin; Morris, Meg E
Aims (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. Methods 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 R2). Results 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 (R2=0.79) and in the immediate 2 or 5 days following matches (R2=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. Conclusions 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. PMID:27789430
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.
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; psports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team 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]; psports the number of competitions per 100 days had a protective effect (HR=0.940; CI95% [0.893; 0.989]; p=0.017). Team 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.
Rodriguez-Ruiz, A; Etxebarria, J; Boatti, L; Marigómez, I
Lanestosa is a chronically polluted site (derelict mine) where the soil (Lanestosa (LA) soil) exceeds screening values (SVs) of regulatory policies in force (Basque Country; Europe) for Zn, Pb and Cd. A scenario-targeted toxicity assessment was carried out on the basis of a multi-endpoint bioassay approach. Acute and chronic toxicity bioassays were conducted with selected test species (Vibrio fischeri, Dictyostelium discoideum, Lactuca sativa, Raphanus sativus and Eisenia fetida) in combination with chemical analysis of soils and elutriates and with bioaccumulation studies in earthworms. Besides, the toxicity profile was compared with that of the mine runoff (RO) soil and of a fresh artificially polluted soil (LAAPS) resembling LA soil pollutant profile. Extractability studies in LA soil revealed that Pb, Zn and Cd were highly available for exchange and/or release into the environment. Indeed, Pb and Zn were accumulated in earthworms and LA soil resulted to be toxic. Soil respiration, V. fischeri, vegetative and developmental cycles of D. discoideum and survival and juvenile production of E. fetida were severely affected. These results confirmed that LA soil had unacceptable environmental risk and demanded intervention. In contrast, although Pb and Zn concentrations in RO soil revealed also unacceptable risk, both metal extractability and toxicity were much lower than in LA soil. Thus, within the polluted site, the need for intervention varied between areas that posed dissimilar risk. Besides, since LAAPS, with a high exchangeable metal fraction, was the most toxic, ageing under in situ natural conditions seemingly contributed to attenuate LA soil risk. As a whole, combining multi-endpoint bioassays with scenario-targeted analysis (including leaching and ageing) provides reliable risk assessment in soils posing unacceptable environmental risk according to SVs, which is useful to optimise the required intervention measures.
Giering, K.; Philipp, Carsten M.; Berlien, Hans-Peter
An analysis of injuries and risks using high frequency (HF) and lasers in medicine based on a literature search with MEDLINE was performed. The cases reported in the literature were classified according to the following criteria: (1) Avoidable in an optimal operational procedure. These kind of injuries are caused by a chain of unfortunate incidents. They are in principle avoidable by the 'right action at the right time' which presupposes an appropriate training of the operating team, selection of the optimal parameters for procedure and consideration of all safety instructions. (2) Avoidable, caused by malfunction of the equipment and/or accessories. The injuries classified into this group are avoidable if all safety regulations were fulfilled. This includes a pre-operational check-up and the use of medical lasers and high frequency devices only which meet the international safety standards. (3) Avoidable, caused by misuse/mistake. Injuries of this group were caused by an inappropriate selection of the procedure, wrong medical indication or mistakes during application. (4) Unavoidable, fateful. These injuries can be caused by risks inherent to the type of energy used, malfunction of the equipment and/or accessories though a pre-operational check-up was done. Some risks and complications are common to high frequency and laser application. But whereas these risks can be excluded easily in laser surgery there is often a great expenditure necessary or they are not avoidable if high frequency if used. No unavoidable risks due to laser energy occur.
Alamgir, Hasanat; Yu, Shicheng; Drebit, Sharla; Fast, Catherine; Kidd, Catherine
Differential risks of occupational injuries by gender have been examined across various industries. With the number of employees in healthcare rising and an overwhelming proportion of this workforce being female, it is important to address this issue in this growing sector. To determine whether compensated work-related injuries among females are higher than their male colleagues in the British Columbia healthcare sector. Incidents of occupational injury resulting in compensated days lost from work over a 1-year period for all healthcare workers were extracted from a standardized operational database and the numbers of productive hours were obtained from payroll data. Injuries were grouped into all injuries and musculoskeletal injuries (MSIs). Detailed analysis was conducted using Poisson regression modelling. A total of 42 332 employees were included in the study of whom 11% were male and 89% female. When adjusted for age, occupation, sub-sector, employment category, health region and facility, female workers had significantly higher risk of all injuries [rate ratio (95% CI) = 1.58 (1.24-2.01)] and MSIs [1.43 (1.11-1.85)] compared to their male colleagues. Occupational health and safety initiatives should be gender sensitive and developed accordingly.
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.
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.
Slodownik, Robert; Ogonowska-Slodownik, Anna; Morgulec-Adamowicz, Natalia
Handball is known to be one of the team sports representing the highest risk of injury. Several investigators have tried to identify injury risk factors in team sports including handball and suggested the need to develop an optimal tool to capture and quantify the potential risk of injury. The aim of the study was to evaluate potential risk of injury among handball players. It was a mixed design study. Handball players from 1st and 2nd division were evaluated (n = 30) using the Functional Movement ScreenTM (FMSTM). Additionally, self-reported history of injury was collected during FMSTM evaluation and after 6 months. Competitive level, training experience, playing position, anthropometric features, symmetry of movement patterns and history of previous injury were analysed while assessing the potential risk of injury. Significant difference between the right and left side (upper limb) was revealed for Shoulder Mobility Test (U = 308.5, p = 0.014). Odds Ratio analysis revealed that having previous injury in the last 12 months is the only statistically significant injury risk factor (OR = 13.71, p = 0.02). Based on this study we can assume that previous injury history reports are crucial in predicting injuries. FMSTM can help in identifying a typical adaptation in throwing shoulder among handball players, but should not be used alone to assess injury risk.
Clausen, M B; Tang, L; Zebis, M K; Krustrup, P; Hölmich, P; Wedderkopp, N; Andersen, L L; Christensen, K B; Møller, M; Thorborg, K
Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (female football. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Baker, R.; Candresse, T.; Dormannsné Simon, E.
The Panel on Plant Health has delivered a scientific opinion on the different risks posed by European and non-European populations of the potato cyst nematodes (PCN) Globodera pallida and Globodera rostochiensis to solanaceous plants in the EU and on the effectiveness of current control measures...... to place of production freedom and soil origin were noted, and the Panel identified additional risk reduction options for certain plants for planting (e.g. bulbs) and additional requirements to confirm the absence of PCN in places of production. The Panel also identified some problems with the existing...... control measures to reduce the spread of PCN within the EU. A thorough and well-coordinated EU-wide survey using standardized methods would be necessary to evaluate the need to maintain these measures. The monitoring of PCN populations should exploit new diagnostic techniques (e.g. mitochondrial DNA...
Han, Ying; Liu, Wenbin; Hansen, Hans Chr. Bruun
Sintering and steel production as the main emission sources of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) may affect environment and human health. The concentrations, profiles, and distributions of PCDD/Fs in soil samples from around four typical sintering and steel production...... plants in Hebei Province, China, were determined. Forty-six soil samples were collected at distances from 500 to 9000 m from industrial plant chimneys. The concentrations of total 17 2,3,7,8-substituted PCDD/F congeners in the soil samples from sites A, B, C, and D were in the range 11-130, 13-284, 2...... will be exposed to low amounts of PCDD/Fs in soil from around the industrial sites, and this exposure will pose potential health risks for the local population living at distances of less than 1000 m from nearest stack but will have no high health risks for people living further away. These results...
Lambert, S J; Thomas, K V; Davy, A J
Antifouling paints are used to reduce the attachment of living organisms to the submerged surfaces of ships, boats and aquatic structures, usually by the release of a biocide. Two 'booster' biocides in common use are the triazine herbicide Irgarol 1051 (N-2-methylthio-4-tert-butylamino-6-cyclopropylamino-s-triazine), and diuron (1-(3,4-dichlorophenyl)-3,3-dimethylurea), which are designed to inhibit algal photosynthesis. Previous research has been directed at the effects of these compounds in marine and estuarine environments. In 2001 we sampled the main rivers and shallow freshwater lakes (Broads) of East Anglia UK for Irgarol 1051, its metabolite GS26575 (2-methylamino-4-tert-butylamino-6-amino-s-triazine) and diuron in order to establish the baseline environmental concentrations of these compounds in freshwater systems of eastern UK and to investigate their possible effects on aquatic plants. Irgarol 1051, GS26575 and diuron were found in water samples collected from 21 locations. The highest concentrations were found in the Norfolk and Suffolk Broads in May. The rivers Great Ouse, Wissey, Bure and Yare also contained all three compounds, as did the Great Ouse Cut-off Channel. The toxicity of these biocides to three macrophyte species (Apium nodiflorum, Chara vulgaris, and Myriophyllum spicatum) was investigated. Deleterious effects on relative growth rate, the maximum quantum efficiency (Fv/Fm) of photosystem II and, for Apium, root mass production were found. C. vulgaris was generally most sensitive; growth, especially of roots, was strongly affected in A. nodiflorum; growth rate of M. spicatum was sensitive to diuron. No observed effect concentrations (NOEC) were interpolated using standard toxicological analysis. These were compared with measured environmental concentrations (MEC) to determine the ranges of risk quotients (MEC/NOEC). Both Irgarol 1051 and diuron represented significant risks to A. nodiflorum and C. vulgaris in this area.
Parker, E M; Jenson, I; Jordan, D; Ward, M P
An algorithm was developed as a tool to rapidly assess the potential for a new or emerging disease of livestock to adversely affect humans via consumption or handling of meat product, so that the risks and uncertainties can be understood and appropriate risk management and communication implemented. An algorithm describing the sequence of events from occurrence of the disease in livestock, release of the causative agent from an infected animal, contamination of fresh meat and then possible adverse effects in humans following meat handling and consumption was created. A list of questions complements the algorithm to help the assessors address the issues of concern at each step of the decision pathway. The algorithm was refined and validated through consultation with a panel of experts and a review group of animal health and food safety policy advisors via five case studies of potential emerging diseases of cattle. Tasks for model validation included describing the path taken in the algorithm and stating an outcome. Twenty-nine per cent of the 62 experts commented on the model, and one-third of those responding also completed the tasks required for model validation. The feedback from the panel of experts and the review group was used to further develop the tool and remove redundancies and ambiguities. There was agreement in the pathways and assessments for diseases in which the causative agent was well understood (for example, bovine pneumonia due to Mycoplasma bovis). The stated pathways and assessments of other diseases (for example, bovine Johne's disease) were not as consistent. The framework helps to promote objectivity by requiring questions to be answered sequentially and providing the opportunity to record consensus or differences of opinion. Areas for discussion and future investigation are highlighted by the points of diversion on the pathway taken by different assessors. © 2011 Blackwell Verlag GmbH.
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.
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.
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.
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...
Xia, Dan; Gao, Li-Rong; Zheng, Ming-Hui; Li, Jing-Guang; Zhang, Lei; Wu, Yong-Ning; Qiao, Lin; Tian, Qi-Chang; Huang, Hui-Ting; Liu, Wen-Bin; Su, Gui-Jin; Liu, Guo-Rui
Chlorinated paraffins (CPs) are complex mixtures of synthetic chemicals found widely in environmental matrices. Short-chain CPs (SCCPs) are candidate persistent organic pollutants under the Stockholm Convention. There should be great concern about human exposure to SCCPs. Data on CP concentrations in human breast milk is scarce. This is the first study in which background SCCP and medium-chain CP (MCCP) body burdens in the general rural population of China have been estimated and health risks posed to nursing infants by CPs in breast milk assessed. The concentrations of 48 SCCP and MCCP formula congeners were determined in 24 pooled human milk samples produced from 1412 individual samples from eight provinces in 2007 and 16 provinces in 2011. The samples were analyzed by comprehensive two-dimensional gas chromatography electron capture negative ionization high-resolution time-of-flight mass spectrometry. The median SCCP and MCCP concentrations were 303 and 35.7ngg -1 lipid weight, respectively, for the 2007 samples and 360 and 45.4ngg -1 lipid weight, respectively, for the 2011 samples. The C 10 and C 14 homologs were the dominant CP carbon-chain-length groups, contributing 51% and 82% of the total SCCP and MCCP concentrations, respectively. There are probably multiple CP sources to the general Chinese population and numerous exposure pathways. The median estimated daily SCCP and MCCP intakes for nursing infants were 1310 and 152ngkg -1 d -1 , respectively, in 2007 and 1520 and 212ngkg -1 d -1 , respectively, in 2011. SCCPs do not currently pose significant risks to infants in China. However, it is necessary to continuously monitor CP concentrations and health risks because CP concentrations in Chinese human breast milk are increasing. Copyright © 2017 Elsevier Ltd. All rights reserved.
Vinstrup, Jonas; Madeleine, Pascal; Jakobsen, Markus Due
in Danish nurses during patient transfers performed with different types of assistive devices, and (2) to combine the exposure profile for each type of assistive device with fortnightly questionnaires to identify the importance of muscle load (intensity and frequency of transfers) and body position (degree...... which type of assistive devices most efficiently prevent LBP, exposure assessments using technological advancements allow for quantification of muscle load and body positions during common work tasks. OBJECTIVE: The main objectives of this study are (1) to quantify low back and neck/shoulder muscle load....... The prospective cohort study will consist of questionnaires at baseline and 1-year follow-up, as well as follow-up via email every other week for one year on questions regarding the frequency of patient transfers, use of assistive devices, intensity of LBP, and back injuries related to patient transfers...
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...
Ferreira, Sara; Amorim, Marco; Couto, Antonio
. This study showed the impact of variables, such as the presence of blood alcohol, the use of protection devices, the type of crash, and the site characteristics, on the injury severity classified according to the MAIS score. Additionally, the sex and age of the victims were analyzed as risk factors, showing that elderly and male road users are highly associated with MAIS 3+ injuries. The comparison between the marginal effects of the variables estimated by the MAIS and LHS models showed significant differences. In addition to the differences in the magnitude of impact of each variable, we found that the impact of the road environment variable was dependent on the injury severity classification. The differences in the effects of risk factors between the classifications highlight the importance of using a reliable classification of injury severity. Additionally, the relationship between LHS and MAIS levels is quite different among countries, supporting the previous conclusion that bias is expected in the assessment of risk factors if an injury severity classification other than MAIS is used.
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.
Objectives. To systematically assess the literature investigating biomechanical knee injury risk factors when an individual lands from a jump. Data sources. Four electronic databases were searched for peer-reviewed English journals containing landing biomechanical studies published over 14 years (1990 - 2003).
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
Fifty years of nuclear weapons production and energy research in the United States during the Cold War generated large amounts of radioactive wastes, spent nuclear fuel (SNF), excess plutonium and uranium, thousands of contaminated facilities, and contaminated soil and groundwater. During most of that half century, the Nation did not have the environmental regulatory structure or nuclear waste cleanup technologies that exist today. The result was a legacy of nuclear waste that was stored and disposed of in ways now considered unacceptable. Cleaning up and ultimately disposing of these wastes is the responsibility of the U.S. Department of Energy (DOE). In 1989, DOE established the Office of Environmental Management (EM) to solve the large scale and technically challenging risks posed by the world's largest nuclear cleanup. This required EM to build a new nuclear cleanup infrastructure, assemble and train a technically specialized workforce, and develop the technologies and tools required to safely decontaminate, disassemble, stabilize, disposition, and remediate unique radiation hazards. The sites where nuclear activities produced legacy waste and contamination include the original Manhattan Project sites--Los Alamos, New Mexico; Hanford, Washington; and Oak Ridge, Tennessee--as well as major Cold War sites, such as Savannah River Site, South Carolina; the Idaho National Laboratory, Idaho; Rocky Flats Plant, Colorado; and Fernald, Ohio. Today EM has responsibility for nuclear cleanup activities at 21 sites covering more than two million acres in 13 states, and employs more than 30,000 Federal and contractor employees, including scientists, engineers and hazardous waste technicians. This cleanup poses unique, technically complex problems, which must be solved under the most hazardous of conditions, and which will require billions of dollars a year for several more decades. The EM program focus during its first 10 years was on managing the most urgent risks and
Fifty years of nuclear weapons production and energy research in the United States during the Cold War generated large amounts of radioactive wastes, spent nuclear fuel (SNF), excess plutonium and uranium, thousands of contaminated facilities, and contaminated soil and groundwater. During most of that half century, the Nation did not have the environmental regulatory structure or nuclear waste cleanup technologies that exist today. The result was a legacy of nuclear waste that was stored and disposed of in ways now considered unacceptable. Cleaning up and ultimately disposing of these wastes is the responsibility of the U.S. Department of Energy (DOE). In 1989, DOE established the Office of Environmental Management (EM) to solve the large scale and technically challenging risks posed by the world's largest nuclear cleanup. This required EM to build a new nuclear cleanup infrastructure, assemble and train a technically specialized workforce, and develop the technologies and tools required to safely decontaminate, disassemble, stabilize, disposition, and remediate unique radiation hazards. The sites where nuclear activities produced legacy waste and contamination include the original Manhattan Project sites--Los Alamos, New Mexico; Hanford, Washington; and Oak Ridge, Tennessee--as well as major Cold War sites, such as Savannah River Site, South Carolina; the Idaho National Laboratory, Idaho; Rocky Flats Plant, Colorado; and Fernald, Ohio. Today EM has responsibility for nuclear cleanup activities at 21 sites covering more than two million acres in 13 states, and employs more than 30,000 Federal and contractor employees, including scientists, engineers and hazardous waste technicians. This cleanup poses unique, technically complex problems, which must be solved under the most hazardous of conditions, and which will require billions of dollars a year for several more decades. The EM program focus during its first 10 years was on managing the most urgent risks and
Germain, Marc; Delage, Gilles; O'Brien, Sheila F; Grégoire, Yves; Fearon, Margaret; Devine, Dana
The recent spread of the Zika virus to the Americas and the recognition that it can cause severe disease in the developing fetus has prompted the adoption of measures to mitigate the risk that this virus might pose to transfusion safety. In nonendemic countries, the risk to transfusion results from donors traveling to an endemic region. Canada implemented a 21-day temporary deferral for prospective donors who traveled to such regions. We present the rationale for this policy, including a quantitative risk assessment supported by a Monte Carlo simulation. The model considered the following parameters, each with specified values and ranges: the probability that a donor recently returned from a Zika-endemic region, the duration of travel to this region, the daily risk of acquiring Zika while in an endemic region, and the incubation and viremic periods. We ran the simulation 20 times, each with 10 million iterations. In the absence of any travel deferral, 32 donors (range, 20-46 donors) would be able to donate while still being at risk of transmitting Zika, corresponding to a rate of 1:312,500 (range, 1:217,000 to 1:500,000). None of these donors would be viremic beyond 21 days after returning from their travel, with a risk estimated at less than 1:200,000,000. A 21-day temporary travel deferral offers an extremely wide margin of safety for the possible transmission of Zika by a donation obtained from someone who recently returned from a country where the virus is circulating. © 2017 AABB.
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/.
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
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.
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...... and adjusted for gender, age, calendar year, presence of a psychiatric family history, epilepsy, infections, autoimmune diseases, and fractures not involving the skull or spine. RESULTS: Head injury was associated with a higher risk of schizophrenia (incidence rate ratio [IRR]=1.65, 95% CI=1...
Hunt, J C
This paper utilizes psychoanalytic theory to examine risk and injury in the case of a male deep sea diver. It examines the unconscious conflicts which appeared to fuel the diver's involvement in deep diving and to lead to a near fatal incident of decompression sickness. Particular attention is paid to the role of the diver's father in the evolution of the preoedipal and oedipal fantasies and conflicts which appear to be linked to the injury. The research is based on interviews with and fieldwork among recreational and deep divers.
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.
Abuduwailil, Jilili; Zhaoyong, Zhang; Fengqing, Jiang
Recently, a large amount of research assessing pollution levels and the related health risks posed by atmosphere dust has been undertaken worldwide. However, little work has been done in the oases of the arid regions of Northwest China. In this paper, we studied the pollution and health risks over a year of seven heavy metals in the atmospheric dust of Ebinur Basin, a typical oasis in Northwest China. The results showed the following: (1) The annual amount of atmospheric deposition in Ebinur Basin was 298.23 g m(-2) and the average monthly atmospheric deposition was 25.06 g m(-2). The average and maximum values of the seven heavy metals measured were all below the National Soil Environmental Quality Standards (2nd). (2) Heavy metals of Cu, Cr, and As in the atmospheric deposition mainly originated from the natural geological background, while Zn came from human activity. This study also showed that among the seven measured heavy metals, the ratios of the no-pollution status of Pb, Cd, and Hg were higher than those of others with moderate degrees of pollution also accounting for a certain ratio. (3) The carcinogenic risks from As, Cd, and Cr were all lower than the corresponding standard limit values, and these metals are considered not harmful to the health of the basin. However, there is a relatively high risk of exposure for children from hand-to-mouth intake, which is worthy of attention. This research showed that both human activity and natural factors, such as wind and altitude, influenced the heavy metal contents in the atmospheric dust of the study area. Furthermore, recent human activity in the study area had the most negative influence on the accumulation of the heavy metals and the corresponding health risks, especially for Hg, Pb, and Cd, which is worthy of attention.
Li, Jiafu; Zhang, Ying; Sun, Tingting; Hao, Huawei; Wu, Hao; Wang, Lili; Chen, Yuxing; Xing, Limin; Niu, Zhiguang
In our study, health risk levels of different age groups of residents living in the vicinity of a municipal solid waste incinerator (MSWI) posed by polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) in atmosphere and soil were evaluated. The toxic equivalent concentrations of PCDD/Fs (TEQ) in surrounding atmosphere and soil of studied MSWI were 0.05-0.12 pg I-TEQ Nm -3 and 7.622-15.450 ng I-TEQ kg -1 , respectively. The PCDFs/PCDDs (F/D) values of PCDD/Fs in surrounding atmosphere of studied MSWI ranged from 0.40 to 5.90 with a mean of 1.80, suggesting that the PCDD/Fs mainly came from combustion sources and studied MSWI could be a key source of PCDD/Fs in surrounding atmosphere. The F/D ratios of PCDD/Fs in surrounding soil ranged from 0.18 to 1.81 with a mean of 0.90, suggesting combustion is not the mainly sources of PCDD/Fs in surrounding soil, and studied MSWI may have limited influence on PCDD/Fs in surrounding soil. O8CDD and 2,3,4,7,8-P5CDF could be the total PCDD/Fs and TEQ indicators in surrounding atmosphere of studied MSWI, respectively. The carcinogenic risk (CR) values of PCDD/Fs in surrounding atmosphere and soil for children, teens and adults were 1.24E-06, 9.06E-07 and 4.41E-06, respectively, suggesting that the potential cancer risk occurred but the risk was at acceptable levels for both children and adults (risk for teens was negligible (risk (non-CR) values of three age groups were lower than 1, indicating that no obvious non-carcinogenic effects occurred. Inhalation of air was the largest contributor of health risk (both CR and non-CR) for three age groups. In addition, a comparison of the health risk between PCDD/Fs and other emerging contaminants and traditional pollutants in soil and atmosphere was performed, which will help us have a good view of the health risk levels of PCDD/Fs in surrounding environment of MWSI. Copyright © 2018 Elsevier B.V. All rights reserved.
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.
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.
Sinikumpu, Juha-Jaakko; Antila, Eeva; Korhonen, Jussi; Rättyä, Johanna; Serlo, Willy
Trampolines for home use have become common in Finland during the past ten years, being especially favored by children. Trampoline jumping is beneficial and constructive physical exercise, but poses a significant risk for injuries. The most common injuries include sprains and strains. During summertime, trampoline injuries account for as many as 13% of children's accidents requiring hospital care. Fractures are by far the most common trampoline injuries requiring hospital care. Injuries can be prevented by using safety nets. Only one child at a time is allowed to jump on the trampoline.
Gaewsky, James P; Weaver, Ashley A; Koya, Bharath; Stitzel, Joel D
A 3-phase real-world motor vehicle crash (MVC) reconstruction method was developed to analyze injury variability as a function of precrash occupant position for 2 full-frontal Crash Injury Research and Engineering Network (CIREN) cases. Phase I: A finite element (FE) simplified vehicle model (SVM) was developed and tuned to mimic the frontal crash characteristics of the CIREN case vehicle (Camry or Cobalt) using frontal New Car Assessment Program (NCAP) crash test data. Phase II: The Toyota HUman Model for Safety (THUMS) v4.01 was positioned in 120 precrash configurations per case within the SVM. Five occupant positioning variables were varied using a Latin hypercube design of experiments: seat track position, seat back angle, D-ring height, steering column angle, and steering column telescoping position. An additional baseline simulation was performed that aimed to match the precrash occupant position documented in CIREN for each case. Phase III: FE simulations were then performed using kinematic boundary conditions from each vehicle's event data recorder (EDR). HIC15, combined thoracic index (CTI), femur forces, and strain-based injury metrics in the lung and lumbar vertebrae were evaluated to predict injury. Tuning the SVM to specific vehicle models resulted in close matches between simulated and test injury metric data, allowing the tuned SVM to be used in each case reconstruction with EDR-derived boundary conditions. Simulations with the most rearward seats and reclined seat backs had the greatest HIC15, head injury risk, CTI, and chest injury risk. Calculated injury risks for the head, chest, and femur closely correlated to the CIREN occupant injury patterns. CTI in the Camry case yielded a 54% probability of Abbreviated Injury Scale (AIS) 2+ chest injury in the baseline case simulation and ranged from 34 to 88% (mean = 61%) risk in the least and most dangerous occupant positions. The greater than 50% probability was consistent with the case occupant's AIS 2
Ali, Roslinah; Shaharudin, Rafiza; Omar, Azahadi; Yusoff, Fadhli
This study on workplace injuries and risk reduction practices was part of the Malaysia National Health Morbidity Survey III (NHMS III) conducted in 2006. This cross-sectional population-based survey was conducted to determine the incidence of workplaces injuries and assess the magnitude of some important risk reduction practices among workers. Data were gathered through face-to-face household interviews using a pre-coded questionnaire. Of the 22 880 eligible respondents, 88·2% (20 180) responded. The incidence rate for injuries at the workplace was 4·9 per 100 (95% CI: 4·6-5·2). The overall proportion of workers who had received occupational safety and health (OSH) training before or within 1 month of starting work was 33·6%. Among respondents who perceived that personal protective equipment (PPE) was required at their workplace, only 38·9% (95% CI: 37·8-39·4) were provided with it by their employers. Further studies are urgently needed to identify reasons for and management of the low uptake of risk reduction practices. This issue needs to be addressed to ensure the safety and health of our working population.
Clausen, Mikkel Bek; Tang, L; Zebis, M K
with low KOOS subscale scores (Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P time-loss knee...... questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (... 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 time-loss knee injury was also significantly increased in players...
Runge, Lisbeth; Kristensen, Peter Lund; Junge, Tina
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...... motor performance (core stability, vertical jump, shuttle run) was positively associated with traumatic and overuse injuries, and negatively (single leg hop) associated with traumatic injuries, indicating different influence on injury risk. Previous injury was a confounder affecting the effect size...... and the significance. More studies are needed to consolidate the findings, to clarify the influence of different performance tests on different types of injuries and to examine the influence of behaviour in relation to injury risk....
Which US States Pose the Greatest Threats to Military Readiness and Public Health? Public Health Policy Implications for a Cross-sectional Investigation of Cardiorespiratory Fitness, Body Mass Index, and Injuries Among US Army Recruits.
Bornstein, Daniel B; Grieve, George L; Clennin, Morgan N; McLain, Alexander C; Whitsel, Laurie P; Beets, Michael W; Hauret, Keith G; Jones, Bruce H; Sarzynski, Mark A
Many states in the southern region of the United States are recognized for higher rates of obesity, physical inactivity, and chronic disease. These states are therefore recognized for their disproportionate public health burden. The purpose of this study was to investigate state-level distributions of cardiorespiratory fitness, body mass index (BMI), and injuries among US Army recruits in order to determine whether or not certain states may also pose disproportionate threats to military readiness and national security. Sex-specific state-level values for injuries and fitness among 165 584 Army recruits were determined. Next, the relationship between median cardiorespiratory fitness and injury incidence at the state level was examined using Spearman correlations. Finally, multivariable Poisson regression models stratified by sex examined state-level associations between fitness and injury incidence, while controlling for BMI, and other covariates. Cardiorespiratory fitness and training-related injury incidence. A cluster of 10 states from the south and southeastern regions (Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas) produced male or female recruits who were significantly less fit and/or more likely to become injured than recruits from other US states. Compared with the "most fit states," the incidence of injuries increased by 22% (95% CI, 17-28; P < .001) and 28% (95% CI, 19-36; P < .001) in male and female recruits from the "least fit states," respectively. The impact of policies, systems, and environments on physical activity behavior, and subsequently fitness and health, has been clearly established. Advocacy efforts aimed at active living policies, systems, and environmental changes to improve population health often fail. However, advocating for active living policies to improve national security may prove more promising, particularly with legislators. Results from this study demonstrate
Laytin, Adam D; Shumway, Martha; Boccellari, Alicia; Juillard, Catherine J; Dicker, Rochelle A
Mental illness, substance abuse, and poverty are risk factors for violent injury, and violent injury is a risk factor for early mortality that can be attenuated through hospital-based violence intervention programs. Most of these programs focus on victims under the age of 30 years. Little is known about risk factors or long-term mortality among older victims of violent injury. To explore the prevalence of risk factors for violent injury among younger (age < 30 years) and older (age 30 ≥ years) victims of violent injury, to determine the long-term mortality rates in these age groups, and to explore the association between risk factors for violent injury and long-term mortality. Adults with violent injuries were enrolled between 2001 and 2004. Demographic and injury data were recorded on enrollment. Ten-year mortality rates were measured. Descriptive analysis and logistic regression were used to compare older and younger subjects. Among 541 subjects, 70% were over age 30. The overall 10-year mortality rate was 15%, and was much higher than in the age-matched general population in both age groups. Risk factors for violent injury including mental illness, substance abuse, and poverty were prevalent, especially among older subjects, and were each independently associated with increased risk of long-term mortality. Mental illness, substance abuse, and poverty constitute a "lethal triad" that is associated with an increased risk of long-term mortality among victims of violent injury, including both younger adults and those over age 30 years. Both groups may benefit from targeted risk-reduction efforts. Emergency department visits offer an invaluable opportunity to engage these vulnerable patients. Copyright © 2018 Elsevier Inc. All rights reserved.
