Biomedical subjects

K Grimmer

Publications and source records attributed to K Grimmer.

At least 19 recordsLinked to original sources

PubMed2006

A systematic review of guidelines for the prevention of heat illness in community-based sports participants and officials.

This paper presents the findings of a systematic review of guidelines on preventing heat illness in sports participants and officials. University library databases and Internet sources were searched for guidelines pertaining to community-based sports, and occupational health and safety, using a comprehensive list of search terms. Guidelines were included if they met the criteria of English language, full text and fully referenced, and dealt specifically with, or could be extrapolated to, prevention of heat illness in sports participants and officials. Guideline inclusion was evaluated by two independent reviewers, who also independently assessed guideline quality using the AGREE instrument. Common guideline themes were identified by synthesis and recommendations for each theme were extracted. A synthesis of recommendations for common themes was then undertaken. Thirteen eligible guidelines were included. Thirty-two guidelines were excluded, as they did not provide sufficient information on construction or references. The methodological quality of the included guidelines was variable. The evidence-base of the guidelines varied, reflecting primary and secondary research. While five common heat-illness prevention themes were identified (fluid intake, heat limits, clothing, acclimatisation, precautionary interventions), variable recommendations were made pertaining to these themes. This potentially reflected the variable underpinning evidence of the guidelines. This review highlighted the need for better quality guideline construction related to defensible and transparent evidence sources regarding sports participation in hot weather. The synthesised recommendations cautiously provide a framework of current best evidence upon which sporting organisations internationally can base strategies for safe participation in the heat.

Adaptation, Physiological↗

PubMed2006

Prevalence of hot weather conditions related to sports participation guidelines: a South Australian investigation.

BACKGROUND: There is scant guidance in the literature on the most appropriate Australian measures of, and thresholds for, extreme heat regarding giving advice on safe sports participation in hot weather. The purpose of this paper is to present a process for investigating two common measures of heat (air temperature, wet bulb globe temperature (WGBT)) in one state in Australia (South Australia), regarding their usefulness in making decisions regarding sports participation in the heat. METHOD: Commonly reported measures and thresholds of extreme heat were identified from a systematic review of guidelines regarding sports participation in hot weather. Dry air temperature (threshold of 35 degrees C), and WBGT index (threshold of 28 degrees C) were highlighted. Repeated daily measures of dry air temperature by the Bureau of Meteorology (BoM) and WBGT index from 12 meteorological recording sites in South Australia (SA) for four consecutive summer periods (2000-2004) were analysed using these thresholds to investigate the prevalence of extremely hot temperatures in SA during these periods. The extremely hot hours-per-day data were standardised using a denominator of per-day-month across the 12 SA recording regions. RESULTS: Across the four summer seasons of data in SA, there were similar standardised numbers of hours-per-day of extremely hot dry air temperature and WBGT index. There was a high correlation between these hours of hot weather measures, highlighting the congruence between hot air and humidity measures. Three distinct regional site groupings were identified, in which there was a different prevalence of extremely hot weather conditions. CONCLUSION: In SA, dry air temperature is an appropriate and robust measure of extreme heat related to sports participation, this measure providing as much information as WBGT in identifying extremely hot periods of weather. Dry air temperature can be readily measured by sports participants or officials irrespective of the geographical location in SA. Three SA regions demonstrated distinct differences in prevalence of extremely hot conditions, suggesting the need for site-specific interpretation of heat participation guidelines to ensure sports safety in hot weather. Other states in Australia could use the approach outlined in this paper to identify the most appropriate measure of extreme heat relevant to local conditions, and to assist in interpreting heat limit guidelines in a local context.

Hot Temperature↗

PubMed2006

Repeated measures of recent headache, neck and upper back pain in Australian adolescents.

