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Purpose: To explore complex system behavior and subsequent team performance in professional rugby union. Methods: Here, we present 2 studies. In the first, we used global positioning system technology to measure player clustering during stoppages in play in nearly 100 games of professional rugby union to explore team (complex system) behavior and performance. In the second, we measured stress hormones (cortisol and testosterone) prior to team meetings and analyzed these relative to amount of time and the frequency with which players looked at peer presenters, as well as subsequent training performance, to explain how stress may lead to behaviors observed in the first study and subsequent match performance. Results: No link between player clustering during stoppages of play and performance was observed. When players (complex system agents) demonstrated greater levels of stress (as indicated by greater cortisol-awakening response and a greater decline in testosterone-to-cortisol ratio across the morning), they tended to look at peer presenters more; however, training quality declined (P =.02). Correlational analysis also showed that training quality was related to testosterone-to-cortisol ratio (P =.04). Conclusions: Team behavior is complex and can be unpredictable. It is possible that under stress, complex system agents (ie, rugby union players) look at (and cluster toward) their teammates more; however, meaningful interaction may not necessarily occur. Furthermore, while complex system (team) analysis may be valuable strategically in rugby union in the context of describing behavior, without understanding "how" or "why" intrateam/interagent behaviors emerge it may have little meaning. [ABSTRACT FROM AUTHOR]

This study assessed the rate of a.) the total and b.) specific psychiatric comorbidities among the three severity ratings for Anorexia Nervosa (AN): DSM-5, ICD-11 and overvaluation of weight and shape (OWS). The sample comprised 312 treatment-seeking patients with AN (mean age = 26.9). Weight and height were taken at intake to calculate BMI, the foundation for the DSM-5 and ICD-11 severity indices. The EDE-Q was used to assess OWS, and the Mini International Neuropsychiatric Interview was conducted to assess psychiatric comorbidities. For the DSM-5, the mild severity group showed a higher total number of psychiatric comorbidities, especially for panic, social anxiety, generalised anxiety, and post-traumatic stress disorders compared to the severe and extremely severe groups. ICD-11 and OWS severity groups did not significantly differ in total comorbidities, except for major depressive disorder and obsessive-compulsive disorders being more prevalent in the "significantly low BMI" ICD-11 group. The high OWS group displayed a notably higher rate of major depressive disorder than the low OWS group. The study underscores inconsistent patterns across the three severity systems, emphasising the need to recognise the current limitations of the assessed severity classification systems in AN assessment and guiding treatment. [ABSTRACT FROM AUTHOR]

With rates of coercive control (CC) increasing, there is a need to ensure that intervention programs are underpinned by evidence-based research. Current interventions are scarce, with their efficacy rarely established. Most current interventions appear to rely on victims seeking support from formal sources/agencies, despite suggestions that victims are more likely to confide in people they know, such as their friends. Researchers suggest that a victim's friends may provide an effective source of support and intervention. The aim of this study was to fill the gap in the literature exploring whether the closeness of the relationship to the victim, bystander gender, and bystander concerns influenced attitudes toward intervening in CC situations. The study used an experimental design, whereby participants were randomly allocated to read a vignette depicting a CC scenario involving a friend, colleague, or stranger, and quantitative methods were used to examine bystanders' willingness and concerns about intervening. The sample was 340 Australian participants (229 female, 111 male), recruited from social media, namely community Facebook groups. The results indicated that friends were significantly more willing to intervene than colleagues or strangers, while strangers reported the highest concerns about intervening. Females reported significantly higher willingness to intervene than men despite also reporting higher concerns. Exploratory analysis of concerns about intervening revealed that the participants were most concerned about risk of harm and their beliefs in their ability to successfully intervene. These findings have implications for bystander intervention programs and campaigns, including offering a range of potential directions to enhance intervention program content. [ABSTRACT FROM AUTHOR]

Background: Burnout and workforce shortages comprise a vicious cycle in medicine, particularly for Australian general practitioners (GPs). Professional diversification, whereby individuals work multiple roles across their week, may help address this problem, but this strategy is under-studied. Methods: We surveyed 1157 Australian GPs using qualitative and quantitative questions examining professional diversification, values, autonomy, and wellbeing. Quantitative data were analysed using inferential statistics, whilst qualitative data were analysed using inductive thematic analysis. We triangulated the data by using the qualitative findings to inform further quantitative testing. Results: Approximately 40% of the sample had diversified. Although diversifying was not significantly associated with wellbeing, the qualitative data indicated that diversification supported GPs' wellbeing by enhancing career sustainability, accomplished through various pathways (e.g. value fulfilment, autonomy, variety). Subsequent quantitative analyses provided evidence that these pathways mediated the relationship between diversification and wellbeing. To diversify, GPs needed particular personal qualities, external supports, flexibility, and serendipity. Barriers to diversifying mirrored these factors, spanning individual (e.g. skillset) and situational levels (e.g. autonomy, location). Conclusions: Diversification can support GPs' wellbeing if it meets their needs. Organisations should focus on publicising opportunities and accommodating requests to diversify. Professional diversification and developing new skillsets can assist general practitioners to sustain their own well-being and engagement with their work. Features that can mediate this relationship include value fulfilment, autonomy, variety, external supports, flexibility, and serendipity. This may help address the current international epidemic of burnout and workforce shortages in general practice. [ABSTRACT FROM AUTHOR]

Objective: To enrich and compare three extracellular vesicles—EV subtypes (apoptotic bodies, microvesicles and small EV) from three periodontal cells (periodontal ligament cells—PDLCs, alveolar bone‐derived osteoblasts—OBs and gingival fibroblasts—GFs), and assess uptake and cell function changes in buccal fat pad‐derived mesenchymal stromal cells (BFP‐MSCs). Background: Periodontal cells such as PDLCs, OBs and GFs have the potential to enhance bone and periodontal regeneration, but face significant challenges, such as the regulatory and cost implications of in vitro cell culture and storage. To address these challenges, it is important to explore alternative 'cell‐free' strategies, such as extracellular vesicles which have emerged as promising tools in regenerative medicine, to facilitate osteogenic differentiation and bone regeneration. Methods and Materials: Serial centrifuges at 2600 and 16 000 g were used to isolate apoptotic bodies and microvesicles respectively. Small EV—sEV was enriched by our in‐house size exclusion chromatography (SEC). The cellular uptake, proliferation, migration and osteogenic/adipogenic differentiation genes were analysed after EVs uptake in BFP‐MSCs. Results: Three EV subtypes were enriched and characterised by morphology, particle size and EV‐associated protein expression—CD9. Cellular uptake of the three EVs subtypes was observed in BFP‐MSCs for up to 7 days. sEV from the three periodontal cells promoted proliferation, migration and osteogenic gene expression. hOBs‐sEV showed superior levels of osteogenesis markers compared to that hPDLCs‐sEV and hGFs‐sEV, while hOBs‐16k EV promoted adipogenic gene expression compared to that from hPDLCs and hGFs. Conclusions: Our proof‐of‐concept data demonstrate that hOBs‐sEV might be an alternative cell‐free therapeutic for bone tissue engineering. [ABSTRACT FROM AUTHOR]

Speed and accuracy of lexical access change with healthy ageing and neurodegeneration. While a word's immediate phonological neighbourhood density (i.e. words differing by a single phoneme) influences access, connectivity to all words in the phonological network (i.e. closeness centrality) may influence processing. This study aimed to investigate the effect of closeness centrality on speed and accuracy of lexical processing pre- and post- a single word-training session in healthy younger and older adults, and adults with logopenic primary progressive aphasia (lvPPA), which affects phonological processing. Participants included 29 young and 17 older healthy controls, and 10 adults with lvPPA. Participants received one session of word-training on words with high or low closeness centrality, using a picture-word verification task. Changes in lexical decision reaction times (RT) and accuracy were measured. Baseline RT was unaffected by age and accuracy was at ceiling for controls. Post-training, only young adults' RT were significantly faster. Adults with lvPPA were slower and less accurate than controls at baseline, with no training effect. Closeness centrality did not influence performance. Absence of training effect for older adults suggests higher threshold to induce priming, possibly associated with insufficient dosage or fatigue. Implications for word-finding interventions with older adults are discussed. [ABSTRACT FROM AUTHOR]

