Socioeconomic status and non-fatal injuries among Canadian adolescents: variations across SES and injury measures

BACKGROUND: While research to date has consistently demonstrated that socioeconomic status (SES) is inversely associated with injury mortality in both children and adults, findings have been less consistent for non-fatal injuries. The literature addressing SES and injury morbidity among adolescents has been particularly inconclusive. To explore potential explanations for these discrepant research findings, this study uniquely compared the relationship across different measures of SES and different causes of injury (recreation versus non-recreation injuries) within a sample of Canadian adolescents. METHODS: The sample included adolescent participants (aged 12 to 19 years) in the Canadian 1996–1997 cross-sectional National Population Health Survey (n = 6967). Five SES measures (household income, two neighbourhood-level proxy measures, two parental indicators) were examined in relation to three injury outcomes (total, recreation, and non-recreation injuries) using multivariable logistic regression. RESULTS: Among males, a clear relationship with injury was observed only for a parental SES index, which was positively associated with total and recreation injuries (odds ratios for the highest versus lowest SES category of 1.9 for total and 2.5 for recreation injuries). Among females, there was some evidence of a positive relationship between SES and injuries, particularly for a neighbourhood-level education measure with total and recreation injuries (odds ratios of 1.7 for total and 2.0 for recreation injuries). CONCLUSION: The results suggest that differences related to the measures of SES chosen and the causes of injury under study may both contribute to discrepancies in past research on SES and non-fatal injuries among adolescents. To clarify the potential SES-injury relationship among youth, the findings emphasize a need for a greater understanding of the meaning and relevance of different SES measures for adolescents, and for an exploration of the pathways through which SES may be related to injury risk

Butting Heads: Tackling Football Concussion and Prevention

Hundreds of thousands of sports concussions occur each year in the United States, and almost half of them are the result of a football injury. Even though they may not initially appear serious, concussions can lead to extreme cognitive impairments in those affected. This article highlights the importance of treating concussions properly and educating coaches, parents, and athletes on the value of allowing young athletes to take the time they need to fully recover

Cyclosporine augments hepatic regenerative response in rats

A number of mechanisms participate in the hepatic injury that occurs during and following liver transplantation. A normal allograft regenerative response is probably essential for a successful transplant outcome. In this study, the effect of cyclosporine, a potent immunosuppressant used routinely after liver transplantation, on the regenerative response of the liver after partial hepatectomy was investigated. Male Wistar rats were pretreated for one week with either cyclosporine or the olive oil vehicle and were subjected to either a two-thirds partial hepatectomy or a sham operation. Animals were sacrificed at various times postoperatively and the remnant livers were weighed to determine the liver weight to body weight ratio, two biochemical measures of a regenerative response (cytosolic ornithine decarboxylase activity and thymidine kinase activity), and the hepatic content of estrogen and androgen receptors, as the content of these receptors has been shown to modulate, at least in part, the subsequent hepatic regenerative response. The preoperative hepatic cytosol content of ornithine decarboxylase, thymidine kinase, and estrogen receptor was significantly greater (P<0.05) in rats pretreated with cyclosporine than in those treated with the vehicle alone. A significant increase in ornithine decarboxylase and thymidine kinase activities occurred after partial hepatectomy in both the cyclosporine-pretreated and vehicle-pretreated animals. The absolute levels for each parameter were also greater in the cyclosporine-treated animals than in the vehicle-treated controls at 24 hr after partial hepatectomy (P<0.05). The pattern of change in the hepatic cytosolic content of estrogen and androgen receptors in both groups of animals was comparable with those described previously for regenerating liver. These data suggest that cyclosporine may predispose the liver to respond to either a regenerative signal or perceived need and thereby fortuitously enhance liver graft performance after successful surgical implantation. © 1989 Plenum Publishing Corporation

Return to driving after head injury

Objectives: To determine whether patients who return to driving after head injury can be considered safe to do so and to compare the patient characteristics of those who return to driving with those who do not. Methods: In a multicentre qualitative study ten rehabilitation units collectively registered 563 adults with traumatic brain injury during a 2.5 year period. Recruitment to the study varied from immediately after hospital admission to several years post injury. Patients and their families were interviewed around three to six months following recruitment. 383 (67.5%) subjects were interviewed within one year of injury, of whom 270 (47.6%) were interviewed within 6 months of injury. Main outcome measures were the presence or absence of driving related problems reported by drivers and ex-drivers, and scores on driving related items of the Functional Independence/Functional Assessment Measure (FIM+FAM). Results: Of the 563 patients 381 were drivers before the injury and 139 had returned to driving at interview. Many current drivers reported problems with behaviour (anger, aggression, irritability) (67 (48.2%)), memory ( 89 (64%)), concentration and attention (39 (28.1%)), and vision (39 (28.1%)). Drivers reported most driving-related problems as frequently as ex-drivers, main exceptions were epilepsy and community mobility. Current drivers scored significantly higher on the FIM+FAM (i.e. more independent), than ex-drivers. The driving group had sustained less severe head injuries than ex-drivers, nevertheless 78 (56.2%) of current drivers had received a severe head injury. Few (61, 16%) previous drivers reported receiving formal advice about driving following injury. Conclusions: The existence of problems which could significantly affect driving do not prevent patients returning to driving after TBI. Patients should be assessed for both mental and physical status before returning to driving after a head injury, and systems put in place to enable clear and consistent advice to be given to patients regarding driving

Avaliação das diferenças de gênero nas estratégias de enfrentamento da dor lombar

