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Hill, Jennifer L. "Female collegiate windmill pitchers : references to injury incidence." Virtual Press, 2003. http://liblink.bsu.edu/uhtbin/catkey/1260621.
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There is little research specifically examining fast-pitch softball pitchers. However of the few studies completed, pitchers have been reported to exhibit a high incidence of injury. How and why these pitchers are suffering from injuries has not been elucidated.The purpose of this study was to investigate the injuries occurring to collegiate softball pitchers and factors that may influence these injuries such as demographic, pitching, training, and injury information.A cross-sectional survey of collegiate softball pitchers from Divisions I, II, and III was conducted using InQsit, a web-based survey system. Instructions on how to complete a web-based survey was sent and completed over a two-week period, by 181 Division I, II, and III collegiate softball pitchers. The survey was composed of questions addressing: 1) demographic information, 2) pitching and game data, 3) training program information, and 4) injury reporting.The results showed that demographic information, pitching and game data, and training were not statistically significant (p<0.05) in relation to injury. Among the 131 reported injuries, 36 were acute, 92 chronic, and 3 unspecified. Of the 92 chronic/overuse injuries, 10 were Grade I, 30 Grade II, 39 Grade III, and 13 Grade IV. Of the total injuries, 80 were a direct result from pitching, with 36 relating to the shoulder and 17 to the lower back. Among the injured pitchers, 109 took Non-Steroidal AntiInflammatory Drugs, 140 used modalities, 11 received surgeries, and 95 saw additional specialists. This study revealed that a high percentage (72.8%) of collegiate pitchers are suffering injuries across the nation and more research focused on this area is needed. In addition, coaches need to continue to be informed of ways they can improve the health and training programs of their pitchers.School of Physical Education
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Harringe, Marita L. "Swedish teamgym - injury incidence, mechanism, diagnosis and postural control /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-415-0/.
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King, Douglas Alistair. "Injuries in rugby league: Incidence, influences, tackles and return to play decisions." AUT University, 2010. http://hdl.handle.net/10292/1007.
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Rugby league is an international collision sport. Players complete physically demanding activities such as running, tackling and passing which often result in musculoskeletal injuries. Injury rates increase as playing level increases. From 1999 to 2007 there were 42,754 rugby league claims costing Accident Compensation Corporation $48,704,704. Moderate to severe injury claims (MSC) represented 14% of these claims but 88% of costs. New Zealand Maori recorded significantly more injury claims and total injury entitlement costs than all other ethnic groups. Soft tissue MSC injuries were common (47%) for females. Concussions accounted for 70% of total rugby league injuries to the head while the knee represented 23% of total injury claims and 20% of injury costs. Neck and spine injuries accounted for 6% of total MSC injury claims but 16% of total MSC costs. In video analysis of 80 games at international, national and youth competition levels, 50% of tackles involved tacklers from behind the visual fields of the ball carrier, either two or three tacklers, and contact with the mid-torso or hip-thigh region. From the prospective injury analysis of one professional team over two consecutive years, tackle-related injuries occurred more to the ball carrier when tackled at shoulder or mid-torso height, in their blind vision, with two or more tacklers, and in the fourth quarter of matches. Tackle-related injury type and site varied by positional group. Hit-up forwards and outside backs recorded more tackle-related injuries as the ball carrier than the tackler. In the prospective study of 63 amateur rugby league players, 80% of players injured as a result of match or training activities saw a health professional as part of their rehabilitation. Team coaches asked players to return to rugby league activities in 28% of cases for training participation and 29% of cases for match participation. In the cross sectional study assessing 95 rugby league support personnel's first aid, injury prevention and concussion knowledge, only 2% achieved an 80% pass mark, 39% incorrectly stated loss of consciousness was required for concussion and only 24% of coaches had a rugby league coaching qualification. This PhD research has contributed knowledge regarding costs and characteristics of injuries to amateur rugby league participants analysed by ethnicity, gender, injury site and injury type. Changes in anthropometric characteristics and speed in regards to incidence of injury, characteristics of tackles in match situations and common tackling positions and positional groups where injuries occur, player perspectives on why they return from injury to participation in rugby league, and the lack of first aid knowledge for rugby league personnel, have all been described.
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Gustafsson, Timmy. "Injury incidence and injury patterns among male elite football players when playing in the national team." Thesis, Linnéuniversitetet, Institutionen för pedagogik, psykologi och idrottsvetenskap, PPI, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-12569.
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Background: An increased load on the European elite football players is seen; both physically, with more matches with the national teams and the club teams, but also mentally. To play football on the highest level induce a high injury risk with injury incidences very high, both in the national team and in the club teams. Objective: To investigate the injury risk among elite football players in UEFA Champions League when playing in their clubs compared to international matches with their national team respectively. Further the objective also was to study the injury incidence and injury pattern differences between national team players and non national team players. Materials and methods: In this study 3233 player seasons were registered for 6141 injuries from 134 UEFA Champions League team seasons, during the seasons 2001/2002 to 2009/2010. Existing data from UEFA research group consisted of injuries, exposure, anthropometric data etc. The author collected data regarding national team exposure. Definitions of injury severity, injury categorization, injury incidence are standard definitions and the definition of being national team player or not were given by the author. Results: The baseline data showed that the national team players played more matches, had more match injuries, had a higher match exposure and were younger. No large differences are seen in injury incidence in the type of injuries. Some specific injuries as Achilles tendon, low back pain and ACL are more common in matches whit the non national team players, while knee MCL injuries are more common among the national team players. The non national team players had more absence from injuries. When comparing the both groups in injury incidence in total, there were no differences. Discussion: The results of this study can be compared to other similar studies, because of the same procedure regarding injury incidence etc. as consensus. The figures in this study show the same figures as other studies in the same subject. Conclusions: The injury incidence and injury pattern do not diverge from one another or from earlier studies on the same topic. The noteworthy finding is that the players who play for the national team have not a higher injury incidence than the players who do not play for the national team.
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Allen, Nick. "Injury incidence and severity in professional ballet dancers over three years." Thesis, University of Wolverhampton, 2014. http://hdl.handle.net/2436/324082.
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Although the benefits of exercise are well documented, the risk of injury as a result of exercise is also documented. The undertaking of exercise in the form of sport or dance carries a risk of injury. This risk is increased in the professional ranks where increased intensity of exercise coupled with greater exposure periods are noted. Two published systematic reviews of the literature pertaining to musculoskeletal injuries and pain in dancers (up to 2008) indicated that there are still major scientific limitations and biases in the literature reviewed and indicated the need for explicit criteria on injury definition and methods of injury reporting. The reviews did comment on the evidence that musculoskeletal injury is an important issue for all dancers and that there is preliminary evidence that comprehensive injury prevention and management strategies may reduce injuries. The purpose of this single cohort observational study was to document injury incidence and severity in professional ballet dancers over three years including any changes as a result of changes within their medical management. While it is recognised that a randomised control trial would be advocated for an interventional study, due to the demands of this high performance environment this was not feasible. As such, steps were taken to improve the reporting of findings through the utilisation of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. To date there are two publications in peer reviewed journals as a result of the data collected in this study. In the absence of international consensus on injury data collection in dance the methodology employed in this study was consistent with the International Consensus Statements on injury data collection from sport. Although the incidence of injuries in Year 1 was lower than that in other sports, the results were higher than other studies that have been reported in dance. The reason for this may be due to the use of a more encompassing injury definition. In response to the data and details obtained through the injury audit process changes in the comprehensive medical management of the dancers were implemented. The pre-participation screening was extended and the individual conditioning programmes were structured using the developed Hybrid Intervention Model. The result of the injury auditing indicated a significant reduction in injury incidence in the Year 2, with a further reduction in Year 3. These findings support the results of the systematic reviews in that there is growing evidence that comprehensive injury prevention and management strategies may reduce injuries in dance and that in the absence of stronger evidence there is a strong recommendation for those charged with caring for professional dancers to implement comprehensive medical management programmes.
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Schwab, Laura M. "Incidence, mechanisms and risk factors for shoulder injuries in community Australian football players." Thesis, Griffith University, 2020. http://hdl.handle.net/10072/398438.
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Background: Australian football is a physically demanding sport. Exposure to multidirectional body contact and the necessity for complex upper body skills can result in significant strain on regions such as the shoulder. Despite the rise in incidence and high recurrence of shoulder injuries reported at the elite Australian Football League (AFL) level there is limited evidence available to determine whether shoulder injuries are also a problem at a community level. The financial ramifications of shoulder injuries for the community AFL player and society can be considerable due to time off work, treatment costs and the high number and expense of emergency department presentations.
Objectives: The aim of this thesis was to evaluate the profile (incidence, severity, mechanisms and clinical management) of shoulder complex injuries in community-level AFL players using automated injury surveillance (SMS text messaging and online survey). The thesis also aimed to investigate whether factors identified during preseason (i.e. musculoskeletal screening, measurement of habitual activity levels, or in-season training workload) were related to shoulder, head or neck time-loss injuries.
Methods: Study 1 and 2 prospectively evaluated a novel, automated method of injury surveillance in community AFL players (during a 20-week season) to assess method feasibility (Chapter 3) and to evaluate the profile of shoulder injuries (Chapter 4). In study 3, video footage of elite AFL players (n = 26) retrospectively examined the biomechanical aetiology of injuries to the shoulder complex (Chapter 5). The final two prospective cohort studies (4 and 5) examined potential risk factors for upper body injuries with similar injury mechanisms. At baseline, community AFL players were assessed using seven screening tests of the upper body, trunk and whole-body function to identify any relationships with in-season injuries to the shoulder, head, or neck (Chapter 6). Screening reference values were also determined. Pre-season habitual activity levels and in-season training workloads were collected to prospectively identify associations with in-season injuries to the upper or lower body regions (Chapter 7).
Results: The automated method of injury surveillance was deemed feasible for reporting injuries in community AFL players. The incidence of injuries to the shoulder complex was reported to be high (2nd highest in matches, 4th overall; 10.4% of all injuries). The severity of these shoulder injuries was mostly mild (<3 games missed), but a substantial number required medical attention (emergency department or doctor). Results also indicated activity mechanisms of injury were body region dependent with the majority of upper body injuries (shoulder, head and neck) due to collision contact. Injuries common to lower body regions (thigh, knee and ankle) were from non-contact/ overuse mechanisms. Video analysis of biomechanical aetiology identified that the majority of shoulder injuries occurred with the arm below 100 degrees flexion/ abduction and were caused by lateral contact (34.6%) and hyperflexion/ abduction (19.2%) mechanisms; potentially unavoidable contact injuries. This study found limited evidence to support the use of the suite of musculoskeletal screening tests selected for the upper body, trunk and whole-body function to identify risk of in-season injuries to the shoulder, head or neck. Furthermore, the results identified the variable nature of total workload characteristics in community AFL players, however, no total workload relationships were identified with common in-season injuries to the upper or lower body.
Conclusions: Shoulder injuries are problematic for community AFL players and the use of feasible methods of injury surveillance may help overcome the challenges associated with collecting shoulder injury data in community team sport. The musculoskeletal screening tests and measures of training and habitual workload selected and investigated in this thesis, however, were unable to adequately detect players ‘at-risk’ of an in-season injury to the shoulder, head or neck region. Future studies could investigate different intrinsic risk factors to the ones selected in this study and results also suggest that examination of extrinsic factors (such as rule changes) could possibly be indicated with an aim of preventing shoulder injuries. Furthermore, results from video analysis of elite players may suggest that prophylactic strategies should be customised to the positions of shoulder injury and also focus on lateral contact injury prevention in community AFL players. Findings from this thesis may help to inform the development of injury prevention strategies and guide future research directions with an aim of decreasing injuries to the shoulder complex in community AFL players.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School Allied Health Sciences
Griffith Health
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Hordijk, Jeanine. "Studies to reduce the incidence of chilling injury in navel orange fruit." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80254.
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Thesis (MScAgric)--Stellenbosch University, 2013.ENGLISH ABSTRACT: Citrus fruit exported from South Africa to markets such as the USA and China undergo a mandatory 24 day exposure of -0.6°C during shipment to kill any insect larvae in the fruit, however, this protocol causes chilling injury (CI). The aim of this study was firstly to determine the influence of various preharvest factors on chilling sensitivity. In addition, Near-Infrared (NIR) spectroscopy was tested as a potential management tool to identify variation in CI susceptibility of fruit and lastly the efficacy of thiabendazole (TBZ) applied in the packline to reduce CI was determined. Various factors influence the susceptibility of a navel orange fruit to CI including cultivar, micro-climate, harvest date, fruit size and rind colour. In this study it was found that ‘Washington’ was more susceptible to CI compared to ‘Navelina’ navel orange. Fruit from the coldest part of Citrusdal (Tharakama) had the highest incidence of CI, which concurred with literature. The incidence of CI was overall less when fruit were harvested in the middle of the commercial harvest window; however, the internal maturity at harvest does not appear to be related to the sensitivity of orange fruit to CI. Near infrared (NIR) spectroscopy was tested as a potential tool to predict fruit quality parameters in relation to CI. Analysing the NIR data with principal components analysis (PCA), score plots were obtained that separate fruit in clusters from the inside and outside of the canopy positions as well as different sizes and rind colours (green vs. orange). However, analysing data with partial least square regression (PLS) using fruit quality parameters (firmness, rind colour and mass), the NIR spectra obtained with the integrated sphere did not provide a good prediction model for CI index. Thiabendazole (TBZ) is reported to reduce the incidence of CI of citrus fruit and this fungicide was applied in a semi-commercial packline in the wax as well as the drench. The results of the application of different fungicides from the TBZ chemical group indicated that the TBZ dip treatments had the highest efficacy in reducing both the incidence and severity of CI and in addition were more effective when applied in warm (40°C) than cold water (10°C). Applications at the commercial recommended rate (20mL.L-1 and half of the commercial recommended rate were both effective in reducing the incidence of CI. Wax application was effective in reducing the incidence of CI however, the application of TBZ in the wax reduced the incidence of CI even more. For the successful reduction of CI incidence in commercial shipments of citrus fruit the focus should not be on a single factor but rather a strategy that encompasses pre-harvest factors that would influence rind quality as well as specific postharvest technologies know to decrease the impact of CI.
