The estimated effect of reducing the maternal smoking rate on neonatal intensive care unit costs in Victorian public hospitals.

This analysis estimates the expected number of Victorian public hospital neonatal intensive care unit cot-days that could be saved annually by reducing the maternal smoking rate. Approximately 106 cot-days could be saved if the maternal smoking rate was reduced from 8.4% to 6.4% (estimated annual cost saving of A$276 000).

Healthcare professionals' knowledge and practice of physical activity promotion in cancer care: Challenges and solutions.

Limited research exists regarding healthcare professionals' knowledge and practice of physical activity promotion for cancer survivors in Ireland. There is also a lack of research identifying the barriers experienced by oncology professionals when promoting physical activity, or referring patients to community-based exercise programmes. This study aims to identify healthcare professionals' knowledge, barriers and practices in relation to physical activity promotion for cancer survivors, and to generate guidance regarding the optimisation of the referral process to community-based exercise programmes. Oncology healthcare professionals (n = 114) were invited to participate in two rounds of an online Delphi study. The response rates in rounds one and two were 38% (43/114) and 70% (30/43). Most respondents acknowledged the value of physical activity for cancer survivors (≥86%) and agreed that discussing physical activity with cancer patients was part of their role (88%). However, the majority of recommendations provided to patients did not align with the current physical activity guidelines. Strategies related to four themes that could optimise the referral process to community-based exercise programmes achieved consensus, including providing education to healthcare professionals and patients regarding the benefits of physical activity and the logistics and quality of programmes, and optimising the logistics of the referral process.

Chronic breathlessness associated with poorer physical and mental health-related quality of life (SF-12) across all adult age groups.

Little is known about the impact of chronic breathlessness (modified Medical Research Council (mMRC) score ≥2 for most days, at least three of the last six months) on health-related quality of life (Short Form-12 (SF-12)). 3005 adults from randomly selected households were interviewed face-to-face in South Australia. mMRC ≥2 community prevalence was 2.9%. Adjusted analyses showed clinically meaningful and statistically significant decrements of physical and mental components of SF-12 (mean SF-12 summary scores in physical (-13.0 (-16.0 to -10.2)) and mental (-10.7 (-13.7 to -7.8)) components compared with people with mMRC=0) as chronic breathlessness severity increased, across five age groupings.

Epidemiology of injury in male collegiate Gaelic footballers in one season.

Despite the popularity of collegiate Gaelic football in Ireland and the recent expansion into the United Kingdom and United States, no previous study has examined injury incidence. A prospective epidemiological study was implemented to establish injury incidence in 217 (19.3 ± 1.9 years) male collegiate Gaelic footballers from two collegiate institutions in one season. An injury was defined as any injury sustained during training or competition resulting in time lost from play or athlete reported restricted performance. Athletic therapy and training students, alongside a certified athletic and rehabilitation therapist, attended all training/matches over one season, and injuries were recorded using a standardized injury report form. The match injury rate was 25.1 injuries per 1000 h, with a significantly higher match injury rate noted in fresher players (players in their 1st year of higher education) (41.6 injuries per 1000 h) than senior players (12.7 injuries per 1000 h). Lower limb injuries were predominant (71.1%), particularly in the hamstring (15.5%), knee (14.1%), and ankle (11.3%). Soft-tissue injuries predominated, particularly strains (32.4%) and sprains (27.5%). A scan and surgery was required in 31% and 12% of injuries, respectively. Thus, injuries are prevalent in male collegiate Gaelic football, and injury prevention programs are required.

Clinical trials of medicinal cannabis for appetite-related symptoms from advanced cancer: a survey of preferences, attitudes and beliefs among patients willing to consider participation.

BACKGROUND: Australian clinical trials are planned to evaluate medicinal cannabis in a range of clinical contexts. AIMS: To explore the preferences, attitudes and beliefs of patients eligible and willing to consider participation in a clinical trial of medicinal cannabis for poor appetite and appetite-related symptoms from advanced cancer. METHODS: A cross-sectional anonymous survey was administered from July to December 2015 online and in eight adult outpatient palliative care and/or cancer services. Respondents were eligible if they were ≥18 years, had advanced cancer and poor appetite/taste problems/weight loss and might consider participating in a medicinal cannabis trial. Survey items focused on medicinal rather than recreational cannabis use and did not specify botanical or pharmaceutical products. Items asked about previous medicinal cannabis use and preferences for delivery route and invited comments and concerns. RESULTS: There were 204 survey respondents, of whom 26 (13%) reported prior medicinal cannabis use. Tablets/capsules were the preferred delivery mode (n = 144, 71%), followed by mouth spray (n = 84, 42%) and vaporiser (n = 83, 41%). Explanations for preferences (n = 134) most commonly cited convenience (n = 66; 49%). A total of 82% (n = 168) of respondents indicated that they had no trial-related concerns, but a small number volunteered concerns about adverse effects (n = 14) or wanted more information/advice (n = 8). Six respondents volunteered a belief that cannabis might cure cancer, while two wanted assurance of efficacy before participating in a trial. CONCLUSION: Justification of modes other than tablets/capsules and variable understanding about cannabis and trials will need addressing in trial-related information to optimise recruitment and ensure that consent is properly informed.

The development and reliability of a simple field based screening tool to assess core stability in athletes.

