Counting organised sport injury cases: Evidence of incomplete capture from routine hospital collections

Organised sports are a popular form of physical activity, but unfortunately, participation can result in injury. Despite this, there have been surprisingly few studies that have reported the population rate of sports injury. Data from the 2005 New South Wales (NSW, Australia) Population Health Survey were analysed to describe self-reported injury experiences during participation in organised sports activities and the source of treatment for such injuries during a 12-month period in a population representative sample of adults aged 16+ years. At interview, 2414 respondents stated that they had participated in organised sport in the previous 12 months and just under one-third (30.9%) reported that they had been injured during this participation. Half of all injuries required formal treatment from a health or medical practitioner. Physiotherapists most commonly provided treatment for sports injury (26.6% of cases) followed by general practitioners (15.6%). Only 2.8% of all injured sports participants were admitted to hospital for their injury and a further 6.1% received treatment in an emergency department. This corresponds to at most only 8.9% of all treated sports injuries receiving treatment in a hospital setting. Population-based estimates of the rate and burden of sports injuries that rely solely on routine hospital data collections are likely to grossly underestimate the size of the problem, as very few cases are treated in a hospital setting.     

Trophic restructuring (Wieser 1953) of free-living nematode in marine sediment experimentally enriched to increasing doses of pharmaceutical penicillin G

Trophic structure of free living nematode from Bizerte lagoon was tested by a microcosmic study after 30 days of exposure with 5 increasing doses of pharmaceutical penicillin G (D1: 3 mg L^?1, D2: 30 mg L^?1, D3: 300 mg L^?1, D4: 600 mg L^?1, D5: 700 mg L^?1). Results showed significant differences between nematode assemblages from undisturbed controls and those from penicillin G treatments. Selective deposit-feeders (1A) or nonselective deposit-feeders (1B), very abundant in the control microcosm, were significantly affected and their dominance declined significantly. Epistrate feeders (2A) were significantly gradual increase for all microcosms treated with penicillin G, appeared to be more tolerant to the antibiotic and to take advantage of the growing scarcity of other trophic groups. Compared to the control microcosms, omnivorous-carnivorous (2B) was found to be higher in all treated microcosms, with the exception of those treated with D5. Trophic index (Σθ²) was significantly reduced in all microcosms treated whereas trophic ratio 1B/2A appears to be insignificant.     

Novice Drivers' Risky Driving Behavior, Risk Perception, and Crash Risk: Findings From the DRIVE Study

Objectives. We explored the risky driving behaviors and risk perceptions of a cohort of young novice drivers and sought to determine their associations with crash risk.Methods. Provisional drivers aged 17 to 24 (n = 20 822) completed a detailed questionnaire that included measures of risk perception and behaviors; 2 years following recruitment, survey data were linked to licensing and police-reported crash data. Poisson regression models that adjusted for multiple confounders were created to explore crash risk.Results. High scores on questionnaire items for risky driving were associated with a 50% increased crash risk (adjusted relative risk = 1.51; 95% confidence interval = 1.25, 1.81). High scores for risk perception (poorer perceptions of safety) were also associated with increased crash risk in univariate and multivariate models; however, significance was not sustained after adjustment for risky driving.Conclusions. The overrepresentation of youths in crashes involving casualties is a significant public health issue. Risky driving behavior is strongly linked to crash risk among young drivers and overrides the importance of risk perceptions. Systemwide intervention, including licensing reform, is warranted.The overrepresentation of youths in crashes involving casualties is a significant public health issue in most high-income countries.^1,2 As a result, prevention of crashes by novice drivers is a key focus for many jurisdictions, policymakers, and researchers. The introduction of graduated driver licensing, which gradually introduces full driving privileges for novice drivers, has brought about significant reductions in crashes, particularly in settings where more stringent conditions such as restrictions on passenger numbers and night driving have been introduced.^3,4 Research on novice drivers'' risky behaviors and risk perceptions is crucial to understanding how this initiative can be improved or how complementary interventions can be developed.There is much to be learned about the impact of novice drivers'' risky driving and how it is associated with their increased risk of crash. Recent research confirms that certain risky driving behaviors are more prevalent among younger drivers than older drivers, especially among men.^5–12 These include high-level speeding and speeding for the thrill of it,^6,11,13–16 following too closely to the vehicle ahead,⁵ violating traffic rules,⁹ not using seatbelts,^17–19 using mobile phones while driving^20–22 (including text messaging^23,24), driving during high-risk nighttime hours,^2,25,26 and driving older vehicles.^14,27,28In addition, certain driving behaviors have been demonstrated to be of higher risk for young novice drivers than for experienced adult drivers; these include carrying peer passengers or multiple passengers^2,29–32 and driving under the influence of alcohol, even at low concentrations.^26,33,34Paradoxically, given higher levels of risk taking, young drivers are often found to be more aware of driving risks than drivers of other age groups, particularly regarding alcohol,^18,35–39 although young males tend to have poorer perceptions of risk than females.^{6,35,37,39–41} Nonetheless, young people who undertake or are exposed to risky driving behaviors tend also to perceive driving risks as low.^15,35,39,42 In a prevalence study conducted recently in Australia, McEvoy et al. reported that those who reported mobile phone use while driving regarded a range of risky driving practices as significantly less dangerous than those who did not report phone use.⁴³Young people''s risk perceptions, however, can be dependent on context. For example, although speeding per se or under usual conditions is typically viewed as risky,^6,39 speeding on a clear, dry day is not.⁶ Driving fast because one is in a hurry is considered not as risky as driving fast to test a car''s speed, whereas racing other cars ranks among the highest perceived risks.³⁵ Likewise, studies have found that the general public considers only small excess rates of speed (64 km/h in a 60-km/h zone and 105 km/h in a 100-km/h zone) to be acceptable¹⁸ but that high school students of driving age accept higher speeds: in one study, one quarter of students accepted 70 km/h or more in a 60-km/h zone as safe and one quarter accepted 120 km/h or more in a 100-km/h zone as safe if conditions were good.³⁷ In another study, when asked how much over a 60 km/h speed limit a driver would have to be going to be considered “stupid,” young drivers reported a significantly higher speed threshold than older drivers, but there were no differences in reported thresholds for a driver to be considered “irresponsible” or “criminal.”⁶Differences in young drivers'' perceptions of other risks have also been found. For example, ratings of perceived risk have increased from very low when peer passengers are in the car to higher ratings when passengers have been drinking alcohol, smoking marijuana, or are not wearing seatbelts to highest ratings when passengers are trying to get the driver to speed or are acting wild.³⁵ Regarding driving while using a mobile phone, hands-free use has been considered less risky than manual use^18,44 and answering a call, dialing, or text messaging as more risky than talking on a phone.^35,45Such findings raise questions about whether risk perception and risky driving behaviors are strongly related and whether either is directly associated with crashes. Few recent studies of novice drivers have explored these issues, particularly the utility of either risk perception or risky driving behaviors for predicting the risk of a crash. An earlier study conducted in Australia found that self-reported risky driving behaviors were linked to increased risk of crashes in the first year of driving, but this study did not examine the impact of risk perception on crash risk.⁴⁶ Our aim was to explore the risky driving behaviors and risk perceptions of a cohort of young, newly licensed drivers and to determine the associations between these factors and crash risk.     