AFRIKAANSE OPSOMMING: Sitrus vrugte ondergaan 'n verpligte 24 dae blootstelling aan -0,6°C om moontlike insek-larwes te dood gedurende die uitvoer na markte soos die VSA en China, maar hierdie protokol veroorsaak koueskade. Die doel van hierdie studie was eerstens om die invloed van verskillende voor-oes faktore op koueskade-sensitiwiteit van nawel lemoene te bepaal. Daarbenewens is naby-infrarooi (NIR) spektroskopie as 'n potensiële tegniek getoets om variasie in koueskade-sensitiwiteit van nawel lemoene te identifiseer, en laastens is die effektiwiteit van thiabendazole (TBZ) toediening in die verpakkings lyn, om koueskade te verminder, ondersoek. Verskillende faktore soos kultivar, mikroklimaat, oesdatum, vruggrootte en skilkleur beïnvloed die koueskade-sensitiwiteit van sitrus. Hierdie studie het bevind dat die ‘Washington’ meer sensitief is vir koueskade as die ‘Navelina’ nawels. Vrugte afkomstig uit die koudste deel van Citrusdal (Tharakama) het die hoogste voorkoms van koueskade. In die algemeen was vrugte ge-oes in die middel van die kommersiële-venster die minste koueskade-sensitief, maar interne rypheid hou nie verband met koueskadesensitiwiteit nie. Naby-Infrarooi (NIR) spektroskopie is getoets as 'n potensiële instrument om vrugkwaliteit parameters te voorspel met betrekking tot koueskade. Deur ontleding van die NIR data met behulp van ‘Principal Components Analysis’ kon vrugte groepeer word volgens posisie (binne vs. buite blaredak), groottes en skilkleur. Deur ‘Partial Least Square Regression’ verdere data ontleding en met inagneming van vrugkwaliteit parameters (fermheid, skil kleur en massa), kon die NIR spektra wat verkry was egter nie 'n goeie voorspelling model vir koueskade verskaf nie. TBZ verminder die voorkoms van koueskade van sitrusvrugte na dit toegedien was in 'n semi-kommersiële verpakkingslyn in die waks, ‘drench’ of baddens. Die toediening van verskillende swamdoders van die TBZ chemiese groep in baddens, het aangedui dat die TBZ doop behandeling effektief was om die voorkoms van koueskade te verminder. Daarbenewens was TBZ meer effektief in verlaging van koueskade as dit toegedien word in warm (40°C) as koue (10°C) water, asook teen die volle (20mL.L-1) en die helfte van die aanbevole kommersiële dosis. Wakstoediening was effektief in die vermindering van die voorkoms van koueskade en byvoeging van TBZ in die waks het die effektiwiteit verhoog. Die suksesvolle vermindering van koueskade tydens kommersiële verskeping van sitrusvrugte moet egter nie fokus op 'n enkele faktor nie, maar op 'n strategie wat bestaan uit voor-oes faktore wat die vrugskil kwaliteit beïnvloed, sowel as spesifieke na-oes tegnologieë en hanteringsprotokolle wat bekend is vir die vermindering van koueskade.
Citrus Research International
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Barbosa, Ribeiro Henrique. "Incidence, predictors and outcomes of myocardial injury following transcatheter aortic valve replacement." Doctoral thesis, Université Laval, 2016. http://hdl.handle.net/20.500.11794/26635.
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Tableau d’honneur de la Faculté des études supérieures et postdoctorales, 2015-2016L’implantation de valve aortique par cathéter (TAVI) a été développée comme une alternative thérapeutique pour les patients avec une sténose aortique sévère et ayant un risque opératoire élevé ou extrême en cas de chirurgie de remplacement valvulaire standard. Par rapport à la chirurgie à cœur ouvert classique, les procédures de TAVI sont moins invasives, parce qu'elles ne sont pas associées au clampage aortique et à la cardioplégie. Toutefois, la procédure implique un certain degré de dommage myocardique dû à la compression du tissu par le ballonnet et la prothèse transcathéter, ainsi que plusieurs courts épisodes d'hypotension extrême et d’ischémie myocardique globale, au cours de la stimulation ventriculaire rapide et du déploiement de la prothèse. De plus, l'approche transapicale, qui est réalisée lorsque l'approche transfémorale n’est pas possible, comprend la ponction de l'apex du ventricule gauche et l'introduction de larges cathéters ce qui augmente vraisemblablement encore les dommages myocardiques. En conséquence, presque tous les patients subissant un TAVI présentent un certain degré de dommage myocardique, défini par une augmentation des enzymes cardiaques, telles que la créatine kinase-MB (CK-MB), la troponine ou le peptide natriurétique de type B (BNP). Néanmoins, les données sur l'incidence exacte des dommages myocardiques, leur étendue, leurs prédicteurs, ainsi que les résultats échocardiographiques et cliniques associés, en fonction des différentes approches et prothèses sont limitées. Les objectifs généraux de mon projet de doctorat sont d'évaluer l'incidence, les facteurs prédictifs et les résultats des dommages myocardiques après TAVI pour le traitement des patients symptomatiques avec sténose aortique sévère ou bioprothèse dysfonctionnelle et à haut risque chirurgical.
Transcatheter aortic valve replacement (TAVR) has emerged as a less invasive therapeutic alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis at very high-risk or prohibitive perioperative risk. Compared to conventional open-heart surgery, TAVR procedures are less invasive, because they are not associated with aortic cross-clamping and cardioplegia. Even so, the procedure involves some degree of myocardial injury due to tissue compression, caused by the balloon and valve prosthesis, as well as several short episodes of extreme hypotension and global ischemia, during rapid ventricular pacing and valve deployment. Also, the transapical approach, which is an alternative to the transfemoral approach, involves the puncture of the ventricular apex and the introduction of large catheters through it. Accordingly, nearly all patients undergoing TAVR present some degree of myocardial injury, as defined by any increase in cardiac biomarkers, including creatine kinase-MB (CK-MB), troponin or B-type natriuretic peptides (BNP). Nonetheless, data on the exact incidence of myocardial injury, extent, predictors, as well as the associated echocardiographic and clinical outcomes, according to the different type of TAVR procedures and transcatheter valves, have been limited. The general objectives of my PhD project are to evaluate the incidence, predictors and outcomes of myocardial injury following TAVR for the treatment of high-risk patients with severe symptomatic AS or dysfunctional aortic bioprosthesis.
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Jenkins, Mark. "Bone fracture incidence, measurement and adaptation: An exploration through the continuum from incidence to measurement and adaptation." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2127.
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This research encompasses four studies exploring bone adaptation, fracture incidence, and preventative measures to decrease fracture risk and increase bone health. Study one was a clinical audit exploring incidence rates for appendicular fractures in children in Western Australia over ten years. Diagnostic and remedial approaches were explored in studies two, three and four by examining the between-day reliability of upper limb scans; reliability of the osteogenic index (OI) for upper-body strength and power exercises; and the diagnostic value or utility of using pQCT in disease profiling, respectively. Fracture rates in the limbs of children were found to be increasing each year, particularly in the forearm, and regardless of gender, between 2005 and 2015, similar to international trend data. pQCT was established as a reliable tool for quantifying upper limb diaphyseal measurements. The OI had varying reliability depending on the equation used, exercise type and exercise intensity when measured using accelerometers at multiple locations. Lastly, paediatric populations with low motor competence and/or neuromuscular disorders were disease profiles which had a measurably negative influence on bone when compared to unaffected controls. The increase in fracture incidence in Western Australia is a concerning trend for bone health in children and adolescents that requires lifestyle and population-based interventions to arrest this incremental problem. pQCT may be a valuable tool for disease profiling with area measurements for bone and some muscle variables more reliable than volumetric measurements in the upper limbs. The OI is a more reliable tool when measuring strength exercises than power exercises; and individuals with a greater risk of weaker bones should apply more daily load to increase their overall bone health. Interventions should be put into place to rehabilitate individuals with already weaker bones, such as targeted and well-designed exercise programs supported by good nutritional practices.
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Curtis, Vernon Glen Lagrotteria. "Incidence of football injuries in different age groups at a professional football club." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7312_1205416141.
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Football is the most popular sport in the world, and it continues to have a progressive annual increase in the number of active players and the number of games played per season, which in turn, leads to an increase in the frequency of injuries. Football is extensively researched worldwide, however, some current studies confirm that the results on football injury factors are limited, as well as inconsistent and incomplete. The main aim of this study was to examine interrelating factors of football injuries through the various age groups at a designated football club. The study aimed to expose the injury risk factors and patterns present in the various age groups.
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Rossouw, Joanne Courtney. "Incidence of traumatic brain injury, prevalence of dysphagia, and factors predicting health outcomes following traumatic brain injury in adults." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16646.
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Includes bibliographical referencesSouth Africa has a high incidence of injury-related disorders, such as traumatic brain injury (TBI) as a result of motor vehicle accidents and assault. Dysphagia is a common sequela of TBI, which may result in malnutrition or aspiration pneumonia. There is limited epidemiological data available for TBI and dysphagia in South Africa which is important for health care planning. There is also inadequate literature reporting predictive factors for dysphagia and health outcomes of patients with TBI and swallowing disorders for the South African context, which would provide management guidelines for Speech-Language Pathologists (SLPs) for patients with TBI and dysphagia. This study aims to begin to provide up-to-date information regarding the incidence of TBI and the prevalence of dysphagia in the population with TBI in Bloemfontein, South Africa. Predictive factors for dysphagia and health outcomes were also investigated in order to provide management guidelines for TBI-related dysphagia for SLPs. A prospective cohort study followed 77 participants aged 18 to 68 years (M = 33.1) with mild to severe traumatic brain injury, admitted to 2 state and 2 private hospitals in the Bloemfontein metropole, South Africa, to investigate the incidence of TBI and the prevalence of TBI-related dysphagia in the adult population in 2013. Participants were tracked from admission to hospital to discharge. Demographic and medical data was collected for each participant, including: gender, age, TBI aetiology, means of nutritional intake, respiratory status, length of hospital stay, and number of speech therapy sessions. Glasgow Coma Scale (GCS) scores at time of admission, swallowing evaluation, and discharge were noted as an indicator of TBI severity and each participant was assessed with the Mann Assessment of Swallowing Ability on admission and prior to discharge to assess the presence of dysphagia. The incidence of TBI for the Bloemfontein metropole was 353 per 100,000 people and was greater in the male than in the female population (11.83:1). The main mechanism for TBI in Bloemfontein was interpersonal violence (67.53%), followed by road traffic accidents (motor and pedestrian vehicle accidents; 23.38%). The prevalence rate for dysphagia was 32%. Twenty-eight percent of those who presented with dysphagia also aspirated. Severe TBI (GCS ≤ 8) was identified as a predictive factor for dysphagia. Participants with dysphagia had longer hospital stays (days; M = 22.04, SD = 17.67) than those with normal swallowing (M = 6.23, SD = 4.28), t(75) = 6.13, p < .001, and took significantly more days to achieve oral intake (M = 6.23, SD = 10.32) than those without dysphagia (M = .31, SD = 1.41), t(75) = 4.08, p < .001. Ventilation was associated with longer hospital stays, rs(25) = -.47, p = .02 and longer duration until achievement of oral intake, rs(22) = -.80, p < .001. Tracheotomised participants also had significantly longer hospital stays, rs(25) = -.67, p < .001, and took longer to achieve oral intake, rs(22) = -.52, p = .01. An increased period of time with a tracheostomy was also significantly associated with mortality, χ2(2, n = 11) = 6.52, p = .04. Participants with dysphagia (M = 3.84, SD = 5.44) required significantly more therapy sessions with an SLP than those without dysphagia (M = .15, SD = .64), t(75) = 4.85, p < .001, and those with low GCS scores were significantly less likely to achieve oral intake prior to discharge, rs(25) = -.45, p = .02, and had longer hospital stays than participants with mild head injuries, rs(25) = -.49, p = .01. All participants who received nutrition via nasogastric tubes returned to oral intake; however, individuals who had percutaneous endoscopic gastrostomies did not achieve oral intake prior to discharge. It is recommended that objective swallowing evaluations be conducted for patients admitted with severe TBIs, and patients with mild and moderate TBIs be screened to determine the presence of dysphagia. TBI prevention initiatives should be developed to reduce the incidence of TBI, specifically in the young adult male population.
