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Diving Into the Health Problems of Competitive Divers:A Systematic Review of Injuries and Illnesses in Pre-elite and Elite Diving Athletes
No full textContext: The Olympic sport of diving involves the competitive disciplines of 3 m springboard and 10 m platform. Although it is generally accepted that lumbar spine injuries are common in diving athletes, the existing literature of health problems in diving athletes remains scarce. Objective: To identify the incidence, prevalence, and type of health problems that occur in competitive diving athletes. Data Sources: Medline, EMBASE, SportsDiscus, PsycINFO, and Google Scholar. Study Selection: Studies written in English investigating elite or pre-elite competitive diving (springboard, platform) injuries and/or illnesses were eligible. Two independent reviewers screened for inclusion by title, abstract, and full text in accordance with the eligibility criteria. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data extraction was completed by 1 author using a structured form. A second author then independently reviewed and verified the extracted data, any discrepancies were resolved through consensus. Results: The search identified 2554 potential articles, with 28 studies meeting eligibility criteria. The surveillance setting of most studies was restricted to competition-based events, with the reported injury incidence proportion ranging from 2.1% to 22.2%. The reported injury incidence rate ranged from 1.9 to 15.5 per 1000 athlete-exposures. Injuries to the shoulder, lower back/lumbar spine, trunk, and wrist/hand were reported most frequently. The prevalence of low back pain was reported as high as 89% (lifetime), 43.1% (period), and 37.3% (point). The illness incidence proportion ranged from 0.0% to 22.2%, with respiratory and gastrointestinal illness reported most frequently. Conclusion: Up to 1 in 5 diving athletes sustain an injury and/or illness during periods of competition. A reporting bias was observed, with most cohort studies limiting surveillance to short competition-based periods only. This limits the current understanding of the health problems experienced by diving athletes to competition periods only and requires expansion to whole-of-year surveillance.</p
Potential role of liver-resident CD3<sup>+</sup> macrophages in HBV clearance in a mouse hepatitis B model
No full textBackground & Aims: Chronic HBV infection usually causes cirrhosis and hepatocellular carcinoma. Comparative investigations of acute and chronic HBV cases would help determine the immune responses crucial for viral clearance. Methods: A fast-cleared HBV mouse model was established in Alb-Cre mice via hydrodynamic injection of HBV plasmid, while persistent HBV model mice were generated via recombinant covalently closed circular DNA-adeno-associated virus 8 infection. The single-cell transcriptomes of CD45+ intrahepatic non-parenchymal cells from these mice were conducted. Multiplexed immunohistochemistry and flow cytometry were used to confirm the findings from single-cell transcriptomes. Transwell, coculture, and adoptive transfer experiments were performed to study the generation and functions of macrophages. Results: Twenty-four clusters of immune cells were identified. Myeloid cells, including granulocytes, monocytes, and dendritic cells, are activated early in HBV fast-cleared mice. Significantly, a cluster of CD3+ macrophages was found in the viral clearance phase, which was confirmed in liver tissue from five acute patients with HBV. These cells highly expressed CXCL1, tumor necrosis factor alpha, and HBsAg-specific T cell receptors. The transwell assay revealed that CD3+ macrophages originate from macrophages (n = 6). T cells and anti-HBsAg antibodies are indispensable for their differentiation, which was further confirmed in T- and/or B-cell-deficient mice. Interestingly, these CD3+ macrophages capable of killing peptide-loaded hepatocytes and engulfing IgG-coated beads were persistently detectable in the mouse liver for 10 weeks after HBV clearance. The expression levels of CD5L and Bcl2, two classical antiapoptotic proteins, increased (p <0.001), suggesting that the CD3+ macrophages are long-term resident populations. Finally, adoptive transfer of CD3+ macrophages accelerated HBV clearance in mice (n = 5, p <0.01). Conclusions: We identified long-term polyfunctional CD3+ macrophages residing in HBV fast-cleared livers that could help elucidate the immune responses involved in eliminating HBV. Impact and implications: The liver is a special organ with unique immune characteristics and tolerance to foodborne antigens. Chronic infections can develop in newborns after exposure to HBV; however, acute infections usually occur in adults, indicating that immune cells in the liver tissue microenvironment can also effectively fight against the virus. Nevertheless, the mechanisms involved in acute HBV infection have rarely been studied. In this study, we identified a macrophage population with both T cell and macrophage characteristics in the livers of acute HBV model mice and revealed that these macrophages play important roles in HBV clearance. Moreover, we confirmed that this population is derived from macrophages in the presence of virus-specific T cells and antibodies. This finding highlights the complexity of antiviral immune responses in liver microenvironments.</p
Suicidality in Primary Care, Youth Mental Health Services:Prevalence, Risk Factors and Implications for Practice
