Bradford Factor and seasonal injury risk in Division I-A collegiate American footballers

© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Purpose: To investigate if participation in a higher percentage of preseason sessions affects the injury profile within Division I-A American Collegiate and whether the Bradford Factor (BF) is viable for practitioner use. Methods: A retrospective research design was used. Training load and injury data were collected and analysed for two collegiate American football seasons for 70 players. Results: A total of 184 injuries were sustained across two seasons with 106 resulting in time loss (15.6 ± 5.4 time loss injuries per 1000 h). On average, athletes completed 93 ± 17% of preseason sessions. For injury likelihood in the following week, an increase in accumulated minutes in 7d increased the injury risk by 35%. For non-contact time-loss injuries, preseason completion showed a reduction in injury likelihood of 2% for additional 3 sessions completed. A high BF in preseason (>7) increases the risk compared to a low BF through the in-season period. Conclusion: Preseason completion was not associated with a substantial reduction in injury risk in-season. A clear difference in BF between groups was evident and may provide a practical “flagging” variable. The BF may provide a simple but practically meaningful measure to monitor adaptation

Subjective wellness, acute: Chronic workloads, and injury risk in college football

© 2019 National Strength and Conditioning Association Sampson, JA, Murray, A, Williams, S, Sullivan, A, and Fullagar, HHK. Subjective wellness, acute: chronic workloads and injury risk in college football. J Strength Cond Res 33(12): 3367-3373, 2019-Acute:chronic workload ratios (ACWRs) are associated with injury risk across team sports. In this study, one season of workload and wellness data from 42 collegiate football players were retrospectively analyzed. Daily 7:21 day exponentially weighted moving average (EWMA) ACWRs were calculated, and z-score fluctuations (“normal,” “better,” and “worse”) in sleep, soreness, energy, and overall wellness were assessed relative to the previous day ACWRs and considered as an interactive effect on the risk of noncontact injury within 0-3 days. Fifty-five noncontact injuries were observed, and injury risks were very likely higher when ACWRs were 2 SDs above (relative risk [RR]: 3.05, 90% confidence interval [CI]: 1.14-8.16) and below (RR: 2.49, 90% CI: 1.11-5.58) the mean. A high ACWR was trivially associated (p, 0.05) with “worse” wellness (r = 20.06, CI: 20.10 to 20.02), muscle soreness (r = 20.07, CI: 20.11 to 20.03), and energy (r = 20.05, CI: 20.09 to 20.01). Feelings of “better” overall wellness and muscle soreness with collectively high EWMA ACWRs displayed likely higher injury risks compared with “normal” (RR: 1.52, 90% CI: 0.91 to 2.54; RR: 1.64, 90% CI: 1.10-2.47) and likely or very likely (RR: 2.36, 90% CI: 0.83 to 674; RR: 2.78, 90% CI: 1.21-6.38) compared with “worse” wellness and soreness, respectively. High EWMA ACWRs increased injury risk and negatively impacted wellness. However, athletes reporting “better” wellness, driven by “better” muscle soreness presented with the highest injury risk when high EWMA ACWRs were observed. This suggests that practitioners are responsive to, and/or athletes are able to self-modulate workload activities

Identifying null meta-analyses that are ripe for updating

BACKGROUND: As an increasingly large number of meta-analyses are published, quantitative methods are needed to help clinicians and systematic review teams determine when meta-analyses are not up to date. METHODS: We propose new methods for determining when non-significant meta-analytic results might be overturned, based on a prediction of the number of participants required in new studies. To guide decision making, we introduce the "new participant ratio", the ratio of the actual number of participants in new studies to the predicted number required to obtain statistical significance. A simulation study was conducted to study the performance of our methods and a real meta-analysis provides further evidence. RESULTS: In our three simulation configurations, our diagnostic test for determining whether a meta-analysis is out of date had sensitivity of 55%, 62%, and 49% with corresponding specificity of 85%, 80%, and 90% respectively. CONCLUSIONS: Simulations suggest that our methods are able to detect out-of-date meta-analyses. These quick and approximate methods show promise for use by systematic review teams to help decide whether to commit the considerable resources required to update a meta-analysis. Further investigation and evaluation of the methods is required before they can be recommended for general use