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Colagiuri, Peter. "Prospective epidemiological study of injuries in the Australian National Soccer Competition." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/12680.
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Sporting participation has numerous benefits to the individual and the community. Sports injury is an unfortunate consequence of participation and can have a negative physical, psychosocial and financial impact. Prevention of sporting injury can reduce the barriers to sporting participation. Injury prevention methodology considers injury surveillance to be one of the initial steps in the process of planning, developing and assessing the effectiveness of any prevention strategy implemented. Injury surveillance relies on a clear and unambiguous definition of injury and a reliable method of data collection to provide an accurate profile of injuries. Globally, there is published injury surveillance data available for professional soccer competitions in most regions of the world, with the notable exception of the Australian competition. Within Australia, injury surveillance results have been published for Rugby League, Rugby Union and Australian Rules Football. Our injury surveillance of the Australian professional soccer competition allows comparison to global injury data on soccer injuries and to other football codes within Australia. It also quantifies the significant risk of subsequent injury after an initial hip/groin injury and the player salary cost of injury in the Hyundai A-League. This new data advances the knowledge base of the sporting injury profile of professional soccer and informs the next stage of injury prevention program development.
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Pérez, Fernández Xose Luis. "Sepsis associated Acute Kidney Injury: incidence, risk factors and continuous renal replacement therapies." Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/667120.
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A-AKI has a high incidence and mortality in critically ill septic patients. We hypothesized that current recommendations for sepsis management do not prevent SA-AKI incidence. Furthermore, the need for CRRT in septic shock patients with SA-AKI is very high. We hypothesized that CRRT timing in these patients should be based on urine output (UO). Finally, when CRRT is indicated, we hypothesized that CVVHD is superior to CVVH in terms of extracorporeal circuit patency and abscence of dialytrauma.
In our first study the worsening of SA-AKI stage or the appearance of SA-AKI during the following 7 days (from sepsis onset) was clearly associated with a worst outcome in terms of survival (90-day survival). An important percentage of septic patients presented hypotension and this was clearly associated with SA-AKI incidence as well as the presence of an abdominal etiology which is a well-known risk factor for SA-AKI development. Although the accomplishment of the SSC tasks in our study population was globally low, contrary to other studies we did not observe a decrease of SA-AKI incidence in those patients who had high levels of accomplishment. When SSC tasks were separately analized, early antibiotic administration was not related with a lower incidence of SA-AKI either. In those patients who were hypotensive, EGDT measures achievement did not decrease SA-AKI incidence.
In our second international observational study, we analyzed all those patients with SA-AKI whom required CRRT due to a septic shock condition within the first 24 h from CRRT initiation. A higher age, severity of illness, medical as opposed to surgical admission, a higher BUN at CRRT initiation, a decreased UO and SCr at CRRT initiation, and more days from hospital admission to CRRT initiation were all associated with worse survival. No association between SA-AKI stage at CRRT initiation and 90-day mortality was observed, the same as the majority of previous studies reported. Whether earlier strategies of CRRT initiation (known as “timing”) could have an impact in the outcome of patients with SA-AKI was evaluated in a subgroup of homogeneous patients with septic shock all of them presenting advanced SA-AKI stage 3 at ICU admission and initiated on CRRT within the first 5 days from ICU admission. UO and time from ICU to CRRT were compared as timing criteria and UO proved to be more useful when deciding CRRT initiation than a standard “clock time” from ICU admission variable.
To demonstrate a higher EC patency with the use of CVVHD in SA-AKI patients we performed a third study comparing the use of CVVHD associated to an adsorption capacity membrane with the use of CVVH associated to the same membrane. Filters were changed at 24 h and 48 h in order to ensure de adsorption capacity. We observed a trend to a longer EC patency with the use of CVVHD although this was not translated in a decrease in the number of dialytrauma events. Cytokines concentrations were measured during the first 72 h and no differences were observed between both groups with the use of an adsorption capacity membrane.
Based on all these previous findings we can conclude that SA-AKI incidence and mortality are high in critically ill patients with sepsis especially in those who present hypotension or septic shock. These last patients due to their severe condition often require CRRT which should be initiated only in advanced AKI stages with immediate initiation criteria together with the help of UO. Finally, CRRT in SA-AKI patients when necessary should be encouraged to a preferential use of CVVHD associated to adsorption capacity membranes which seem to improve EC patency with no clinical outcome differences when compared to CVVH.A pesar de los avances en los campos del fracaso renal agudo (FRA) y la sepsis, la aparición de fracaso renal agudo de origen séptico (FRA-S) en el paciente crítico continúa asociándose a una elevada morbimortalidad. En la actualidad el tratamiento del FRA-S es de soporte y fundamentalmente dirigido al cumplimiento de las recomendaciones internacionales en el manejo del paciente séptico, minimizar la hipervolemia asociada a la disminución de la diuresis, y evitar el uso de nefrotóxicos. En estos pacientes críticos con FRA-S es habitual la necesidad de terapias de reemplazo renal (TRR) como tratamiento de soporte. El momento de inicio de las TRR y la modalidad empleada han generado en los últimos tiempos una importante discusión científica sin que por el momento se haya evidenciado ninguna mejoría pronóstica con el inicio precoz o con el uso de una modalidad determinada. Es por ello que el propósito de este trabajo durante estos años ha sido el de evaluar la incidencia real y mortalidad asociada que el FRA-S tiene en el paciente crítico con sepsis, la identificación de los factores de riesgo asociados a la aparición de FRA-S, el impacto que el cumplimiento de las medidas internacionales en la sepsis tiene sobre la incidencia de FRA-S, la identificación de las variables clínicas asociadas al pronóstico de los pacientes críticos con FRA-S que requieren TRR así como su posible utilidad para definir una estrategia de inicio precoz (con impacto pronóstico), y por último, a través un ensayo clínico piloto, evaluar en el mismo tipo de población (enfermos críticos con FRA-S) los beneficios del uso de una modalidad difusiva como la hemodiálisis venovenosa continua (HDVVC) en comparación con el uso de una modalidad convectiva como la hemofiltración venovenosa continua (HVVC), empleando la misma membrana con capacidad de adsorción en ambos grupos.
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Chéron, Charlène. "Blessures de surutilisation des membres : l'exposition sportive a-t-elle une influence?" Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLS150/document.
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Le sport est largement conseillé chez les enfants et les adolescents mais a pour inconvénient le développement de blessures musculosquelettiques au niveau des membres et du rachis. Les blessures de surutilisation des membres représentent une part importante des blessures musculo-squelettiques.Cette thèse avait pour but de déterminer s’il existait des différences entre les sports en ce qui concerne l’incidence, la localisation et le diagnostic de blessures de surutilisation des membres chez les enfants et si certains sports étaient des facteurs de risques pour le développement de ces blessures. De plus, elle avait pour but de comparer les résultats obtenus à ceux des adultes.Pour ce faire, deux revues systématiques ont été réalisées, la première pour les enfants et adolescents et la seconde pour les adultes. De plus, une étude prospective réalisée dans une population générale d’enfants a été analysée.Il existence peu d’évidences scientifiques sur l’incidence, les localisations et les diagnostics des blessures de surutilisation dans la littérature. Pour ces deux populations, et pour tous les sports étudiés les blessures de surutilisation affectent plus fréquemment les membres inférieurs. Chez les enfants/adolescents, les blessures affectent en particulier les genoux et la jambe, sans grande différence entre les sports. Alors que chez les adultes des différences apparaissent entre les sports et les zones les plus souvent touchées sont différentes des enfants. Concernant les diagnostics, il n’y a pas de différence entre les sports chez les enfants ; et il n’est pas possible de se prononcer chez les adultes. On note des différences entre les diagnostics retrouvés chez les enfants/adolescents et les adultes.L’étude prospective permet d’obtenir l’incidence des blessures pour neuf sports, et identifie parmi ceux-ci deux sports à risque : le football et le handballIn youngsters, physical activity has many direct health benefits but can also cause musculoskeletal injuries. Overuse injuries of the extremities represent an important part of all the musculoskeletal injuries that can occur in childhood.The aim of this thesis is to determine if some sports are more likely to expose children and adolescents to a greater risk of developing overuse injuries of the extremities and to investigate if there is difference regarding the diagnosis and the localisation of these injuries between different types of sports. Another aim was to compare these findings with those relating to adults.To achieve this, two systematic reviews have been done, one for youngsters and one for adults, and data from a large prospective study of schoolchildren were analysed.Paucity of relevant information in the literature made it difficult to obtain clear answers to our questions. However, we noticed that, for both population and all sports, overuse injuries more often affected the lower limb. In youngsters, the sites most often affected are the knee, the lower limb and the foot, and this is almost the same for all sports that were studied. In adults the localisation varies for the different sports and is not the same between youngsters and adults. Also the diagnoses do not vary between sports in youngsters ; whereas it was not possible to study this in adults. The diagnoses were different between the two populations studied. The prospective study of the schoolchildren permitted to determine the incidence of overuse injuries reported in children participating in nine different sports and to relate these results to their exposure to these sports (dose-response). Two sports were identified as risk factors: football and handball
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Hägglund, Martin. "Epidemiology and prevention of football injuries." Doctoral thesis, Linköpings universitet, Socialmedicin och folkhälsovetenskap, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8500.
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The aims of this thesis were to study the incidence, severity and pattern of injury in male and female elite football players; to study time trends in injury risk; to identify risk factors for injury; and to test the effectiveness of an intervention programme aimed at preventing re-injury. All studies followed a prospective design using standardised definitions and data collection forms. Individual training and match exposure was registered for all players participating. Time loss injuries were documented by each team’s medical staff. The amount of training increased by 68% between the 1982 and 2001 Swedish top male division seasons, reflecting the shift from semi-professionalism to full professionalism. No difference in injury incidence or injury severity was found between seasons. The injury incidence was 4.6 vs. 5.2/1000 training hours and 20.6 vs. 25.9/1000 match hours. The incidence of severe injury (absence >4 weeks) was 0.8/1000 hours in both seasons. The Swedish and Danish top male divisions were followed during the spring season of 2001. A higher risk for training injury (11.8 vs. 6.0/1000 hours, p<0.01) and severe injury (1.8 vs. 0.7/1000 hours, p=0.002) was observed among the Danish players. Re-injury accounted for 30% and 24% of injuries in Denmark and Sweden respectively. The Swedish top male division was studied over two consecutive seasons, 2001 and 2002, and comparison of training and match injury incidences between seasons showed similar results. Players who were injured in the 2001 season were at greater risk for injury in the following season compared to non-injured players (relative risk 2.7; 95% CI 1.7-4.3). Players with a previous hamstring injury, groin injury and knee joint trauma were two to three times more likely to suffer an identical injury to the same limb in the following season, but no such relationship was found for ankle sprain. Age was not associated with an increased injury risk. The effectiveness of a coach-controlled rehabilitation programme on the rate of re-injury was studied in a randomised controlled trial at amateur male level. In the control group, 23 of 79 injured players suffered a recurrence during the season compared to 10 of 90 players in the intervention group. There was a 75% lower re-injury risk in the intervention group for lower limb injuries (relative risk 0.25; 95% CI 0.11-0.57). The preventive effect was greatest during the first weeks after return to play. Both the male and female Swedish top divisions were followed during the 2005 season. Male elite players had a higher risk for training injury (4.7 vs. 3.8/1000 hours, p<0.05) and match injury (28.1 vs. 16.1/1000 hours, p<0.001) than women. However, no difference was observed in the rate of severe injury (0.7/1000 hours in both groups). The thigh was the most common site of injury in both men and women, while injury to the hip/groin was more frequent in men and to the knee in women. Knee sprain accounted for 31% and 37% of the time lost from training and match play in men and women respectively.Serienumret i serien Linköping University medical dissertation är fel. Det korrkta numret är 988. The serial number in the series Linköping University medical dissertation is incorrect. The correct number is 988.
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Diacogiorgis, Dimitri. "Incidence and aetiological factors in the development of medial tibial stress syndrome." Thesis, University of Ballarat, 2005. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/62497.
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The aim of this 13 week prospective study was to investigate whether differences in hip, knee, ankle, subtalar, or first metatarsophalangeal joint (MPJ) range of motion and physical activity levels increase a person's likelihood of developing medial tibial stress syndrome (MTSS)." --p.2.Master of Applied Science
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Logsdon, Susannah M. "The Incidence of Stress Fractures Among All Female Division I Athletes at Virginia Polytechnic Institute and State University." Thesis, Virginia Tech, 1999. http://hdl.handle.net/10919/42175.
