Sociodemographic profile of an Olympic team.

OBJECTIVES: To document the distribution of sociodemographic markers (race and relative access to wealth) in athletes participating at the summer and Winter Olympic Games (OGs). STUDY DESIGN: Cross-sectional descriptive epidemiological study. METHODS: Sociodemographic data were collected from publically available resources for all athletes representing four countries (Canada, United States of America, Great Britain and Australia) at the 2014 Sochi Winter OGs and 2016 Rio Summer OGs. The prevalence of white and privately educated athletes were identified for each sport, country, and team with consideration and comparison to the general population. Access indices (i.e. the combined race socio-economic access index [CAI]) were developed to describe the relative distribution of white and privately educated athletes representing each sport, country and team compared to the respective general population. RESULTS: A total of 568 winter and 1643 summer athletes were included in this study. Privately educated athletes constituted 30.3% and 32.7% of winter and summer athletes, respectively; while 94.9% of winter and 81.7% of summer athletes were white. The CAIs of the Canadian, American, British and Australian winter Olympic teams were 0.52, 0.42, 0.61 and 0.45, respectively. The CAIs, for the Canadian, American, British and Australian summer Olympic teams were 0.89, 1.13, 0.82 and 0.83, respectively. Summer and winter sports with the greatest and least racial and socio-economic biases were identified. CONCLUSION: Racial and socio-economic biases were identified in both summer and winter Olympic sports; predominantly favouring white and privately educated Olympic athletes. These findings prompt further inquiry into barriers for sport-specific participation and advancement, in addition to the practice of providing substantial public resources in support for Olympic sports and athletes.

What is lost when searching only one literature database for articles relevant to injury prevention and safety promotion?

OBJECTIVE: To assess what is lost if only one literature database is searched for articles relevant to injury prevention and safety promotion (IPSP) topics. METHOD: Serial textword (keyword, free-text) searches using multiple synonym terms for five key IPSP topics (bicycle-related brain injuries, ethanol-impaired driving, house fires, road rage, and suicidal behaviors among adolescents) were conducted in four of the bibliographic databases that are most used by IPSP professionals: EMBASE, MEDLINE, PsycINFO, and Web of Science. Through a systematic procedure, an inventory of articles on each topic in each database was conducted to identify the total unduplicated count of all articles on each topic, the number of articles unique to each database, and the articles available if only one database is searched. RESULTS: No single database included all of the relevant articles on any topic, and the database with the broadest coverage differed by topic. A search of only one literature database will return 16.7-81.5% (median 43.4%) of the available articles on any of five key IPSP topics. Each database contributed unique articles to the total bibliography for each topic. CONCLUSION: A literature search performed in only one database will, on average, lead to a loss of more than half of the available literature on a topic.

Using online databases to find journal articles on injury prevention and safety promotion research: key journals and the databases that index them.

OBJECTIVES: (1) To determine the trends of the number of journals that publish injury prevention and safety promotion (IPSP) articles and the number of articles published each year from 1900 through 2006; (2) to determine the coverage of key IPSP journals in widely used literature databases. METHODS: Journals were identified through a structured procedure that included hand-searching selected classification categories of two major listings of periodicals that publish four or more IPSP-relevant articles per year. Article relevance was assessed using the inclusion criteria for SafetyLit (a database of scholarly literature selected for its relevance to the IPSP field). Each identified journal was hand-searched from its first issue, and IPSP-relevant articles were added to the SafetyLit archive database. A MySQL database was used to perform basic queries and statistical summary analyses for journals published 1900-2006. The number of IPSP journals and journal articles was plotted for these years to identify publication trends. The publication year range of each IPSP journal was compared with the coverage, if any, of the journals in each of the five databases. RESULTS: Of the 17 839 journals assessed, 597 met the threshold for inclusion in this study. This amounts to thousands of IPSP-related articles published each year: 6100 in 2006. Only 160 (26.8%) of the journals are included in all five databases, and none have all publication years included in all of the databases. CONCLUSIONS: Some key IPSP journals are completely excluded from some of the databases. Thus, a search in a single database may miss key information from one of the many disciplines that publish IPSP-relevant information.

Phosphoinositide 3-kinase modulation of beta(3)-integrin represents an endogenous "braking" mechanism during neutrophil transmatrix migration.

