The lived experience of Australian opioid replacement therapy recipients in a community-based program in regional Victoria
- Authors: Patil, Tejaswini , Cash, Penelope , Cant, Robyn , Mummery, Jane , Penney, Wendy
- Date: 2019
- Type: Text , Journal article
- Relation: Drug and Alcohol Review Vol. 38, no. 6 (2019), p. 656-663
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- Description: Introduction and Aims Treatment of opioid dependence through opioid replacement therapy is widely recognised as effective. Nonetheless, while there has been a community-based program in the state of Victoria for over two decades, consumer experiences have received little attention. This study aimed to describe the experiences of opioid replacement therapy consumers living in rural and regional areas of the state. Design and Methods A qualitative design employed an interpretative phenomenological approach. Sixteen consumers were interviewed. Thematic analysis was conducted by the researchers to examine the phenomena of consumers ' experiences and findings were verified by a stakeholder group. Results Findings centred on themes of consumers ' experience of becoming recipients; consumer perceptions of pharmacists and pharmacy settings and psychosocial impacts on consumers. A majority of participants believed opioid replacement therapy brought increased normality to their life, however systemic and psychosocial barriers impacted on well-being. The pharmacy setting itself as a public dosing space commonly provoked feelings of stigma and discrimination among consumers. Other barriers prominently reported were restrictions on number of takeaways, cost of dispensing and lack of access to medical practitioners and allied supports. Discussion and Conclusions There were psychosocial impacts on opioid replacement therapy consumers relating to financial and social burdens, stigma and discrimination. Access to medical care and a choice of pharmacy appeared to be restricted in rural regions. The findings suggest a need to address, in particular, the financial and dispensing point burdens experienced by consumers to facilitate program retention.
The relationship between phobic anxiety and 2-year readmission after Acute Coronary Syndrome : What is the role of heart rate variability?
- Authors: O'Neil, Adrienne , Taylor, Barr , Hare, David , Thomas, Emma , Toukhsati, Samia , Oldroyd, John , Scovelle, Anna , Oldenburg, Brian
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 247, no. (2019), p. 73-80
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- Description: Objective: Phobic anxiety is a risk factor for poor prognosis following Acute Coronary Syndrome (ACS). A psychophysiological marker of vagal function, autonomic dysfunction may play a critical role in this relationship. The aim of the study was two-fold: to assess whether phobic anxiety was characterised by autonomic dysfunction (heart rate variability) in the short (1-month) and longer term (12-months) following ACS, and (ii) to quantify the extent to which HRV parameters modified the effect of phobic anxiety on all-cause hospital readmission over 2 years. Methods: The ADVENT study followed 416 ACS patients. At 1-month following discharge (T0), phobic anxiety and autonomic functioning were assessed using the Crown Crisp Index (CCI) and 11 indices of heart rate variability (HRV), respectively. HRV was measured again at 12-months (T1) (n = 359). Hospital readmission (all cause) was derived from an audit of hospital records by two medically trained research fellows. Generalised linear modelling (GLM) was used to first determine the association between CCI score at T0 and HRV parameters at T0 and T1. Binary logistic regression was used to measure the relationship between CCI scores and readmission (yes/no) and the extent to which HRV parameters modified this effect. Results: CCI scores were associated with 7 of the 11 indices of HRV: Average RR (ms), SDRR (ms), RMSSD (ms), SDSD (ms), pRR50 (%), LF Powers (ms2) and HF Powers (ms2) at T0 but not T1. CCI scores at T0 significantly predicted likelihood of readmission to hospital in the subsequent 2 year period. No parameter of HRV at T0 modified this effect. Limitations: We were unable to provide adjudicated major adverse coronary events outcome data, or account for changes in medication adherence, diet or physical activity. Conclusions: While phobic anxiety is associated with both reduced vagal function in the short term after an ACS event and 2 year all cause readmission, HRV does not appear to be the pathway by which phobic anxiety drives this outcome.