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Stress fractures are common overuse injuries that have plagued athletes for many years. Often referred to as fatigue fractures, they are formed when the skeletal muscles fatigue and can no longer absorb the shock of repetitive pounding activities such as running. Stress fractures are most common in the weight-bearing bones of the lower extremities and are usually preceded by sudden increases or changes in training routines. Because they are most common in athletes who are least fit, it has been hypothesized that freshmen athletes who are not prepared for the increased physical demands of college athletics have the greatest risk for developing stress fractures compared to other academic classes. As of yet however, there have been very few studies that have examined the interaction of different variables such as academic class, on the formation of stress fractures. Therefore, the purpose of this study was to look at the incidence, frequency and pattern of stress fractures among the female athletes at Virginia Polytechnic Institute and State University. A retrospective analysis of 28 injury cases over four years revealed that 67% of the injuries occurred in freshmen athletes. The majority of these were in the lower leg and occurred in mid-season rather than pre-season. There were no relationships found between the variables sport, class, site and season and thus it was concluded that the incidence of injury was not affected by the interaction of these variables. However, the variables themselves did influence the formation of stress fractures. Ultimately, this study provided insight on what factors should be carefully examined in order to prevent future stress fracture injuries in collegiate athletes.Master of Science
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Luhr, Owe. "Acute lung injury : incidence and predictors of outcome with special reference to inhaled nitric oxide /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3456-8/.
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Hodgson, Phillips Lisa. "The role of ground conditions in the increased incidence of injury in summer rugby league." Thesis, University of Nottingham, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.342499.
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Singh, Nanak. "Incidence and pathogenesis of acute lung injury and the acute respiratory distress syndrome in humans." Thesis, University of East Anglia, 2013. https://ueaeprints.uea.ac.uk/48050/.
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Acute lung injury (ALI) and it’s more severe form, acute respiratory distress syndrome (ARDS), are conditions characterised by neutrophilic pulmonary inflammation, refractory hypoxaemia and diffuse alveolar damage. This work reports on the first UK based prospective study of the incidence and longer term mortality of ALI/ARDS in a general intensive care unit. Results reveal significant under recognition of this condition, which occurred in 12.5% of the ICU population (n=344). Hospital and 2 year mortality rates were 50-55% and 58-61% respectively. Neutrophils are central in the pathogenesis of ALI/ARDS. Neutrophil priming, a reversible process whereby the response of neutrophils to an activating stimulus is up-regulated by prior exposure to a priming agent, is a pre-requisite for neutrophil-mediated tissue damage. Comparisons of the trans-pulmonary gradient of several markers of neutrophil priming were made in different patient groups. Patients with sepsis but healthy lungs (n=6) were found to have a positive trans-pulmonary gradient with respect to neutrophil expression of CD62L, suggesting that CD62L ‘low’ (primed) neutrophils are being de-primed in the pulmonary circulation. In patients with ARDS this gradient was reversed, suggesting that neutrophils are being primed within the lung. This leads to the novel hypothesis that, in conditions such as sepsis, neutrophils primed systemically may be held in the pulmonary capillary bed and there allowed to de-prime, before being released in a quiescent state. Failure of this process may allow net accumulation of primed neutrophils in the lung with consequent lung injury. Currently there are no effective pharmacological therapies for ALI/ARDS, which is compounded by the relative lack of human models. An 18 month, prospective study of the incidence of ALI/ARDS post oesophagectomy revealed an incidence of 31% and suggested intra-operative one lung ventilation as a causative factor. Hence, patients undergoing oesophagectomy present an attractive model for future ALI/ARDS research.
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Jones, Lauren Margaret. "Data Analysis Techniques Using National Hospital Datasets To Estimate Incidence Of Traumatic Spinal Cord Injury." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/14012.
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Objective: To develop an analysis technique using national hospital discharge data to estimate incidence rates of people hospitalised following acute traumatic spinal cord injury (TSCI). Method: Exploratory data analysis techniques and a logical decision process were applied to select the incident admission of people hospitalised with a TSCI in Australia and New Zealand between 1999/00 and 2004/05 (six years of discharge data were analysed to produce five years of estimates). The incident admission was the most acute episode of care selected from a series of episodes for each person represented in the data. Datasets were evaluated to ensure suitable coverage and accessibility of content for the descriptive study. The datasets from Australia and New Zealand had the same clinical content but only New Zealand had an episode-matching variable and the application (order) of the algorithms was changed to adjust for the different data structures. Results: In New Zealand, for the five years of complete admission data (1999/00 to 2003/04) the crude incidence estimates ranged from 27 to 32 per million of population for people hospitalised with a TSCI. In Australia, for the same five years, the crude incidence estimates ranged from 19 to 21 per million of population. Comparison of the estimated rates of TSCI, using age, sex standardisation based on the conditional likelihood test showed the relative risk of reported TSCI in New Zealand was 1.6 times higher than for people in Australia (RR=1.59). Conclusion: TSCI is a small volume, high cost, and catastrophic event with far reaching effects on the person, their family, and society. The identification of new cases was possible because of reasonably consistent national/international standards of practice, representative population coverage (with virtually all people who sustain a TSCI included in national hospital discharge datasets) and standardised clinical data content and disease classification coding practices.
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PIGGOTT, Benjamin, and ben_piggott@yahoo com. "The relationship between training load and incidence of injury and illness over a pre-season at an Australian Football League Club." Edith Cowan University. Computing, Health And Science: School Of Exercise, Biomedical & Health Science, 2008. http://adt.ecu.edu.au/adt-public/adt-ECU2008.0018.html.
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In any competitive sporting environment, it is crucial to a team's success to have the maximum number of their players free from injury and illness and available for selection in as many games as possible throughout the season. The training programme of the club, and therefore training load, can have an impact on the incidence of injury and illness amongst the players. The purpose of this study was to investigate the relationship between the training load and the incidence of injury and illness over an entire pre-season at an Australian Football League (AFL) club. Sixteen players were subjects; all full time professional male AFL players (mean + or - standard deviation; age 23.8 + or - 5.1 years; height 188.9 + or - 7.4 m; weight 90.9 + or - 9.2 kg). A longitudinal research design was employed, where training load, injury and illness were monitored over a 15 week pre-season and Pearson Correlation Coefficients were used to examine relationships.
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D, Costa Punam. "Incidence, severity and time course of pressure injuries over the first two years following discharge from hospital in people with spinal cord injuries in Bangladesh." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29427.
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Pressure injuries are a common complication of spinal cord injury (SCI) particularly following discharge from hospital. They are believed to be more prevalent in low-and-middle-income countries (LMICs) than high-income countries (HICs). Pressure injuries are a leading cause of premature death particularly in LMICs. Despite the problems pressure injuries pose for people with SCI in LMICs, there are few accurate data about the incidence and severity of pressure injuries from these countries: the focus of my thesis.
My thesis includes a cohort study that was embedded in a clinical trial. One hundred and eighty-six participants were contacted by telephone 39 times and assessed in person 4 to 6 times over the two years following discharge as part of the cohort study. At each point of contact the presence and severity of pressure injuries were determined using the Pressure Ulcer Scale for Healing (PUSH). Survival analyses were done to determine the time course of development of pressure injuries and recovery from pressure injuries. Lasso regression was used to construct multivariate prediction models.
Seventy-seven participants (41%; 95% CI 34% to 49%) developed at least one pressure injury, 21 participants (11%) developed two pressure injuries, and 18 participants (10%) developed three or more pressure injuries in the first two years after discharge. The incidence rate was 0.27 per person-year (95% CI 0.22 to 0.34). Most pressure injuries were on the sacrum (23%). Pressure injuries took a median (interquartile range, IQR) of 40 days (29 to 57) days to heal. The median peak PUSH score was 11/17 (8 to 13.5). The multivariate prediction models had poor predictive properties (maximum c-statistic 0.75).
My study proves that pressure injuries are still a very common and severe complication of SCI in LMICs like Bangladesh. Interestingly, it is very difficult to predict who are likely to develop pressure injuries at the time of discharge from hospital.
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Piggott, Benjamin. "The relationship between training load and incidence of injury and illness over a pre-season at an Australian Football League Club." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2008. https://ro.ecu.edu.au/theses/25.
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In any competitive sporting environment, it is crucial to a team's success to have the maximum number of their players free from injury and illness and available for selection in as many games as possible throughout the season. The training programme of the club, and therefore training load, can have an impact on the incidence of injury and illness amongst the players. The purpose of this study was to investigate the relationship between the training load and the incidence of injury and illness over an entire pre-season at an Australian Football League (AFL) club. Sixteen players were subjects; all full time professional male AFL players (mean + or - standard deviation; age 23.8 + or - 5.1 years; height 188.9 + or - 7.4 m; weight 90.9 + or - 9.2 kg). A longitudinal research design was employed, where training load, injury and illness were monitored over a 15 week pre-season and Pearson Correlation Coefficients were used to examine relationships.
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Paulsen, Carrie. "Incidence and nature of complications post primary repair of Obstetric Anal Sphincter Injury (OASI): Retrospective chart review." Master's thesis, Faculty of Health Sciences, 2019. https://hdl.handle.net/11427/31687.
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Background. A multitude of data exists regarding global incidence of OASI as well as its contributing factors and complications. Little to no data exists regarding the incidence of OASI or its complications and the nature of these complications within South Africa. Objective. To describe the rate and nature of complications of OASI that occur within 6 weeks following primary repair of an OASI, followed up at the GSH perineal clinic. Secondarily, to investigate the incidence of OASI and follow up rate post primary repair Methods. This was a retrospective chart review. Participants were identified from theatre record books between January 2014 and December 2015. The charts of those that attended the perineal clinic follow up were reviewed and complications and possible associated risk factors were identified from the clinical notes. Primary aims were to identify the incidence and nature of complications seen in this population as well as possible related risk factors. The secondary aims were to determine the incidence of OASI and follow up rate for complication following primary OASI repair. Results. The mean age of participants was 25.85 years with a mean body mass index of 25.15kg/m2 . The mean birthweight seen was 3382.05 grams. Constipation (10.87%), pain with defaecation (11.96%) and anal incontinence (10.87%) were the most frequently reported complications. Wound infection was found on examination in 3.26% of participants and wound dehiscence was seen in 6.67%. Incidence of OASI in this study group was 8.64 per 1000 vaginal deliveries. The follow up rate of these participants was 26.20%. A total of 374 OASI were repaired within this region during the study period. Only 97 of these attended follow up, for which 93 folders were available to be included in analysis Conclusion. The Incidence of OASI in this Western Cape region is within the range seen worldwide but the proportion of complications seem to be less than global data suggests despite adverse conditions, theatre delays and the fact that repairs were mostly performed by specialists in training. It was not possible to identify any relationship with possible associated factors. There is a very poor follow up rate within this community which needs to be explored and systems need to be put in place to ensure all participants are given the opportunity of follow up.
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Terblanche, Henri-Charl. "The influence of a intense training program on hypermobility and correlation between hypermobility and incidence of injury." Diss., University of Pretoria, 2015. http://hdl.handle.net/2263/53047.
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Joint hypermobility (JH) in its various forms is in many ways misinterpreted and underdiagnosed. As a symptom of heritable disorders of connective tissue (HDCT), it is well known, whilst understanding around JH as a non-symptomatic occurrence in physically active populations is vague at best. With literature suggesting associations between JH and musculoskeletal injury (MSI), an inherent risk for populations undergoing intense physical training (PT) is implied. This dissertation set out to shed light on the incidence of hypermobility in a South African context, whilst seeking to clarify the implications of JH on intense PT and vice versa. The research was conducted by employing an in depth literature review on the broad spectrum of physiological factors linked to hypermobility, along with three comprehensive scientific studies which answered definitive questions relating to the paper s main research objectives.
In investigating the causative factors of JH, literature indicated congenital amino-acid substitutions in collagen synthesis which compromises the molecular nano-mechanics of connective tissues, thus negating the structural integrity of collagen containing compounds such as tendons, ligaments, joint capsules, skin, demineralised bone and nerve receptors. This concept, along with current thinking which suggests that the shape of bones and low muscle tone may also contribute to hypermobility, clearly indicates compromised joint biomechanics in hypermobile individuals. A commonly linked neurologic factor of hypermobility i.e. diminished joint proprioceptive acuity, lead to our proposed concept of a closed cycle of causative vs. symptomatic factors, which perpetuates abnormal articular biomechanics. The initial study which sought to investigate the incidence rates of hypermobility in the general South African population, employed a cross-sectional research approach with a sample population of 480 individuals from four wide-spread geographical areas. Individuals were tested for JH according to the Beighton nine-point hypermobility score with a diagnostic criteria of 4/9 or greater. Results indicated a 26.19% overall incidence of JH, with sex specific totals showing a 36.41% incidence for females compared to 13.96% for males. Thus concurring with contemporary studies indicating a significantly high prevalence of JH in the general population.
The second study which concerned the interactions between muscular component and hypermobility, correlated Beighton nine-point hypermobility scores and lean body mass (LBM) at three intervals during a 20 week intense training intervention period in a military sample. Linear regressions indicated a significant correlation between increased LBM and associated decreases in hypermobility, even though hypermobility peaked after 12 weeks of intense exercise. We proposed that the hypermobility peak leading up to week 12 can be clarified by initial training induced generalized flexibility, neural adaptation of exercise which increases ROM amongst other factors.
In aiming to clarify one of the most prevalent discussions in hypermobility research i.e. the association between JH and MSI, the final study compared MSI incidences between hypermobile and non-hypermobile individuals who endured 20 weeks of intense military basic training protocols. Odds ratios indicated that hypermobile individuals are 1.8 times more likely to sustain MSI when undergoing intense physical activity. Chi-square tests indicated a marginal, though significant association between JH and MSI. Ulterior results showed increased MSI prevalence amongst females as well as no significant difference in MSI location distribution amongst the hypermobile and control groups.