Full Text Available Example-based mesh deformation techniques produce natural and realistic shapes by learning the space of deformations from examples. However, skeleton-based methods cannot manipulate a global mesh structure naturally, whereas the mesh-based approaches based on a translational control do not allow the user to edit a local mesh structure intuitively. This paper presents an example-driven mesh editing framework that achieves both global and local pose manipulations. The proposed system is built with a surface deformation method based on a two-step linear optimization technique and achieves direct manipulations of a model surface using translational and rotational controls. With the translational control, the user can create a model in natural poses easily. The rotational control can adjust the local pose intuitively by bending and twisting. We encode example deformations with a rotation-invariant mesh representation which handles large rotations in examples. To incorporate example deformations, we infer a pose from the handle translations/rotations and perform pose space interpolation, thereby avoiding involved nonlinear optimization. With the two-step linear approach combined with the proposed multiresolution deformation method, we can edit models at interactive rates without losing important deformation effects such as muscle bulging.
Alcocer Urueta, Jaime; Bonilla Mares, Marcela; Gorbea Chávez, Viridiana; Velázquez Valassi, Beatriz
To identify risk factors for bladder injury during cesarean delivery, to let patients and doctors know them and their importance. We conducted a case-control study of women undergoing cesarean delivery at the Instituto Nacional de PerinatologíaIsidro Espinosa de los Reyes between January 2001 and December 2007. Cases were women with bladder injuries at the time of cesarean section. Two controls per case were selected randomly. Medical records were reviewed for clinical and demographic data to compare them. Twenty-one bladder injuries were identified among 24, 057 cesarean sections, (incidence 0.087%), only 19 were analized. Prior cesarean section was more prevalent among cases than controls (63% vs 42% p 0.134), with an OR of 2.35 (95% CI 0.759-7.319), when we take only patients with one cesarea in contrast with no cesarea the OR is 3.75 (95% CI 1.002- 14.07). Statistically significant differences (P values < .05) between cases and controls were found in gestacional age (38.16 vs 37.35 weeks), prior cesareans (42% vs 18%), adhesions (79% vs 5%), Odds ratio of 67.5 (95% CI 11.14- 408), VBAC (31.5 vs 3%), median skin incisión (16% vs 68%), Pfannenstiel (84% vs 32%), blood loss (744cc vs 509cc) and length of surgery 135 vs 58 minutes). No differences were found among age, BMI, prior surgery, labor, premature rupture of membranes, station, chorioamnioitis, induction, uterine incision, timing of delivery, uterine rupture. Prior cesarean section and adhesions are risk factors for bladder injury at the time of repeat cesarean delivery. Elective cesarean delivery is valid but it is duty of physicians to inform patients the risks of it.
Austin, Laurel Cecelia; Fischhoff, Baruch
fail to see risks, do not make use of available protective interventions or misjudge the effectiveness of protective measures. If these misunderstandings can be reduced through context-appropriate risk communications, then their improved mental models may help people to engage more effectively...... and create an expert model of the risk situation, interviewing lay people to elicit their comparable mental models, and developing and evaluating communication interventions designed to close the gaps between lay people and experts. This paper reviews the theory and method behind this research stream...... 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...
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.
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.
Lu, Zengbin; Dang, Cong; Han, Naishun; Shen, Zhicheng; Peng, Yufa; Stanley, David; Ye, Gongyin
The ecological risks to nontarget organisms should be rigorously assessed before Bt crops are released. Here, the impacts of a new Cry1Ab/Vip3H rice line on arthropod communities in rice agroecosystems were evaluated across 3 yr. Arthropods collected via vacuum were sorted into five guilds. The abundance and proportion of each guild as well as community-level parameters were determined in Cry1Ab/Vip3H and control rice fields. Changes in arthropod species assemblage over sampling dates were investigated by principal response curves (PRCs). Cry1Ab/Vip3H rice did not exert significant impacts on the seasonal density and proportion of each guild, except parasitoids. Detritivore seasonal density, but not its relative abundance, was significantly affected by Cry1Ab/Vip3H rice. Four community indices (species richness S, Shannon-Wiener index H', Simpson index D, and evenness index J') were similar between rice types. PRCs revealed a slight community difference between rice types in the past two tested years, with rice types accounting for 1.0-3.5% of the variance among arthropod communities. However, sampling dates explain 32.1-67.6% for these community differences. Of the 46 taxa with higher species weights, 26.1% of the taxa were significantly different, including seven taxa with higher abundance and five with lower density in Cry1Ab/Vip3H rice fields. These differences may be attributed to change in abundance of prey or hosts but not to direct effects of Bt proteins. We infer that this new Cry1Ab/Vip3H rice line poses no unintended ecological risks to the arthropod community. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Evans, N P; Bellingham, M; Sharpe, R M; Cotinot, C; Rhind, S M; Kyle, C; Erhard, H; Hombach-Klonisch, S; Lind, P M; Fowler, P A
Biosolids (processed human sewage sludge), which contain low individual concentrations of an array of contaminants including heavy metals and organic pollutants such as polycyclic aromatic hydrocarbons (PAH), polychlorinated biphenyls (PCB), and polychlorinated dibenzodioxins/polychlorinated dibenzofurans known to cause physiological disturbances, are increasingly being used as an agricultural fertilizer. This could pose a health threat to both humans and domestic and wild animal species. This review summarizes results of a unique model, used to determine the effects of exposure to mixtures of environmentally relevant concentrations of pollutants, in sheep grazed on biosolids-treated pastures. Pasture treatment results in nonsignificant increases in environmental chemical (EC) concentrations in soil. Whereas EC concentrations were increased in some tissues of both ewes and their fetuses, concentrations were low and variable and deemed to pose little risk to consumer health. Investigation of the effects of gestational EC exposure on fetal development has highlighted a number of issues. The results indicate that gestational EC exposure can adversely affect gonadal development (males and females) and that these effects can impact testicular morphology, ovarian follicle numbers and health, and the transcriptome and proteome in adult animals. In addition, EC exposure can be associated with altered expression of GnRH, GnRH receptors, galanin receptors, and kisspeptin mRNA within the hypothalamus and pituitary gland, gonadotroph populations within the pituitary gland, and regional aberrations in thyroid morphology. In most cases, these anatomical and functional differences do not result in altered peripheral hormone concentrations or reproductive function (e.g., lambing rate), indicating physiological compensation under the conditions tested. Physiological compensation is also suggested from studies that indicate that EC effects may be greater when exposure occurs either
Gibert, A.; Kruizinga, A.G.; Neuhold, S.; Houben, G.F.; Canela, M.A.; Fasano, A.; Catassi, C.
Background: In patients with treated celiac disease (CD), the ingestion of gluten traces contained in gluten-free (GF) wheat substitutes (eg, GF bread, flour, and pasta) could cause persisting intestinal mucosal damage. Objective: The objective was to evaluate the proportion of CD patients at risk
Moller, Merete; Attermann, Jorn; Myklebust, Grethe; Wedderkopp, Niels
To assess the injury incidence in elite handball, and if gender and previous injuries are risk factors for new injuries. Cohort study of 517 male and female elite handball players (age groups under (u)16, u-18 and senior). Participants completed a web survey establishing injury history, demographic information and sports experience, and provided weekly reports of time-loss injuries and handball exposure for 31 weeks by short message service text messaging (SMS). Injuries were further classified by telephone interview. The weekly response rate ranged from 85% to 90% 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 17.8 to 30.4), 15.1 (95% CI 9.7 to 22.2), 11.1 (95% CI 7.0 to 16.6) injuries per 1000 match hours among senior, u-18 and u-16 players, respectively. U-18 male players had an overall 1.76 (95% CI 1.10 to 2.80) times higher risk of injury compared to females. Having had two or more previous injuries causing 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)). The incidence of time-loss injuries in elite handball was higher during match play than previously reported in recreational handball. Previous injuries were a risk factor for new injuries among u-16 players. Male players had a significant higher injury rate in the u-18 group.
van Poppel, Dennis; Scholten-Peeters, Gwendolijne G.M.; van Middelkoop, Marienke; Koes, Bart W.; Verhagen, Arianne P.
Background: Running injuries are very common. Risk factors for running injuries are not consistently described across studies and do not differentiate between runners of long- and short distances within one cohort. Objectives: The aim of this study is to determine risk factors for running injuries
Voss, M.; Knottenbelt, J. D.; Peden, M. M.
OBJECTIVE--To assess risk factors for important neurosurgical effects in patients who reattend after head injury. DESIGN--Retrospective study. SUBJECTS--606 patients who reattended a trauma unit after minor head injury. MAIN OUTCOME MEASURES--Intracranial abnormality detected on computed tomography or the need for neurosurgical intervention. RESULTS--Five patients died: two from unrelated causes and three from raised intracranial pressure. On multiple regression analysis the only significant predictor for both abnormality on computed tomography (14.4% of reattenders) and the need for operation (5% of reattenders) was vault fracture seen on the skull radiograph (P personality change, and seizures were significantly associated only with abnormality on computed tomography. Headache, dizziness, nausea, and vomiting were common in reattenders but were found to have no independent significance. CONCLUSIONS--All patients who reattend after head injury should undergo computed tomography as at least 14% of scans can be expected to yield positive results. Where this facility is not available patients with predictors for operation should be urgently referred for neurosurgical opinion. Other patients can be readmitted and need referral only if symptoms persist despite symptomatic treatment or there is neurological deterioration while under observation. These patients are a high risk group and should be treated seriously. PMID:8520273
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.
Van Gent, Jan-Michael; Calvo, Richard Yee; Zander, Ashley L; Olson, Erik J; Sise, C Beth; Sise, Michael J; Shackford, Steven R
Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given that recent data suggesting postinjury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of postinjury DVT and PE are different. We examined all adult trauma patients admitted to our Level I trauma center from July 2006 to December 2011 who received at least one surveillance duplex ultrasound of the lower extremities and who were at high risk or greater for DVT. Outcomes included DVT and PE events, and time-to-event from admission. We used competing risks analysis to evaluate risk factors for DVT while accounting for PE as a competing event, and vice versa. Of 2,370 patients, 265 (11.2%) had at least one venous thromboembolism event, 235 DVT only, 19 PE only, 11 DVT and PE. Within 2 days of admission, 38% of DVT cases had occurred compared with 26% of PE. Competing risks modeling of DVT as primary event identified older age, severe injury (Injury Severity Score, ≥ 15), mechanical ventilation longer than 4 days, active cancer, history of DVT or PE, major venous repair, male sex, and prophylactic enoxaparin and prophylactic heparin as associated risk factors. Modeling of PE as the primary event showed younger age, nonsevere injury (Injury Severity Score, risk factors for PE and DVT after injury were different, suggesting that they are clinically distinct events that merit independent consideration. Many DVT events occurred early despite prophylaxis, bringing into question the preventability of postinjury DVT. We recommend trauma center quality reporting program measures be revised to account for DVT and PE as unique events. Epidemiologic, level III.
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.
Sulistyowati Tuminah Darjoko
Women and stroke sufferers were at higher risk of fall-related injury among older persons. Prevention of fall-related injury should be done by older persons through periodic control of their health condition.
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...... intrinsic and extrinsic factors for risk of these injuries. METHODS: Weekly musculoskeletal pain, sport participation and sports type were reported by 1326 school children (8-15 years). Knee injuries were classified as traumatic or overuse. Multinomial logistic regression was used for analyses. RESULTS...
Yang, Yan; Liu, Yue; Cao, Fengqin; Chen, Xiuping; Cheng, Lisheng; Romeis, Jörg; Li, Yunhe; Peng, Yufa
By consuming mulberry leaves covered with pollen from nearby genetically engineered, insect-resistant rice lines producing Cry proteins derived from Bacillus thuringiensis (Bt), larvae of the domestic silkworm, Bombyx mori (Linnaeus) (Lepidoptera: Bombyxidae), could be exposed to insecticidal proteins. Laboratory experiments were conducted to assess the potential effects of Cry1C- or Cry2A-producing transgenic rice (T1C-19, T2A-1) pollen on B. mori fitness. In a short-term assay, B. mori larvae were fed mulberry leaves covered with different densities of pollen from Bt rice lines or their corresponding near isoline (control) for the first 3 d and then were fed mulberry leaves without pollen. No effect was detected on any life table parameter, even at 1800 pollen grains/cm2 leaf, which is much higher than the mean natural density of rice pollen on leaves of mulberry trees near paddy fields. In a long-term assay, the larvae were fed Bt and control pollen in the same way but for their entire larval stage (approximately 27 d). Bt pollen densities ≥150 grains/cm2 leaf reduced 14-d larval weight, increased larval development time, and reduced adult eclosion rate. ELISA analyses showed that 72.6% of the Cry protein was still detected in the pollen grains excreted with the feces. The low exposure of silkworm larvae to Cry proteins when feeding Bt rice pollen may be the explanation for the relatively low toxicity detected in the current study. Although the results demonstrate that B. mori larvae are sensitive to Cry1C and Cry2A proteins, the exposure levels that harmed the larvae in the current study are far greater than natural exposure levels. We therefore conclude that consumption of Bt rice pollen will pose a low to negligible risk to B. mori. PMID:25014054
Krause, Trudy Millard; Ukhanova, Maria; Lee Revere, Frances; Finkel, Kevin W
To evaluate risk predictors of acute kidney injury (AKI) after contrast-media procedures in a broader cohort of patients than previously reported. Comprehensive medical and pharmacy commercial claims data from 2012 to 2014. Claims associated with contrast-media procedures for 2,737,020 persons between January 1, 2012 and November 30, 2014, were reviewed. The overall incidence of AKI after a contrast-media procedure was 0.85%. AKI occurred in 26% of cases that had two or more contrast procedures within 30 days, compared with 9% of non-AKI cases. Although the incidence of postcontrast AKI was low, 10% of patients who developed AKI had a recent previous episode of AKI. In cases when AKI had occurred within 180 days of contrast administration, the odds of subsequent kidney injury was 9.39. Overall, there is a low risk (0.85%) of developing an AKI after a procedure with contrast-media consistent with several recent studies. However, in adults with a recent history of AKI, physicians must consider this history as a risk factor for subsequent AKI. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Sinikumpu, Juha-Jaakko; Salokorpi, Niina; Suo-Palosaari, Maria; Pesälä, Juha; Serlo, Willy
Although the majority of trampoline injuries in children are minor, severe injuries occur as well. We have analyzed the risk factors, treatment and outcome of severe trampoline injuries treated in the Oulu University Hospital in children and the young between April and November 2105. There was a total of eight severe injuries. Five injuries involved a danger of death. Almost all severe trampoline injuries resulted from an unsuccessful trick. A safety net was in use in half of the cases. All cervical spine injuries would have been avoided provided that the children would have refrained from doing a somersault on the trampoline.
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
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
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.
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.
Bena, Antonella; Giraudo, Massimiliano
To study the relationship between job tenure and injury risk, controlling for individual factors and company characteristics. Analysis of incidence and injury risk by job tenure, controlling for gender, age, nationality, economic activity, firm size. Sample of 7% of Italian workers registered in the INPS (National Institute of Social Insurance) database. Private sector employees who worked as blue collars or apprentices. First-time occupational injuries, all occupational injuries, serious occupational injuries. Our findings show an increase in injury risk among those who start a new job and an inverse relationship between job tenure and injury risk. Multivariate analysis confirm these results. Recommendations for improving this situation include the adoption of organizational models that provide periods of mentoring from colleagues already in the company and the assignment to simple and not much hazardous tasks. The economic crisis may exacerbate this problem: it is important for Italy to improve the systems of monitoring relations between temporary employment and health.
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
Hagen, Erika W; Sadek-Badawi, Mona; Carlton, David P; Palta, Mari
Permissive hypercapnia is a respiratory-care strategy that is used to reduce the risk for lung injury. The goal of this study was to evaluate whether permissive hypercapnia is associated with higher risk for intraventricular hemorrhage and early childhood behavioral and functional problems than normocapnia among very low birth weight infants. Very low birth weight infants from a statewide cohort were eligible for this study when they were born at <32 weeks' gestational age and survived at least 24 hours. Infants were classified as receiving a permissive hypercapnia, normocapnia, or unclassifiable respiratory strategy during the first 24 hours after birth according to an algorithm based on Pco(2) values and respiratory-treatment decisions that were abstracted from medical charts. Intraventricular hemorrhage diagnosis was also abstracted from the medical chart. Behavioral and functional outcomes were assessed by parent interview at 2 to 3 years. Logistic regression was used to evaluate the relationship between intraventricular hemorrhage and respiratory strategy; ordinary linear regression was used to evaluate differences in behavior and function scores between children by respiratory strategy. Infants who received a permissive hypercapnia strategy were not more likely to have intraventricular hemorrhage than those with normocapnia. There were no differences in any of the behavioral or functional scores among children according to respiratory strategy. There was a significant interaction between care strategy and 1-minute Apgar score, indicating that infants with lower Apgar scores may be at higher risk for intraventricular hemorrhage with permissive hypercapnia. This study suggests that permissive hypercapnia does not increase risk for brain injury and impairment among very low birth weight children. The interaction between respiratory strategy and Apgar score is a potential worrisome exception to this conclusion. Future research should further evaluate the effect
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
MacLennan, P A; McGwin, G; Metzger, J; Moran, S G; Rue, L W
Unbelted occupants may increase the risk of injury for other occupants in a motor vehicle collision (MVC). This study evaluated the association between occupant restraint use and the risk of injury (including death) to other vehicle occupants. A population based cohort study. United States. MVC occupants (n = 152 191 unweighted, n = 18 426 684 weighted) seated between a belted or unbelted occupant and the line of the principal direction of force in frontal, lateral, and rear MVCs were sampled from the 1991-2002 National Automotive Sampling System General Estimates System. Offset MVCs were not included in the study. Risk ratios and 95% confidence intervals for injury (including death) for occupants seated contiguous to unbelted occupants compared to occupants seated contiguous to belted occupants. Risk ratios were adjusted for at risk occupant's sex, age, seating position, vehicle type, collision type, travel speed, crash severity, and at risk occupants' own seat belt use. Exposure to unbelted occupants was associated with a 40% increased risk of any injury. Belted at risk occupants were at a 90% increased risk of injury but unbelted occupants were not at increased risk. Risks were similar for non-incapacitating and capacitating injuries. There was a 4.8-fold increased risk of death for exposed belted occupants but no increased risk of death for unbelted occupants. Belted occupants are at an increased risk of injury and death in the event of a MVC from unbelted occupants.
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 (pposicionamiento quirúrgico en pacientes adultos. investigación metodológica, conducida en dos etapas: construcción y validación de faz y de contenido de la escala e investigación de campo, con la participación de 115 pacientes. la Escala de Evaluación de Riesgo para el Desarrollo de Lesiones Debidas al Posicionamiento Quirúrgico contiene siete ítems, siendo que cada uno presenta cinco subítems. La puntuación de esa escala varia de siete a 35 puntos en que, cuanto mayor la puntuación, mayor el riesgo del paciente. El Índice de Validez de Contenido de la escala fue 0,88. Mediante la aplicación de la prueba t de Student, para igualdad de medias, fue constatada validez de criterio concurrente entre los scores de la escala de Braden y de la escala construida. Para evaluar la validez de criterio predictiva, fue testada la asociación de la presencia de dolor debido al posicionamiento quirúrgico y el desarrollo de úlcera por presión con el score de
Molloy, Joseph M
Running-related musculoskeletal injuries among U.S. military recruits negatively impact military readiness. Low aerobic fitness, prior injury, and weekly running distance are known risk factors. Physical fitness screening and remedial physical training (or discharging the most poorly fit recruits) before entry-level military training have tended to reduce injury rates while decreasing attrition, training, and medical costs. Incorporating anaerobic running sessions into training programs can offset decreased weekly running distance and decrease injury risk. Varying lower extremity loading patterns, stride length or cadence manipulation, and hip stability/strengthening programming may further decrease injury risk. No footstrike pattern is ideal for all runners; transitioning to forefoot striking may reduce risk for hip, knee, or tibial injuries, but increase risk for calf, Achilles, foot or ankle injuries. Minimal evidence associates running surfaces with injury risk. Footwear interventions should focus on proper fit and comfort; the evidence does not support running shoe prescription per foot type to reduce injury risk among recruits. Primary injury mitigation efforts should focus on physical fitness screening, remedial physical training (or discharge for unfit recruits), and continued inclusion of anaerobic running sessions to offset decreased weekly running distance. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.
... 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...
Laursen, Bjarne; Nielsen, Jeppe W
. Risk differences were found for all injury mechanisms; however the risk for burns was 1.9 (1.6-2.3) times higher in the lowest-income group than in the highest-income group, the relative risk for poisoning was 1.7(1.4-2.1). For scalds from hot water, tea or coffee, the relative risk for the lowest......-income group was 2.4(1.8-3.2). Living in a one- or two-parent family and size of the dwelling had little or no effect on risk. CONCLUSION: Childhood injury incidence depended on sociodemographic factors. The effect of the sociodemographic factors varied between injury mechanisms and products involved......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...
Lauridsen, Eva Fejerskov; Hermann, Nuno Vibe; Gerds, Thomas Alexander
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...... to a standardized protocol. Statistical Analysis: The risk of PN was analysed separately for teeth with immature and mature root development by the Kaplan–Meier method, the log-rank test and Cox regression analysis. The level of significance was set at 5%. Risk factors included in the analysis were gender, patient......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...
Singh, Santosh Kumar; Ekka, Roseleen; Mishra, Mitali; Mohapatra, Harapriya
The present study explored the association between multiple antibiotic resistance (MAR) index and virulence index to determine what percent of environmental antibiotic-resistant (eARB) bacteria could pose threat as potential pathogen. 16srRNA-based sequencing of 113 non-duplicate isolates identified majority of them to be gram negative belonging to Enterobacter, Pseudomonas, Aeromonas, Proteus, Acinetobacter, and Klebsiella. Statistical comparison of MAR indices of the abovementioned genera indicated differences in the median values among the groups (p Klebsiella = Acinetobacter > Proteus > Aeromonas > Enterobacter. Association between MAR index and virulence index revealed that 25% of isolates in the population under study posed high threat to human/animal or both; out of which 75% isolates belonged to genus Pseudomonas. Based on observations of comparative analysis of the six gram-negative genera, it could be concluded that Pseudomonas isolates from environment pose significantly high threat as potential pathogens while Enterobacter isolates posed no threat.
Steffen, K; Pensgaard, A M; Bahr, R
Identifying and understanding injury risk factors are necessary to target the injury-prone athlete and develop injury prevention measurements. The influence of psychological factors on injuries in football is poorly documented. The purpose of this 8-month prospective cohort study therefore was to examine whether psychological player characteristics assessed by a self-administered questionnaire represent risk factors for injury. At baseline, female football players (14-16 years) were asked to complete a detailed questionnaire covering player history, previous injuries, perception of success and motivational climate, life stress, anxiety and coping strategies. During the 2005 season, a total of 1430 players were followed up to record injuries. A history of a previous injury [odds ratio (OR)=1.9 (1.4; 2.5), Pfemale football players.
Frisch, A; Seil, R; Urhausen, A; Croisier, J L; Lair, M L; Theisen, D
This study analyzed sex-specific injury patterns and risk factors in young athletes (n=256) from 12 sport disciplines practicing at the national or the international level in the Grand-Duchy of Luxembourg. Injury occurrence as a result of sport practice was analyzed retrospectively over the year 2006 using a standardized self-administered questionnaire. Overall incidence was not different between girls and boys (1.20 and 1.21 injuries/1000 athlete-hours, respectively), but in the context of team sport competition girls tended to be at a greater risk (rate ratio 2.05, P=0.053). Girls had a higher proportion of injuries in the ankle/foot region compared with boys (34.8% vs 16.8%). No sex-related differences were found regarding injury severity. Multivariate logistic regression (controlling for age and practice volume) revealed that girls' team sports were associated with a greater injury risk compared with individual sports [odds ratio (OR) of 4.76], while in boys this was observed for racket sports (OR=3.31). Furthermore, physical or emotional stress tended to be a specific risk factor in girls. There was a tendency for injury outside sports to be coupled to a higher injury risk in girls and boys. Consideration of sex-specific injury patterns and risk factors could be of importance for effective injury prevention.
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)
Møller, Martin Nue; Sørensen, Christian Hjort
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...... in level I B and level II A, respectively. In 95 patients with oral cancer 13 (14%) of the cases had malfunction of the lower lip domain 2 weeks after neck dissection in level I B indicating paresis to the MMN. Follow-up analyses 1-2 years after the operation showed permanent paralysis in 4 to 7......% 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...
Chang, David C; Anderson, Jamie E; Kobayashi, Leslie; Coimbra, Raul; Bickler, Stephen W
The lifetime risk and expected cost of trauma care would be valuable for health policy planners, but this information is currently unavailable. The cumulative incidence rates methodology, based on a cross-sectional population analysis, offers an alternative approach to prohibitively costly prospective cohort studies. Retrospective analysis of the California Office of Statewide Health Planning and Development (OSHPD) database was performed for 2008. Trauma admissions were identified by ICD-9 primary diagnosis codes 800-959, with certain exclusions. Cumulative incidence rates were calculated as the cumulative summation of incidence risks sequentially across age groups. A total of 2.2 million admissions were identified, with mean age of 63.8 y, 49.6% men, 82.8% Whites, 5.7% Blacks, 11.3% Hispanics, and 3.1% Asians. The cumulative incidence rate for patients older than age 85 y was 1119 per 10,000 people, with the majority of risk in the elderly, compared with 24,325 per 10,000 people for all-cause hospitalizations. The rates were 946 for men, 1079 for women, 999 for non-Hispanic Whites, 568 for Blacks, 577 for Hispanics, and 395 for Asians, per 10,000 population. The cumulative expected hospital charge was $6538, compared with $81,257 for all-cause hospitalizations. The cumulative lifetime risk of trauma/injury requiring hospitalization for a person living to age 85 y in California is 11.2%, accounting for 4.6% of expected lifetime hospitalizations, but accounting for 8.0% of expected lifetime hospital expenditures. Risk of trauma is significant in the elderly. The total expenditure for all trauma hospitalizations in California was $7.62 billion in 2008. Copyright © 2012 Elsevier Inc. All rights reserved.
Panzer, Matthew B; Bass, Cameron R Dale; Rafaels, Karin A; Shridharani, Jay; Capehart, Bruce P
The widespread use of explosives by modern insurgents and terrorists has increased the potential frequency of blast exposure in soldiers and civilians. This growing threat highlights the importance of understanding and evaluating blast injury risk and the increase of injury risk from exposure to repeated blast effects. Data from more than 3,250 large animal experiments were collected from studies focusing on the effects of blast exposure. The current study uses 2,349 experiments from the data collection for analysis of the primary blast injury and survival risk for both long- and short-duration blasts, including the effects from repeated exposures. A piecewise linear logistic regression was performed on the data to develop survival and injury risk assessment curves. New injury risk assessment curves uniting long- and short-duration blasts were developed for incident and reflected pressure measures and were used to evaluate the risk of injury based on blast over pressure, positive-phase duration, and the number of repeated exposures. The risk assessments were derived for three levels of injury severity: nonauditory, pulmonary, and fatality. The analysis showed a marked initial decrease in injury tolerance with each subsequent blast exposure. This effect decreases with increasing number of blast exposures. The new injury risk functions showed good agreement with the existing experimental data and provided a simplified model for primary blast injury risk. This model can be used to predict blast injury or fatality risk for single exposure and repeated exposure cases and has application in modern combat scenarios or in setting occupational health limits. .Copyright © 2012 by Lippincott Williams & Wilkins
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
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.
Saragiotto, B.T.; Yamato, T.P.; Hespanhol, L.C.; Rainbow, M.J.; Davis, I.S.; Lopes, A.D.
Background: Despite several studies that have been conducted on running injuries, the risk factors for running-related injuries are still not clear in the literature. Objective: The aim of this study was to systematically review prospective cohort studies that investigated the risk factors for
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
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....
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....
Møller, Merete; Attermann, Jørn; Myklebust, Grethe
ObjectiveTo assess the injury incidence in elite handball, and if gender and previous injuries are risk factors for new injuries.MethodsCohort study of 517 male and female elite handball players (age groups under (u)16, u-18 and senior). Participants completed a web survey establishing injury.......8 to 30.4), 15.1 (95% CI 9.7 to 22.2), 11.1 (95% CI 7.0 to 16.6) injuries per 1000 match hours among senior, u-18 and u-16 players, respectively. U-18 male players had an overall 1.76 (95% CI 1.10 to 2.80) times higher risk of injury compared to females. Having had two or more previous injuries causing...
Lauridsen, Eva Fejerskov; Hermann, Nuno Vibe; Gerds, Thomas Alexander
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......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...
Kim, Sun Hyu
This study was performed to examine the characteristics of indoor and outdoor falls in older patients and the factors related to severe injury in the emergency department (ED). In total, 26,515 patients fell indoors and 19,581 outdoors. The general and clinical characteristics were compared between the two groups and factors associated with severe injury following the falls were evaluated. Younger males fell more frequently outdoors than indoors. The common activities during outdoor falls were sports and leisure activities. Environmental hazards lead to more outdoor falls than indoor falls. Factors associated with severe injury after indoor falls were transport to the ED by public ambulance or from another medical facility rather than individual transportation, fall from stairs rather than fell over, and a head and neck injury rather than a lower extremity injury. Factors related to severe injury after outdoor falls were male sex, transport to the ED by public ambulance or from another medical facility or by another method rather than individual transportation, state employed, fall from stairs rather than fell over, head and neck or thorax or abdomen injury rather than a lower extremity injury. Transport to the ED by public ambulance or from another medical facility, and head and neck injury were risks for severe injury following indoor and outdoor falls in elderly subjects. Efforts to identify the risk factors for severe injury and for falling itself are important to prevent and reduce fall injuries in elderly subjects. Copyright © 2015 Elsevier Ireland 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.