Time-to-event analysis for sports injury research part 1 : Time-varying exposures
- Authors: Nielsen, Rasmus , Bertelsen, Michael , Ramskov, Daniel , Møller, Merete , Hulme, Adam , Theisen, Daniel , Finch, Caroline , Fortington, Lauren , Mansournia, Mohammad , Parner, Erik
- Date: 2019
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 53, no. 1 (2019), p. 61-68
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- Description: Background: 'How much change in training load is too much before injury is sustained, among different athletes?' is a key question in sports medicine and sports science. To address this question the investigator/practitioner must analyse exposure variables that change over time, such as change in training load. Very few studies have included time-varying exposures (eg, training load) and time-varying effect-measure modifiers (eg, previous injury, biomechanics, sleep/stress) when studying sports injury aetiology. Aim: To discuss advanced statistical methods suitable for the complex analysis of time-varying exposures such as changes in training load and injury-related outcomes. Content: Time-varying exposures and time-varying effect-measure modifiers can be used in time-to-event models to investigate sport injury aetiology. We address four key-questions (i) Does time-to-event modelling allow change in training load to be included as a time-varying exposure for sport injury development? (ii) Why is time-to-event analysis superior to other analytical concepts when analysing training-load related data that changes status over time? (iii) How can researchers include change in training load in a time-to-event analysis? and, (iv) Are researchers able to include other time-varying variables into time-to-event analyses? We emphasise that cleaning datasets, setting up the data, performing analyses with time-varying variables and interpreting the results is time-consuming, and requires dedication. It may need you to ask for assistance from methodological peers as the analytical approaches presented this paper require specialist knowledge and well-honed statistical skills. Conclusion: To increase knowledge about the association between changes in training load and injury, we encourage sports injury researchers to collaborate with statisticians and/or methodological epidemiologists to carefully consider applying time-to-event models to prospective sports injury data. This will ensure appropriate interpretation of time-to-event data. © 2019 Author(s).
Time-to-event analysis for sports injury research part 2 : Time-varying outcomes
- Authors: Nielsen, Rasmus , Bertelsen, Michael , Ramskov, Daniel , Møller, Merete , Hulme, Adam , Theisen, Daniel , Finch, Caroline , Fortington, Lauren , Mansournia, Mohammad , Parner, Erik
- Date: 2019
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 53, no. 1 (2019), p. 70-78
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- Description: Background: Time-to-event modelling is underutilised in sports injury research. Still, sports injury researchers have been encouraged to consider time-to-event analyses as a powerful alternative to other statistical methods. Therefore, it is important to shed light on statistical approaches suitable for analysing training load related key-questions within the sports injury domain. Content: In the present article, we illuminate: (i) the possibilities of including time-varying outcomes in time-to-event analyses, (ii) how to deal with a situation where different types of sports injuries are included in the analyses (ie, competing risks), and (iii) how to deal with the situation where multiple subsequent injuries occur in the same athlete. Conclusion: Time-to-event analyses can handle time-varying outcomes, competing risk and multiple subsequent injuries. Although powerful, time-to-event has important requirements: researchers are encouraged to carefully consider prior to any data collection that five injuries per exposure state or transition is needed to avoid conducting statistical analyses on time-to-event data leading to biased results. This requirement becomes particularly difficult to accommodate when a stratified analysis is required as the number of variables increases exponentially for each additional strata included. In future sports injury research, we need stratified analyses if the target of our research is to respond to the question: 'how much change in training load is too much before injury is sustained, among athletes with different characteristics?' Responding to this question using multiple time-varying exposures (and outcomes) requires millions of injuries. This should not be a barrier for future research, but collaborations across borders to collecting the amount of data needed seems to be an important step forward.