In considering all our findings we concluded that JH is an underdiagnosed common occurrence in the South African general population. The congenital influences on connective tissue development in hypermobile individuals sufficiently undermines musculoskeletal integrity to the extent where they are susceptible to increased risk of injury when participating in intense physical activity. These debilitating mechanisms can however be counteracted by the implementation of specific exercises promoting joint stabilization, proprioceptive acuity and increased muscular component.Dissertation (MSc)--University of Pretoria, 2015.
Physiology
MSc
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Schweim, Jarrett Joshua. "Do any of a set of Lower Extremity Functional Assessment tests predict in the incidence of injury among a Cohort of collegiate freshmen football players? A Pilot Study." Columbus, Ohio : Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1243851951.
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Goldsmith, Helen Anna. "The Incidence, Impact and Experience of Pain in Recently Discharged Adult Trauma Patients: A Convergent Parallel Mixed Methods Study." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/17974.
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Introduction Despite being given ‘take-home’ analgesics and hospital discharge information, trauma patients frequently report pain at moderate to severe levels at home. Patients who have inadequate pain relief following injury can experience a delayed return to work, psychological stress, disability and chronic pain. Aim The aim of this thesis was to investigate the pain and pain management experiences of recently discharged adult trauma patients and to generate evidence to inform future interventions to improve pain management in this population. Methods A convergent parallel mixed methods study was conducted. Eighty-two participants completed questionnaires, medical records were reviewed and 12 semi-structured interviews were performed. Descriptive statistics were used for quantitative data analysis. Qualitative data were thematically analysed. Quantitative and qualitative data were then integrated to produce greater understanding of, and explanation for, the pain management practices of recently discharged adult trauma patients and to inform the recommendations from this research. Results The mean age of participants was 52 years (SD = 19.8), of which 54 (66%) were males. Approximately half of the participants (n = 43, 52%) had an Injury Severity Score (ISS) < 9, with two or three body regions typically injured. Participants were seen in the trauma outpatient clinic 16 days (IQR 14 − 23) after hospital discharge, with the majority of them reporting pain since discharge (n = 80, 98%). Injury pain was common, intense and debilitating and hospital discharge information and ‘take-home’ analgesics were inadequate. The trauma patients wanted to manage their pain independently at home; however, without sufficient knowledge or understanding about their injury trajectory and pain management, they did not have the confidence to do so. Conclusion Improved hospital discharge processes and specific injury discharge information and education are recommended to enhance the trauma patient’s understanding of the injury trajectory and their pain management practices. Better organisational processes, and information and education about pain and injury could facilitate the appropriate use of analgesics at home and improve the management of injury related pain.
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O'Loughlin, Jennifer. "The incidence and risk factors for falls and fall-related injury among elderly persons living in the community /." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=70260.
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To determine the frequency of and risk factors for falls and fall-related injury, a one-year prospective follow-up study of 417 community-dwelling persons aged 65 years or older was conducted. Following an initial at-home interview, each subject was telephoned every four weeks for 48 weeks to collect data on falls experienced since the last contact. Data were also collected on exposures which could fluctuate over time. The response rate to the initial interview was 75%, and 90% or more of study participants completed each of the 12 follow-up interviews. Twenty-nine percent of subjects fell during follow-up; 61% of fallers fell once and 39% fell two or more times. The majority of falls resulted in no injury or in minor injury only. A total of 28 independent predictors of falls and fall-related injury were identified in multiple logistic-regression analyses. These included a wide range of sociodemographic, lifestyle and health characteristics, and reflect the multifactorial and complex etiology of falls in the elderly. The strongest predictors of increased fall and fall-injury rates were similar for falls and fall-related injury, and included dissatisfaction with health, dissatisfaction with social life and dizziness.
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Opperman, Roedolph A. (Roedolph Adriaan). "Astronaut Extravehicular Activity : safety, injury & countermeasures; &, Orbital collisions & space debris : incidence, impact & international policy." Thesis, Massachusetts Institute of Technology, 2010. http://hdl.handle.net/1721.1/62498.
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Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Aeronautics and Astronautics; and, (S.M. in Technology and Policy)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2010.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 155-161).
Extravehicular Activity (EVA) spacesuits are a key enabling technology which allow astronauts to survive and work in the harsh environment of space. Of the entire spacesuit, the gloves may perhaps be considered the most difficult engineering design issue. A significant number of astronauts sustain hand and shoulder injuries during extravehicular activity (EVA) training and operations. In extreme cases these injuries lead to fingernail delamination (onycholysis) or rotator cuff tears and require medical or surgical intervention. In an effort to better understand the causal mechanisms of injury, a study consisting of modeling, statistical and experimental analyses was performed in section I of this thesis. A cursory musculoskeletal modeling tool was developed for use in comparing various spacesuit hard upper torso designs. The modeling effort focuses on optimizing comfort and range of motion of the shoulder joint within the suit. The statistical analysis investigated correlations between the anthropometrics of the hand and susceptibility to injury. A database of 192 male crewmembers' injury records and anthropometrics was sourced from NASA's Johnson Space Center. Hand circumference and width of the metacarpophalangeal (MCP) joint were found to be significantly associated with injuries by the Kruskal-Wallis test. Experimental testing was conducted to characterize skin blood flow and contact pressure inside the glove. This was done as part of NASA's effort to evaluate a hypothesis that fingernail delamination is caused by decreasing blood flow in the finger tips due to compression of the skin inside the extravehicular mobility unit (EMU) glove. The initial investigation consisted of a series of skin blood flow and contact pressure tests of the bare finger, and showed that blood flow decreased to approximately 60% of baseline value with increasing force, however, this occurred more rapidly for finger pads (4N) than for finger tips (ION). A gripping test of a pressure bulb using the bare hand was also performed at a moderate pressure of 13.33kPa (100mmHg) and at a high pressure of 26.66kPa (200mmHg), and showed that blood flow decreased 50% and 45%, respectively. Excessive hyperperfusion was observed for all tests following contact force or pressure, which may also contribute to the onset of delamination. Preliminary data from gripping tests inside the EMU glove in a hypobaric chamber at NASA's Johnson Space Center show that skin blood flow decreased by 45% and 40% when gripping at 3 moderate and high pressures, respectively. These tests show that finger skin blood flow is significantly altered by contact force/pressure, and that occlusion is more sensitive when it is applied to the finger pad than the finger tip. Our results indicate that the pressure on the finger pads required to articulate stiff gloves is more likely to impact blood flow than the pressure on the fingertips associated with tight or ill-fitting gloves. Improving the flexibility of the gloves will therefore not only benefit operational performance, but may also be an effective approach in reducing the incidence of finger injury. Space Policy Abstract EVA injury is only one of many dangers astronauts face in the extreme environment of space. Orbital debris presents a significant threat to astronaut safety and is a growing cause of concern. Since the dawn of satellites in the early 1950's, space debris from intentionally exploded spacecraft, dead satellites, and on-orbit collisions has significantly increased and currently outnumbers operational space hardware. Adding to this phenomenon, the advent of commercial spaceflight and the recent space activities in China and India to establish themselves as spacefairing nations are bound to accelerate the rate of space debris accumulating in low Earth orbit, thus, exacerbating the problem. The policies regulating orbital debris were drafted in the 1960s and 1970s and fail to effectively address the dynamic nature of the debris problem. These policies are not legally enforced under international law and implementation is entirely voluntary. Space debris is a relevant issue in international space cooperation. Unless regulated, some projections indicate space debris will reach a point of critical density, after which the debris will grow exponentially, as more fragments are generated by collisions than are removed by atmospheric drag. Space debris proliferation negatively impacts human spaceflight safety, presents a hazard to orbiting space assets, and may lead to portions of near-Earth orbit becoming inaccessible, thus limiting mission operations. The aim of this research effort was to review current international space policy, legislation and mitigation strategies in light of two recent orbital collision episodes. The first is the February 2009 collision between a defunct Russian Cosmos spacecraft and a commercial Iridium satellite. The second is China's display of technological prowess during the January 2007 intentional demolition of its inactive Fengyun-IC weather satellite using a SC-19 antisatellite (ASAT) missile. In each case the stakeholders, politics, policies, and consequences of the collision are analyzed. The results of this analysis as well as recommendations for alternative mitigation and regulatory strategies are presented.
by Roedolph A. Opperman.
S.M.in Technology and Policy
S.M.
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Marsh, Jarred. "Injury incidence and severity at the South African Rugby Union (SARU) Youth Weeks Tournaments: a four year study." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29198.
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Introduction
Rugby Union (hereinafter referred to as ‘rugby’) is a contact sport with players being exposed to repetitive collisions throughout a match. As the risk of injury is relatively high, incidence surveillance studies within rugby has become popular. However most of the studies have focussed on senior players. The data on injuries among youth rugby players are limited. This makes it difficult to develop the game to make it safer for youth of all ages.
Objectives
The first objective of this study was to establish if any injury trends exist across different ages of youth rugby players (13 to 18 years). The second objective was to determine the patterns of injuries changed over four years (2011 to 2014).
Methods
The South African Rugby Union (SA Rugby) hosts four local youth tournaments annually to for local rugby talent: Craven Week under-13, Grant Khomo under-16, Academy Week under-18 and Craven Week under-18. Injury data were collected from the four SARU Youth Week Tournaments between 2011 and 2014. These data were compiled into one central SARU injury surveillance database. Injury categories were used to group data: ‘Type’, ‘Location’, ‘Event’ and ‘Severity’ of injury were assessed. Injuries were defined as either ‘Time-loss’ (those injuries that prevented a player from match participation for one or more days), or ‘Medical attention’ (injuries that required the player to seek medical attention at the time of or after injury but were not required to miss a match). Injury rates were represented by injury incidence densities (IIDs) (corresponding 95% confidence intervals (95% CIs) for IID were calculated for the number of injuries regardless of whether one person was injured more than once) per 1000 hours of match play. Incidence densities were considered to be significantly different from each other if their 95% CIs did not overlap and using Poisson regression analysis.
Results
The ‘overall’ combined IID across all four years was 54.6 injuries per 1000 hours of match play (95%CI: 51.0-58.2). The combined ‘time-loss’ IID was 18.9 injuries per 1000 hours of match play (95%CI: 16.8-21.0). ‘Time-loss’ injuries were greatest in 2011 (23.2 per 1000 match hours (95% CI: 18.5-28.0)). However, ‘time-loss’ injuries rates were significantly reduced in 2013, when compared to these injury rates in 2011 (13.3 (9.7-17.0). Craven Week under-13 presented significantly greater ‘overall’ injury incidence densities when compared to the older age groups (71.9 per 1000 match hours (95% CI: 62.4-81.4)). Overall, joint/ligament/tendon injuries were most common ‘overall’ and ‘time-loss’ injury sustained by players between 2011 and 2014 (30% and 33% respectively). This was followed closely by concussion injuries, which accounted for 29% of ‘time-loss’ and 12% of ‘overall’ injuries. A large proportion of both ‘overall’ (57%) and ‘time-loss’ (55%) injuries occurred during the tackle event, with the tackler being injured more often than the ball-carrier (37% and 18% respectively). However, there were no statistically significant differences when comparing ‘overall’ and ‘time-loss’ IID between the different tournaments from 2011 until 2014.
Discussion
Significant differences were found when comparing ‘overall’ and ‘time-loss’ IID between the different tournaments from 2011 until 2014. Craven Week under-13 presented significantly greater ‘overall’ injury incidence densities. This finding contradicts previous literature within youth rugby research. The tackle (combination of tackler and ball-carrier) still accounts for the highest proportion both ‘time-loss’ and ‘overall’ injury events (57% and 55% respectively). This is in accordance with previous studies. However, a point of concern was that concussion accounted for 29% of all ‘time-loss’ injuries and 12% of all ‘overall’ injuries. This finding suggests a gradual increase in the number of concussions suffered during the SARU Youth Week Tournaments between 2011 and 2014. Further research is required to determine the reason for this pattern.
Conclusion
Further research within youth rugby cohorts is required to determine the risk associated with involvement at various level of participation. Injury prevention programs should place focus on reducing the prevalence of concussion at youth level by educating players and coaches about safe tackle techniques. Future studies should focus on local youth cohorts for seasonal
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Marshall, Charlene. "Minimalist versus conventional running shoes : effects on lower limb injury incidence, pain and muscle function experienced distance runners." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/3019.
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Includes abstract.Includes bibliographical references.
The aim of this randomised clinical trial over 12 weeks was to determine if the gradual transition (accompanied by calf muscle training), from conventional to minimalist running shoes 1) increased the risk of lower limb pain or injury and 2) improved lower limb muscle function (endurance, flexibility and power) in experienced distance runners. In addition, the effects of the transition on runner satisfaction were studied. To determine whether there were significant differences in lower limb injury incidence and pain, calf endurance, lower limb muscle flexibility, lower limb muscle power, footposture index, hallux ROM and participants’ satisfaction with the type of running shoes and performance between an experimental group, that ran in minimalist shoes, and a control group that ran in conventional shoes. (b) To determine whether there were significant differences in lower limb injury incidence and pain, calf endurance, lower limb muscle flexibility, lower limb muscle power, foot posture index, hallux ROM and participants’ satisfaction with the type of running shoes and performance between groups over time.
