Preventing human immunodeficiency virus infection among sexual assault survivors in Cape Town, South Africa: an observational study.

We describe 131 South African sexual assault survivors offered HIV post-exposure prophylaxis (PEP). While the median days completed was 27 (IQR 27, 28), 34% stopped PEP or missed doses. Controlling for baseline symptoms, PEP was not associated with symptoms (OR = 1.30, 95% CI = 0.66, 2.64). Factors associated with unprotected sex included prior unprotected sex (OR = 6.46, 95% CI = 3.04, 13.74), time since the assault (OR = 1.33, 95% CI = 1.12, 1.57) and age (OR = 1.30, 95% CI = 1.08, 1.57). Trauma counseling was protective (OR = 0.18, 95% CI = 0.05, 0.58). Four instances of seroconversion were observed by 6 months (risk = 3.7%, 95% CI = 1.0, 9.1). Proactive follow-up is necessary to increase the likelihood of PEP completion and address the mental health and HIV risk needs of survivors. Adherence interventions and targeted risk reduction counseling should be provided to minimize HIV acquisition

Social inclusion and professional female migrants in multicultural Australia

The goal of the thesis is to scrutinise the experiences of professional female migrants in Australia. The study was undertaken in the context of the emergence of a policy focus on ‘social inclusion’ and ‘social exclusion’ in Australia and elsewhere and in the context of renewed debates in Australia about multiculturalism. Social inclusion refers to a policy focus on enabling the full participation of citizens in the life of the nation, including economic, social, cultural and political participation (Gillard & Wong, 2007). In turn, social exclusion refers to a policy focus on identifying and addressing groups whose participation is constrained, often measured along the dimensions of consumption, production, political engagement, social support and cultural life (see for example, Burchardt, Le Grand, & Piachaud, 2002; Richardson & Le Grand, 2002). This research is interested in testing the relevance of these frameworks for understanding and addressing the experiences of professional female migrants in multicultural Australia. The thesis involved a study of twenty professional female migrants living in Sydney who participated in in-depth interviews. All respondents belonged to a highly skilled occupational group and a prerequisite was that they held a primary professional qualification before migration to Australia. Participants, who were from both English speaking and non-English speaking backgrounds provided detailed narratives of their lives and experiences since migration to Australia, and these narratives provided a window into the specificities of professional female migrants’ perceptions of moving to Australia, settling in Australia and ‘belonging’ in Australia. These insights add to the body of knowledge on migration and social inclusion and exclusion. The research found that the relevance of the dominant social inclusion framework for analysing their migration and settlement experiences is only partial: this is because of the prioritisation of economic participation as a route to social inclusion. The social inclusion framework, consequently, fails to recognise the cultural dimension of social inclusion by assuming that social inclusion in multicultural Australia can be achieved and maintained through the active economic participation of Australian citizens. In addition, the study found that the dominant social inclusion policy framework does not recognise an important aspect of professional female migrants’ identity: transnational relationships and transnational belonging. In terms of the specificities of professional female migrants’ experiences, the thesis proposes a structure for talking about differences in experiences of inclusion that uses measures such as participation in paid work, either in mainstream or in ethno-specific workplaces; participation in social life, either in or in and beyond their own ethnic community; self-perception of being, or not being, included - a dimension that was often based on whether or not they experienced racism. Based on these factors, women’s experiences could be categorised as varying between deep, borderline, marginal and shallow inclusion. The thesis also finds that although social inclusion does not equal assimilation or a transition from being a migrant, social inclusion is possible in the context of ethnic and cultural differences

Efficacy of a 3 month training program on the jump-landing technique in jump-landing sports. Design of a cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>With the relatively high rate of injuries to the lower extremity due to jump-landing movement patterns and the accompanied high costs, there is need for determining potential preventive programs. A program on the intervention of jump-landing technique is possibly an important preventative measure since it appeared to reduce the incidence of lower extremity injuries. In real life situations, amateur sports lack the infrastructure and funds to have a sports physician or therapist permanently supervising such a program. Therefore the current prevention program is designed so that it could be implemented by coaches alone.</p> <p>Objective</p> <p>The objective of this randomized controlled trial is to evaluate the effect of a coach supervised intervention program targeting jump-landing technique on the incidence of lower extremity injuries.</p> <p>Methods</p> <p>Of the 110 Flemish teams of the elite division, 24 teams are included and equally randomized to two study groups. An equal selection of female and male teams with allocation to intervention and control group is obtained. The program is a modification of other prevention programs previously proven to be effective. All exercises in the current program are adjusted so that a more progressive development in the exercise is presented. Both the control and intervention group continue with their normal training routine, while the intervention group carries out the program on jump-landing technique. The full intervention program has a duration of three months and is performed 2 times a week during warm-up (5-10 min). Injuries are registered during the entire season.</p> <p>Discussion</p> <p>The results of this study can give valuable information on the effect of a coach supervised intervention program on jump-landing technique and injury occurrence. Results will become available in 2011.</p> <p>Trial registration</p> <p>Trial registration number: NTR2560</p

Differential neuromuscular training effects onACL injury risk factors in"high-risk" versus "low-risk" athletes