Depletion of Beta Cell Intranuclear Rodlets in Human Type II Diabetes

Intranuclear rodlets (INRs) are rod-shaped intranuclear bodies of unknown function present in the nuclei of pancreatic beta cells. Previous studies have demonstrated a significant depletion of INRs from beta cells in mouse models of type II diabetes, suggesting that they may have pathological significance. The objective of the present study was to determine whether beta cell INRs show quantitative alterations in human type II diabetes. In sections of non-neoplastic pancreas from 23 diabetic patients and 23 controls who had undergone complete or partial pancreatectomy, we detected a significant reduction in the proportion of INRs in insulin-immunoreactive beta cells. In addition, we showed that beta cell INRs are immunoreactive for the RNA-binding protein HuR. The results of this study confirm and extend our previous study and implicate this enigmatic nuclear structure in the cellular pathophysiological mechanisms underlying the development of type II diabetes in humans.     

TP53 codon 72 polymorphism, p53 expression, and 1p/19q status in oligodendroglial tumors

The functional single-nucleotide polymorphism (SNP) in codon 72 of TP53 has been shown to be both a risk factor and a prognostic biomarker in various cancers. Such results were also reported in brain tumors, notably in astrocytomas. This SNP has never been precisely investigated in oligodendroglial tumors. We retrospectively analyzed blood samples of 275 oligodendroglial tumor patients for the TP53 codon 72 polymorphism and compared them with a series of 144 healthy controls. Arg/Arg, Arg/Pro, and Pro/Pro genotypes were found in 54.2 versus 60.4%, 39.3 versus 34.0%, and 7.3 versus 5.6% of patients and controls, respectively. This suggests no association between oligodendroglial tumors and the SNP in codon 72 of TP53. Similarly, no correlation was found among the TP53 codon 72 polymorphism and prognosis, p53 expression, and chromosomes 1p and 19q status.     

Recommendations for the implementation of genetic testing for metastatic prostate cancer patients in Canada

IntroductionGenetic testing in advanced prostate cancer is rapidly moving to become standard of care. Testing for genetic alterations in genes involved in DNA repair pathways, particularly those implicated in the homologous recombination repair (HRR) pathway, in patients with metastatic prostate cancer (mPCa) can inform selection of optimal therapies, as well as provide information about familial cancer risks; however, there are currently no consistent Canadian guidelines in place for genetic testing in mPCa.MethodsA multidisciplinary steering committee guided the process of an environmental scan to define the current landscape, as well as the perceived challenges, through interviews with specialists from 14 sites across Canada. The challenges most commonly identified include limited testing guidelines and protocols, inadequate education and awareness, and insufficient resources. Following the environmental scan, an expert multidisciplinary working group with pan-Canadian representation from medical oncologists, urologists, medical geneticists, genetic counsellors, pathologists, and clinical laboratory scientists convened in virtual meetings to discuss the challenges in implementation of genetic testing in mPCa across Canada.ResultsKey recommendations from the working group include implementation of germline and tumor HRR testing for all patients with mPCa, with a mainstreaming model in which non-geneticist clinicians can initiate germline testing. The working group defined the roles and responsibilities of the various healthcare providers (HCPs) involved in the genetic testing pathway for mPCa patients. In addition, the educational needs for all HCPs involved in the genetic testing pathway for mPCa were defined.ConclusionsAs genetic testing for mPCa becomes standard of care, additional resources and investments will be required to implement the changes that will be needed to support the necessary volume of genetic testing, to ensure equitable access, and to provide education to all stakeholders.