Too many rib ticklers? Injuries in Australian women's cricket (PhD Academy Award)
- Authors: Perera, Nirmala
- Date: 2019
- Type: Text , Journal article , Editorial Material
- Relation: British Journal of Sports Medicine Vol. 53, no. 22 (Nov 2019), p. 1436-1437
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When this happens, you want the best care : Players' experiences of barriers and facilitators of the immediate management of rugby-related acute spinal cord injury
- Authors: Badenhorst, Marelise , Verhagen, Evert , Lambert, Mike , van Mechelen, Willem , Brown, James
- Date: 2019
- Type: Text , Journal article
- Relation: Qualitative Health Research Vol. 29, no. 13 (2019), p. 1862-1876
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- Description: Most contact sports, including rugby union, carry a risk of injury. Although acute spinal cord injuries (ASCIs) in rugby are rare, the consequences of such injuries are far-reaching. Optimal management of these injuries is challenging, and a detailed understanding of the different barriers and facilitators to optimal care is needed. In this study, we aimed to describe the perception of players, regarding factors related to the optimal immediate management of a catastrophic injury in a developing country with socioeconomic and health care inequities. The most frequently reported barriers were transportation delays after injury and admission to appropriate medical facilities. Other barriers included inadequate equipment, the quality of first aid care, and barriers within the acute hospital setting. Barriers were more prevalent in rural and lower socioeconomic areas. These findings are relevant for all rugby stakeholders and may help shape education, awareness, and future policy around the immediate management of ASCIs.
Adverse life events and the onset of anxiety disorders
- Authors: Miloyan, Beyon , Bienvenu, Oscar , Brilot, Ben , Eaton, William
- Date: 2018
- Type: Text , Journal article
- Relation: Psychiatry Research Vol. 259, no. (2018), p. 488-492
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- Description: This study tested the hypothesis that adverse events are associated with increased risk of onset of anxiety disorders. Data from Waves 1 (N = 43,093; 2001–2002) and 2 (N = 34,653; 2004–2005) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) were used to assess whether adverse events at baseline are associated with increased risk of anxiety disorder onset over three years of follow up. Sixty-six percent (SE: 1.0) of respondents with an anxiety disorder in the intervening period between Waves 1 and 2 had experienced an adverse life event in the year prior to the Wave 1 interview. In logistic regression models adjusted for sociodemographic and psychiatric characteristics, adverse life events at baseline were associated with anxiety disorder onset within the three-year follow up period. The pattern of association between adverse events and anxiety disorder onset was similar across sub-types, and injury, illness or death of family or close friends consistently had the strongest association with anxiety disorder onset. These findings suggest that adverse life events play a role in the onset of anxiety disorders.
Are patients with concussion getting optimal discharge advice at a regional emergency department?
- Authors: Brown, Ashlee , Twomey, Dara , Wong Shee, Anna
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 2 (2018), p. 134-135
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- Description: Mild traumatic brain injury (mTBI), known as concussion, is receiving increasing global attention. Growing concerns about the potential long-term effects of mTBI have highlighted the need for good management and follow- up care.1 Given that regional emergency departments (EDs) experience higher rates of mTBI presentations compared with metropolitan EDs and are often the first point of contact, the provision of evidence-based care in these settings is crucial for positive patient outcomes.2 Followup after mTBI has shown promising results in reducing the number and severity of symptoms.
Awareness and use of the 11+ injury prevention program among coaches of adolescent female football teams
- Authors: Donaldson, Alex , Callaghan, Aisling , Bizzini, Mario , Jowett, Andrew , Keyzer, Patrick , Nicholson, Matthew
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Sports Science and Coaching Vol. 13, no. 6 (2018), p. 929-938
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- Description: Coaches are essential to participant safety, particularly by implementing injury prevention programs. The evidence-based injury prevention programs developed by sports scientists will not prevent injuries in real-world sports settings if they are not properly implemented. This study investigated the knowledge and use of the highly efficacious 11+ injury prevention program among coaches of adolescent, female football teams, in Victoria, Australia. A cross-sectional online survey based on the RE-AIM framework identified that nearly half (42%) of the 64 respondents (response rate = 36%) were not aware of the 11+, and only one-third (31%) reported using it. Three-quarters (74%) of the 19 respondents who reported on the 11+ components they used, did not use the entire program. Nearly half (44%) of the 18 respondents who reported the frequency with which they used the 11+, used it less than the recommended twice a week. Barriers to implementing the 11+ included: limited awareness of the 11+; lack of knowledge about how to implement it; not having time to implement it; and believing that the 11+ does not incorporate appropriate progression. This study suggests that it is unlikely that the 11+ prevents a significant number of injuries in real-world football settings due to the lack of awareness and use among coaches. Football-governing bodies should use evidence-based strategies to raise awareness of the 11+, build coach competency to implement it, and address time-related implementation barriers that coaches experience. Coaches should keep up-to-date with injury prevention research evidence and prioritize injury prevention at training, including allocating time to implement injury prevention programs properly.
