Lifetime prevalence of non-melanoma and melanoma skin cancer in Australian recreational and competitive surfers

Background/Purpose Surfing is one of the most popular outdoor aquatic activities in Australia with an estimated 2.7 million recreational surfers; however, Australia has long been recognized as having the highest incidence of melanoma in the world, and it is the most common type of cancer in young Australians. The aim of this study was to investigate the lifetime prevalence of non-mela- noma [basal cell carcinoma (BCC), squamous cell carcinoma (SCC)] and melanoma skin cancers in Australian recreational and competitive surfers. Methods Australian surfers were invited to complete an online surveillance survey to determine the lifetime prevalence of non-melanoma and melanoma skin cancers. Results A total of 1348 surfers (56.9% recreational) participated in this study, of which 184 surfers reported a skin cancer (competitive n = 96, recreational n = 87). Of non-melanoma and melanoma cancers reported, BCC was the most common (6.8%), followed by melanoma (1.4%) and SCC (0.6%). The relative risk was higher (P \u3c 0.001) in competitive vs. recreational surfers [OR 1.74 (CI 1.28–2.31)]. There was a higher (P \u3c 0.05) number of skin cancers reported on the face (23.5%), back (16.4%) and arms (12.4%). There were significant trends (P \u3c 0.001) in reported skin cancers between competitive and recreational surfers, as well as significantly (P \u3c 0.001) more skin cancers reported in males (14.6%) than females (9.4%). Conclusion Based upon these findings, individuals who surf are advised to regularly uti- lize sun protection strategies (avoid peak ultraviolet radiation (10 am– 3 pm), rashvest, hat and sunscreen) and primary care physicians are rec- ommended to regularly screen their patients who surf

Exercise intensity-dependent effects of arm and leg-cycling on cognitive performance

Physiological responses to arm and leg-cycling are different, which may influence psychological and biological mechanisms that influence post-exercise cognitive performance. The aim of this study was to determine the effects of maximal and submaximal (absolute and relative intensity matched) arm and leg-cycling on executive function. Thirteen males (age, 24.7 ± 5.0 years) initially undertook two incremental exercise tests to volitional exhaustion for arm-cycling (82 ± 18 W) and leg-cycling (243 ± 52 W) for the determination of maximal power output. Participants subsequently performed three 20-min constant load exercise trials: (1) arm-cycling at 50% of the ergometer-specific maximal power output (41 ± 9 W), (2) leg-cycling at 50% of the ergometer-specific maximal power output (122 ± 26 W), and (3) leg-cycling at the same absolute power output as the submaximal arm-cycling trial (41 ± 9 W). An executive function task was completed before, immediately after and 15-min after each exercise test. Exhaustive leg-cycling increased reaction time (p 0.05). Improvements in reaction time following arm-cycling were maintained for at least 15-min post exercise (p = 0.008, d = -0.73). Arm and leg-cycling performed at the same relative intensity elicit comparable improvements in cognitive performance. These findings suggest that individuals restricted to arm exercise possess a similar capacity to elicit an exercise-induced cognitive performance benefit

The Prevalence and Severity of External Auditory Exostosis in Young to Quadragenarian-Aged Warm-Water Surfers: A Preliminary Study

External auditory exostosis (EAE) has previously only been shown to occur in cold water surfers. We assessed young surfers living and surfing in Queensland, Australia, for EAE in water temp ranges from 20.6 °C (69.1 °F, Winter) to 28.2 °C (82.8 °F, Summer). All participants underwent a bilateral otoscopic examination to assess the presence and severity of EAE. A total of 23 surfers participated with a mean age of 35.4 years (8.3 years) and a mean surfing experience of 20.0 years (9.9 years). Nearly two-thirds of participants (n = 14, 60.9%) had regular otological symptoms, most commonly water trapping (n = 13, 56.5%), pain (n = 8, 34.8%), and hearing loss (n = 6, 26.1%). Only 8.7% (n = 2) of all surfers reported regular use of protective equipment (e.g., earplugs) on a regular basis. The overall prevalence of exostosis was 69.6% (n = 16), and the majority (n = 12, 80.0%) demonstrated bilateral lesions of a mild grade (<33% obstruction of the external auditory canal). This is the first study assessing EAE in young surfers exposed to only warm waters (above 20.6 °C). The prevalence of EAE in this study highlights that EAE is not restricted to cold water conditions, as previously believed. Warm water surfing enthusiasts should be screened on a regular basis by their general medical practitioner and utilize prevention strategies such as earplugs to minimize exposure to EAE development

A novel computerized test for detecting and monitoring visual attentional deficits and delirium in the ICU

Objectives: Delirium in the ICU is associated with poor outcomes but is under-detected. Here we evaluated performance of a novel, graded test for objectively detecting inattention in delirium, implemented on a custom-built computerized device (Edinburgh Delirium Test Box–ICU). Design: A pilot study was conducted, followed by a prospective case-control study. Setting: Royal Infirmary of Edinburgh General ICU. Patients: A pilot study was conducted in an opportunistic sample of 20 patients. This was followed by a validation study in 30 selected patients with and without delirium (median age, 63 yr; range, 23–84) who were assessed with the Edinburgh Delirium Test Box–ICU on up to 5 separate days. Presence of delirium was assessed using the Confusion Assessment Method for the ICU. Measurements and Main Results: The Edinburgh Delirium Test Box–ICU involves a behavioral assessment and a computerized test of attention, requiring patients to count slowly presented lights. Thirty patients were assessed a total of 79 times (n = 31, 23, 15, 8, and 2 for subsequent assessments; 38% delirious). Edinburgh Delirium Test Box–ICU scores (range, 0–11) were lower for patients with delirium than those without at the first (median, 0 vs 9.5), second (median, 3.5 vs 9), and third (median, 0 vs 10.5) assessments (all p < 0.001). An Edinburgh Delirium Test Box–ICU score less than or equal to 5 was 100% sensitive and 92% specific to delirium across assessments. Longitudinally, participants’ Edinburgh Delirium Test Box–ICU performance was associated with delirium status. Conclusions: These findings suggest that the Edinburgh Delirium Test Box–ICU has diagnostic utility in detecting ICU delirium in patients with Richmond Agitation and Sedation Scale Score greater than –3. The Edinburgh Delirium Test Box–ICU has potential additional value in longitudinally tracking attentional deficits because it provides a range of scores and is sensitive to change