Predicting suicides after outpatient mental health visits in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

The 2013 US Veterans Administration/Department of Defense Clinical Practice Guidelines (VA/DoD CPG) require comprehensive suicide risk assessments for VA/DoD patients with mental disorders but provide minimal guidance on how to carry out these assessments. Given that clinician-based assessments are not known to be strong predictors of suicide, we investigated whether a precision medicine model using administrative data after outpatient mental health specialty visits could be developed to predict suicides among outpatients. We focused on male nondeployed Regular US Army soldiers because they account for the vast majority of such suicides. Four machine learning classifiers (naive Bayes, random forests, support vector regression and elastic net penalized regression) were explored. Of the Army suicides in 2004-2009, 41.5% occurred among 12.0% of soldiers seen as outpatient by mental health specialists, with risk especially high within 26 weeks of visits. An elastic net classifier with 10-14 predictors optimized sensitivity (45.6% of suicide deaths occurring after the 15% of visits with highest predicted risk). Good model stability was found for a model using 2004-2007 data to predict 2008-2009 suicides, although stability decreased in a model using 2008-2009 data to predict 2010-2012 suicides. The 5% of visits with highest risk included only 0.1% of soldiers (1047.1 suicides/100 000 person-years in the 5 weeks after the visit). This is a high enough concentration of risk to have implications for targeting preventive interventions. An even better model might be developed in the future by including the enriched information on clinician-evaluated suicide risk mandated by the VA/DoD CPG to be recorded

The BSR-PsA:study protocol for the British Society for Rheumatology psoriatic arthritis register

Acknowledgements We acknowledge contribution of BSR-PsA study staff, under the supervision of KFK: Maureen Heddle, Barry Morris, Jonathan Lock and Jane Brady. We also acknowledge the support from the Centre for Healthcare Randomised Trials (CHaRT) at the University of Aberdeen, especially Mark Forrest and Brian Taylor, for database and IT support. We would like to thank Professor Iain McInnes from the University of Glasgow, and our International Advisory Committee (Professors Merete Hetland, Oliver Fitzgerald and Philip Mease), for their comments when developing the protocol and for advice in harmonising data collection with other international studies, and the staff at the British Society for Rheumatology, in particular Alan Roach, Ross Matthews, Chris Hiley and Debbie MacDonald. Finally, we are indebted to the staff at all participating NHS trusts (details of which are available from www.abdn.ac.uk/bsr-psa) and especially the NIHR Clinical Research Network research nurses for their assistance with participant recruitment and data collection. Funding The BSR-PsA is funded by the BSR as part of its rheumatology registers portfolio and, in turn, receives funding for this from pharmaceutical companies. At the time of publication, only Amgen (previously Celgene) have contributed to the funding of the BSR-PsA. Pharmaceutical companies providing funds to BSR do not participant in the conduct or oversight of the study. However, they do receive advance notice of publications on which they are able to comment. Companies contributing to the funding of the register can request anonymised data on clinically confirmed serious adverse events and some events of special interest (e.g. pregnancy) among participants prescribed the specific bDMARD or tsDMARD agents that they manufacture. Other than this information, they do not have access to any raw data. They may, however, request specific analyses to be performed, for which a pre-specific analysis plan is discussed, and additional funds are provided.Peer reviewedPublisher PD

Incommensurable worldviews? Is public use of complementary and alternative medicines incompatible with support for science and conventional medicine?