Body mass index is negatively associated with telomere length : A collaborative cross-sectional meta-analysis of 87 observational studies
- Authors: Gielen, Marij , Hageman, Geja , Antoniou, Evangelia , Nordfjall, Katarina , Mangino, Massimo , Balasubramanyam, Muthuswamy , De Meyer, Tim de , Hendricks, Audrey , Giltay, Erik , Hunt, Steven , Nettleton, Jennifer , Salpea, Klelia , Diaz, Vanessa , Farzaneh-Far, Ramin , Atzmon, Gil , Harris, Sarah , Hou, Lifang , Gilley, David , Hovatta, Iiris , Kark, Jeremy , Nassar, Hisham , Kurz, David , Mather, Karen , Willeit, Peter , Zheng, Yun-Ling , Pavanello, Sofia , Demerath, Ellen , Rode, Line , Bunout, Daniel , Steptoe, Andrew , Boardman, Lisa , Marti, Amelia , Needham, Belinda , Zheng, Wei , Ramsey-Goldman, Rosalind , Pellatt, Andrew , Kaprio, Jaakko , Hofmann, Jonathan , Gieger, Christian , Paolisso, Giuseppe , Hjelmborg, Jacob , Mirabello, Lisa , Seeman, Teresa , Wong, Jason , Van Der Harst, Pim , Broer, Linda , Kronenberg, Florian , Kollerits, Barbara , Strandberg, Timo , Eisenberg, Dan , Duggan, Catherine , Verhoeven, Josine , Schaakxs, Roxanne , Zannolli, Raffaela , Dos Reis, Rosana , Charchar, Fadi , Tomaszewski, Maciej , Mons, Ute , Demuth, Ilja , Molli, Andrea , Cheng, Guo , Krasnienkov, Dmytro , D'Antono, Bianca , Kasielski, Marek , McDonnell, Barry , Ebstein, Richard , Sundquist, Kristina , Pare, Guillaume , Chong, Michael , Zeegers, Maurice
- Date: 2018
- Type: Text , Journal article
- Relation: American Journal of Clinical Nutrition Vol. 108, no. 3 (2018), p. 453-475
- Relation: http://purl.org/au-research/grants/nhmrc/1123472
- Full Text: false
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- Description: Background: Even before the onset of age-related diseases, obesity might be a contributing factor to the cumulative burden of oxidative stress and chronic inflammation throughout the life course. Obesity may therefore contribute to accelerated shortening of telomeres. Consequently, obese persons are more likely to have shorter telomeres, but the association between body mass index (BMI) and leukocyte telomere length (TL) might differ across the life span and between ethnicities and sexes. Objective: A collaborative cross-sectionalmeta-analysis of observational studies was conducted to investigate the associations between BMI and TL across the life span. Design: Eighty-seven distinct study samples were included in the meta-analysis capturing data from 146,114 individuals. Studyspecific age- and sex-adjusted regression coefficients were combined by using a random-effects model in which absolute [base pairs (bp)] and relative telomere to single-copy gene ratio (T/S ratio) TLs were regressed against BMI. Stratified analysis was performed by 3 age categories ("young": 18-60 y; "middle": 61-75 y; and "old": >75 y), sex, and ethnicity. Results: Each unit increase in BMI corresponded to a-3.99 bp (95% CI: -5.17, -2.81 bp) difference in TL in the total pooled sample; among young adults, each unit increase in BMI corresponded to a -7.67 bp (95% CI:-10.03,-5.31 bp) difference. Each unit increase in BMI corresponded to a -1.58 × 10-3 unit T/S ratio (0.16% decrease; 95% CI: -2.14 × 10-3, -1.01 × 10-3) difference in ageand sex-adjusted relative TL in the total pooled sample; among young adults, each unit increase in BMI corresponded to a -2.58 × 10-3 unit T/S ratio (0.26% decrease; 95% CI: -3.92 × 10-3, -1.25 × 10-3). The associations were predominantly for the white pooled population. No sex differences were observed. Conclusions: A higher BMI is associated with shorter telomeres, especially in younger individuals. The presently observed difference is not negligible. Meta-analyses of longitudinal studies evaluating change in body weight alongside change in TL arewarranted.
