The COVID-19 lockdown in Australia: a case study of exercise programming in male academy football players to prepare for return to play.

PURPOSE: In 2020, the COVID-19 pandemic forced global lockdowns. Herein, we examine the effect of a lockdown exercise programme in a case-study of youth Australian A-league academy football players. METHODS: Fifty-five u13-u15 age-grade players were provided with a 110 minute exercise programme including technical, tactical, cardiovascular and muscle strengthening exercises to perform 4 per week at home during the 10-week COVID-19 lockdown. RESULTS: Pre/Post lockdown, maximum aerobic speed was determined via the 30-15 intermittent fitness test (IFT). Exercise compliance was high (78.5% CI72.2-83.8) with an average of 3.15 sessions completed each week. All time-loss (TL) and medical attention (MA) injuries were recorded. Pre/Post lockdown, no difference in the mean incidence or burden of total time-loss (TL), match TL, training TL or medical attention (MA) injuries or injury rate ratio (1.21 CI:0.85-2.74) was observed. Similarly, no difference was observed in any injury incidence or burden data or the injury rate ratio (1.53 CI:0.85-2.74) when comparing the 9-week period prior to lockdown with the first 9 weeks post lockdown (9v9 only). A 9.6% (p = <0.01) increase was also observed in Pre/Post 30-15 IFT composite scores (18.7 CI: 18.3-19.1 to 20.5 CI:20-21). CONCLUSION: In this case study, compliance to the home-based exercise programme was high and no increase in injury was apparent. These findings must however be considered alongside the limitations associated within this case-study.

CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients.

Purpose: To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. Materials and Methods: 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. Results: The accuracy was 94.4 % for histopathological analysis and 97.7 % for microbiological analysis. In 25 % of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy cross-sectional imaging concerning suspected malignancy was 69 %/78 %. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81 %/44 %. In 52 % of all cases, the biopsy result changed subsequent patient management. Conclusion: Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection. Key Points: • CT-guided spine biopsy is an accurate and reliable procedure in case of infection and tumour.• The results of the CT-guided spine biopsy have a significant influence on the subsequent patient management.• Pathogen recovery-rate in case of infection is moderate but not significantly affected by prebiopsy antibiotic therapy. Citation Format: • Rehm J, Veith S, Akbar M et al. CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients. Fortschr Röntgenstr 2016; 188: 1156 - 1162.

[Competence centre for victims of violence as part of the public health services--a consecutive case series of the "Schutzambulanz Fulda"]. / Kompetenzzentrum für Gewaltopfer im ÖGD--Analyse des Fallaufkommens der Schutzambulanz Fulda.

Health-care services often fail to address violence sufficiently and to provide adequate forensic medical examination and documentation, especially in cases of intimate partner violence and violence against people in need of care. The "Schutzambulanz Fulda", hosted by the public health department of Fulda county, aims to close this gap in the east Hessian region. We have evaluated the first year of service. Between November 26(th) 2010 and November 26(th) 2011 a total of 154 persons called for support. Data concerning personal characteristics of the victims and the suspected perpetrators, the time and place of the incidents, and their impacts were analysed. 76.6% of th subjects were female, 23.4% male and 18.8% were less than 18 years old. In 60 cases a documentation of the injuries suitable for use in court was made. The majority of clients were women who reported having been assaulted by their partner or ex-partner. Community violence was less frequently stated. Contact to people in need of care suffering from violence was very rare. Currently, the "Schutzambulanz" as part of a public health department meets the goals to some degree. A comparative evaluation could help to identify the benefits and disadvantages of various trusteeships within the health-care system.

The beginning of baccalaureate nursing education at the University of Kansas: a midwestern experience.

An issue in the historiography of nursing is whether nurses desired baccalaureate education for their occupation, and were unable to accomplish this, or whether they preferred diploma schools. Examination of resource materials at a midwestern university revealed that nurses were neither victims nor heroines of a male-dominated system. Although the evidence supports the oppressor/victim model of women in the professions, it also shows that nurses were instrumental in challenging the university to respond to the need for upgraded nursing education. Particularly striking in the resource material was the effect student nurses had on the development of the occupation at this institution.

The effect of chronic ethanol consumption on salivary gland morphology and function in the rat.