This study examined verbal and non‐verbal features of mother–infant shared book reading in Australia during the first year of life and explored the relationship between these features and infant cognition. Mother–infant dyads were observed in this cross‐sectional study reading an unfamiliar book in a laboratory setting when infants were aged 6 months (n = 17), 9 months (n = 14), or 12 months (n = 17). High frequency maternal behaviours coded from video were the production of attention attracting behaviours, immediate talk, and verbal encouragement to maintain infant book engagement. Few significant relationships were found for infant problem‐solving scores. Infant communication scores were however associated with non‐immediate talk at 6 months, maternal questions at 9 months, and non‐book related talk at 12 months. Shared book reading provides opportunities for verbal responsiveness and literacy engagement which likely serve as an important vehicle for facilitating early cognitive development. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of multidirectional elastic tape on pain and function in individuals with lateral elbow tendinopathy. Study Design: Randomised crossover trial. Setting: Biomechanics laboratory. Subjects: 27 participants (11 females, mean (SD) age: 48.6 (11.9) years) with clinically diagnosed lateral elbow tendinopathy of at least six weeks' duration. Interventions: Tensioned multidirectional elastic tape applied over the wrist, compared to control tape (untensioned), and no tape conditions. Main measures: Pain-free grip strength and pressure pain threshold were recorded at three timepoints for each condition: baseline, post-application, and following an exercise circuit. Change scores were calculated as the post-application or post-exercise value minus baseline. Repeated-measure analyses of variance were used to examine differences between conditions. Results: There were no statistically significant differences in pain-free grip strength between conditions (flexed position: F2,52 = 0.02, p = 0.98; extended position: F2,52 = 2.26, p = 0.12) or across timepoints (post-application vs post-exercise) (flexed position: F1,26 = 0.94, p = 0.34; extended position: F1,26 = 0.79, p = 0.38). Seven participants (26%) increased pain-free grip strength above the minimal detectable change following application of multidirectional elastic tape. There were no statistically significant differences in pressure pain threshold between conditions (affected lateral epicondyle: F1.51,39.17 = 0.54, p = 0.54) or across timepoints (affected lateral epicondyle: F1,26 = 0.94, p = 0.34). Conclusion: Tensioned multidirectional elastic tape may not immediately improve pain-free grip strength or pressure pain threshold in our lateral elbow tendinopathy population; however, individual variation may exist. [ABSTRACT FROM AUTHOR]

Background: The oral health of many older Australians is poor and associated with many systemic health problems. However, nurses often have a limited understanding of the importance of oral healthcare for older people. This study aimed to investigate Australian nursing students' perception, knowledge, and attitude toward providing oral healthcare for older people and associated factors. Methods: A cross-sectional study was conducted among final year nursing students studying at accredited nursing programs using an online self-reported 49-item survey. The data were analysed using univariate and bivariate analysis (t-test, ANOVA, Spearman's correlation test). Results: A total of 416 final-year nursing students from 16 accredited programs in Australia completed the survey. Mean scores showed that more than half of the participants felt they lacked confidence (55%, n = 229) and had limited knowledge about oral healthcare for older people (73%, n = 304); however, their attitude towards providing such care was favourable (89%, n = 369). A positive correlation was found between students' confidence in delivering oral healthcare to older people and their perceived knowledge (r = 0.13, p < 0.01). Results revealed a statistically significant positive association between students' experience in providing oral healthcare to older people and students' perception (t = 4.52, p < 0.001), knowledge (t = 2.87, p < 0.01), and attitude (t = 2.65, p < 0.01) mean scores in such care. Nearly 60% (n = 242) of participants received education/training in oral healthcare for older people at university, but this was often for less than one hour. Around 56% (n = 233) believed that the current nursing curriculum did not prepare them to provide effective oral healthcare to older people. Conclusion: Findings suggested a need for nursing curricula to be revised to include oral health education and clinical experience. Knowledge of evidence-based oral healthcare by nursing students may improve the quality of oral healthcare for older people. [ABSTRACT FROM AUTHOR]

Suicide is a global concern with rates in Australia continuing to increase. Effective post-suicidal care is critical for reducing persistent suicidal behaviour. One model of care is that adopted by Alfred Health, delivering a multidisciplinary, hybrid clinical and non-clinical (psycho-social support), assertive outreach approach. This study measured improvements in resilience and wellbeing, changes to distress and suicidal ideation at least 6-months post-discharge from care. Thirty-one consumers participated including a one-on-one interview to gather qualitative feedback. There was a significant change on all outcome measures with large effect sizes. Participants had significantly reduced suicidal ideation and distress and increased coping self-efficacy, hope and well-being. The qualitative findings indicated that a key component to recovery was the staff. Limitations included a low sample size, and broad time range of follow-up data collection. Providing assertive, multidisciplinary, collaborative and outreach-focused post-suicidal care can increase and sustain protective psychological factors and reduced suicidal ideation in most individuals. [ABSTRACT FROM AUTHOR]

Caring for an autistic child is associated with elevated stress, anxiety and depression. Although some data suggest that 'child' or 'carer' factors may moderate the severity of carer distress, relatively few international comparisons have been made, limiting the generalizability of previous findings. This study aimed to address this issue. A survey-based comparison was made of carers from three nations (Australia, Denmark, Greece), and the effects of demographic, child, and carer variables upon carer anxiety and depression were investigated. Only limited cross-nation consistency was found for nation, child, or carer variables and their effects upon carer anxiety or depression. The application of universal treatment models for carer anxiety and depression may be of differing value across nations. [ABSTRACT FROM AUTHOR]

Consistency of word production contributes to carers' ability to understand children's speech. Reports of the proportion of words produced consistently by typically developing preschool children, however, vary widely from 17% to 87%. This paper examines the quantitative (consistency count) and qualitative (e.g. phonemic analysis) characteristics of word consistency in 96 children aged 36–60 months. Children named 15 pictures twice, in separate trials, in the same assessment session. The mean consistency of the production for the whole group was 82%. Older children were more consistent than younger children. Girls were more consistent than boys. Words produced correctly in one trial and in error in another may indicate resolving error patterns. Words produced in error in two different ways provided useful evidence about the nature of inconsistent word production in typically developing children. The clinical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association between metabolic syndrome (MetS) and frailty, and determine whether co-existent MetS and frailty affect disability-free survival (DFS), assessed through a composite of death, dementia or physical disability. Design: Longitudinal study. Setting and Participants: Community-dwelling older adults from Australia and the United States (n=18,264) from "ASPirin in Reducing Events in the Elderly" (ASPREE) study. Measurements: MetS was defined according to American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (2018). A modified Fried phenotype and a deficit accumulation Frailty Index (FI) were used to assess frailty. Association between MetS and frailty was examined using multinomial logistic regression. Cox regression was used to analyze the association between MetS, frailty and DFS over a median follow-up of 4.7 years. Results: Among 18,264 participants, 49.9% met the criteria for MetS at baseline. Participants with Mets were more likely to be pre-frail [Relative Risk Ratio (RRR): 1.22; 95%Confidence Interval (CI): 1.14, 1.30)] or frail (RRR: 1.66; 95%CI: 1.32, 2.08) than those without MetS. MetS alone did not shorten DFS while pre-frailty or frailty alone did [Hazard Ratio (HR): 1.68; 95%CI: 1.45, 1.94; HR: 2.65; 95%CI:1.92, 3.66, respectively]. Co-existent MetS with pre-frailty/frailty did not change the risk of shortened DFS. Conclusions: MetS was associated with pre-frailty or frailty in community-dwelling older individuals. Pre-frailty or frailty increased the risk of reduced DFS but presence of MetS did not change this risk. Assessment of frailty may be more important than MetS in predicting survival free of dementia or physical disability. [ABSTRACT FROM AUTHOR]