Cognitive behavior therapy for older adults with insomnia and depression : A randomized controlled trial in community mental health services
- Authors: Sadler, Paul , McLaren, Suzanne , Klein, Britt , Harvey, Jack , Jenkins, Megan
- Date: 2018
- Type: Text , Journal article
- Relation: Sleep Vol. 41, no. 8 (2018), p. 1-12
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- Description: Study Objectives: To investigate whether cognitive behavior therapy was effective for older adults with comorbid insomnia and depression in a community mental health setting, and explore whether an advanced form of cognitive behavior therapy for insomnia produced better outcomes compared to a standard form of cognitive behavior therapy for insomnia. Methods: An 8-week randomized controlled clinical trial was conducted within community mental health services, Victoria, Australia. Seventy-two older adults (56% female, M age 75 ± 7 years) with diagnosed comorbid insomnia and depression participated. Three conditions were tested using a group therapy format: cognitive behavior therapy for insomnia (CBT-I, standard), cognitive behavior therapy for insomnia plus positive mood strategies (CBT-I+, advanced), psychoeducation control group (PCG, control). The primary outcomes were insomnia severity (Insomnia Severity Index) and depression severity (Geriatric Depression Scale). Primary and secondary measures were collected at pre (week 0), post (week 8), and follow-up (week 20). Results: CBT-I and CBT-I+ both generated significantly greater reductions in insomnia and depression severity compared to PCG from pre to post (p < .001), which were maintained at follow-up. Although the differences between outcomes of the two treatment conditions were not statistically significant, the study was not sufficiently powered to detect either superiority of one treatment or equivalence of the two treatment conditions. Conclusion: CBT-I and CBT-I+ were both effective at reducing insomnia and depression severity for older adults. Mental health services that deliver treatment for comorbid insomnia with cognitive behavior therapy may improve recovery outcomes for older adults with depression. Trial Registration: Australian and New Zealand Clinical Trials Registry (ANZCTR); URL: https://www.anzctr.org.au; Trial ID: ACTRN12615000067572; Date Registered: December 12, 2014.
Collecting health and exposure data in Australian olympic combat sports : Feasibility study utilizing an electronic system
- Authors: Bromley, Sally , Drew, Michael , Talpey, Scott , McIntosh, Andrew , Finch, Caroline
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 20, no. 10 (2018), p. 1-11
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- Description: Background: Electronic methods are increasingly being used to manage health-related data among sporting populations. Collection of such data permits the analysis of injury and illness trends, improves early detection of injuries and illnesses, collectively referred to as health problems, and provides evidence to inform prevention strategies. The Athlete Management System (AMS) has been employed across a range of sports to monitor health. Australian combat athletes train across the country without dedicated national medical or sports science teams to monitor and advocate for their health. Employing a Web-based system, such as the AMS, May provide an avenue to increase the visibility of health problems experienced by combat athletes and deliver key information to stakeholders detailing where prevention programs May be targeted. Objective: The objectives of this paper are to (1) report on the feasibility of utilizing the AMS to collect longitudinal injury and illness data of combat sports athletes and (2) describe the type, location, severity, and recurrence of injuries and illnesses that the cohort of athletes experience across a 12-week period. Methods: We invited 26 elite and developing athletes from 4 Olympic combat sports (boxing, judo, taekwondo, and wrestling) to participate in this study. Engagement with the AMS was measured, and collected health problems (injuries or illnesses) were coded using the Orchard Sports Injury Classification System (version 10.1) and International Classification of Primary Care (version 2). Results: Despite >160 contacts, athlete engagement with online tools was poor, with only 13% compliance across the 12-week period. No taekwondo or wrestling athletes were compliant. Despite low overall engagement, a large number of injuries or illness were recorded across 11 athletes who entered data—22 unique injuries, 8 unique illnesses, 30 recurrent injuries, and 2 recurrent illnesses. The most frequent injuries were to the knee in boxing (n=41) and thigh in judo (n=9). In this cohort, judo players experienced more severe, but less frequent, injuries than boxers, yet judo players sustained more illnesses than boxers. In 97.0% (126/130) of cases, athletes in this cohort continued to train irrespective of their health problems. Conclusions: Among athletes who reported injuries, many reported multiple conditions, indicating a need for health monitoring in Australian combat sports. A number of factors May have influenced engagement with the AMS, including access to the internet, the design of the system, coach views on the system, previous experiences with the system, and the existing culture within Australian combat sports. To increase engagement, there May be a requirement for sports staff to provide relevant feedback on data entered into the system. Until the Barriers are addressed, it is not feasible to implement the system in its current form across a larger cohort of combat athletes.
