Nonsuicidal self-injury in Indian adolescents: nonexistent or unacknowledged?

Nonsuicidal self-injury (NSSI) has been a neglected entity in low- and middle-income countries (LMICs). In this correspondence (letter to the editor), authors are advocating for greater research in this area in LMICs as it will help to compare and contrast prevalence rates of NSSI in these countries with high-income countries (HICs), identify context-specific risk and protective factors to better understand the pathophysiology of NSSI and devise context-specific interventions resulting in improvement in adolescent mental health worldwide.

Persisting side-to-side differences in bone mineral content, but not in muscle strength and tendon stiffness after anterior cruciate ligament reconstruction

Tendon stiffness may be involved in limiting peak musculoskeletal forces and thus may constitute an upper limit for bone strength. The patellar tendon bone (PTB) graft, which is harvested from the patellar tendon during surgical reconstruction of the anterior cruciate ligament (ACL), is an ideal scenario to test this hypothesis. Eleven participants were recruited who had undergone surgical reconstruction of the ACL with a PTB graft 1-10 years prior to study inclusion. As previously reported, there was no side-to-side difference in thigh muscle cross-sectional area, in maximum voluntary knee extension torque, or in patellar tendon stiffness, suggesting full recovery of musculature and tendon. However, in the present study bone mineral content (BMC), assessed by peripheral quantitative computed tomography, was lower on the operated side than on the control side in four regions studied (P = 0·0019). Differences were less pronounced in the two sites directly affected by the operation (patella and tibia epiphysis) when compared to the more remote sites. Moreover, significant side-to-side differences were found in BMC in the trabecular compartment in the femoral and tibial epiphysis (P = 0·004 and P = 0·047, respectively) with reductions on the operated side, but increased in the patella (P = 0·00016). Cortical BMC, by contrast, was lower on the operated side at all sites except the tibia epiphysis (P = 0·09). These findings suggest that impaired recovery of BMC following ACL reconstruction is not because of lack of recovery of knee extensor strength or patellar tendon stiffness. The responsible mechanisms still remain to be determined.

Review of the literature on the use of social media by people with traumatic brain injury (TBI)

Purpose: To review the literature relating to use of social media by people with a traumatic brain injury (TBI), specifically its use for social engagement, information exchange or rehabilitation.

Method: A systematic review with a qualitative meta-synthesis of content themes was conducted. In June 2014, 10 databases were searched for relevant, peer-reviewed research studies in English that related to both TBI and social media.

Results: Sixteen studies met the inclusion criteria, with Facebook™ and Twitter™ being the most common social media represented in the included studies. Content analysis identified three major categories of meaning in relation to social media and TBI: (1) risks and benefits; (2) barriers and facilitators; and (3) purposes of use of social media. A greater emphasis was evident regarding potential risks and apparent barriers to social media use, with little focus on facilitators of successful use by people with TBI.

Conclusions: Research to date reveals a range of benefits to the use of social media by people with TBI however there is little empirical research investigating its use. Further research focusing on ways to remove the barriers and increase facilitators for the use of social media by people with TBI is needed. Implications for Rehabilitation: Communication disabilities following traumatic brain injury (TBI) can be wide-ranging in scope and social isolation with loss of friendships after TBI is common. For many people, social media is rapidly becoming a usual part of everyday communication and its use has the potential to increase communication and social participation for people with TBI.There is emerging evidence and commentary regarding the perceived benefits and risks, barriers and facilitators and purposes of use of social media within the TBI population.Risks associated with using social media, and low accessibility of social media sites, form barriers to its use. Facilitators for social media use in people with TBI include training the person with TBI and their communication partners in ways to enjoy and use social media safely.There is minimal rigorous evaluation of social media use by people with TBI and scant information regarding social media use by people with communication disabilities after TBI. Further investigation is needed into the potential benefits of social media use on communication, social participation and social support with the aim of reducing social isolation in people with TBI.