Context: Ankle sprains are common among adolescent ballet dancers and may be attributed to inadequate ankle proprioception. Thus, a short period of training utilizing proprioceptive activities requires evaluation. Objective: To assess training conducted for 3 or 6 weeks on a textured-surface balance board using ankle proprioception scores for ballet dancers with and without chronic ankle instability, and with and without previous ankle sprain (PAS). Design: Intervention study. Setting: The Australian Ballet School. Participants: Forty-two ballet dancers, aged 14-18 years. Interventions: Dancers randomized into 2 groups: group 1 undertook 1 minute of balance board training daily for 3 weeks; group 2 undertook the same training for 6 weeks. Main Outcome Measures: Preintervention, Cumberland Ankle Instability Tool questionnaire data were collected, and PAS during the last 2 years was reported. Active ankle inversion movement discrimination ability was tested immediately pre and post intervention and at 3 and 4 weeks. Results: Ankle discrimination acuity scores improved over time for both groups, with a performance decline associated with the early cessation of training for group 1 ( P = .04). While dancers with PAS had significantly worse scores at the first test, before balance board training began (P< .01), no significant differences in scores at any test occasion were found between dancers with and without chronic ankle instability. A significantly faster rate of improvement in ankle discrimination ability score over the 4 test occasions was found for dancers with PAS (P = .002). Conclusions: Three weeks of textured balance board training improved the ankle discrimination ability of ballet dancers regardless of their reported level of chronic ankle instability and at a faster rate for dancers with PAS. Previous ankle sprain was associated with a lower level of ankle discrimination ability; however, following 3 weeks of balance board training, previously injured dancers had significantly improved their ankle discrimination acuity scores. [ABSTRACT FROM AUTHOR]

This Australian study compared perspectives of family quality of life (FQOL) of parents of preschool children attending early childhood intervention services (ECIS) with parents of school‐aged children with disability. It examined the relationships between disability‐related services, parent occupations, and FQOL. Two mixed‐methods studies with 122 participants and 24 in‐depth interviews were conducted. The first study included 72 parents attending ECIS. The second study included 50 parents of school‐aged children with disability. The quantitative aspect (N = 122) used the Beach Center FQOL survey and a demographic questionnaire. Twelve semistructured interviews were conducted for each study. Spearmann's Rho correlations for quantitative data analysis and thematic analysis for qualitative data were used for each study. A two‐way analysis of variance along with a qualitative comparative analysis were conducted to compare the findings from both studies. Results indicated lower scores on FQOL in parents with school‐aged children when compared with the ECIS group. Loss of work, lack of time for caregiver health, lack of respite, and interim residential care had detrimental impacts on parents' long‐term well‐being. Based on the results, it can be concluded that the hardships and challenges of caregiving increase as the child gets older; however, positive adaptations, beliefs, and positive transformations help FQOL. Family‐centered care and supportive practitioners assist FQOL and are highly recommended. [ABSTRACT FROM AUTHOR]

Purpose: The ability to produce expository discourse (the use of language to convey information) is important for classroom participation and access to the curriculum, particularly during the middle school years. This study investigated the spoken expository discourse skills of students with reading comprehension (RC) difficulties compared to their peers with average reading skills. Method: In this study, we administered a modified favourite game or sport (M-FGS) task developed by Heilmann and Malone to 48 students who were in their fifth year of schooling (9.33 − 11.11 years of age). Expository language samples were transcribed and analysed on measures of (a) microstructure: syntax (MLU in words) and vocabulary (number of different words [NDW]); and (b) macrostructure (Expository Scoring Scheme [ESS]). Result: Compared to their peers with average RC skills, students with RC difficulties demonstrated significant difficulties at the micro- and macro-structure levels. Subgroup analysis revealed the importance of spoken language comprehension proficiency (at text level) for expository discourse skills. Conclusion: The results from this small-scale investigation demonstrated the usefulness of the M-FGS task in describing challenges in expository discourse of students with RC difficulties, with clear implications for intervention. [ABSTRACT FROM AUTHOR]

Smoking is disproportionately prevalent among Aboriginal and Torres Strait Islander Australian peoples, with 39% of Indigenous Australians aged over 15 years smoking daily. Efforts to reduce the prevalence include culturally focused media campaigns, designed through community consultation, that highlight the need to determine how such health messaging is perceived by smokers. This study aimed to examine Indigenous Australian smokers' reactions to a culturally focused anti-smoking mass media campaign. Intercept surveying across health services and events recorded demographics, smoking status, quit attempts, smoking health effects, anti-smoking campaign recall, social support, and campaign reactions. Participants rated four different campaign images in five domains: (1) whether it made them stop and think; (2) personal relevance; (3) believability of design and message; (4) prompting concern about smoking; and (5) motivation towards quitting. Cluster analysis was used to identify smoker types. Smoking health effects knowledge was high, and did not differ by quit readiness, attempts, or social support. Cessation support access was higher among those with greater readiness to quit. Social smoking behaviour and confidence to support others quitting did not significantly differ between participants, however importance of others quitting did. Quit readiness, attempts, and social support were associated with reaction to campaign design, but not message recall. Four types of smokers were identified using smoking characteristics, who differed in campaign message reactions. Culturally focused anti-smoking media can benefit from exploring how smoker types can be used to differentiate messaging by smokers' profile characteristics, to support mass media smoking cessation efforts. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of match-start time and days relative to match compared with the habitual sleep characteristics of elite Australian Football (AF) players. Methods: 45 elite male AF players were assessed during the preseason (habitual) and across 4 home matches during the season. Players wore an activity monitor the night before (-1), night of (0), 1 night after (+1), and 2 nights (+2) after each match and completed a self-reported rating of sleep quality. A 2-way ANOVA with Tukey post hoc was used to determine differences in sleep characteristics between match-start times and days relative to the match. Two-way nested ANOVA was conducted to examine differences between competition and habitual phases. Effect size ± 90% confidence interval (ES ± 90% CI) was calculated to quantify the magnitude of pairwise differences. Results: Differences observed in sleep-onset latency (ES = 0.11 ± 0.16), sleep rating (ES = 0.08 ± 0.14), and sleep duration (ES = 0.08 ± 0.01) between competition and habitual periods were trivial. Sleep efficiency was almost certainly higher during competition than habitual, but this was not reflected in the subjective rating of sleep quality. Conclusions: Elite AF competition does not cause substantial disruption to sleep characteristics compared with habitual sleep. While match-start time has some impact on sleep variables, it appears that the match itself is more of a disruption than the start time. Subjective ratings of sleep from well-being questionnaires appear limited in their ability to accurately provide an indication of sleep quality. [ABSTRACT FROM AUTHOR]

Frontal plane postures during the ultimate step of sidestepping are linked to increased anterior cruciate ligament injury risk. However, there is a lack of research detailing the kinematic strategies present in the penultimate step. This study, therefore, investigated penultimate and ultimate step kinematics of planned sidestepping (pSS) and unplanned sidestepping (upSS) to further understand the effect of planning time on known ultimate step kinematic and kinetic differences. Sixty male amateur Australian Rules football players performed three trials of straight‐line running (RUN), pSS, and upSS in a randomized order. Mediolateral foot placement and three‐dimensional joint kinematics for the knee, pelvis, and trunk were measured at final foot contact of the penultimate step and initial foot contact of the ultimate step. Peak knee moments were measured during the weight acceptance phase of the ultimate step. In pSS, at the penultimate step final foot contact, the support foot was placed across the midline of the center of mass, in the frontal plane, contralateral to the sidestep direction. Greater trunk lateral flexion toward the sidestep direction and greater negative pelvic lateral tilt were observed in pSS compared with upSS and RUN. Differences between pSS and upSS frontal plane kinematics at penultimate step final foot contact suggest preparatory reorientation strategies are likely constrained by the amount of planning time available. As there are clear differences in preparatory kinematics, we recommend that planning time be considered when training and assessing sidestepping maneuvers and planned and unplanned maneuvers not be treated as interchangeable skills. [ABSTRACT FROM AUTHOR]

