Spinal cord injuries in South African Rugby Union (1980-2007)

Objectives and design. To address an apparent increase in the number of rugby-related spinal cord injuries (SCIs) in South Africa, a retrospective case-series study was conducted on injuries that occurred between 1980 and 2007. We aimed to identify preventable causes to reduce the overall rate of SCIs in South African rugby. Methods. We identified 264 rugby-related SCIs. A structured questionnaire was used, and it was possible to obtain information on a total of 183 players, including 30 who had died. Results. SCIs increased in number in the 1980s and in 2006. Forwards sustained 76% of all SCIs, and club players 60%. Players aged 17 had the highest number of SCIs. In only 50% of cases were medical personnel present at the time of injury, and 49% of injured players waited longer than 6 hours for acute management. Of players with an SCI, 61% had a catastrophic outcome after 12 months, including 8% who died during that time; 65% received no financial compensation; and only 29% of players had medical aid or health insurance. Conclusion. A register of all rugby-related SCIs in South Africa is essential to monitor the magnitude of the problem, identify potential risk factors, and formulate appropriate preventive interventions. The lack of reliable denominator data limits calculation of incident rates. Players from previously disadvantaged communities in particular suffered the consequences of limited public health care resources and no financial compensation

Spinal cord injuries in South African Rugby Union (1980 - 2007)

Objectives and design. To address an apparent increase in the number of rugby-related spinal cord injuries (SCIs) in South Africa, a retrospective case-series study was conducted on injuries that occurred between 1980 and 2007. We aimed to identify preventable causes to reduce the overall rate of SCIs in South African rugby. Methods. We identified 264 rugby-related SCIs. A structured questionnaire was used, and it was possible to obtain information on a total of 183 players, including 30 who had died. Results. SCIs increased in number in the 1980s and in 2006. Forwards sustained 76% of all SCIs, and club players 60%. Players aged 17 had the highest number of SCIs. In only 50% of cases were medical personnel present at the time of injury, and 49% of injured players waited longer than 6 hours for acute management. Of players with an SCI, 61% had a catastrophic outcome after 12 months, including 8% who died during that time; 65% received no financial compensation; and only 29% of players had medical aid or health insurance. Conclusion. A register of all rugby-related SCIs in South Africa is essential to monitor the magnitude of the problem, identify potential risk factors, and formulate appropriate preventive interventions. The lack of reliable denominator data limits calculation of incident rates. Players from previously disadvantaged communities in particular suffered the consequences of limited public health care resources and no financial compensation

Far-UVC (222 nm) efficiently inactivated an airborne pathogen in a room-sized chamber

Funding: We acknowledge the financial assistance of the United Kingdom’s Department for Health and Social Care (2020/092).Many infectious diseases, including COVID-19, are transmitted by airborne pathogens. There is a need for effective environmental control measures which, ideally, are not reliant on human behaviour. One potential solution is Krypton Chloride (KrCl) excimer lamps (often referred to as Far-UVC), which can efficiently inactivate pathogens, such as coronaviruses and influenza, in air. Research demonstrates that when KrCl lamps are filtered to remove longer-wavelength ultraviolet emissions they do not induce acute reactions in the skin or eyes, nor delayed effects such as skin cancer. While there is laboratory evidence for Far-UVC efficacy, there is limited evidence in full-sized rooms. For the first time, we show that Far-UVC deployed in a room-sized chamber effectively inactivates aerosolised Staphylococcus aureus. At a room ventilation rate of 3 air-changes-per-hour (ACH), with 5 filtered-sources the steady-state pathogen load was reduced by 98.4% providing an additional 184 equivalent air changes (eACH). This reduction was achieved using Far-UVC irradiances consistent with current American Conference of Governmental Industrial Hygienists threshold limit values for skin for a continuous 8-h exposure. Our data indicate that Far-UVC is likely to be more effective against common airborne viruses, including SARS-CoV-2, than bacteria and should thus be an effective and “hands-off” technology to reduce airborne disease transmission. The findings provide room-scale data to support the design and development of effective Far-UVC systems.Publisher PDFPeer reviewe

Dairy foods and dairy protein consumption is inversely related to markers of adiposity in obese men and women