No full textIntroduction: Youth suicide is a concern worldwide, and suicidality—the presence of suicidal ideation or intent—is a critical risk for youth mental health services. This study aimed to determine the prevalence of suicidality in primary care, youth mental health services, along with its correlates and the course of treatment offered to clients. Methods: Routinely collected data from Australia's headspace National Youth Mental Health Foundation, which has over 160 centres across Australia providing mental health care to young people aged 12–25 years, were analysed for new clients who started and completed their first episode of care between 1 July 2022 and 30 June 2023. This included 30 437 young people/episodes of care and 74 393 occasions of service. Results: Results showed that suicidality was evident in almost one-quarter of young people, although it was rarely reported as a primary presenting issue. When present, it was usually identified at first visit. Those most at risk were young people in unstable accommodation, who identified as LGBTIQA+ or who were indigenous. Conclusions: The findings show that suicidality should be anticipated in young people presenting to primary care mental health settings, and youth services need to be able to competently deal with suicide risk rather than using this as exclusion criteria.</p
The complete mental health of Australia's adolescents and emerging adults:Distress and wellbeing across 3 nationally representative community samples
No full textAims The high level of psychological distress in young people is a growing concern. However, there are few national surveys that describe the trajectories of mental health and wellbeing through adolescence into early adulthood. Further, existing research has largely focused exclusively on mental ill-health, with little focus on positive mental health. This study provides the first national profile of the mental health and wellbeing of Australians aged 12-25 years. Methods Participants completed the National Youth Mental Health survey in 2018 (n1 = 3832), 2020 (n2 = 974) or 2022 (n3 = 961). We applied Keyes' Complete Mental Health (CMH) framework to derive categories of mental health and wellbeing, and examine rates of CMH over time, by age and gender. Results While approximately half of those surveyed reported flourishing (high wellbeing without mental illness), rates of flourishing declined between 2018 and 2022. Rates of flourishing generally decreased with age, and flourishing was more prevalent amongst males than females. Conclusions The findings provide a unique contrast of youth mental health pre-, during and post- the COVID-19 pandemic. While rates of psychological distress are consistently high, the proportion of youth reporting flourishing highlights the need to consider all aspects of psychological functioning to accurately understand and respond to the mental health needs of young people.</p
Current cultural citizens: the importance of creating spaces in art galleries for young people
No full textThe Influence of Running Technique Modifications on Vertical Tibial Load Estimates:A Combined Experimental and Machine Learning Approach in the Context of Medial Tibial Stress Syndrome
No full textBackground/Objectives: Currently, there is no strong evidence to support interventions for medial tibial stress syndrome (MTSS), a common running injury associated with tibial loading. Vertical ground reaction force (vGRF) and axial tibial acceleration (TA) are the most common methods of estimating tibial loads, yet clinical recommendations for technique modification to reduce these metrics are not well documented. This study investigated whether changes to speed, cadence, stride length, and foot-strike pattern influence vGRF and TA. Additionally, machine-learning models were evaluated for their ability to estimate vGRF metrics. Methods: Sixteen runners completed seven 1 min trials consisting of preferred technique, ±10% speed, ±10% cadence, forefoot, and rearfoot strike. Results: A 10% speed reduction decreased peak tibial acceleration (PTA), vertical average loading rate (VALR), vertical instantaneous loading rate (VILR), and vertical impulse by 13%, 10.9%, 9.3%, and 3.2%, respectively. A 10% cadence increase significantly reduced PTA (11.5%), VALR (15.6%), VILR (13.5%), and impulse (3.5%). Forefoot striking produced significantly lower PTA (26.6%), VALR (68.3%), and VILR (68.9%). Habitual forefoot strikers had lower VALR (58.1%) and VILR (47.6%) compared to rearfoot strikers. Machine-learning models predicted all four vGRF metrics with mean average errors of 9.5%, 10%, 10.9%, and 3.4%, respectively. Conclusions: This study demonstrates that small-scale modifications to running technique effectively reduce tibial load estimates. Machine-learning models offer an accessible, affordable tool for gait retraining by predicting vGRF metrics without reliance on IMU data. The findings support practical strategies for reducing MTSS risk.<br/
Modelling the impact on a local mental health system of previously implemented care programs:The experience of assertive outreach teams in Bizkaia (Spain)