The epidemiological and clinical literature identifies strong associations between adult headache, cervical and thoracic spine dysfunction and spinal posture. This paper reports on the prevalence and incidence of headache, neck and upper back pain which occurred in the previous week, in urban Australians aged 13-17 years. Commencing in 1999, we followed a cohort of South Australian students through 5 years of secondary schooling. Of our commencing cohort of students, 132 (30%) provided data on bodily pain every year. For both girls and boys, there was a significantly decreasing prevalence of headache over the study period, while neck pain and upper back pain increased. There was a significantly increasing trend over time for boys with upper back pain. Twenty percent of girls and boys consistently reported headache, neck pain or upper back pain over 5 years. The progression of early adolescent headaches to mid-adolescent neck and upper back pain potentially reflects the adolescents' biomechanical responses to intrinsic and extrinsic imposts. This requires further investigation to understand the causes of adolescent headache, neck and upper thoracic pain.

Adolescent↗

PubMed2004

School furniture and the user population: an anthropometric perspective.

The purpose of this study was to determine the relationship between reported spinal symptoms in an adolescent student population, and the match between their individual anthropometric dimensions and their school furniture. The hypothesis was that students who were too large or too small for their school furniture, i.e. with anthropometric measurements furthest from the group whose anthropometry was the 'best fit' with the furniture, would have a higher frequency of reported symptoms. From data collected from 1269 schoolchildren, reported spinal symptoms and anthropometric measures were examined. Stature measures were divided into quartiles. A standard government issue school chair and desk was measured and the anthropometric quartile of the population having the 'best fit' with the furniture was identified using standard ergonomics recommendations. Odds ratios were calculated for spinal symptoms reported within each quartile group. The first quartile group (the smallest students) was identified as having the 'best fit' with the school furniture. An overall higher odds of reporting low back pain was noted in students with anthropometric dimensions in the fourth quartile (the tallest students). While it is acknowledged that there is a multifactorial nature of causality of adolescent spinal symptoms, it is contended that the degree of mis-match between child anthropometry and school furniture set-up should be further examined as a strong and plausible associate of adolescent low back pain.

Anthropometry↗

PubMed2003

Injury in junior Australian Rules footballers.

This paper reports on injuries sustained by Australian Rules footballers aged seven to 17 years, who played a full season of junior South Australia National Football League (SANFL) affiliated school or club competition in 2000. 697 boys provided information on injuries sustained throughout the season. 136 players (19.5% of the total) reported 234 injuries (1.7 injuries per injured player). The leg, the head and face, and hands were the most commonly injured areas, with 43.2% of injuries related to a collision. The majority of injuries were minor, involving soft tissue contusions. The 12-14 year olds playing club competition had the highest risk of injuries, and the most common occurrence of head and hand injuries. Over 60% of injuries occurred in the last two quarters of the game, and 21% of the reported injuries occurred at training. This study identified the need to review rule modification in the young adolescent age groups playing club competition to ensure that growing bodies are not exposed to unsafe playing practices.

Adolescent↗

PubMed2002

The effect of either a pre or post exercise stretch on straight leg raise range of motion (SLR-ROM) in females.

This study examined the order effect of a hamstring muscle stretch and resisted hamstring exercises on straight leg raise range of movement (SLR-ROM), in a group of twenty females aged 20-34 years. The stretch was applied either immediately before or Immediately after a resisted hamstring exercise. Exercise significantly decreased SLR-ROM (p < 0.05) and stretching significantly increased SLR-ROM (p < 0.05). The overall change in SLR-ROM for the two groups showed that a significant increase in SLR-ROM was detected (at a low force level) in Group 1 subjects who performed exercise and then stretched. A non-significant increase in SLR-ROM was detected by the higher force level in Group 1 subjects. In contrast, Group 2 subjects (stretch then exercise) showed a non-significant reduction in SLR-ROM at both levels of force.

Adult↗

PubMed2001

Isotype-dependent inhibition of tumor growth in vivo by monoclonal antibodies to death receptor 4.