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Calligeris, Theodore. "The incidence of injury and exposure times of footballers playing in a professional football club in the PS." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/10187.
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Includes bibliographical references.Several studies on European players at the elite or professional level have shown a high risk of injury. However, the studies used different data collection methods, making it difficult to compare results. This suggested a need to standardise the definition of an injury and method of data collection. There are no data on injuries associated with football in South Africa, which makes it difficult to develop an evidence-based strategy to manage injuries associated with football. Therefore, in an attempt to address the deficiency on soccer related injuries in South Africa, a Professional Soccer League (PSL) team (AJAX CT) was monitored throughout the season by the medical support staff of the team using the F-MARC data collection system devised by FIFA. The main objective of this study was to undertake a retrospective epidemiological study documenting the incidence of injury in this team and the exposure time (practice and match) of the players over a full season.
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Newcombe, Virginia Felicity Jane. "Using diffusion tensor imaging to demonstrate the incidence, temporal variations and clinical correlates of brain injury secondary to neurotrauma." Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611532.
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Senzilet, Linda Debra. "The impact of Ontario's child restraint legislation on the incidence, severity and patterns of injury in children under five years." Thesis, University of Ottawa (Canada), 1992. http://hdl.handle.net/10393/7698.
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In 1983, the Ontario government introduced legislation which mandated the restraint of all child passengers under 50 pounds in restraint systems appropriate to their weight. The efficacy of such restraint systems has been proven, and standards for their manufacture have been set by the government of Canada. The objectives of this study were to determine whether Ontario's child restraint legislation has resulted in significant and sustained reductions in the incidence and severity of injury, as well as changes in the anatomical patterns of fatal and non-fatal injury. Data sources included the Hospital Medical Records Institute (HMRI) and Transport Canada's Traffic Accident Information Data Bank (TRAID). The study used the interrupted time-series design and autoregressive integrated moving average (ARIMA) modelling to analyze a variety of rates and indicators calculated for children under 5, as well as for a control group of adults 20-44 years old. The study period encompassed five pre-law years and five post-law years, extending from 1979 to 1988. Results suggested that there were no significant changes in either the incidence, severity or anatomical patterns of injury in children covered by the legislation. Two possible explanations for the apparent lack of an intervention effect are that either the pre- to post-legislation increase in (proper) usage rates was not large enough, or that any positive effects of the law were too gradual to be detected. These conclusions are supported by evidence that there was a relatively high usage of child restraints prior to the legislation, and that rates of proper wearing of restraints did not exceed 50% in the years following implementation. Child restraint laws cannot achieve their objectives without a higher level of sustained compliance. Several means of achieving this objective are presently being implemented by the so-called "95 by 95" program, i.e., the National Occupant Restraint Program that is operating in all provinces, and whose stated goal is a 95% wearing rate of restraints in all age groups by the year 1995. (Abstract shortened by UMI.)
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Kinder, Jessica Marie. "The Relationship of Hip Muscle Activation and the Incidence of Shoulder Injury in Collegiate Women's Volleyball Athletes: A Pilot Study." Thesis, North Dakota State University, 2018. https://hdl.handle.net/10365/28776.
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Previous studies have indicated weak hip muscle activation in baseball pitchers leads to an increased incidence of shoulder injuries. This relationship, however, has not been explored in other overhead athletes, such as volleyball players. Surface electromyography (EMG) was used to evaluate each participant?s muscle activation during five dynamic activities. Dynamic activity was normalized according to MMTs for the rectus femoris, biceps femoris, gluteus maximus, and gluteus medius. The GMed during the eccentric box jump was statistically significant for position where setters showed the greatest activation and defensive players the least. The GMax during the single-leg deadlift was statistically significant for position where setters showed the greatest activation and defensive players the least. The hamstring showed statistically significant activation during the eccentric box jump where defensive players showed the highest activation and setters the least. The results should serve as a pilot study for future research due to the limited population.
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Winqvist, S. (Satu). "Alcohol misuse in relation to traumatic brain injury:the Northern Finland 1966 birth cohort study." Doctoral thesis, University of Oulu, 2008. http://urn.fi/urn:isbn:9789514287961.
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Abstract
Traumatic brain injury (TBI) is often the leading cause of death and the most common cause of permanent disability in children and young adults. The hospital admission rates as well as the incidence and mortality rates of TBI vary enormously in different countries and populations. Even though alcohol misuse is a well-known modifiable risk factor for TBI and other injuries, few studies have been carried out on drinking patterns in relation to TBI, alcohol's role in recurrent brain injuries as well as TBI in relation to alcohol use in children and adolescents.
The Northern Finland 1966 Birth Cohort was used to study the epidemiology and recurrence of TBI as well as alcohol use by children with TBI by the age of 14 years and those who sustained TBI later in life. The role of parents' alcohol misuse on children's TBI was also studied.
The incidence of TBI in the whole study population was 118/100 000 person-years (PY), and the pediatric incidence of TBI (children aged under 16 years) was 130/100 000 PY. Up to the age of 10 years, the occurrence of TBI did not differ by gender, but after that age, boys and men had a higher incidence compared to girls and women. Mortality from TBI in the whole study population was 14/100 000 PY. Parental alcohol misuse and male gender were significant risk factors for the occurrence of TBI in childhood. Drinking to intoxication at the age of 14 years was a more common habit of TBI subjects than controls, especially among girls. Frequent alcohol drinking and drunkenness reported at the age of 14 years as well as male gender were independent predictors of TBI later in life. An alcohol-related first TBI and urban place of birth were found to be significant risk factors for recurrent TBI. A significant positive correlation between first and recurrent TBIs with respect to alcohol involvement was observed.
Alcohol drinking and parental alcohol misuse should be recognized among children and adolescents with acute TBI. Because alcohol drinking predicts the recurrence of TBI, a brief intervention focused on drinking habits is needed as an immediate preventive measure.
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Alves, Ana Sofia Machado. "Estudo epidemiológico das lesões cervicais no futebol americano: revisão bibliográfica." Bachelor's thesis, [s.n.], 2021. http://hdl.handle.net/10284/10619.
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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaIntrodução: o futebol americano é um desporto dinâmico e de contacto, constituído por duas equipas, com 11 jogadores cada lado, uma que defende e outra que ataca. Por ser um jogo de grande contacto, ocorrem frequentemente lesões na cervical. Objetivo: verificar o tipo de lesões cervicais mais frequentes no futebol americano, assim como analisar o risco, a incidência e a severidade das mesmas. Metodologia: foi efetuada uma pesquisa nas bases de dados PubMed, PEDro e Web of Science para identificar estudos que abordassem lesões na cervical em atletas masculinos de futebol americano, integrados na National Football League ou National Collegiate Athletic Association ou High School Football, a partir do ano 2009 até 2021. Resultados: as lesões mais frequentemente referidas foram a lesão do plexo braquial e a dor/tensão cervical. Estas lesões ocorrem maioritariamente durante a temporada, e são causadas por contacto com outro jogador. Os jogadores que ocupam as posições line backer, defensive secondary, e running back foram os que sofreram um maior número de lesões. Constatou-se também que a maioria das lesões são primárias, na maioria das lesões necessitam apenas de uma paragem ou alteração do gesto desportivo de um tempo inferior a 24h, ou de 1 a 6 dias. Conclusão: Independentemente da época desportiva e do nível competitivo, parece existir um padrão lesivo no Futebol Americano.
Introduction: American Football is a dynamic and contact sport, made up of two teams, with 11 players on each side, one defending and the other attacking. As it is a great contact game, cervical injuries often occur. Aim: verify the most frequent type of cervical injuries in American football, as well as analyze their risk, incidence and severity. Metodology: a search was carried out in the PubMed, PEDro and Web of Science databases to identify studies that addressed cervical injuries in male American Football athletes, as part of the National Football League or National Collegiate Athletic Association or High School Football, from the year 2009 until 2021. Results: the most frequently reported injuries were brachial plexus injury and cervical pain/tension. These injuries mostly occur during the season, and are caused by contact with another player. The players who occupy the linebacker, defensive secondary and running back positions were the ones who suffered the greatest number of injuries. It was also found that most injuries are primary, in most injuries they only require a stop or change in the sporting gesture for a period of less than 24 hours, or 1 to 6 days. Conclusion: Regardless of the sporting season and competitive level, there seems to be a harmful pattern in American Football.
N/A
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Smith, Tanya. "Injury risk assessment and the incidence of musculo-skeletal injuries in recreational long-distance runners over a 3-month training period." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27235.
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Background: Long distance road running is continually growing as competitive and recreational sport, globally. Despite its popularity, a high burden of incidence of injury exists among runners. Previous research has focussed on specific injuries, whereas others have investigated isolated risk factors that may contribute to running related injuries. The purpose of the study is to determine possible internal and external screening variables that may predict the incidence of running-related injuries in general. Methods: Forty one recreational runners participated in an observational study over the course of 12 weeks. Screening assessments consisted of injury history, training history, and anthropometric measurements. Functional and performance assessments included the Foot Posture Index (FPI), the Functional Movement Screen (FMS), vertical jump, single leg hop and sit-and-reach tests. Participants were monitored over a period of 12 weeks by completing a weekly online logbook regarding their training and possible incidence of injury. Monitoring was terminated after 12 weeks of observation. Differences between injured and non-injured runners were determined using Independent -T-tests for mean differences, or Mann-Whitney U Test for distributional differences (non-parametric data). Binomial Logistic regression models were used to determine the influence of internal, external functional and external behavioural factors on the risk for running injury, respectively. Results: The total group revealed a cumulative incidence of injury of 63% over the 12 weeks of observation. There was no gender difference between incidences of injuries over the 12 week observation training period (OTP). Injured runners achieved a higher total FMS score (median = 16, Interquartile Range = 3) compared to uninjured runners (median = 15, Interquartile range = 3; p = 0.006). Binomial logistic regression models of external functional (FMS, Vertical Jump, Sit-and-Reach scores) factors [X² (3) = 9.764, p = 0.021] were statistically significant. Only the FMS score contributed significantly to the incidence of injury (p = 0.013) of the three external functional factors in the Regression Model. Discussion and Conclusion: The study adds to current evidence that the assessment of the Functional Movement Screen is important in predicting injury, however, the present study shows that a higher score obtained during the FMS increase your odds to sustain an injury. The study is in contrast with the body of evidence that the incidence of previous injury is the strongest predictor of the incidence of a current injury. The study concluded that the Functional Movement Screen is a useful screening tool to determine a long distance runner's risk for running-related injuries and should be included in health-injury risk assessments of recreational runners.
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Pinto, Samuel Amorim Pereira. "Prevalência lesiva do guarda-redes no futebol: revisão bibliográfica." Bachelor's thesis, [s.n.], 2021. http://hdl.handle.net/10284/10640.
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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em FisioterapiaObjetivo: obter um maior conhecimento sobre a prevalência de lesões em guarda-redes de futebol. Metodologia: a pesquisa computorizada foi realizada na base de dados PubMed, Web of Science e EBSCOhost. A análise metodológica dos artigos selecionados foi feita com base na Checklist for Prevalence Studies. Resultados: um total de 5 estudos foram incluídos nesta revisão, respeitando os critérios de seleção com um número interveniente de 124 guarda-redes de futebol, do sexo masculino, de diferentes nacionalidades, Turquia, Polónia, Nigéria e Brasil, com idades compreendidas entre 12 e 29 anos. A região anatómica mais comumente atingida foi o joelho (variando de 12% a 45.4%), seguida pelo pé (de 18.2% a 23.9%), enquanto o tipo de lesão mais frequente foram as contusões (63.6%) e fraturas (de 1.2% a 50%). A severidade foi abordada por apenas um estudo em que todas as lesões foram mínimas. Na taxa lesiva em que um artigo abordou a mesma em treinos e jogos (6,48/1000 horas) e outro apenas em jogos (8,33/1000h). Conclusão: o perfil lesivo dos guarda-redes não é consensual, mas o local de lesão mais comum é o joelho e o tipo é a contusão. São necessários mais estudos epidemiológicos para estimar com maior precisão a incidência e taxa lesiva.
N/A
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Tibério, Lígia Isabel Moura. "Crianças Seguras, Famílias Felizes!: Lesões não intencionais numa região do Alentejo em crianças até aos 4 anos de idade." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2019. http://hdl.handle.net/10400.26/29332.
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Mestrado em Enfermagem, Área de especialização: Enfermagem Saúde Infantil e PediátricaAs lesões não intencionais nas crianças representam um problema de saúde pública, estando entre as principais causas de morte, incapacidade e internamento, sendo essen-cial a implementação e gestão de ambientes seguros. Ao longo do presente relatório explanamos as experiências mobilizadas para a aquisição de Competências de Enfermeiro Especialista em Enfermagem de Saúde Infan-til e Pediátrica e de Mestre através das atividades desenvolvidas nos diferentes contex-tos de estágio e pela realização do Projeto de Intervenção. O Projeto de Intervenção transversal aos diferentes contextos práticos pretendeu ‘Contribuir para a segurança das crianças até aos 4 anos de idade, no que respeita às lesões não intencionais, numa região do Alentejo’. Possibilitou-nos a transmissão dos números associados às lesões não intencionais nas crianças até aos 4 anos de idade, sen-sibilizar os profissionais de enfermagem para a importância dos cuidados antecipatórios e otimizar estratégias para a promoção de ambientes seguros.