During episodes of inflammation, neutrophils (polymorphonuclear leukocytes [PMNs]) encounter subendothelial matrix substrates that may require additional signaling pathways as directives for movement through the extracellular space. Using an in vitro endothelial and epithelial model, inhibitors of phosphoinositide 3-kinase (PI3K) were observed to promote chemoattractant-stimulated migration by as much as 8 +/- 0.3-fold. Subsequent studies indicated that PMNs respond in a similar manner to RGD-containing matrix substrates and that PMN-matrix interactions are potently inhibited by antibodies directed against beta(3)- but not beta(1)-integrin antibodies, and that PI3K inhibitors block beta(3)-integrin dependence. Biochemical analysis of intracellular beta(3)-integrin uncoupling by PI3K inhibitors revealed diminished beta(3)-integrin tyrosine phosphorylation and decreased association with p72(syk). Similarly, the p72(syk) inhibitor piceatannol promoted PMN transmatrix migration, whereas HIV-tat peptide-facilitated loading of peptides corresponding to the beta(3)-integrin cytoplasmic tail identified the functional tyrosine residues for this activity. These data indicate that PI3K-regulated beta(3)-integrin represents a natural "braking" mechanism for PMNs during transit through the extracellular matrix.

The vasodilator-stimulated phosphoprotein is regulated by cyclic GMP-dependent protein kinase during neutrophil spreading.

The expression and phosphorylation state of the vasodilator-stimulated phosphoprotein (VASP), a membrane-associated focal adhesion protein, was investigated in human neutrophils. Adhesion and spreading of neutrophils induced the rapid phosphorylation of VASP. The phosphorylation of VASP was dependent on cell spreading, as VASP was expressed as a dephosphorylated protein in round adherent cells and was phosphorylated at the onset of changes in cell shape from round to spread cells. Immunofluorescence microscopy demonstrated that VASP was localized at the cell cortex in round cells and redistributed to focal adhesions at the ventral surface of the cell body during cell spreading. Dual labeling of spread cells indicated that VASP was colocalized with F-actin in filopodia and in focal adhesions, suggesting that the phosphorylation of VASP during cell spreading may be involved in focal adhesion complex organization and actin dynamics. VASP is a prominent substrate for both cGMP-dependent protein kinase (cGK) and cAMP-dependent protein kinase. Evidence suggested that cGK regulated neutrophil spreading, as both VASP phosphorylation and neutrophil spreading were inhibited by Rp-8-pCPT-cGMPS (cGK inhibitor), but not KT5720 (cAMP-dependent protein kinase inhibitor). In contrast, neutrophil spreading was accelerated when cGMP levels were elevated with 8-Br-cGMP, a direct activator of cGK. Furthermore, the same conditions that lead to VASP phosphorylation during neutrophil adherence and spreading induced significant elevations of cGMP in neutrophils. These results indicate that cGMP/cGK signal transduction is required for neutrophil spreading, and that VASP is a target for cGK regulation.

Evaluation of a program of university placement for spinal cord injured rehabilitation clients in Louisiana.

The Louisiana State Department of Social Services, Rehabilitation Services (LRS) offers a program of financial support for spinal cord injured persons to attend college. We evaluated this program's effectiveness and attempted to identify factors that may predict student success. We examined the LRS case records of all students with documented SCI who had enrolled in the LRS college program before 1988. We compared the proportion of LRS clients who graduated with the proportion of general population students attending the same schools. We measured the association between graduation and factors that may help predict success. Of the 51 LRS clients studied, 25 (49%) graduated from baccalaureate institutions within 6 years. Of Louisiana students-at-large who attended the colleges that housed LRS students, 36% of those graduated within 6 years. The best predictor of success was the American College Test score. All students with a score of 17 or more graduated. A larger proportion of LRS-sponsored students graduated than did students from the general population.

High school football-related cervical spinal cord injuries in Louisiana: the athlete's perspective.

Louisiana has one of the highest rates in the nation of cervical spinal cord injuries to high school football players. When the national rate of these injuries is applied to the number of high school participants in Louisiana, we would expect there to be only one catastrophic neck injury every 14 years. Louisiana, however, has averaged 2.3 spinal cord injuries per year for the past seven football seasons. Players who use the top of their helmets to tackle, block, or strike opponents are at greatest risk for these injuries. This study was undertaken to describe the safe tackling knowledge, attitudes, and practices of Louisiana high school football players. We surveyed 596 players from 16 Louisiana high schools. When asked if it was within the rules to tackle anyone by using the top of their helmet, 29% incorrectly answered "yes". Similarly, when asked if they had ever tackled anyone using the top of their helmet, 33% reported that they had. Twenty-eight percent said that they had been taught to use this unsafe method. Of these, 83% said that their coach taught them this dangerous and illegal method. Using the helmet as a battering ram must be discouraged. Education for officials, coaches, and players is needed to improve recognition of improper tackling. Proper training in tackling and blocking is an important means of minimizing the possibility of catastrophic injury.