This paper presents findings from the evaluation of an Australian trial of self‐managed home aged care. The self‐management model was codesigned by advocacy organisation COTA Australia, consumers and service providers. The primary aim of the evaluation was to examine whether self‐management improved consumers' perceptions of their choice, control, and wellbeing. The secondary aim was to examine whether provider prior experience with self‐managed packages significantly influenced consumers' perceptions of choice, control and wellbeing, thereby confounded trial effects. A pre‐test post‐test quasi‐experimental design and mixed‐methods design were used to collect data over nine months in 2018–2019. The pre‐trial methods and findings have been published. The post‐trial evaluation replicated the pre‐trial data collection method of an online survey (n = 60) and semi‐structured telephone interviews with consumers (n = 9), family carers (n = 13), and consumers and carers jointly (n = 2), totalling 24 interviews. Semi‐structured telephone interviews were also conducted with CEOs and senior managers from each of the seven providers (n = 14). Three providers had prior experience supporting self‐management. Parametric and non‐parametric tests examined the statistical data. Qualitative data were analysed thematically and framed according to self‐determination principles and ecological systems theory. Both datasets demonstrated that consumers reported greater choice and control at post‐trial than pre‐trial. This finding was not affected by providers' prior experience with self‐management; therefore, it was not a confounding factor. Participants reported improved wellbeing in interviews, however this was not reinforced statistically. Key desirable features of self‐management included greater autonomy and control over spending, recruiting support staff and paying lower administration fees. There was no evidence of increased risks or fraud. The research limitations included a small sample size, convenience sampling with providers recruiting interview participants, no control group and differences in trial implementation. The findings support the expansion of self‐management opportunities and more comprehensive evaluations that use mixed methods. [ABSTRACT FROM AUTHOR]

Introduction: Some chiropractors seem to have an inflated belief in the powers of spinal manipulation (SMT), for example aiming at preventing future spinal degeneration and health problems, activities that are without supporting evidence. Non-evidenced health beliefs have been shown to be associated with a tendency toward magical thinking. Holding such beliefs about SMT is associated with a limitless scope of practice (LLSoP). Recent studies have shown that "chiropractic conservatism" (ChiroCon) is also associated with such approaches. We wanted to understand ChiroCon and these attitudes toward SMT by exploring three different factors: intolerance to uncertainty, academic achievement, and tendency toward magical thinking and how they relate to ChiroCon and LLSoP. Method: A cross-sectional survey of 243 chiropractic students from an Australian chiropractic program was conducted in May 2020. Students answered a questionnaire involving a patient case-scenario for LLSoP, levels of ChiroCon, validated questionnaires on (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. LLSoP was defined as wanting to treat with SMT a 5-year-old asymptomatic child for future (i) Musculoskeletal (MSK) problems and/or (ii) Non-musculoskeletal diseases. Logistic regression models were used to confirm if there was an association between ChiroCon and LLSoP and to explore associations between LLSoP and (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. We repeated the same analyses using ChiroCon as the outcome variable. Results: We confirmed that chiropractic students in the more extreme ChiroCon group were more likely to want to prevent future spinal disorders in an asymptomatic 5-year-old child as compared to those with lower levels (OR = 3.9, (95%CI 1.97–7.72). This was also the case for the prevention of future diseases in the same child (OR = 6.9, (95%CI 3.11–15.06). Of the three predictor variables, magical belief was positively associated with both ChiroCon and LLSoP. Conclusion: Not surprisingly, ChiroCon is closely related to LLSoP and both were linked to magical thinking. Therefore, the questionnaire 'Magical Health Beliefs' could be a useful instrument to screen future chiropractic students to prevent a mismatch between student and institution. Depending on the outlook of the school, some schools would welcome these students, whereas other institutions would want to avoid them in their education program. [ABSTRACT FROM AUTHOR]

For undergraduate nursing students, an integral mode of learning is their clinical placements. Learning within the clinical setting is influenced by factors such as the facilitators, peers, unit, or department the student is placed on. What is not known is the role of a social context that is grounded in Self‐Determination Theory and how this influences the development of therapeutic relationship skills among undergraduate nursing students. The aim of this study was to examine the role of autonomy support in the professional learning of undergraduate nursing students. This study employed a two‐group pre‐test and post‐test design, with undergraduate nursing students placed in either an autonomy‐supportive group or a comparison group in an Australian context. Therapeutic relationship skills were assessed at the beginning and end of their compulsory mental health clinical placement. Participants were 210 (n = 210) Australian undergraduate nursing students. Using a tertile split, 140 students were placed into one of two groups based on their perception of autonomy support at the post‐test time point. Pre‐ and post‐test therapeutic relationship data were collected for both groups. A repeated measures analysis of variance was used to examine whether engagement in different clinical placements would illicit significant differences in therapeutic relationship skills. Undergraduate nursing students who were engaged in the autonomy‐supportive setting had significantly higher scores associated with the therapeutic relationship subscales: Positive Collaboration and Positive Clinical Input. The importance of the social context is underscored, which is strongly influenced by the educational leader, typically referred to as a nurse facilitator. [ABSTRACT FROM AUTHOR]

High altitude exposure can increase resting metabolic rate (RMR) and induce weight loss in obese populations, but there is a lack of research regarding RMR in athletes at moderate elevations common to endurance training camps. The present study aimed to determine whether 4 weeks of classical altitude training affects RMR in middle-distance runners. Ten highly trained athletes were recruited for 4 weeks of endurance training undertaking identical programs at either 2200m in Flagstaff, Arizona (ALT, n = 5) or 600m in Canberra, Australia (CON, n = 5). RMR, anthropometry, energy intake, and hemoglobin mass (Hbmass) were assessed pre- and posttraining. Weekly run distance during the training block was: ALT 96.8 ± 18.3km; CON 103.1 ± 5.6km. A significant interaction for Time*Group was observed for absolute (kJ.day-1) (F-statistic, p-value: F(1,8)=13.890, p = .01) and relative RMR (F(1,8)=653.453, p = .003) POST-training. No significant changes in anthropometry were observed in either group. Energy intake was unchanged (mean ± SD of difference, ALT: 195 ± 3921kJ, p = .25; CON: 836 ± 7535kJ, p = .75). A significant main effect for time was demonstrated for total Hbmass (g) (F(1,8)=13.380, p = .01), but no significant interactions were observed for either variable [Total Hbmass (g): F(1,8)=1.706, p = .23; Relative Hbmass (g⋅kg-1): F(1,8)=0.609, p = .46]. These novel findings have important practical application to endurance athletes routinely training at moderate altitude, and those seeking to optimize energy management without compromising training adaptation. Altitude exposure may increase RMR and enhance training adaptation,. During training camps at moderate altitude, an increased energy intake is likely required to support an increased RMR and provide sufficient energy for training and performance. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of a change in training environment on the sleep characteristics of elite Australian Rules football (AF) players. Methods: In an observational crossover trial, 19 elite AF players had time in bed (TIB), total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO) assessed using wristwatch activity devices and subjective sleep diaries across 8-d home and camp periods. Repeated-measures ANOVA determined mean differences in sleep, training load (session rating of perceived exertion [RPE]), and environment. Pearson product-moment correlations, controlling for repeated observations on individuals, were used to assess the relationship between changes in sleep characteristics at home and camp. Cohen effect sizes (d) were calculated using individual means. Results: On camp TIB (+34 min) and WASO (+26 min) increased compared with home. However, TST was similar between home and camp, significantly reducing camp SE (-5.82%). Individually, there were strong negative correlations for TIB and WASO (r = -.75 and r = -.72, respectively) and a moderate negative correlation for SE (r = -.46) between home and relative changes on camp. Camp increased the relationship between individual s-RPE variation and TST variation compared with home (increased load r = -.367 vs .051, reduced load r = .319 vs -.033, camp vs home respectively). Conclusions: Camp compromised sleep quality due to significantly increased TIB without increased TST. Individually, AF players with higher home SE experienced greater reductions in SE on camp. Together, this emphasizes the importance of individualized interventions for elite team-sport athletes when traveling and/or changing environments. [ABSTRACT FROM AUTHOR]