Unintentional injuries in children represent a public health problem, being among the main causes of death, disability and hospitalization, and the implementation and management of safe environments is essential. Throughout the present report, we explain the experiences mobilized for the acquisition of Nursing Specialist Skills in Infantile and Pediatric and Master's Health Nursing through the activities developed in the different practical contexts and through the Intervention Project. The Intervention Project transversal to the different practical contexts was intended to 'Contribute to the safety of children up to 4 years of age with regard to unintentional injuries in a region of Alentejo'. It has enabled us to transmit the numbers associated with unintentional injuries in children up to 4 years of age, to sensitize nursing professionals to the importance of anticipatory care and to optimize strategies for the promotion of safe environments.
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Cenenkienė, Regina. "Medicinos darbuotojų profesiniai biologiniai rizikos veiksniai." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2007. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2007~D_20070803.112554-92008.
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Medicinos darbuotojai dėl kasdieninio kontakto su žmogaus organizmo skysčiais priskiriami didžiausios biologinių veiksnių rizikos grupei. Incidentų – mikrotraumų ir ekspozicijos krauju, rizika yra susijusi su kraujo keliu plintančiomis infekcijomis (HBV, HCV, ŽIV).
Darbo tikslas: Nustatyti medicinos darbuotojų profesinių biologinių veiksnių riziką ir paplitimą Kauno medicinos universiteto klinikų chirurgijos profilio skyriuose.
Tyrimo metodika. Vykdytas retrospektyvinis tyrimas 2006 m. 1-6 mėnesių, duomenys rinkti Kauno medicinos universiteto klinikų chirurgijos profilio skyriuose. Atlikta anketinė apklausa. Išdalintos 347 anoniminės anketos, atsako dažnis 89,6 % (311). Statistiniam duomenų apdorojimui naudotas SPSS 11.0 programinis paketas.
Rezultatai. 64,5% respondentų patyrė mikrotraumą, 71,1 % – ekspoziciją biologiniais skysčiais, mikrotraumą, ir ekspoziciją patyrė 39,6% darbuotojų. Visais mikrotraumų atvejais buvo sužeistos rankos, ekspozicijų metu 63% respondentų apsitaškė sveiką odą, 20% – akis. Dažniausiai darbuotojai apsitaškė krauju (60%). Gydytojai mikrotraum��� dažniausiai patyrė operacijų metu (79,3%), slaugytojos – apruošdamos instrumentus (35,1%), pagalbiniai darbuotojai – tvarkydami atliekas (75,8%). Gydytojai dažniausiai susižeidė chirurgine adata (72,4%), slaugytojos – injekcine adata (72,4%), pagalbiniai darbuotojai – stiklu (60,6%). 86% respondentų nebuvo pasiskiepiję HB vakcina. Mikrotraumų metu 14,5%, ekspozicijų metu 5% respondentų asmeninių apsaugos... [toliau žr. visą tekstą]The health care workers are attributed to the highest biological factors risk group, as they daily come into contact with fluids of human body. Risk of incidents – sharps injuries and blood exposure – is related to the infections, spread by blood (HBV, HCV, HIV). Aim of the study. Determine the professional biological risk factors for health care workers and their incidence in the surgical departments of Kaunas Medical University Hospital. Methods. Retrospective study of 1-6 months of year 2006 was performed; data was collected in the surgical departments of Kaunas Medical University Hospital. Anonymous questionnaire survey was performed. 347 questionnaires were distributed; rate of response was 89.6% (311). SPSS 11.0 software was used for statistical data processing. Results. 64.5% of respondents had experienced sharps injury, 71.1% were exposed to the biological fluids, and 39.6% of workers had experienced the injury and the exposure. The hands were injured during all the sharps injury cases; 63% of respondents were drabbled by blood on the healthy skin and 20 % were drabbled into the eyes during the blood exposure. In most cases worker were drabbled by blood (60%). Physicians mostly experience the sharps injury during the surgery (79.3%), nurses – during the preparation of instruments (35.1%), supporting staff – disposing the waste (75.8%). Commonly physicians were injured by the surgical needle (72.4%), nurses – by needlestick (72.4%), and the supporting staff – by glass... [to full text]
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Öberg, Koivumaa Alex, and William Wikström. "Skadeförekomsten på Sveriges alpina skidgymnasium : En enkätstudie om skadeförekomst på svenska idrottsstudenter." Thesis, Umeå universitet, Avdelningen för idrottsmedicin, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-184893.
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Introduktion Alpin skidåkning är en populär men skadedrabbad vinteridrott som varit en olympisk gren sedan 1936. Idrotten består av fyra grenar: Slalom, Storslalom, Super-G och Störtlopp. I Sverige finns det möjlighet för ungdomar att specialisera sig inom sin idrott i samband med gymnasiet, där de kan kombinera studier med idrott. Allvarliga skador har visats påverka individuella idrottares rankingpoäng och karriärer. Syftet med denna studie var dels att undersöka skadeförekomsten mellan årskurser och kön vid Sveriges alpina skidgymnasium och dels vilken typ av skada som var mest förekommande. Metod En enkät skickades ut till sammanlagt 116 elever vid Sveriges alpina skidgymnasium varav 87 av dessa (40 män respektive 47 kvinnor i åldern 16–20 år) valde att delta i studien. Resultat Resultatet av enkätundersökningen visar att 64 % av skadorna i studien rapporterades av kvinnor och 36 % rapporterades av män. Studien visade en låg skillnad i träningsmängd och sömn mellan män och kvinnor. Av totalt 53 akuta och belastningsrelaterade skador var 40 % ryggskador. Av alla svarande uppgav 53 % att de någon gång under nuvarande läsår (2020–2021) tränat med smärta eller i behov av behandling. Resultatet visar också att årskurs 2 hade störst procentuell skadeförekomst med 81 % under nuvarande läsår. Slutsats Baserat på skadorna som rapporterats i studien skulle män och kvinnor möjligen gynnas av att ha olika träningsupplägg. Ett mer aktivt jobb med skadeprevention kan behövas med tanke på att 61 % av deltagarna varit skadade minst en gång senaste läsåret. Bättre kommunikation mellan tränare och elever gällande träning med besvär kan behövas. Nyckelord: Skadeförekomst, Idrottsgymnasium, TräningsbelastningIntroduction Alpine skiing is a popular winter sport that is often associated with injury. It has been part of the winter Olympics since 1936 and is categorized into four different disciplines; Slalom, Giant Slalom, Super G and Downhill. Young athletes in Sweden have the opportunity to specialize in alpine skiing as they start high school, where they can combine studies with sports. Severe injuries can significantly affect individual athletes’ ranking points and careers. The purpose of this study was to investigate which injury is the most common and the difference in injury incidence between the sexes and first to fourth grade at Swedish Alpine High Schools. Method A questionnaire was sent out to students at Sweden's Alpine Ski High School, of which 87 students (40 men and 47 women aged 16–20) chose to participate in the study. Results Of all injuries in the study, 64 % were reported by women and 36 % by men. The study only showed a slight difference in sleeping patterns and training volume between the sexes. Out of 53 reported acute and overuse injuries, 40 % were back injuries. Of all the participants 53 % claimed they had exercised while in pain or need of treatment during the previous year. Second grade had the highest injury incidence, with 81 % during the previous year. Conclusion Based on the injuries reported in the study, men and women would most likely benefit from personalized training programs. A more effective job with injury prevention could be needed considering 61 % of the participants have been injured at least once during the previous year. Better communication between coaches and students about training with pain or in need of treatment might be required. Keywords: Incidence of injury, Sports High School, Training load
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Hendricks, Candice. "Factors associated with injuries in road-runners at a local athletic club." Thesis, University of the Western Cape, 2011. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_6762_1361370450.
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Across the world, physical inactivity was found to be associated with cardiovascular and chronic diseases of lifestyle which often leads to an increased rate of various physical disabilities andpremature death. To combat these high incidences of chronic diseases of lifestyle, WHO strongly encourages people to become physically active on a daily basis to reduce the risk of
premature death. Running has thus become the preferred choice of physical activity by thousands of people to help improve their overall health and wellbeing. Apart from the health benefits
that running provides, it can also predispose the runner to potential injury especially when runners follow an inappropriate training programme and have inadequate knowledge about factors causing injury. Therefore, baseline data about the prevalence, incidence of injury and the identification of the aetiological factors associated with running injuries are needed to develop and
implement preventative programmes to allow runners to optimally perform in training and races without injury. In South Africa, there is limited research available on the incidence of injury in runners yet there is an annual increase in participation in races such as Two Oceans and Comrades marathon which could lead to an increase in the number of running injuries.Thus, the purpose of this study was to determine the incidence of injuries and identify the various risk factors that are associated with injuries in road runners at a local athletic club. Methods: A prospective cohort study design over a 16 week period using quantitative research methods was used. A sample of 50 runners had consented to participate in the study. The participants had to complete a self-administered questionnaire and clinical measurements of BMI, Q-angle, leglength, muscle strength of lower leg and ROM of hip and knee were recorded. The participants had
to complete an injury report form to record any new injuries sustained over the 16 week period of the study. Statistical Package for Social Sciences (SPSS) version 18 and software SAS v9 (SAS Institute Inc., Cary, NC, USA) was used for data capturing and analysis. Descriptive and inferential statistics were done to summarize the data and was expressed as frequencies, percentages, means and standard deviations. Injury prevalence and cumulative incidence was calculated as a proportion rate along with 95% confidence interval. The Poisson regression model was used to analyse the association between running injury and the independent variables of interest such as demographics, anthropometric measurements, training methods, running experience and
previous injury. The alpha level was set as p<
0.05. Results: The study found that the majority (92%) of the participants (n=46) sustained running injuries in the past prior to the study. A total of 16 participants sustained a number of 50 new injuries over the 16 week study period. Thus the prevalence rate of injuries was 32%. The incidence rate of injuries for this study was 0.67 per
1000km run at a 95% confidence interval of 0.41, 1.08. Furthermore, the most common location of new injuries reported were the calf (20%) and the second most common location was the
knee (18%). PFPS was the most common type of knee injury diagnosed, followed by lumbar joint sprain. The results showed that none of the identified factors (running distance, stretching, age, Q-angle, BMI, running experience, leg-length discrepancy and previous running injuries) were directly associated with running injuries. However, a marginal significance was found for
running distance (p = 0.08) and leg length discrepancy (p = 0.06). Conclusions: The study found a high prevalence and incidence rate of injury thus the need for preventative programmes have been highlighted. There was no statistical significance found between the identified factors and risk of injury however, there was clinical relevance found between factors identified. One major
limitation was the small sample of participants and the short duration of study period. Thus, future research is needed to further determine possible factors associated with running injuries over a longer period and including a larger sample. The results of the study will be made available to all the stakeholders (runners, coaches and medical team) to implement in athletic club.
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Puljula, J. (Jussi). "Alcohol-related traumatic brain injuries before and after the reduction of alcohol prices:observations from Oulu Province and Northern Ostrobothnia." Doctoral thesis, Oulun yliopisto, 2012. http://urn.fi/urn:isbn:9789514299513.