Spinal cord injuries in Louisiana due to falls from deer stands, 1985-1994.

Serious injuries resulting in paralysis and death have occurred to hunters who have fallen from deer stands that were not equipped with safety restraints. Among the most serious of these are spinal cord injuries. We examined all deer stand-related spinal cord injuries reported to Louisiana's Spinal Cord Injuries Registry from 1985 through 1994. During the 1985 through 1991 hunting seasons, we received reports of 28 deer stand falls resulting in permanent paralysis (an average of four each year) and 13 reports of temporary neurologic deficit. These injuries led to first-year medical care charges estimated at more than $4.2 million. None of the patients in the reported cases were using a safety restraint at the time of injury. After a public information campaign to make hunters aware of the risk of using deer stands without safety belts was conducted in 1992, there were no reported spinal cord injuries associated with deer stand falls for the following three years.

Heat exposure in an enclosed automobile.

During July 1995, an infant in southeast Louisiana died as a result of heat exposure in an enclosed automobile. To evaluate degree of heat exposure in a vehicle, we compared the temperature rise inside an enclosed, dark-colored vehicle with the temperature rise in light-colored vehicle with the windows partly open. Within 20 minutes, readings in both cars exceeded 125 degrees F and reached approximately 140 degrees F in 40 minutes--a temperature rise of over 45 degrees F. A person who is unable to remove himself from an enclosed vehicle is at risk for a life-threatening crisis if left alone in a sun-exposed car for even a relatively short period of time.

Survey of Louisiana physicians on communicable disease reporting.

We evaluated the participation of Louisiana physicians in the reporting of communicable diseases. In the spring of 1990 we surveyed a stratified random sample of Louisiana physicians from specialties likely to see patients with reportable diseases. Between 30% and 67% of physicians indicated that they reported all the cases of the queried diseases they had seen during the past year. The proportion reporting all cases differed by disease. AIDS and pertussis were always reported by more than half of the respondents. Mumps was least reported. Perceived barriers and suggestions to improve reporting are discussed.

Needle-sharing among intravenous drug users in New Orleans.

We studied needle sharing among intravenous drug users in New Orleans, where needles are not controlled by prescription. Three hundred and eighty self-identified intravenous drug users were interviewed regarding needle-sharing practices, frequency of drug use, and drug(s) of choice. Overall, 65.8% admitted they regularly used needles which had been used by others. No significant differences in needle sharing were found by sex, race, frequency of injection, or drug of choice. A survey of pharmacies found that 85.5% have self-imposed restrictions on the sale of needles and syringes. Legal availability of injection equipment may not be equivalent to actual availability to the consumer.

Complications from i.v. therapy: results from field-started and emergency department-started i.v.'s compared.

Because the complications resulting from IV therapy started outside the hospital seem inordinately higher than those resulting from IV therapy started in the emergency department, we undertook a comparative two-month study of the complications resulting from both sources. We found the number and severity of complications from IV therapy started in the field significantly greater than complications from that started in the ED. The phlebitis rate in the prehospital group was 4.65 times that in the ED group (P less than .001). The percentage of patients with unexplained fever in the prehospital group was 5.58 times that in the ED group (P less than .01). Means for reducing the complications and areas for further research are suggested.

The effect of spatial separation of speech and noise sources on the optimal setting of the master hearing aid.

The sound fields in which hearing aid evaluations are performed with tests of speech discrimination are far from standardized. This investigation was concerned with the nature of the sound field in terms of separation of speech and noise sources as related to the optimal setting of a master hearing aid as indicated by listener performance scores on tests of speech discrimination in noise. Two sound fields were used in this investigation, one with speech and noise from the same source and another with speech and noise sources separated by 90 degrees and 45 degrees off the axis of the midsagittal plane of the listener. The repeatability of the optimal setting of the master hearing aid from one configuration to the other and the resolution available in each sound field, were of prime interest. The data indicated that the sound field configuration has no bearing on the optimal setting of the master hearing aid. The data did indicate that maximum resolution was available in the case of speech and noise from the same source.

Protocol for evaluation of the effect of hearing aid electroacoustic parameters on perception of amplified speech.

A protocol for the evaluation of the effects of changes in hearing aid electroacoustic parameters was developed and evaluated. The protocol called for the creation of a matrix with as many dimensions as there are parameters to be evaluated. The protocol also called for each dimension to have as many divisions as there are possible variations of a parameter. The cell entries in the matrix were the listener speech discrimination scores in noise. It was found that one cell within the matrix always uniquely contained the highest listener speech discrimination score. It was concluded that use of such a protocol would allow the establishment of the precise electroacoustic settings of a master hearing aid which would result in best speech understanding for the listener.