Purpose: To compare development and variations in body composition of early-, mid-, and late-career professional Australian Football (AF) players over 3 successive seasons. Methods: Regional and total-body composition (body mass [BM], fat mass [FM], fat-free soft-tissue mass [FFSTM], and bone mineral content [BMC]) were assessed 4 times, at the same time of each season--start preseason (SP), end preseason (EP), midseason (MS), and end season (ES)--from 22 professional AF players using pencil-beam dual-energy X-ray absorptiometry. Nutritional intake for each player was evaluated concomitantly using 3-d food diaries. Players were classified according to their age at the beginning of the observational period as either early- (<21 y, n = 8), mid- (21 to 25 y, n = 9), or late- (>25 y, n = 5) career athletes. Results: Early-career players had lower FFSTM, BMC, and BM than mid- and late-career throughout. FM and %FM had greatest variability, particularly in the early-career players. FM reduced and FFSTM increased from SP to EP, while FM and FFSTM decreased from EP to MS. FM increased and FFSTM decreased from MS to ES, while FM and FFSTM increased during the off-season. Conclusions: Early-career players may benefit from greater emphasis on specific nutrition and resistance-training strategies aimed at increasing FFSTM, while all players should balance training and diet toward the end of season to minimize increases in FM. [ABSTRACT FROM AUTHOR]

Instrumented measurements of postural control provide a more accurate insight into the motor development of children with autism. This study aimed to identify postural control deficits in autistic children during quiet standing before and after transient locomotor task. It was hypothesized that the parameters that characterize the trajectory of center of foot pressure (COP) displacement would be higher in autistic children compared to typically developing children. Sixteen autistic children aged 6–10 but without a comorbidity diagnosis, were enrolled in the study group. The control group comprised 16 typically developing peers. The assessment of the transitional task comprised four different conditions: unperturbed and perturbed transition, stepping up, and stepping down tasks. Analysis of the COP signal was carried out for three distinct phases, i.e., phase 1 – quiet standing before step initiation, phase 2 – transit, and phase 3 - quiet standing until measurement completion. The two-way ANOVA with a 2 × 4 factorial design (group × testing condition) revealed a group effect on all posturographic variables in the antero-posterior and medio-lateral directions of phase 1 and in the antero-posterior direction of phase 3. The Bonferroni post-hoc test showed the means of all those variables were significantly higher for the autistic than for typically developing children. Group allocation also had an effect on the time of transit and step length, which turned out to be significantly longer in autistic children compared to healthy peers. Autistic children show increased postural sway before and after transitional locomotor tasks compared to typically developing children. The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12621001113842; date registered: 23.08.2021). • Autistic children show postural control deficits before and after step initiation. • Autistic children take longer to complete a step than typically developing peers. • Posturography can be used to assess postural control in autistic children. [ABSTRACT FROM AUTHOR]

We investigated the effects of increasing physical activity (PA) and reducing sedentary behaviour (SB) of mental health professionals on their attitudes towards and practices in recommending more PA and less SB to their clients. A 4-week pre-post intervention trial was conducted involving 17 mental health professionals. The participants who increased their own physical activity during the intervention increased the frequency of recommending more PA (p = 0.009) and less SB (p = 0.005) to their clients. A relatively simple, low-cost intervention, consisting of group behaviour change counselling, goal setting and positive feedback, may improve the practices of mental health professionals. Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1972189. [ABSTRACT FROM AUTHOR]

Oral narrative assessments are important for diagnosis of language disorders in school-age children so scoring needs to be reliable and consistent. This study explored the impact of training on the variability of story grammar scores in children's oral narrative assessments scored by multiple raters. Fifty-one speech pathologists and 19 final-year speech pathology students attended training workshops on oral narrative assessment scoring and analysis. Participants scored two oral narratives prompted by two different story stimuli and produced by two children of differing ages. Demographic information, story grammar scores and a confidence survey were collected pre- and post-training. The total story grammar score changed significantly for one of the two oral narratives. A significant effect was observed for rater years of experience and the change in total story grammar scores post training, with undergraduate students showing the greatest change. Two story grammar elements, character and attempt, changed significantly for both stories, with an overall trend of increased element scores post-training. Confidence ratings also increased post-training. Findings indicated that training via an interactive workshop can reduce rater variability when using researcher-developed narrative scoring systems. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the nutrition knowledge of elite Australian athletes, and to obtain feedback from sports dietitians on the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaires' (PEAKS‐NQ) suitability. Methods: Sports dietitians from the National Institute Network across Australia recruited athletes to complete the online, 50‐item PEAKS‐NQ which contained two sections (General Nutrition and Sports Nutrition). Sports dietitians provided feedback on the PEAKS‐NQ using a 14‐item questionnaire (with two open‐ended items). The main outcome measures were nutrition knowledge score and tool suitability (usefulness, acceptability and feasibility) scores. For knowledge scores, independent t‐tests, ANOVA and Chi‐square tests were used to evaluate differences between groups. Suitability was evaluated using descriptive statistics. Results: Twelve sports dietitians from the National Institute Network in Australia recruited a convenience sample of 240 athletes (21.3 ± 4.3 years, 63.5% female, 63.3% competed internationally). Athletes scored 70.7 ± 10.5%, with better general vs sports nutrition knowledge. Females had higher overall scores (P <.001) with no differences for age or sport played. University‐educated athletes scored higher than non‐tertiary educated athletes (P =.004). Knowledge gaps were identified in fats (role and food sources), recovery nutrition and managing body composition. Sports dietitians rated suitability of PEAKS‐NQ positively with complete agreement on 8 of 12 items. Conclusions: Athletes have greater understanding of general nutrition compared to sports nutrition concepts and may benefit from education on applying nutrition in sports‐specific contexts. Sports dietitians' responses showed PEAKS‐NQ was a highly acceptable, feasible and useful measure. [ABSTRACT FROM AUTHOR]

Training load (TL) is monitored with the aim of making evidence-based decisions on appropriate loading schemes to reduce injuries and enhance team performance. However, little is known in detail about the variables of load and methods of analysis used in high-level football. Therefore, the aim of this study was to provide information on the practices and practitioners' perceptions of monitoring in professional clubs. Eighty-two high-level football clubs from Europe, the United States, and Australia were invited to answer questions relating to how TL is quantified, how players' responses are monitored, and their perceptions of the effectiveness of monitoring. Forty-one responses were received. All teams used GPS and heart-rate monitors during all training sessions, and 28 used rating of perceived exertion. The top-5-ranking TL variables were acceleration (various thresholds), total distance, distance covered above 5.5 m/s, estimated metabolic power, and heart-rate exertion. Players' responses to training are monitored using questionnaires (68% of clubs) and submaximal exercise protocols (41%). Differences in expected vs actual effectiveness of monitoring were 23% and 20% for injury prevention and performance enhancement, respectively (P < .001 d = 1.0-1.4). Of the perceived barriers to effectiveness, limited human resources scored highest, followed by coach buy-in. The discrepancy between expected and actual effectiveness appears to be due to suboptimal integration with coaches, insufficient human resources, and concerns over the reliability of assessment tools. Future approaches should critically evaluate the usefulness of current monitoring tools and explore methods of reducing the identified barriers to effectiveness. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the seasonal changes in body composition, nutrition, and upper-body (UB) strength in professional Australian Football (AF) players. The prospective longitudinal study examined changes in anthropometry (body mass, fat-free soft-tissue mass [FFSTM], and fat mass) via dual-energy X-ray absorptiometry 5 times during an AF season (start preseason, midpreseason, start season, midseason, end season) in 45 professional AF players. Dietary intakes and strength (bench press and bench pull) were also assessed at these time points. Players were categorized as experienced (>4 y experience, n = 23) or inexperienced (<4 y experience, n = 22). Fat mass decreased during the preseason but was stable through the in-season for both groups. %FFSTM was increased during the preseason and remained constant thereafter. UB strength increased during the preseason and was maintained during the in-season. Changes in UB FFSTM were related to changes in UB-strength performance (r= .37-.40). Total energy and carbohydrate intakes were similar between the experienced and inexperienced players during the season, but there was a greater ratio of dietary fat intake at the start-preseason point and an increased alcohol, reduced protein, and increased total energy intake at the end of the season. The inexperienced players consumed more fat at the start of season and less total protein during the season than the experienced players. Coaches should also be aware that it can take >1 y to develop the appropriate levels of FFSTM in young players and take a long-term view when developing the physical and performance abilities of inexperienced players. [ABSTRACT FROM AUTHOR]