Chronic ethanol consumption in rats resulted in a striking fat accumulation in the acinar cells of the parotid gland demonstrated by light microscopy. In addition, a significant decrease in parotid wet weight (p greater than 0.02) and in protein content of the gland (p greater than 0.02) was observed following alcohol feeding. Wet weight, protein content, and morphology of the submaxillar gland were not affected by ethanol feeding. Alcohol metabolism, similar to that found in the pancreas, via a cytosolic alcohol dehydrogenase could be demonstrated in both the parotid and the submaxillar gland. However, the activity of this enzyme was not affected by chronic ethanol ingestion. Subsequently, chronic ethanol consumption significantly decreased salivary flow rate stimulated by pilocarpine hydrochloride (p greater than 0.02), salivary alpha-amylase activity (p greater than 0.02), and salivary sodium concentration (p greater than 0.01), whereas potassium concentration of the saliva was increased (p greater than 0.05). In contrast salivary total protein concentration was not affected by alcohol ingestion. The changes of salivary electrolyte composition observed after chronic ethanol feeding could be due to an altered aldosterone metabolism or to a change in aldosterone receptors of the parotid gland caused by ethanol administration. The reduced salivary flow could play a role in the pathogenesis of oropharyngeal cancer in the alcoholic.

Duodenal gamma-glutamyltransferase activity in human biopsies: effect of chronic ethanol consumption and duodenal morphology.

Gamma-glutamyltransferase activity was determined in duodenal biopsies, and in the sera of forty-six non-alcoholic and eighteen alcoholic patients with a daily alcohol consumption of more than 80 g. Additionally, duodenal morphology was examined in biopsy material obtained at the same time. In both alcoholics (P less than 0.05) and in non-alcoholics (P less than 0.001) the duodenal gamma-glutamyltransferase activity revealed a significant positive correlation with duodenal villus length. In addition, alcoholics exhibited a significant decrease in duodenal villus length (338 +/- 13 vs. 363 +/- 13 microns, P less than 0.01), and a significant increase in duodenal gamma-glutamyltransferase activity (13.0 +/- 1.4 vs. 8.4 +/- 0.6 mU mg-1 protein, P less than 0.01) when compared to controls. No significant correlation was found between duodenal and serum gamma-glutamyltransferase activity in alcoholics and non-alcoholics. During follow up of two patients, duodenal gamma-glutamyltransferase activity decreased and duodenal villus length increased after withdrawing alcohol. These data underline the damaging effect of alcohol on the duodenal mucosa and demonstrate that chronic alcohol intake reversibly effects duodenal gamma-glutamyltransferase. In addition, the small intestine appears of minor importance as an origin for the elevated serum gamma-glutamyltransferase activities seen in the alcoholic.

Ethanol and intestinal carcinogenesis in the rat.

The effect of chronic ethanol administration on 1,2-dimethylhydrazine induced rectal carcinogenesis was investigated in 32 paired male Sprague-Dawley rats fed a nutritionally adequate liquid diet containing 36% of total calories either as ethanol or isocaloric carbohydrates. Chronic ethanol ingestion increased the total number of rectal tumors significantly (17 vs. 6, p less than 0.02), whereas no cocarcinogenic effect of ethanol was observed in other parts of the intestine. Alcohol did not influence tumor size or histopathology. A 47% increase in the activity of mucosal alcohol dehydrogenase in the distal colorectum was found between chronically ethanol fed and pair fed controls (0.241 +/- 0.019 vs. 0.164 +/- 0.020 mumol mg protein-1 hr-1, p less than 0.01). This could in part explain the cocarcinogenic effect of alcohol in this tissue. The data give experimental support to the epidemiologic findings of an increased incidence of rectal cancer in the alcoholic.

Different effects of dietary chenodeoxycholic acid and ursodeoxycholic acid on colonic adenylate cyclase in the rat.

The oral administration of dietary chenodeoxycholic acid (1%), but not of ursodeoxycholic acid (1%), to male Sprague Dawley rats results in a significant increase in the colonic adenylate cyclase activity without any influence on the colonic cyclic-AMP phosphodiesterase activity. No effect of chronic bile acid feeding on the response of colonic adenylate cyclase to prostaglandin E2 and vasoactive intestinal peptide is observed. These data emphasize a dependence of the cyclic-AMP adenylate cyclase activation on the chemical structure of the bile acid. This may be of pathophysiologic relevance with respect to the frequently observed diarrhea as a side effect of oral chenodeoxycholic, but not ursodeoxycholic acid therapy for cholesterol gallstone dissolution in man.