A number of intervention studies have reported that the prevalence of obesity may be in part inversely related to dairy food consumption while others report no association. We sought to examine relationships between energy, protein and calcium consumption from dairy foods (milk, yoghurt, cheese, dairy spreads, ice-cream) and adiposity including body mass index (BMI), waist (WC) and hip circumference (HC), and direct measures of body composition using dual energy X-ray absorptiometry (% body fat and abdominal fat) in an opportunistic sample of 720 overweight/obese Australian men and women. Mean (SD) age, weight and BMI of the population were 51 ± 10 year, 94 ± 18 kg and 32.4 ± 5.7 kg/m2, respectively. Reduced fat milk was the most commonly consumed dairy product (235 ± 200 g/day), followed by whole milk (63 ± 128 g/day) and yoghurt (53 ± 66 g/day). Overall dairy food consumption (g/day) was inversely associated with BMI, % body fat and WC (all p < 0.05). Dairy protein and dairy calcium (g/day) were both inversely associated with all adiposity measures (all p < 0.05). Yoghurt consumption (g/day) was inversely associated with % body fat, abdominal fat, WC and HC (all p < 0.05), while reduced fat milk consumption was inversely associated with BMI, WC, HC and % body fat (all p < 0.05). Within a sample of obese adults, consumption of dairy products, dairy protein, and calcium was associated with more favourable body composition

Use of Multiple Low Cost Carbon Dioxide Sensors to Measure Exhaled Breath Distribution with Face Mask Type and Wearing Behaviour

The use of cloth face coverings and face masks has become widespread in light of the COVID-19 pandemic. This paper presents a method of using low cost wirelessly connected carbon dioxide (CO2) sensors to measure the effects of properly and improperly worn face masks on the concentration distribution of exhaled breath around the face. Four types of face masks are used in two indoor environment scenarios. CO2 as a proxy for exhaled breath is being measured with the Sensirion SCD30 CO2 sensor, and data are being transferred wirelessly to a base station. The exhaled CO2 is measured in four directions at various distances from the head of the subject, and interpolated to create spatial heat maps of CO2 concentration. Statistical analysis using the Friedman’s analysis of variance (ANOVA) test is carried out to determine the validity of the null hypotheses (i.e., distribution of the CO2 is same) between different experiment conditions. Results suggest CO2 concentrations vary little with the type of mask used; however, improper use of the face mask results in statistically different CO2 spatial distribution of concentration. The use of low cost sensors with a visual interpolation tool could provide an effective method of demonstrating the importance of proper mask wearing to the public

Field measurement of natural ventilation rate in an idealised full-scale building located in a staggered urban array: comparison between tracer gas and pressure-based methods

Currently, no clear standards exist for determining urban building natural ventilation rates, especially under varying realistic meteorological conditions. In this study, ventilation rates are determined using tracer gas decay and pressure-based measurements for a full-scale (6 m tall) cube. The cube was either isolated (2 months of observations) or sheltered within a staggered array (7 months), for both single-sided and cross ventilation (openings 0.4 x 1 m). Wind speeds at cube height ranged between 0.04 m s-1 and 13.1 m s-1. Errors for both ventilation methods are carefully assessed. There is no discernible linear relation between normalised ventilation rates from the two methods, except for cross ventilation in the array case. The ratio of tracer gas and pressure derived ventilation rates is assessed with wind direction. For single-sided (leeward opening) cases it approached 1. For cross ventilation the ratio was closer to 1 but with more scatter. One explanation is that agreement is better when internal mixing is less jet-dominated, i.e. for oblique directions in the isolated case and for all directions for unsteady array flows. Sheltering may reduce the flushing rate of the tracer gas from the cube relative to internal mixing rate. This new dataset provides an extensive range of conditions for numerical model evaluation and for understanding uncertainty of ventilation rates. Knowledge of the latter is critical in buildin

Upper-Room Ultraviolet Light and Negative Air Ionization to Prevent Tuberculosis Transmission

Background Institutional tuberculosis (TB) transmission is an important public health problem highlighted by the HIV/AIDS pandemic and the emergence of multidrug- and extensively drug-resistant TB. Effective TB infection control measures are urgently needed. We evaluated the efficacy of upper-room ultraviolet (UV) lights and negative air ionization for preventing airborne TB transmission using a guinea pig air-sampling model to measure the TB infectiousness of ward air. Methods and Findings For 535 consecutive days, exhaust air from an HIV-TB ward in Lima, Perú, was passed through three guinea pig air-sampling enclosures each housing approximately 150 guinea pigs, using a 2-d cycle. On UV-off days, ward air passed in parallel through a control animal enclosure and a similar enclosure containing negative ionizers. On UV-on days, UV lights and mixing fans were turned on in the ward, and a third animal enclosure alone received ward air. TB infection in guinea pigs was defined by monthly tuberculin skin tests. All guinea pigs underwent autopsy to test for TB disease, defined by characteristic autopsy changes or by the culture of Mycobacterium tuberculosis from organs. 35% (106/304) of guinea pigs in the control group developed TB infection, and this was reduced to 14% (43/303) by ionizers, and to 9.5% (29/307) by UV lights (both p < 0.0001 compared with the control group). TB disease was confirmed in 8.6% (26/304) of control group animals, and this was reduced to 4.3% (13/303) by ionizers, and to 3.6% (11/307) by UV lights (both p < 0.03 compared with the control group). Time-to-event analysis demonstrated that TB infection was prevented by ionizers (log-rank 27; p < 0.0001) and by UV lights (log-rank 46; p < 0.0001). Time-to-event analysis also demonstrated that TB disease was prevented by ionizers (log-rank 3.7; p = 0.055) and by UV lights (log-rank 5.4; p = 0.02). An alternative analysis using an airborne infection model demonstrated that ionizers prevented 60% of TB infection and 51% of TB disease, and that UV lights prevented 70% of TB infection and 54% of TB disease. In all analysis strategies, UV lights tended to be more protective than ionizers. Conclusions Upper-room UV lights and negative air ionization each prevented most airborne TB transmission detectable by guinea pig air sampling. Provided there is adequate mixing of room air, upper-room UV light is an effective, low-cost intervention for use in TB infection control in high-risk clinical settings