Purpose: High-performance tennis environments aim to prepare athletes for competitive demands through simulated-match scenarios and drills. With a dearth of direct comparisons between training and tournament demands, the current investigation compared the perceptual and technical characteristics of training drills, simulated match play, and tournament matches. Methods: Data were collected from 18 high-performance junior tennis players (gender: 10 male, 8 female; age 16 ± 1.1 y) during 6 + 2 drill-based training sessions, 5 ± 2 simulated match-play sessions, and 5 ± 3 tournament matches from each participant. Tournament matches were further distinguished by win or loss and against seeded or nonseeded opponents. Notational analysis of stroke and error rates, winners, and serves, along with rating of perceived physical exertion (RPE) and mental exertion was measured postsession. Results: Repeated-measures analyses of variance and effect-size analysis revealed that training sessions were significantly shorter in duration than tournament matches (P < .05, d = 1.18). RPEs during training and simulated match-play sessions were lower than in tournaments (P >.05, d = 1.26, d = 1.05, respectively). Mental exertion in training was lower than in both simulated match play and tournaments (P > .05; d- 1.10, d = 0.86, respectively). Stroke rates during tournaments exceeded those observed in training (P < .05, d = 3.41) and simulated-match-play (P < .05, d = 1.22) sessions. Furthermore, the serve was used more during tournaments than simulated match play (P < .05, d = 4.28), while errors and winners were similar independent of setting (P > .05, d < 0.80). Conclusions: Training in the form of drills or simulated match play appeared to inadequately replicate tournament demands in this cohort of players. Coaches should be mindful of match demands to best prescribe sessions of relevant duration, as well as internal (RPE) and technical (stroke rate) load, to aid tournament preparation. [ABSTRACT FROM AUTHOR]

This study investigated the ergogenic effects of a commercial energy drink (Red Bull) or an equivalent dose of anhydrous caffeine in comparison with a noncaffeinated control beverage on cycling performance. Eleven trained male cyclists (31.7 ± 5.9 y 82.3 ± 6.1 kg, ...O2max = 60.3 ± 7.8 mL ⋅ kg-1 ⋅ min-1) participated in a double-blind, placebo-controlled, crossover-design study involving 3 experimental conditions. Participants were randomly administered Red Bull (9.4 mL/kg body mass [BM] containing 3 mg/kg BM caffeine), anhydrous caffeine (3 mg/kg BM given in capsule form), or a placebo 90 min before commencing a time trial equivalent to 1 h cycling at 75% peak power output. Carbohydrate and fluid volumes were matched across all trials. Performance improved by 109 ± 153 s (2.8%, P = .039) after Red Bull compared with placebo and by 120 ± 172 s (3.1%, P = .043) after caffeine compared with placebo. No significant difference (P > .05) in performance time was detected between Red Bull and caffeine treatments. There was no significant difference (P > .05) in mean heart rate or rating of perceived exertion among the 3 treatments. This study demonstrated that a moderate dose of caffeine consumed as either Red Bull or in anhydrous form enhanced cycling time-trial performance. The ergogenic benefits of Red Bull energy drink are therefore most likely due to the effects of caffeine, with the other ingredients not likely to offer additional benefit. [ABSTRACT FROM AUTHOR]

Purpose: A 2014 study found that the Lumbar Spine Instability questionnaire predicts response to two different types of exercise therapy. This is the first decision tool that has predicted response to exercise for chronic low back pain. The objective of this study was to evaluate the Lumbar Spine Instability questionnaire using Rasch analysis. Methods: Baseline data from patients included in a randomized controlled trial with chronic non-specific low back pain were included. Rasch Measurement Theory was used to assess the ordering of items along a common scale, data-to-model fit, Person Separation Index, unidimensionality and Differential Item Functioning. Results: Responses from 172 patients (102 females) underwent Rasch analysis. All Lumbar Spine Instability questionnaire items had fit residuals between ± 2.5 and Chi-Square values were non-significant with Bonferroni corrections. The Lumbar Spine Instability questionnaire demonstrated a Person Separation Index of 0.64, which is below the recommended cut-off of 0.7. Differential Item Functioning by different pain levels was identified for one item. Conclusion: The Lumbar Spine Instability questionnaire was found to be unidimensional, suggesting that the use of a summary score is appropriate. However, the low Person Separation Index value suggests that more items may be needed to increase the questionnaire's ability to discriminate among individuals with high and low clinical instability. [ABSTRACT FROM AUTHOR]

Purpose: To quantify activity profiles in approximately 5-min periods to determine if the intensity of rugby league match play changes after the most intense period of play and to determine if the intensity of activity during predefined periods of match play differ between successful and less-successful teams playing at an elite standard. Methods: Movement was recorded using a MinimaxX global positioning system (GPS) unit sampling at 10 Hz during 25 rugby league matches, equating to 200 GPS files. Data for each half of match play were separated into 8 equal periods. These periods represented the most intense phase of match play (peak period), the period after the most intense phase of match play (subsequent period), and the average demands of all other periods in a match (mean period). Two rugby league teams were split into a high-success and a low-success group based on their success rates throughout their season. Results: Compared with their less-successful counterparts, adjustables and hit-up forwards from the high-success team covered less total distance (P < .01) and less high-intensity-running distance (P < .01) and were involved in a greater number of collisions (P < .01) during the mean period of match play. Conclusions: Although a greater number of collisions during match play is linked with a greater rate of success, greater amounts of high-intensity running and total distance are not related to competitive success in elite rugby league. These results suggest that technical and tactical differences, rather than activity profiles, may be the distinguishing factor between successful and less-successful rugby league teams. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the relationship between repeated high-intensity-effort (RHIE) ability and selected physical qualities in rugby league players. Methods: Sixteen rugby league players underwent measurements of upper-body strength (4-repetition-maximum [4RM] bench press, weighted chin-up, weighted dips), upper-body muscle endurance (body-mass maximum-repetition chin-up, body-mass maximum-repetition dips), lower-body strength (4RM squat), estimated maximal aerobic power (multistage fitness test), and RHIE ability. The RHIE-ability test consisted of 1 x 10-m sprint, 3 x full-contact 1-on-1 tackling efforts, and a 30-m jog recovery. Players performed 4 repetitions of the test, with each repetition completed in 40 second. During the RHIE test, player speed was evaluated with a 10-m sprint effort while the movement of players was recorded using a wearable micro-technology device. 2D Player Load was used to quantify the collision component of the test. Results: Speed decrement was lower for the first- (-2.4% ± 1.0%) than the second-grade (-4.7% ± 2.1%) players. Players with greater initial speed had a higher average speed over the 4 sprints (r = .75), while players with greater maximum-repetition dips maintained a higher 2D Player Load (r = .76). Conclusions: These findings demonstrate a relationship between well-developed acceleration and upper-body muscle-endurance qualities and RHIE ability in rugby league players. Training programs designed to develop acceleration and upper-body muscle endurance are likely to improve RHIE ability. [ABSTRACT FROM AUTHOR]