El dolor lumbar puede ser visto como un gran problema de salud pública. Las diferencias de género son importantes factores que influyen en los síntomas y en las respuestas del comportamiento. El objetivo de este estudio fue investigar las diferencias de género en los comportamientos de dolor y en el manejo del dolor lumbar crónico. La muestra estuvo conformada por 158 participantes (66,5% mujeres), con edades entre los 30 y 88 años que fueron diagnosticados con artrosis lumbar. Los instrumentos utilizados fueron: la Escala Visual Analógica, el Cuestionario de Calidad de Vida y un cuestionario para evaluar las actividades de ocio y distracción del dolor. Los resultados del MANOVA demostraron que las mujeres presentaron mayor percepción del dolor que los hombres. También fue posible observar frecuencias más altas de actividades sociales en las mujeres, así como correlaciones significativas entre las actividades sociales y los dominios psicológicos, sociales y medio ambientales. En conclusión, las mujeres presentan un mayor número de estrategias de afrontamiento para el dolor, lo cual puede influir positivamente en su calidad de vida.A dor lombar pode ser vista como um grande problema de saúde pública. As diferenças de gênero são importantes fatores que influenciam nos sintomas e nas respostas do comportamento. O objetivo deste estudo foi pesquisar as diferenças de gênero nos comportamentos de dor e na gestão da dor lombar crônica. A amostra foi conformada por 158 participantes (66,5% mulheres), com idade entre 30 e 88 anos, que foram diagnosticadas com artrose lombar. Os instrumentos utilizados foram: a Escala Visual Analógica, o Questionário de Qualidade de Vida e um questionário para avaliar as atividades de lazer e distração da dor. Os resultados do MANOVA demonstraram que as mulheres apresentaram maior percepção da dor do que os homens. Também foi possível observar frequências mais altas de atividades sociais nas mulheres, bem como correlações significativas entre as atividades sociais e os domínios psicológicos, sociais e meio ambientais. Em conclusão, as mulheres apresentaram um maior número de estratégias de enfrentamento para a dor, o que pode influenciar positivamente em sua qualidade de vida.Low-back pain is considered a serious public health problem. Gender differences are important factors that influence symptoms and behavioral responses. This research aimed to investigate gender differences in pain behaviors and pain management of chronic low back pain. The sample consisted of 158 participants (66.5% female), aged 30-88 who were diagnosed with Lumbar Osteoarthritis. The instruments used were the Visual Analogue Scale, the Quality of Life Questionnaire and a questionnaire to assess leisure and distraction activities from pain. Results of MANOVA showed that women have significant greater pain perception than men. Higher frequencies of social activities were also observed for women as well as significant correlations between social activities and psychological, social and environmental domains. In conclusion, women presented a greater number of coping strategies for pain than men, which probably tend to have a positive influence in their life quality

Frequent mild head injury promotes trigeminal sensitivity concomitant with microglial proliferation, astrocytosis, and increased neuropeptide levels in the trigeminal pain system.

BACKGROUND: Frequent mild head injuries or concussion along with the presence of headache may contribute to the persistence of concussion symptoms. METHODS: In this study, the acute effects of recovery between mild head injuries and the frequency of injuries on a headache behavior, trigeminal allodynia, was assessed using von Frey testing up to one week after injury, while histopathological changes in the trigeminal pain pathway were evaluated using western blot, ELISA and immunohistochemistry. RESULTS: A decreased recovery time combined with an increased mild closed head injury (CHI) frequency results in reduced trigeminal allodynia thresholds compared to controls. The repetitive CHI group with the highest injury frequency showed the greatest reduction in trigeminal thresholds along with greatest increased levels of calcitonin gene-related peptide (CGRP) in the trigeminal nucleus caudalis. Repetitive CHI resulted in astrogliosis in the central trigeminal system, increased GFAP protein levels in the sensory barrel cortex, and an increased number of microglia cells in the trigeminal nucleus caudalis. CONCLUSIONS: Headache behavior in rats is dependent on the injury frequency and recovery interval between mild head injuries. A worsening of headache behavior after repetitive mild head injuries was concomitant with increases in CGRP levels, the presence of astrocytosis, and microglia proliferation in the central trigeminal pathway. Signaling between neurons and proliferating microglia in the trigeminal pain system may contribute to the initiation of acute headache after concussion or other traumatic brain injuries

The age related prevalence of aggression and self-injury in persons with an intellectual disability: A review

The aim of this study was to analyse statistically published data regarding the age related prevalence of aggression and self-injury in persons with intellectual disability. Studies including prevalence data for aggression and/or self-injury broken down by age band were identified and relative risk analyses conducted to generate indices of age related change. Despite conflicting results, the analysis conducted on included studies considered to be the most methodologically robust indicated that the relative risk of self-injury, and to a lesser extent aggression, increased with age until mid-adulthood, with some indication of a curvilinear relationship for self-injury. These conclusions have implications for the understanding of the development of different forms of challenging behavior and the importance of early intervention strategies

Workers’ Compensation, Wages, and the Risk of Injury

[Excerpt] In many respects the structures of the workers\u27 compensation and unemployment insurance systems are similar. Each is actually a system of individual state systems. Both are financed by a payroll tax that is imperfectly experience rated. Both provide insurance against an adverse consequence (work injury or unemployment) that leads to time away from work; the incidence and duration of these events are at least partially determined by both employer and employee behavior. Both systems provide, at least for temporary events, a structure of benefits that ties compensation to a worker\u27s previous earnings. Because of these similarities, it is not inappropriate for an individual such as myself, who has conducted some research on the unemployment insurance system but none on the workers\u27 compensation system, to provide an analysis and summary of the effects of the latter on work injury experience. Indeed, one contribution of this chapter will be to point out how lessons learned from research on other forms of social insurance can be applied to research on workers\u27 compensation. Nonetheless, there are important differences in, and complexities of, the workers\u27 compensation system that analyses of it must take into account; these are highlighted as well