Stimulation of chemically induced rectal carcinogenesis by chronic ethanol ingestion.

The effect of chronic ethanol administration on 1, 2-dimethylhydrazine-induced rectal carcinogenesis was investigated in 32 paired male Sprague-Dawley rats fed a nutritionally-adequate liquid diet containing 36% of the total calories as either ethanol or isocaloric carbohydrates. Chronic ethanol ingestion increased the total number of rectal tumors significantly (17 vs 6; P less than 0.02), whereas no cocarcinogenic effect of ethanol was observed in other parts of the intestine. Alcohol did not influence tumor size or histopathology. A 47% increase in the activity of mucosal alcohol dehydrogenase in the distal colorectal region was found between chronically-ethanol-fed rats and pair-fed controls (0.241 +/- 0.019 vs 0.164 +/- 0.020 mumol/mg of protein/hr; P less than 0.01). This could in part explain the cocarcinogenic effect of alcohol in this tissue. Faecal bile acids, however, do not play a role as promotors of rectal carcinogenesis under the present experimental conditions. The results give experimental support to the epidemiologic findings of an increased incidence of rectal cancer in the alcoholic.

In vivo interactions between H2-receptor antagonists and ethanol metabolism in man and in rats.

The influence of a 7-day medication of either cimetidine (1,000 mg per day) or ranitidine (300 mg per day) on serum ethanol concentrations after a single oral dose of ethanol (0.8 gm per kg body weight) was investigated in a randomized placebo-controlled study in eight male volunteers. Compared with the placebo, cimetidine but not ranitidine produced a significant increase in both the peak serum ethanol concentration (85.9 +/- 3.5 vs. 73.0 +/- 3.2 mg dl-1, p less than 0.02) and in the area under the serum ethanol concentration time curve (350 +/- 19 vs. 304 +/- 25 mg dl-1 hr-1, p less than 0.05). However, the ethanol elimination rate was not affected by cimetidine. When ethanol (1.0 gm per kg body weight) was administered intravenously, cimetidine failed to induce a change in ethanol metabolism. Furthermore, the effect of H2-receptor antagonists was studied in animal experiments. Female Sprague-Dawley rats received a single dose of ethanol (7 or 3 gm per kg body weight) together with an intraperitoneal injection of either cimetidine (120 mg per kg body weight), ranitidine (120 mg per kg body weight) or isotonic saline. After alcohol absorption, ethanol elimination was significantly inhibited by both cimetidine (3.99 +/- 0.39 vs. 5.68 +/- 0.23 mmoles kg-1 hr-1, p less than 0.02) and ranitidine (4.21 +/- 0.14 vs. 5.68 +/- 0.23 mmoles kg-1 hr-1, p less than 0.02) at high ethanol concentrations (60 to 20 mM) but not at blood ethanol concentrations below 20 mM.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhancement of 1,2-dimethylhydrazine-induced rectal carcinogenesis following chronic ethanol consumption in the rat.

The incidence, distribution, size, and histopathology of grossly visible intestinal tumors induced by the parenteral administration of 1,2-dimethylhydrazine dihydrochloride were examined in 32 paired rats fed a nutritionally adequate liquid diet containing 36% of total calories either as ethanol or isocaloric carbohydrates. The liquid diets were begun 4 wk before the first of four weekly injections of 1,2-dimethylhydrazine dihydrochloride. At the time of the subcutaneous application of the procarcinogen, liquid diets were omitted for 3 wk, and were replaced by a standard laboratory diet. This feeding schedule was repeated four times, and after 32 wk the animals were killed. Chronic ethanol ingestion increased the total number of rectal tumors significantly (17 vs. 6, p less than 0.02). However, alcohol had no effect on tumor size or histopathology. Chronic ethanol ingestion did not exhibit any cocarcinogenic effect in tissues other than the rectum. A 47% increase in the activity of mucosal alcohol dehydrogenase in the distal colorectum was found between chronically ethanol-fed rats and pair-fed controls (0.241 +/- 0.019 vs. 0.164 +/- 0.020 mumol X mg protein-1 X h-1, p less than 0.01). This could in part explain the cocarcinogenic effect of alcohol in this tissue. Fecal bile acids, however, do not play a role as promoters of rectal cancer under the present experimental conditions. The data give experimental support to the epidemiologic findings of an increased incidence of rectal cancer in the alcoholic.