Down the rabbit hole : Assessing the influence of schizotypy on the experience of the Barbie Doll Illusion
- Authors: Van Doorn, George , De Foe, Alexander , Wood, Alle , Wagstaff, Danielle , Hohwy, Jakob
- Date: 2018
- Type: Text , Journal article
- Relation: Cognitive Neuropsychiatry Vol. 23, no. 5 (2018), p. 284-298
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- Description: Introduction: “Body swapping” illusions have been used to explore factors contributing to the experience of “owning” an artificial body. Preliminary research indicated that those people diagnosed with schizophrenia experience more vivid illusions of this kind than do “normal” individuals. Objectives: Here, we explored whether participants who rated themselves “high” on the cognitive-perceptual factor of the Schizotypal Personality Questionnaire (SPQ) experienced a more compelling sense of immersion in a variation of the body swapping illusion: The Barbie Doll Illusion. We also hypothesised that these individuals would experience a change in size perception when immersed in the illusion. Method: Forty-four participants wore a pair of Head-Mounted Display goggles connected to a video-camera, and thus a doll’s body replaced their own body in their visual field. In two conditions, touch was either applied synchronously or asynchronously to the doll’s and each participant’s leg. After each condition, participants filled out a questionnaire relating to their experience in the illusion. When both conditions were completed, they filled out the SPQ. Results: Our first hypothesis was confirmed, which suggested that people with higher cognitive-perceptual SPQ scores do indeed experience a more compelling Barbie Doll Illusion; however, our second hypothesis was not supported. Conclusion: Our study demonstrated, for the first time, that proneness to the positive and interpersonal factors of schizotypy in a normal population is sufficient to produce a compelling sense of swapping bodies.
Effectiveness of online tailored advice to prevent running-related injuries and promote preventive behaviour in Dutch trail runners : A pragmatic randomised controlled trial
- Authors: Hespanhol, Luiz , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: British journal of sports medicine Vol. 52, no. 13 (2018), p. 851-858
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- Description: BACKGROUND: Trail running is popular worldwide, but there is no preventive intervention for running-related injury (RRI). AIM: To evaluate the effectiveness of adding online tailored advice (TrailS6 ) to general advice on (1) the prevention of RRIs and (2) the determinants and actual preventive behaviour in Dutch trail runners. METHODS: Two-arm randomised controlled trial over 6 months. 232 trail runners were randomly assigned to an intervention or control group. All participants received online general advice on RRI prevention 1 week after baseline. Every 2 weeks, participants in the intervention group received specific advice tailored to their RRI status. The control group received no further intervention. Bayesian mixed models were used to analyse the data. RESULTS: Trail runners in the intervention group sustained 13% fewer RRIs compared with those in the control group after 6 months of follow-up (absolute risk difference -13.1%, 95% Bayesian highest posterior credible interval (95% BCI) -23.3 to -3.1). A preventive benefit was observed in one out of eight trail runners who had received the online tailored advice for 6 months (number needed to treat 8, 95% BCI 3 to 22). No significant between-group difference was observed on the determinants and actual preventive behaviours. CONCLUSIONS: Online tailored advice prevented RRIs among Dutch trail runners. Therefore, online tailored advice may be used as a preventive component in multicomponent RRI prevention programmes. No effect was observed on determinants and actual preventive behaviours. TRIAL REGISTRATION NUMBER: The Netherlands National Trial Register (NTR5431).