Context: Accelerometer peak impact accelerations are being used to measure player physical demands in contact sports. However, their accuracy to do so has not been ascertained. Purpose: To compare peak-impact-acceleration data from an accelerometer contained in a wearable tracking device with a 3-dimensional motion-analysis (MA) system during tackling and bumping. Methods: Twenty-five semielite rugby athletes wore a tracking device containing a 100-Hz triaxial accelerometer (MinimaxX S4, Catapult Innovations, Australia). A single retroreflective marker was attached to the device, with its position recorded by a 12-camera MA system during 3 physical-collision tasks (tackle bag, bump pad, and tackle drill; N = 625). The accuracy, effect size, agreement, precision, and relative errors for each comparison were obtained as measures of accelerometer validity. Results: Physical-collision peak impact accelerations recorded by the accelerometer overestimated (mean bias 0.60 g) those recorded by the MA system (P < .01). Filtering the raw data at a 20-Hz cutoff improved the accelerometer's relationship with MA data (mean bias 0.01 g; P > .05). When considering the data in 9 magnitude bands, the strongest relationship with the MA system was found in the 3.0-g or less band, and the precision of the accelerometer tended to reduce as the magnitude of impact acceleration increased. Of the 3 movements performed, the tackle-bag task displayed the greatest validity with MA. Conclusions: The findings indicate that the MinimaxX S4 accelerometer can accurately measure physical-collision peak impact accelerations when data are filtered at a 20-Hz cutoff frequency. As a result, accelerometers may be useful to measure physical collisions in contact sports. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the variation in training demands, physical performance, and player well-being across a women's soccer season. Methods: Seventeen elite female players wore GPS tracking devices during every training session (N = 90) throughout 1 national-league season. Intermittent high-speed-running capacity and 5-, 15-, and 25-m-sprint testing were conducted at the beginning of preseason, end of preseason, midseason, and end of season. In addition, subjective well-being measures were self-reported daily by players over the course of the season. Results: Time over 5 m was lowest at the end of preseason (mean 1.148 s, SE 0.017 s) but then progressively deteriorated to the end of the season (P < .001). Sprint performance over 15 m improved by 2.8% (P = .013) after preseason training, while 25-m-sprint performance peaked at midseason, with a 3.1% (P = .05) improvement from the start of preseason, before declining at the end of season (P = .023). Training demands varied between phases, with total distance and high-speed distance greatest during preseason before decreasing (P < .001) during the early- and late-season phases. Endurance capacity and well-being measures did not change across training phases. Conclusions: Monitoring training demands and subsequent physical performance in elite female soccer players allow coaches to ensure that training periodization goals are being met and related positive training adaptations are being elicited. [ABSTRACT FROM AUTHOR]

The current study examined the acute and longitudinal effects of regular away travel on training load (TL), player wellness, and injury surrounding competitive football (soccer) matches. Eighteen male professional football players, representing a team competing in the highest national competition in Australia, volunteered to participate in the study. Training loads, player well-ness and injury incidence, rate, severity, and type, together with the activity at the time of injury, were recorded on the day before, the day of, and for4d after each of the 27 matches of the 2012-13 season. This included 14 home and 13 away matches, further subdivided based on the midpoint of the season into early (1-13) and late competition (14-27) phases. While TLs were significantly greater on day 3 at home compared with away during the early competition phase (P = .0.3), no other significant effects of match location were identified (P > .05). Total TL and mean wellness over the 6 d surrounding matches and TL on day 3 were significantly reduced during the late compared with the early competition phase at home and away (P < .05). Although not significantly (P > .05), training missed due to injury was 60% and 50% greater during the late than during the early competition phase at home and away, respectively. In conclusion, no significant interactions between match location and competition phase were evident during the late competition phase, which suggests that away travel had negligible cumulative effects on the reduction in player wellness in the latter half of the season. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the reliability of the Reactive Strength Index (RSI) and jump-height (JH) performance from multiple drop heights in an elite population. Methods: Thirteen professional basketball players (mean ±SD age 25.8 ± 3.5 y, height 1.96 ± 0.07 m, mass 94.8 ± 8.2 kg) completed 3 maximal drop-jump attempts onto a jump mat at 4 randomly assigned box heights and 3 countermovement-jump trials. Results: No statistical difference was observed between 3 trials for both the RSI and JH variable at all the tested drop heights. The RSI for drop-jump heights from 20 cm resulted in a coefficient of variation (CV) = 3.1% and an intraclass correlation (ICC α) = .96, 40 cm resulted in a CV = 3.0% and an ICC α = .95, and 50 cm resulted in a CV = 2.1% and an ICC α = .99. The JH variable at the 40-cm drop-jump height resulted in the highest reliability CV = 2.8% and an ICC α = .98. Conclusion: When assessing the RSI the 20-, 40-, and 50-cm drop heights are recommended with this population. When assessing large groups it appears that only 1 trial is required when assessing the RSI variable from the 20, 40-, and 50-cm drop heights. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of prior knowledge of exercise duration on the pacing strategies employed during game-based activities. Methods: Twelve semiprofessional team-sport athletes (mean ± SD age 22.8 ± 2.1 y) participated in this study. Players performed 3 small-sided games in random order. In one condition (Control), players were informed that they would play the small-sided game for 12 min and then completed the 12-min game. In a 2nd condition (Deception), players were told that they would play the small-sided game for 6 minutes, but after completing the 6-min game, they were asked to complete another 6 min. In a 3rd condition (Unknown), players were not told how long they would be required to play the small-sided game, but the activity was terminated after 12 min. Movement was recorded using a GPS unit sampling at 10 Hz. Post hoc inspection of video footage was undertaken to count the number of possessions and the number and quality of disposals. Results: Higher initial intensities were observed in the Deception (130.6 ± 3.3 m/min) and Unknown (129.3 ± 2.4 m/min) conditions than the Control condition (123.3 ± 3.4 m/min). Greater amounts of high-speed running occurred during the initial phases of the Deception condition, and more low-speed activity occurred during the Unknown condition. A moderately greater number of total skill involvements occurred in the Unknown condition than the Control condition. Conclusions: These findings suggest that during game-based activities, players alter their pacing strategy based on the anticipated endpoint of the exercise bout. [ABSTRACT FROM AUTHOR]

This study compared the movement demands of players competing in matches from the elite Australian and European rugby league competitions. Methods: Global positioning system devices were used to measure 192 performances of forwards, adjustables, and outside backs during National Rugby League (NRL; n = 88) and European Super League (SL; n = 104) matches. Total and relative distances covered overall and at low (0-3.5 m/s), moderate (3.6-5 m/s), and high (>5 m/s) speeds were measured alongside changes in movement variables across the early, middle, and late phases of the season. Results: The relative distance covered in SL matches (95.8 ± 18.6 m/min) was significantly greater (P < .05) than in NRL matches (90.2 ± 8.3 m/min). Relative low-speed activity (70.3 ± 4.9 m/min vs 75.5 ± 18.9 m/min) and moderate-speed running (12.5 ± 3.3 m m/min vs 14.2 ± 3.8 m/min) were highest (P < .05) in the SL matches, and relative high-speed distance was greater (P < .05) during NRL matches (7.8 ± 2.1 m/min vs 6.1 ± 1.7 m/min). Conclusions: NRL players have better maintenance of high-speed running between the first and second halves of matches and perform less low- and moderate-speed activity, indicating that the NRL provides a higher standard of rugby league competition than the SL. [ABSTRACT FROM AUTHOR]

Non‐suicidal self‐injury (NSSI) is a major public health concern and is also associated with increased risk of suicide. The type of care people with NSSI receive at the hospital impacts their health outcomes. This study explored emergency department (ED) and mental health nurses' (MHNs) understanding, attitudes, empathy and confidence to work with people presenting with NSSI. ED and MHNs who belonged to either the College of Emergency Nursing Australasia (CENA) or the Australian College of Mental Health Nurses (ACMHN) were invited to complete an online survey through a group email from their college. One hundred and one nurses (56 ED and 45 MHNs) completed the survey. The results revealed that nurses from both groups had an accurate understanding of NSSI and had positive attitudes about patients who self‐injure. However, confidence was higher among MHNs. Greater knowledge of NSSI was correlated with increased confidence, positive attitudes and empathy. For mental health nurses, but not ED nurses, years of clinical practice was associated with nurses' confidence. In contrast, ED nurses with more than 10 years' experience were less confident in addressing NSSI than ED nurses with less experience. Issues that affect both ED and MHNs' knowledge, attitude, empathy and confidence to care for patients who self‐injure are multifactorial. Future education and training should focus on therapeutic interactions with people at risk of repeat NSSI. Further, more research is recommended to explore patients' perspectives of nurses' attitudes in care for people who self‐injure. [ABSTRACT FROM AUTHOR]

