Adverse Physical Effects Research Articles

Dog bites dog: The use of news media articles to investigate dog-on-dog aggression

Dog-on-dog aggression is a common behavioral problem and has the potential to result in dog and/or human injury, the need for veterinary treatment and financial and legal repercussions. Despite this, few studies of dog-on-dog aggression have occurred. News reports of dog-on-dog aggression provide a method of understanding the demographics of these attacks. National and local news articles between September 2016 and February 2020 were identified through Yahoo and Google news. Information was retrieved including victim/attacker dog information (age, breed, size, sex, injury, veterinary treatment, on/off a lead, with/without the owner/walker), situation, intervention, owner injury, and outcome. In the majority of these attacks, one dog initiated the attack and this dog tended to be a medium-sized breed and off-leash. The most reported attacking breed was the Staffordshire bull terrier. The victim tended to be a small-sized dog, and these attacks often had adverse psychological and physical effects. Costs as a result of the attack ranged from £75 to £9,000 (∼$98-11,800 USD). The owner intervened in just under half of cases and often suffered injuries defending their dog. Based on the results of this study, we advise that further guidance on dog bite prevention, management, and education is needed for all dog owners, in particular those who own dogs with a history of aggression. The limitations of using news articles are discussed, and further research on dog-on-dog bite incidents via combining the data from news reports with other information resources is suggested to be beneficial.

A Randomised Controlled Trial Study of the Effects of a Digital Divorce Platform on Mental and Physical Health.

Two decades of divorce research has consistently documented adverse mental and physical health effects of divorce. Responding to calls for evidence-based online divorce interventions, this study tests effects of the "Cooperation after Divorce" (CAD) digital intervention platform on divorcees' mental and physical health. Randomised control trial 12-month longitudinal study using a sample of 1,856 newly divorced Danes. Mental and physical health were measured using the SF-36 at baseline and 3, 6, and 12months from baseline. Intervention effects were investigated using linear mixed effect models and Cohen's (d) for effect sizes. The study found significant treatment effects of the CAD intervention on mental and physical health. These effects were evident across all eight health domains constituting the mental and physical health components. The study also found that the intervention group had significantly better mental health than the control group at subsequent 6- and 12-month assessments from baseline while for physical health, the intervention group had significantly better physical health at the 6-month assessment from baseline only. The results indicate that digital solutions allowing for individually tailored user experiences may hold great potential in reducing well-known adverse health effects of divorce. The study finds highly significant treatment effects of the "CAD" digital divorce intervention on mental and physical health indicating that online interventions may be successfully integrated into help offered to divorcees post-divorce.

Improving Physical and Mental Health in Patients with Prostate Cancer Undergoing Androgen Deprivation Therapy: Strategies to Promote and Improve Physical Activity Quality and Quantity.

Prostate cancer continues to be one of the highest-incident cancers among men. Reducing serum testosterone with androgen deprivation therapy (ADT) is a common effective treatment. While well-demonstrated for cancer suppression, there are numerous adverse effects caused by ADT that can contribute to short- and long-term prognosis. Increased levels of physical activity (PA) during treatment may reduce these side effects. However, uptake of PA is low. The purpose of this review is to identify and evaluate the current literature on strategies to promote and increase the levels of PA in patients with prostate cancer undergoing ADT. Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, and grey literature were searched using Google Scholar up until April 2020. At present the most appropriate modes and dosages of PA for specific ADT toxicities is not known. It is established that some PA in the form of exercise, whether aerobic or resistance, is better than being sedentary for improvements in physical health, but beyond this prescription specifics have not been established. Further research is required to understand the impact of PA on the mental and physical health of men with prostate cancer undergoing ADT. Being physically active and avoiding sedentary behaviour is important for men with prostate cancer undergoing ADT, especially the implementation of strength training. PA in the form of exercise can assist in reducing the adverse physical side effects in the short- and long-term, with limited understanding of the effects on mental health. PA improves mental health outcomes across populations, which may also translate to men with prostate cancer, although further research is required. An important strategy to improve PA within the prostate cancer population is to provide an early referral to an exercise professional, such as an accredited exercise physiologist/clinical exercise physiologist or physical therapist/physiotherapist, and is supported by research as best practice for people affected by cancer undergoing active treatment.