To explore an approach for death receptor targeting in cancer, we developed murine mAbs to human death receptor 4 (DR4). The mAb 4H6 (IgG1) competed with Apo2L/TNF-related apoptosis-inducing ligand (DR4's ligand) for binding to DR4, whereas mAb 4G7 (IgG2a) did not. In vitro, both mAbs showed minimal intrinsic apoptosis-inducing activity, but each triggered potent apoptosis upon cross-linking. In a colon tumor nude mouse model in vivo, mAb 4H6 treatment without addition of exogenous linkers induced apoptosis in tumor cells and caused complete tumor regression, whereas mAb 4G7 partially inhibited tumor growth. An IgG2a isotype switch variant of mAb 4H6 was much less effective in vivo than the parent IgG1-4H6, despite similar binding affinities to DR4. The same conclusion was obtained by comparing other IgG1 and IgG2 mAbs to DR4 for their anti-tumor activities in vivo. Thus, the isotype of anti-DR4 mAb may be more important than DR4 binding affinity for tumor elimination in vivo. Anti-DR4 mAbs of the IgG1 isotype may provide a useful tool for investigating the therapeutic potential of death receptor targeting in cancer.

Animals↗

PubMed2001

Vertical anthropometric measures and low back pain in adolescents.

BACKGROUND AND PURPOSE: The present paper explores aspects of a large dataset of adolescent potentiates of low back pain. Standing, trunk and shoulder height, subischial height, weight and mean leg length are examined in relation to reports of low back pain in the last two weeks, in strata of age and gender. METHOD: The present study examined 1254 adolescents, aged 11-18 years, drawn from 12 Adelaide public high schools during 1998. RESULTS: At each year of age, girls reported significantly more low back pain than boys. Girls and boys at each year of age provided different relationships between low back pain and anthropometric features, highlighting the unique nature of adolescent growth. The most consistent findings were anthropometric differences between 16-year-old boys, and 13- and 15-year-old girls, with and without low back pain, who may be at critical stages of the peak growth curve. CONCLUSION: We suggest a high prevalence of low back pain in adolescents, and that young sufferers with low back pain may be reflecting attributes of their stage of anthropometric growth.

Adolescent↗

PubMed2001

Effects of backpacks on students: measurement of cervical and shoulder posture.

The aims of this pilot study were to determine whether the weight of a backpack, its position on the spine or time carried affected adolescents cervical and shoulder posture. Standing posture measured from the sagittal and frontal planes of 13 students was recorded photographically under several load carrying conditions. Cervical and shoulder position angles were calculated and compared. Results revealed that both backpack weight and time carried influenced cervical and shoulder posture. Forward head posture increased when carrying a backpack, especially one with a heavy load. Carrying a backpack weighing 15% of body weight appeared to be too heavy to maintain standing posture for adolescents. These findings have implications for future load carrying studies in adolescents.

Adolescent↗

PubMed2001

The effect of a standard activity on the size of the median nerve as determined by ultrasound visualization.

The purpose of this study was to determine whether a standardized hand activity would produce changes in the cross-sectional diameter of the median nerve. Ultrasound measures of proven reliability of the cross-sectional diameter of the median nerve in the wrist were taken. These measures were taken before activity and immediately after the activity, after 5 minutes, and after 10 minutes. The median nerves of 40 normal subjects showed an increase in cross-sectional diameter immediately after hand activity then returned to a size close to the preactivity size within 10 minutes. The cross-sectional area of the carpal canal did not change significantly after the hand activity was performed. Female gender and body mass index over 25 were associated with significantly larger size increases in the median nerve. This preliminary study suggests that ultrasound is sensitive to the effects of activity upon the hand.

Adolescent↗

PubMed2001

The development, validity and application of a new instrument to assess the quality of discharge planning activities from the community perspective.

OBJECTIVE: To describe the development, validity and application of a new instrument (PREPARED) for obtaining feedback from community consumers of discharge planning activities. DESIGN: Iterative qualitative and quantitative investigations. SETTING: The community catchment area of a metropolitan Australian tertiary public hospital. STUDY PARTICIPANTS: Patients aged over 65 years, with a range of conditions, recently discharged from hospital, their carers, and hospital nursing staff. ACTIONS: PREPARED was constructed from interviews with patients, carers and hospital staff. It was trialed and modified to ensure sensitive measurement of key attributes of discharge planning process and outcome. This paper explores the patient and carer versions of PREPARED. Data items were reduced to domains of key questions by factor analysis. Instrument performance was assessed by correlation of process and outcome measures, by comparing PREPARED responses with subsequent unstructured interview data, and by testing whether PREPARED responses were independent of health-related quality of life at the time of survey. RESULTS: Four key process domains were identified: information exchange (community services and equipment), medication management, preparation for coping after discharge and control of discharge circumstances. Outcome was measured as overall satisfaction with discharge, whether equipment and community service needs had been met, use of health services and health related costs post-discharge. The instrument performed well when compared with interview data, the process and outcome domains were largely independent of each other, as were responses to PREPARED and SF-36. CONCLUSIONS: PREPARED offers a comprehensive way of closing the quality improvement loop, by providing information from the community perspective on the quality of planning for discharge from the acute hospital setting.

