Approximately 4.2 million workers were injured in the United States in 2005, costing employers over $171 billion, a figure under-estimating the true cost. This retrospective descriptive occupational injury study analyzed existing health and safety data from 2002 through 2006 at a large US manufacturing employer. All work-related injuries from six geographic locations were included in the study. A total of 36,611 injuries involving 20,738 employees were analyzed using descriptive statistics to characterize the injuries, and general estimating equations (GEE) and multivariate logistic regression analyses to identify risk factors affecting the severity of occupational injuries.Nearly two-thirds of injuries reported were recorded on the OSHA log. Forty percent of occupational injuries resulted in restricted days, and 21% resulted in lost days. Three-quarters of the occupational injuries occurred among Production and Maintenance employees. Various injury characteristics and personal/work characteristics influenced recordability of occupational injury, restricted activity and lost days following occupational injury. Repetitive motion and over-exertion injuries were most commonly associated with recordable injuries and injuries with restricted or lost days. Employees with injuries due to repetitive motion in shop operations were more than twice as likely to experience lost days following injury as workers with most other types of injuries. Men were six times as likely to sustain a repetitive motion injury in shop operations. Union affiliation increased the likelihood of having an injury being recorded on the OSHA log or incurring restricted or lost days; however, significant interaction terms that included union status and other variables, suggest that the results should be viewed cautiously. Production & Maintenance workers were at greatest risk for incurring multiple injuries.Results of this study can be used to enhance prevention programs already in place in this company. Targeting future repetitive motion and over-exertion injuries and ensuring proper treatment and prevention interventions may reduce the severity and recurrence of injuries.

Spinal cord injuries can cause the catastrophic loss of motor and sensory function. The neurological deficits that result are the consequence of not only the primary injury to the spinal cord, but also a complex milieu of secondary pathological processes that are now beginning to be understood. The major mechanisms that underlie this secondary pathology include vascular disruption, ischemia, oxidative stress, excitotoxicity, and inflammation. In light of this, the fact that this secondary pathology occurs after the initial impact makes it potentially amenable to therapeutic intervention. Pharmacotherapies may attenuate some of these processes and minimize secondary damage. Some of the promising treatments that are emerging for acute spinal cord injury are drugs that are already used by physicians for the treatment of unrelated diseases. These drugs, which have already been established to be safe for humans, offer the unique advantage over other novel therapeutic interventions that have yet to be tested in humans. This would save a tremendous amount of time and money needed for human safety studies, if considered as a treatment for spinal cord injury. Examples of such drugs include minocycline (an antibiotic), erythropoietin (a recombinant hormone used to treat anemia), and statins (a popular class of blood cholesterol reducers), all of which have demonstrated the ability to attenuate the various pathophysiological processes initiated after trauma to the central nervous system. In a series of studies, erythropoietin, darbepoetin, atorvastatin, simvastatin, and minocycline were all evaluated for their ability to improve neurologic recovery in a clinically relevant model of spinal cord injury. My experiments revealed that erythropoietin, darbepoetin, atorvastatin and minocycline did not significantly improve neurological recovery. These negative results were in stark contrast to the positive findings which had been published in the literature suggesting that differences in experimental models and methodology influence the neuroprotective efficacy of these drugs. Simvastatin, on the other hand, demonstrated significant improvements in locomotor and histological outcomes. Although this is indeed exciting, the results were modest at best. My results highlight the need for further preclinical work on the above treatments to refine and optimize them prior to proposing them for human testing.

The original purpose of this investigation was to determine if soccer players who performed an agility training program in a specialized training shoe would have a lower incidence of acute ankle sprains as compared to controls. Two elite male college soccer teams participated in the study. The experimental team performed an agility training program two to three days per week over a three month period wearing the Nike Free Trainer. Data on ankle sprain incidence throughout the season was collected, as well as scores on tests of ankle strength, static balance, dynamic balance, agility and self-reports of ankle function. These scores were compared to those of the control team. Statistical analysis showed a statistically significant improvement in the experimental team members in the anteromedial reach direction of the dynamic balance test (p=0.001). This group also showed positive trends in ankle strength ratio and five of the eight other reach directions of the dynamic balance test. Unfortunately, pre-test, post-test statistical analysis was possible for only half of the experimental team subjects. Post-test data was not generated for the other half of these subjects due to unrelated injury or subject noncompliance. Lack of pre-test data due to subject non-compliance in the control team hindered between group statistical comparisons. This study uncovered promising trends as to the potential for gains in dynamic balance as a result of agility training with Nike Free Trainer. This study also established the reliability of three clinical tests of ankle strength, static balance and dynamic balance. Future well-designed studies are recommended to research this area further to discern the effect of this agility training program on dynamic balance and establish its’ effect on ankle sprain incidence.

No description available.