Differences in the Bodyweight, Hydration Levels, Lean Mass, and Fat Mass in Spanish Junior Elite Judokas.

Combat sports have a great interest in society and among professional sports. They are an important group of sports in the Olympic Games, but the strategies carried out by athletes to reduce body weight for weighing day, is famously known, suffering the adverse physical and psychological effects of rapid weight loss. This could compromise not only the performance, but the health and development of young athletes. A total of 22 elite male judokas (18.05 ± 1.05 years old) were evaluated during four different competitions in one season; the variables of body weight, water levels, and lean and fat mass were measured by bioimpedance (BIA), (Tanita BC545N) during one season. Using the linear mixed model test, we found significant differences in bodyweight variable during the competitions 3–4. The water level variable showed significant differences in all competitions, except for 2–4. Body mass index was significantly different in all competitions, being higher in the later competitions, except between competitions 1–2 and 2–3. Judokas participate in weight loss methods for their weigh-in days. Furthermore, the age at which the athletes reduced their water levels are worrisome. These results could be used to create healthy programs, especially in elite judokas, in order to carry out strategies before, during, and after competitions with weight loss and controlled water levels increasing future performance and health.

Psychedelic Microdosing: A Subreddit Analysis

ABSTRACT Self-administration of very low doses of psychedelic drugs to improve mental health and wellbeing and enhance cognitive function, known as microdosing, has received recent media attention, but little research has been conducted. We conducted a content analysis of discussions about microdosing from the online forum Reddit. We examined motivations, dosing practices, and perceived benefits and limitations of microdosing. Motivations included self-management of mental health issues, improvement of psychosocial wellbeing, and cognitive enhancement. Self-reported benefits included cognitive and creative enhancement, reduced depression and anxiety, enhanced self-insight and mindfulness, improved mood and attitude toward life, improved habits and health behaviors, and improved social interactions and interpersonal connections. Perceived limitations included issues related to dosing, adverse physical effects, taking illegal substances, limited or no mental health or cognitive improvement, increased anxiety, unpleasant “off” days, only short-term benefits, and concerns about dependence and drug-related risks. Standard doses of psychedelic drugs provided in therapeutic settings have potential as novel treatments for some mental health conditions, but clinical research is needed to understand if this is also the case for microdosing. In the meantime, harm reduction resources should be developed and made available to provide the best available information on the safer use of self-administered psychedelics.

Influence of smartphone use on the median frequency of mastigatory and trapezius muscles in women - a Pilot study

IntroductionThe use of smartphones is growing every year, and their excessive use can cause adverse physical and mental effects. AimThis study aimed to evaluate the influence of smartphone use on the median frequency of the masticatory muscles and upper trapezius muscles in healthy women. MethodSix healthy young women were evaluated. All the volunteers underwent a submaximal bite test to evaluate their masticatory muscles. In addition, the volunteers underwent a test for bilateral shoulder elevation to a submaximal load to evaluate their upper trapezius muscles. Both protocols were performed before and after a task using the smartphone for 30 min. Median frequency (MF) values were collected during the submaximal bite and submaximal shoulder elevation tests. ResultsData were analyzed using specific statistical tests. A statistically significant reduction in the MF for all the masticatory muscles was observed in the bilateral bite task when comparing pre and post smartphone use (p < 0.005). A significant reduction in the MF was also found for the right upper trapezius when comparing pre and post smartphone use in the shoulder elevation task (p = 0.001). ConclusionIt appears that prolonged smartphone use may contribute to fatigue in the masticatory and upper trapezius muscles. Therefore, guidelines for smartphone users should include advice on the moderate use of this device.