Aged↗

PubMed2000

Gender-age environmental associates of adolescent low back pain.

This paper describes adolescent low back pain and tests its associations with environmental features of backpack load, time spent carrying loads, time sitting, and time playing sport, using data from 1269 adolescents in twelve volunteer high schools in Adelaide, South Australia. Backpacks were the preferred method of load carrying, two-thirds of wearers preferring to carry the load over two shoulders. The average load weighed 5.3 kg (approximating 10% of body weight). The youngest students carried approximately the same amount as the oldest students. Girls were more likely than boys to report recent low back pain, and there were gender- and age-specific associations between recent low back pain, the amount of time spent sitting, the backpack load and time spent carrying it, and time playing sport. Body mass was not a confounder of any association. These findings support ongoing concerns regarding environmental contributions to adolescent low back pain.

Adolescent↗

PubMed2000

Reliability of adolescents' self-report of recent recreational injury.

PURPOSE: To assess the reliability of adolescents' self-report of recent recreational injury. METHOD: Identical written questionnaires were administered twice in a 3-week period to 75 randomly selected adolescents (aged 11-12 years and 15-16 years) in state primary and secondary schools in South Australia, Australia. The questionnaires sought information on injury sustained in the previous week. Parents of 60 of the adolescents were contacted in the same week as one of the questionnaire administrations, to verify their adolescent's most recent injury self-report. Intraclass and Pearson correlation coefficients provided evidence of agreement between responses, and stability of measure. RESULTS: There was high stability and good agreement between the parent and adolescent responses provided in the same week, suggesting that adolescents accurately reported recent recreational injury. The poor stability and low agreement between repeated adolescent responses over the 3-week period indicated not poor recall, but the changing nature of mostly minor recreational injury. These findings suggest that the nature of the injury reported in the first questionnaire had changed by the time of the second questionnaire administration, and that this was accurately reported. CONCLUSION: Confidence can be placed in adolescents' self-reports of recreational injury in the preceding week.

Adolescent↗

PubMed2000

A systematic review of the clinical diagnostic tests for carpal tunnel syndrome.

The purpose of this report was to critically review studies of the clinical diagnostic tests for carpal tunnel syndrome. The reports were located through Medline, Current Contents, related readings, and the reference lists of the articles. They all explored the use of clinical diagnostic tests for carpal tunnel syndrome compared with the results of NCS. Criteria for systematically reviewing the studies were developed, tested for reliability, and applied to the studies. Many studies did not have sufficient detail to allow repetition of the protocol by other researchers. The sensitivities and specificities reported for each can be compared with the quality criteria ratings they each received. The literature supports the use of the wrist flexion and carpal compression test and suggests that 2-point discrimination has low sensitivity for diagnosing carpal tunnel syndrome. Many reports do not include methodology, which makes the results difficult to reproduce and to apply to other populations. (J Hand Surg 2000; 25A:120-127.

Carpal Tunnel Syndrome↗

PubMed1999

Frequency of headaches associated with the cervical spine and relationships with anthropometric, muscle performance, and recreational factors.

