Analysis of Training Loads in Elite Under 18 Australian Rule Football Players

Elsworthy, N ORCiD: 0000-0002-5223-6803Differences in training loads (TL) between under 18 (U18) Australian Rules football (AF) State Academy selected and non-selected players were investigated. Players were categorised relating to their highest representative level; State Academy selected (n = 9) and TAC Cup level players (n = 38). Data were obtained from an online training-monitoring tool implemented to collect player training and match information across a 20 - week period during the regular season. Parameters modelled included AF skills, strength, and other sport training sessions. Descriptive statistics (mean ± SD) and between-group comparisons (Cohen's d) were computed. A J48 decision tree modelled which TL variables could predict selection level. Pooled data showed 60% of weekly training duration consisted of AF training sessions. Similar AF TL were reported between State Academy and TAC Cup players (1578 ± 1264 arbitrary units (AU) v 1368 ± 872 AU; d = .05). While higher TL were reported for State selected players comparative to TAC Cup in total training (d = .20), core stability (d = .36), flexibility (d = .44), on-feet conditioning (d = .26), and off-feet conditioning (d = .26). Decision tree analysis showed core stability duration and flexibility TL the most influential parameters in classifying group selection (97.7% accuracy TAC Cup level; 35.8% accuracy State Academy level). Insights of U18 AF players' weekly training structures, loads, and characteristics of higher achieving players are provided. This study supports the application of training diaries and session rating of perceived exertion (sRPE) for TL monitoring in junior athletes

Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study

Current clinician-led melanoma surveillance models require frequent routinely scheduled clinic visits, with associated travel, cost, and time burden for patients. Patient-led surveillance is a new model of follow-up care that could reduce health care use such as clinic visits and medical procedures and their associated costs, increase access to care, and promote early diagnosis of a subsequent new melanoma after treatment of a primary melanoma. Understanding patient experiences may allow improvements in implementation. Objective: This study aims to explore patients’ experiences and perceptions of patient-led surveillance during the 6 months of participation in the MEL-SELF pilot randomized controlled trial. Patient-led surveillance comprised regular skin self-examination, use of a mobile dermatoscope to image lesions of concern, and a smartphone app to track and send images to a teledermatologist for review, in addition to usual care. Methods: Semistructured interviews were conducted with patients previously treated for melanoma localized to the skin in New South Wales, Australia, who were randomized to the patient-led surveillance (intervention group) in the trial. Thematic analysis was used to analyze the data with reference to the technology acceptance model. Results: We interviewed 20 patients (n=8, 40% women and n=12, 60% men; median age 62 years). Patients who were more adherent experienced benefits such as increased awareness of their skin and improved skin self-examination practice, early detection of melanomas, and opportunities to be proactive in managing their clinical follow-up. Most participants experienced difficulty in obtaining clear images and technical problems with the app. These barriers were overcome or persevered by participants with previous experience with digital technology and with effective help from a skin check partner (such as a spouse, sibling, or friend). Having too many or too few moles decreased perceived usefulness

Perspectives and Experiences of Patient-Led Melanoma Surveillance Using Digital Technologies From Clinicians Involved in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study

The growing number of melanoma patients who need long-term surveillance increasingly exceeds the capacity of the dermatology workforce, particularly outside of metropolitan areas. Digital technologies that enable patients to perform skin self-examination and send dermoscopic images of lesions of concern to a dermatologist (mobile teledermoscopy) are a potential solution. If these technologies and the remote delivery of melanoma surveillance are to be incorporated into routine clinical practice, they need to be accepted by clinicians providing melanoma care, such as dermatologists and general practitioners (GPs). Objective: This study aimed to explore perceptions of potential benefits and harms of mobile teledermoscopy, as well as experiences with this technology, among clinicians participating in a pilot randomized controlled trial (RCT) of patient-led melanoma surveillance. Methods: This qualitative study was nested within a pilot RCT conducted at dermatologist and skin specialist GP–led melanoma clinics in New South Wales, Australia. We conducted semistructured interviews with 8 of the total 11 clinicians who were involved in the trial, including 4 dermatologists (3 provided teledermatology, 2 were treating clinicians), 1 surgical oncologist, and 3 GPs with qualifications in skin cancer screening (the remaining 3 GPs declined an interview). Thematic analysis was used to analyze the data with reference to the concepts of “medical overuse” and “high-value care.