OBJECTIVES: To adapt the trunk stability test to facilitate further sub-classification of higher levels of core stability in athletes for use as a screening tool. To establish the inter-tester and intra-tester reliability of this adapted core stability test. DESIGN: Reliability study. SETTING: Collegiate athletic therapy facilities. PARTICIPANTS: Fifteen physically active male subjects (19.46 ± 0.63) free from any orthopaedic or neurological disorders were recruited from a convenience sample of collegiate students. MAIN OUTCOME MEASURES: The intraclass correlation coefficients (ICC) and 95% Confidence Intervals (CI) were computed to establish inter-tester and intra-tester reliability. RESULTS: Excellent ICC values were observed in the adapted core stability test for inter-tester reliability (0.97) and good to excellent intra-tester reliability (0.73-0.90). While the 95% CI were narrow for inter-tester reliability, Tester A and C 95% CI's were widely distributed compared to Tester B. CONCLUSIONS: The adapted core stability test developed in this study is a quick and simple field based test to administer that can further subdivide athletes with high levels of core stability. The test demonstrated high inter-tester and intra-tester reliability.

Musculoskeletal Health, Kidney and Liver Function in Retired Jockeys.

The long-term implications of making-weight daily on musculoskeletal health and functioning of the kidney and liver remain unknown. This study aimed to investigate musculoskeletal health and kidney and liver function in a group of retired jockeys. 28 retired male jockeys (age 50-70 years) provided fasting blood samples for markers of bone metabolism and kidney and liver function. A dual-energy x-ray absorptiometry (DXA) scan was performed for the assessment of bone mineral density (BMD). Established reference ranges were used for interpretation of results. Comparisons were made between retired jockeys based on the professional racing licence held: Flat, National Hunt or Dual. Mean whole-body osteopenia was reported, with no differences between groups. Bone markers, micronutrients, electrolytes and associated hormones, and markers for kidney and liver function were within clinical normative ranges. No differences existed between groups. Results indicate the retired jockeys in this study do not demonstrate compromised bone health or kidney and liver function. However, the retired jockeys may not have undergone chronic weight cycling in the extreme manner evident in present-day jockeys, indicating the next generation of jockeys may face more of a problem. Jockeys should be tracked longitudinally throughout their racing career and beyond.

Adductor tenotomy in the management of groin pain in athletes.

This study evaluates the efficacy of adductor longus tenotomy in athletes with chronic tendinopathy refractory to conservative management. In a retrospective case series we report our experience with 109 male athletes who underwent unilateral adductor tenotomy during the period 2000-2005, all of whom responded to a detailed questionnaire. The criterion for tenotomy was chronic adductor origin pain which prevented training or playing (Level 4), limited training or playing (Level 3), or affected performance (Level 2)and which had failed to respond to conservative management including rest, rehabilitation and/or local steroid injection. Level 1 performance is classified as optimal performance with no pain. 99 of the 109 patients (91%) reported improvement. Best results were achieved in patients with maximum discomfort preoperatively (Level 4) with 32 of 38 (84%) patients returning to Level 1 performance. In conclusion, adductor tenotomy in athletes with severely incapacitating pain (Level 3/4) which fails to respond to conservative management offers the best opportunity of returning to competitive sport.

Graphomotor perseveration and wandering in Alzheimer's disease.

Perseveration, spatial orientation, and attention/concentration were assessed in 15 patients with a probable diagnosis of senile dementia of the Alzheimer's type. Subjects were divided into two groups, wanderers and nonwanderers, based on caregiver ratings using a modified version of the Caregiver Checklist. Graphic productions of wanderers on the Bender Visual Motor Gestalt Test and Clock Drawing Test displayed greater total perseveration and more recurrent and continuous perseverations than those of nonwanderers. Spatial orientation and attention/concentration were similar between groups. These preliminary results suggest that graphomotor perseverations exhibited during the mild to moderate stages may serve as a marker for wandering in Alzheimer's disease.

Gentle exercise with a previously inactive muscle group hastens the decline of blood lactate concentration after strenuous exercise.

The aim of this study was to elucidate the mechanism by which the disappearance of blood lactate following severe exercise is enhanced during active recovery in comparison with recovery at rest. Rates of decline of arterialised venous blood lactate concentrations in man after maximal one-leg exercise were compared during four different modes of recovery: passive (PR), exercise of the muscles involved in the initial exercise (SL), exercise of the corresponding muscles in the hitherto-inactive leg (OL), or exercise of one arm (RA). Recovery exercise workloads were each 40% of the onset of blood lactate accumulation (OBLA) for the limb used. In comparison with PR, SL and OL accelerated the fall in blood lactate to similar extents whereas RA was without effect. The first-order rate constant (min-1) for decline of arterialised venous blood lactate concentration after the intense exercise was 0.027 (0.003) in PR, 0.058 (0.025) in SL, 0.034 (0.002) in OL, and in RA was 0.028 (0.002) [mean (SEM), n = 6 subjects]. Preliminary studies had shown that RA in isolation elevated blood lactate whereas SL and OL did not. Thus, with appropriate workloads, exercise of either hitherto active or passive muscles enhanced blood lactate decline during recovery from intense exercise. This suggests that the effect resulted principally from the uptake and utilisation of lactate in the circulation by those exercising muscles rather than from increased transport of lactate to other sites of clearance by sustained high blood flow through the previously active muscles.