<p>Abstract</p> <p>Background</p> <p>Neuromuscular training may reduce risk factors that contribute to ACL injury incidence in female athletes. Multi-component, ACL injury prevention training programs can be time and labor intensive, which may ultimately limit training program utilization or compliance. The purpose of this study was to determine the effect of neuromuscular training on those classified as "high-risk" compared to those classified as "low-risk." The hypothesis was that high-risk athletes would decrease knee abduction moments while low-risk and control athletes would not show measurable changes.</p> <p>Methods</p> <p>Eighteen high school female athletes participated in neuromuscular training 3×/week over a 7-week period. Knee kinematics and kinetics were measured during a drop vertical jump (DVJ) test at pre/post training. External knee abduction moments were calculated using inverse dynamics. Logistic regression indicated maximal sensitivity and specificity for prediction of ACL injury risk using external knee abduction (25.25 Nm cutoff) during a DVJ. Based on these data, 12 study subjects (and 4 controls) were grouped into the high-risk (knee abduction moment >25.25 Nm) and 6 subjects (and 7 controls) were grouped into the low-risk (knee abduction <25.25 Nm) categories using mean right and left leg knee abduction moments. A mixed design repeated measures ANOVA was used to determine differences between athletes categorized as high or low-risk.</p> <p>Results</p> <p>Athletes classified as high-risk decreased their knee abduction moments by 13% following training (Dominant pre: 39.9 ± 15.8 Nm to 34.6 ± 9.6 Nm; Non-dominant pre: 37.1 ± 9.2 to 32.4 ± 10.7 Nm; p = 0.033 training X risk factor interaction). Athletes grouped into the low-risk category did not change their abduction moments following training (p > 0.05). Control subjects classified as either high or low-risk also did not significantly change from pre to post-testing.</p> <p>Conclusion</p> <p>These results indicate that "high-risk" female athletes decreased the magnitude of the previously identified risk factor to ACL injury following neuromuscular training. However, the mean values for the high-risk subjects were not reduced to levels similar to low-risk group following training. Targeting female athletes who demonstrate high-risk knee abduction loads during dynamic tasks may improve efficacy of neuromuscular training. Yet, increased training volume or more specific techniques may be necessary for high-risk athletes to substantially decrease ACL injury risk.</p

Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes

Background: Female athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes. Hypothesis: Prescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading, predicting anterior cruciate ligament injury risk. Study Design: Cohort study; Level of evidence, 2. Methods: There were 205 female athletes in the high-risk sports of soccer, basketball, and volleyball prospectively measured for neuromuscular control using 3-dimensional kinematics (joint angles) and joint loads using kinetics (joint moments) during a jump-landing task. Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament. Results: Nine athletes had a confirmed anterior cruciate ligament rupture; these 9 had significantly different knee posture and loading compared to the 196 who did not have anterior cruciate ligament rupture. Knee abduction angle (P \u3c .05) at landing was 8° greater in anterior cruciate ligament–injured than in uninjured athletes. Anterior cruciate ligament–injured athletes had a 2.5 times greater knee abduction moment (P \u3c .001) and 20% higher ground reaction force (P \u3c .05), whereas stance time was 16% shorter; hence, increased motion, force, and moments occurred more quickly. Knee abduction moment predicted anterior cruciate ligament injury status with 73% specificity and 78% sensitivity; dynamic valgus measures showed a predictive r 2 of 0.88. Conclusion: Knee motion and knee loading during a landing task are predictors of anterior cruciate ligament injury risk in female athletes. Clinical Relevance: Female athletes with increased dynamic valgus and high abduction loads are at increased risk of anterior cruciate ligament injury. The methods developed may be used to monitor neuromuscular control of the knee joint and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective, targeted interventions

Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes

Background: Female athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes. Hypothesis: Prescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading, predicting anterior cruciate ligament injury risk. Study Design: Cohort study; Level of evidence, 2. Methods: There were 205 female athletes in the high-risk sports of soccer, basketball, and volleyball prospectively measured for neuromuscular control using 3-dimensional kinematics (joint angles) and joint loads using kinetics (joint moments) during a jump-landing task. Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament. Results: Nine athletes had a confirmed anterior cruciate ligament rupture; these 9 had significantly different knee posture and loading compared to the 196 who did not have anterior cruciate ligament rupture. Knee abduction angle (P \u3c .05) at landing was 8° greater in anterior cruciate ligament–injured than in uninjured athletes. Anterior cruciate ligament–injured athletes had a 2.5 times greater knee abduction moment (P \u3c .001) and 20% higher ground reaction force (P \u3c .05), whereas stance time was 16% shorter; hence, increased motion, force, and moments occurred more quickly. Knee abduction moment predicted anterior cruciate ligament injury status with 73% specificity and 78% sensitivity; dynamic valgus measures showed a predictive r 2 of 0.88. Conclusion: Knee motion and knee loading during a landing task are predictors of anterior cruciate ligament injury risk in female athletes. Clinical Relevance: Female athletes with increased dynamic valgus and high abduction loads are at increased risk of anterior cruciate ligament injury. The methods developed may be used to monitor neuromuscular control of the knee joint and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective, targeted interventions

Why fencers should bounce: a new method of movement to engage the stretch-shortening cycle

While teaching a heel first contact style of footwork in fencing (also referred to as toe contribution avoidance) is in keeping with long standing traditions, it is not conducive to today’s modern style of fast paced and explosive fencing. Equally, fencers towards the elite-end seem to be gradually adopting a more spring-based style, as their body progressively and organically transitions to “ball of the foot” based footwork, in order for them to fence competitively in the manner they have intuitively associated with success. Therefore, if from a young age fencers are taught to make full use of the stretch shortening cycle (SSC) via “bouncing” or simply by initiating movement via the ball of the foot, this will expedite the learning process. It will demonstrate to them how the SSC can be used to move at greater speed, cover greater distances when advancing, retreating and lunging, and conserve the much-needed energy required to compete over day long competitions. This paper details the mechanistic underpinnings of the SSC and its application to the modern day fencer