Everyday discrimination in the Australian workplace : Assessing its prevalence and age and gender differences
- Authors: Taylor, Philip , McLoughlin, Christopher , Earl, Catherine
- Date: 2018
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 37, no. 4 (2018), p. 245-251
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- Description: Objective: This study aimed to increase understanding of the nature and prevalence of discriminatory experiences in the workplace, focusing on issues of age and gender. Methods: The concept of everyday discrimination was operationalised in a survey of a representative sample of Australian workers. Results: It was observed that overall, experiences of everyday discrimination were rare. Among men, such experiences declined with age, whereas for women almost no age differences were observed. Conclusion: It is argued that the nature of labour market age barriers has been misunderstood and the extent of discrimination faced by older workers possibly overstated.
Head impact velocities in FIS World Cup snowboarders and freestyle skiers : Do real-life impacts exceed helmet testing standards?
- Authors: Steenstrup, Sophie , Mok, Kam-Ming , McIntosh, Andrew , Bahr, Roald , Krosshaug, Tron
- Date: 2018
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 52, no. 1 (2018), p. 32-40
- Full Text: false
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- Description: Introduction Prior to the 2013-2014 season, the International Ski Federation (FIS) increased the helmet testing speed from a minimum requirement of 5.4 to 6.8 m/s for alpine downhill, super-G and giant slalom and for freestyle ski cross, but not for the other freestyle disciplines or snowboarding. Whether this increased testing speed reflects impact velocities in real head injury situations on snow is unclear. We therefore investigated the injury mechanisms and gross head impact biomechanics in four real head injury situations among World Cup (WC) snowboard and freestyle athletes and compared these with helmet homologation laboratory test requirements. The helmets in the four cases complied with at least European Standards (EN) 1077 (Class B) or American Society for Testing and Materials (ASTM) F2040. Methods We analysed four head injury videos from the FIS Injury Surveillance System throughout eight WC seasons (2006-2014) in detail. We used motion analysis software to digitize the helmet's trajectory and estimated the head's kinematics in two dimensions, including directly preimpact and postimpact. Results All four impacts were to the occiput. In the four cases, the normal-to-slope preimpact velocity ranged from 7.0(±SD 0.2) m/s to 10.5±0.5 m/s and the normalto-slope velocity change ranged from 8.4±0.6 m/s to 11.7±0.7 m/s. The sagittal plane helmet angular velocity estimates indicated a large change in angular velocity (25.0±2.9 rad/s to 49.1±0.3 rad/s). Conclusion The estimated normal-to-slope preimpact velocity was higher than the current strictest helmet testing rule of 6.8 m/s in all four cases. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.
Head injury mechanisms in FIS World Cup alpine and freestyle skiers and snowboarders
- Authors: Steenstrup, Sophie , Bakken, Arnhild , Bere, Tone , Patton, Declan , Bahr, Roald
- Date: 2018
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 52, no. 1 (2018), p. 61-69
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- Description: Introduction Head injuries represent a concern in skiing and snowboarding, with traumatic brain injuries being the most common cause of death. Aim To describe the mechanisms of head and face injuries among World Cup alpine and freestyle skiers and snowboarders. Methods We performed a qualitative analysis of videos obtained of head and face injuries reported through the International Ski Federation Injury Surveillance System during 10 World Cup seasons (2006-2016). We analysed 57 head impact injury videos (alpine n=29, snowboard n=13, freestyle n=15), first independently and subsequently in a consensus meeting. Results During the crash sequence, most athletes (84%) impacted the snow with the skis or board first, followed by the upper or lower extremities, buttocks/pelvis, back and, finally, the head. Alpine skiers had sideways (45%) and backwards pitching falls (35%), with impacts to the rear (38%) and side (35%) of the helmet. Freestyle skiers and snowboarders had backwards pitching falls (snowboard 77%, freestyle 53%), mainly with impacts to the rear of the helmet (snowboard 69%, freestyle 40%). There were three helmet ejections among alpine skiers (10% of cases), and 41% of alpine skiing injuries occurred due to inappropriate gate contact prior to falling. Athletes had one (47%) or two (28%) head impacts, and the first impact was the most severe (71%). Head impacts were mainly on snow (83%) on a downward slope (63%). Conclusion This study has identified several characteristics of the mechanisms of head injuries, which may be addressed to reduce risk.