Crystal methamphetamine's impact on frontline emergency services in Victoria, Australia

BackgroundThe use of crystal methamphetamine is a growing problem in Australia. Methamphetamine users can suffer adverse physical health effects, psychotic symptoms and methamphetamine-related aggressive behaviour. The increasing use and related harms of crystal methamphetamine is presenting serious problems for frontline emergency responders. MethodsA population-based retrospective analysis was undertaken of data collected by Ambulance Victoria describing crystal methamphetaminerelated events attended by ambulance across Victoria over six financial years from 2011/12 to 2016/17. ResultsMethamphetamine-related events attended by Victoria Ambulance paramedics significantly increased from 2011/12 to 2016/17, particularly in regional Victoria. The most frequent age group requiring ambulance attendance is 25–39 years. The proportion of events requiring police coattendance significantly increased, as did transportation to emergency department/hospital. ConclusionThe substantial increases in methamphetamine-related events attended by ambulance indicate the need for increased resources and support for paramedics, particularly in regional/rural areas. The large increase among young people aged 15–24 years indicates a need for policy action on prevention, harm reduction and expanded treatment services to reduce health problems and methamphetamine-related harms.

State-Specific Severe Joint Pain and Physical Inactivity Among Adults with Arthritis - United States, 2017.

An estimated 54.4 million (approximately one in four) U.S. adults have doctor-diagnosed arthritis (arthritis) (1). Severe joint pain and physical inactivity are common among adults with arthritis and are linked to adverse mental and physical health effects and limitations (2,3). CDC analyzed 2017 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate current state-specific prevalence of arthritis and, among adults with arthritis, the prevalences of severe joint pain and physical inactivity. In 2017, the median age-standardized state prevalence of arthritis among adults aged ≥18 years was 22.8% (range=15.7% [District of Columbia] to 34.6% [West Virginia]) and was generally highest in Appalachia and Lower Mississippi Valley regions.* Among adults with arthritis, age-standardized, state-specific prevalences of both severe joint pain (median=30.3%; range=20.8% [Colorado] to 45.2% [Mississippi]) and physical inactivity (median=33.7%; range=23.2% [Colorado] to 44.4% [Kentucky]) were highest in southeastern states. Physical inactivity prevalence among those with severe joint pain (47.0%) was higher than that among those with moderate (31.8%) or no/mild joint pain (22.6%). Self-management strategies such as maintaining a healthy weight or being physically active can reduce arthritis pain and prevent or delay arthritis-related disability. Evidence-based physical activity and self-management education programs are available that can improve quality of life among adults with arthritis.

Preservation of Cardiopulmonary Function in Patients Treated with Ultrasound-Accelerated Thrombolysis in the Setting of Submassive Pulmonary Embolism

PurposeTo evaluate the clinical effectiveness of ultrasound-assisted thrombolysis (USAT) in resolution of right ventricular dysfunction (RVD), preservation of cardiopulmonary function, and quality of life (QoL) in patients with acute submassive pulmonary embolism (PE). Materials and MethodsA single-center prospective study of patients presenting with acute PE and signs of RVD, as determined by right ventricle-to-left ventricle diameter ratio (RV:LV) > 0.9 on computed tomographic angiography of the thorax, was performed. Patients underwent USAT with recombinant tissue plasminogen activator. Primary endpoints measured were RV:LV by echocardiogram at baseline presentation and at 72 hours and 90 days after treatment. Secondary endpoints were QoL scores assessed by SF-36 Health Surveys at baseline and at 90 days, cardiopulmonary exercise test (CPET) parameters at 90 days, and procedural outcomes, including response of pulmonary artery pressure (PAP) and procedural complications. ResultsTwenty-five patients were treated between June 17, 2013, and September 15, 2014, with mean reduction of RV:LV by echocardiogram from 1.38 ± 0.28 at presentation to 0.92 ± 0.14 (P < .0001) at 72 hours and 0.84 ± 0.25 (P < .0001) at 90 days. SF-36 Health Survey scores demonstrated no long-term self-perceived adverse physical or mental effects as a result of PE. CPET parameters, including VO2max, weight-adjusted VO2, VE/VCO2, and VD/VT demonstrated no pulmonary vascular impairment at 90 days. PAP significantly improved after USAT, with mean initial systolic pressure of 50.46 ± 13.98 mmHg reduced to 39.64 ± 8.66 mmHg (P = .0001). There were no deaths, recurrent venous thromboembolism, hemodynamic decompensation, or hemorrhage. ConclusionsUSAT resulted in significant reduction of RV:LV at 72 hours, which was preserved at 90 days. QoL and objective measures of cardiopulmonary function are preserved at 90 days in this population. Further studies with long-term follow-up are needed to determine the potential value of USAT for the prevention of post-PE syndrome in patients with submassive PE.