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Abstract Traumatic brain injury (TBI) is an enormous health and economic problem. The proportion of alcohol involvement among subjects with TBI varies 34–51%. Acute alcohol intoxication increases the risk for head trauma compared with other parts of the body. Therefore, alcohol is a major, yet preventable risk factor for TBI. Alcohol taxes were reduced in 2004 and limits on tax-free imports from other EU countries were also removed. Within a year, total alcohol consumption increased by 10% in Finland. Alcohol-induced liver diseases and sudden deaths involving alcohol increased after the reduction. The effects of the reduction on the incidence and mortality of TBI were not known. Data on all TBI subjects admitted to Oulu University Hospital (1999, 2007) were gathered, as well as data on all fatal TBIs among the residents of Oulu Province (1999, 2006, and 2007). A cohort of subjects with head trauma admitted to Oulu University Hospital in 1999 was followed up until the end of 2009. Alcohol involvement was based on positive alcohol measurement or alcohol-related cause of death on death certificate or hospital chart notes made by health care providers. The incidence and mortality rates of moderate-to-severe TBI and alcohol involvement between the observation years were compared. Cumulative survival rates were calculated to demonstrate the effect of alcohol price reduction on the mortality of the head trauma cohort during a 10-year follow-up. The incidence of moderate-to-severe and fatal TBI was similar before and after the reduction of alcohol prices. After the reduction, the proportion of alcohol-related moderate-to-severe and fatal TBIs increased among middle-aged people, but decreased among young adults. The increase in TBIs among the middle-aged was mainly due to an increase in falls, whereas the decrease among young adults was due to a decreased number of suicides (particularly among young men). After the reduction of alcohol prices, harmful drinkers were significantly more likely to die than those who were not harmful drinkers. The overall incidence of moderate-to-severe and fatal TBIs did not increase after the reduction of alcohol prices, but the proportions of alcohol-related TBIs due to falls increased among middle-aged people. Our observations demonstrate that harmful drinkers and middle-aged people were the groups which suffered the most TBI-related harm after the reduction of alcohol pricesTiivistelmä Traumaattiset aivovammat aiheuttavat mittavia terveydellisiä ja taloudellisia ongelmia. Alkoholin vaikutuksen alaisena on vammautumishetkellä 34–51 % aivovammapotilaista. Akuutti päihtymystila lisää riskiä saada pään alueen vamma verrattuna muihin vartalon osiin. Alkoholi on merkittävä ja estettävissä oleva aivovammojen riskitekijä. Vuonna 2004 toteutettiin merkittävä alkoholin veronalennus sekä poistettiin muista EU-maista tuotavien verottomien juomien rajoitukset. Alkoholin kulutus lisääntyi 10 % vuoden aikana. Alkoholin aiheuttamat maksasairaudet sekä äkkikuolemat lisääntyivät alkoholin veronalennuksen jälkeen. Vaikutuksia traumaattisten aivovammojen ilmaantuvuuteen ja kuolleisuuteen ei ole vielä tutkittu. Tiedot kerättiin Oulun yliopistollisessa sairaalassa hoidetuista aivovammapotilaista (1999 ja 2007) sekä Oulun läänin alueella aivovammoihin kuolleista (1999, 2006 ja 2007) vainajista. Vuonna 1999 pään vamman vuoksi Oulun yliopistollisessa sairaalassa käyneitä potilaita seurattiin vuoden 2009 loppuun saakka. Tiedot alkoholin käytöstä perustuivat positiiviseen mitattuun alkoholipitoisuuteen sekä asiakirjamerkintöihin alkoholin käytöstä. Lievää vaikeampien traumaattisten aivovammojen ilmaantuvuutta, kuolleisuutta sekä alkoholiin liittyvien tapausten osuutta verrattiin tutkimusvuosien välillä. Vuonna 1999 päätään loukanneiden pitkäaikaisseurannassa tutkittiin alkoholin veronalennuksen vaikutusta kuolleisuuteen. Lievää vaikeampien aivovammojen ilmaantuvuus sekä aivovammakuolleisuus pysyivät samansuuruisina ennen ja jälkeen alkoholin veronalennuksen. Veronalennuksen jälkeen alkoholiin liittyvien aivovammojen osuus lisääntyi keski-ikäisillä mutta väheni nuorilla. Keski-ikäisillä havaittu alkoholi liitännäisten aivovammojen lisääntyminen johtui pääasiallisesti siitä että kaatumisvammoja tapahtui enemmän, kun taas nuorten kohdalla havaittu väheneminen johtui itsemurhien vähenemisestä. Alkoholin veronalennuksen jälkeen alkoholia haitallisesti käyttävien kuolleisuus lisääntyi merkittävästi verrattuna niihin, jotka eivät käyttäneet alkoholia haitallisesti. Lievää vaikeampien aivovammojen ilmaantuvuus sekä kuolleisuus eivät lisääntynyt alkoholin veronalennuksen jälkeen, mutta keski-ikäisten alkoholiin liittyvät kaatumistapaukset lisääntyivät. Havainnot osoittavat, että erityisesti haitallisesti alkoholia käyttävillä sekä keski-ikäisillä oli suurempi riski saada aivovammoihin liittyviä ongelmia veronalennuksen jälkeen
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Zavareh, Milad [Verfasser], and Tobias [Akademischer Betreuer] Huber. "Impact of interaction of diabetes mellitus and impaired renal function onprognosis and the incidence of acute kidney injury in patients undergoingtranscatheter aortic valve replacement (TAVI) / Milad Zavareh ; Betreuer: Tobias Huber." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2020. http://d-nb.info/1208834010/34.
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Santos, Reginaldo Passoni dos. "Injúria renal aguda em unidade de terapia intensiva: um estudo longitudinal." Universidade Estadual do Oeste do Paraná, 2018. http://tede.unioeste.br/handle/tede/3682.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
The objective of this study was to identify the occurrence and risk factors for Acute Kidney Injury (AKI) in critically ill Brazilian patients. Study retrospective, documentary and with quantitative approach. The AKI identification was performed using the criteria proposed by the acronym KDIGO (Kidney Disease Improving Global Outcomes). Data were collected, between October 2016 and January 2018, from patients admitted to the Intensive Care Unit (ICU) between January 2011 and December 2016 Was used a form constructed and validated specifically for use in the study, which extracted patients' information registered at admission to the ICU, which refer to the clinical- epidemiology patients profile, as well as laboratory and hemodynamic parameters and the need for dialysis. The data collected evaluated the AKI incidence, its risk factors and the overall mortality rate, as well as among AKI patients and among patients with dialysis. Descriptive and inferential statistical analyzes were performed, using logistic regression tests and the receiver operating characteristic (ROC) curve. In all analyzes p-value <0.05 was considered statistically significant and all data were analyzed in software R. The study included 1,500 patients, AKI incidence was 40.5% (n = 608) and need of dialysis was 13% (n = 79). The risk factors at ICU admission to AKI occurrence were: hypertension (odds ratio (OR) = 1.44, 95% confidence interval (CI) = 1.07-1.94, p = 0.017), serum creatinine concentration (OR = 3.54; 95% CI = 2.65-4.73; cutoff: >1.16 mg/dL; p <0.001), serum albumin concentration (OR = 1.42, 95% CI = 1.07-1.89, cutoff: 0.35, p 0.015), APACHE II score (OR = 2.10, 95% CI = 1.56-2.81, cutoff: >24 points, p <0.001) and SAPS 3 score (OR = 1.75, 95% CI = 1.31-2.33, cutoff: >68 points, p <0.001). The overall mortality rate was 18.5%, at AKI patients 39.1%, and at patients with AKI dialytic 62%. The AKI incidence was high and the data are consonant with the literature. We identified the AKI predictors among critically ill Brazilian patients, and the results of this study may contribute to the implementation of targeted care therapies, as well as to establish strategies that can promote patient safety.
Objetivou-se identificar, nesta pesquisa, a ocorrência e os fatores de risco para Injúria Renal Aguda (IRA) em pacientes brasileiros em estado crítico por meio de um estudo retrospectivo, documental e com abordagem quantitativa. A identificação de IRA foi realizada com a aplicação dos critérios propostos pelo acrônimo KDIGO (Kidney Disease Improving Global Outcomes). Coletou-se, entre outubro de 2016 e janeiro de 2018, dados de pacientes que foram admitidos em Unidade de Terapia Intensiva (UTI) entre janeiro de 2011 e dezembro de 2016. Utilizando-se um formulário construído e validado especificamente para uso neste estudo, extraiu-se dos prontuários informações registradas na admissão à UTI, as quais referiam-se ao perfil clínico-epidemiológico dos pacientes, bem como aos parâmetros laboratoriais e hemodinâmicos e à necessidade de diálise. Por meio dos dados coletados, avaliou-se a incidência de IRA, os fatores de risco e a taxa de mortalidade global entre pacientes com IRA e entre aqueles com IRA dialítica. Foram realizadas análises estatísticas descritivas e inferenciais, com aplicação de testes de regressão logística e da curva ROC (receiver operating characteristic). Em todas as análises, considerou-se p-valor < 0,05 como estatisticamente significativo e todos os dados foram analisados no software R. Incluíram-se no estudo 1.500 pacientes, sendo que a incidência de IRA foi de 40,5% (n= 608) e de IRA dialítica de 13% (n= 79). Os fatores de risco na admissão à UTI para ocorrência de IRA foram: hipertensão (odds ratio (OR) = 1.44, intervalo de confiança (IC) 95% = 1.07-1.94; p-valor = 0.017), concentração sérica de creatinina (OR = 3.54; IC 95% = 2.65-4.73; cut-off: >1.16 mg/dL; p-valor <0.001), concentração sérica de albumina (OR = 1.42; IC 95% = 1.07-1.89; cut-off: ≤ 2.81; p-valor 0.015), escore do APACHE II (OR = 2.10; IC 95% = 1.56-2.81; cut-off: >24 pontos; p-valor <0.001) e escore do SAPS 3 (OR = 1.75; IC 95% = 1.31-2.33; cut-off: > 68 pontos; p-valor <0.001). A taxa de mortalidade global foi de 18,5%, nos pacientes com IRA 39,1%, e nos pacientes com IRA dialítica de 62%. A incidência de IRA foi alta e os dados estão em consonância com a literatura especializada. Identificamos os preditores para IRA entre pacientes brasileiros criticamente enfermos, assim sendo, os resultados deste estudo podem contribuir para implementação de terapias de cuidado direcionadas, bem como para estabelecer estratégias que possam promover a segurança do paciente.
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Brindle, Christopher T. "Incidence and Predictor Variables of Pressure Injuries in Patients Undergoing Ventricular Assist Device and Total Artificial Heart Surgeries: An Eight-Year Retrospective Review." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/6038.
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BACKGROUND
Cardiac surgery patients have some of the highest reported incidence and prevalence of pressure injuries (PI). A growing subset of cardiac surgery include patients with end-stage heart failure who undergo ventricular assist device (VAD) or total artificial heart (TAH) surgery. The risk of PI and their natural history of development in this population are unknown and the specific risk factors for PI development remain unexplored.
OBJECTIVES
To perform a systematic review of the literature to identify the incidence and risk factors of PI development in patients undergoing VAD-TAH surgery and thereby inform study design and variables in an eight-year retrospective study of all patients undergoing VAD-TAH surgery at a large academic university medical center.
METHODS
The preferred reporting items for systematic reviews and meta-analyses or PRISMA statement guided this systematic review. Quality of evidence was determined using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale. Two reviewers independently appraised manuscripts matching the eligibility criteria for study inclusion. Four databases including PubMed, CINAHL, Web of Science, Google Scholar, and hand searches of journals based on reference lists from included studies were utilized. Initial results of this primary search revealed zero studies that met inclusion and this search methodology was confirmed by medical librarian consultation. Therefore, a follow up retrospective study was necessary to identify incidence of PI in the VAD-TAH population. However, a secondary search, dropping keywords of VAD-TAH and instead focusing on studies of on-pump cardiac surgery and mixed surgical studies where cardiac surgery patients were included, was conducted to establish variables to guide a retrospective study of all VAD-TAH surgeries between 2010-2018. The retrospective study evaluated the incidence of pressure ulcers by case, patient and incidence density for each of the respective 1000 patient days during the study period. Univariate statistics are reported by four different VAD-TAH devices. Variables significant in bivariate analysis were entered in a stepwise logistic regression model.
RESULTS
In the systematic review, 312 articles were identified from the databases with eight additional articles from hand searches. Following abstract review, 208 were excluded for not meeting inclusion criteria or study quality metrics. 77 articles were read in full, with 61 excluded, leaving 16 articles for inclusion. 31 risk factors were identified for PI development in on-pump cardiac surgery patients with 11 risk factors which were identified as significant in multivariate analysis for inclusion in the retrospective study.
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Åman, Malin. "Acute sports injuries in Sweden and their possible prevention : an epidemiological study using insurance data." Doctoral thesis, Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:gih:diva-5128.
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Physical activity is an essential component of a healthy life, e.g. to prevent obesity, cardiovascular disease and premature death, of which sports can be an important part. Unfortunately, sports activities increase the risk of both overuse and acute injuries. Severe acute injuries may also lead to a permanent medical impairment (PMI), which may influence the ability to be physically active throughout life. However, sports injuries may be prevented, but a profound understanding of the injuries and how to prevent them is needed. This doctoral thesis examine acute sports injuries reported by licensed athletes of all ages and level of sports nationwide in Sweden, by using national insurance data. Approximately 80% of all the Sports Federations (SF) had their mandatory accident insurance in the insurance company Folksam, and since there is no national sports injury surveillance system in Sweden, this is a unique database, able to be used in epidemiological studies on acute injuries occurring in organized sports in Sweden. The main aim of this thesis was to identify high-risk sports for acute injuries, the most common and the most severe injuries, especially in large sports with numerous licensed athletes, many injuries and injuries resulting in PMI. Based on the results, there will be recommendations regarding sports and body locations where injury prevention efforts should be focused to gain the greatest prevention effect at a national level in Sweden. Another aim was to evaluate the effectiveness of a neuromuscular knee control training program (KCP) that has been implemented nationwide to reduce knee and cruciate ligament injuries, among football players in Sweden. After evaluating the validity and reliability of the information within the database based on international guidelines, acute injury data were examined and the results presented in four papers. These results showed that there is a need of injury prevention especially in motorcycle sports, team ball sports, and ice hockey. Particularly, knee injuries need to be prevented since they were both the most common injuries and leading to PMI. The severe head- and upper limb injuries also need attention. Sixty-nine percent of the PMI injured athletes, were younger than 25 years. The injury prevention training program, KCP can be considered partially implemented nationwide, since 21 out of 24 district SFs provided KCP educations. The incidence of knee and cruciate ligament injuries has decreased among football players in Sweden. A concerning aspect is that there is no national official policy regarding sports injury and injury prevention in Sweden, nor an official authority that has the explicit responsibility for these issues.
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Albertsson, Pontus. "Occupant casualties in bus and coach traffic : injury and crash mechanisms." Doctoral thesis, Umeå : Deptartment of Surgical and Perioperative Sciences, Division of surgery, Umeå university, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-482.
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