Health professional students' rural placement satisfaction and rural practice intentions : a national cross-sectional survey
- Authors: Smith, Tony , Sutton, Keith , Pit, Sabrina , Muyambi, Kuda , Terry, Daniel , Farthing, Annie , Courtney, Claire , Cross, Merylin
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 1 (2018), p. 26-32
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- Description: Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention. © 2017 National Rural Health Alliance Inc.
Hermeneutic Constructivism : An ontology for qualitative research
- Authors: Peck, Blake , Mummery, Jane
- Date: 2018
- Type: Text , Journal article
- Relation: Qualitative Health Research Vol. 28, no. 3 (2018), p. 389-407
- Full Text: false
- Reviewed:
- Description: Qualitative research is entirely an operation with language, in language, and occasionally on language. This article suggests a tension between theoretical recognition of a multiplicity of human experience on one hand and a reliance upon practices of thematic representation that prioritize the common or the general over individualized experience. The fulcrum of this tension is the nature of language itself and its role in human experience and meaning-making. This article sets out the theoretical foundations of Hermeneutic Constructivism as one proposed approach to redress this problematic within many qualitative frameworks and open up an opportunity for a deeper and more nuanced understanding of human being. Within Hermeneutic Constructivism, a Fundamental Postulate and 11 elaborative corollaries detail a cogent relationship between language and the structures and processes of mental activity that support the human comportment toward understanding. The authors argue that this theoretical position is able to inform a model for qualitative research that makes possible an exploration of a person’s experience at a deeper level of abstraction and that may provide an avenue for overcoming this identified tension. © 2017, © The Author(s) 2017.
Hospital-treated snow sport injury in Victoria, Australia : A summary of 2003–2012
- Authors: Siesmaa, Emma , Clapperton, Angela , Twomey, Dara
- Date: 2018
- Type: Text , Journal article
- Relation: Wilderness and Environmental Medicine Vol. 29, no. 2 (2018), p. 194-202
- Full Text: false
- Reviewed:
- Description: Introduction: To determine the incidence rate and changes over time for ice and snow sports injury in Victoria, Australia, from 2003 to 2012 and describe the most common types and causes of these injuries. Methods: Retrospective data from the Victorian Injury Surveillance Unit describing hospital admissions and emergency department presentations were extracted for the 10-year period of 2003 to 2012 for all ice- and snow-related injury. Descriptive injury data and participation-adjusted trend analyses using log-linear regression modelling of data (statistical significance, P<0.05) from the Exercise, Recreation and Sport Survey 2003 to 2010 are presented. Results: Overall, there were 7387 ice- and snow-related injuries, with a significant increase in hospital-treated snowboard injuries and a (nonsignificant) decline in hospital-treated ski injuries over the 10 years. Skiing (39%) and snowboarding (37%) had the highest incidence of hospital-treated injury, with males aged 15 to 24 years injured most frequently in both sports. Falls were the most common cause of injury in both skiing (68%) and snowboarding (78%). Conclusions: Patterns of snow sports injury in Australia during 2003 to 2012 remain similar to findings of national studies conducted decades earlier. More importantly, however, Australian injury patterns are comparable to international statistics and thus may be generalizable internationally. Head injuries, although infrequent, are associated with great injury severity due to a high frequency of hospitalization. Furthermore, research into the use of personal protective equipment and other injury prevention measures among Australian participants, particularly by young, male snowboarders, is required. Given the similar injury patterns, injury prevention measures implemented internationally could reasonably translate to an Australian setting.