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.
Bærentzen, Jakob Andreas; Hansen, Kristian Evers; Erleben, Kenny
In this paper, we propose a pose editing and animation method for triangulated surfaces based on a user controlled partitioning of the model into deformable parts and rigid parts which are denoted handles. In our pose editing system, the user can sculpt a set of poses simply by transforming...... the handles for each pose. Using Laplacian editing, the deformable parts are deformed to match the handles. In our animation system the user can constrain one or several handles in order to define a new pose. New poses are interpolated from the examples poses, by solving a small non-linear optimization...... problem in order to obtain the interpolation weights. While the system can be used simply for building poses, it is also an animation system. The user can specify a path for a given constraint and the model is animated correspondingly....
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.
Tam, Emily W Y; Haeusslein, Laurel A; Bonifacio, Sonia L; Glass, Hannah C; Rogers, Elizabeth E; Jeremy, Rita J; Barkovich, A James; Ferriero, Donna M
To investigate the contribution of hypoglycemia in the first 24 hours after birth to brain injury in term newborns at risk for neonatal encephalopathy. A prospective cohort of 94 term neonates born between 1994 and 2010 with early postnatal brain magnetic resonance imaging studies were analyzed for regions of brain injury. Neurodevelopmental outcome was assessed at 1 year of age. Hypoglycemia (glucose encephalopathy with increased corticospinal tract injury and adverse motor and cognitive outcomes. Copyright © 2012 Mosby, Inc. All rights reserved.
van der Worp, Maarten P.; ten Haaf, Dominique S. M.; van Cingel, Robert; de Wijer, Anton; Nijhuis-van der Sanden, Maria W. G.; Staal, J. Bart
Background The popularity of running continues to increase, which means that the incidence of running-related injuries will probably also continue to increase. Little is known about risk factors for running injuries and whether they are sex-specific. Objectives The aim of this study was to review information about risk factors and sex-specific differences for running-induced injuries in adults. Search Strategy The databases PubMed, EMBASE, CINAHL and Psych-INFO were searched for relevant articles. Selection Criteria Longitudinal cohort studies with a minimal follow-up of 1 month that investigated the association between risk factors (personal factors, running/training factors and/or health and lifestyle factors) and the occurrence of lower limb injuries in runners were included. Data Collection and Analysis Two reviewers’ independently selected relevant articles from those identified by the systematic search and assessed the risk of bias of the included studies. The strength of the evidence was determined using a best-evidence rating system. Sex differences in risk were determined by calculating the sex ratio for risk factors (the risk factor for women divided by the risk factor for men). Main Results Of 400 articles retrieved, 15 longitudinal studies were included, of which 11 were considered high-quality studies and 4 moderate-quality studies. Overall, women were at lower risk than men for sustaining running-related injuries. Strong and moderate evidence was found that a history of previous injury and of having used orthotics/inserts was associated with an increased risk of running injuries. Age, previous sports activity, running on a concrete surface, participating in a marathon, weekly running distance (30–39 miles) and wearing running shoes for 4 to 6 months were associated with a greater risk of injury in women than in men. A history of previous injuries, having a running experience of 0–2 years, restarting running, weekly running distance (20–29
Full Text Available -adverse-effect-level approach (OAELA) and a quantitative microbial risk assessment (QMRA). The OAELA was based on the occurrence of E coli in the study waters to determine the possible risk of infection and the QMRA probable risk of infection by salmonellae. The WRQMRA...
Müller-Rath, R; Miltner, O; Mamarvar, M; Mumme, T
Increasing professionalism in competitive karate has led to a specific injury pattern. The aim of our study was to investigate the injury pattern in junior competitive karate and to evaluate the prophylactic effect of fist padding. During the 4 (th) Junior World Championships of the World Karate Confederation (WKC) 2004 235 karate fights were observed and injury-related data were recorded. Fist padding was used in 183 fights, 52 fights were carried out without. In 22 % of all fights we saw an injury. Most of them were mild injuries of the head and face: 32 bruises of the face (13 with epistaxis), 7 facial lacerations and 3 concussions (mild brain injury). 14 fights were stopped due to an injury. Only in the category male 18 - 20 years a higher rate of injuries was seen without fist padding (shobu ippon) compared to shobu sanbon (with fist padding). The injury pattern of junior competitive karate is comparable to senior karate. Fist padding does not generally reduce the incidence or severity of injuries.
Brown, Stephen I
Updated and expanded, this second edition satisfies the same philosophical objective as the first -- to show the importance of problem posing. Although interest in mathematical problem solving increased during the past decade, problem posing remained relatively ignored. The Art of Problem Posing draws attention to this equally important act and is the innovator in the field. Special features include: * an exploration ofthe logical relationship between problem posing and problem solving * a special chapter devoted to teaching problem posing as a separate course * sketches, drawings, diagrams, and cartoons that illustrate the schemes proposed * a special section on writing in mathematics.
Kenny, Sarah J; Whittaker, Jackie L; Emery, Carolyn A
Preprofessional dancers partake in rigorous training and have high injury prevalence. Attempts to identify risk factors for dance injuries have focused on a diversity of intrinsic and extrinsic factors. To identify and evaluate the evidence examining risk factors for musculoskeletal injury in preprofessional ballet and modern dancers. Fifteen electronic databases were systematically searched to October 2015. Studies selected met a priori inclusion criteria and investigated musculoskeletal injury risk factors in preprofessional (elite adolescent, student, young adult) ballet and modern dancers. Two reviewers independently assessed the quality and level of evidence using the Downs and Black (DB) criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Of 1364 potentially relevant studies, 47 were included and scored. Inconsistent injury definition and methodology precluded meta-analysis. The most common modifiable risk factors investigated were anthropometrics (ie, body mass index, adiposity), joint range of motion (ie, lower extremity), dance exposure (ie, years training, exposure hours) and age. The median DB score across studies was 8/33 (range 2-16). The majority of studies were classified as level 3 evidence and few considered risk factor inter-relationships. There is some level 2 evidence that previous injury and poor psychological coping skills are associated with increased injury risk. Because of the lack of high-quality studies, consensus regarding risk factors for musculoskeletal injury in preprofessional dancers remains difficult. There is a need for injury definition consensus and high-quality prospective studies examining the multifactorial relationship between risk factors and injury in preprofessional dance. 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/
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.
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
Wanke, E M; Thiel, N; Groneberg, D A; Fischer, A
Parkour sport is the playfully breaching of obstacles originally not created to get from A to B in the fastest manner. There have been only few publications on injuries in this young and trendy sport mainly performed in urban areas. The aim of this study is to analyse parkour-related acute injuries and their factors. For the retrospective cross-sectional study, a total of n = 266 traceurs (m: n = 255, w: n = 11) completed anonymized online questionnaires. On average, each traceur sustained 1.9 injuries per sport career/year, or 5.5 injuries/1000 h training, respectively. The upper extremity was the most affected body region (58 %), followed by the lower extremity (27 %), head and the back. An increase of injuries from proximal to distal was observed in the upper extremity. However, for the lower extremity it was the opposite. Of all injuries, the most common were skin abrasions (70.3 %). Muscle injuries were observed in 13.1 % of the traceurs, followed by dislocations (6.1 %), and soft tissue (e. g., ligaments, tendons) injuries (5.3 %). Passive precautionary measures were abandoned by the majority of the traceurs (88 %). Landing belonged to the movement elements resulting in most of the injuries (61 %), followed by supportive and static efforts of the arms (10.7 %). Overestimation (23 %) as well as misjudging the situation (20 %) were the most common causes. Other than expected, parkour is an urban movement style with most of the injuries being neither severe nor common despite the lack of precautionary measures. Localisation and type of injuries reflect the characteristic movement elements. There is a need for further investigations to allow a more differentiated analysis in order to develop injury prevention concepts. © Georg Thieme Verlag KG Stuttgart · New York.
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.
Full Text Available Raising awareness on a disorder is important for its prevention and for promoting public health. However, for sports injuries like the anterior cruciate ligament (ACL injury no studies have investigated the awareness on risk factors for injury and possible preventative measures in the general population. The sources of information among the population are also unclear. The purpose of the present study was to identify these aspects of public awareness about the ACL injury.A questionnaire was randomly distributed among the general population registered with a web based questionnaire supplier, to recruit 900 participants who were aware about the ACL injury. The questionnaire consisted of two parts: Question 1 asked them about their sources of information regarding the ACL injury; Question 2 asked them about the risk factors for ACL injury. Multivariate logistic regression was used to determine the information sources that provide a good understanding of the risk factors.The leading source of information for ACL injury was television (57.0%. However, the results of logistic regression analysis revealed that television was not an effective medium to create awareness about the risk factors, among the general population. Instead "Lecture by a coach", "Classroom session on Health", and "Newspaper" were significantly more effective in creating a good awareness of the risk factors (p < 0.001.
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.
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.
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 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/.
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...
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...
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.
Molineri, A; Signorini, M L; Tarabla, H D
A 1-year prospective study was carried out to look for risk factors of farm-related injuries in Egusquiza, Santa Fe (Argentina). Information on demographic characteristics and occupational accidents was collected on (N=110, n=78) farm workers by means of personal interviews using a structured questionnaire. Monthly telephone contact was then maintained with the workers for 1 year to document all farm-related injuries. Data analysis included incidence rate, χ2 and logistic regression. Sixty-nine farm-related injuries were reported during the study period, six injuries being the maximum number affecting one worker. A total of 46.3% of the workers suffered at least one injury during the year. The incidence rate was 7.5 injuries/100 individual-month at risk. Medical assistance was needed in 26.8% of the cases and 5.8% of the injuries caused at least 1 day off work. Hospitalization for at least 1 day was required for 2.9% of the injured workers. Previous work-related injury in the family (p=0.005) (odds ratio (OR)=4.6, 95% confidence interval (CI)=1.6-13.3) and worker's activity (p=0.021) (OR=3.7, 95%CI=1.2-11.6) were associated with the dependent variable work injury. Agricultural and livestock farming are of great importance for the national economy. Workers' training on farm safety may play a key role to prevent work-related injuries and diseases.
Sullivan, Michael J L; Adams, Heather; Martel, Marc-Olivier; Scott, Whitney; Wideman, Timothy
The article will summarize research that has supported the role of pain catastrophizing and perceived injustice as risk factors for problematic recovery after whiplash injury. This article focuses on two psychological variables that have been shown to impact on recovery trajectories after whiplash injury; namely pain catastrophizing and perceived injustice. Research has shown that psychological variables play a role in determining the trajectory of recovery after whiplash injury. This article will focus on two psychological variables that have been shown to impact on recovery trajectories after whiplash injury; namely pain catastrophizing and perceived injustice. The article will summarize research that has supported the role of pain catastrophizing and perceived injustice as risk factors for problematic recovery after whiplash injury. Several investigations have shown that measures of catastrophizing and perceived injustice prospectively predict problematic trajectories of recovery after whiplash injury. Basic research points to the potential roles of expectancies, attention, coping and endogenous opioid dysregulation as possible avenues through which catastrophizing might heighten the probability of the persistence of pain after whiplash injury. Although research has yet to systematically address the mechanisms by which perceived injustice might contribute to prolonged disability in individuals with whiplash injuries, there are grounds for suggesting the potential contributions of catastrophizing, pain behavior and anger. A challenge for future research will be the development and evaluation of risk factor-targeted interventions aimed at reducing catastrophizing and perceived injustice to improve recovery trajectories after whiplash injury.
Wong, Christopher Kevin; Chihuri, Stanford T; Li, Guohua
To assess fall-related injury risk and risk factors in people with lower limb amputation. Prospective longitudinal cohort with follow-up every 6 months for up to 41 months. Community-dwelling adults with lower limb amputations of any etiology and level recruited from support groups and prosthetic clinics. Demographic and clinical characteristics were obtained by self-reported questionnaire and telephone or in-person follow-up. Fall-related injury incidence requiring medical care per person-month and adjusted hazard ratio of fall-related injury were calculated using multivariable proportional hazards regression modeling. A total of 41 subjects, with 782 follow-up person-months in total, had 11 fall-related injury incidents (14.1/1,000 person-months). During follow-up, 56.1% of subjects reported falling and 26.8% reported fall-related injury. Multivariable proportional hazard modeling showed that women were nearly 6 times more likely as men to experience fall-related injury and people of non-white race were 13 times more likely than people of white race to experience fall-related injury. The final predictive model also included vascular amputation and age. Risk of fall-related injury requiring medical care in people with lower limb amputation appears to be higher than in older adult inpatients. Intervention programs to prevent fall-related injury in people with lower limb amputation should target women and racial minorities.
Long, Rachel N; Sun, Kan; Neitzel, Richard L
Occupational injury is one of many health concerns related to small-scale gold mining (ASGM), but few data exist on the subject, especially in sub-Saharan Africa. In 2011 and 2013, we examined accidents, injuries, and potential risk factors in a Ghanaian ASGM community. In 2011, 173 participants were surveyed on occupational history and health, and 22 of these were surveyed again in 2013. Injury rates were estimated at 45.5 and 38.5 injuries per 100 person-years in 2011 and in 2013, respectively; these rates far surpass those of industrialized mines in the U.S. and South Africa. Demographic and job characteristics generally were not predictive of injury risk, though there was a significant positive association with injury risk for males and smokers. Legs and knees were the most common body parts injured, and falling was the most common cause of injury. The most common type of injuries were cuts or lacerations, burns and scalds, and contusions and abrasions. Only two miners had ever received any occupational safety training, and PPE use was low. Our results suggest that injuries should be a priority area for occupational health research in ASGM.
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.
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
REPORT TYPE 08/26/2017 Poster 4. TJTLE AND SUBTITLE t\\.1odification of l’vfeasures,of Acute Kidney Injury to Risk Stratify Cotnbat Casualties 6...profiles and potential future conflicts , identifying acute kidney injury (AKI) early can help us determine the need for rapidity of evacuation
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…
Worp, M.P. van der; Haaf, D.S. Ten; Cingel, R. van; Wijer, A. de; Nijhuis-Van der Sanden, M.W.G.; Staal, J.B.
BACKGROUND: The popularity of running continues to increase, which means that the incidence of running-related injuries will probably also continue to increase. Little is known about risk factors for running injuries and whether they are sex-specific. OBJECTIVES: The aim of this study was to review
Garg, Amit X.; Kurz, Andrea; Sessler, Daniel I.; Cuerden, Meaghan; Robinson, Andrea; Mrkobrada, Marko; Parikh, Chirag R.; Mizera, Richard; Jones, Philip M.; Tiboni, Maria; Font, Adrià; Cegarra, Virginia; Gomez, Maria Fernanda Rojas; Meyhoff, Christian S.; VanHelder, Tomas; Chan, Matthew T. V.; Torres, David; Parlow, Joel; de Nadal Clanchet, Miriam; Amir, Mohammed; Bidgoli, Seyed Javad; Pasin, Laura; Martinsen, Kristian; Malaga, German; Myles, Paul; Acedillo, Rey; Roshanov, Pavel S.; Walsh, Michael; Dresser, George; Kumar, Priya; Fleischmann, Edith; Villar, Juan Carlos; Painter, Thomas; Biccard, Bruce; Bergese, Sergio; Srinathan, Sadeesh; Cata, Juan P.; Chan, Vincent; Mehra, Bhupendra; Wijeysundera, Duminda N.; Leslie, Kate; Forget, Patrice; Whitlock, Richard; Yusuf, Salim; Devereaux, P. J.; Alvarez, A.; Bulach, R.; Hannon, S.; Ives, K.; de Hert, S.
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
traumatic brain injury (TBI) is a risk factor for posttraumatic stress disorder ( PTSD ) has been difficult to determine because of the prevalence of...Qualification Test; CAPS, Clinician-Administered PTSD Scale; PTSD , posttraumatic stress disorder ; TBI, traumatic brain injury. a For the zeromodel, base...New onset and persistent symptoms of post - traumatic stress disorder self reported after deployment and combat exposures. BMJ.
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.
Shi, Xiuquan; Wheeler, Krista K; Shi, Junxin; Stallones, Lorann; Ameratunga, Shanthi; Shakespeare, Tom; Xiang, Huiyun
An increased risk of unintentional injuries among individuals with disability has been reported in many studies, yet quantitative syntheses of findings from previous studies have not been done. We conducted a systematic review and meta-analysis to characterize the relationship between pre-existing disability and unintentional injuries. We searched 14 electronic databases to identify original research published between Jan 1, 1990 and Feb 28, 2013. Included studies reported the odds ratio (OR) or relative risk (RR) of unintentional injuries in adults 18+ years of age with pre-existing disabilities compared with adults without disabilities. Twenty six eligible studies were included covering 54,586 individuals with disabilities. We conducted quality assessments and then analyzed the pooled effects using random-effect models. The pooled OR of unintentional injuries was 1.77 (95% CI 1.51-2.07) for all studies in individuals with disabilities compared with individuals without disabilities. The pooled ORs were 1.87 (95% CI 1.52-2.30) for overall unintentional injuries, 1.64 (95% CI 1.39-1.94) for falls-related injuries, 1.62 (95% CI 1.24-2.13) for occupational injuries, and 1.91 (95% CI 1.59-2.30) for non-occupational injuries. Compared with adults without disabilities, individuals with disabilities are at a significantly higher risk of unintentional injuries. Evidence about the association between cognitive disabilities and unintentional injuries is weak. Future researchers are encouraged to use International Classification of Functioning, Disability and Health (ICF) to classify disability and use rigorous evaluation methods to assess and implement the most appropriate injury prevention efforts to mitigate the risks identified. Copyright © 2015 Elsevier Inc. All rights reserved.
Schneider, S; Seither, B; Tönges, S; Schmitt, H
To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups. The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18-79. 3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups. Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.
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.
Development of a semi-quantitative risk assessment model for evaluating environmental threat posed by the three first EU watch-list pharmaceuticals to urban wastewater treatment plants: An Irish case study.
Tahar, Alexandre; Tiedeken, Erin Jo; Clifford, Eoghan; Cummins, Enda; Rowan, Neil
Contamination of receiving waters with pharmaceutical compounds is of pressing concern. This constitutes the first study to report on the development of a semi-quantitative risk assessment (RA) model for evaluating the environmental threat posed by three EU watch list pharmaceutical compounds namely, diclofenac, 17-beta-estradiol and 17-alpha-ethinylestradiol, to aquatic ecosystems using Irish data as a case study. This RA model adopts the Irish Environmental Protection Agency Source-Pathway-Receptor concept to define relevant parameters for calculating low, medium or high risk score for each agglomeration of wastewater treatment plant (WWTP), which include catchment, treatments, operational and management factors. This RA model may potentially be used on a national scale to (i) identify WWTPs that pose a particular risk as regards releasing disproportionally high levels of these pharmaceutical compounds, and (ii) help identify priority locations for introducing or upgrading control measures (e.g. tertiary treatment, source reduction). To assess risks for these substances of emerging concern, the model was applied to 16 urban WWTPs located in different regions in Ireland that were scored for the three different compounds and ranked as low, medium or high risk. As a validation proxy, this case study used limited monitoring data recorded at some these plants receiving waters. It is envisaged that this semi-quantitative RA approach may aid other EU countries investigate and screen for potential risks where limited measured or predicted environmental pollutant concentrations and/or hydrological data are available. This model is semi-quantitative, as other factors such as influence of climate change and drug usage or prescription data will need to be considered in a future point for estimating and predicting risks. Copyright © 2017 Elsevier B.V. All rights reserved.
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.
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...
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
Gabriel Fernando Todeschi Variane
Conclusion: This study supports previous results and demonstrates the utility of amplitude‐integrated electroencephalography for monitoring brain function and predicting early outcome in the studied groups of infants at high risk for brain injury.
Azar, Sandra T; Miller, Elizabeth A; Stevenson, Michael T; Johnson, David R
Inadequate supervision has been linked to children's injuries. Parental injury prevention beliefs may play a role in supervision, yet little theory has examined the origins of such beliefs. This study examined whether mothers who perpetrated child neglect, who as a group provide inadequate supervision, have more maladaptive beliefs. Then, it tested a social information processing (SIP) model for explaining these beliefs. SIP and injury prevention beliefs were assessed in disadvantaged mothers of preschoolers (N = 145), half with child neglect histories. The neglect group exhibited significantly more maladaptive injury prevention beliefs than comparisons. As predicted, SIP was linked to beliefs that may increase injury risk, even after accounting for relevant sociodemographic variables. Findings support the link of beliefs to injury risk and suggest that specific cognitive problems may underlie these beliefs. Future work should further validate this model, which may inform enhancements to prevention efforts. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: email@example.com
von Rosen, Philip; Heijne, Annette I.-L. M.; Frohm, Anna
Context: In orienteering, the number of injury-registration studies is limited. Most researchers have used a cross-sectional design during specific events and, therefore, have mainly identified acute injuries. Objective: To determine the prevalence of injuries by registering acute and overuse injuries in adolescent elite orienteerers over 26 weeks and to study the variation of injury prevalence over the season and the potential risk factors. Design: Cohort study. Setting: Two high schools in Sweden with national orienteering teams. Patients or Other Participants: All athletes (33 adolescent girls, 31 adolescent boys; age = 17 ± 1 years) from 2 high schools with orienteering teams. Main Outcome Measure(s): We used a weekly Web-based questionnaire to identify the incidence and prevalence of injuries and training variables. Risk factors for injury were calculated using multiple linear regression techniques. Results: The average weekly prevalence of overuse and acute injuries was 35.7% (95% confidence interval = 34.8%, 36.6%) and 1.7% (95% confidence interval = 1.3%, 2.1%), respectively; overuse injuries (78.0%, n = 85) accounted for the majority. The incidence of acute and overuse injuries was highest for the foot/lower leg (48.6%, n = 53), and 71.6% (n = 78) of all injuries affected the foot/lower leg and knee area. Time to the first reported injury was associated with training volume (β = 0.184, P = .001), competition time (β = −0.701, P = .009), running on asphalt roads (β = −0.348, P = .008), and running on forest surfaces and trails (β = −0.331, P = .007), with a model fit of r 2 = 0.50 (intercept = 2.196, P injuries in the foot/lower leg (r 2 = 0.33, P = .001); the highest prevalence (26.9%) was at the beginning of the competitive season. Conclusions: Overuse injuries, predominately in the foot/lower leg area, were more common than acute injuries in adolescent elite orienteerers. These injuries had the highest prevalence at
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...
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.
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
Background Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. Objective To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. Material and methods Five 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 PRISMA guidelines were followed. Two independent authors assessed the quality [Downs and Black (DB) criteria] and level of evidence (Oxford Centre of Evidence-Based Medicine model). Results 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). Four studies considered interrelationships between risk factors, seven reported diagnostic accuracy and none tested an intervention program 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. Conclusions 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 pre-participation screening and LE injury prevention programs through high quality randomized controlled trials targeting individuals at greater risk of injury based upon screening tests with validated test properties. PMID:27935483
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
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.
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.
Kathryn van Boom
factors associated with injuries or return-to-play (RTP) time. Objectives: To .... metacarpal fractures contributing mostly to the prolonged recovery ... to recover from TBIs/hypoxia. This follows .... gear and the legality of knee and elbow strikes to.
Larsen, Ann D; Hannerz, Harald; Møller, Simone V
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....... 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...
Radford, P J; Williamson, D M; Lowdon, I M
A prospective survey has been made of the injuries to members of the public attending a well established ice rink in a major city. Comparison is made with series in the literature reporting high levels of injuries, with corresponding demands on local hospital services, from newly established ice rinks. The main conclusion is that demands on hospital services have been markedly reduced for the well established rink, with corresponding savings in health service resources. PMID:3167509
Full Text Available Young, adolescent female athletes are at particular high risk of sustaining a non-contact anterior cruciate ligament (ACL injury during sport. Through the last decades much attention has been directed toward various anatomical and biomechanical risk factors for non-contact ACL injury, and important information have been retrieved about the influence of external loading factors on ACL injury risk during given sports-specific movements. However, much less attention has been given to the aspect of neuromuscular control during such movements and only sparse knowledge exists on the specific muscle activation patterns involved during specific risk conditions. Therefore, the aim of this narrative review was (1 to describe anatomical aspects, strength aspects and biomechanical aspects relevant for the understanding of ACL non-contact injury mechanisms in young female athletes, and (2 to review the existing literature on lower limb muscle activation in relation to risk of non-contact ACL-injury and prevention of ACL injury in young female athletes. Studies investigating muscle activity patterns associated with sports-specific risk situations were identified, comprising cohort studies, intervention studies and prospective studies. Based on the retrieved studies, clear gender-specific differences in muscle activation and coordination were identified demonstrating elevated quadriceps activity and reduced hamstring activity in young female athletes compared to their male counterparts, and suggesting young female athletes to be at elevated risk of non-contact ACL injury. Only few studies (n = 6 examined the effect of preventive exercise-based intervention protocols on lower limb muscle activation during sports-specific movements. A general trend toward enhanced hamstring activation was observed during selected injury risk situations (e.g., sidecutting and drop landings. Only a single study examined the association between muscle activation deficits and ACL
Bencke, Jesper; Aagaard, Per; Zebis, Mette K
Young, adolescent female athletes are at particular high risk of sustaining a non-contact anterior cruciate ligament (ACL) injury during sport. Through the last decades much attention has been directed toward various anatomical and biomechanical risk factors for non-contact ACL injury, and important information have been retrieved about the influence of external loading factors on ACL injury risk during given sports-specific movements. However, much less attention has been given to the aspect of neuromuscular control during such movements and only sparse knowledge exists on the specific muscle activation patterns involved during specific risk conditions. Therefore, the aim of this narrative review was (1) to describe anatomical aspects, strength aspects and biomechanical aspects relevant for the understanding of ACL non-contact injury mechanisms in young female athletes, and (2) to review the existing literature on lower limb muscle activation in relation to risk of non-contact ACL-injury and prevention of ACL injury in young female athletes. Studies investigating muscle activity patterns associated with sports-specific risk situations were identified, comprising cohort studies, intervention studies and prospective studies. Based on the retrieved studies, clear gender-specific differences in muscle activation and coordination were identified demonstrating elevated quadriceps activity and reduced hamstring activity in young female athletes compared to their male counterparts, and suggesting young female athletes to be at elevated risk of non-contact ACL injury. Only few studies ( n = 6) examined the effect of preventive exercise-based intervention protocols on lower limb muscle activation during sports-specific movements. A general trend toward enhanced hamstring activation was observed during selected injury risk situations (e.g., sidecutting and drop landings). Only a single study examined the association between muscle activation deficits and ACL injury risk
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
Sports 1997, 7:304–311. 23. Knapik JJ, Spiess A, Swedler D, Grier T, Darakjy S, Amoroso P, Jones BH: Injury risk factors in parachuting and...reducing parachute-related ankle injuries. Med Sci Sports Exerc 2004, 36:S312. 26. Knapik JJ, Grier T, Spiess A, Swedler DI, Hauret KG, Graham B, Yoder...Knapik JJ, Spiess A, Darakjy S, Grier T, Manning F, Livingstone E, Swedler D, Amoroso P, Jones BH: Risk factors for parachute injuries and comments about
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.
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.
Schofield, Katherine E; Alexander, Bruce H; Gerberich, Susan G; MacLehose, Richard F
Insurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders. Workers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI). Compared no LP contact, one contact was associated with a 27% reduction of risk (HR=0.73, CI=0.65-0.82), two with a 41% (HR=0.59, CI=0.51-0.68), and three or more contacts with a 28% reduction of risk (HR=0.72, CI=0.65-0.81). LP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries. Reduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
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.
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
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.
Taylor, M. L.; Ritondo, M.; Earp Singer, L.; Rogers, J. V.; Price, J. A.; Fleming, E. J.; Chappie, D.; McGonigle, D.; Nichols, T. L.; Sonich-Mullin, C.
The Threat and Consequence Assessment Division (TCAD) of the U.S. Environmental Protection Agency's (EPA) National Homeland Security Research Center (NHSRC) is developing methodology for performing rapid risk assessments needed for incident management, cleanup, and mitigation of hazards in the aftermath of a terrorist event. TCAD, working with the Department of Defense's Chemical and Biological Defense Information Analysis Center (CBIAC, operated by Battelle) has developed SERRA - Support for Environmental Rapid Risk Assessment. This paper describes the methodology utilized to formulate SERRA, presents current contents of the SERRA database (information derived from assessments of over 3,000 publications selected from 10,000 citations), and describes SERRA implementation. The paper also discusses how an Internet-accessible version of the SERRA database could be utilized by a country or countries to prepare for and respond to the intentional release of chemical, biological or radiological materials.(author)
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.
van Seters, Christine; van Rijn, Rogier M; van Middelkoop, Marienke; Stubbe, Janine H
To determine whether student characteristics, lower-extremity kinematics, and strength are risk factors for sustaining lower-extremity injuries in preprofessional contemporary dancers. Prospective cohort study. Codarts University of the Arts. Forty-five first-year students of Bachelor Dance and Bachelor Dance Teacher. At the beginning of the academic year, the injury history (only lower-extremity) and student characteristics (age, sex, educational program) were assessed using a questionnaire. Besides, lower-extremity kinematics [single-leg squat (SLS)], strength (countermovement jump) and height and weight (body mass index) were measured during a physical performance test. Substantial lower-extremity injuries during the academic year were defined as any problems leading to moderate or severe reductions in training volume or in performance, or complete inability to participate in dance at least once during follow-up as measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Health Problems. Injuries were recorded on a monthly basis using a questionnaire. Analyses on leg-level were performed using generalized estimating equations to test the associations between substantial lower-extremity injuries and potential risk factors. The 1-year incidence of lower-extremity injuries was 82.2%. Of these, 51.4% was a substantial lower-extremity injury. Multivariate analyses identified that ankle dorsiflexion during the SLS (OR 1.25; 95% confidence interval, 1.03-1.52) was a risk factor for a substantial lower-extremity injury. The findings indicate that contemporary dance students are at high risk for lower-extremity injuries. Therefore, the identified risk factor (ankle dorsiflexion) should be considered for prevention purposes.