Association between perception of fault for the crash and function, return to work and health status 1 year after road traffic injury: a registry-based cohort study

Objectives To establish the association between the patient's perception of fault for the crash and 12-month outcomes after non-fatal road traffic injury.Setting Two adult major trauma centres, one regional trauma centre and one metropolitan trauma centre in Victoria, Australia.Participants 2605 adult, orthopaedic trauma patients covered by the state's no-fault third party insurer for road traffic injury, injured between September 2010 and February 2014.Outcome measures EQ-5D-3L, return to work and functional recovery (Glasgow Outcome Scale—Extended score of upper good recovery) at 12 months postinjury.Results After adjusting for key confounders, the adjusted relative risk (ARR) of a functional recovery (0.57, 95% CI 0.46 to 0.69) and return to work (0.92, 95% CI 0.86 to 0.99) were lower for the not at fault compared to the at fault group. The ARR of reporting problems on EQ-5D items was 1.20–1.35 times higher in the not at fault group. Conclusions Patients who were not at fault, or denied being at fault despite a police report of fault, experienced poorer outcomes than the at fault group. Attributing fault to others was associated with poorer outcomes. Interventions to improve coping, or to resolve negative feelings from the crash, could facilitate better outcomes in the future.

A systematic evaluation of field-based screening methods for the assessment of anterior cruciate ligament (ACL) injury risk

BACKGROUND: Laboratory-based measures provide an accurate method to identify risk factors for anterior cruciate ligament (ACL) injury; however, these methods are generally prohibitive to the wider community. Screening methods that can be completed in a field or clinical setting may be more applicable for wider community use. Examination of field-based screening methods for ACL injury risk can aid in identifying the most applicable method(s) for use in these settings. OBJECTIVE: The objective of this systematic review was to evaluate and compare field-based screening methods for ACL injury risk to determine their efficacy of use in wider community settings. DATA SOURCES: An electronic database search was conducted on the SPORTDiscus™, MEDLINE, AMED and CINAHL databases (January 1990-July 2015) using a combination of relevant keywords. A secondary search of the same databases, using relevant keywords from identified screening methods, was also undertaken. STUDY SELECTION: Studies identified as potentially relevant were independently examined by two reviewers for inclusion. Where consensus could not be reached, a third reviewer was consulted. Original research articles that examined screening methods for ACL injury risk that could be undertaken outside of a laboratory setting were included for review. STUDY APPRAISAL AND SYNTHESIS METHODS: Two reviewers independently assessed the quality of included studies. Included studies were categorized according to the screening method they examined. A description of each screening method, and data pertaining to the ability to prospectively identify ACL injuries, validity and reliability, recommendations for identifying 'at-risk' athletes, equipment and training required to complete screening, time taken to screen athletes, and applicability of the screening method across sports and athletes were extracted from relevant studies. RESULTS: Of 1077 citations from the initial search, a total of 25 articles were identified as potentially relevant, with 12 meeting all inclusion/exclusion criteria. From the secondary search, eight further studies met all criteria, resulting in 20 studies being included for review. Five ACL-screening methods-the Landing Error Scoring System (LESS), Clinic-Based Algorithm, Observational Screening of Dynamic Knee Valgus (OSDKV), 2D-Cam Method, and Tuck Jump Assessment-were identified. There was limited evidence supporting the use of field-based screening methods in predicting ACL injuries across a range of populations. Differences relating to the equipment and time required to complete screening methods were identified. LIMITATIONS: Only screening methods for ACL injury risk were included for review. Field-based screening methods developed for lower-limb injury risk in general may also incorporate, and be useful in, screening for ACL injury risk. CONCLUSIONS: Limited studies were available relating to the OSDKV and 2D-Cam Method. The LESS showed predictive validity in identifying ACL injuries, however only in a youth athlete population. The LESS also appears practical for community-wide use due to the minimal equipment and set-up/analysis time required. The Clinic-Based Algorithm may have predictive value for ACL injury risk as it identifies athletes who exhibit high frontal plane knee loads during a landing task, but requires extensive additional equipment and time, which may limit its application to wider community settings.