No full textAims The study assessed the interactions and the impact of specialist mobile community care teams (assertive outreach teams or AOTs) implemented in the mental health (MH) system of Bizkaia (Spain) using a methodology derived from an ecosystem perspective. Methods First, the experts assessed the system's services and codified them according to an international classification system. Second, following an iterative methodology for expert-knowledge elicitation, a clients' flow diagram showing the inter-dependencies of the system's components was developed. It included variables and their relationships represented in a causal model. Third, the system elements where the AOTs had a major impact (stress nodes) were identified. Fourth, three scenarios (variable combinations representing the 'stress points' of the system) were modelled to assess its relative technical efficiency (technical performance indicator). Results The classification system identified the lack of fidelity of the AOTs to the original assertive community treatment model, categorizing them as non-acute low-intensity mobile care. The causal model identified the following elements of the system as 'stress nodes' in relation to AOT: users' families; social services (outside of the healthcare system); acute hospitals; non-acute residential facilities and, to a lesser extent, acute hospital day care services. When the stress nodes inside the healthcare system were modelled separately, acute and non-acute hospital care services resulted in a large deterioration in the system performance, while acute day hospital care had only a small impact. Conclusions The development of the expert-knowledge-based causal model from an ecosystem perspective was helpful in combining information from different levels, from nano to macro, to identify the components in the system likely to be most affected by a potential policy intervention, such as the closure of AOTs. It was also able to illustrate the interaction between the MH system components over time and the impact of the potential changes on the technical performance of the system. Such approaches have potential future application in assisting with service planning and decision-making in other health systems and socio-economic contexts.</p
The role of wetland birds in biocultural conservation:analysing global discourses and practices on species and ecosystems
No full textBiocultural approaches for conservation weave knowledge systems of both Indigenous Peoples and Local Communities (IP&LCs) with scientific insights to address environmental justice and promote local and global sustainability. Enduring people-nature relationships, particularly through wetland birds, hold both ecological and cultural significance that can guide wetland conservation efforts. We conducted a systematic review of biocultural research literature published between 2000 and 2023, following PRISMA guidelines. This review identified 414 publications that addressed taxa, ecosystems, and biocultural discourses. The publications spanned 96 countries, with Mexico, the United States, and India having the highest numbers of studies. This is consistent with the ethnobotanical research tradition from the dominant anthropological discourse. Post-2010, an ethico-political dimension emerged from intergovernmental agreements and advocacy by IP&LCs, particularly from Latin America and Australasia. As essential socio-ecosystems and culturally significant taxa, wetlands and birds possess profound ecological and cultural values. The tangible and intangible meanings of wetland birds for IP&LCs highlight the importance of integrating biocultural approaches into conservation policies, strategies, and management to encompass diverse discourses, species, and ecosystems. Diversifying biocultural conservation discourses can address research and practice gaps, helping scholars and policymakers adapt to regional contexts, develop effective conservation strategies that support community welfare, and uphold IP&LC rights. By embracing diverse worldviews, conservation science and practice can become pluralizing and just, and assist thus the world in transformative change.</p
Assessing the effects of menstrual hygiene, water, and sanitation on girls’ academic performances in public schools, Ethiopia
No full textThis study examined relationship between menstrual hygiene management (MHM), water, sanitation, and hygiene (WASH) services, and girls' academic performance in Ethiopia. This study employed cross-sectional mixed study design with 912 public schoolgirls. Also, 22 key informants, and six focus group discussions in 37 randomly selected public schools. The median age of the schoolgirls was 16 years. Two of the five schoolgirls reported missing classes during menstruation. Out of 912 schoolgirls, 82.5% (95% CI; 81%-84%) achieved good academic performance during the academic year. Schoolgirls who attended class regularly during menstruation (AOR=14.82, 95% CI 8.652-25.391), schoolgirls who were informed about menstrual hygiene before menarche (AOR=1.81, 95% CI 1.011-3.229), schoolgirls whose mothers were educated (AOR=1.88, 95% CI 1.063-3.313), schoolgirls who had basic water services (AOR=4.72, 95% CI 2.315-9.618), schoolgirls who had basic sanitation services (AOR=6.32, 95% CI 4.643-33.670) and who had limited sanitation services (AOR=1.56, 95% CI 1.768-6.636) were significantly associated with good academic performance. Educating mothers about menstrual hygiene, increasing access to WASH, and providing safe spaces for girls can have positive ripple effect on their daughters' academic success. The findings of study provide critical evidence to inform decision makers to address MHM challenges in alignment with Sustainable Development Goals (SDGs) 2030.</p