Job satisfaction and job-related stress among nurses: The moderating effect of mindfulness.

Job stress can positively influence individuals' work motivation; however, it is more typical for job stress to have adverse physical and psychological effects, which in turn undermine job satisfaction. The present study has two purposes: to evaluate the effect of the health-promotion lifestyle and job stress to job satisfaction and turnover intention, respectively; and to investigate the moderating effect of mindfulness on each relationship. The present study surveyed 200 nurses employed at small-to-medium-sized hospitals in South Korea. To verify the internal consistency, the reliability of the scales that was administered with the Cronbach's alpha. Correlations between mindfulness, health-promotion lifestyle, job satisfaction, stress factors, and turnover intention were analyzed. The moderating effect of mindfulness on the relationships among aforementioned measures were evaluated. We found significant associations between the health-promotion lifestyle and job satisfaction (p < 0.001), and mindfulness had a moderating effect on the relationship between the health-promotion lifestyle and job satisfaction (p < 0.05). The enhancing effect of mindfulness in these relationships can suggest an important role of mindfulness in the relationship between life style and job attitude.

Physical restraints in intensive care units: a national questionnaire survey of physical restraint use for critically ill patients undergoing invasive mechanical ventilation in Japan.

AimsPhysical restraints are often used for patients undergoing mechanical ventilation to protect important medical equipment. However, they have adverse physical and psychological effects and could pose ethical hazards. Physical restraint use varies by country, but so far there is little understanding of the frequency of physical restraint use among intensive care unit (ICU) patients in Japan. The present study aims to describe the frequency of physical restraint use among Japanese patients undergoing mechanical ventilation. Additionally, it attempts to verify the hypothesis that insufficient human resources have increased the frequency of physical restraints.MethodsWe undertook a cross‐sectional online open anonymous survey of ICU nurses using a self‐administered questionnaire to examine the use of physical restraints for patients undergoing invasive mechanical ventilation in Japan.ResultsWe obtained 175 responses, of which 46 were excluded. Of the respondents, 43% reported that physical restraints were used for more than 75% of mechanically ventilated patients. Intensive care units with a higher frequency of physical restraint use had a significantly greater number of beds per nurse compared to those with a lower frequency; however, after adjusting for the number of beds in the ICU and hospital type in a logistic regression analysis, the number of beds per nurse was no longer significantly related to the use of physical restraints.ConclusionsPhysical restraints are commonly used among patients undergoing mechanical ventilation in Japan. A systematic approach to reducing physical restraint use among mechanically ventilated patients is needed.

Enhancing Quality of Life Through an Innovative, Multidisciplinary Model of Supportive Cancer Care and Rehabilitation

Background: Advancements in diagnosis and cancer treatment mean survival rates have improved but as a consequence many people are living with the adverse physical effects of complex treatments, financial hardship, work and relationship stress, and fear of recurrence. Person-centered, holistic care is required to help people maximize all aspects of their quality of life when living with and beyond their cancer, but debate continues around which models are economically sustainable and effective in achieving the desired outcomes. Maggie's ( www.maggiescentres.org ) is an innovative, multidisciplinary model of holistic supportive cancer care, widely regarded as an exemplar of best practice in cancer rehabilitation and supported self-management. In 2017 Maggie's received 249,247 visits across the network of centres in the UK, Hong Kong and Tokyo. The Maggie's program is designed to incorporate evidence based psychoeducation techniques delivered by multidisciplinary oncology professionals; offer personalised and understandable treatment and lifestyle information; and maximize the opportunity for social-support. Outcome evaluation is embedded within the model of care. Aim: To illustrate the holistic Maggie's model using outcome data from “Managing Stress” and “Living with and after Prostate Cancer (LWAPC)” courses to provide examples of the impact Maggie´s makes in enhancing quality of life. Methods: A subset of participants in “Managing Stress” and “Living with and after Prostate Cancer” courses across the network of UK Maggie´s Centres completed pre and post course standardized questionnaires. Results: Participants in “Managing Stress” found significant improvements in overall psychological well-being and quality of life (QoL) (t(40)=3.28, P = .002) and significant improvements in their ability to tolerate uncertainty (t(47) = 3.23, P = .002). Participants in the LWAPC found significant improvements in overall prostate cancer specific QoL ( t(37)=3.603, P = .001), general well-being ( t(37)=2.61, P = .013), and emotional well-being ( t(37)=2.62, P = .013). Also, significant reductions were found in overall negative appraisal of life (t(52)=2.96, P = .005), overall health worries (t(52) 2.28, P = 0.27), worries about the future (t(52) = 2.85, P = .006) and uncertainty (t(52) = 3.89, P &lt; .001). Conclusion: Globally, the supportive care needs of people affected by cancer are changing but the Maggie's model of care offers valuable lessons that can be generalized across varied support settings to meet these emerging needs.