Quality in care homes: How wearable devices and social network analysis might help

Social network analysis can support quality improvement in care homes but traditional approaches to social network analysis are not always feasible in care homes. Recalling contacts and movements in a home is difficult for residents and staff and documentary and other sources of individual contacts can be unreliable. Bluetooth enabled wearable devices are a potential means of generating reliable, trustworthy, social network data in care home communities. In this paper, we explore the empirical, theoretical and real-world potential and difficulties in using Bluetooth enabled wearables with residents and staff in care homes for quality improvement. We demonstrate, for the first time, that a relatively simple system built around the Internet of Things, Bluetooth enabled wearables for residents and staff and passive location devices (the CONTACT intervention) can capture social networks and data in homes, enabling social network analysis, measures, statistics and visualisations. Unexpected variations in social network measures and patterns are surfaced, alongside “uncomfortable” information concerning staff time spent with residents. We show how technology might also help identify those most in need of social contact in a home. The possibilities of technology-enabled social network analysis must be balanced against the implementation-related challenges associated with introducing innovations in complex social systems such as care homes. Behavioural challenges notwithstanding, we argue that armed with social network information, care home staff could better tailor, plan and evaluate the effects of quality improvement with the sub-communities that make up a care home community

What is the relationship between indoor air quality parameters and airborne microorganisms in hospital environments? A systematic review and meta?analysis

Airborne microorganisms in hospitals have been associated with several hospital‐acquired infections (HAIs), and various measures of indoor air quality (IAQ) parameters such as temperature, relative humidity, carbon dioxide (CO2), particle mass concentration, and particle size have been linked to pathogen survival or mitigation of pathogen spread. To investigate whether there are quantitative relationships between the concentration of airborne microorganisms and the IAQ in the hospital environment. Web of Science, Scopus and PubMed databases were searched for studies reporting airborne microbial levels and any IAQ parameter(s) in hospital environments, from database inception to October 2020. Pooled effect estimates were determined via random‐effects models. Seventeen of 654 studies were eligible for the meta‐analysis. The concentration of airborne microbial measured as aerobic colony count (ACC) was significantly correlated with temperature (r = 0.25 [95% CI = 0.06–0.42], p = 0.01), CO2 concentration (r = 0.53 [95% CI = 0.40–0.64], p ˂ 0.001), particle mass concentration (≤5 µg/m3; r = 0.40 [95% CI = 0.04–0.66], p = 0.03), and particle size (≤5 and ˃5 µm), (r = 0.51 [95% CI = 0.12–0.77], p = 0.01 and r = 0.55 [95% CI = 0.20–0.78], p = 0.003), respectively, while not being significantly correlated with relative humidity or particulate matter of size >5 µm. Conversely, airborne total fungi (TF) were not significantly correlated with temperature, relative humidity, or CO2 level. However, there was a significant weak correlation between ACC and TF (r = 0.31 [95% CI = 0.07–0.52], p = 0.013). Although significant correlations exist between ACC and IAQ parameters, the relationship is not definitive; the IAQ parameters may affect the microorganisms but are not responsible for the presence of airborne microorganisms. Environmental parameters could be related to the generating source, survival, dispersion, and deposition rate of microorganisms. Future studies should record IAQ parameters and factors such as healthcare worker presence and the activities carried out such as cleaning, sanitizing, and disinfection protocols. Foot traffic would influence both the generation of microorganisms and their deposition rate onto surfaces in the hospital environment. These data would inform models to improve the understanding of the likely concentration of airborne microorganisms and provide an alternative approach for real‐time monitoring of the healthcare environment