Ashraf, M; Biswas, J; Gupta, S; Alam, N
Wound infection remains a major source of postoperative morbidity leading to prolonged hospital stays and increased total cost, including indirect expenses related to the wound infection. We examined whether there is any higher risk of wound infection in patients undergo a reoperation after an initial operation or excision/incision biopsy. A retrospective review of medical charts of patients with breast operations between January 1990 and July 2008 was carried out. The overall incidence of wound infection was 18.2% (231/1267). The rate of wound infection was (32%) when reoperation was done after previous modified radical mastectomy, 18.9% and 16.8% when the previous operations were lumpectomy/segmenectomy with axillary dissection and simple mastectomy without axillary dissection, respectively and (10.8%) when reoperation was performed after previous biopsy. Reoperation involving axillary dissection was associated with significantly higher rates of wound infection (pprocedure affects the risk of wound infection in subsequent operation in patients with breast cancer. Significantly higher risks of wound infection are seen in those patients who had undergone axillary dissection or modified radical mastectomy.
Gosling, Cameron McR; Donaldson, Alex; Forbes, Andrew B; Gabbe, Belinda J
To explore stakeholder perceptions of triathlon competition safety and injury risk. Qualitative focus group study. Triathlon stakeholders from Melbourne, Australia. Competition organizers, coaches, and competitors of various skill levels, age, gender, and experience (n = 18). Focus groups were conducted, recorded, and transcribed for analysis. Key themes were identified using content analysis. The perceived risk of serious injury was highest for cycling. Running was most commonly linked to minor injuries. Physical and environmental factors, including course turning points, funneling of competitors into narrow sections, and the weather, were perceived as contributing to injury. Experience, skill level, feelings of vulnerability, personal awareness, club culture, and gender issues were perceived as the competitor-related factors potentially contributing to injury. The cycling mount/dismount area, cycling, and swim legs were the race sections perceived as the riskiest for competitors. Competition organizers were considered to generally have the competitors' best interest as a priority. Triathlons were acknowledged as risky activities and individual competitors accepted this risk. This study has highlighted the main risks and concerns perceived by triathlon competitors, coaches, and competition organizers, which will help identify potential, context-relevant intervention strategies to reduce injury risk.
Rupp, Jonathan D; Flannagan, Carol A C; Kuppa, Shashi M
Injury risk curves for the skeletal knee-thigh-hip (KTH) relate peak force applied to the anterior aspect of the flexed knee, the primary source of KTH injury in frontal motor-vehicle crashes, to the probability of skeletal KTH injury. Previous KTH injury risk curves have been developed from analyses of peak knee-impact force data from studies where knees of whole cadavers were impacted. However, these risk curves either neglect the effects of occupant gender, stature, and mass on KTH fracture force, or account for them using scaling factors derived from dimensional analysis without empirical support. A large amount of experimental data on the knee-impact forces associated with KTH fracture are now available, making it possible to estimate the effects of subject characteristics on skeletal KTH injury risk by statistically analyzing empirical data. Eleven studies were identified in the biomechanical literature in which the flexed knees of whole cadavers were impacted. From these, peak knee-impact force data and the associated subject characteristics were reanalyzed using survival analysis with a lognormal distribution. Results of this analysis indicate that the relationship between peak knee-impact force and the probability of KTH fracture is a function of age, total body mass, and whether the surface that loads the knee is rigid. Comparisons between injury risk curves for the midsize adult male and small adult female crash test dummies defined in previous studies and new risk curves for these sizes of occupants developed in this study suggest that previous injury risk curves generally overestimate the likelihood of KTH fracture at a given peak knee-impact force. Future work should focus on defining the relationships between impact force at the human knee and peak axial compressive forces measured by load cells in the crash test dummy KTH complex so that these new risk curves can be used with ATDs.
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.
Saragiotto, Bruno Tirotti; Yamato, Tiê Parma; Hespanhol Junior, Luiz Carlos; Rainbow, Michael J; Davis, Irene S; Lopes, Alexandre Dias
Despite several studies that have been conducted on running injuries, the risk factors for running-related injuries are still not clear in the literature. The aim of this study was to systematically review prospective cohort studies that investigated the risk factors for running injuries in general. We conducted electronic searches without restriction of language on EMBASE (1980 to Dec 2012), PUBMED (1946 to Dec 2012), CINAHL (1988 to Dec 2012) SPORTDiscus (1977 to Dec 2012), Latin American and Caribbean Centre on Health Sciences Information (1985 to Dec 2012) and Scientific Electronic Library Online (1998 to Dec 2012) databases, using subject headings, synonyms, relevant terms and variant spellings for each database. Only prospective cohort studies investigating the risk factors for running-related musculoskeletal injuries were included in this review. Two independent reviewers screened each article and, if they did not reach a consensus, a third reviewer decided whether or not the article should be included. Year of publication, type of runners, sample size, definition of running-related musculoskeletal injury, baseline characteristics, reported risk factors and the statistical measurement of risk or protection association were extracted from the articles. A scale adapted by the authors evaluated the risk of bias of the articles. A total of 11 articles were considered eligible in this systematic review. A total of 4,671 pooled participants were analysed and 60 different predictive factors were investigated. The main risk factor reported was previous injury (last 12 months), reported in 5 of the 8 studies that investigated previous injuries as a risk factor. Only one article met the criteria for random selection of the sample and only six articles included a follow-up of 6 months or more. There was no association between gender and running injuries in most of the studies. It is possible that eligible articles for this review were published in journals that were
Bray, George A.
Sugar intake in the United States has increased by >40 fold since the American Revolution. The health concerns that have been raised about the amounts of sugar that are in the current diet, primarily as beverages, are the subject of this review. Just less than 50% of the added sugars (sugar and high-fructose corn syrup) are found in soft drinks and fruit drinks. The intake of soft drinks has increased 5-fold between 1950 and 2000. Most meta-analyses have shown that the risk of obesity, diabet...
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.
Yoon, Jin-Ha; Hong, Jeong-Suk; Roh, Jaehoon; Kim, Chi-Nyon; Won, Jong-Uk
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 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. PMID:25599757
Cochran, Gerald; Field, Craig; Caetano, Raul
Risk-level drinking, drinking and driving, and alcohol-related violence are risk factors that result in injuries. The current study sought to identify which subgroups of patients experience the most behavioral change following a brief intervention. A secondary analysis of data from a brief alcohol intervention study was conducted. The sample (N = 664) includes at-risk drinkers who experienced an injury and were admitted for care to a Level 1 trauma center. Injury-related items from the Short Inventory of Problems+6 were used to perform a latent transition analysis to describe class transitions participants experienced following discharge. Four classes emerged for the year before and after the current injury. Most individuals transitioned from higher-risk classes into those with lower risk. Some participants maintained risky profiles, and others increased risks and consequences. Drinking and driving remained a persistent problem among the study participants. Although a large portion of intervention recipients improved risks and consequences of alcohol use following discharge, more intensive intervention services may be needed for a subset of patients who showed little or no improvement.
Brown, Stephen I
As a result of the editors' collaborative teaching at Harvard in the late 1960s, they produced a ground-breaking work -- The Art Of Problem Posing -- which related problem posing strategies to the already popular activity of problem solving. It took the concept of problem posing and created strategies for engaging in that activity as a central theme in mathematics education. Based in part upon that work and also upon a number of articles by its authors, other members of the mathematics education community began to apply and expand upon their ideas. This collection of thirty readings is a tes
Chen, S-Y; Fong, P-C; Lin, S-F; Chang, C-H; Chan, C-C
To investigate modifiable risk and preventive factors of work-related eye injuries. A case-crossover study conducted to explore the associations between transient risk factors and work-related eye injuries. Patients seen at seven medical centres in Taiwan with work-related eye injuries over a 4-year period were enrolled in the study. Clinical information was collected from medical charts and detailed information on exposure to eight potentially modifiable factors during the 60 minutes prior to the occurrence of each injury, as well as during the same time interval on the last work day prior to the injury, were obtained using questionnaire surveys. Matched-pair interval analysis was adopted to assess the odds ratios (ORs) for work-related eye injuries given exposure to the eight modifiable factors. A total of 283 subjects were interviewed. Most of these injured workers were young, male, and self-employed or small enterprise workers. The most common injury type was photokeratitis (33.2%), mainly caused by welding (30.4%). The OR for a work-related eye injury was increased with the performance of an unfamiliar task (57.0), operation of a faulty tool or piece of equipment (48.5), distractions (24.0), being rushed (13.0), or fatigued (10.0), and a poor work environment (4.3). Wearing eye protection devices was found to have a significant protective effect on workers who might otherwise have been exposed to eye injuries (OR = 0.4; 95% CI 0.2 to 0.7). Potential modifiable risk and preventive factors for work-related eye injuries were identified using a case-crossover study. This information should be helpful in the development of preventive strategies.
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.
Spector, June T; Bonauto, David K; Sheppard, Lianne; Busch-Isaksen, Tania; Calkins, Miriam; Adams, Darrin; Lieblich, Max; Fenske, Richard A
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.
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.
Pongpiachan, Siwatt; Tipmanee, Danai; Khumsup, Chukkapong; Kittikoon, Itthipon; Hirunyatrakul, Phoosak
To investigate the potential cancer risk resulting from biomass burning, polycyclic aromatic hydrocarbons (PAHs) bound to fine particles (PM2.5) were assessed in nine administrative northern provinces (NNP) of Thailand, before (N-I) and after (N-II) a haze episode. The average values of Σ 3,4-ring PAHs and B[a] P Equivalent concentrations in world urban cities were significantly (p<0.05) much higher than those in samples collected from northern provinces during both sampling periods. Application of diagnostic binary ratios of PAHs underlined the predominant contribution of vehicular exhaust to PM2.5-bound PAH levels in NNP areas, even in the middle of the agricultural waste burning period. The proximity of N-I and N-II values in three-dimensional (3D) principal component analysis (PCA) plots also supports this conclusion. Although the excess cancer risk in NNP areas is much lower than those of other urban area and industrialized cities, there are nevertheless some concerns relating to adverse health impacts on preschool children due to non-dietary exposure to PAHs in home environments. Copyright © 2014 Elsevier B.V. All rights reserved.
Hitchcock, Penny J; Mair, Michael; Inglesby, Thomas V; Gross, Jonathan; Henderson, D A; O'Toole, Tara; Ahern-Seronde, Joa; Bahnfleth, William P; Brennan, Terry; Burroughs, H E Barney; Davidson, Cliff; Delp, William; Ensor, David S; Gomory, Ralph; Olsiewski, Paula; Samet, Jonathan M; Smith, William M; Streifel, Andrew J; White, Ronald H; Woods, James E
The prospect of biological attacks is a growing strategic threat. Covert aerosol attacks inside a building are of particular concern. In the summer of 2005, the Center for Biosecurity of the University of Pittsburgh Medical Center convened a Working Group to determine what steps could be taken to reduce the risk of exposure of building occupants after an aerosol release of a biological weapon. The Working Group was composed of subject matter experts in air filtration, building ventilation and pressurization, air conditioning and air distribution, biosecurity, building design and operation, building decontamination and restoration, economics, medicine, public health, and public policy. The group focused on functions of the heating, ventilation, and air conditioning systems in commercial or public buildings that could reduce the risk of exposure to deleterious aerosols following biological attacks. The Working Group's recommendations for building owners are based on the use of currently available, off-the-shelf technologies. These recommendations are modest in expense and could be implemented immediately. It is also the Working Group's judgment that the commitment and stewardship of a lead government agency is essential to secure the necessary financial and human resources and to plan and build a comprehensive, effective program to reduce exposure to aerosolized infectious agents in buildings.
Herman, Daniel C; Jones, Debi; Harrison, Ashley; Moser, Michael; Tillman, Susan; Farmer, Kevin; Pass, Anthony; Clugston, James R; Hernandez, Jorge; Chmielewski, Terese L
Laboratory-based studies on neuromuscular control after concussion and epidemiological studies suggest that concussion may increase the risk of subsequent musculoskeletal injury. The purpose of this study was to determine if athletes have an increased risk of lower extremity musculoskeletal injury after return to play from a concussion. Injury data were collected from 2006 to 2013 for men's football and for women's basketball, soccer and lacrosse at a National Collegiate Athletic Association Division I university. Ninety cases of in-season concussion in 73 athletes (52 male, 21 female) with return to play at least 30 days prior to the end of the season were identified. A period of up to 90 days of in-season competition following return to play was reviewed for time-loss injury. The same period was studied in up to two control athletes who had no concussion within the prior year and were matched for sport, starting status and position. Lower extremity musculoskeletal injuries occurred at a higher rate in the concussed athletes (45/90 or 50 %) than in the non-concussed athletes (30/148 or 20 %; P relationship between concussion and an increased risk of lower extremity musculoskeletal injury after return to play, and may have implications for current medical practice standards regarding evaluation and management of concussion injuries.
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)
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.
Colby, Marcus J; Dawson, Brian; Heasman, Jarryd; Rogalski, Brent; Rosenberg, Michael; Lester, Leanne; Peeling, Peter
Colby, MJ, Dawson, B, Heasman, J, Rogalski, B, Rosenberg, M, Lester, L, and Peeling, P. Preseason workload volume and high-risk periods for noncontact injury across multiple Australian Football League seasons. J Strength Cond Res 31(7): 1821-1829, 2017-The purpose of this study was to assess the association between preseason workloads and noncontact injury risk in Australian football players. Individual player injury data were recorded over 4 full seasons (2012-15) from one professional club. Noncontact injury incidence (per 1,000 "on legs" field training and game hours) was compared across the preseason, precompetition, and in-season phases to determine relative noncontact injury risk. Preseason workloads (global positioning system-derived total distance run and sprint distance) and individual (fixed) injury risk factors (age, previous injury history) were incorporated into the analysis. A generalized estimating equation with a binary logistic function modeled potential risk factors with noncontact injury for selected periods across the annual cycle. Odds ratios were calculated to determine the relative injury risk. The (preseason) precompetition phase (19.1 injuries per 1,000 hours) and (in-season) rounds 12-17 (16.0 injuries per 1,000 hours) resulted in the highest injury incidence. Low cumulative total distances in late preseason (<108 km) and precompetition (76-88 km) periods were associated with significantly (p ≤ 0.05) greater injury risk during the in-season phase. In conclusion, these results suggest players are at the greatest injury risk during the precompetition period, with low preseason cumulative workloads associated with increased in-season injury risk. Therefore, strength and conditioning staff should place particular emphasis on achieving at least moderate training loads during and leading into this phase, where competitive game play is first introduced.
Orchard, John; Rodas, Gil; Til, Lluis; ArdevÒl, Jordi; Chivers, Ian
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. Key pointsExcessive shoe-surface traction is a hypothesised risk factor for knee ligament injuries, including anterior cruciate ligament injuries.Portable natural grass systems (by their nature in order to prevent grass rolls or squares from falling apart) will tend to exhibit high resistance to tearing when first
Bray, George A
Sugar intake in the United States has increased by >40 fold since the American Revolution. The health concerns that have been raised about the amounts of sugar that are in the current diet, primarily as beverages, are the subject of this review. Just less than 50% of the added sugars (sugar and high-fructose corn syrup) are found in soft drinks and fruit drinks. The intake of soft drinks has increased 5-fold between 1950 and 2000. Most meta-analyses have shown that the risk of obesity, diabetes, cardiovascular disease, and metabolic syndrome are related to consumption of beverages sweetened with sugar or high-fructose corn syrup. Calorically sweetened beverage intake has also been related to the risk of nonalcoholic fatty liver disease, and, in men, gout. Calorically sweetened beverages contribute to obesity through their caloric load, and the intake of beverages does not produce a corresponding reduction in the intake of other food, suggesting that beverage calories are "add-on" calories. The increase in plasma triglyceride concentrations by sugar-sweetened beverages can be attributed to fructose rather than glucose in sugar. Several randomized trials of sugar-containing soft drinks versus low-calorie or calorie-free beverages show that either sugar, 50% of which is fructose, or fructose alone increases triglycerides, body weight, visceral adipose tissue, muscle fat, and liver fat. Fructose is metabolized primarily in the liver. When it is taken up by the liver, ATP decreases rapidly as the phosphate is transferred to fructose in a form that makes it easy to convert to lipid precursors. Fructose intake enhances lipogenesis and the production of uric acid. By worsening blood lipids, contributing to obesity, diabetes, fatty liver, and gout, fructose in the amounts currently consumed is hazardous to the health of some people.
Joseph Jonathan Lee
Full Text Available To determine the predictive value and sensitivity of demographic features and injuries (indicators for maltreatment-related codes in hospital discharge records of children admitted with a head or neck injury or fracture.Population-based, cross sectional study.NHS hospitals in England.Children under five years old admitted acutely to hospital with head or neck injury or fracture.Hospital Episodes Statistics, 1997 to 2009.Maltreatment-related injury admissions, defined by ICD10 codes, were used to calculate for each indicator (demographic feature and/or type of injury: i the predictive value (proportion of injury admissions that were maltreatment-related; ii sensitivity (proportion of all maltreatment-related injury admissions with the indicator.Of 260,294 childhood admissions for fracture or head or neck injury, 3.2% (8,337 were maltreatment-related. With increasing age of the child, the predictive value for maltreatment-related injury declined but sensitivity increased. Half of the maltreatment-related admissions occurred in children older than one year, and 63% occurred in children with head injuries without fractures or intracranial injury.Highly predictive injuries accounted for very few maltreatment-related admissions. Protocols that focus on high-risk injuries may miss the majority of maltreated children.
Arriaza, Rafael; Inman, David; Arriaza, Alvaro; Saavedra, Miguel A
Prospective studies on injuries in martial arts competition are scarce, especially those involving young practitioners, but the upsurge of children and adolescents taking part in organized training and competition in these sports requires clarification of the injury risk that they represent for youths. Top-level karate competition for young adolescents (cadets, or 14- to 15-year-olds) has a low injury rate and can be safely promoted. Descriptive epidemiological study. Prospective recording of the injuries resulting from all bouts in 3 consecutive World Karate Championships (2009, 2011, and 2013) for cadets was performed. Data were collected prospectively in situ with checklists that described competitor sex, bout category, and weight as well as injured area, diagnosis, mechanism of injury, severity, and treatment. A total of 1020 bouts were reviewed, 671 in the male category and 349 in the female category. A total of 61 injuries were recorded. Of those, only 3 were time-loss injuries. During the 2009 and 2011 championships, there was 1 injury per 25.6 fights, while during the 2013 championship the number of injuries increased, with 1 injury per 10 fights (P = .003). There was no statistical difference in the total injury rate between the male and female categories (P = .71), with an odds ratio of 1.16 (95% CI, 0.52-2.55). The injury rate for cadet top-level karate competition found in this prospective study is much lower than the rates previously published for karate or other martial arts competitions, but there seems to be a marked increase as more championships are held, which is a matter of concern. © 2015 The Author(s).
Tsuboi, Kazuto; Omura, Nobuo; Yano, Fumiaki; Hoshino, Masato; Yamamoto, Se-Ryung; Akimoto, Shusuke; Masuda, Takahiro; Kashiwagi, Hideyuki; Yanaga, Katsuhiko
Mucosal injury during myotomy is the most frequent complication seen with the Heller-Dor procedure for achalasia. The present study aimed to examine risk factors for such mucosal injury during this procedure. This was a retrospective analysis of patients who underwent the laparoscopic Heller-Dor procedure for achalasia at a single facility. Variables for evaluation included patient characteristics, preoperative pathophysiological findings, and surgeon's operative experience. Logistic regression was used to identify risk factors. We also examined surgical outcomes and the degree of patient satisfaction in relation to intraoperative mucosal injury. Four hundred thirty-five patients satisfied study criteria. Intraoperative mucosal injury occurred in 67 patients (15.4%). In univariate analysis, mucosal injury was significantly associated with the patient age ≥60 years, disease history ≥10 years, prior history of cardiac diseases, preoperative esophageal transverse diameter ≥80 mm, and surgeon's operative experience with fewer than five cases. In multivariate analysis involving these factors, the following variables were identified as risk factors: age ≥60 years, esophageal transverse diameter ≥80 mm, and surgeon's operative experience with fewer than five cases. The mucosal injury group had significant extension of the operative time and increased blood loss. However, there were no significant differences between the two groups in the incidence of reflux esophagitis or the degree of symptom alleviation postoperatively. The fragile esophagus caused by advanced patient age and/or dilatation were risk factor for mucosal injury during laparoscopic Heller-Dor procedure. And novice surgeon was also identified as an isolated risk factor for mucosal injury.
Hyun Lee, Seung; Ahn, Jae Kyoun
The objective of this study was to evaluate risk factors associated with eyeball loss and ambulatory vision loss on emergent examination of patients with ocular trauma. We reviewed the medical records of 1,875 patients hospitalized in a single tertiary referral center between January 2003 and December 2007. Emergent examinations included a history of trauma, elapsed time between injury and hospital arrival, visible intraocular tissues, and initial visual acuity (VA) using a penlight. The main outcome measures were ocular survival and ambulatory vision survival (>20/200) at 1 year after trauma using univariate and multivariate regression analysis. The ocular trauma scores were significantly higher in open globe injuries than in closed globe injuries (p eyeball loss. Elapsed time more than 12 hours and visible intraocular tissues were the significant risk factors associated with ambulatory vision loss. The most powerful predictor of eyeball loss and ambulatory vision loss was eyeball rupture. In closed globe injuries, there were no significant risk factors of eyeball loss, whereas initial vision less than LP and the presence of relative afferent pupillary defect were the significant risk factors associated with ambulatory vision loss. An initial VA less than LP using a penlight, a history of golf ball injury, and elapsed time more than 12 hours between ocular trauma and hospital arrival were associated with eyeball loss and ambulatory vision loss. Physicians should bear these factors in mind so that they can more effectively counsel patients with such injuries.
Kim, Hyocher; Räsänen, Kimmo; Chae, Hyeseon; Kim, Kyungsu; Kim, Kyungran; Lee, Kyungsuk
Agriculture is known to be a risk-filled industry in South Korea, as it is worldwide. The aims of this study were to identify the magnitude of farm work-related injuries and evaluate the association between injury and possible risk factors. Farmers, including farm members (N = 16,160), were surveyed. After excluding 7 subjects with missing data in questions about injury, 16,153 farmer responses were used for the analysis. Of the 16,153 farmers, 3.6% answered having at least one farm work-related injury requiring outpatient treatment or hospitalization during 2012. The proportion of injured men (4.3%) was 1.5 times higher than women (2.9%). From an age perspective, the proportion was 1.3% of those aged 49 or below, 2.7% of those aged 50-59, 4.2% of those aged 60-69, 4.2% of those aged 70-79, and 3.1% of those aged 80 or above. We used a multivariate logistic regression analysis with a stepwise model (forward) for risk factors (gender, age, farm ownership, farm type, work years in agriculture, work months during 2012, night work experience, and work experience under the influence of alcohol). The increased risk of farm work-related injuries significantly remained associated with age, farm ownership, and experience of night work. Further studies should be conducted to consistently identify injury characteristics, especially for old farmers, considering the crop cultivation in Asian countries.
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
Wozniak, Edward J; Lawrence, Gena; Gorchakov, Rodion; Alamgir, Hasanat; Dotson, Ellen; Sissel, Blake; Sarkar, Sahotra; Murray, Kristy O
Triatomine bugs are a group of hematophagous arthropods that can serve as biological vectors for Trypanosoma cruzi , the etiological agent of American trypanosomiasis (Chagas disease). Because of differences in the biology and feeding habits among triatomine species, some are more likely than others to be involved in zoonotic and/or human-to-human transmission cycles of T. cruzi . In an attempt to assess the risk for Chagas disease exposure in south-central Texas, human habitations across Texas Health Service Region 8 (HSR 8) and surrounding counties were surveyed for triatomines to characterize the geographic distribution, species-specific biology, and T. cruzi -infection prevalence better. Between May 2010 and August 2013, a total of 545 triatomines representing all 5 known indigenous species (Triatoma gerstaeckeri, Triatoma indictiva, Triatoma lecticularia, Triatoma sanguisuga, and Triatoma protracta woodi) were collected from 59 sites across the region. Triatoma gerstaeckeri was the species most commonly found in domestic and peridomestic ecotopes across Texas HSR 8, representing over 80% of the triatomines collected. Adult T. gerstaeckeri exhibited a seasonal dispersal pattern that began in late April, peaked in mid-May, and then continued into August. On homes with available crevices in the exterior walls, adult T. gerstaeckeri were observed emerging from or entering these protective microhabitats, suggesting possible opportunistic colonization of some exterior walls compartments. Laboratory testing of triatomine hindgut contents for T. cruzi by PCR demonstrated the adult T. gerstaeckeri-infection prevalence across Texas HSR 8 to be 64%. Monitoring peridomestic adult T. gerstaeckeri over the seasonal dispersal peak demonstrated statistically significant increases in both their T. cruzi -infection prevalence (P < 0.01) and tendency to invade human dwellings (P < 0.01) in the later aspect of the emergence peak. In addition to the adult insects, variably sized
Regina, Guido; Angiletta, Domenico; Impedovo, Giovanni; De Robertis, Giovanni; Fiorella, Marialuisa; Carratu', Maria Rosaria
The incidence of cranial and cervical nerve injury during carotid endarterectomy (CEA) ranges from less than 7.6% to more than 50%. Lesions are mainly due to surgical maneuvers such as traction, compression, tissue electrocoagulation, clamping, and extensive dissections. The use of dexamethasone (DEX) and its beneficial effects in spinal cord injuries have already been described. We investigated whether DEX could also be beneficial to minimize the incidence of cranial and cervical nerve injury during CEA. To evaluate whether dexamethasone is able to reduce the incidence of cranial nerve injuries. From March 1999 through April 2006, 1126 patients undergoing CEA because of high-grade carotid stenosis were enrolled and randomized by predetermined randomization tables into two groups. The first group, "A", included 586 patients that all received an intravenous administration of dexamethasone following a therapeutic scheme. The second group, "B", included 540 control subjects that received the standard pre- and postoperative therapy. All patients were submitted to a deep cervical plexus block, eversion carotid endarterectomy, and selective shunting. Three days after the operation, an independent neurologist and otorhinolaryngologist evaluated the presence of cranial nerve deficits. All patients (group A and group B) showing nerve injuries continued the treatment (8 mg of dexamethasone once in the morning) for 7 days and were re-evaluated after 2 weeks, 30 days, and every 3 months for 1 year. Recovery time took from 2 weeks to 12 months, with a mean time of 3.6 months. The chi(2) test was used to compare the two groups and to check for statistical significance. The incidence of cranial nerve dysfunction was higher in group B and the statistical analysis showed a significant effect of dexamethasone in preventing the neurological damage (P = .0081). The incidence of temporary lesions was lower in group A and the chi(2) test yielded a P value of .006. No statistically
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
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.
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.
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.
Watanabe, Yukari; Watanabe, Takamitsu
Head injury is considered as a potential risk factor for amyotrophic lateral sclerosis (ALS). However, several recent studies have suggested that head injury is not a cause, but a consequence of latent ALS. We aimed to evaluate such a possibility of reverse causation with meta-analyses considering time lags between the incidence of head injuries and the occurrence of ALS. We searched Medline and Web of Science for case-control, cross-sectional, or cohort studies that quantitatively investigated the head-injury-related risk of ALS and were published until 1 December 2016. After selecting appropriate publications based on PRISMA statement, we performed random-effects meta-analyses to calculate odds ratios (ORs) and 95% confidence intervals (CI). Sixteen of 825 studies fulfilled the eligibility criteria. The association between head injuries and ALS was statistically significant when the meta-analysis included all the 16 studies (OR 1.45, 95% CI 1.21-1.74). However, in the meta-analyses considering the time lags between the experience of head injuries and diagnosis of ALS, the association was weaker (OR 1.21, 95% CI 1.01-1.46, time lag ≥ 1 year) or not significant (e.g. OR 1.16, 95% CI 0.84-1.59, time lag ≥ 3 years). Although it did not deny associations between head injuries and ALS, the current study suggests a possibility that such a head-injury-oriented risk of ALS has been somewhat overestimated. For more accurate evaluation, it would be necessary to conduct more epidemiological studies that consider the time lags between the occurrence of head injuries and the diagnosis of ALS.
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.
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.
Boyer, Jon; Galizzi, Monica; Cifuentes, Manuel; d'Errico, Angelo; Gore, Rebecca; Punnett, Laura; Slatin, Craig
Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers' compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions. A single community hospital provided workforce demographics and WC claim records for 2003-2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the O*NET online database. Occupational exposures and SES categories were assigned to workers through their O*NET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES. The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims. Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings.
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.
Background: Falls in ambulatory individuals with chronic spinal cord injury (SCI) are common and may have adverse consequences. Little and inconclusive research has been done in this population, and there is a need for more knowledge in order to develop prevention strategies appropriate for this population. Aim: The overall aim of this thesis was to study the incidence of and identify the risk factors for recurrent (>2) and injurious falls in ambulatory individuals with SCI...
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.
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
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
... NIOSH 141-A] Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at... publication entitled ``Preventing Deaths and Injuries of Fire Fighters Using Risk Management Principles at... fires in unoccupied structures to using established risk management principles at all structure fires...