Alcohol is a recognized cause of over 60 injuries and diseases and is consistently in the top 5 most important risk factors for global burden of disease. It is important to be able to measure how drinking alcohol affects our health, and how our risk of getting injured or acquiring diseases caused by alcohol is dependent on how much alcohol we drink. This type of information allows us to make personal choices about our health and is an integral piece of public health evidence to inform how alcohol policy is informed, implemented, or monitored. This analysis will, for the first time, model the effects of alcohol for injury outcomes over the entire drinking lifetime for men and women separately using a new method that aims to improve upon existing calculations by accounting for different patterns of drinking – both acute consumption and average daily drinking. In both cases, both the amount consumed and the number of times it is consumed is taken into account. Within acute consumption, the number of occasions and the amount ii consumed at each occasion was counted. What’s more, for the first time in this field, a lifetime approach was adopted – risks will no longer be seen as discrete, individual events that occur independently of each other. In this study, risks are combined much like other exposures to environmental substances or contaminants – in a cumulative manner over a lifetime of drinking. The method combines data sources from experimental data, from meta-analyses, Canadian mortality and hospital data, and survey data, making this a rich, yet complicated analysis. Its products were dose-response risk curves for each injury outcome, by sex, and age group, and alcohol-attributable fractions and their variance estimation for mortality and morbidity for injury. This study has important implications for forming and planning health policy, represents advancements in absolute risk calculation, and will result in important consumer-level information that will enable development of limits around healthy drinking.

Background. In Canada, motor vehicle collisions are the leading cause of unintentional injury deaths and second leading cause of injury hospitalization. Nationally, serious traffic injury has reduced 35% (1986-2005). Social determinants of health have not been studied with serious traffic injury in adulthood. Study Aims. To determine whether lower SES (measured by education, income, and employment), is associated with serious traffic and fall injury and injury severity and whether the pattern of association differed between traffic and fall injury. To reveal issues to be made by decision makers regarding at risk groups. Methods. Combined cycles (1.1, 2.1, and 3.1) of the cross-sectional Canadian Community Health Survey were used. Injuries in the past year ‘serious enough to limit normal activities’ were studied. Deaths and less serious injuries are not captured. “Transportation accident” was used to represent traffic injury. It does not specify victim type (e.g. driver, bicyclist) yet the category pertains to “automobiles” and published research used it as a proxy for motor vehicle collisions. Power analyses, survey weighting and bootstrapping were executed to prevent biased population estimates. Records with missing data were excluded. Logistic regression models were performed for tests with binary outcomes. Injury severity selected individuals’ highest treatment within 48 hours - admitted to hospital, Emergency Department visit, or seeing a health professional. Results. Socioeconomic variables were associated with serious traffic and fall injury and severity. For serious traffic injury, those with some post-secondary education were at higher risk (OR=1.34; 95%CI 1.08, 1.67) than post-secondary graduates. For serious fall injury, an education by gender interaction resulted. Males who did not complete high school had a higher risk (OR=1.14; 95%CI 1.03, 1.27) relative to post-secondary graduates. With the same reference group, females who completed high school had a lower risk (OR=0.86; 95%CI 0.75, 0.98). For serious fall injury, those in the lowest, versus top, personal income quintile had a higher risk (OR=1.37; 95%CI 1.23, 1.51). Females had a higher risk (OR=1.18; 95%CI 1.03, 1.35) of serious traffic injury relative to males. Youth/young adults had a higher risk of serious traffic injury (OR=1.75; 95%CI 1.50, 2.06) relative to the middle-aged group. The younger group had a higher risk of serious fall injury (OR=1.41; 95%CI 1.25, 1.60) relative to seniors. With serious traffic injury, seniors had a lower risk (OR=0.50; 95%CI 0.37, 0.68) than the middle-aged group. This did not support the literature with young and old at risk for traffic injury. In the two-level traffic severity model, employed, versus unemployed, individuals had a higher risk (OR=1.69; 95%CI 1.12, 2.55). Discussion. Associations were found between SES variables and serious traffic and fall injury for Canadians 12 years of age and over that were mostly but not always in the direction of lower SES having higher rates. Findings must be interpreted with caution due to sampling bias from missing data removal (27%). Information was not available on culpability or vehicle miles travelled. The traffic injury-SES relationship and SES-traffic severity relationship merit further inquiry in other contexts or with other datasets.