Proponents of controversial Complementary and Alternative Medicines, such as homeopathy, argue that these treatments can be used with great effect in addition to, and sometimes instead of, ?conventional? medicine. In doing so, they accept the idea that the scientific approach to the evaluation of treatment does not undermine use of and support for some of the more controversial CAM treatments. For those adhering to the scientific canon, however, such efficacy claims lack the requisite evidential basis from randomised controlled trials. It is not clear, however, whether such opposition characterises the views of the general public. In this paper we use data from the 2009 Wellcome Monitor survey to investigate public use of and beliefs about the efficacy of a prominent and controversial CAM within the United Kingdom, homeopathy. We proceed by using Latent Class Analysis to assess whether it is possible to identify a sub-group of the population who are at ease in combining support for science and conventional medicine with use of CAM treatments, and belief in the efficacy of homeopathy. Our results suggest that over 40% of the British public maintain positive evaluations of both homeopathy and conventional medicine simultaneously. Explanatory analyses reveal that simultaneous support for a controversial CAM treatment and conventional medicine is, in part, explained by a lack of scientific knowledge as well as concerns about the regulation of medical research

Assessing the psychometric and ecometric properties of neighborhood scales using adolescent survey data from urban and rural Scotland

This work was supported by NHS Health Scotland and the University of St Andrews.Background:  Despite the well-established need for specific measurement instruments to examine the relationship between neighborhood conditions and adolescent well-being outcomes, few studies have developed scales to measure features of the neighborhoods in which adolescents reside. Moreover, measures of neighborhood features may be operationalised differently by adolescents living in different levels of urban/rurality. This has not been addressed in previous studies. The objectives of this study were to: 1) establish instruments to measure adolescent neighborhood features at both the individual and neighborhood level, 2) assess their psychometric and ecometric properties, 3) test for invariance by urban/rurality, and 4) generate neighborhood level scores for use in further analysis. Methods:  Data were from the Scottish 2010 Health Behaviour in School-aged Children Survey, which included an over-sample of rural adolescents. The survey responses of interest came from questions designed to capture different facets of the local area in which each respondent resided. Intermediate data zones were used as proxies for neighborhoods. Internal consistency was evaluated by Cronbach’s alpha. Invariance was examined using confirmatory factor analysis. Multilevel models were used to estimate ecometric properties and generate neighborhood scores. Results:  Two constructs labeled neighborhood social cohesion and neighborhood disorder were identified. Adjustment was made to the originally specified model to improve model fit and measures of invariance. At the individual level, reliability was .760 for social cohesion and .765 for disorder, and between .524 and .571 for both constructs at the neighborhood level. Individuals in rural areas experienced greater neighborhood social cohesion and lower levels of neighborhood disorder compared with those in urban areas. Conclusions:  The scales are appropriate for measuring neighborhood characteristics experienced by adolescents across urban and rural Scotland, and can be used in future studies of neighborhoods and health. However, trade-offs between neighborhood sample size and reliability must be considered.Publisher PDFPeer reviewe

North Flinders Reef (Coral Sea, Australia) Porites sp. corals as a candidate Global Boundary Stratotype Section and Point for the Anthropocene Series