Aim: There is limited information on the snacking behaviour of Australian adults, and the role of snacking in the diet may depend on how it is defined. This study aimed to compare the dietary snacking behaviours and associated nutritional intake and body composition in Australian adults, using an objective vs a subjective definition for snacking. Methods: Cross‐sectional data were analysed from the 2011 to 2012 National Nutrition and Physical Activity Survey (n = 8361, 19+ years). Objective snacking was defined based on time of day between main meals. Subjective snacking was self‐reported by participants. Results: Using the objective definition, 88.2% of adults were snack consumers; where snacking contributed 20.0% (SD 20.0%) of total daily energy intake and 27.0% (SD 31.4%) of total daily discretionary energy. 41.3% (SD 37.1%) of snacking energy intake came from discretionary foods. Using the subjective definition, 98.5% of adults were snack consumers, where discretionary foods contributed 52.6% (SD 35.2%) of all snacking energy. The proportion of objective and subjective snacking energy from discretionary foods did not differ across body mass index groups. Conclusions: Objective snacking energy contributed more to core food groups than discretionary, was not associated with anthropometric measures, and contributed less to total discretionary energy than the evening meal. When snacking was defined subjectively, more than half of snacking energy was discretionary, suggesting that adults are more likely to perceive discretionary foods as snacks. Differences between snacking definitions means that associations between self‐reported snacking and diet or health outcomes, should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective study aimed to amass large data sets to enable statistical comparisons of communication outcomes for infants receiving cochlear implants (CIs) before 9 months of age compared to groups who received their first CI between 9 months and 3.5 years of age. Method: Speech perception scores and experienced clinicians’ observations were used to refine the Categories of Auditory Performance Index (CAPI), thus creating its revised version, namely, the CAPI-Revised (CAPI-R). Standardized and criterion-referenced language data were used to create the novel Categories of Linguistic Performance (CLIP). The association between CAPI-R and CLIP data at two time points post implant (at 2 years of device experience and at 5 years of age) was examined in a large unselected cohort stratified for age at first implant: before 9 months (Group 1), between 9 and 12 months (Group 2), between 13 and 18 months (Group 3), between 19 and 24 months (Group 4), between 25 and 30 months (Group 5), between 31 and 36 months (Group 6), and between 37 and 42 months (Group 7). Results: CAPI-R medians were 5 at 2 years of device experience, and 6 at 5 years of age. At 2 years of device experience, there was no significant difference in CAPI-R medians for children who received their first CI before 9 months compared to all other age-at-implant groups. At 5 years of age, a significantly better CAPI-R median was demonstrated by Group 1 (CI before 9 months) compared to Groups 4, 5, 6, and 7. CLIP medians were 3 at 2 years of device experience, and at 5 years of age. At 2 years device experience, and at 5 years of age, the Group 1 CLIP medians were significantly better than later age-atimplant groups. Conclusion: Median CAPI-R outcomes supported access to CIs before 18 months of age for speech perception, and median CLIP outcomes supported access to CIs before 9 months of age for optimum language development. [ABSTRACT FROM AUTHOR]

Purpose: A limitation of most rugby league time-motion studies is that researchers have examined the demands of single teams, with no investigations o f all teams in an entire competition. This study investigated the activity profiles and technical and tactical performances o f successful and less-successful teams throughout an entire rugby league competition. Methods: In total, 185 rugby league players representing 11 teams from a semiprofessional competition participated in this study. Global positioning system analysis was completed across the entire season. Video footage from individual matches was also coded via notational analysis for technical and tactical performance of teams. Results: Trivial to small differences were found among Top 4, Middle 4, and Bottom 4 teams for absolute and relative total distances covered and distances covered at low speeds. Small, nonsignificant differences (P = .054, ES = 0.31) were found between groups for the distance covered sprinting, with Top 4 teams covering greater sprinting distances than Bottom 4 teams. Top 4 teams made more meters in attack and conceded fewer meters in defense than Bottom 4 teams. Bottom 4 teams had a greater percentage o f slow play-the-balls in defense than Top 4 teams (74.8% ± 7.3% vs 67.2% ± 8.3%). Middle 4 teams showed the greatest reduction in high-speed running from the first to the second half (-20.4%), while Bottom 4 teams completed 14.3% more high-speed running in the second half than in the first half. Conclusion: These findings demonstrate that a combination of activity profiles and technical and tactical performance are associated with playing success in semiprofessional rugby league players. [ABSTRACT FROM AUTHOR]

Purpose: To compare the acute effects of back squats and power cleans on sprint performance. Methods: Thirteen elite junior rugby league players performed 20-m linear sprints before and 7 min after 2 different conditioning activities or 1 control condition. The conditioning activities included 1 set of 3 back squats or power cleans at 90% 1-repetition maximum. A 2 x 2 repeated-measures ANOVA was used to compare preconditioning and postconditioning changes in sprint performance. Results: Both the back-squat and power-clean conditioning activities demonstrated a potentiation effect as indicated by improved sprint time (back squat: P - .001, ES = -0.66; power cleans: P = .001, ES = -0.92), velocity (back squat: P = .001, ES = 0.63; power cleans: P = .001, ES = 0.84), and average acceleration over 20 m (back squat: P = .001, ES = 0.70; power cleans: P = .001, ES = * 00). No potentiation effect was observed after the control condition. Overall, the power clean induced a greater improvement in sprint time (P = .042, ES = 0.83), velocity (P = .047, ES = 1.17), and average acceleration (P = .05, ES = 0.87) than the back squat. Conclusions: Back-squat and power-clean conditioning activities both induced improvements in sprint performance when included as part of a potentiation protocol. However, the magnitude of improvement was greater after the power cleans. From a practical perspective, strength and conditioning coaches should consider using power cleans rather than back squats to maximize the performance effects of potentiation complexes targeting the development of sprint performance. [ABSTRACT FROM AUTHOR]

The importance of the flat serve in tennis is well documented, with an abundance of research evaluating the service technique of adult male players. Comparatively, the female and junior serves have received far less attention. Therefore, the aims of this study were to quantify the flat serve kinematics in elite prepubescent, pubescent, and postpubescent female tennis players. Full body, racket, and ball kinematics were derived using a 22-camera Vicon motion capture system. Racket velocity was significantly lower in the prepubescent group than in the two older groups. In generating racket velocity, the role of the serving arm appears to become more pronounced after the onset of puberty, whereas leg drive and "shoulder-over-shoulder" rotation mature even later in development. These factors are proposed to relate to strength deficits and junior players' intentions to reduce the complexity of the skill. Temporally, coupling perception (cues from the ball) and action (body movements) are less refined in the prepubescent serve, presumably reducing the "rhythm" (and dynamism) of the service action. Practically, there appears scope for equipment scaling to preserve kinematic relevance between the junior and senior serve and promote skill acquisition. [ABSTRACT FROM AUTHOR]

Prospective cohort. Patients referred to medical specialist outpatient clinics in Australian public hospitals often wait longer than the recommended timeframe for their first appointment. This study examines the use of advanced hand therapy practitioners to facilitate access to care for long-waitlisted patients with chronic hand conditions. To examine patient-reported function and satisfaction outcomes with advanced practice hand therapy. Data was collected from eight public hospital outpatient departments in Queensland, Australia. Patients with chronic hand conditions were screened from waitlists at each site and invited to participate in the hand therapy program while waiting to see a medical practitioner. A total of 1947 patients were screened from the waitlists, and 1116 patients completed advanced practice therapy. Patients completing hand therapy were older (P ≤.001) and more likely to have more than one diagnosis (P ≤.001). They reported a significant improvement in function using the Michigan Hand Questionnaire (P ≤.001) and demonstrated increased grip strength (left injuries P =.016, right injuries P =.001). Ninety-three percent were satisfied or highly satisfied with hand therapy care. Some variation in Michigan Hand Questionnaire scores was observed across different diagnoses, with those with carpal tunnel syndrome and trigger finger reporting the best outcomes. Advanced practice hand therapy for long-waitlisted patients with chronic hand conditions was associated with improvements in patient function and satisfaction. Further research is warranted to study the specific response of different diagnostic groups to intervention using this model of care. [ABSTRACT FROM AUTHOR]