Cannabidiol treatment reduces the motivation to self-administer methamphetamine and methamphetamine-primed relapse in rats.

Methamphetamine is an addictive stimulant that can cause many adverse physical, psychological and psychosocial effects. Preliminary evidence shows cannabidiol, a non-intoxicating constituent of the cannabis plant, may have efficacy in treating opioid and nicotine dependence. However, no study has yet examined whether cannabidiol treatment might impact on methamphetamine addiction. The current study investigated whether cannabidiol administration reduces the motivation to self-administer methamphetamine and relapse to methamphetamine-seeking behavior following abstinence. Thirty-two male Sprague Dawley rats with implanted jugular vein catheters were initially trained to self-administer methamphetamine via lever press during two-hour sessions on a fixed ratio 1 schedule of reinforcement. Rats in experiment 1 ( n=16) then advanced to a progressive ratio reinforcement schedule to examine the effects of cannabidiol (0, 20, 40, and 80 mg/kg intraperitoneal) on motivation to self-administer methamphetamine. Rats in experiment 2 ( n=16) were tested for cannabidiol effects on methamphetamine-primed reinstatement following extinction. Cannabidiol (80 mg/kg, but not 40 mg/kg, or 20 mg/kg) reduced the motivation to self-administer methamphetamine and attenuated methamphetamine-primed relapse to methamphetamine-seeking behavior after extinction. This is the first demonstration that cannabidiol can reduce the motivation to seek and consume methamphetamine, and suggests that cannabidiol might be worth trialing as a novel pharmacotherapy for methamphetamine dependence.

Prevalence of obesity and it’s associated risk factors among policemen of Chitradurga district, Karnataka, India

Background: Obesity is an increasingly prevalent disease worldwide and can be regarded as a health problem among individuals of different occupations, including policemen, who are responsible for public security. Working throughout the day in stressful atmosphere produces adverse physical and psychological effects. We conducted this study to find the prevalence of obesity among policemen, if any, and to identify the associated risk factors for obesity in this population.Methods: Cross sectional study was conducted among 410 police personnel of 4 talukas of Chitradurga District, Karnataka from July 2017 to January 2018. Semi-structured questionnaire was prepared to collect the data, which consist of socio-demographic data, clinical examination findings, anthropometric measurements and biochemical investigations. At the end whoever had high risk factors, were treated for the same along with advice on healthy life style. Data entered in Microsoft Excel 2007 and analysed using SPSS software, version 20. Frequency tables, ANOVA test and chi-square test were used for analysis and interpretation.Results: There were total 392 males and 18 females. Age group was ranging from 21 years to 59 years. 201(49%) of the police officers were overweight and 45(11%) were obese. Ideal weight police men were younger than obese policemen and weighed less than obese police. There was statistical difference in BMI between the three groups of policemen. The mean TG and TC levels among overweight and obese were higher than ideal weight policemen and this difference was statistically significant. 32.9% of participants had a high TC level (≥200 mg/100 ml). Moreover, 93.4% and 84.1% had a low level of HDL-C and high level of LDL-C, respectively (&lt;40 mg/ 100 ml and &gt;150 mg/100 ml, respectively). 49.5% of our study participants had TG levels &gt;150mg/100 ml. 60.5% and 42.7% had high SBP and DBP, respectively (&gt;130 mmHg and &gt;90mmHg). The difference between TC and HDL between different BMI groups was statistically significant.Conclusions: Obesity and hypertension are high risk factors for development of cardiovascular diseases. Early detection of the same and effective implementation of a physical fitness program, a regular balanced diet, inoculation training for managing stress can improve the life of police personnel.

