The new normal for food insecurity? A repeated cross-sectional survey over 1 year during the COVID-19 pandemic in Australia.

BACKGROUND: Food insecurity during the COVID-19 pandemic has been impacted by necessary public health restrictions. Tasmania, an island state south of the Australian mainland, recorded no community transmission of COVID-19 between May 2020 to November 2021 due to strong border restrictions. This study aimed to determine the changes in prevalence and sociodemographic predictors of food insecurity throughout the COVID-19 pandemic in Tasmania, Australia. METHODS: In May 2020 (survey 1: during lockdown), September 2020 (survey 2: eased restrictions) and May 2021 (survey 3: 1-year post-lockdown), cross-sectional, online surveys using convenience sampling methods determined food insecurity in Tasmanian adults using the USDA Household Food Security Survey Module: Six-Item Short Form, in addition to key sociodemographic questions. Crude and age-adjusted prevalence of food insecurity was calculated, and binary logistic regression determined at-risk groups and changes in prevalence over time. RESULTS: The age-adjusted prevalence of food insecurity was 27.9% during lockdown (n = 1168), 19.5% when restrictions had eased (n = 1097) and 22.6% 1-year post-lockdown (n = 1100). Young adults, Aboriginal and/or Torres Strait Islander people, individuals with disabilities, families with dependents and temporary residents were at highest risk across all time points. CONCLUSIONS: The prevalence of food insecurity was higher than pre-pandemic levels across all three time points. Our results indicate the potential long-term impacts of the COVID-19 pandemic on food security in Australia, where despite easing social distancing restrictions and a lack of COVID-19 transmission, the prevalence of food insecurity reduced, but did not recover to pre-pandemic levels 1-year following a lockdown.

The physiological demands of helicopter winch rescue in water and over land.

Physically demanding water and over land winch rescues are critical tasks for helicopter paramedics. To assess the physiological demands of winch rescue, 14 intensive care flight paramedics (12 male, 2 female, mean (±SD) age 44.3 (±5.4) years, experience 7.1 (±5.2) years) completed land and water-based task simulations. For the land task, VO2 was 41.7 (±4.5) mL kg-1 min-1, or 86 (±11) % of VO2peak. Task duration was 7.0 (±3.6) min, or 53 (±27) % of maximal acceptable work duration (MAWD) (13.2 (±9.0) min). For the water task, VO2 was 36.7 (±4.4) mL kg-1 min-1, (81 (±12) % of VO2peak). Water task duration was 10.2 (±1.1) min, or 47.6 (±4.8) % of calculated MAWD (21.0 (±15.6) min). These results demonstrate that helicopter rescue paramedics work at very high physiological workloads for moderate durations, and these demands should be considered when developing selection tests and when deploying to rescues, to ensure staff are capable of task performance. Practitioner summary: Paramedics performed helicopter winch rescue task simulations in water and over land. Paramedics worked at 81% of VO2peak for 10.2 min and 86% of VO2peak for 7 min for swim and land tasks respectively. Rescue organisations should consider these demands when selecting and credentialing staff and when deploying to incidents. Abbreviations: HEMS: helicopter emergency medical service; ICFP: intensive care flight paramedic; MAWD: maximal acceptable work duration; PES: physical employment standards; SAR: search and rescue.

Comparison of swimming versus running maximal aerobic capacity in helicopter rescue paramedics.

Swimming is a critical task for helicopter rescue paramedics and aerobic capacity is assessed in this occupation to determine job suitability. We evaluated one treadmill-based and one pool-based assessment of maximal aerobic capacity (V̇O2peak) in 14 helicopter rescue paramedics. There was a small absolute difference (p = 0.11, d = 0.46) between V̇O2peak in the swim (45.5 ± 7.8 ml.kg-1.min-1) compared to the run (48.5 ± 5.5 ml.kg-1.min-1), with a moderate relationship noted (r = 0.74, 95% CI [0.35-, 0.91], p = 0.0023). Whilst not interchangeable, run V̇O2peak was a predictor of swim V̇O2peak. Maximal blood lactate was similar (p = 0.93) in swim (13.4 ± 3.8 mmol.L-1) and run (12.2 ± 3.0 mmol.L-1), and maximal heart rate 13% lower (p < 0.0001) in the swim (162 ± 11 bpm) versus the run (186 ± 10 bpm). To estimate swimming V̇O2peak in paramedics a treadmill test is sufficient but does not replace assessment of swimming proficiency. Practitioner Summary: We developed a swim protocol to assess maximal aerobic capacity in helicopter rescue paramedics. Compared to a treadmill-based test, our swim protocol generated 20% lower submaximal V̇O2 and 6% lower V̇O2peak. Although not interchangeable, a treadmill V̇O2peak test is indicative of maximal aerobic capacity in rescue paramedics whilst swimming. Abbreviations: HEMS: helicopter emergency medical service; PES: physical employment standards; ICFP: intensive care flight paramedic; RPE: rating of perceived exertion.