OBJECTIVE: To investigate headache specifically associated with the cervical spine, and factors associated with it. DESIGN: Cross-sectional, population-based observational study. SETTING: Two agriculturally based municipalities in southern Tasmania, Australia. PATIENTS: Four hundred fifty adults were randomly selected from electoral rolls; after refusals and exclusions, 427 subjects participated. OUTCOME MEASURE: For analysis, subjects were divided into three groups: those who did not have a particular type of headache in the previous month, those reporting fewer than two headaches of this type for the month (occasional headache), and those reporting two or more (frequent) headaches of this type in the month. STUDY FACTORS: Information collected by questionnaire and by objective measurement on anthropometric and functional measurements, wearing glasses or dentures, usual occupation, and usual recreational activities. RESULTS: The monthly prevalence of frequent headaches associated with the cervical spine was 28.3% (95% confidence interval [CI], 24.2-32.9), and another 35.4% (30.9-40.1) of subjects had these headaches occasionally. The frequency of headache occurrence was associated with a difference between front and back neck length of 2 cm or more. Occasional participation in recreational sport by men and wearing glasses by women were significant predictors of headache. CONCLUSION: Headaches of this type were more frequent in subjects with a long anterior neck length relative to their posterior neck length, particularly if they occasionally participated in recreational sports (men) or wore glasses (women).

Adult↗

PubMed1999

Staff perceptions of discharge planning: a challenge for quality improvement.

One hundred staff in three acute care public hospitals were asked about their perceptions of successes and failures of their discharge planning activities. The intention was to highlight ways in which the quality of discharge planning could be improved within the acute hospital setting. Generally staff described failures more commonly than successes, with a number of key failures being identified, including problems associated with vacating beds, lack of appropriate staff, patients and career education about discharge activities, general process issues, problems associated with community service provision and patients who are difficult to discharge. Staff identified the lack of feedback on the outcome of their efforts as a source of frustration and a barrier to improving discharge planning activities. The challenges for improving the quality of discharge planning in the acute hospital setting would appear to be in establishing appropriate structures and processes that promote interaction between staff, patients and community providers, and provide incentives for behavioural change.

Attitude of Health Personnel↗

PubMed1999

Differences in stakeholder expectations in the outcome of physiotherapy management of acute low back pain.

OBJECTIVE: To compare stakeholder expectations of outcome of physiotherapy management of acute low back pain. DESIGN: Observational design using interviews and questionnaires. SETTING: Practice/workplace. STUDY PARTICIPANTS: The study sample was from South Australia. It comprised 74 physiotherapists randomly selected from professional association listings (49.3% response rate), 121 physiotherapy patients (recruited by participating physiotherapists when attending their first physiotherapy treatment for acute low back pain), 21 general practitioners randomly selected from medical practitioner listings in the metropolitan telephone book (36.2% response rate) and 13 third party payers of a total of 16 available insurers in the metropolitan area (82% response rate). MAIN OUTCOME MEASUREMENTS: Stakeholders reported expectations of outcome at the end of the first treatment session and at the completion of the episode of care. RESULTS: There were differences in expectations between stakeholders, as well as between naive and experienced patients. Overall, patients expected symptom relief at the end of the first treatment. Naive patients decided to return for further treatment based on the relationship established with the therapist, whereas experienced patients also expected some advice on their condition during the first contact. Physiotherapists and referrers expected symptom relief and then long-term management strategies to be provided, and third party payers expected cost-efficient management of the condition and patient satisfaction. CONCLUSION: Physiotherapists need to address potential imbalance of consumer knowledge and foster a quality partnership with their patients on the first visit to physiotherapy. Patients who are in pain may not derive full value from information provided in an untimely manner.

Acute Disease↗

PubMed1998

Differences between metropolitan and country public hospital allied health services.

This paper compares patient and episode characteristics in allied health services delivered in country and metropolitan hospitals. Eight public hospitals (46 allied health services) participated in the study (three country and five metropolitan sites, situated in South Australia, Queensland and Tasmania). Standardised rates of patient throughput were similar for country and metropolitan allied health services, despite smaller numbers of country staff providing services to larger geographical areas. Although the differences were not significant, country patients were generally older and had more chronic conditions than metropolitan patients. Fewer country patients than metropolitan patients were eligible for rebates in the private sector. In addition, fewer alternative services were available in country communities, which heightened the role of the public hospital outpatients services within the community. This paper provides an argument for similar funding arrangements for country and metropolitan ambulatory allied health services.

Adolescent↗