The effects of military body armour on trunk and hip kinematics during performance of manual handling tasks

Musculoskeletal injuries are reported as burdening the military. An identified risk factor for injury is carrying heavy loads; however, soldiers are also required to wear their load as body armour. To investigate the effects of body armour on trunk and hip kinematics during military-specific manual handling tasks, 16 males completed 3 tasks while wearing each of 4 body armour conditions plus a control. Three-dimensional motion analysis captured and quantified all kinematic data. Average trunk flexion for the weightiest armour type was higher compared with control during the carry component of the ammunition box lift (p < 0.001) and sandbag lift tasks (p < 0.001). Trunk rotation ROM was lower for all armour types compared with control during the ammunition box place component (p < 0.001). The altered kinematics with body armour occurred independent of armour design. In order to optimise armour design, manufacturers need to work with end-users to explore how armour configurations interact with range of personal and situational factors in operationally relevant environments. Practitioner Summary: Musculoskeletal injuries are reported as burdening the military and may relate to body armour wear. Body armour increased trunk flexion and reduced trunk rotation during military-specific lifting and carrying tasks. The altered kinematics may contribute to injury risk, but more research is required.

Comparative microarray analysis identifies commonalities in neuronal injury: evidence for oxidative stress, dysfunction of calcium signalling, and inhibition of autophagy-lysosomal pathway

Mitochondrial dysfunction, ubiquitin-proteasomal system impairment and excitotoxicity occur during the injury and death of neurons in neurodegenerative conditions. The aim of this work was to elucidate the cellular mechanisms that are universally altered by these conditions. Through overlapping expression profiles of rotenone-, lactacystin- and N-methyl-D-aspartate-treated cortical neurons, we have identified three affected biological processes that are commonly affected; oxidative stress, dysfunction of calcium signalling and inhibition of the autophagic-lysosomal pathway. These data provides many opportunities for therapeutic intervention in neurodegenerative conditions, where mitochondrial dysfunction, proteasomal inhibition and excitotoxicity are evident.

A way through the dark and thorny thickets? The adjudication of ‘serious injury’ under the narrative tests in the Transport Accident Act 1986 (Vic) and the Workplace Injury Rehabilitation and Compensation Act 2013 (Vic)

The so-called narrative test provides the means by which injured persons who satisfy the statutory and common law definition of serious injury may bring proceedings for common law damages under s 93 of the Transport Accident Act 1986 (Vic) and s 134AB of the Accident Compensation Act 1985 (Vic) (or, for injuries after 1 July 2014, under ss 324-347 of the Workplace Injury Rehabilitation and Compensation Act 2013 (Vic)). These are among the most litigated provisions in Australia. This article outlines the legislative and political background to these provisions, the provisions themselves, and an account of the statutory and common law requirements needed to satisfy the provisions.

Musculoskeletal analysis of mining activities

This paper presents a framework for motion capture and musculoskeletal analysis of underground mining procedures. The framework discusses suitable motion capture solutions, musculoskeletal modelling and best practices. Preliminary analysis was conducted to assess quantitative musculoskeletal risks of rod handling and fitting with the drilling rig. The preliminary results of the analysis provide recommendations to minimise risks of potential muscular injuries.

The injury profile of an Australian specialist policing unit

This study investigated the injuries sustained by an Australian specialist police division. Injury records spanning four-years were analyzed. The role being performed when the injury occurred, injury cause, body part injured, and injury-related costs were quantified. The percentage of personnel injured multiple times was documented. One hundred and thirty eight personnel reported injuries, 58 of these on multiple occasions. This resulted in 229 injuries and 76 claims being raised. Half of the injuries occurred during operational policing tasks, however training activities accounted for >30% of injuries. The most common injury was strain/sprain, and upper body injuries were 2.5-times more common than lower-body or torso injuries. 1107 shifts were lost, and injuries cost the organization $487,159 (Australian Dollars) over the four-year period. The injury costs (both financial and in manpower) may prompt policy makers to review the current training and post-injury rehabilitation protocols.

The microbiome: a biological mechanism underpinning the social gradient of musculoskeletal conditions?

We read with interest the article by Steves et al, published in J Bone Miner Res, 2016; 31(2):261-269 (1). The authors review available evidence and suggest that the modifiable nature of the gut microbiome (GM) provides a potential therapeutic target to intervene in musculoskeletal conditions of aging.