Association of germline variants in telomere maintenance genes (POT1, TERF2IP, ACD, and TERT) with spitzoid morphology in familial melanoma: A multi-center case series

Spitzoid morphology in familial melanoma has been associated with germline variants in POT1, a telomere maintenance gene (TMG), suggesting a link between telomere biology and spitzoid differentiation. The aim is to assess if familial melanoma cases associated with germline variants in TMG (POT1, ACD, TERF2IP, and TERT ) commonly exhibit spitzoid morphology.Medicin

Dietary Fiber and Saturated Fat Intake Associations with Cardiovascular Disease Differ by Sex in the Malmö Diet and Cancer Cohort: A Prospective Study

BACKGROUND: The aim of the study was to examine associations between intake of macronutrients and dietary fiber and incident ischemic cardiovascular disease (iCVD) in men and women. METHODS: We used data from 8,139 male and 12,535 female participants (aged 44-73 y) of the Swedish population-based Malmö Diet and Cancer cohort. The participants were without history of CVD and diabetes mellitus, and had reported stable dietary habits in the study questionnaire. Diet was assessed by a validated modified diet history method, combining a 7-d registration of cooked meals and cold beverages, a 168-item food questionnaire (covering other foods and meal patterns), and a 1-hour diet interview. Sociodemographic and lifestyle data were collected by questionnaire. iCVD cases, which included coronary events (myocardial infarctions or deaths from chronic ischemic heart disease) and ischemic strokes, were ascertained via national and local registries. Nutrient-disease associations were examined by multivariate Cox regressions. RESULTS: During a mean follow-up of 13.5 years, we identified 1,089 male and 687 female iCVD cases. High fiber intakes were associated with lower incidence rates of iCVD in women and of ischemic stroke in men. In post-hoc analysis, we discovered statistically significant interactions between intake of fiber and saturated fat; these interactions also differed between men and women (p<0.001). CONCLUSIONS: In this well-defined population, a high fiber intake was associated with lower risk of iCVD, but there were no robust associations between other macronutrients and iCVD risk. Judging from this study, gender-specific nutrient analysis may be preferable in epidemiology

Inherited Genetic Variants Associated with Occurrence of Multiple Primary Melanoma

Recent studies including genome-wide association studies have identified several putative low-penetrance susceptibility loci for melanoma. We sought to determine their generalizability to genetic predisposition for multiple primary melanoma in the international population-based Genes, Environment, and Melanoma (GEM) Study. GEM is a case-control study of 1,206 incident cases of multiple primary melanoma and 2,469 incident first primary melanoma participants as the control group. We investigated the odds of developing multiple primary melanoma for 47 single nucleotide polymorphisms (SNP) from 21 distinct genetic regions previously reported to be associated with melanoma. ORs and 95% CIs were determined using logistic regression models adjusted for baseline features (age, sex, age by sex interaction, and study center). We investigated univariable models and built multivariable models to assess independent effects of SNPs. Eleven SNPs in 6 gene neighborhoods (TERT/CLPTM1L, TYRP1, MTAP, TYR, NCOA6, and MX2) and a PARP1 haplotype were associated with multiple primary melanoma. In a multivariable model that included only the most statistically significant findings from univariable modeling and adjusted for pigmentary phenotype, back nevi, and baseline features, we found TERT/CLPTM1L rs401681 (P = 0.004), TYRP1 rs2733832 (P = 0.006), MTAP rs1335510 (P = 0.0005), TYR rs10830253 (P = 0.003), and MX2 rs45430 (P = 0.008) to be significantly associated with multiple primary melanoma while NCOA6 rs4911442 approached significance (P = 0.06). The GEM study provides additional evidence for the relevance of these genetic regions to melanoma risk and estimates the magnitude of the observed genetic effect on development of subsequent primary melanoma

The Role of Debriefing within a Simulation Exercise with Undergraduate Nursing Students

Simulation is becoming a very widely used resource within many professions, and can provide different learning experiences within a safe and secure environment. This article focuses upon the medical/nursing profession but may be related to many other fields of practice.However, it could be argued that without a structured debrief there is little point in running a simulation exercise.  It is widely accepted that debriefing is the most crucial part of any simulation exercise and should therefore be a large part of any simulation-based education. Debriefing should allow the learner to reflect on their own practice as well as that of others, optimising the learner experience. Simulation with the immediate provision of a debrief enhances the learning experience.  Although recognised, debriefing is not routinely practiced within the theoretical or clinical setting. It is often feedback that is given or mistakenly thought of as debriefing -therefore it is important to acknowledge the difference between feedback and debriefing. To feedback is to give positive constructive criticism or praise to the person or team who have been involved in the simulation by the observer or facilitator, this feedback is based on what they have seen and heard. However, to debrief is to first identify what the participants thought, allowing the discussion to be led by the participant, unpicking the events by first exploring the participants feelings and fixations. These may not have been obvious to the facilitator, the ability to listen and explore the learners experience is key. Without exploring them the learner will not be able to understand and analyse the learning that has taken place.The aim of this article is to explore whether debriefing is useful, in particular for undergraduate nurses, following a simulation exercise, and if so, why.Twenty undergraduate child nursing students were randomly allocated into two groups. Both completed a pre participation questionnaire focusing on previous experience of simulation and debriefing and their expectations of simulation, personally and educationally.Both teams received the same pre brief and orientation to the environment, simulator and equipment.Group one had a debrief immediately followed by the post participation questionnaire. Group Two were asked to complete the post participation questionnaire first, without any discussion, and then received their debrief after approximately half an hour.Results were analysed from the post participation questionnaire using a thematic approach. This study demonstrated that, if a debriefing is not carried out, practitioners may be left feeling highly anxious, under confident and stressed – potentially impacting upon their mental health, confidence and self-esteem