Effects of oral intake of water in patients with oropharyngeal dysphagia

<p>Abstract</p> <p>Background</p> <p>Dysphagia is associated with numerous medical conditions and the major intervention to avoid aspiration in people with dysphagia involves modifying the diet to thickened fluids. This is associated with issues related to patient quality of life and in many cases non-compliance leading to dehydration. Given these concerns and in the absence of conclusive scientific evidence, we designed a study, to further investigate the effects of oral intake of water in people with dysphagia.</p> <p>Methods</p> <p>We monitored lung related complications, hydration levels and assessed quality of life in two groups of people with dysphagia. The control group was allowed only thickened fluids and patients in the intervention group were allowed access to water for a period of five days.</p> <p>Results</p> <p>Our findings indicate a significantly increased risk in the development lung complications in patients given access to water (6/42; 14.3%) compared to the control group (0/34; no cases). We have further defined patients at highest risk, namely those with degenerative neurologic dysfunction who are immobile or have low mobility. Our results indicate increased total fluid intake in the patients allowed access to water, and the quality of life surveys, albeit from a limited number of patients (24% of patients), suggest the dissatisfaction of patients to diets composed of only thickened fluids.</p> <p>Conclusions</p> <p>On the basis of these findings we recommend that acute patients, patients with severe neurological dysfunction and immobility should be strongly encouraged to adhere to a thickened fluid or modified solid consistency diet. We recommend that subacute patients with relatively good mobility should have choice after being well-informed of the relative risk.</p> <p>Trial registration</p> <p>Australia and New Zealand Clinical Trials Register (ANZCTR): <a href="http://www.anzctr.org.au/ACTRN12608000107325.aspx">ACTRN12608000107325</a></p

Do hard playing fields increase the risk of injury in community level Australian football?

Introduction: Certain ground conditions, including hardness, have been associated with an increased injury risk. Many sporting grounds have been deemed unplayable based on hardness measures and subsequently closed. However, most research linking injury to ground conditions has been based on subjective observations or focussed at high performance venues. The aim of this study was to identify the relationship between ground hardness and injury incidence in community level Australian football. Methodology: Measurements of ground hardness, using the Clegg hammer, were recorded on eight community level football grounds between 4 and 8 times during the 2007 season. Injury data was collected by trained data collectors over the season. The 1st Clegg hammer drop was used as the hardness measure, and injuries were ranked as ‘likely’, ‘possibly’, and ‘unlikely’ to be related to grounds by three independent assessors. Results: 130 injuries were recorded at the grounds tested. The Clegg hammer measures ranged from 55 to 134 gravities (g), with four injuries sustained at readings over 120 × g. Of the 130 injuries, 12 were classified as ‘likely’ to be related to ground conditions, 29 ‘possibly’ related, 75 ‘unlikely’ and 14 unknown due to incomplete details. None of the ‘likely’ injuries were sustained on readings over 120 × g. No significant relationships were found between ground hardness and any injury profiles (0.02 < r < 0.14, p < 0.01). Conclusions: Presently, sporting grounds are being closed with hardness readings exceeding 120 × g. The results of this study provide some evidence to challenge this, however, due to low injury rates further research with a larger cohort is necessary