Hankin, Abigail; Wei, Stanley; Foreman, Juron; Houry, Debra
Homicide is the second leading cause of death among youth aged 15-24. Prior cross-sectional 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. 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 chi-square and logistic regression analyses. 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 visit, return visits for injuries were significantly
Iwaski, Tamiko; Kobayashi, Sadayoshi; Takeda, Atsuhiko
The ICRP Committee stated in their publications that it is important to compare the total harm that may be caused by the radiation with the total harm involved in other occupations, with respect to fatal or minor injury, occupational disease, or the effects of mutagenesis in the working environment. Death has commonly been used as an index of the comparative safety or harm of different industries, and the frequency of death attributable to occupational causes already has a certain validity. In this way, assessment was made on the yearly trend of change in the fatality rates due to occupational work in seven categories of industry in Japan during the period from 1975 to 1984. furthermore, the frequency of injuries of defined severity in occupational hazards, fatality rates of accidents and diseases due to occupational work, and also commuting accidents to and from work were examined
Laflamme, Lucie; Månsdotter, Anna; Lundberg, Michael; Magnusson, Cecilia
In 1974, Sweden became the first country to permit fathers to take paid parental leave. Other countries are currently following suit issuing similar laws. While this reform supports the principles of the United Nations convention of the right for children to be with both parents and enshrines the ethos of gender equality, there has been little systematic examination of its potential impact on child health. Instead, there is uninformed debate that fathers may expose their children to greater risks of injury than mothers. In this Swedish national study, the authors therefore assess whether fathers' parental leave can be regarded as a more serious risk factor for child injuries than that of mothers. Nationwide register-based ecological and longitudinal studies of hospitalisation due to injury (and intoxication) in early childhood, involving the Swedish population in 1973-2009 (ecological design), and children born in 1988 and 1989 (n=118 278) (longitudinal design). An increase in fathers' share of parental leave over time was parallelled by a downward trend in child injury rates (age 0-4 years). At the individual level, the crude incidence of child injury (age 0-2 years) was lower during paternity as compared with maternity leave. This association was, however, explained by parental socio-demographic characteristics (multivariate HR 0.96, 95% CI 0.74 to 1.2). There is no support for the notion that paternity leave increases the risk of child injury.
Bencke, Jesper; Aagaard, Per; Zebis, Mette K
, and important information have been retrieved about the influence of external loading factors on ACL injury risk during given sports-specific movements. However, much less attention has been given to the aspect of neuromuscular control during such movements and only sparse knowledge exists on the specific......, intervention studies and prospective studies. Based on the retrieved studies, clear gender-specific differences in muscle activation and coordination were identified demonstrating elevated quadriceps activity and reduced hamstring activity in young female athletes compared to their male counterparts......Young, adolescent female athletes are at particular high risk of sustaining a non-contact anterior cruciate ligament (ACL) injury during sport. Through the last decades much attention has been directed toward various anatomical and biomechanical risk factors for non-contact ACL injury...
Conclusions. 1. In examined firefighters, abnormalities in basic motor patterns are observed in the FMS test. 2. The risk of injury in FMS surveyed firefighters is very high. 3. The FMS test results correlate with BMI, work experience and age of firefighters. 4. No correlation was found between injuries and injuries and physical activity in firefighters and the FMS test result.
Metzger, Kristina B; Gruschow, Siobhan; Durbin, Dennis R; Curry, Allison E
Several studies have evaluated the correlation between U.S. or Euro New Car Assessment Program (NCAP) ratings and injury risk to front seat occupants, in particular driver injuries. Conversely, little is known about whether NCAP 5-star ratings predict real-world risk of injury to restrained rear seat occupants. The NHTSA has identified rear seat occupant protection as a specific area under consideration for improvements to its NCAP. In order to inform NHTSA's efforts, we examined how NCAP's current 5-star rating system predicts risk of moderate or greater injury among restrained rear seat occupants in real-world crashes. We identified crash-involved vehicles, model year 2004-2013, in NASS-CDS (2003-2012) with known make and model and nonmissing occupant information. We manually matched these vehicles to their NCAP star ratings using data on make, model, model year, body type, and other identifying information. The resultant linked NASS-CDS and NCAP database was analyzed to examine associations between vehicle ratings and rear seat occupant injury risk; risk to front seat occupants was also estimated for comparison. Data were limited to restrained occupants and occupant injuries were defined as any injury with a maximum Abbreviated Injury Scale (AIS) score of 2 or greater. We linked 95% of vehicles in NASS-CDS to a specific vehicle in NCAP. The 18,218 vehicles represented an estimated 6 million vehicles with over 9 million occupants. Rear seat passengers accounted for 12.4% of restrained occupants. The risk of injury in all crashes for restrained rear seat occupants was lower in vehicles with a 5-star driver rating in frontal impact tests (1.4%) than with 4 or fewer stars (2.6%, P =.015); results were similar for the frontal impact passenger rating (1.3% vs. 2.4%, P =.024). Conversely, side impact driver and passenger crash tests were not associated with rear seat occupant injury risk (driver test: 1.7% for 5-star vs. 1.8% for 1-4 stars; passenger test: 1.6% for 5
Wong, Imelda S; Breslin, F Curtis
Parental involvement in keeping their children safe at work has been examined in a handful of studies, with mixed results. Evidence has suggested that non-work injury risk is higher among children from single-parent families, but little is known about their risk for work-related injuries. Five survey cycles of the Canadian Community Health Survey were pooled to create a nationally representative sample of employed 15-19-year old students (N = 16,620). Multivariable logistic regression estimated the association between family status and work injury. Risk of work-related repetitive strains (OR:1.24, 95%CI: 0.69-2.22) did not differ by family type. However, children of single parents were less likely to sustain a work injury receiving immediate medical care (OR:0.43, 95%CI: 0.19-0.96). Despite advantages and disadvantages related to family types, there is no evidence that work-related injury risk among adolescents from single parent families is greater than that of partnered-parent families. Am. J. Ind. Med. 60:285-294, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
C. Schwebel, David; Swart, Dehran
Paraffin (called kerosene in North America and other parts of the world) is the most commonly used fuel in non-electrified dwellings worldwide. It is especially popular in Africa and South Asia. Although paraffin offers many advantages – especially its comparatively low cost to produce – it poses two major risks of injury. First, paraffin poisoning is common, either through ingestion or through inhalation of smoke and fumes. Second, paraffin is highly flammable, and poses fire risk t...
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.
Mutto, Milton; Lawoko, Stephen; Ovuga, Emilio; Svanstrom, Leif
Childhood injuries remain understudied in Uganda. The objective of this study was to determine the extent, nature and determinants of school-related childhood injury risk in north-western Uganda. A cohort of 1000 grade fives from 13 elementary schools was followed-up for one term. Survival and multi-level modelling techniques compared the risk rates across gender, schools and locations. Childhood injuries are common in north-western Uganda. Most of them occur during travel, breaks, practical classes and gardening, while walking, playing, learning and digging. Most injuries result from collisions with objects, sports and falls. Two-thirds of children receive first aid and hospital care. Times to injury were 72.1 and 192.9 person days (p = 0.0000). Gender differences in time to event were significant (p = 0.0091). Girls had better survival rates: cumulative prevalence of childhood injury was 36.1%; with significant gender differences (p = 0.007). Injury rate was 12.3/1000 person days, with a hazard ratio of 1.4. Compared to girls, boys had a 37% higher injury rate (p = 0.004). Rates varied among schools. Associated factors include sex and school. Rural-urban location and school differences do influence childhood injury risk. Childhood injuries are common: the risk is high, gender- and school-specific. Determinants include gender and school. Location and school contexts influence injury risk.
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.…
Oesterlund, Anna H; Lander, Flemming; Lauritsen, Jens
questionnaire will be used to collect basic demographic data and information on eight transient risk factors. Based on previous studies and knowledge on occupational injuries the transient risk factors we chose to examine were: time pressure, performing a task with a different method/using unaccustomed......, but so far no relevant research has been conducted in Europe. METHOD: Case-crossover studies of occupational injuries were collected from PubMed and Embase and read through. Previous experiences concerning method, exposure and outcome, time-related measurements and construction of the questionnaire were...
Full Text Available are allowed to flood. Such flooding-induced seismicity can have significant environmental, social and economic consequences, and may endanger neighbouring mines and surface communities. While fluid-induced seismicity has been observed in other settings (e...
Alnaser, Musaed Z
The purpose of this study was to examine the prevalence and risk factors of occupational musculoskeletal injuries (OMIs) among occupational therapy practitioners over a 12-month period. A self-administered questionnaire mailed to 500 randomly selected practicing occupational therapists (OTs) and occupational therapy assistants (OTAs) living in the state of Texas. A response rate of 38 % was attained with 192 questionnaires returned. In a 12-months working period, 23 % of occupational therapy practitioners experienced musculoskeletal injuries. Muscle strain (52 %) was most reported injury and lower back (32 %) was most injured body part. Years of practicing experience (t = 2.83, p = 0.01), and age x(2)(2, N = 192) = 8.28, p = 0.02 were found as significant factors associated with injuries among OTAs. No factors were significantly associated with injuries among OTs. Patient handling was the primary factor associated with injuries. Also, minimal experience and older age were concluded as risk factors that might contribute to OMIs.
O'Kane, John W.; Gray, Kristen E.; Levy, Marni R.; Neradilek, Moni; Tencer, Allan F.; Polissar, Nayak L.; Schiff, Melissa A.
Objective Describe acute lower extremity injuries and evaluate extrinsic risk factors in female youth soccer Design Nested case-control study Setting Youth soccer clubs in Washington State, USA. Participants Female soccer players (N= 351) ages 11 to 15 years randomly selected from 4 soccer clubs from which 83% of their players were enrolled with complete follow-up for 92% of players. Interventions Injured players were interviewed regarding injury, field surface, shoe type, and position. Uninjured controls, matched on game or practice session, were also interviewed. Main Outcome Measures The association between risk factors and acute lower extremity injury using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). Results One hundred seventy-three acute lower extremity injuries occurred involving primarily the ankle (39.3%), knee (24.9%), and thigh (11.0%). Over half (52.9%) recovered within 1 week, while 30.2% lasted beyond 2 weeks. During practices, those injured were approximately 3-fold ( OR 2.83, 95% CI 1.49-5.31) more likely to play on grass than artificial turf and 2.4-fold (95% CI 1.03-5.96) more likely to wear cleats on grass than other shoe and surface combinations. During games injured players were 89% (95% CI 1.03-4.17) more likely to play defender compared to forward. Conclusions Half of the acute lower extremity injuries affected the ankle or knee. Grass surface and wearing cleats on grass increased training injuries. PMID:26327288
Full Text Available We identified risk factors for road traffic injuries among road users who received treatment at two major trauma hospitals in urban Gambia. The study includes pedestrians, bicyclists, motorcyclists, and drivers/passengers of cars and trucks. We examined distributions of injury by age, gender, collision vehicle types and vehicle category, and driver and environment factors. Two hundred and fifty-four patients were included in the study. Two-thirds were male and one-third female. Two-thirds (67% of road traffic injuries involved pedestrians, bicyclists, and motorcyclists; and these were more common during weekdays (74% than weekends. Nearly half (47% of road traffic injuries involved pedestrians. One-third (34% of injured patients were students (mean age of students was less than 14 years, more than half (51% of whom were injured on the roadway as pedestrians. Head/skull injuries were common. Concussion/brain injuries were 3.5 times higher among pedestrians, bicyclists, and motorcyclists than vehicle occupants. Crashes involving pedestrians were more likely to involve young people (<25 years; aOR 6.36, 95% CI: 3.32–12.17 and involve being struck by a motor car (aOR 3.95, 95% CI: 2.09–7.47. Pedestrians contribute the largest proportion of hospitalizations in the Gambia. Young pedestrians are at particularly high risk. Prevention efforts should focus on not only vehicle and driver factors, but also protecting pedestrians, bicyclists, and motorcyclists.
Edouard, Pascal; Depiesse, Frédéric; Branco, Pedro; Alonso, Juan-Manuel
To further analyze newly incurred injuries and illnesses (I&Is) during Athletics International Championships to discuss risk factors. Prospective recording of newly occurred injuries and illnesses. The 2012 European Athletics (EA) Championships in Helsinki, Finland. National team and local organizing committee physicians and physiotherapists and 1342 registered athletes. Incidence and characteristics of new injuries and illnesses. Ninety-three percent of athletes were covered by medical teams, with a response rate of 91%. One hundred thirty-three injuries were reported (incidence of 98.4 injuries per 1000 registered athletes). Sixty-two injuries (47%) resulted in time loss from sport. The most common diagnosis was hamstring strain (11.4% of injuries and 21% of time-loss injuries). Injury risk was higher in males and increased with age. The highest incidences of injuries were found in combined events and middle- and long-distance events. Twenty-seven illnesses were reported (4.0 illnesses per 1000 athlete days). The most common diagnoses were upper respiratory tract infection (33.3%) and gastroenteritis/diarrhea (25.9%). During outdoor EA Championships, injury and illness incidences were slightly lower and injury characteristics were comparable with those during outdoor World Athletics Championships. During elite athletics Championships, gender (male), age (older than 30 years), finals, and some events (combined events and middle- and long-distance races) seem to be injury risk factors. Illness risk factors remain unclear. As in previous recommendations, preventive interventions should focus on overuse injuries, hamstring strains, and adequate rehabilitation of previous injuries, decreasing risk of infectious diseases transmission, appropriate event scheduling, sports clothes, and heat acclimatization.
Martyna, Michałowska; Tomasz, Walczak; Krzysztof, Grabski Jakub; Monika, Grygorowicz
Lower limb injury risk assessment was proposed, based on isokinetic examination that is a part of standard athlete's biomechanical evaluation performed mainly twice a year. Information about non-contact knee injury (or lack of the injury) sustained within twelve months after isokinetic test, confirmed in USG were verified. Three the most common types of football injuries were taken into consideration: anterior cruciate ligament (ACL) rupture, hamstring and quadriceps muscles injuries. 22 parameters, obtained from isokinetic tests were divided into 4 groups and used as input parameters of five feedforward artificial neural networks (ANNs). The 5th group consisted of all considered parameters. The networks were trained with the use of Levenberg-Marquardt backpropagation algorithm to return value close to 1 for the sets of parameters corresponding injury event and close to 0 for parameters with no injury recorded within 6 - 12 months after isokinetic test. Results of this study shows that ANN might be useful tools, which simplify process of simultaneous interpretation of many numerical parameters, but the most important factor that significantly influence the results is database used for ANN training.
Developing predictive models for return to work using the Military Power, Performance and Prevention (MP3) musculoskeletal injury risk algorithm: a study protocol for an injury risk assessment programme.
Rhon, Daniel I; Teyhen, Deydre S; Shaffer, Scott W; Goffar, Stephen L; Kiesel, Kyle; Plisky, Phil P
Musculoskeletal injuries are a primary source of disability in the US Military, and low back pain and lower extremity injuries account for over 44% of limited work days annually. History of prior musculoskeletal injury increases the risk for future injury. This study aims to determine the risk of injury after returning to work from a previous injury. The objective is to identify criteria that can help predict likelihood for future injury or re-injury. There will be 480 active duty soldiers recruited from across four medical centres. These will be patients who have sustained a musculoskeletal injury in the lower extremity or lumbar/thoracic spine, and have now been cleared to return back to work without any limitations. Subjects will undergo a battery of physical performance tests and fill out sociodemographic surveys. They will be followed for a year to identify any musculoskeletal injuries that occur. Prediction algorithms will be derived using regression analysis from performance and sociodemographic variables found to be significantly different between injured and non-injured subjects. Due to the high rates of injuries, injury prevention and prediction initiatives are growing. This is the first study looking at predicting re-injury rates after an initial musculoskeletal injury. In addition, multivariate prediction models appear to have move value than models based on only one variable. This approach aims to validate a multivariate model used in healthy non-injured individuals to help improve variables that best predict the ability to return to work with lower risk of injury, after a recent musculoskeletal injury. NCT02776930. 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/.
Simonsen, Louise Lau; Sonne-Holm, Stig; Krasheninnikoff, Michael
The incidence of heterotopic ossification (HO) among patients with traumatic brain injury (TBI) varies in the literature from 11 to 73.3%. The aim of this study was to determine the incidence of HO among patients with very severe TBI treated in a new established intensive rehabilitation Brain...... Injury Unit and to list some of the risk-predicting features. The study comprised an approximately complete, consecutive series of 114 adult patients from a well-defined geographical area, and with a posttraumatic amnesia period of at least 28 days, i.e. very severe TBI. Demographic and functional data...... as well as data about trauma severity and hospital stay of these patients have been registered prospectively in a database (Danish National Head Injury database) at the Brain Injury Unit where the sub acute rehabilitation took place. The present study was based retrospectively on this database, combined...
Torba, M; Gjata, A; Buci, S; Bushi, G; Zenelaj, A; Kajo, I; Koceku, S; Kagjini, K; Subashi, K
The management of colon injuries has distinctly evolved over the last three decades. However, trauma surgeons often find themselves in a dilemma, whether to perform a diversion or to perform a primary repair. The purpose of this study is to evaluate risk factors in colon injury management and their influence on abdominal complications. This is a prospective study conducted at a national level I trauma center in Tirana, Albania from January 2009 to December 2012. The data with respect to demographics, physiological risk factors, intraoperative findings, and surgical procedures were collected. Colonic injury-related morbidity and mortality were analyzed. Multivariate logistic regression analysis was performed by assessing the influence of risk factors on abdominal complications. Of the 157 patients treated with colon injury, was performed a primary repair in 107 (68.15%) of the patients and a diversion in the remaining 50 (31.85%). The mean PATI was 18.6, while 37 (23.6%) of patients had PATI greater than 25. The complications and their frequencies according to the surgical technique used (primay repair vs diversion respectively) includes: wound infections (9.3% vs 50%), anastomotic leak (1.8% vs 8.7%), and intra-abdominal abscess (1.8% vs 6.5%). The multivariate analysis identified two independent risk factors for abdominal complications: transfusions of 4 units of blood within the first 24 hours (OR = 1.2 95% CI (1.03 - 1.57) p =0.02), and diversion (OR = 9.6, 95% CI 4.4 - 21.3, pcolon injuries are both independent risk factors for abdominal complications. The socioeconomic impact and the need for a subsequent operation in colostomy patients are strong reasons to consider primary repair in the management of colon injuries.
Baranzini, Federico; Diurni, Marcello; Ceccon, Francesca; Poloni, Nicola; Cazzamalli, Sara; Costantini, Chiara; Colli, Cristiano; Greco, Laura; Callegari, Camilla
Polypharmacy is regarded as an important risk factor for fallingand several studies and meta-analyses have shown an increased fall risk in users of diuretics, type 1a antiarrhythmics, digoxin and psychotropic agents. In particular, recent evidence has shown that fall risk is associated with the use of polypharmacy regimens that include at least one established fall risk-increasing drug, rather than with polypharmacy per se. We studied the role of polypharmacy and the role of well-known fall risk-increasing drugs on the incidence of injurious falls. A retrospective observational study was carried out in a population of elderly nursing home residents. An unmatched, post-stratification design for age class, gender and length of stay was adopted. In all, 695 falls were recorded in 293 residents. 221 residents (75.4%) were female and 72 (24.6%) male, and 133 (45.4%) were recurrent fallers. 152 residents sustained no injuries when they fell, whereas injuries were sustained by 141: minor in 95 (67.4%) and major in 46 (32.6%). Only fall dynamics (p = 0.013) and drugs interaction between antiarrhythmic or antiparkinson class and polypharmacy regimen (> or =7 medications) seem to represent a risk association for injuries (p = 0.024; OR = 4.4; CI 95% 1.21 - 15.36). This work reinforces the importance of routine medication reviews, especially in residents exposed to polypharmacy regimens that include antiarrhythmics or antiparkinson drugs, in order to reduce the risk of fall-related injuries during nursing home stays.
Full Text Available Abstract Background Polypharmacy is regarded as an important risk factor for fallingand several studies and meta-analyses have shown an increased fall risk in users of diuretics, type 1a antiarrhythmics, digoxin and psychotropic agents. In particular, recent evidence has shown that fall risk is associated with the use of polypharmacy regimens that include at least one established fall risk-increasing drug, rather than with polypharmacy per se. We studied the role of polypharmacy and the role of well-known fall risk-increasing drugs on the incidence of injurious falls. Methods A retrospective observational study was carried out in a population of elderly nursing home residents. An unmatched, post-stratification design for age class, gender and length of stay was adopted. In all, 695 falls were recorded in 293 residents. Results 221 residents (75.4% were female and 72 (24.6% male, and 133 (45.4% were recurrent fallers. 152 residents sustained no injuries when they fell, whereas injuries were sustained by 141: minor in 95 (67.4% and major in 46 (32.6%. Only fall dynamics (p = 0.013 and drugs interaction between antiarrhythmic or antiparkinson class and polypharmacy regimen (≥7 medications seem to represent a risk association for injuries (p = 0.024; OR = 4.4; CI 95% 1.21 - 15.36. Conclusion This work reinforces the importance of routine medication reviews, especially in residents exposed to polypharmacy regimens that include antiarrhythmics or antiparkinson drugs, in order to reduce the risk of fall-related injuries during nursing home stays.
Donnelly, John P; Griffin, Russell Lee; Sathiakumar, Nalini; McGwin, Gerald
This study sought to describe variations in the risk of motor vehicle collision (MVC) injury and death by occupant body mass index (BMI) class and vehicle type. We hypothesized that the relationship between BMI and the risk of MVC injury or mortality would be modified by vehicle type. This is a retrospective cohort study of occupants involved in MVCs using data from the Crash Injury Research and Engineering Network and the National Automotive Sampling System Crashworthiness Data System. Occupants were grouped based on vehicle body style (passenger car, sport utility vehicle, or light truck) and vehicle size (compact or normal, corresponding to below- or above-average curb weight). The relationship between occupant BMI class (underweight, normal weight, overweight, or obese) and risk of injury or mortality was examined for each vehicle type. Odds ratios (ORs) adjusted for various occupant and collision characteristics were estimated. Of an estimated 44 million occupants of MVCs sampled from 2000 to 2009, 37.1% sustained an injury. We limited our analysis to injuries achieving an Abbreviated Injury Scale (AIS) score of 2 or more severe, totaling 17 million injuries. Occupants differed substantially in terms of demographic and collision characteristics. After adjustment for confounding factors, we found that obesity was a risk factor for mortality caused by MVC (OR, 1.6; 95% confidence interval [CI], 1.2-2.0). When stratified by vehicle type, we found that obesity was a risk factor for mortality in larger vehicles, including any-sized light trucks (OR, 2.1; 95% CI, 1.3-3.5), normal-sized passenger cars (OR, 1.6; 95% CI, 1.1-2.3), and normal-sized sports utility vehicles or vans (OR, 2.0; 95% CI, 1.0-3.8). Being overweight was a risk factor in any-sized light trucks (OR, 1.5; 95% CI, 1.1-2.1). We identified a significant interaction between occupant BMI class and vehicle type in terms of MVC-related mortality risk. Both factors should be taken into account when
Full Text Available Time-loss injuries are still a major occurrence in Canada, injuring thousands of Canadian workers each year. With obesity rates on the rise across the country, as well as around the world, it is important that the possible effects of obesity in the workplace be fully understood, especially those effects linked to lost-time injuries. The aim of this paper was to evaluate predictors of workplace lost-time injuries and how they may be related to obesity or high body mass index by examining factors associated with lost-time injuries in the health care sector, a well-studied industry with the highest number of reported time loss injuries in Canada. A literature review focusing on lost-time injuries in Registered Nurses (RNs was conducted using the keywords and terms: lost time injury, workers' compensation, occupational injury, workplace injury, injury, injuries, work, workplace, occupational, nurse, registered nurse, RN, health care, predictors, risk factors, risk, risks, cause, causes, obese, obesity, and body mass index. Data on predictors or factors associated with lost-time injuries in RNs were gathered and organized using Loisel's Work Disability Prevention Management Model and extrapolated upon using existing literature surrounding obesity in the Canadian workplace.
Leonhardt, Merçè; Forns, Maria; Calderón, Caterina; Reinoso, Marta; Gargallo, Estrella
Neonatal brain injuries are the main cause of visual deficit produced by damage to posterior visual pathways. While there are several studies of visual function in low-risk preterm infants or older children with brain injuries, research in children of early age is lacking. To assess several aspects of visual function in preterm infants with brain injuries and to compare them with another group of low-risk preterm infants of the same age. Forty-eight preterm infants with brain injuries and 56 low-risk preterm infants. The ML Leonhardt Battery of Optotypes was used to assess visual functions. This test was previously validated at a post-menstrual age of 40 weeks in newborns and at 30-plus weeks in preterm infants. The group of preterm infants with brain lesions showed a delayed pattern of visual functions in alertness, fixation, visual attention and tracking behavior compared to infants in the healthy preterm group. The differences between both groups, in the visual behaviors analyzed were around 30%. These visual functions could be identified from the first weeks of life. Our results confirm the importance of using a straightforward screening test with preterm infants in order to assess altered visual function, especially in infants with brain injuries. The findings also highlight the need to provide visual stimulation very early on in life. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Sellon, Debra C; Martucci, Katherine; Wenz, John R; Marcellin-Little, Denis J; Powers, Michelle; Cullen, Kimberley L
OBJECTIVE To identify potential risk factors for digit injuries in dogs training and competing in agility events. DESIGN Internet-based, retrospective, cross-sectional survey. ANIMALS 1,081 dogs training or competing in agility events. PROCEDURES Data were collected for eligible animals via retrospective surveys distributed electronically to handlers of dogs participating in agility-related activities. Variables evaluated included demographic (handlers) and signalment (dogs) information, physical characteristics of dogs, and injury characteristics. A separate survey of dogs competing in similar agility-related activities but without digit injuries was also administered. Multivariable logistic regression was used to develop a model for assessment of risk factors. RESULTS Data were collected from 207 agility dogs with digit injuries and 874 agility dogs without digit injuries. Factors associated with significantly increased odds of injury included Border Collie breed (OR, 2.3; 95% confidence interval [CI], 1.5 to 3.3), long nails (OR, 2.4; 95% CI, 1.3 to 4.5), absence of front dewclaws (OR, 1.9; 95% CI, 1.3 to 2.6), and greater weight-to-height ratio (OR, 1.5; 95% CI, 1.1 to 2.0). Odds of injury decreased with increasing age of the dog (OR, 0.8; 95% CI, 0.76 to 0.86). CONCLUSIONS AND CLINICAL RELEVANCE Results should be cautiously interpreted because of potential respondent and recall bias and lack of review of medical records. Nevertheless, results suggested that retaining healthy dewclaws, maintaining lean body mass, and trimming nails short for training and competition may decrease the likelihood of digit injuries. Research to investigate training practices, obstacle construction specifcations, and surface considerations for dogs competing in agility activities is indicated.
Evans, Daniel; Pester, Jonathan; Vera, Luis; Jeanmonod, Donald; Jeanmonod, Rebecca
Falls in the elderly are a significant cause of morbidity and mortality. We sought to better categorize this patient population and describe factors contributing to their falls. This is a retrospective review of geriatric patients presenting to a level 1 community trauma center. We queried our trauma database for all patients 65 years and older presenting with fall and triaged to the trauma bay from 2008 to 2013. Researchers reviewed the patients' trauma intake paperwork to assess mechanism, injury, and location of fall, whereas discharge summaries were reviewed to determine disposition, morbidity, and mortality. A total of 650 encounters were analyzed. Five hundred thirty-nine resided at home (82.9%), 110 presented from nursing homes or assisted living (16.9%), and 1 came from hospice (0.15%). Ninety-five patients died or were placed on hospice as a result of their falls (14.7%), of which 88 came from home. Controlling for Injury Severity Score, living at home was an independent risk factor for fall-related mortality (odds ratio, 3.0). Comparing the elderly (age 65-79 years; n = 274) and the very elderly (age ≥80 years; n = 376), there were no differences in Injury Severity Score (P = .33), likelihood of death (P = .49), likelihood of C-spine injury (P = 1.0), or likelihood of other axial or long bone skeletal injury (P = .23-1.0). There was a trend for increased likelihood of head injury in very elderly patients (P = 0.06). Prevention measures to limit morbidity and mortality in elderly fall patients should be aimed at the home setting, where most severe injuries occur. Very elderly patients may be at increased risk for intracranial fall-related injuries. Copyright © 2015 Elsevier Inc. All rights reserved.
developing countries, which lack access to renal replacement therapy, ... To examine the relationship between AKI risk factor recognition and monitoring of renal ..... Travel costs were supported by the award of a Baxter Clinical Evidence.
Hels, Tove; Lyckegaard, Allan; Bernhoft, Inger Marie
, benzoylecgonine, cocaine, cannabis, illicit opiates, benzodiazepines and Z-drugs, i.e. zolpidem and zopiclone, medicinal opioids, alcohol-drug combinations and drug-drug combinations). Data from six countries were included in the study: Belgium, Denmark, Finland, Italy, Lithuania and the Netherlands. Case samples...... substances. For alcohol, risk increased exponentially with blood alcohol concentration (BAC). The second most risky category contained various drug-drug combinations, amphetamines and medicinal opioids. Medium increased risk was associated with medium sized BACs (at or above 0.5 g/L, below 0.8 g....../L) and benzoylecgonine. The least risky drug seemed to be cannabis and benzodiazepines and Z-drugs. For male drivers, the risk of being severely injured by driving with any of the psychoactive substances was about 65% of that of female drivers. For each of the substance groups there was a decrease in the risk of severe...
Bonanno, Daniel R; Munteanu, S E; Murley, G S; Landorf, K B; Menz, H B
This study aimed to identify risk factors associated with the development of common lower limb injuries during initial defence training in naval recruits who were enrolled in a randomised trial. Three-hundred and six naval recruits were randomly allocated flat insoles (n=153) or foot orthoses (n=153) while undertaking 11 weeks of initial training. Participant characteristics (including anthropometrics, general health, physical activity, fitness and foot characteristics) were collected at the baseline assessment and injuries were documented prospectively. Injury was defined as the combined incidence of participants with medial tibial stress syndrome, patellofemoral pain, Achilles tendinopathy and plantar fasciitis/plantar heel pain throughout the 11 weeks of training. A discriminant function analysis was used to explore the ability of baseline measures to predict injury. Overall, 67 (21.9%) participants developed an injury. Discriminant function analysis revealed that participants who sustained an injury were slightly younger (mean 21.4±SD 4.1 vs 22.5±5.0 years) and were less likely to be allocated to the foot orthosis group (40% vs 53%) compared with those who remained uninjured. The accuracy of these baseline variables to predict injury was moderate (78.1%). Lower limb injury was not accurately predicted from health questionnaires, fitness results and clinical assessments in naval recruits undertaking initial defence training. However, although not reaching statistical significance, the use of foot orthoses may be protective against common lower limb injuries. ACTRN12615000024549; Post-results. © 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.
