The 4W Model of Drowning

The aim of the study was to develop a conceptual model of drowning incidents. The authors conducted qualitative content analysis of drowning-incident videos (n = 41), and semi-structured interviews of those involved in drowning incidents (n = 34), followed by the measurement of frequencies and Boolean search with matrix intersection. Results confirmed that when there is human activity in, above, or around an aquatic environment, a drowning incident may occur to whomever, wherever, and under whatever circumstance. Factors that determined drowning outcome were, in order of importance, rescuer characteristics (Who1), casualty characteristics (Who2), location (Wherever), and general circumstances (Whatever). The interaction of the rescuer with the casualty largely determines the outcome of drowning. The 4W model is a promising tool in lifesaving and lifeguarding

Prevalence of neoplasia at colonoscopy among testicular cancer survivors treated with platinum-based chemotherapy

Testicular cancer survivors (TCS) treated with platinum-based chemotherapy have an increased risk of colorectal cancer (CRC). We determined the yield of colonoscopy in TCS to assess its potential in reducing CRC incidence and mortality. We conducted a colonoscopy screening study among TCS in four Dutch hospitals to assess the yield of colorectal neoplasia. Neoplasia was defined as adenomas, serrated polyps (SPs), advanced adenomas (AAs: ≥10 mm diameter, high-grade dysplasia or ≥25% villous component), advanced serrated polyps (ASPs: ≥10 mm diameter or dysplasia) or CRC. Advanced neoplasia (AN) was defined as AA, ASP or CRC. Colonoscopy yield was compared to average-risk American males who underwent screening colonoscopy (n = 24,193) using a propensity score matched analysis, adjusted for age, smoking status, alcohol consumption and body mass index. A total of 137 TCS underwent colonoscopy. Median age was 50 years among TCS (IQR 43–57) vs 55 years (IQR 51–62) among American controls. A total of 126 TCS were matched to 602 controls. The prevalence of AN was higher in TCS than in controls (8.7% vs 1.7%; P =.0002). Nonadvanced adenomas and SPs were detected in 45.2% of TCS vs 5.5% of controls (P &lt;.0001). No lesions were detected in 46.0% of TCS vs 92.9% of controls (P &lt;.0001). TCS treated with platinum-based chemotherapy have a higher prevalence of neoplasia and AN than matched controls. These results support our hypothesis that platinum-based chemotherapy increases the risk of colorectal neoplasia in TCS. Cost-effectiveness studies are warranted to ascertain the threshold of AN prevalence that justifies the recommendation of colonoscopy for TCS.</p

Prevalence of neoplasia at colonoscopy among testicular cancer survivors treated with platinum-based chemotherapy

Testicular cancer survivors (TCS) treated with platinum-based chemotherapy have an increased risk of colorectal cancer (CRC). We determined the yield of colonoscopy in TCS to assess its potential in reducing CRC incidence and mortality. We conducted a colonoscopy screening study among TCS in four Dutch hospitals to assess the yield of colorectal neoplasia. Neoplasia was defined as adenomas, serrated polyps (SPs), advanced adenomas (AAs: ≥10 mm diameter, high-grade dysplasia or ≥25% villous component), advanced serrated polyps (ASPs: ≥10 mm diameter or dysplasia) or CRC. Advanced neoplasia (AN) was defined as AA, ASP or CRC. Colonoscopy yield was compared to average-risk American males who underwent screening colonoscopy (n = 24,193) using a propensity score matched analysis, adjusted for age, smoking status, alcohol consumption and body mass index. A total of 137 TCS underwent colonoscopy. Median age was 50 years among TCS (IQR 43–57) vs 55 years (IQR 51–62) among American controls. A total of 126 TCS were matched to 602 controls. The prevalence of AN was higher in TCS than in controls (8.7% vs 1.7%; P =.0002). Nonadvanced adenomas and SPs were detected in 45.2% of TCS vs 5.5% of controls (P &lt;.0001). No lesions were detected in 46.0% of TCS vs 92.9% of controls (P &lt;.0001). TCS treated with platinum-based chemotherapy have a higher prevalence of neoplasia and AN than matched controls. These results support our hypothesis that platinum-based chemotherapy increases the risk of colorectal neoplasia in TCS. Cost-effectiveness studies are warranted to ascertain the threshold of AN prevalence that justifies the recommendation of colonoscopy for TCS.</p

Prevalence of neoplasia at colonoscopy among testicular cancer survivors treated with platinum-based chemotherapy