Retrospective analysis of chronic injuries in recreational and competitive surfers:Injury location, type, and mechanism

Only two studies have reported on chronic musculoskeletal surfing injuries. They found over half of the injuries were non-musculoskeletal, but did not consider mechanisms of injury. This study identified the location, type, and mechanisms of chronic injury in Australian recreational and competitive surfers using a crosssectional retrospective observational design. A total of 1,348 participants (91.3% males, 43.1% competitive surfers) reported 1,068 chronic injuries, 883 of which were classified as major. Lower back (23.2%), shoulder (22.4%), and knee (12.1%) regions had the most chronic injuries. Competitive surfers had significantly (p \u3c .05) more lower back, ankle/foot, and head/face injuries than recreational surfers. Injuries were mostly musculoskeletal with only 7.8% being of non-musculoskeletal origin. Prolonged paddling was the highest frequency (21.1%) for mechanism of injury followed by turning maneuvers (14.8%). The study results contribute to the limited research on chronic surfing injuries

Towards a new paradigm of healthcare: Addressing challenges to professional identities through Community Operational Research

Healthcare worldwide faces severe quality and cost issues, and the search for sustainability in healthcare establishes a grand challenge. Public interest is growing in a systemic re-conceptualizing of healthcare, from primarily a consumerist problem of individual need for treatment to a need for communities themselves to become more effective in systemic prevention, coping and caring. In community led approaches, scarce resources are moved away from ever-increasing consumerist services to empower, develop and enable communities to plan their own health and community improvements in mutually interdependent patterns of care often seen as ‘co-production’. This approach is exemplified by the innovative NUKA system of community led healthcare which originated in Alaska and which was trialled in Scotland in 2012, where it did not achieve similar acclaim as in the United States. In the Scottish NUKA trial opposition from professionals meant the trial was ended early. Our research found that omitting to account for the strong professional identity of GPs and other practice staff was instrumental in the failure of the trial. Beyond deficiencies inadequately considering professional identities, the trial also failed to engage the community and its patients as owners and architects of the system. We argue that the root cause of these problems, was a more general critical systemic failure to manage participatory boundaries and associated identities. Community Operational Research practitioners have developed relevant theories, methodologies and methods to address issues of participation and identity, so could make a significant contribution to opening up new solutions for community led healthcare

Hazardous drinking is associated with expectancies for the simultaneous use of alcohol and e-cigarettes

Background: Alcohol and tobacco use are especially prevalent among college students, with co-use rates being as high as 59% (Weitzman, 2005). Related adverse health outcomes are further magnified during simultaneous use. Expectancies for substance use are consistently associated with heaviness of use and substance-related consequences. Therefore, the current study examined associations between expectancies for e-cigarette use and heaviness of alcohol use. Methods: College students (N = 362; Mage = 19.32, SD = 0.98, 72% Female) completed psychological measures (i.e. The Alcohol Use Disorder Identification Test (AUDIT) and the Nicotine and Other Substance Interaction Expectancies-E-cig Revised (NOSIE-ER). Results: Half (51%) of participants endorsed both lifetime e-cigarette and alcohol use. Of these, 30% use an e-cigarette at least once a month and 62% report hazardous drinking (AUDIT ≥ 8). AUDIT scores were associated with expectancies that drinking increases e-cigarette consumption (r=.29, p \u3c .001), with expectancies that e-cigarette consumption increases drinking (r=.17, p \u3c .05), and with overall expectancies for the simultaneous use of alcohol and e-cigarettes (r=.30, p \u3c.001). Conclusions: Results suggest that as college students engage in more hazardous drinking, they report greater expectancies for simultaneous use of alcohol and e-cigarette. Future studies should use experimental paradigms to test causal links between alcohol and e-cigarette use, especially across individuals with varying degrees of alcohol and nicotine consumption.https://orb.binghamton.edu/research_days_posters_spring2020/1092/thumbnail.jp

Learning clinical competencies: self confidence in nurse practitioner students

Self confidence and the nurse practitioner: • Nurse Practitioner students need to learn a range of new competencies as part of their education • Self confidence is essential to promote learning, however over-confidence can be as dangerous as under-confidence • It would be useful therefore if teaching staff had a tool that would allow them to assess student self confidence in learning competencies • Leonard and Steele presented such a tool to NONPF in 2008; the East Carolina University Nurse Practitioner Self Efficacy Scale (NPSES). Aims of the study: • To assess whether the NPSES questionnaire could be understood and completed by UK students • To investigate the possibility of reducing the size of the questionnaire (51 items) to something much shorter • To identify those factors which students felt least confident about at the start of their clinical module(s) • To identify those factors which students felt most confident about at the start of their clinical module(s) • To investigate if there was any correlation between self confidence scores and OSCE performance