Rayane Oliveira Cedraz
Full Text Available Abstract Objective: To evaluate the incidence and risk factors associated with falls and pressure injuries in a clinical unit. Methods: A quantitative, cross-sectional, descriptive-exploratory study was conducted at a university hospital in Rio de Janeiro using secondary data from patient records and information of registers of patients treated in 2015/2016. Data were analyzed using descriptive and inferential statistics. Results: Of the 157 treated patients, women, cardiovascular (43.9% and oncological diseases (35.0% predominated. The risk and incidences of falls and pressure injuries were higher in men. There were significant associations of gender with the risk of falling, the occurrence of falls and pressure injuries, and between the length of hospital stay and risk of falling. Conclusion: Risk management is essential to promote patient safety and improve quality of health care. Nurse staff plays a fundamental role in the process of guiding activities, updating the nursing team and evaluating interventions. The use of tools, such as protocols and indicators, allows the optimization of the work process and the achievement of these goals.
Dalle Carbonare, S; Folli, F; Patrini, E; Giudici, P; Bellazzi, R
The increasing demand of health care services and the complexity of health care delivery require Health Care Organizations (HCOs) to approach clinical risk management through proper methods and tools. An important aspect of risk management is to exploit the analysis of medical injuries compensation claims in order to reduce adverse events and, at the same time, to optimize the costs of health insurance policies. This work provides a probabilistic method to estimate the risk level of a HCO by computing quantitative risk indexes from medical injury compensation claims. Our method is based on the estimate of a loss probability distribution from compensation claims data through parametric and non-parametric modeling and Monte Carlo simulations. The loss distribution can be estimated both on the whole dataset and, thanks to the application of a Bayesian hierarchical model, on stratified data. The approach allows to quantitatively assessing the risk structure of the HCO by analyzing the loss distribution and deriving its expected value and percentiles. We applied the proposed method to 206 cases of injuries with compensation requests collected from 1999 to the first semester of 2007 by the HCO of Lodi, in the Northern part of Italy. We computed the risk indexes taking into account the different clinical departments and the different hospitals involved. The approach proved to be useful to understand the HCO risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.
Full Text Available Health care workers (HCW are at a risk of occupational acquisition of Human Immunodeficiency Virus (HIV infection, primarily due to accidental exposure to infected blood and body fluids. In our general public hospital, over a period of one year (June 2000 - 2001 a total number of 38 self reported incidences of needlestick injuries and other exposures to patient′s blood and body fluids were reported by HCWs. A greater incidence of occupational exposure was seen in surgery residents as compared to medicine residents. Till date, i.e. in one and a half-year follow up period, no seroconversion was seen in any of the reported accidental injury cases. This data emphasizes, that needle stick injuries present the single greatest risk to medical personnel and the importance of increased awareness and training in universal safety precautions (USP, for prevention of nosocomial infection.
Nielsen, Helena B; Larsen, Ann D; Dyreborg, Johnny
during the past week increases risk of injury when reducing recall bias and unmeasured confounding. Methods We linked daily working hours at the individual level of 69 200 employees (167 726 person years from 2008-2015), primarily working at hospitals to registry information on 11 834 injuries leading......Objectives Evening and night work have been associated with higher risk of injury than day work. However, previous findings may be affected by recall bias and unmeasured confounding from differences between day, evening and night workers. This study investigates whether evening and night work...... to emergency room visits or death. Analyses were conducted with Poisson regression models in the full population including permanent day, evening and night workers, and in two sub-populations of evening and night workers, with both day and evening or night work, respectively. Thus, the exchangeability between...
Bidassie, Balmatee; McGlothlin, James D; Mena, Irene; Duffy, Vincent G; Barany, James W
For decades the literature has shown an association between work-related risk factors and back injuries among employees. However, only recently, there is a growing body of literature that suggests lifestyle risk factors may also be associated with back injuries. The purpose of this research was to determine if selected lifestyle risk factors are associated with a greater risk of back injuries. Further, there may be an association between job status and incident reporting, lost workdays cases and workers' compensation (WC) paid for back injuries among university employees. Aggregate data from a Health Risk Assessment (HRA) questionnaire were used to analyze 6053 university employees for lifestyle risk factors associated with back injuries. Of the total sample, 57% (n=3471) were female; 46% (n=2778) worked as clerical or service staff; and the mean age was 45years. Pearson chi-square (chi(2)) analyses indicate that job status (chi(2)=307.07, df=4, pOSHA) 300 logs and WC claims data paid for back injuries supported the finding that clerical or service staff had the greatest risk of back injuries. Based on the results of this study, there appears to be an association between lifestyle risk factors, job status and back injuries among university employees. We believe our evaluation approach may be used to study other work populations to verify the outcomes observed in this study.
Brumitt, Jason; Heiderscheit, Bryan C; Manske, Robert C; Niemuth, Paul E; Rauh, Mitchell J
Functional tests have been used primarily to assess an athlete's fitness or readiness to return to sport. The purpose of this prospective cohort study was to determine the ability of the standing long jump (SLJ) test, the single-leg hop (SLH) for distance test, and the lower extremity functional test (LEFT) as preseason screening tools to identify collegiate athletes who may be at increased risk for a time-loss sports-related low back or lower extremity injury. A total of 193 Division III athletes from 15 university teams (110 females, age 19.1 ± 1.1 y; 83 males, age 19.5 ± 1.3 y) were tested prior to their sports seasons. Athletes performed the functional tests in the following sequence: SLJ, SLH, LEFT. The athletes were then prospectively followed during their sports season for occurrence of low back or LE injury. Female athletes who completed the LEFT in $118 s were 6 times more likely (OR=6.4, 95% CI: 1.3, 31.7) to sustain a thigh or knee injury. Male athletes who completed the LEFT in #100 s were more likely to experience a time-loss injury to the low back or LE (OR=3.2, 95% CI: 1.1, 9.5) or a foot or ankle injury (OR=6.7, 95% CI: 1.5, 29.7) than male athletes who completed the LEFT in 101 s or more. Female athletes with a greater than 10% side-to-side asymmetry between SLH distances had a 4-fold increase in foot or ankle injury (cut point: >10%; OR=4.4, 95% CI: 1.2, 15.4). Male athletes with SLH distances (either leg) at least 75% of their height had at least a 3-fold increase (OR=3.6, 95% CI: 1.2, 11.2 for the right LE; OR=3.6, 95% CI: 1.2, 11.2 for left LE) in low back or LE injury. The LEFT and the SLH tests appear useful in identifying Division III athletes at risk for a low back or lower extremity sports injury. Thus, these tests warrant further consideration as preparticipatory screening examination tools for sport injury in this population. The single-leg hop for distance and the lower extremity functional test, when administered to Division III
Toni Caparrós, Martí Casals, Álvaro Solana, Javier Peña
Full Text Available The primary purpose of this study was to identify potential risk factors for sports injuries in professional basketball. An observational retrospective cohort study involving a male professional basketball team, using game tracking data was conducted during three consecutive seasons. Thirty-three professional basketball players took part in this study. A total of 29 time-loss injuries were recorded during regular season games, accounting for 244 total missed games with a mean of 16.26 ± 15.21 per player and season. The tracking data included the following variables: minutes played, physiological load, physiological intensity, mechanical load, mechanical intensity, distance covered, walking maximal speed, maximal speed, sprinting maximal speed, maximal speed, average offensive speed, average defensive speed, level one acceleration, level two acceleration, level three acceleration, level four acceleration, level one deceleration, level two deceleration, level three deceleration, level four deceleration, player efficiency rating and usage percentage. The influence of demographic characteristics, tracking data and performance factors on the risk of injury was investigated using multivariate analysis with their incidence rate ratios (IRRs. Athletes with less or equal than 3 decelerations per game (IRR, 4.36; 95% CI, 1.78-10.6 and those running less or equal than 1.3 miles per game (lower workload (IRR, 6.42 ; 95% CI, 2.52-16.3 had a higher risk of injury during games (p < 0.01 in both cases. Therefore, unloaded players have a higher risk of injury. Adequate management of training loads might be a relevant factor to reduce the likelihood of injury according to individual profiles.
Ford, Kevin R; DiCesare, Christopher A; Myer, Gregory D; Hewett, Timothy E
Biofeedback training enables an athlete to alter biomechanical and physiological function by receiving biomechanical and physiological data concurrent with or immediately after a task. To compare the effects of 2 different modes of real-time biofeedback focused on reducing risk factors related to anterior cruciate ligament injury. Randomized crossover study design. Biomechanics laboratory and sports medicine center. Female high school soccer players (age 14.8 ± 1.0 y, height 162.6 ± 6.8 cm, mass 55.9 ± 7.0 kg; n = 4). A battery of kinetic- or kinematic-based real-time biofeedback during repetitive double-leg squats. Baseline and posttraining drop vertical jumps were collected to determine if either feedback method improved high injury risk landing mechanics. Maximum knee abduction moment and angle during the landing was significantly decreased after kinetic-focused biofeedback (P = .04). The reduced knee abduction moment during the drop vertical jumps after kinematic-focused biofeedback was not different (P = .2). Maximum knee abduction angle was significantly decreased after kinetic biofeedback (P < .01) but only showed a trend toward reduction after kinematic biofeedback (P = .08). The innovative biofeedback employed in the current study reduced knee abduction load and posture from baseline to posttraining during a drop vertical jump.
Feldman, Ruth; Eidelman, Arthur I
To examine whether a triplet birth per se poses a risk to the development of infants' cognitive competencies and to the mother-infant relationship. Twenty-three sets of triplets were matched with 23 sets of twins and 23 singleton infants (n = 138) with respect to gestational age, birth weight, and medical and demographic features. Infants with perinatal asphyxia, intraventricular hemorrhage of grade 3 or 4, periventricular leukomalacia, or central nervous system infection were excluded from the study. At 6, 12, and 24 months of age, mother-infant interaction was observed and infants' cognitive development was tested with the Bayley II test. Mothers of triplets displayed lower levels of sensitivity at 6, 12, and 24 months and infants were less socially involved at 6 and 24 months, compared with singletons and twins. Triplets scored lower than singletons and twins on the Bayley Mental Developmental Index at 6, 12, and 24 months. A weight discordance of >15% was found for 15 triplet sets (65.2%). The discordant triplets showed decreased cognitive skills at 12 and 24 months, compared with their siblings, and received the lowest scores for maternal sensitivity. Hierarchical multivariate regression analysis revealed that greater medical risk at birth, multiple-birth status, lower maternal sensitivity, and reduced infant social involvement in the first 2 years were each predictive of lower cognitive outcomes at 2 years (R2 = 0.33). Triplets appear to be at higher risk for cognitive delays in the first 2 years of life, and discordant infants are at especially high risk. This delay is related in part to the difficulty of providing sensitive mothering to 3 infants at the same time. The findings may assist practitioners in guiding prenatal and postpartum parental care and management.
Betz, Marian E.; Barber, Catherine; Miller, Matthew
The association between home firearms and the likelihood and nature of suicidal thoughts and plans was examined using the Second Injury Control and Risk Survey, a 2001-2003 representative telephone survey of U.S. households. Of 9,483 respondents, 7.4% reported past-year suicidal thoughts, 21.3% with a plan. Similar proportions of those with and…
Bernhoft, I.M. Hels, T. Lyckegaard, A. Houwing, S. & Verstraete, A.G.
Prevalence and injury risk of driving with alcohol, illicit drugs and medicines have been estimated as part of the DRUID (Driving under the Influence of Drugs, Alcohol and Medicines) project of FP6. Prevalence in the driving population was based on roadside surveys in thirteen European countries,
Lauridsen, Eva; Blanche, Paul; Amaloo, Catherina
BACKGROUND/AIM: Traumatic dental injuries (TDIs) in the primary dentition occur frequently. Long term complications may potentially cause damage to the permanent successor. The aim of this study was to report the risk of pulp necrosis (PN), pulp canal obliteration (PCO), repair related resorption...
de Groot, S.; Post, M. W.; Snoek, G. J.; Schuitemaker, M.; van der Woude, L. H.
Objective: To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related
Simonsen, Louise Lau; Sonne-Holm, Stig; Krasheninnikoff, Michael
Injury Unit and to list some of the risk-predicting features. The study comprised an approximately complete, consecutive series of 114 adult patients from a well-defined geographical area, and with a posttraumatic amnesia period of at least 28 days, i.e. very severe TBI. Demographic and functional data...
Guitton, Thierry G.; Zurakowski, David; van Dijk, Niek C.; Ring, David
Radiographic arthrosis is a common sequela of elbow trauma. Few studies have addressed risk factors for radiographic arthrosis after elbow injury, especially in the long term. Data from multiple long-term follow-up studies of patients with surgically treated elbow fractures provided us with an
van der Does, Henrike Teunisje Dorothe; Brink, Michel Sanne; Otter, Ruby Tina Ardi; Visscher, Chris; Lemmink, Koen Alfons Plechelmus Marie
Objective: The aim of this study is to investigate if changes in perceived stress and recovery over the course of a season are risk factors for acute and overuse injuries. Design: A prospective nonexperimental cohort design. Setting: Data were gathered at the SportsFieldLab Groningen and at the
Steelman, Eric D; Alexander, Jeffrey L
Little is known regarding the risk perceptions and attitudes of laboratory animal care workers toward biologic safety. The purpose of this descriptive study was to assess the attitudes and perceptions of laboratory animal workers toward occupational and injury risk. Subscribers to the CompMed and TechLink listservs (n = 4808) were surveyed electronically, and 5.3% responded; data from 215 respondents were included in the final analysis. Primary variables of interest included AALAS certificati...
Isenberg, J.; Bao, D.; Yasskin, P.B.
One rather fundamental question concerning supergravity remains unresolved: Is supergravity a well-posed field theory? That is, does a set of certain (Cauchy) data specified on some initial spacelike surface determine a unique, causally propagating spacetime solution of the supergravity field equations (at least in some finite neighborhood of the initial surface)? In this paper, the authors give a very brief report on work directed towards answering this question. (Auth.)
Hels, Tove; Bernhoft, Inger Marie; Lyckegaard, Allan
contributed to the study on the relative risk of getting seriously injured: Denmark, Finland, Lithuania, Italy, Belgium and the Netherlands. Four countries contributed to the study on the relative risk of getting killed: Finland, Norway, Sweden and Portugal. The risk for a driver of getting seriously injured...... or killed in an accident while positive for a given substance was calculated as the ratio between the odds for a driver of being seriously injured/killed in an accident while positive for a given substance and the odds of being seriously injured/killed while negative. The odds ratios were calculated...... by means of logistic regression using the SAS 9.2 procedure proc logistic. Data from the case study population consisted of samples from the hospital studies of seriously injured drivers and those of killed drivers (Isalberti et al., 2011). In total, 2,490 seriously injured drivers and 1,112 killed drivers...
Tuggy, M L
Telemark skiing has become increasingly popular over the past 5 years. Telemark skiing poses unique risks when compared to alpine skiing, because of different equipment, technique, and varied skiing environments. A retrospective survey of telemark skiers was conducted in Western Washington in 1994 to obtain skier information on ski habits, demographics, frequency and types of injury, and equipment used at time of injury. During the 5 month survey period, 118 (63%) of 187 surveys distributed at 7 sites were returned. The overall injury rate was comparable to alpine skiing injury rates at 10.7/1000 skier days. Less experienced skiers and women had higher injury rates, 20/1000 and 13.1/1000 skier days, respectively. The predominant injury sites were knee (41%), hip (13%), and thumb (8%). The knee injuries sustained by telemark skiers appear to be less severe than alpine skiers, with less duration of disability and lower surgical rates. An association was found between the use of plastic reinforced boots and significant ligamentous knee injuries when compared to skiers with leather boots (p < 0.01, chi 2 = 5.43).
Leppänen, Mari; Pasanen, Kati; Kujala, Urho M; Vasankari, Tommi; Kannus, Pekka; Äyrämö, Sami; Krosshaug, Tron; Bahr, Roald; Avela, Janne; Perttunen, Jarmo; Parkkari, Jari
Few prospective studies have investigated the biomechanical risk factors of anterior cruciate ligament (ACL) injury. To investigate the relationship between biomechanical characteristics of vertical drop jump (VDJ) performance and the risk of ACL injury in young female basketball and floorball players. Cohort study; Level of evidence, 3. At baseline, a total of 171 female basketball and floorball players (age range, 12-21 years) participated in a VDJ test using 3-dimensional motion analysis. The following biomechanical variables were analyzed: (1) knee valgus angle at initial contact (IC), (2) peak knee abduction moment, (3) knee flexion angle at IC, (4) peak knee flexion angle, (5) peak vertical ground-reaction force (vGRF), and (6) medial knee displacement. All new ACL injuries, as well as match and training exposure, were then recorded for 1 to 3 years. Cox regression models were used to calculate hazard ratios (HRs) and 95% CIs. Fifteen new ACL injuries occurred during the study period (0.2 injuries/1000 player-hours). Of the 6 factors considered, lower peak knee flexion angle (HR for each 10° increase in knee flexion angle, 0.55; 95% CI, 0.34-0.88) and higher peak vGRF (HR for each 100-N increase in vGRF, 1.26; 95% CI, 1.09-1.45) were the only factors associated with increased risk of ACL injury. A receiver operating characteristic (ROC) curve analysis showed an area under the curve of 0.6 for peak knee flexion and 0.7 for vGRF, indicating a failed-to-fair combined sensitivity and specificity of the test. Stiff landings, with less knee flexion and greater vGRF, in a VDJ test were associated with increased risk of ACL injury among young female basketball and floorball players. However, although 2 factors (decreased peak knee flexion and increased vGRF) had significant associations with ACL injury risk, the ROC curve analyses revealed that these variables cannot be used for screening of athletes.
National Basketball Association (NBA) athletes experience a high rate of injuries. Injury prevention requires identifying observable and controllable risk factors. To examine the relationship among game load, fatigue, and injuries in NBA athletes. Cross-sectional study. Game statistics and injury reports over 3 NBA seasons (2012-2015). Data represented 627 players (height = 200.7 ± 8.9 cm, mass = 100.6 ± 12.1 kg, NBA experience = 4.8 ± 4.2 years, pre-NBA experience = 3.2 ± 1.9 years), 73 209 games, and 1663 injury events. An injury event was defined as a player missing or leaving a game due to injury. Logistic multilevel regression was used to predict injuries from time-lagged fatigue and game load with between-subjects differences explained by demographic variables. The odds of injury increased by 2.87% ( P NBA experience and 10.59% ( P = .02) for a 6-cm decrease in height. I observed variability in the intercepts ( P NBA experience, and being shorter than average. Both baseline injury risk and the magnitude of the load-injury and fatigue-injury associations varied across individuals. Researchers should explore the nature of these relationships.
Matsui, Yusuke; Hiraki, Takao; Gobara, Hideo; Uka, Mayu; Masaoka, Yoshihisa; Tada, Akihiro; Toyooka, Shinichi; Mitsuhashi, Toshiharu; Mimura, Hidefumi; Kanazawa, Susumu
To retrospectively investigate the incidence of and risk factors for phrenic nerve injury after radiofrequency (RF) ablation of lung tumors. The study included 814 RF ablation procedures of lung tumors. To evaluate the development of phrenic nerve injury, chest radiographs obtained before and after the procedure were examined. Phrenic nerve injury was assumed to have developed if the diaphragmatic level was elevated after the procedure. To identify risk factors for phrenic nerve injury, multiple variables were compared between cases of phrenic nerve injury and randomly selected controls by using univariate analyses. Multivariate analysis was then performed to identify independent risk factors. Evaluation of phrenic nerve injury from chest radiographs was possible after 786 procedures. Evidence of phrenic nerve injury developed after 10 cases (1.3%). Univariate analysis revealed that larger tumor size (≥ 20 mm; P = .014), proximity of the phrenic nerve to the tumor (phrenic nerve injury. Multivariate analysis demonstrated that the proximity of the phrenic nerve to the tumor (phrenic nerve injury after RF ablation was 1.3%. The proximity of the phrenic nerve to the tumor was an independent risk factor for phrenic nerve injury. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.
Orr, Robin; Pope, Rodney; Peterson, Samantha; Hinton, Benjamin; Stierli, Michael
Tactical trainees, like those entering the police force, are required to undergo vigorous training as part of their occupational preparation. This training has the potential to cause injuries. In addition, the physical training, communal living and pressures of tactical training are known to induce immune suppression and have the potential to increase the risk of illness. The aim of this study was to investigate the relationship between leg power, as measured by a vertical jump (VJ), and rates of reported injuries and illnesses during police recruit training. Retrospective data from recruits (n = 1021) undergoing basic police recruit training at an Australian Police Force College was collected. Recruits completed a VJ assessment at the commencement of their second state of training. Formally reported illness and injuries were collected 12 weeks later, following completion of training. Correlations between VJ height and rates of reported illness and injury were low (r = -0.16 and -0.09, respectively) but significant (p Police recruits with lower VJ height are at a significantly greater risk of suffering an injury or illness during police basic recruit training.
Sari Amarria Dila
Full Text Available Companies that have manual work, muscle injury is one of the major health issues that often occur when working. XYZ Ceramics Yogyakarta is still doing work activities involving manual processes and there has been identified that worker posture has the potential to cause injury. From the Nordic Body Map questionnaire, complaint was identified in the back were 88%, the knees were 80%, the upper arm 75%, and the right shoulder by 70% from 15 workers. The Ovako Work Posture Analysis System (OWAS method is used to evaluate and analyze work attitudes so that improved categories of work methods and recommendations could be obtained. Plan for Identifiering av Belastningsfaktorer (PLIBEL was used to identify the factors that cause muscle injury or harmful effect. In addition, the Nordic Body Map was applied to determine the critical work station. The purpose of this research is to analyze work posture and description of risk level related to musculoskeletal injury at critical work station. The three highest percentage of risk of muscle injury identified at raw material processing station, based on calculation result of PLIBEL Checklist, were on elbow, forearm, and hand. Based on the assessment of working posture using OWAS, the highest action category is identified in the activity of moving the cart containing the soil to the automatic pest that is the action category of 4, which means that this activity is very dangerous for the musculoskeletal system.
Fatal high-voltage injuries present a problem which has not yet been studied sufficiently in the context of interaction between the human body and electricity, as a technical, anthropogenic and natural phenomenon. The forensic medicine records of 291 cases of death caused by high-voltage current for a 41-year-long period (1965-2006) were examined in retrospect. The descriptive statistical analyses were made using the SPSS 11.0 software. Death was found to result most commonly from contact between the deceased and elements of the power transmission and distribution grid: (41.24%), and from the action of lightning: (32.3%), the difference in their relative share being insignificant. Much more rarely, death was due to contact with construction and repair electrical devices: (7.56%), or with elements of the power transport railway infrastructure: (6.87%). Death resulting from contact with agricultural electrical devices was only occasional: (0.68%). The victims' average age was 36.19 years. Our analysis indicates that the relative share (43.98%) of the victims is the highest in the age period between 25 and 44. The ratio between women and men is 1:21.38.
Hui, Xuan; Haider, Adil H; Hashmi, Zain G; Rushing, Amy P; Dhiman, Nitasha; Scott, Valerie K; Selvarajah, Shalini; Haut, Elliott R; Efron, David T; Schneider, Eric B
Patients with traumatic brain injury (TBI) frequently require mechanical ventilation (MV). The objective of this study was to examine the association between time spent on MV and the development of pneumonia among patients with TBI. Patients older than 18 y with head abbreviated injury scale (AIS) scores coded 1-6 requiring MV in the National Trauma Data Bank 2007-2010 data set were included. The study was limited to hospitals reporting pneumonia cases. AIS scores were calculated using ICDMAP-90 software. Patients with injuries in any other region with AIS score >3, significant burns, or a hospital length of stay >30 d were excluded. A generalized linear model was used to determine the approximate relative risk of developing all-cause pneumonia (aspiration pneumonia, ventilator-associated pneumonia [VAP], and infectious pneumonia identified by the International Classification of Disease, Ninth Revision, diagnosis code) for each day of MV, controlling for age, gender, Glasgow coma scale motor score, comorbidity (Charlson comorbidity index) score, insurance status, and injury type and severity. Among the 24,525 patients with TBI who required MV included in this study, 1593 (6.5%) developed all-cause pneumonia. After controlling for demographic and injury factors, each additional day on the ventilator was associated with a 7% increase in the risk of pneumonia (risk ratio 1.07, 95% confidence interval 1.07-1.08). Patients who have sustained TBIs and require MV are at higher risk for VAP than individuals extubated earlier; therefore, shortening MV exposure will likely reduce the risk of VAP. As patients with TBI frequently require MV because of neurologic impairment, it is key to develop aggressive strategies to expedite ventilator independence. Copyright © 2013 Elsevier Inc. All rights reserved.
Gaballah, Kamis; Warbuton, Dorothy; Sihmbly, Kamal; Renton, Tara
Aim To evaluate the risk factors of needle stick injuries (NSIs) sustained by undergraduate dental students and nurse students at the King's College London (KCL) Dental Institute. Materials and methods A retrospective study evaluated the incident reports relating to NSIs reported over a period of 2 years. Factors including the dental department, study year, and when the injury took place during administration of local anaesthesia (LA) and recapping conventional syringe or clearing work surface or during disposal. Results This report showed that students are at the highest risk of NSIs at the fourth year of their 5-year BDS course. About one-third of injuries were reported among this group of students followed by year 5 students (25%). Oral surgery clinics were the major source of incident reporting when compared with other specialised dental clinics within the institute. The left hands of the students were the most frequently affected by such injuries and then the right hands of student dental nurses. The attempt of needle recapping of conventional syringes was the least reported mechanism of injuries and constituted only 15% of the total injuries and mainly occurred in third year students. The most frequent injuries among student nurses were during disposal of the needle. Conclusion Less NSIs occur when using safety syringes. A non-recapping policy with immediate disposal of either the conventional or safety syringe systems after injection would prevent all clearance-related NSIs sustained by nurses. To avoid NSIs, education plays a vital role particularly with effective implementation of the change to safety syringes with appropriate training. PMID:22741025
Full Text Available Aim: To evaluate the risk factors of needle stick injuries (NSIs sustained by undergraduate dental students and nurse students at the King's College London (KCL Dental Institute. Materials and methods: A retrospective study evaluated the incident reports relating to NSIs reported over a period of 2 years. Factors including the dental department, study year, and when the injury took place during administration of local anaesthesia (LA and recapping conventional syringe or clearing work surface or during disposal. Results: This report showed that students are at the highest risk of NSIs at the fourth year of their 5-year BDS course. About one-third of injuries were reported among this group of students followed by year 5 students (25%. Oral surgery clinics were the major source of incident reporting when compared with other specialised dental clinics within the institute. The left hands of the students were the most frequently affected by such injuries and then the right hands of student dental nurses. The attempt of needle recapping of conventional syringes was the least reported mechanism of injuries and constituted only 15% of the total injuries and mainly occurred in third year students. The most frequent injuries among student nurses were during disposal of the needle. Conclusion: Less NSIs occur when using safety syringes. A non-recapping policy with immediate disposal of either the conventional or safety syringe systems after injection would prevent all clearance-related NSIs sustained by nurses. To avoid NSIs, education plays a vital role particularly with effective implementation of the change to safety syringes with appropriate training.