Corals are unique in the suite of proposed Anthropocene Global Boundary Stratotype Section and Point (GSSP) archives, as living organisms that produce aragonite exoskeletons preserved in the geological record that contain highly accurate and precise (<±1 year) internal chronologies. The GSSP candidate site North Flinders Reef in the Coral Sea (Australia) is an offshore oceanic reef, and therefore less vulnerable to local human influences than those closer to the coast. Here, we present geochemical records from two Porites sp. corals sampled at an annual to pluri-annual (i.e. 3–5 years) resolution that shows clear global and regional human impacts. Atmospheric nuclear bomb testing by-products (14C,239+240Pu) show a clear increase in the Flinders Reef corals coincident with well-dated nuclear testing operations. By contrast, the radionuclides 241Am and 137Cs are present at low or undetectable levels, as are spheroidal carbonaceous fly-ash particles. Coral δ13C shows centennial variability likely influenced by growth effects in the 18th century and with a progression to lower values starting in 1880 and accelerating post-1970. The latter may be related to the Suess Effect resulting from 13C-depleted fossil fuel burning. Coral δ15N decreased between 1710 and 1954 with a reversal post-1954. Coral temperature proxies indicate prominent centennial variability with equally warm conditions in the 18th and end of 20th century. However, the exact mechanisms responsible for the mid-20th century changes in these parameters need to be scrutinised in further detail. Plain Language summary: This work proposes a candidate natural archive for the official marker of the Anthropocene that geologists will use to mark this important interval in time. Our candidate is a live coral from North Flinders Reef in the Coral Sea (Australia), located 150 km east of the Great Barrier Reef, a location that is remote from direct local human influences. Corals are a unique archive of tropical ocean change because they incorporate the geochemical signature from seawater into their limestone skeleton during their long life-spans. Here we investigated a number of geochemical markers in yearly growth layers of the corals to define several markers for the Anthropocene based on changes in temperature, water chemistry, chemicals from pollution and fertilisers, radioactive products from nuclear bomb testing, and by-products from burning fossil fuels. We have detected clear human influences in several of these markers

Elevated levels of Dickkopf-related protein 3 in seminal plasma of prostate cancer patients

<p>Abstract</p> <p>Background</p> <p>Expression of Dkk-3, a secreted putative tumor suppressor, is altered in age-related proliferative disorders of the human prostate. We now investigated the suitability of Dkk-3 as a diagnostic biomarker for prostate cancer (PCa) in seminal plasma (SP).</p> <p>Methods</p> <p>SP samples were obtained from 81 patients prior to TRUS-guided prostate biopsies on the basis of elevated serum prostate-specific antigen (PSA; > 4 ng/mL) levels and/or abnormal digital rectal examination. A sensitive indirect immunoenzymometric assay for Dkk-3 was developed and characterized in detail. SP Dkk-3 and PSA levels were determined and normalized to total SP protein. The diagnostic accuracies of single markers including serum PSA and multivariate models to discriminate patients with positive (N = 40) and negative (N = 41) biopsy findings were investigated.</p> <p>Results</p> <p>Biopsy-confirmed PCa showed significantly higher SP Dkk-3 levels (100.9 ± 12.3 vs. 69.2 ± 9.4 fmol/mg; <it>p </it>= 0.026). Diagnostic accuracy (AUC) of SP Dkk-3 levels (0.633) was enhanced in multivariate models by including serum PSA (model A; AUC 0.658) or both, serum and SP PSA levels (model B; AUC 0.710). In a subpopulation with clinical follow-up > 3 years post-biopsy to ensure veracity of negative biopsy status (positive biopsy N = 21; negative biopsy N = 25) AUCs for SP Dkk-3, model A and B increased to 0.667, 0.724 and 0.777, respectively.</p> <p>Conclusions</p> <p>In multivariate models to detect PCa, inclusion of SP Dkk-3 levels, which were significantly elevated in biopsy-confirmed PCa patients, improved the diagnostic performance compared with serum PSA only.</p

Can Systemic Interventions Designed to Reduce Reoffending by Youth also Reduce their Victimization?

Previous research indicates considerable overlap between populations of boys who are victimized and boys who victimize others. This study was concerned with whether a systems-focused treatment program designed to address individual and systemic risk factors associated with the perpetration of sexual and violent crimes might also be successful in reducing boys’ victimization by others. Boys adjudicated for sexual offences who received ‘treatment as usual’ (TAU; n = 335) were compared with similarly adjudicated boys who completed the treatment program (n = 200) on their histories of contact with police either as offenders or victims. Despite their higher rates of pre-intervention victimization, the treatment group were victimized less frequently post-intervention than the TAU group. Continued offending was the strongest predictor of victimization post-intervention. These findings suggest that offending and victimization share common risk factors that may be addressed simultaneously within offence-focused treatment