This study was done to investigate the effect of ischemia-reperfusion injury on cytosolic and mitochondrial glutathione levels in the rat kidney. Glutathione is the main cellular defense against free radicals that are thought to cause ischemia-reperfusion injury. Right kidneys from anesthetized female Lewis rats (9-12 months old) were exposed to 60 minutes of ischemia followed by 0, 30, or 120 minutes of reperfusion. The kidneys were perfused with isotonic saline, harvested, homogenized, and separated into cytosolic and mitochondrial fractions by differential centrifugation. Reduced (GSH) and oxidized (GSSG) glutathione levels were measured spectrophotometrically. There were significant decreases in both the GSH levels and the % GSH/Total Glutathione in the cytosol and mitochondria of kidneys exposed to ischemia-reperfusion injury when compared to control kidneys. The glutathione levels in either the cytosol or mitochondria did not recover even after 120 minutes of reperfusion. This study demonstrates that 60 minutes of ischemia followed by 0, 30, or 120 minutes of reperfusion decreases both cytosolic and mitochondrial levels of glutathione in the rat kidney. / Department of Physiology and Health Science

Boredom is a common human experience, yet little is known about its underlying neural mechanisms. This thesis first set out to investigate the construct of boredom and more closely examined its relationship to phenomenologically similar mood states of depression, apathy and anhedonia. Next, deficits in sustained attention, and novelty seeking were examined in patients with traumatic brain injury (TBI), who are characterized by atypically high levels of boredom. Study 1 established that although related to varying degrees to apathy, anhedonia, and depression, boredom is indeed a distinct emotional experience. Furthermore, two boredom proneness subtypes - agitated and apathetic - were identified which varied in their relationships to depression. The relationship between boredom and depression was found to be high only in the agitated boredom prone subtype, which is characterised by a high degree of motivation to engage in meaningful, stimulating activities despite the fact that all attempts to do so fail to satisfy. In Study 2, the relationship between boredom proneness and depression was found to be greater in TBI patients than in healthy controls. Using a behavioral measure of sustained attention (SART; Robertson et al., 1997), Study 3 demonstrated a relationship between boredom proneness and sustained attention in healthy controls, such that RTs were faster and commission errors more prevalent in the agitated boredom prone subtype. No relationship between boredom proneness and sustained attention was found in TBI patients. So while attention and boredom show a clear relationship in the healthy brain, this relationship may be disrupted in TBI patients. Finally, Study 4 demonstrated an association between agitated boredom proneness and a preference for novel stimuli across participant groups. In addition, patients had a poorer ability to discriminate between similar and dissimilar stimuli than controls, which was more evident in the agitated boredom prone group. It may be the case then that agitated boredom prone individuals fail to satisfy their desire to engage in stimulating activities in part because they fail to accurately identify when something is indeed novel. Taken together, these results highlight important distinctions between apathetic and agitated boredom proneness, and the way in which these subtypes relate to depression, attention, and novelty seeking, in brain injured patients and healthy controls. More work is needed to determine the role played by boredom in TBI, particularly as this evolves from acute to chronic stages of the illness. Importantly, identifying boredom as a key element in depressive mood disorders, attention deficits (e.g., attention deficit hyperactivity disorder), and novelty seeking behaviour, facilitates the design and implementation of appropriate intervention strategies. For example, it will become increasingly important to deal with boredom as a significant component of depression. Thus, the work presented here represents a novel and important contribution to the study of boredom in that it brings the field one step closer to understanding and treating the experience. Further investigation with greater numbers of patients is necessary to fully explicate the relationship between boredom and depression, attention, and novelty seeking in TBI.

Brain injuries (BI) are the leading cause of death and disability among people under the age of 45 (Ontario Brain Injury Association, 2004). With improved survival rates, more individuals each year return to the community with impairments and disabilities caused by their injury (Smith, Magill–Evans, and Brintnell, 1998). Adjusting to these impairments may affect the individual’s subjective well being; therefore, attention to community reintegration by researchers, policy developers, and health care providers is important. Using qualitative research methods and systems theory as the theoretical framework, the purpose of the study was to examine community reintegration from the perspectives of three key groups: individuals with BI, community based agencies, and primary care physicians regarding the meaning attributed to “successful reintegration”, as well as the key characteristics and barriers experienced during reintegration. “Successful” reintegration appears to be an individually derived concept. Participants consistently identified the need for information about the process of community reintegration, and resources available both during rehabilitation and after discharge from the hospital as being both a key aspect of community reintegration, as well as a barrier experienced during the return to community.

Introduction: An injury surveillance system was piloted in 2011 to monitor injuries in Canadian Forces. This evaluation of the key system attributes examined system performance. Methods: A retrospective chart review, a coding reliability study, a completeness of forms study and a key informant interview. Results: Sensitivity was 0.36 (95% CI: 0.28, 0.46). The system was missing patients over age 35. Kappa coefficients over 0.80 demonstrated good agreement. Completeness of forms study demonstrated high percentages of response for most questions and lower rates for questions related to using protective equipment, and consent for information sharing. Interviews proved acceptability to stakeholders, usefulness for identifying clusters and trends, simple and complete data collection, and flexibility. Conclusion: The injury surveillance system had good potential for several reasons: data collection did not require additional work in clinics; the system was well accepted and partially proved usefulness and timeliness in identifying unusual injury events.