Petitjean, Audrey; Trosseille, Xavier; Petit, Philippe; Irwin, Annette; Hassan, Joe; Praxl, Norbert
The development of the WorldSID 50th percentile male dummy was initiated in 1997 by the International Organisation for Standardisation (ISO/SC12/TC22/WG5) with the objective of developing a more biofidelic side impact dummy and supporting the adoption of a harmonised dummy into regulations. More than 45 organizations from all around the world have contributed to this effort including governmental agencies, research institutes, car manufacturers and dummy manufacturers. The first production version of the WorldSID 50th male dummy was released in March 2004 and demonstrated an improved biofidelity over existing side impact dummies. Full scale vehicle tests covering a wide range of side impact test procedures were performed worldwide with the WorldSID dummy. However, the vehicle safety performance could not be assessed due to lack of injury risk curves for this dummy. The development of these curves was initiated in 2004 within the framework of ISO/SC12/TC22/WG6 (Injury criteria). In 2008, the ACEA- Dummy Task Force (TFD) decided to contribute to this work and offered resources for a project manager to coordinate of the effort of a group of volunteer biomechanical experts from international institutions (ISO, EEVC, VRTC/NHTSA, JARI, Transport Canada), car manufacturers (ACEA, Ford, General Motors, Honda, Toyota, Chrysler) and universities (Wayne State University, Ohio State University, John Hopkins University, Medical College of Wisconsin) to develop harmonized injury risk curves. An in-depth literature review was conducted. All the available PMHS datasets were identified, the test configurations and the quality of the results were checked. Criteria were developed for inclusion or exclusion of PMHS tests in the development of the injury risk curves. Data were processed to account for differences in mass and age of the subjects. Finally, injury risk curves were developed using the following statistical techniques, the certainty method, the Mertz/Weber method, the
Malone, Shane; Owen, Adam; Newton, Matt; Mendes, Bruno; Collins, Kieran D; Gabbett, Tim J
To examine the association between combined sRPE measures and injury risk in elite professional soccer. Observational cohort study. Forty-eight professional soccer players (mean±SD age of 25.3±3.1 yr) from two elite European teams were involved within a one season study. Players completed a test of intermittent-aerobic capacity (Yo-YoIR1) to assess player's injury risk in relation to intermittent aerobic capacity. Weekly workload measures and time loss injuries were recorded during the entire period. Rolling weekly sums and week-to-week changes in workload were measured, allowing for the calculation of the acute:chronic workload ratio, which was calculated by dividing the acute (1-weekly) and chronic (4-weekly) workloads. All derived workload measures were modelled against injury data using logistic regression. Odds ratios (OR) were reported against a reference group. Players who exerted pre-season 1-weekly loads of ≥1500 to ≤2120AU were at significantly higher risk of injury compared to the reference group of ≤1500AU (OR=1.95, p=0.006). Players with increased intermittent-aerobic capacity were better able to tolerate increased 1-weekly absolute changes in training load than players with lower fitness levels (OR=4.52, p=0.011). Players who exerted in-season acute:chronic workload ratios of >1.00 to soccer players. A higher intermittent-aerobic capacity appears to offer greater injury protection when players are exposed to rapid changes in workload in elite soccer players. Moderate workloads, coupled with moderate-low to moderate-high acute:chronic workload ratios, appear to be protective for professional soccer players. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Norman, Rosana; Schneider, Michelle; Bradshaw, Debbie; Jewkes, Rachel; Abrahams, Naeemah; Matzopoulos, Richard; Vos, Theo
Burden of disease estimates for South Africa have highlighted the particularly high rates of injuries related to interpersonal violence compared with other regions of the world, but these figures tell only part of the story. In addition to direct physical injury, violence survivors are at an increased risk of a wide range of psychological and behavioral problems. This study aimed to comprehensively quantify the excess disease burden attributable to exposure to interpersonal violence as a risk factor for disease and injury in South Africa. The World Health Organization framework of interpersonal violence was adapted. Physical injury mortality and disability were categorically attributed to interpersonal violence. In addition, exposure to child sexual abuse and intimate partner violence, subcategories of interpersonal violence, were treated as risk factors for disease and injury using counterfactual estimation and comparative risk assessment methods. Adjustments were made to account for the combined exposure state of having experienced both child sexual abuse and intimate partner violence. Of the 17 risk factors included in the South African Comparative Risk Assessment study, interpersonal violence was the second leading cause of healthy years of life lost, after unsafe sex, accounting for 1.7 million disability-adjusted life years (DALYs) or 10.5% of all DALYs (95% uncertainty interval: 8.5%-12.5%) in 2000. In women, intimate partner violence accounted for 50% and child sexual abuse for 32% of the total attributable DALYs. The implications of our findings are that estimates that include only the direct injury burden seriously underrepresent the full health impact of interpersonal violence. Violence is an important direct and indirect cause of health loss and should be recognized as a priority health problem as well as a human rights and social issue. This study highlights the difficulties in measuring the disease burden from interpersonal violence as a risk factor
Full Text Available Abstract Background Burden of disease estimates for South Africa have highlighted the particularly high rates of injuries related to interpersonal violence compared with other regions of the world, but these figures tell only part of the story. In addition to direct physical injury, violence survivors are at an increased risk of a wide range of psychological and behavioral problems. This study aimed to comprehensively quantify the excess disease burden attributable to exposure to interpersonal violence as a risk factor for disease and injury in South Africa. Methods The World Health Organization framework of interpersonal violence was adapted. Physical injury mortality and disability were categorically attributed to interpersonal violence. In addition, exposure to child sexual abuse and intimate partner violence, subcategories of interpersonal violence, were treated as risk factors for disease and injury using counterfactual estimation and comparative risk assessment methods. Adjustments were made to account for the combined exposure state of having experienced both child sexual abuse and intimate partner violence. Results Of the 17 risk factors included in the South African Comparative Risk Assessment study, interpersonal violence was the second leading cause of healthy years of life lost, after unsafe sex, accounting for 1.7 million disability-adjusted life years (DALYs or 10.5% of all DALYs (95% uncertainty interval: 8.5%-12.5% in 2000. In women, intimate partner violence accounted for 50% and child sexual abuse for 32% of the total attributable DALYs. Conclusions The implications of our findings are that estimates that include only the direct injury burden seriously underrepresent the full health impact of interpersonal violence. Violence is an important direct and indirect cause of health loss and should be recognized as a priority health problem as well as a human rights and social issue. This study highlights the difficulties in measuring
Full Text Available Abstract Background While child maltreatment is recognised as a global problem, solid epidemiological data on the prevalence of child maltreatment and risk factors associated with child maltreatment is lacking in Australia and internationally. There have been recent calls for action to improve the evidence-base capturing and describing child abuse, particularly those data captured within the health sector. This paper describes the quantity of documentation of maltreatment risk factors in injury-related paediatric hospitalisations in Queensland, Australia. Methods This study involved a retrospective medical record review, text extraction and coding methodology to assess the quantity of documentation of risk factors and the subsequent utility of data in hospital records for describing child maltreatment and data linkage to Child Protection Service (CPS. Results There were 433 children in the maltreatment group and 462 in the unintentional injury group for whom medical records could be reviewed. Almost 93% of the maltreatment code sample, but only 11% of the unintentional injury sample had documentation identified indicating the presence of any of 20 risk factors. In the maltreatment group the most commonly documented risk factor was history of abuse (41%. In those with an unintentional injury, the most commonly documented risk factor was alcohol abuse of the child or family (3%. More than 93% of the maltreatment sample also linked to a child protection record. Of concern are the 16% of those children who linked to child protection who did not have documented risk factors in the medical record. Conclusion Given the importance of the medical record as a source of information about children presenting to hospital for treatment and as a potential source of evidence for legal action the lack of documentation is of concern. The details surrounding the injury admission and consideration of any maltreatment related risk factors, both identifying their
Ecotoxicological evaluation of the risk posed by bisphenol A, triclosan, and 4-nonylphenol in coastal waters using early life stages of marine organisms (Isochrysis galbana, Mytilus galloprovincialis, Paracentrotus lividus, and Acartia clausi).
Tato, Tania; Salgueiro-González, Noelia; León, Víctor M; González, Sergio; Beiras, Ricardo
This study assessed the environmental risk on coastal ecosystems posed by three phenolic compounds of special environmental and human health concern used in plastics and household products: bisphenol A (BPA), triclosan (TCS) and 4-nonylphenol (4-NP). These three chemicals are among the organic contaminants most frequently detected in wastewater. The most toxic compound tested was 4-NP, with 10% effective concentration at 11.1 μg L -1 for Isochrysis galbana, 110.5 μg L -1 for Mytilus galloprovincialis, 53.8 μg L -1 for Paracentrotus lividus, and 29.0 μg L -1 for Acartia clausi, followed by TCS (14.6 μg L -1 for I. galbana, 149.8 μg L -1 for M. galloprovincialis, 129.9 μg L -1 for P. lividus, and 64.8 μg L -1 for A. clausi). For all species tested, BPA was the less toxic chemical, with toxicity thresholds ranging between 400 and 1200 μg L -1 except for A. clausi nauplii (186 μg L -1 ). The relatively narrow range of variation in toxicity considering the broad physiological differences among the biological models used point at non-selective mechanisms of toxicity for these aromatic organics. Microalgae, the main primary producers in pelagic ecosystems, showed particularly high susceptibility to the chemicals tested. When the toxicity thresholds experimentally obtained were compared to the maximum environmental concentrations reported in coastal waters, the risk quotients obtained correspond to very low or low risk for BPA and TCS, and from low to high for 4-NP. Copyright © 2017 Elsevier Ltd. All rights reserved.
Grier, Tyson; Canham-Chervak, Michelle; McNulty, Vancil; Jones, Bruce H
Brigades and battalions throughout the US Army are currently implementing a variety of exercise and conditioning programs with greater focus on preparation for mission-specific tasks. An Army physical therapy clinic working with a light infantry brigade developed the Advanced Tactical Athlete Conditioning (ATAC) program. The ATAC program is a unique physical training program consisting of high-intensity aquatic exercises, tactical agility circuits, combat core conditioning, and interval speed training. Along with ATAC, battalions have also incorporated components of fitness programs such as the Ranger Athlete Warrior program and CrossFit (Crossfit, Inc, Santa Monica, CA) an extreme conditioning program (ECP). To determine if these new programs (ATAC, ECP) had an effect on injury rates and physical fitness. Surveys were administered to collect personal characteristics, tobacco use, personal physical fitness training, Army physical fitness test results, and self-reported injuries. Medical record injury data were obtained 6 months before and 6 months after the implementation of the new program. Predictors of injury risk were assessed using multivariate logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were reported. Injury incidence among Soldiers increased 12% for overall injuries and 16% for overuse injuries after the implementation of the ATAC/ECPs. However, injury incidence among Soldiers not participating in ATAC/ECPs also increased 14% for overall injuries and 10% for overuse injuries. Risk factors associated with higher injury risk for Soldiers participating in ATAC/ECPs included: greater mileage run per week during unit physical training (OR (>16 miles per week÷≤7 miles per week)=2.24, 95% CI, 1.33-3.80); higher body mass index (BMI) (OR (BMI 25-29.9÷BMI<25)=1.77, 95% CI, 1.29-2.44), (OR (BMI =30÷BMI<25)=2.72, 95% CI, 1.67-4.43); cigarette use (OR (smoker÷nonsmoker)=1.80, 95% CI, 1.34-2.42); poor performance on the 2-mile run during
Support System for Injury Surveillance”. Data collected by abstraction of medical records by trained personnel using registry form in patients who had hospitalized in 3 hospitals from January to August 2010. Severe head injury classified by the Glasgow Coma Scale (GCS score 3-9 diagnosed severe head injury, 10-12 moderate head injury and 13-15 mild head injury. Results: Out of 450 injured patients, 36 patients (8% who had severe head injuries. Patient who was suspected alcohol and addictive narcotic use had nearly 5-fold increase the risk in severe head injury [adjusted odds ratio (ORa=4.77; 95% confidence interval (CI=1.04-21.75] compared to not suspected. Patient who was referred had a 5.5-fold increase the risk in severe head injury (ORa=5.50; 95% CI=2.28-13.27 compared with not referred. Injured person due to traffic accident than other type of accident had 3-fold increase the risk of severe head injury (ORa=3.43; 95% CI=1.14-10.32. Conclusion: Suspected alcohol or addictive narcotic was the highest risk to severe head injury. Campaign against alcohol and addictive narcotic should be done to prevent head injury severity. (Health Science Indones 2011;34-40
Pisani, Francesco; Spagnoli, Carlotta
Due to the increasing number of surviving preterm newborns and to the recognition of therapeutic hypothermia as the current gold standard in newborns with hypoxic-ischaemic encephalopathy, there has been a growing interest in the implementation of brain monitoring tools in newborns at high risk for neurological disorders. Among the most frequent neurological conditions and presentations in the neonatal period, neonatal seizures and neonatal status epilepticus, paroxysmal non-epileptic motor p...
Chapman, R L; Buckley, L; Sheehan, M; Shochet, I M
School connectedness is an important protective factor for adolescent risk-taking behaviour. This study examined a pilot version of the Skills for Preventing Injury in Youth (SPIY) programme, combining teacher professional development (PD) for increasing school connectedness (connectedness component) with a risk and injury prevention curriculum for early adolescents (curriculum component). A process evaluation was conducted on the connectedness component, involving assessments of programme reach, participant receptiveness and initial use, and a preliminary impact evaluation was conducted on the combined connectedness and curriculum programme. The connectedness component was well received by teacher participants, who saw benefits for both themselves and their students. Classroom observation also showed that teachers who received PD made use of the programme strategies. Grade 8 students who participated in the SPIY programme were less likely to report violent behaviour at 6-month follow-up than were control students, and trends also suggested reduced transport injuries. The results of this research support the use of the combined SPIY connectedness and curriculum components in a large-scale effectiveness trial to assess the impact of the programme on students' connectedness, risk-taking and associated injuries.
Anne Paul Anthikkat
Full Text Available Objective. This study reviews modifiable risk factors associated with fatal and nonfatal injury from low-speed vehicle runover (LSVRO incidents involving children aged 0–15 years. Data Sources. Electronic searches for child pedestrian and driveway injuries from the peer-reviewed literature and transport-related websites from 1955 to 2012. Study Selection. 41 studies met the study inclusion criteria. Data Extraction. A systematic narrative summary was conducted that included study design, methodology, risk factors, and other study variables. Results. The most commonly reported risk factors for LSVRO incidents included age under 5 years, male gender, and reversing vehicles. The majority of reported incidents involved residential driveways, but several studies identified other traffic and nontraffic locations. Low socioeconomic status and rental accommodation were also associated with LSVRO injury. Vehicles were most commonly driven by a family member, predominantly a parent. Conclusion. There are a number of modifiable vehicular, environmental, and behavioural factors associated with LSVRO injuries in young children that have been identified in the literature to date. Strategies relating to vehicle design (devices for increased rearward visibility and crash avoidance systems, housing design (physical separation of driveway and play areas, and behaviour (driver behaviour, supervision of young children are discussed.
Bartsch, Adam J; Benzel, Edward C; Miele, Vincent J; Morr, Douglas R; Prakash, Vikas
In spite of ample literature pointing to rotational and combined impact dosage being key contributors to head and neck injury, boxing and mixed martial arts (MMA) padding is still designed to primarily reduce cranium linear acceleration. The objects of this study were to quantify preliminary linear and rotational head impact dosage for selected boxing and MMA padding in response to hook punches; compute theoretical skull, brain, and neck injury risk metrics; and statistically compare the protective effect of various glove and head padding conditions. An instrumented Hybrid III 50th percentile anthropomorphic test device (ATD) was struck in 54 pendulum impacts replicating hook punches at low (27-29 J) and high (54-58 J) energy. Five padding combinations were examined: unpadded (control), MMA glove-unpadded head, boxing glove-unpadded head, unpadded pendulum-boxing headgear, and boxing glove-boxing headgear. A total of 17 injury risk parameters were measured or calculated. All padding conditions reduced linear impact dosage. Other parameters significantly decreased, significantly increased, or were unaffected depending on padding condition. Of real-world conditions (MMA glove-bare head, boxing glove-bare head, and boxing glove-headgear), the boxing glove-headgear condition showed the most meaningful reduction in most of the parameters. In equivalent impacts, the MMA glove-bare head condition induced higher rotational dosage than the boxing glove-bare head condition. Finite element analysis indicated a risk of brain strain injury in spite of significant reduction of linear impact dosage. In the replicated hook punch impacts, all padding conditions reduced linear but not rotational impact dosage. Head and neck dosage theoretically accumulates fastest in MMA and boxing bouts without use of protective headgear. The boxing glove-headgear condition provided the best overall reduction in impact dosage. More work is needed to develop improved protective padding to minimize
Tanaka, Jun; Yugue, Itaru; Shiba, Keiichiro; Maeyama, Akira; Naito, Masatoshi
A retrospective, consecutive case series. To determine the risk factors for a tracheostomy in patients with a cervical spinal cord injury. Respiratory status cannot be stabilized in patients with a cervical spinal cord injury (CSCI) for various reasons, so a number of these patients require long-term respiratory care and a tracheostomy. Various studies have described risk factors for a tracheostomy, but none have indicated a relationship between imaging assessment and the need for a tracheostomy. The current study used imaging assessment and other approaches to assess and examine the risk factors for a tracheostomy in patients with a CSCI. Subjects were 199 patients who were treated at the Spinal Injuries Center within 72 hours of a CSCI over 8-year period. Risk factors for a tracheostomy were retrospectively studied. Patients were assessed in terms of 10 items: age, sex, the presence of a vertebral fracture or dislocation, ASIA Impairment Scale, the neurological level of injury (NLI), PaO2, PaCO2, the level of injury on magnetic resonance imaging (MRI), the presence of hematoma-like changes (a hypointense core surrounded by a hyperintense rim in T2-weighted images) on MRI, and the Injury Severity Score.Items were analyzed multivariate logistic regression, and P tracheostomy, accounting for 11.6% of patients with a CSCI. Univariate analyses of the risk factors for tracheostomy revealed significant differences for six items: age, Injury Severity Score, presence of fracture or dislocation, ASIA Impairment Scale A, NLI C4 or above, and MRI scans revealing hematoma-like changes. Multivariate logistic regression analyses revealed significant differences in terms of two items: NLI C4 or above and MRI scans revealing hematoma-like changes. Thirty patients had both an NLI C4 or above and MRI scans revealing hematoma-like changes. Of these, 17 (56.7%) required a tracheostomy. Patients with an NLI C4 or above and MRI scans revealing hematoma-like changes were likely to
S. Ilgin Guler
Full Text Available The objective of this work is to identify characteristics of different metrics of exposure for quantifying multi-modal travel injury risk. First, a discussion on the use of time-based and trip-based metrics for road user exposure to injury risk, considering multiple travel modes, is presented. The main difference between a time-based and trip-based metric is argued to be that a time-based metric reflects the actual duration of time spent on the road exposed to the travel risks. This can be proven to be important when considering multiple modes since different modes typically different speeds and average travel distances. Next, the use of total number of trips, total time traveled, and mode share (time-based or trip-based is considered to compare the injury risk of a given mode at different locations. It is argued that using mode share the safety concept which focuses on absolute numbers can be generalized. Quantitative results are also obtained from combining travel survey data with police collision reports for ten counties in California. The data are aggregated for five modes: (i cars, (ii SUVs, (iii transit riders, (iv bicyclists, and (v pedestrians. These aggregated data are used to compare travel risk of different modes with time-based or trip-based exposure metrics. These quantitative results confirm the initial qualitative discussions. As the penetration of mobile probes for transportation data collection increases, the insights of this study can provide guidance on how to best utilize the added value of such data to better quantify travel injury risk, and improve safety.
Yannis, George; Papadimitriou, Eleonora; Dupont, Emmanuelle; Martensen, Heike
In this article the factors affecting fatality and injury risk of road users involved in fatal accidents are analyzed by means of in-depth accident investigation data, with emphasis on parameters not extensively explored in previous research. A fatal accident investigation (FAI) database is used, which includes intermediate-level in-depth data for a harmonized representative sample of 1300 fatal accidents in 7 European countries. The FAI database offers improved potential for analysis, because it includes information on a number of variables that are seldom available, complete, or accurately recorded in road accident databases. However, the fact that only fatal accidents are examined requires for methodological adjustments, namely, the correction for two types of effects on a road user's baseline risk: "accident size" effects, and "relative vulnerability" effects. Fatality and injury risk can be then modeled through multilevel logistic regression models, which account for the hierarchical dependences of the road accident process. The results show that the baseline fatality risk of road users involved in fatal accidents decreases with accident size and increases with the vulnerability of the road user. On the contrary, accident size increases nonfatal injury risk of road users involved in fatal accidents. Other significant effects on fatality and injury risk in fatal accidents include road user age, vehicle type, speed limit, the chain of accident events, vehicle maneuver, and safety equipment. In particular, the presence and use of safety equipment such as seat belt, antilock braking system (ABS), and electronic stability program (ESP) are protection factors for car occupants, especially for those seated at the front seats. Although ABS and ESP systems are typically associated with positive effects on accident occurrence, the results of this research revealed significant related effects on accident severity as well. Moreover, accident consequences are more severe
Fariba Sadeghi Fazel
Full Text Available Pressure Ulcers (PUs remain among the most common complications after traumatic spinal cord Injuries (SCIs. The main goal of risk factor assessment with different tools has been to provisionally estimate the chance of developing pressure ulcers in patients with Spinal Cord Injury (SCI. Braden tool has been of good predictive value and most commonly employed in hospital communities for risk assessment of pressure sore development. The objective of this study was to determine the Braden risk factors as well as the prevalence of pressure injuries in SCI patients. This cross-sectional study was performed from June 2013 to December 2015 on 163 consecutive referred outpatients with chronic traumatic SCI in our tertiary SCI rehabilitation clinic. We assessed pressure induced skin injuries as well as their Braden risk factors and analyzed their association with stage and location of Pressure Ulcer (PU and calculated prevalence of PU. One hundred and sixty-three patients out of 580 were found to have active pressure sores, with a prevalence of 28.1%. In the multiple models, only the Braden scale had significant association with the presence of active pressure sore. Patients with severe and moderate Braden scores were 2.36 and 1.82 times, more at risk of pressure sore development, as compared with those having mild scores (P≤0.01. It may be deduced that in various stages of SCI rehabilitation, the Braden scale may be calculated, and patients with moderate and severe risks (according to Braden sale may need more attention and/or inpatient care for PU prevention.
Pykhtin, Kirill; Simankina, Tatiana; Sharmanov, Vladimir; Kopytova, Anna
The danger of injuries and accidents in various industries such as transportation and construction urges the government to control the occupational health and safety more strictly. However, in order to do so with the minimal costs modern risk management tools, have to be implemented. Risk-based approach is an essential tool for competent risk- assessment and used in a great variety of other countries, demonstrating great results in providing of safe working environment. The article describes the problems that the implementation of the method faces in Russia and suggests certain ways to resolve them.
Luo, Huabin; Beckles, Gloria L A; Fang, Xiangming; Crews, John E; Saaddine, Jinan B; Zhang, Xinzhi
To examine whether socioeconomic status, as measured by educational attainment and annual household income, is associated with lifetime risk for workplace eye injury in a large US population. In analyses of data from the Behavioral Risk Factor Surveillance System (2005-2007, N = 43,510), we used logistic regression analysis and propensity score matching to assess associations between socioeconomic measures and lifetime risk for workplace eye injury among those aged ≥50 years. The lifetime prevalence of self-reported workplace eye injury was significantly higher among men (13.5%) than women (2.6%) (P workplace eye injury than those with more than a high school education. Men with an annual household income workplace eye injury than those whose income was >$50,000 (adjusted OR = 1.44, 95% CI: 1.07-1.95). After adjusting for other factors, no statistically significant associations between education, income, and lifetime workplace eye injury were found among women. Socioeconomic status was associated with lifetime risk for workplace eye injury among men but not women. Greater public awareness of individual and societal impacts of workplace eye injuries, especially among socioeconomically disadvantaged men, could help support efforts to develop a coordinated prevention strategy to minimize avoidable workplace eye injuries.
Pasulka, Jacqueline; Jayanthi, Neeru; McCann, Ashley; Dugas, Lara R; LaBella, Cynthia
Current trends among young athletes towards earlier specialization age and year-round training on multiple teams has raised concern for increased injury risk. Our previous analyses showed higher risk for injury in highly specialized young athletes. The goal of this research was to determine whether sports specialization and injury patterns vary by sports type. In this clinical case-control study, injured athletes (aged 7-18 years) were recruited from sports medicine clinics and compared to similarly aged uninjured athletes recruited from primary care clinics. Participants completed a survey reporting age, gender, sport type, specialization patterns, and details regarding sports-related injuries in the previous 6 months. Clinical diagnoses were collected from patients' medical records. Injuries were classified as acute, overuse, or serious overuse. Of 1,190 athletes enrolled, 26% (313) were single-sport specialized (reported participation in one sport and trained >8 months/year). Sports with the highest proportion of single-sport specialized athletes were tennis (46.7%), gymnastics (30.1%), and dance (26.3%). Single-sport specialized athletes in individual sports started specializing at a younger age (11.2 ± 2.4 vs. 12.0 ± 2.7, p = 0.05) and reported higher training volumes (11.8 vs. 10.3 h/week, p = 0.04) than those in team sports. Sports with the youngest specialization age were gymnastics (8.9 ± 1.7), dance (10.8 ± 3.0), and soccer (10.9 ± 2.4). Single-sport specialized athletes in individual sports accounted for a higher proportion of overuse injuries (44.3% vs 32.2%, OR = 1.67, p = 0.037) and serious overuse injuries (23.4% vs 11.6%, OR = 2.38, p = 0.011), but a lower proportion of acute injuries (28.8% vs 13.8%, OR = 0.37, p = 0.001) compared to single-sport specialized athletes involved in team sports. Athletes in individual sports may be more likely to specialize in a single sport than team sport athletes. Single
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
Tsai, Wei-Hsuan; Huang, Shih-Tsai; Liu, Wen-Chung; Chen, Lee-Wei; Yang, Kuo-Chung; Hsu, Kuei-Chang; Lin, Cheng-Ta; Ho, Yen-Yi
Rhabdomyolysis often occurs after traumatic compartment syndrome, and high morbidity and mortality have been reported with the acute kidney injury that develops subsequently. We focused on the risk factors for rhabdomyolysis and acute kidney injury in patients with traumatic compartment syndrome. We also analyzed the relation between renal function and rhabdomyolysis in these patients. A retrospective chart review was conducted from January 2006 to March 2012. Inpatients with traumatic compartment syndrome were included. We evaluated patients' demographics, history of illicit drugs use or alcohol consumption, mechanism of injury, symptoms, serum creatine kinase levels, and kidney function. A total of 52 patients with a mean age of 40.9 years were included; 23 patients had rhabdomyolysis (44.2%), of which 9 patients developed acute kidney injury (39.1%). Significant predictive factors for rhabdomyolysis were history of illicit drugs or alcohol use (P=0.039; odds ratio, 5.91) and ischemic injury (P=0.005). We found a moderate correlation between serum creatine kinase levels and serum creatinine levels (R=0.57; PRhabdomyolysis was a predisposing factor for acute kidney injury (P=0.011; odds ratio, 8.68). Four patients with rhabdomyolysis required a short period of renal replacement therapy. A high percentage of patients with traumatic compartment syndrome developed rhabdomyolysis (44.2%). Patients with rhabdomyolysis had a higher possibility of developing acute kidney injury (39.1%), and rhabdomyolysis was correlated to renal function. Early diagnosis, frequent monitoring, and aggressive treatment are suggested once compartment syndrome is suspected. The overall prognosis is good with early diagnosis and proper treatment.
Alqahtani, Saad M; Alzahrani, Mohammad M; Tanzer, Michael
Adult reconstructive surgery is an orthopedic subspecialty characterized by surgical tasks that are physical, repetitive, and require some degree of stamina from the surgeon. This can result strain and/or injury of the surgeon's musculoskeletal system. This study investigates the prevalence of work-related injuries among arthroplasty surgeons. A modified version of the physical discomfort survey was sent to surgeon members of the Hip Society, the International Hip Society, and the Canadian Orthopedic Arthroplasty via email. One hundred and eighty-three surgeons completed the survey. Overall, 66.1% of the arthroplasty surgeons reported that they had experienced a work-related injury. The most common injuries that occurred were low back pain (28%), lateral epicondylitis of the elbow (14%), shoulder tendonitis (14%), lumbar disc herniation (13%), and wrist arthritis (12%). Overall, 27% of surgeons took time off from work because of the injury. As the number of disorders diagnosed increased, there was a significant increase in the incidence of requiring time off work because of the disorder (P increased the risk of the surgeon requiring time off because of the disorder were age >55 years, practicing for more than >20 years, and performing >100 total hip arthroplasty procedures per year (P < .05). In addition, 31% of the orthopedic surgeons surveyed required surgery for their injury. Although most studies concentrate on the importance of patient safety and thus the quality of the health care system, the surgeon's safety is also considered an integral part of this system's quality. This study highlights a high prevalence of musculoskeletal work-related injuries among arthroplasty surgeons and indicates the need for the identification of preventive measures directed toward improving the operative surgical environment and work ergonomics for the surgeons. Copyright © 2015 Elsevier Inc. All rights reserved.
Wilhelm, Andrew; Choi, Changryol; Deitch, John
The rate of early sport specialization in professional baseball players is unknown. To report the incidence and age of sport specialization in current professional baseball players and the impact of early specialization on the frequency of serious injuries sustained during the players' careers. We also queried participants about when serious injuries occurred, the players' current position on the field, and their opinions regarding the need for young athletes to specialize early to play at the professional level. Descriptive epidemiological study. A total of 102 current professional baseball players anonymously completed a 7-question written survey. Early sport specialization was defined as "single-sport participation prior to high school." Injury was defined as "a serious injury or surgery that required the player to refrain from sports (baseball) for an entire year." Chi-square tests were used to investigate the risk of injury in those who specialized early in baseball versus those who did not. Independent-sample t tests were used to compare injury rates based on current player position. Fifty (48%) baseball players specialized early. The mean age at initiation of sport specialization was 8.91 years (SD, 3.7 years). Those who specialized early reported more serious injuries (mean, 0.54; SD, 0.838) during their professional baseball career than those who did not (mean, 0.23; SD, 0.425) ( P = .044). Finally, 63.4% of the queried players believed that early sport specialization was not required to play professional baseball. Our study demonstrated a statistically significant higher rate of serious injury during a baseball player's professional career in those players who specialized early. Most current professional baseball players surveyed believed that sport specialization was not required prior to high school to master the skills needed to play at the professional level. Our findings demonstrate an increased incidence of serious injuries in professional baseball
Sipe Eilynn K
Full Text Available Abstract Background We sought to determine torso injury rates and sensitivities associated with fluid-positive abdominal ultrasound, metabolic acidosis (increased base deficit and lactate, and impaired pulmonary physiology (decreased spirometric volume and PaO2/FiO2. Methods Level I trauma center prospective pilot and post-pilot study (2000–2001 of stable patients. Increased base deficit was 2.5 mmol/L in ethanol-negative and ≥ 3.0 mmol/L in ethanol-positive patients. Decreased PaO2/FiO2 was Results Of 215 patients, 66 (30.7% had a torso injury (abdominal/pelvic injury n = 35 and/or thoracic injury n = 43. Glasgow Coma Scale score was 14.8 ± 0.5 (13–15. Torso injury rates and sensitivities were: abdominal ultrasound negative and normal base deficit, lactate, PaO2/FiO2, and spirometric volume – 0.0% & 0.0%; normal base deficit and normal spirometric volume – 4.2% & 4.5%; chest/abdominal soft tissue injury – 37.8% & 47.0%; increased lactate – 39.7% & 47.0%; increased base deficit – 41.3% & 75.8%; increased base deficit and/or decreased spirometric volume – 43.8% & 95.5%; decreased PaO2/FiO2 – 48.9% & 33.3%; positive abdominal ultrasound – 62.5% & 7.6%; decreased spirometric volume – 73.4% & 71.2%; increased base deficit and decreased spirometric volume – 82.9% & 51.5%. Conclusions Trauma patients with normal base deficit and spirometric volume are unlikely to have a torso injury. Patients with increased base deficit or lactate, decreased spirometric volume, decreased PaO2/FiO2, or positive FAST have substantial risk for torso injury. Increased base deficit and/or decreased spirometric volume are highly sensitive for torso injury. Base deficit and spirometric volume values are readily available and increase or decrease the suspicion for torso injury.