Physiological Response in a Specialist Paramedic During Helicopter Winch Rescue in Remote Wilderness and Extreme Heat.

Tasks performed by search and rescue (SAR) teams can be physically demanding. SAR organizations are faced with mounting challenges due to increased participation in recreation in remote locations and more frequent extreme weather. We sought to describe the physiological response and the methods for data collection during helicopter emergency medical service (HEMS) winch rescue from remote wilderness in extreme heat. A flight paramedic sustained 81% of maximum heart rate (VO2 ~44.8 mL/kg/min) for ~10 minutes at a rate of perceived exertion of 19/20, and a relative heart rate of 77.5% in 37.1°C. Maximal acceptable work time for this task was calculated at 37.7 minutes. Our data collection methods were feasible, and the data captured demonstrated the level of physiological strain that may be encountered during HEMS SAR operations in austere environments and hot climate. It is essential that SAR teams that perform physically demanding tasks use a scientific approach to adapt and evolve. This is necessary to ensure personnel are appropriately selected, trained, and equipped to respond in an era of increasing demand and extreme environments.

The metabolic syndrome: recognition and management.

The National Cholesterol Education Program defines the metabolic syndrome as three or more of five abnormalities: waist circumference of >40 in (102 cm) for men or >35 in (88 cm) for women, triglyceride level of > or =150 mg/dL, high-density lipoprotein cholesterol of <40 mg/dL in men or <50 mg/dL in women, blood pressure of > or =130 or > or =85 mm Hg, and fasting glucose of > or =110 mg/dL. It is related to insulin resistance, but the two terms are not synonymous. Both are associated strongly with obesity. The metabolic syndrome is important as an indicator of increased risk of cardiovascular disease (CVD) in patients with and without clinical CVD. The CVD risk of the metabolic syndrome is greater than that conferred by any single CVD risk factor. Since risk factors tend to cluster, if one component of the metabolic syndrome is present, one should assess for other risk factors. The metabolic syndrome is also predictive of new-onset type 2 diabetes. Early diagnosis provides justification for measures that can improve components of the syndrome and reduce CVD risk. The management strategy for metabolic syndrome focuses on overall CVD risk rather than single risk factors; effective therapy includes priority for weight reduction and increased physical activity. Pharmacotherapy is typically needed for control of high blood pressure, hypercoagulability, and increased levels of blood glucose and triglycerides.

The Basics of Bacteriuria: Strategies of Microbes for Persistence in Urine.

Bacteriuria, the presence of bacteria in urine, is associated with asymptomatic, as well as symptomatic, urinary tract infection (UTI). Bacteriuria underpins some of the dynamics of microbial colonization of the urinary tract, and probably impacts the progression and persistence of infection in some individuals. Recent molecular discoveries in vitro have elucidated how some key bacterial traits can enable organisms to survive and grow in human urine as a means of microbial fitness adaptation for UTI. Several microbial characteristics that confer bacteruric potential have been identified including de novo synthesis of guanine, relative resistance to D-serine, and catabolism of malic acid. Microbial characteristics such as these are increasingly being defined through the use of synthetic human urine (SHU) in vitro as a model to mimic the in vivo environment that bacteria encounter in the bladder. There is considerable variation in the SHU model systems that have been used to study bacteriuria to date, and this influences the utility of these models. In this review, we discuss recent advances in our understanding of bacteruric potential with a focus on the specific mechanisms underlying traits that promote the growth of bacteria in urine. We also review the application of SHU in research studies modeling UTI and discuss the chemical makeup, and benefits and limitations that are encountered in utilizing SHU to study bacterial growth in urine in vitro.

The Metabolic Syndrome in African Americans: a review.

The Metabolic Syndrome represents a specific clustering of cardiovascular risk factors. One of several recently proposed definitions encompasses 3 or more of the following 5 abnormalities: waist circumference > 102 cm in men or > 88 cm in women, serum triglyceride level > or = 150 mg/dL, high-density lipoprotein cholesterol level < 40 mg/dL in men or < 50 mg/dL in women, blood pressure (BP) > or = 130/> or = 85 mm Hg and serum glucose > or = 110 mg/dL. The diagnosis of Metabolic Syndrome allows early recognition of an increased risk of cardiovascular disease. African Americans have the highest coronary heart disease mortality of any ethnic group in the United States. African-American women and Hispanic men and women have the highest prevalence of the Metabolic Syndrome. This phenomenon is attributable mainly to the disproportionate occurrence of elevated BP, obesity, and diabetes in African Americans, and the high prevalence of obesity and diabetes in Hispanics. Management of the Metabolic Syndrome consists primarily of modification or reversal of the root causes and direct therapy of the risk factors. The first strategy involves weight reduction and increased physical activity, both of which can improve all components of the syndrome. The second strategy often involves drug treatment of the individual risk factors to further improve BP, lipids, and glucose thereby decreasing the risk of cardiovascular disease. This comprehensive review is provided as part of the educational activities of the African-American Lipid and Cardiovascular Council (AALCC).