Impact of COVID-19 on lifestyle and mental wellbeing in a drought-affected rural Australian population.

INTRODUCTION: The SARS-CoV-2 (COVID-19) pandemic has caused unprecedented social and economic disruption, accompanied by the enactment of a multitude of public health measures to restrain disease transmission. These public health and social measures have had a considerable impact on lifestyle and mental wellbeing, which has been well studied with metropolitan populations. However, limited literature concerning such effects on a selectively rural population is presently available. Additionally, the use of a standardised scoring system for lifestyle may be valuable for an overall assessment of lifestyle that may be incorporated into clinical practice. METHODS: This study examined the associations between psychological distress and changes in SNAPS health behaviours (smoking, nutrition, alcohol, physical activity, sleep) since the onset of COVID-19 in Australia. A cross-sectional anonymous survey was distributed online to adults in the Western New South Wales Primary Health Network in August 2020 and included measures of psychological distress, income, disposition and lifestyle factors during the pandemic as well as changes to lifestyle due to COVID-19. A novel Global Lifestyle Score (GLS) was generated as a holistic assessment of lifestyle across multiple domains. RESULTS: The survey was completed by 304 individuals (modal age group 45-54 years, 86.8% female). High distress on the Kessler-5 scale was present in over one-third of participants (n=95, 33.7%). Detrimental change was reported for sleep (22.7%), nutrition (14.5%), alcohol (16.7%), physical exercise (34.0%) and smoking (24.7%) since the onset of the pandemic. Changes in sleep, nutrition, physical activity and smoking were associated with distress. Participants with a poor lifestyle (GLS) during the pandemic were significantly more distressed. Perceived COVID-19 impact was associated with high distress, drought impact and loss of income. Participants who reported negative impact from both COVID-19 and drought were significantly more distressed than those reporting a negative impact from drought alone or neither event. CONCLUSION: High rates of distress among rural Australians during the COVID-19 pandemic was linked to low GLS, worsening lifestyles and loss of income. Healthy lifestyle strategies should be considered by health professionals for the management of crisis-related distress. Further research may explore the impact of COVID-19 on a larger study population with a greater proportion of male participants and to examine the effect of modifying lifestyle factors in reducing distress in the context of a stressor such as this pandemic.

Long-Term Results of Charité Lumbar Disc Replacement: A 17-Year Follow-Up in a Workers' Compensation Cohort.

BACKGROUND: Lumbar total disc replacement (TDR) is an alternative to lumbar fusion for the management of degenerative disc disease. This study aims to provide insight into the long-term clinical outcomes of lumbar TDR with a mean follow-up of 17.2 years in a group of workers' compensation patients. METHODS: A total of 26 workers' compensation patients with radiographically confirmed discogenic low back pain were treated with the Charité total lumbar disc replacement. Visual analog scale (VAS) scores were assessed before and after the surgery. At follow-up, patients were assessed on quality of life, employment, further lumbar spine surgeries, and associated complications. Simple nonparametric statistical analysis was performed by the first author using Microsoft Excel. RESULTS: Sixteen patients (62%) were able to be contacted with a mean follow-up time of 17.2 years. VAS scores at 17 years were significantly lower than their preoperation level. Of those 16 patients, 81% returned to work and worked for an average of 9.1 years after surgery. Additionally, 6 (38%) patients underwent further lumbar spinal surgery, of whom 4 underwent fusions of the adjacent segment. Nearly all patients (94%) were satisfied with the surgery. CONCLUSION: This study suggests lumbar TDR may be a useful treatment for degenerative disc disease in select workers' compensation patients. CLINICAL RELEVANCE: Clinically relevant improvements in pain and employment can be achieved with the charite lumbar TDR in the treatment of degenerative disc disease in workers' compensation patients. These results are sustained over the long term.

Drugs associated with cataract formation represent an unmet need in cataract research.

Decreased light transmittance through the ocular lens, termed cataract, is a leading cause of low vision and blindness worldwide. Cataract causes significantly decreased quality of life, particularly in the elderly. Environmental risk factors, including aging, UV exposure, diabetes, smoking and some prescription drugs, are all contributors to cataract formation. In particular, drug-induced cataract represents a poorly-addressed source of cataract. To better understand the potential impact of prescription drugs on cataract, we analyzed publicly-available drug prescriptions data from the Australian Pharmaceutical Benefits Scheme. The data was analyzed for the 5-year period from July 2014 to June 2019. Analyses included the number of prescriptions for each drug, as well as the associated government and total prescription costs. The drugs chosen for analysis belonged to any of four broad categories-those with known, probable, possible or uncertain association with cataract in patients. The analyses revealed high prescription rates and costs for drugs in the Known category (e.g., steroids) and Possible category (e.g., psychotropic drugs). Collectively, these data provide valuable insights into specific prescription drugs that likely contribute to the increasing annual burden of new cataract cases. These data highlight the need-as well as new, stem cell-based opportunities-to elucidate molecular mechanisms of drug-induced cataract formation.

Massive Chondrolysis and Joint Destruction after Artificial Anterior Cruciate Ligament Repair.

The Ligament Augmentation Reconstruction System (LARS) is an artificial ligament made of polyethylene terephthalate (PET) used for anterior cruciate ligament (ACL) reconstruction in Australia. Poor results with previous generations of synthetic grafts causing synovitis, graft failure, and premature osteoarthritis have encouraged the production of the newer LARS ligament with good results. We present a case of massive chondrolysis and joint destruction after LARS implantation requiring total knee replacement in a 23-year-old male. This case documents a rare and severe complication to the LARS ligament as caution for the implementation of this device in young athlete.

IAEA Isotope-enabled coupled catchment-lake water balance model, IWBMIso: description and validation.

The International Atomic Energy Agency (IAEA) Water Balance Model with Isotopes (IWBMIso) is a spatially distributed monthly water balance model that considers water fluxes and storages and their associated isotopic compositions. It is composed of a lake water balance model that is tightly coupled with a catchment water balance model. Measured isotope compositions of precipitation, rivers, lakes, and groundwater provide data that can be used to make an improved estimate of the magnitude of the fluxes among the model components. The model has been developed using the Object Modelling System (OMS). A variety of open source geographic information systems and web-based tools have been combined to provide user support for (1) basin delineation, characterization, and parameterization; (2) data pre-processing; (3) model calibration and application; and (4) visualization and analysis of model results. In regions where measured data are limited, the model can use freely available global data sets of climate, isotopic composition of precipitation, and soils and vegetation characteristics to create input data files and estimate spatially distributed model parameters. The OMS model engine and support functions, and the spatial and web-based tool set are integrated using the Colorado State University Environmental Risk Assessment and Management System (eRAMS) framework. The IWBMIso can be used to assess the spatial and temporal variability of annual and monthly water balance components for input to water planning and management.