Changes in gastrointestinal DNA synthesis produced by acute and chronic ethanol consumption in the rat: a biochemical study.

The effect of acute and chronic ethanol administration on DNA synthesis in the gastrointestinal tract of the rat was investigated. Acute intragastric ethanol administration (3 g/kg; 50%) decreased significantly in vivo DNA synthesis when measured 1 hour after alcohol application in the stomach and in the upper small intestine, whereas acute intravenous ethanol administration had no significant effect. In contrast, chronic ethanol ingestion resulted in a significant increase of in vivo and in vitro DNA synthesis in the upper gastrointestinal tract. In addition, even a more enhanced stimulation of DNA synthesis after chronic ethanol consumption was found in isolated intestinal cells. These results indicate an inhibition of gastrointestinal cell regeneration directly after the oral application of ethanol. The enhanced cellular regenerativity observed after chronic ethanol consumption may be secondary to the ethanol induced damage of the gastrointestinal tract.

Effect of chronic ethanol ingestion on the cyclic AMP system of the upper gastrointestinal tract in the rat.

Chronic ethanol consumption significantly increases gastric adenylate cyclase (AC) activity (p less than 0.05) without influencing low Km 3',5'-cyclic adenosine monophosphate (cAMP) phosphodiesterase (PD) activity in the rat. On the other hand, in the duodenum and upper part of the jejunum, chronic ethanol feeding leads to a significant decrease of adenylate cyclase activity (p less than 0.02) and, again, does not affect low Km cAMP phosphodiesterase activity. In addition, the effect of various hormonal secretagoques on small intestinal adenylate cyclase activity was investigated. Prostaglandin I2 and D2, as well as glucagon, do not stimulate AC at all. However, small intestinal adenylate cyclase exhibits a lower sensitivity to prostaglandin E2 and vasoactive intestinal peptide (VIP), and a lower efficacy to VIP after chronic ethanol consumption when compared to controls. The decrease of both basal and stimulated AC activity following ethanol ingestion in the upper small intestine may be due to membrane alterations and tissue damage caused by ethanol. The ethanol-induced increase in gastric AC may be of relevance with respect to an increased acid secretion observed after alcohol administration.

Microsomal ethanol oxidation in the colonic mucosa of the rat. Effect of chronic ethanol ingestion.

A microsomal ethanol oxidizing system (MEOS) is present in the colonic mucosa of the rat. This MEOS metabolizes ethanol to acetaldehyde at the physiological pH of 7.4. Alcohol dehydrogenase or catalase are not involved in the reaction. The Michaelis Menten constant of the reaction is 13.7 +/- 0.3 mM and the maximal velocity is 219 +/- 30 pmoles acetaldehyde/mg microsomal protein X min. Bacterial ethanol metabolism does not contribute to the acetaldehyde production in the colonic MEOS. Chronic ethanol consumption has no effect on colonic MEOS activity. In addition, chronic ethanol ingestion does not affect colonic microsomal NADPH-cytochrome-c-reductase nor benzo(a) pyrene hydroxylase activity.

Teaching nursing management by programmed instruction.

Student and faculty dissatisfaction with lectures prompted several revisions of teaching methods for nursing management. Revisions centered around a programmed text for business plus various methods of application to nursing. One part of management (control) was also programmed in nursing terms. Data collected revealed that students who used the programmed business text and participated in small group discussions achieved significantly higher scores than either students who attended lectures or used the programmed business text in conjunction with a tutorial system. Data also demonstrated that students who used the unit programmed specifically for nursing management achieved significantly higher scores than students who used the programmed text for business management. This data suggest students level of achievement is increased when the transfer step from business to nursing is eliminated. For this reason, two faculty members completed the writing of a programmed text for nursing management. This text has been tested over the past two years and will be published in the near future. We were unable to collect objective data regarding the actual application of management principles to nursing practice. Subjectively, we felt the students had a stronger framework of principles unique to nursing management and were able to transfer this knowledge to leading a team with greater ease than previously. Without student dissatisfaction originally, and student acceptance and participation throughout the changes, this study would not have evolved. It was student encouragement which prompted the program specific to nursing.