ABSTRACT
SUMMARY: Professional jockeys are routinely exposed to high impact trauma and sustain fractures frequently. We found that jockeys restrict their caloric intake in order to maintain regulation weights, and that bone turnover is high. There are significant health and safety implications for the racing industry. INTRODUCTION: Professional jockeys routinely sustain fractures from high impact falls. Jockeys maintain a low percentage body fat and a low body mass index (BMI) to achieve low weight targets in order to race. We evaluated dietary habits and bone metabolism in jockeys. METHODS: Bone mineral density (BMD) was measured in 27 male jockeys of the 144 jockeys licensed in Ireland. Fourteen (52%) had BMD T score below -1.0, of whom 12 consented to clinical review, nutritional survey, endocrine studies, and bone turnover markers (BTM). BTM were compared to age- and sex-matched controls (n = 16). RESULTS: BMI was 20.6 +/- 1.7 kg/m(2); previous fracture frequency was 3.2 +/- 2.0 per rider. All had normal endocrine axes. The jockeys' diet as determined by a 7-day dietary recall was deficient in energy, calcium, and vitamin D intake. Compared with the control group, the jockey group had evidence of increased bone turnover. CONCLUSIONS: A substantial proportion of the professional jockeys in Ireland have low-normal BMD, low BMI, and high bone turnover that may result from weight and dietary restrictions. These factors seem to have a deleterious effect on their bone health and predispose the jockeys to a high fracture risk that should be remediated.
Subject(s)
Bone Diseases, Metabolic/etiology , Bone and Bones/metabolism , Occupational Diseases/etiology , Sports/physiology , Adult , Body Mass Index , Bone Density/physiology , Bone Diseases, Metabolic/physiopathology , Case-Control Studies , Diet/adverse effects , Feeding Behavior , Humans , Male , Occupational Diseases/physiopathology , Young AdultABSTRACT
The literature suggests that 40% to 60% of nursing home residents have some degree of dysphagia, i.e., difficulty in swallowing. Poorly managed, this can lead to aspiration pneumonia; choking; chronic malnutrition; decreased quality of life; and frustration for residents, family, and staff. This article reviews the nursing literature on dysphagia management and then describes a comprehensive protocol to assess and manage patients with swallowing problems in long term care.
Subject(s)
Deglutition Disorders/nursing , Deglutition Disorders/therapy , Geriatric Nursing/methods , Nursing Assessment/methods , Patient Care Planning , Aged , Deglutition Disorders/diagnosis , Humans , Nursing HomesABSTRACT
Various studies suggest that between 50% and 75% of nursing home residents have some difficulty in swallowing. Some of these residents are assessed and treated by speech pathologists, but many are managed by nursing staff without specialist input. A training program called Swallowing ... on a Plate (SOAP) has been developed by the Centre for Education and Research on Ageing and the Inner West Geriatrics and Rehabilitation Service to help address swallowing-related problems in local nursing homes (Inner West of Sydney, Australia). The training program teaches nursing staff how to identify, assess, and manage swallowing problems, including making appropriate referrals. Several new instruments were developed specifically for this program including two assessment checklists, a set of management guidelines, and a swallowing care plan. Evaluation of the program--including 3 months follow-up--showed it to be highly successful. A stand-alone training resource has been produced for wide distribution to help staff implement the program as a permanent aspect of their nursing care. This paper describes the development, content, presentation, resource, and evaluation of the above program.
Subject(s)
Deglutition Disorders/nursing , Education, Nursing , Nursing Homes , Aged , Deglutition/physiology , Deglutition Disorders/diagnosis , Deglutition Disorders/prevention & control , Deglutition Disorders/therapy , Follow-Up Studies , Humans , Inservice Training , Nursing Assessment , Nursing Evaluation Research , Nursing Process , Nursing Staff/education , Program Development , Referral and ConsultationABSTRACT
A case control study of risk factors for non-melanoma skin cancer (NMSC) was carried out on 396 patients and individually age and sex-matched controls. Cases were significantly more likely than controls to have had a rural domicile (P = 0.007), light eye colour (P = 0.004) a tendency to develop sunburn very easily (P less than 0.05) and a family history of NMSC (P less than 0.001). Other indices of exposure or sensitivity to ultraviolet (UV) radiation did not differ significantly between the two groups. It is suggested that while the role of UV radiation in the aetiology of NMSC is not in doubt, other factors not yet identified must also be important, at least among the Irish population.