Exercise Addiction in Practitioners of Endurance Sports: A Literature Review.

Practice of endurance sports/activities has gained most devotees over recent decades, thanks to its capacity to maintain and improve health. However, their characteristics and accessibility have facilitated the emergence of addictive behaviors. Excessive practicing can lead to adverse physical and psychological effects seriously prejudicial to health, to the extent that individuals are unable to control this behavior. Recognizing that exercise addiction is still a controversial concept, the aim of the present review is to analyze the state of research into addictive exercise behaviors, specifically centering on running and endurance sports. To this end, a search covering article written in English and dated from 2010 onward was carried out in the Pubmed, Scopus, Web of Science and EBSCOhost databases. Of a total of 2,675 articles in the four databases, 25 were eligible for the final review. The studies reviewed confirmed that excessive practice could encourage the appearance of addictive behaviors and health problems. Most research has reported no age or sex differences in exercise dependence among endurance sport practitioners; however, obsessive passion and dedication to sports activities may be predictors for addiction to exercise. Owing to terminological confusion and the variety of tools used to measure addiction, figures for prevalence differ widely among studies, with values quoted ranging from 3 to 42%. Furthermore, it is clear that there are problems in delimiting, defining and diagnosing this sort of behavior, which has led to addiction to exercise not yet being considered a behavioral disorder.

Post-finasteride Syndrome: A Review of Current Literature

A constellation of persistent adverse effects—collectively termed post-finasteride syndrome (PFS)—after 5α-reductase inhibitor treatment for benign prostatic hyperplasia (BPH) and androgenic alopecia (AGA) has recently been described. The severity of these sexual, physical, neurological, and psychiatric side effects raises important concerns regarding the treatment of these conditions, especially given the prevalence of indications for these medications. Here we review the literature exploring the symptoms, proposed mechanisms, and potential disease modulating factors for PFS. While the persistent sexual side effects associated with PFS are well documented, research on the physical, neurological, and psychiatric adverse effects is much less ubiquitous. Though the mechanisms leading to PFS have been proposed, a clear treatment plan for these patients has not been established. In the treatment of BPH and AGA with 5α-reductase inhibitors, the risks of PFS should be considered. The occurrence of persistent adverse sexual, physical, neurological, and psychiatric side effects after 5α-reductase inhibitor is well supported by the existing data. While additional studies are needed to better evaluate the role of 5α-reductase inhibitors in the manifestation of the symptoms of PFS, the risks of PFS should be critically evaluated when treating patients with BPH or AGA.

Effectiveness of a digital platform-based implementation strategy to prevent work stress in a healthcare organization: a 12-month follow-up controlled trial

Objectives Healthcare workers frequently deal with work stress. This is a risk factor for adverse mental and physical health effects. The objective of this study was to investigate the effectiveness of a digital platform-based implementation strategy - compared to a control group - on stress, work stress determinants (ie. psychosocial work factors) and the level of implementation among healthcare workers. Methods By way of matching, 30 teams from a healthcare organization were assigned to the experimental (15 teams; N=252) or wait-list control (15 teams; N=221) group. The experimental group received access to the strategy for 12 months. They were asked to complete the 5-step protocol within six months. The primary outcome was stress (DASS-21) and secondary outcomes were psychological demands, social support, autonomy, and the level of implementation. Questionnaire-based data were collected at baseline, and at 6- and 12-months follow-up. Linear mixed model analyses were used to test differences between the two groups. Results In total, 210 participants completed the baseline questionnaire and at least one follow-up questionnaire. There was a significant effect of the strategy on stress in favor of the experimental group [B=-0.95, 95% confidence interval (CI) -1.81 - -0.09]. No statistically significant differences were found for any secondary outcomes. Conclusions The strategy showed potential for primary prevention of work stress, mainly explained by an increase in stress in the control group that was prevented in the experimental group. More research is necessary to assess the full potential of the strategy.