Testicular cancer survivors (TCS) treated with platinum-based chemotherapy have an increased risk of colorectal cancer (CRC). We determined the yield of colonoscopy in TCS to assess its potential in reducing CRC incidence and mortality. We conducted a colonoscopy screening study among TCS in four Dutch hospitals to assess the yield of colorectal neoplasia. Neoplasia was defined as adenomas, serrated polyps (SPs), advanced adenomas (AAs: ≥10 mm diameter, high-grade dysplasia or ≥25% villous component), advanced serrated polyps (ASPs: ≥10 mm diameter or dysplasia) or CRC. Advanced neoplasia (AN) was defined as AA, ASP or CRC. Colonoscopy yield was compared to average-risk American males who underwent screening colonoscopy (n = 24,193) using a propensity score matched analysis, adjusted for age, smoking status, alcohol consumption and body mass index. A total of 137 TCS underwent colonoscopy. Median age was 50 years among TCS (IQR 43-57) vs 55 years (IQR 51-62) among American controls. A total of 126 TCS were matched to 602 controls. The prevalence of AN was higher in TCS than in controls (8.7% vs 1.7%; P = .0002). Nonadvanced adenomas and SPs were detected in 45.2% of TCS vs 5.5% of controls (P < .0001). No lesions were detected in 46.0% of TCS vs 92.9% of controls (P < .0001). TCS treated with platinum-based chemotherapy have a higher prevalence of neoplasia and AN than matched controls. These results support our hypothesis that platinum-based chemotherapy increases the risk of colorectal neoplasia in TCS. Cost-effectiveness studies are warranted to ascertain the threshold of AN prevalence that justifies the recommendation of colonoscopy for TCS

Influence of intervals of radiant heat performance and pacing dynamics during rowing exercise

The purpose of this study was to investigate whether intervals of radiant heat during thermoneutral exercise altered either the performance outcome or the dynamics of pacing within the exercise bout.\ud \ud Eleven male participants (VO2peak; 56 ± 12 ml·kg^-1·min^-1) performed three 5000m exercise trials on a rowing ergometer in three different conditions, in a random order. The participants were either: non-warmed (NW), warmed (W), or periodically warmed in intervals throughout each trial (IW). Warming was achieved using radiant heat lamps to raise the localised environmental temperature from 18°C to 35°C. Intervals of warming were applied over fixed periods of the 5000m bouts between 1000-2000m (W1) and 3000-4000m (W2).\ud \ud The results of the experiment demonstrated that performance time and average power output of the 5000m matched intensity trials were not significantly different between conditions (p=0.10 ; p=0.189). However, the application of warming significantly reduced intra-trial power output during the first (W1) interval in the IW condition (p=0.03) but not during the second (W2) warming interval (p=0.10). Tsk increased by 0.51°C (p=0.05) in response to the application of warming during W1 in the IW condition and by 0.15°C in W2 (p=0.28). No significant between-condition differences were observed in Tc throughout the trials.\ud \ud These findings suggest that an abrupt change to environmental conditions brought about through intervals of radiant warming can affect the transient pacing dynamics of an exercise bout, but not necessarily impact overall performance time. Performance time appears unaffected by intervals of radiant heat during an exercise bout, although further work is required in more challenging dynamic environmental conditions

Season-to-season variations of physiological fitness within a squad of professional male soccer players

The purpose of this study was to examine season-to-season variations in physiological fitness parameters among a 1st team squad of professional adult male soccer players for the confirmatory purposes of identifying normative responses (immediately prior to pre-season training (PPS), mid-season (MID), and end-of-season (EOS)). Test-retest data were collected from a student population on the primary dependent variables of anaerobic threshold (AT) and maximal aerobic power (VO2 max) to define meaningful measurement change in excess of test-retest technical error between test-to-test performances. Participants from a pool of 42 professional soccer players were tested over a set sequence of tests during the 3-year period: 1) basic anthropometry, 2) countermovement jump (CMJ) tests 3) a combined AT and VO2 max test. Over the 3-year period there were no test-to-test changes in mean VO2 max performance exceeding pre-defined limits of test agreement (mean of eight measures: 61.6 ± 0.6 ml·kg-1·min-1). In contrast, VO2 at AT was significantly higher at the MID test occasion in seasons 2 (+4.8%; p = 0.04, p < 0.05) and 3 (+6.8%; p = 0.03, p < 0.05). The CMJ tests showed a test-to-test improvement of 6.3% (best of 3 jumps) (p = 0.03, p < 0.05) and 10.3% (20-s sustained jumping test) (p = 0.007, p < 0.01) between PPS2 and MID2 and thereafter remained stable. Anthropometrics were unaffected. In summary, despite some personnel changes in the elite cohort between test-to-test occasions, VO2 max values did not vary significantly over the study which supports previous short-term observations suggesting a general 'elite' threshold of 60 ml·kg-1 min. Interestingly, AT significantly varied where VO2 max was stable and these variations also coincided with on- and off-seasons suggesting that AT is a better indication of acute training state than VO2 max