Amanda Clacy

Depression, anxiety, and stress in young adults with phenylketonuria: associations with biochemistry.

Objective: Increasing concurrent phenylalanine to “off-diet” levels in adults with phenylketonuria (PKU) has been shown to lead to mood disturbances. However, the impact of controlled phenylalanine exposure across the developmental life span and mood stability remains questionable. The aim of this study was to investigate correlations between lifetime and concurrent phenylalanine (Phe) and tyrosine (Tyr) with levels of depression, anxiety, and stress in young adults maintaining a continuously treated diet for PKU. Method: Eight young adults (6 females, 2 males) aged 15 to 25 years (mean = 19.37, SD = 3.62) recruited through the Royal Childrens Hospital Brisbane, with early and continuously treated PKU completed the Depression Anxiety Stress Scale, which was correlated with lifetime and concurrent measures of Phe, Tyr, and Phe-Tyr ratios. Results: There was a strong significant correlation between lifetime Phe and levels of anxiety and stress (p < .01). Greater Phe-to-Tyr blood ratios were indicative of increased depression and anxiety levels (p < .01). Conclusions: An interaction between biochemical regulation and depression, anxiety, and stress levels was present in young adults with continuously treated PKU who were actively attempting to maintain dietary control. Strong associations were present with lifetime levels, suggesting a developmental impact of PKU-related biochemical exposure and the emergence of mood disturbances.

Is it really good to talk? Testing the impact of providing concurrent verbal protocols on driving performance

Abstract Questions have been raised regarding the impact that providing concurrent verbal protocols has on task performance in various settings; however, there has been little empirical testing of this in road transport. The aim of this study was to examine the impact of providing concurrent verbal protocols on driving performance. Participants drove an instrumented vehicle around a set route, twice whilst providing a concurrent verbal protocol, and twice without. A comparison revealed no differences in behaviour related to speed, braking and steering wheel angle when driving mid-block, but a significant difference in aspects of braking and acceleration at roundabouts. When not providing a verbal protocol, participants were found to brake harder on approach to a roundabout and accelerate more heavily coming out of roundabouts. It is concluded that providing verbal protocols may have a positive effect on braking and accelerating. Practical implications related to driver training and future research are discussed. Practitioner Summary: Verbal protocol analysis is used by ergonomists to understand aspects of cognition and decision-making during complex tasks such as driving and control room operation. This study examines the impact that it has on driving performance, providing evidence to support its continued use in ergonomics applications.

A knock to the system: A new sociotechnical systems approach to sport-related concussion

ABSTRACT Broader contextual factors that influence concussion management have tended to be overlooked. To address this, the present study used a sociotechnical systems approach to identify perceived responsibilities and applied strategies for three domains of concussion management (i.e., prevention, identification and treatment). Participants were 118 members of the community rugby union system in Australia (69.2% male). Participants from throughout the rugby system (e.g., players, parents, coaches, club management) were asked open-ended questions about their perceived responsibilities and the strategies they use for concussion management. It was found that (a) proper training, technique correction and education were recurrent prevention themes; (b) the majority of key stakeholders felt that they could consistently identify concussion; however, medical aids (medics) were the only system actors who stated a responsibility to use standardised concussion assessment measures and (c) less than one third of the respondents indicated their involvement in treating concussion. This study identifies specific junctures in the system that prevents effective concussion management strategies. A sociotechnical systems approach improves the understanding of concussion prevention, and management beliefs and behaviours.

A systems approach to understanding the identification and treatment of sport-related concussion in community rugby union

AIM The aim of the present study was to utilise a systems thinking approach to explore the perceived responsibilities for identifying and treating concussion held by different actors across the community rugby system (e.g., players, coaches, parents, medics, referees, and management), as well as their role-specific concussion management strategies. METHODS A systems approach was taken to assess what different stakeholders within rugby systems perceive their roles to be regarding concussion identification and treatment. Through an online survey, 118 members of the amateur (community) rugby union system were asked about their role-specific concussion management responsibilities and strategies. Respondents included players, parents, medics, coaches, club managers, administrators, and volunteers. RESULTS The majority of respondents indicated that they were able to identify the symptoms of rugby-related concussion, however, only medics stated their responsibility to use formal concussion assessments (e.g., SCAT2). A smaller number of the respondents indicated that they were involved in treating concussion within their current role/s (majority of which were medics). CONCLUSIONS This study illustrated that the current challenges in the identification and treatment of rugby-related concussion in community sport may be due to role/responsibility confusion and possible overreliance on field-side medics. These findings offer insight into the possible limitations of the current concussion management guidelines and may offer empirically based direction for future revisions.