HDL2- and HDL3- Mediated Transport of Sphingosine-1-phosphate in Mixed Dyslipidemia: Effect of Statin Treatment

The use of crystal methamphetamine is a growing problem in Australia. Methamphetamine users can suffer adverse physical health effects, psychotic symptoms and methamphetamine-related aggressive behaviour. The increasing use and related harms of crystal methamphetamine is presenting serious problems for frontline emergency responders.A population-based retrospective analysis was undertaken of data collected by Ambulance Victoria describing crystal methamphetaminerelated events attended by ambulance across Victoria over six financial years from 2011/12 to 2016/17.Methamphetamine-related events attended by Victoria Ambulance paramedics significantly increased from 2011/12 to 2016/17, particularly in regional Victoria. The most frequent age group requiring ambulance attendance is 25–39 years. The proportion of events requiring police coattendance significantly increased, as did transportation to emergency department/hospital.The substantial increases in methamphetamine-related events attended by ambulance indicate the need for increased resources and support for paramedics, particularly in regional/rural areas. The large increase among young people aged 15–24 years indicates a need for policy action on prevention, harm reduction and expanded treatment services to reduce health problems and methamphetamine-related harms.

Clinical Oncology Society of Australia position statement on exercise in cancer care.

Clinical research has established exercise as a safe and effective intervention to counteract the adverse physical and psychological effects of cancer and its treatment. This article summarises the position of the Clinical Oncology Society of Australia (COSA) on the role of exercise in cancer care, taking into account the strengths and limitations of the evidence base. It provides guidance for all health professionals involved in the care of people with cancer about integrating exercise into routine cancer care. Main recommendations: COSA calls for: exercise to be embedded as part of standard practice in cancer care and to be viewed as an adjunct therapy that helps counteract the adverse effects of cancer and its treatment; all members of the multidisciplinary cancer team to promote physical activity and recommend that people with cancer adhere to exercise guidelines; and best practice cancer care to include referral to an accredited exercise physiologist or physiotherapist with experience in cancer care. Changes in management as a result of the guideline: COSA encourages all health professionals involved in the care of people with cancer to: discuss the role of exercise in cancer recovery; recommend their patients adhere to exercise guidelines (avoid inactivity and progress towards at least 150 minutes of moderate intensity aerobic exercise and two to three moderate intensity resistance exercise sessions each week); and refer their patients to a health professional who specialises in the prescription and delivery of exercise (ie, accredited exercise physiologist or physiotherapist with experience in cancer care).

Assessment of the safety of Bacillus Calmette-Guérin vaccine administered orally to badgers (Meles meles)

European badgers (Meles meles) are a wildlife reservoir for Mycobacterium bovis (M. bovis) in parts of England, Wales and Ireland, constituting a potential source of tuberculosis (TB) infection for cattle. Vaccination of badgers against TB is one of the tools available for helping reduce the prevalence of bovine TB in badgers, made possible by the licensing in 2010 of Bacillus Calmette-Guérin (BCG) vaccine for intramuscular administration to badgers (BadgerBCG). However, practical limitations associated with administering an injected vaccine to wild animals make an oral, bait-delivered form of the vaccine highly desirable. Evaluation of the safety of oral BCG to badgers and the environment is a mandatory step on the road to licensing an oral vaccine. This study had the following objectives: (a) to determine whether adverse effects followed the oral administration of BCG vaccine to badgers; (b) to measure the quantity and frequency of BCG excreted in the faeces of vaccinated badgers; and (c) to assess whether there was evidence of the vaccine spreading to unvaccinated, ‘sentinel’ badgers sharing the same environment as vaccinated animals. We report here that the oral administration per badger of ≥6.4 × 109 cfu BCG, followed 14 days later by a single oral dose of ≥6.4 × 107 cfu BCG caused no adverse physical effects and did not affect the social behaviour and feeding habits of the vaccinated animals. BCG was cultured from the faeces of two of nine vaccinated animals (372 cfu/g and 996 cfu/g, respectively) approximately 48 h after the higher dose of BCG was administered and by one of the nine vaccinated animal (80 cfu/g) approximately 24 h after receiving the lower dose of BCG. We found no evidence for the transmission of BCG to unvaccinated, sentinel, badgers housed with the vaccinated animals despite the occasional excretion of BCG in faeces.