Warren, Ann Marie; Boals, Adriel; Elliott, Timothy R; Reynolds, Megan; Weddle, Rebecca Jo; Holtz, Pamela; Trost, Zina; Foreman, Michael L
Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) occur in individuals who sustain physical injury and share a significant overlap in symptoms. PTSD rates in the civilian injury population range from 20% to 40%. The current study examined the presence of PTSD symptoms at multiple time points (3 months and 6 months after injury) among individuals with and without TBI after admission to a Level I trauma center. This prospective cohort study included patients 18 years and older admitted to a Level I trauma center for 24 hours or greater. Demographic and injury-related data were gathered in addition to assessments of PTSD during initial hospitalization after injury, as well as 3 months and 6 months later. The Primary Care PTSD Screen and PTSD Checklist-Civilian version were used to determine probable PTSD. International Classification of Diseases, 9th Rev. codes were used to determine mild TBI (MTBI). A total of 494 patients were enrolled at baseline, 311 (63%) completed 3-month follow-up, and 231 (47%) completed 6-month follow-up at the time of analysis. Preinjury PTSD was reported by 7% of the participants. At 3 months, patients with MTBI evidenced a probable PTSD rate of 18%, compared with a rate of 9% for patients with no MTBI (p = 0.04), although this relationship became a nonsignificant trend (p = 0.06) when demographics were included. At 6 months, patients with MTBI evidenced a probable PTSD rate of 26%, compared with a rate of 15% for patients with no MTBI (p = 0.04), and this relationship remained significant when demographics were included. Preinjury history of TBI did not predict PTSD, but incidence of TBI for the injury in which they were hospitalized did predict PTSD. TBI at time of injury demonstrated a nonsignificant trend toward higher rates of PTSD at 3 months and significantly predicted PTSD at 6 months after injury. This important finding may help clinicians identify patients at high risk for PTSD after injury and target these
Mercado, Miguel Angel; Franssen, Bernardo; Arriola, Juan Carlos; Garcia-Badiola, Artemio; Arámburo, Rigoberto; Elnecavé, Alejandro; Cortés-González, Rubén
Bile duct injury remains constant in the era of laparoscopic cholecystectomy and misidentification of structures remains one of the most common causes of such injuries. Abnormalities in liver segment IV, which is fully visible during laparoscopic cholecystectomy, may contribute to misidentification as proposed herein. We describe the case of a 36-year-old female who had a bile duct injury during a laparoscopic cholecystectomy where the surgeon noticed an unusually small distance between the gallbladder and the round ligament. We define hypoplasia of liver segment IV as well as describe the variation of the biliary anatomy in the case. We also intend to fit it in a broader spectrum of developmental anomalies that have both hyopoplasia of some portion of the liver and variations in gallbladder and bile duct anatomy that may contribute to bile duct injury. To our knowledge, hypoplasia of liver segment IV has not been suggested in the literature as a risk factor for bile duct injury except in the extreme case of a left-sided gallbladder. Surgeons should be vigilant during laparoscopic cholecystectomy when they become aware of an unusually small distance between the gallbladder bed and the round ligament prior to beginning their dissection, variations in the common bile duct and cystic duct should be expected.
Kassam-Adams, Nancy; Marsac, Meghan L; Hildenbrand, Aimee; Winston, Flaura
After pediatric injury, transient traumatic stress reactions are common, and about 1 in 6 children and their parents develop persistent posttraumatic stress (PTS) symptoms that are linked to poorer physical and functional recovery. Meta-analytic studies identify risk factors for persistent PTS, including preinjury psychological problems, peritrauma fear and perceived life threat, and posttrauma factors such as low social support, maladaptive coping strategies, and parent PTS symptoms. There is growing prospective data indicating that children's subjective appraisals of the injury and its aftermath influence PTS development. Secondary prevention of injury-related PTS often involves parents and focuses on promoting adaptive child appraisals and coping strategies. Web-based psychoeducation and targeted brief early intervention for injured children and their parents have shown a modest effect, but additional research is needed to refine preventive approaches. There is a strong evidence base for effective psychological treatment of severe and persistent PTS via trauma-focused cognitive behavioral therapy; evidence is lacking for psychopharmacological treatment. Pediatric clinicians play a key role in preventing injury-related PTS by providing "trauma-informed" pediatric care (ie, recognizing preexisting trauma, addressing acute traumatic stress reactions associated with the injury event, minimizing potentially traumatic aspects of treatment, and identifying children who need additional monitoring or referral).
Moore, Scott M; Zhang, Hua; Maeda, Nobuyo; Doerschuk, Claire M; Faber, James E
Collaterals lessen tissue injury in occlusive disease. However, aging causes progressive decline in their number and smaller diameters in those that remain (collateral rarefaction), beginning at 16 months of age in mice (i.e., middle age), and worse ischemic injury-effects that are accelerated in even 3-month-old eNOS(-/-) mice. These findings have found indirect support in recent human studies. We sought to determine whether other cardiovascular risk factors (CVRFs) associated with endothelial dysfunction cause collateral rarefaction, investigate possible mechanisms, and test strategies for prevention. Mice with nine different models of CVRFs of 4-12 months of age were assessed for number and diameter of native collaterals in skeletal muscle and brain and for collateral-dependent perfusion and ischemic injury after arterial occlusion. Hypertension caused collateral rarefaction whose severity increased with duration and level of hypertension, accompanied by greater hindlimb ischemia and cerebral infarct volume. Chronic treatment of wild-type mice with L-N (G)-nitro-arginine methylester caused similar rarefaction and worse ischemic injury which were not prevented by lowering arterial pressure with hydralazine. Metabolic syndrome, hypercholesterolemia, diabetes mellitus, and obesity also caused collateral rarefaction. Neither chronic statin treatment nor exercise training lessened hypertension-induced rarefaction. Chronic CVRF presence caused collateral rarefaction and worse ischemic injury, even at relatively young ages. Rarefaction was associated with increased proliferation rate of collateral endothelial cells, effects that may promote accelerated endothelial cell senescence.
Full Text Available The aims of this study were to: (1 evaluate the epidemiology of simultaneous upper gastrointestinal bleeding (UGIB and myocardial injury using parameters including troponin I (TnI; and (2 investigate the predictive risk factors of this syndrome. One hundred and fifty-five patients (101 men, 54 women; mean age, 64.7 ± 10.4 years; range, 38–94 years at the emergency department (ED with the major diagnosis of UGIB were included. They underwent serial electrocardiography (ECG and cardiac enzyme follow-up. Emergent gastroendoscopy was performed within 24 hours in most patients except for those who refused or were contraindicated. Mild myocardial injury was defined as the presence of any of the following: typical ST-T change on ECG, elevated creatine kinase-MB (CK-MB > 12U/L, or TnI > 0.2ng/dL. Moderate myocardial injury was defined as the presence of any two of the previously mentioned conditions. In total, 51 (32.9% and 12 (7.74% patients developed mild and moderate myocardial injuries, respectively. Myocardial injury was more common among patients with variceal bleeding (20/25 = 80.0% than those with ulcer bleeding (23/112 = 20.5%. It could partially be attributed to a higher baseline TnI level in cirrhotic patients. After adjusting for significant risk factors revealed by the univariate analysis, UGIB patients with a history of liver cirrhosis and more than three cardiac risk factors comprised a high-risk group for simultaneously developing myocardial injury. Other factors including age, gender, the color of nasogastric tube irrigation fluid, history of nonsteroidal anti-inflammatory drug use, vasopressin or terlipressin administration, vital signs, and creatinine recorded at the ED were not significant predictors. Those who developed myocardial injury had a longer hospital stay (mean duration, 8.73 ± 6.94 vs. 6.34 ± 2.66 days; p = 0.03 and required transfusion of more units of packed erythrocytes.
Kim, Insook; Won, Seonae; Lee, Mijin; Lee, Won
The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.
Singh, Prabhleen; Rifkin, Dena E; Blantz, Roland C
Epidemiologic evidence suggests that chronic kidney disease (CKD) is a risk factor for acute kidney injury (AKI) due to the prevalence of CKD in patients who have episodes of AKI. However, the high burden of comorbidities such as age, diabetes, peripheral vascular, cardiovascular, and liver disease accompanying CKD, and the difficulties of defining AKI in the setting of CKD make these observations difficult to interpret. These comorbidities not only could alter the course of AKI but also may be the driving force behind the epidemiologic association between CKD and AKI because of systemic changes and/or increased exposure to potential nephrotoxic risks. Here, we contend that studies suggesting that CKD is a risk factor for AKI may suffer from residual confounding and reflect an overall susceptibility to illness rather than biologic susceptibility of the kidney parenchyma to injury. In support of our argument, we discuss the clinical evidence from epidemiologic studies, and the knowledge obtained from animal models on the pathophysiology of AKI and CKD, demonstrating a preconditioning influence of the previously impaired kidneys against subsequent injury. We conclude that, under careful analysis, factors apart from the inherent pathophysiology of the diseased kidney may be responsible for the increased frequency of AKI in CKD patients, and the impact of CKD on the risk and severity of AKI needs further investigation. Moreover, certain elements in the pathophysiology of a previously injured kidney may, surprisingly, bear out to be protective against AKI.
Read, Paul J; Oliver, Jon L; De Ste Croix, Mark B A; Myer, Gregory D; Lloyd, Rhodri S
Early specialisation is characterised by formal participation in a single sport at the exclusion of others. Limited data are available to support this approach in the development of soccer players who attain elite status later in life. Of growing concern is the associated increased risk of injury and suggestions that single sport specialisation is a risk factor independent of age, growth, biological maturation and training volumes. In the United Kingdom, elite soccer organisations have recently adopted an early sport specialisation approach following the introduction of the Elite Player Performance Plan. A key tenet of this programme is increased opportunities for training through a marked rise in the specified on-pitch hours per week. The accumulation of high training hours may be less of a relevant marker for success, and the impact of such a significant increase in training volume for young athletes who are experiencing a range of growth and maturational processes is currently unknown. This critical commentary includes an evidence-based discussion of the effectiveness of early sport specialisation and the potential injury risks associated with such programmes placing a specific focus on elite male youth soccer players. Available data indicate that modifications to the existing Elite Player Performance Plan framework could enhance players' development and reduce injury risk. Proposed alterations include reduced volume of soccer-specific training at key stages of growth and maturation and guidelines for the provision of a greater variety of physical activities that are integrated within other programme components.
Keller, Robert A; Marshall, Nathan E; Guest, John-Michael; Okoroha, Kelechi R; Jung, Edward K; Moutzouros, Vasilios
The number of Major League Baseball (MLB) pitchers requiring ulnar collateral ligament (UCL) reconstructions is increasing. Recent literature has attempted to correlate specific stresses placed on the throwing arm to risk for UCL injury, with limited results. Eighty-three MLB pitchers who underwent primary UCL reconstruction were evaluated. Pitching velocity and percent of pitch type thrown (fastball, curve ball, slider, and change-up) were evaluated 2 years before and after surgery. Data were compared with control pitchers matched for age, position, size, innings pitched, and experience. The evaluation of pitch velocity compared with matched controls found no differences in pre-UCL reconstruction pitch velocities for fastballs (91.5 vs. 91.2 miles per hour [mph], P = .69), curveballs (78.2 vs. 77.9 mph, P = .92), sliders (83.3 vs. 83.5 mph, P = .88), or change-ups (83.9 vs. 83.8 mph, P = .96). When the percentage of pitches thrown was evaluated, UCL reconstructed pitchers pitch significantly more fastballs than controls (46.7% vs. 39.4%, P = .035). This correlated to a 2% increase in risk for UCL injury for every 1% increase in fastballs thrown. Pitching more than 48% fastballs was a significant predictor of UCL injury, because pitchers over this threshold required reconstruction (P = .006). MLB pitchers requiring UCL reconstruction do not pitch at higher velocities than matched controls, and pitch velocity does not appear to be a risk factor for UCL reconstruction. However, MLB pitchers who pitch a high percentage of fastballs may be at increased risk for UCL injury because pitching a higher percent of fastballs appears to be a risk factor for UCL reconstruction. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
Morioka, Hisayoshi; Itani, Osamu; Jike, Maki; Nakagome, Sachi; Otsuka, Yuichiro; Ohida, Takashi
To identify risk factors at birth that are predictive of subsequent injury among preschool children. Retrospective analysis of population-based birth cohort data from the "Longitudinal Survey of Babies Born in the 21st Century" was performed from 2001 through 2007 in Japan (n = 47,015). The cumulative incidence and the total number of hospitalizations or examinations conducted at medical facilities for injury among children from birth up to the age of 5 years were calculated. To identify risk factors at birth that are predictive of injury, multivariate analysis of data for hospitalization or admission because of injury during a 5-year period (age, 0-5 years) was performed using the total number of hospital examinations as the dependent variable. The cumulative incidence (95% confidence interval) of hospital examinations for injury over the 5-year period was 34.8% (34.2%-35.4%) for boys and 27.6% (27.0%-28.2%) for girls. The predictive risk factors at birth we identified for injury among preschool children were sex (boys), heavy birth weight, late birth order, no cohabitation with the grandfather or grandmother, father's long working hours, mother's high education level, and strong intensity of parenting anxiety. Based on the results of this study, we identified a number of predictive factors for injury in children. To reduce the risk of injury in the juvenile population as a whole, it is important to pursue a high-risk or population approach by focusing on the predictive factors we have identified.
Mock, Charles N; Grossman, David C; Kaufman, Robert P; Mack, Christopher D; Rivara, Frederick P
We sought to investigate the effect of increased body weight on the risk of death and serious injury to occupants in motor vehicle crashes. We employed a retrospective cohort study design utilizing data from the National Automotive Sampling System, Crashworthiness Data System (CDS), 1993-1996. Subjects in the study included occupants involved in tow-away crashes of passenger cars, light trucks, vans and sport utility vehicles. Two outcomes were analyzed: death within 30 days of the crash and injury severity score (ISS). Two exposures were considered: occupant body weight and body mass index (BMI; kg/m2). Occupant weight was available on 27263 subjects (76%) in the CDS database. Mortality was 0.67%. Increased body weight was associated with increased risk of mortality and increased risk of severe injury. The odds ratio for death was 1.013 (95% CI: 1.007, 1.018) for each kilogram increase in body weight. The odds ratio for sustaining an injury with ISS > or = 9 was 1.008 (95% CI: 1.004, 1.011) for each kilogram increase in body weight. After adjustment for potentially confounding variables (age, gender, seatbelt use, seat position and vehicle curbweight), the significant relationship between occupant weight and mortality persisted. After adjustment, the relationship between occupant weight and ISS was present, although less marked. Similar trends were found when BMI was analyzed as the exposure. In conclusion, increased occupant body weight is associated with increased mortality in automobile crashes. This is probably due in part to increased co-morbid factors in the more overweight occupants. However, it is possibly also due to an increased severity of injury in these occupants. These findings may have implications for vehicle safety design, as well as for transport safety policy.
Risk factors were included NVD (difficult vaginal delivery, high gestation age, and low Apgar score at first minute of life, shoulder dystocia, vacuum and birth at night. Conclusion: The present study revealed that the incidence of birth injuries in this area is high. Considering the serious complications of birth injuries and hypoxic-ischemic encephalopathy with no treatment for some cases, it seems that using the preventing methods to reduce the prevalence of birth injuries is nessesary
Divani, Afshin A; Vazquez, Gabriela; Barrett, Anna M; Asadollahi, Marjan; Luft, Andreas R
Stroke survivors are at high risk for falling. Identifying physical, clinical, and social factors that predispose stroke patients to falls may reduce further disability and life-threatening complications, and improve overall quality of life. We used 5 biennial waves (1998-2006) from the Health and Retirement Study to assess risk factors associated with falling accidents and fall-related injuries among stroke survivors. We abstracted demographic data, living status, self-evaluated general health, and comorbid conditions. We analyzed the rate ratio (RR) of falling and the OR of injury within 2 follow-up years using a multivariate random effects model. We identified 1174 stroke survivors (mean age+/-SD, 74.4+/-7.2 years; 53% female). The 2-year risks of falling, subsequent injury, and broken hip attributable to fall were 46%, 15%, and 2.1% among the subjects, respectively. Factors associated with an increased frequency of falling were living with spouse as compared to living alone (RR, 1.4), poor general health (RR, 1.1), time from first stroke (RR, 1.2), psychiatric problems (RR, 1.7), urinary incontinence (RR, 1.4), pain (RR, 1.4), motor impairment (RR, 1.2), and past frequency of > or = 3 falls (RR, 1.3). Risk factors associated with fall-related injury were female gender (OR, 1.5), poor general health (OR, 1.2), past injury from fall (OR, 3.2), past frequency of > or = 3 falls (OR, 3.1), psychiatric problems (OR, 1.4), urinary incontinence (OR, 1.4), impaired hearing (OR, 1.6), pain (OR, 1.8), motor impairment (OR, 1.3), and presence of multiple strokes (OR, 3.2). This study demonstrates the high prevalence of falls and fall-related injuries in stroke survivors, and identifies factors that increase the risk. Modifying these factors may prevent falls, which could lead to improved quality of life and less caregiver burden and cost in this population.
Libin, Alexander; Tinsley, Emily A; Nash, Mark S; Mendez, Armando J; Burns, Patricia; Elrod, Matt; Hamm, Larry F; Groah, Suzanne L
Evidence suggests an elevated prevalence of cardiometabolic risks among persons with spinal cord injury (SCI); however, the unique clustering of risk factors in this population has not been fully explored. The purpose of this study was to describe unique clustering of cardiometabolic risk factors differentiated by level of injury. One hundred twenty-one subjects (mean 37 ± 12 years; range, 18-73) with chronic C5 to T12 motor complete SCI were studied. Assessments included medical histories, anthropometrics and blood pressure, and fasting serum lipids, glucose, insulin, and hemoglobin A1c (HbA1c). The most common cardiometabolic risk factors were overweight/obesity, high levels of low-density lipoprotein (LDL-C), and low levels of high-density lipoprotein (HDL-C). Risk clustering was found in 76.9% of the population. Exploratory principal component factor analysis using varimax rotation revealed a 3-factor model in persons with paraplegia (65.4% variance) and a 4-factor solution in persons with tetraplegia (73.3% variance). The differences between groups were emphasized by the varied composition of the extracted factors: Lipid Profile A (total cholesterol [TC] and LDL-C), Body Mass-Hypertension Profile (body mass index [BMI], systolic blood pressure [SBP], and fasting insulin [FI]); Glycemic Profile (fasting glucose and HbA1c), and Lipid Profile B (TG and HDL-C). BMI and SBP formed a separate factor only in persons with tetraplegia. Although the majority of the population with SCI has risk clustering, the composition of the risk clusters may be dependent on level of injury, based on a factor analysis group comparison. This is clinically plausible and relevant as tetraplegics tend to be hypo- to normotensive and more sedentary, resulting in lower HDL-C and a greater propensity toward impaired carbohydrate metabolism.
Bowerman, Erin Anne; Whatman, Chris; Harris, Nigel; Bradshaw, Elizabeth
The objective of this study was to review the evidence for selected risk factors of lower extremity overuse injuries in young elite female ballet dancers. An electronic search of key databases from 1969 to July 2013 was conducted using the keywords dancers, ballet dancers, athletes, adolescent, adolescence, young, injury, injuries, risk, overuse, lower limb, lower extremity, lower extremities, growth, maturation, menarche, alignment, and biomechanics. Thirteen published studies were retained for review. Results indicated that there is a high incidence of lower extremity overuse injuries in the target population. Primary risk factors identified included maturation, growth, and poor lower extremity alignment. Strong evidence from well-designed studies indicates that young elite female ballet dancers suffer from delayed onset of growth, maturation, menarche, and menstrual irregularities. However, there is little evidence that this deficit increases the risk of overuse injury, with the exception of stress fractures. Similarly, there is minimal evidence linking poor lower extremity alignment to increased risk of overuse injury. It is concluded that further prospective, longitudinal studies are required to clarify the relationship between growth, maturation, menarche, and lower extremity alignment, and the risk of lower extremity overuse injury in young elite female ballet dancers.
Long, Rachel N.; Sun, Kan; Neitzel, Richard L.
Occupational injury is one of many health concerns related to small-scale gold mining (ASGM), but few data exist on the subject, especially in sub-Saharan Africa. In 2011 and 2013, we examined accidents, injuries, and potential risk factors in a Ghanaian ASGM community. In 2011, 173 participants were surveyed on occupational history and health, and 22 of these were surveyed again in 2013. Injury rates were estimated at 45.5 and 38.5 injuries per 100 person-years in 2011 and in 2013, respectively; these rates far surpass those of industrialized mines in the U.S. and South Africa. Demographic and job characteristics generally were not predictive of injury risk, though there was a significant positive association with injury risk for males and smokers. Legs and knees were the most common body parts injured, and falling was the most common cause of injury. The most common type of injuries were cuts or lacerations, burns and scalds, and contusions and abrasions. Only two miners had ever received any occupational safety training, and PPE use was low. Our results suggest that injuries should be a priority area for occupational health research in ASGM. PMID:26213958
Rachel N. Long
Full Text Available Occupational injury is one of many health concerns related to small-scale gold mining (ASGM, but few data exist on the subject, especially in sub-Saharan Africa. In 2011 and 2013, we examined accidents, injuries, and potential risk factors in a Ghanaian ASGM community. In 2011, 173 participants were surveyed on occupational history and health, and 22 of these were surveyed again in 2013. Injury rates were estimated at 45.5 and 38.5 injuries per 100 person-years in 2011 and in 2013, respectively; these rates far surpass those of industrialized mines in the U.S. and South Africa. Demographic and job characteristics generally were not predictive of injury risk, though there was a significant positive association with injury risk for males and smokers. Legs and knees were the most common body parts injured, and falling was the most common cause of injury. The most common type of injuries were cuts or lacerations, burns and scalds, and contusions and abrasions. Only two miners had ever received any occupational safety training, and PPE use was low. Our results suggest that injuries should be a priority area for occupational health research in ASGM.
Williams, David; Odin, Louise
Public session access to diving boards is one of the stepping stones for those wishing to develop their skills in the sport of diving. The extent to which certain dive forms are considered risky (forward/backward/rotations) and therefore not permitted is a matter for local pool managers. In Study 1, 20 public pools with diving facilities responded to a U.K. survey concerning their diving regulation policy and related injury incidence in the previous year. More restrictive regulation of dive forms was not associated with a decrease in injuries (rs  = -0.20, p = 0.93). In Study 2, diving risk perception and attitudes towards regulation were compared between experienced club divers (N = 22) and nondivers (N = 22). Risk was perceived to be lower for those with experience, and these people favored less regulation. The findings are interpreted in terms of a risk thermostat model, where for complex physical performance activities such as diving, individuals may exercise caution in proportion to their ability and previous experience of success and failure related to the activity. Though intuitively appealing, restrictive regulation of public pool diving may be ineffective in practice because risk is not simplistically associated with dive forms, and divers are able to respond flexibly to risk by exercising caution where appropriate. © 2015 Society for Risk Analysis.
Virk, Jasveer; Li, Jiong; Lauritsen, Jens; Olsen, Jørn
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. Population-based cohort study. Denmark. All singleton births in Denmark between 1 January 1995 and 31 December 2006 were identified. These newborns were then linked to mothers, fathers, grandparents and siblings using individually assigned civil personal registration numbers. We identified that data on childhood injuries were obtained from the Danish National Patient Registry, which contains data on all hospital stays and outpatient visits. Incidence rate ratios (IRRs) were estimated from birth using log-linear Poisson regression models, and person-years were used as the offset variable. Age, residence, calendar period, maternal education, maternal income and parental-cohabitation status are treated as time-dependent variables (records were extracted from the offspring's birth year). Exposure to maternal bereavement due to a father's death had the strongest association with childhood injuries, especially when the cause of death was due to a traumatic event (adjusted estimates of IRR (aIRR): 1.25, 95%CI: 0.99 to 1.58). We did not find an association for childhood injuries and maternal bereavement due to grandparent's death, and we only found an association for sibling death when restricting to deaths due to traumatic events (aIRR: 1.20, 95%CI:1.03 to 1.39). The aetiology of childhood injuries is complex and may be related to events that take place during prenatal life. This study suggests that exposure to a stressful life event during gestation may be linked to injury susceptibility in childhood. However, changes in postnatal family conditions related to loss or genetic factors may also play a role. Developmental plasticity related to early life exposures leading to disease programming in offspring is a theory with substantial theoretical and empirical support. Prenatal stress exposure has been
Richmond, Sarah A.; Nettel-Aguirre, Alberto; Doyle-Baker, Patricia K.; Macpherson, Alison; Emery, Carolyn A.
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 internati...
Teofili, Luciana; Bianchi, Maria; Zanfini, Bruno A.; Catarci, Stefano; Sicuranza, Rossella; Spartano, Serena; Zini, Gina; Draisci, Gaetano
Background. We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH). Methods. We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without fresh frozen plasma (FFP) and platelet (PLT) transfusion. Clinical records were then retrieved and examined for respiratory distress events. Accor...
Vaca, Federico E.; Anderson, Craig L.
The adolescent Latino male mortality profile is an anomaly when compared to an otherwise more favorable overall U.S. Latino population mortality profile. Motor vehicle crash fatalities bear a considerable proportion of mortality burden in this vulnerable population. Friend influence and relational connection are two contextual domains that may mediate crash injury risk behavior in these adolescents. Our study goal was to assess the role of friend influence over time and relational connections...
Theisen, Daniel; Malisoux, Laurent; Genin, Joakim; Delattre, Nicolas; Seil, Romain; Urhausen, Axel
In this double-blind randomised controlled trial, we tested if leisure-time runners using shoes with less compliant midsoles have a higher running-related injury (RRI) risk. We provided 247 runners with standard running shoes having either a soft study shoes (soft-SS) or a hard study shoes (hard-SS) midsole and followed them prospectively for 5 months regarding RRI. All information about sports practice and injuries was uploaded on a dedicated internet platform and checked for consistency and completeness. RRI was defined as any first-time pain sustained during or as a result of running practice and impeding normal running activity for at least 1 day. Cox proportional hazards regressions were used to identify RRI risk factors. The type of study shoes used for running was not associated with RRIs (HR=0.92; 95% CI 0.57 to 1.48). The hard-SS had a 15% greater overall stiffness in the heel region. The two study groups were similar regarding personal and sports participation characteristics, except for years of running experience, which was higher (prunning. No between-group differences were found regarding injury location, type, severity or category. Nevertheless, the adjusted regression model revealed positive associations with RRI risk for body mass index (HR=1.126; 95% CI 1.033 to 1.227), previous injury (HR=1.735; 95% CI 1.037 to 2.902) and mean session intensity (HR=1.396; 95% CI 1.040 to 1.874). Protective factors were previous regular running activity (HR=0.422; 95% CI 0.228 to 0.779) and weekly volume of other sports activities (HR=0.702; 95% CI 0.561 to 0.879). Midsole hardness of modern cushioned running shoes does not seem to influence RRI risk.
human injury risk would be of critical importance for guiding the design of blast- protective helmets and face shields. Materials and Methods ...Biomedical Imaging (IEEE, Piscataway, NJ), Vol 53, pp 1142–1145. 39. Prevost TP, Balakrishnan A, Suresh S, Socrate S (2011) Biomechanics of brain tissue. Acta...3006–3012. 51. El Sayed T, Mota A, Fraternali F, Ortiz M (2008) Biomechanics of traumatic brain in- jury. Comput Methods Appl Mech Eng 197(51–52):4692
Full Text Available Abstract Background The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service. Methods The trial design was a population-based, randomised study. Two successive cohorts of male conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospectively for one 6-month term to determine the baseline incidence of injury. After this period, two new successive cohorts in the same four companies were randomised into two groups and followed prospectively for 6 months. Military service is compulsory for about 90% of 19-year-old Finnish men annually, who comprised the cohort in this study. This randomised, controlled trial included 968 conscripts comprising 501 conscripts in the intervention group and 467 conscripts in the control group. A neuromuscular training programme was used to enhance conscripts' motor skills and body control, and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries. The main outcome measures were acute injuries of the lower and upper limbs. Results In the intervention groups, the risk for acute ankle injury decreased significantly compared to control groups (adjusted hazards ratio (HR = 0.34, 95% confidence interval (95% CI = 0.15 to 0.78, P = 0.011. This risk decline was observed in conscripts with low as well as moderate to high baseline fitness levels. In the latter group of conscripts, the risk of upper-extremity injuries also decreased significantly (adjusted HR = 0.37, 95% CI 0.14 to 0.99, P = 0.047. In addition, the intervention groups tended to have less time loss due to injuries (adjusted HR = 0.55, 95% CI 0
ter Stege, Marloes H. P.; Dallinga, Joan M.; Benjaminse, Anne; Lemmink, Koen A. P. M.
Background Knee injuries are one of the most common types of injuries in team ball sports, and prevention is crucial because of health and economic implications. To set up effective prevention programs, these programs must be designed to target potential, modifiable risk factors. In addition, it is
Objectives: Injuries and mortality resulting from pedestrian road traffic crashes are a major public health problem in Ghana. This study investigated risk factors for road transport-related injury among pedestrians in rural Ghana. Design: Case study design using qualitative data. Method: In-depth interviews were conducted with pedestrians.…
Lin, Man-Xia; Ye, Jie-Yi; Tian, Wen-Shuo; Xu, Ming; Zhuang, Bo-Wen; Lu, Ming-De; Xie, Xiao-Yan; Kuang, Ming
Bile duct injury after ablation of malignant liver tumors (MLTs) was not unusual and should be avoided. However, few studies have focused on evaluating the risk factors for intrahepatic bile duct injury. To evaluate the risk factors for intrahepatic bile duct injury after ablation of MLTs and to evaluate the minimum safe distance for ablating tumors abutting bile ducts. Sixty-five patients with intrahepatic bile duct injury after ablation of MLTs, and 65 controls were recruited. Risk factors for intrahepatic bile duct injury were analyzed. Tumor location was recorded as ≤5 mm (group A), 5-10 mm (group B), and >10 mm (group C) from the right/left main duct or segmental bile duct. Ascites history (P bile duct dilatation before ablation (P bile duct injury. Significant differences in the risk of intrahepatic bile duct injury were found between groups B and C (P = 0.000), but not between groups A and B (P = 0.751). Ascites history (P = 0.002) and tumor location (P Bile duct injury after ablation of MLTs was the result of local treatment-related factors combined with the patients' general condition. The minimum safe distance for ablation of tumor abutting a bile duct was 10 mm.
Scholten, Annemieke C.; Haagsma, Juanita A.; Cnosse