Does a greater training load increase the risk of injury and illness in ultramarathon runners? : A prospective, descriptive, longitudinal design

Background: Ultramarathon running has become extremely popular over the years. Despite the numerous health benefits of running, there are also many negative effects of running, such as increased risk of musculoskeletal injury and illness. Monitoring of an athlete’s training load has become extremely important in terms of injury prevention. Currently, the relationship between training loads and injury and illness incidence is uncertain. Objectives: To determine if there are any associations between injury and illness incidences and training loads among ultramarathon runners in the 12 week period preceding an ultramarathon event and the four week period after the event. Methods: This prospective, descriptive, longitudinal study design was conducted in 119 runners who were training for the 2019 Two Oceans ultramarathon event. Data were collected once a week via an online logbook over 16 weeks. Training parameters measured included weekly average running distance, average duration, average frequency and average sessional RPE. Injury data included injury counts, the structure injured, the main anatomical location and the time-loss as a result of injury. Illness data included illness counts, the main illness-related symptoms and the time-loss as a result of illness. Results: The overall injury incidence was five per 1000 training hours and the overall illness incidence was 16 per 1000 training days. There was a significant relationship between external training load and injury and illness incidence for those who ran less than 30 km per week. There was also a significant relationship between the ACWR (Acute Chronic Workload Ratio) and injury incidence when the ACWR was >1.5 and for illness incidence when the ACWR was <0.5. Conclusion: The use of both absolute and relative workloads in the monitoring of an athlete’s training load with the aim of minimising injury and illness risk and maximising performance in ultramarathon runners is recommended

Management of COVID-19 in the community and the role of primary care: how the pandemic has shone light on a fragmented health system

[Extract] The Australian health care system is well regarded on the global stage in terms of the balance between investment in health care and outcomes delivered, particularly in terms of universal access, quality and safety.1 However, there is considerable fragmentation and poor coordination of care and communication between hospitals and primary care, which limits further improvement.2, 3 Geographical barriers, workforce shortages and issues relating to acceptability of services limit health care access for residents of rural, regional and remote communities, Aboriginal peoples and Torres Strait Islanders, and together with an inadequate focus on prevention, limit progress towards health equity. Australian responses to the coronavirus disease 2019 (COVID-19) pandemic through both public health responses and the acute health sector have been viewed as among the best in the world. Nevertheless, challenges in the structure, organisatIon and financing of the Australian health care system have been brought into stark relief by the evolution of responses to the pandemic

Value based analysis of acquisition portfolios

Thesis (S.M. in System Design and Management)--Massachusetts Institute of Technology, Engineering Systems Division, 2010.Vita. Cataloged from PDF version of thesis.Includes bibliographical references (p. 113-119).Currently, program-funding allocation is based on program performance. Funding cuts commonly lead to a poor reflection on the program management assigned to the given program. If additional factors such as program risk and benefit are objectively factored in, this may lead to a more effective exit strategy for program capabilities, which are no longer required. An enterprise architecture analysis and applied framework case study were carried out to develop a methodology to quantify system-level value for the Office of the Assistant Secretary of the Air Force for Acquisition Research, Development, Test and Evaluation portfolio. Portfolio value is quantified in order to transition from a single program, single stakeholder value analysis to a program portfolio and stakeholder system composite analysis. This methodology is developed based on interviews, official organization literature, and a case study. The results of the applied framework case study on a portfolio of seven programs showed a positive correlation between quantitative capability, execution and risk data at the portfolio level and access to a more informed and objective identification of programs of greatest interest and concern as compared to a qualitative program-by-program analysis when allocating Air Force Acquisition resources. This system includes 17 stakeholder categories, which significantly influence the allocation of resources for a portfolio worth roughly 0.4% of the US GDP. Interviews include high-ranking leadership, including two 3-Star Generals in the US Air Force.by Cheri Nicole Markt Burgess.S.M.in System Design and Managemen

Does experiencing a traumatic life event increase the risk of intimate partner violence for young women? A cross-sectional analysis and structural equation model of data from the Stepping Stones and Creating Futures intervention in South Africa

OBJECTIVES: To investigate associations and potential pathways between women's lifetime exposure to traumatic events and their recent experiences of intimate partner violence (IPV). SETTING: South African informal settlements near Durban. PARTICIPANTS: 677 women, living in informal settlements, aged 18-30 years, currently out of school or formal employment. PRIMARY AND SECONDARY OUTCOME MEASURES: Self-reported experiences of IPV in the past 12 months and exposure to traumatic neighbourhood events (including witnessing murder, being robbed or kidnapped, witnessing and experiencing rape). RESULTS: Exposure to traumatic events was common among the 677 women surveyed. Over 70% had experienced at least one in their lifetime; one quarter (24%) had experienced 3 or more different events. Women exposed to any traumatic event had a 43% increase in the odds of experiencing IPV in comparison to those with no exposure (aOR 1.43, p≤0.000). Exposure to non-partner rape is more strongly associated with IPV than any other traumatic experience. Pathways from exposure to traumatic events and non-partner rape to recent IPV experience are mediated by a latent variable of poor mental health. Food insecurity is associated with all forms of traumatic experience, and is also indirectly associated with IPV through views by women that are unsupportive of gender equality. CONCLUSIONS: Women living in South African informal settlements who witness or experience traumatic events were likely to experience IPV, and this increases when women were exposed to multiple types of events. Our model suggests that experiencing traumatic events, and non-partner rape in particular, has negative effects on women's mental health in ways that may increase their vulnerability to IPV. IPV prevention interventions should consider the broader impacts of women's exposure to neighbourhood violence and severe poverty on IPV risk in settings where these are endemic. TRIAL REGISTRATION NUMBER: NCT03022370; post-results