Risk factors to sport-related concussion for junior athletes

Abstract Introduction As more than just an enjoyable activ-ity, team sport offers a range of in-valuable benefits to players and has the potential to provide personal, physical and social growth. Despite the many benefits of team sport par -ticipation, these benefits do not come without some cost. Although there are strict rules and guidelines in all contact sports, the risk of injuries such as concussion are impossible to prevent completely. Sport-related concussion is a growing concern in contact sport; however, the underly-ing risk factors and epidemiology of sport-related concussion in junior athletes is not well understood. The notable cognitive, hormonal and neurophysiological changes occur -ring during development throughout late childhood and adolescence po-tentially places paediatric athletes at greater risk of sustaining and experi-encing enduring effects of brain inju-ry. The aim of this review is to discuss the risk factors to sport-related con-cussion for junior athletes.

Return-to-Play Confusion: Considerations for Sport-Related Concussion

A much debated topic regarding the sideline treatment of concussion in sport is who decides whether an athlete is fit to return to play after a head knock. The case study proposed by Mellifont, Peetz, and Sayers (2012) is a timely stimulus for debate concerning this important and difficult issue. The lack of longitudinal prospective data complicates the area and makes any advice to Rosemary, the mother of the concussed athlete in the case, largely speculative and equivocal. The most objective person present in the case outlined by Mellifont, Peetz, and Sayers (2012), as at almost every sporting event, is the sports medicine professional (SMP). Although the SMP may not be a doctor or a head injury specialist, he or she will have had basic first aid training and should be equipped with standardized sport concussion assessment tools (e.g., the SCAT 2 or ImPACT) and some form of player history, including details of previous injuries and preseason baseline data (McCrory et al. 2005). A parent’s judgement concerning medical treatment is often clouded by mixed feelings of encouragement and parental protectiveness. Similarly, coaches have spent time and effort training players; however, in the moment, their attention is divided amongst the other players on the field. Further, athletes spend years striving toward goals (such as playing professionally) and so may not make sound decisions regarding their ownmedical treatment—especially when it could see them removed from play. Despite these obvious biases, SMPs regularly are disregarded by the athletes, coaches, and parents due to the inter-sport and even inter-club inconsistencies concerning who has the final say, which often sees SMPs conceding to the demands of the athlete. Most symptoms of sport-related concussion resolve within seven to 10 days, although for some athletes the recovery time is longer (McCrory et al. 2005). It is unclear why some athletes suffer adverse and ongoing effects of concussion, while others return to play the following week with no apparent concerns. Our current research team is focused on evaluating the risk factors associated with outcomes of concussion within a prospective longitudinal design. Previous studies have suggested an association between repeated sport-related concussion and long-term cognitive impairment (or “punch drunkenness”). Recent Bioethical Inquiry (2013) 10:127–128 DOI 10.1007/s11673-012-9421-8

Evaluation of novel urban rail level crossing designs using driving simulation

Rail level crossings (RLXs) are a public safety concern internationally. The design of the RLX environment has been implicated in many recent crashes. In this study we evaluated three novel RLX design concepts using a driving simulator. Participants completed four drives, each incorporating one of the RLX designs (one baseline and three novel designs) in both train coming and train not coming mode. Measures of speed and braking on approach were analyzed, along with subjective measures of workload and usability. Superior driving behavior and subjective ratings were achieved for a design that incorporated an in-vehicle device while the lowest subjective ratings were given in relation to a shared space design that incorporated a simplified crossing environment and sharing of the road environment between motorized and non-motorized users. The implications for RLX safety are discussed.

Applying systems ergonomics methods in sport: A systematic review

INTRODUCTION As sports systems become increasingly more complex, competitive, and technology-centric, there is a greater need for systems ergonomics methods to consider the performance, health, and safety of athletes in context with the wider settings in which they operate. Therefore, the purpose of this systematic review was to identify and critically evaluate studies which have applied a systems ergonomics research approach in the context of sports performance and injury management. MATERIAL AND METHODS Five databases (PubMed, Scopus, ScienceDirect, Web of Science, and SPORTDiscus) were searched for the dates 01 January 1990 to 01 August 2017, inclusive, for original peer-reviewed journal articles and conference papers. Reported analyses were underpinned by a recognised systems ergonomics method, and study aims were related to the optimisation of sports performance (e.g. communication, playing style, technique, tactics, or equipment), and/or the management of sports injury (i.e. identification, prevention, or treatment). RESULTS A total of seven articles were identified. Two articles were focussed on understanding and optimising sports performance, whereas five examined sports injury management. The methods used were the Event Analysis of Systemic Teamwork, Cognitive Work Analysis (the Work Domain Analysis Abstraction Hierarchy), Rasmussens Risk Management Framework, and the Systems Theoretic Accident Model and Processes method. The individual sport application was distance running, whereas the team sports contexts examined were cycling, football, Australian Football League, and rugby union. CONCLUSIONS The included systems ergonomics applications were highly flexible, covering both amateur and elite sports contexts. The studies were rated as valuable, providing descriptions of injury controls and causation, the factors influencing injury management, the allocation of responsibilities for injury prevention, as well as the factors and their interactions underpinning sports performance. Implications and future directions for research are described.