In this older population with a high prevalence of hearing loss (39.4%), both a question about hearing and the HHIE-S appeared sufficiently sensitive and specific to provide reasonable estimates of hearing loss prevalence. Both could be recommended for use in epidemiological studies that aim to assess the magnitude of the burden caused by age-related sensory impairment but cannot measure hearing loss by audiometry.

Interventions aimed at reducing age-related hearing loss, particularly by reducing excessive work-related noise exposure, and the effective, timely treatment of ear-related infections, may all decrease the risk of tinnitus.

This study investigated the relationship between GPS variables measured in training and gameplay and injury occurrences in professional soccer. Nineteen professional soccer players competing in the Australian Hyundai A-League were monitored for 1 entire season using 5 Hz Global Positioning System (GPS) units (SPI-Pro GPSports) in training sessions and preseason games. The measurements obtained were total distance, high-intensity running distance, very-high-intensity running distance, new body load, and meters per minute. Noncontact soft tissue injuries were documented throughout the season. Players' seasons were averaged over 1- and 4-week blocks according to when injuries occurred. These blocks were compared with each other and with players' seasonal averages. Players performed significantly higher meters per minute in the weeks preceding an injury compared with their seasonal averages (+9.6 and +7.4% for 1- and 4-week blocks, respectively) (p < 0.01), indicating an increase in training and gameplay intensity leading up to injuries. Furthermore, injury blocks showed significantly lower average new body load compared with seasonal averages (-15.4 and -9.0% for 1- and 4-week blocks, respectively) (p < 0.01 and p = 0.01). Periods of relative underpreparedness could potentially leave players unable to cope with intense bouts of high-intensity efforts during competitive matches. Although limited by Fédération Internationale de Football Association regulations, the results of this study isolated 2 variables predicting soft tissue injuries for coaches and sports scientists to consider when planning and monitoring training.

Objective: To establish the rate of and reasons for cancellations of surgery on the scheduled day in an Australian hospital. Design: Prospective survey. Setting: Major metropolitan tertiary hospital, 13 May to 15 November 2002. Main outcome measures: Proportion of operations cancelled on the day of surgery, obtained each day from the operating theatre list and a separate list of additions and cancellations compiled on the day; reasons for cancellations from the cancellation list, extended or confirmed, as necessary, by questioning of bookings and ward staff, or members of the surgical team; estimated and actual duration of each operation and patient information from hospital clinical records. Results: 7913 theatre sessions were scheduled by 133 surgeons in the study period; 941 of these (11.9%) were cancelled on the day, including 724 of 5472 (13.2%) elective procedures on working weekdays. Main reasons for cancellation were: no theatre time due to over‐run of previous surgery (18.7%); no postoperative bed (18.1%); cancelled by patient (17.5%); and change in patient clinical status (17.1%). Procedural reasons (including patient not ready, no surgeon, list error, administrative cause, and communication failure) totalled 21.0%. Ear, nose and throat surgery experienced the most cancellations (19.6%), followed by cardiothoracic surgery (15.8%). Conclusions: There were five major reasons of similar magnitude for on‐the‐day surgery cancellations. We estimated that 60% of cancellations of elective procedures were potentially avoidable. Change of one factor leading to cancellation (eg, provision of more postoperative beds) is not likely to lead to improvement unless the other major factors are also tackled.

No abstract

Objective: To define health outcomes of whiplash associated disorders (WAD) at three months, six months, and two years after injury and to examine predictors of these outcomes. Design: Prospective cohort study. Setting: New South Wales, Australia. Subjects: People with compensable motor crash injuries who reported whiplash as one of their injuries. Interventions: None. Main outcome measures: Functional Rating Index (FRI), Short Form 36 (SF-36) at three months, six months, and two years after injury, ascertained by telephone interview. Results: At three months, 33.6% of the cohort was recovered (as defined by FRI(25), increasing marginally at six months (38.9% recovered), but more significantly at two years (51.7% recovered, p = 0.001). The mean physical component score of the SF-36 improved at each time point (p = 0.002), while the mean mental component score did not (p = 0.59). Predictors of recovery at two years (as defined by global perceived effect) included a lower FRI index at baseline (p = 0.001) and closure of the claim at two years (p = 0.02). Conclusion: Whiplash injury had a large effect on the health of this Australian cohort of whiplash sufferers, with only 50% of the cohort recovered at two years. Physical measures of health appear to improve over time, whereas mental measures of health did not. Despite this, this cohort is largely able to participate in activities and work at two years. Prevention of chronic disability may lie with concentration of resources to those who score highly on the FRI at baseline. In addition, chronic psychological ill health may be prevented by directing treatment to those with poor scores on sensitive measures of psychological ill health at baseline.

The ATOP is a psychometrically valid instrument for the measurement of treatment outcomes in Australian opioid treatment populations and can feasibly be implemented as part of routine clinical practice in specialist opioid treatment program clinics. The role of the ATOP to measure outcomes in other drug and alcohol treatment modalities requires exploration.

The Blue Mountains Hearing Study (BMHS) has shown that tinnitus affects one in three older Australians with 16% of cases describing severe annoyance. Among persons describing severe symptoms, 52% have sought professional help. We aim to identify factors associated with the severity of tinnitus in 2,015 persons aged over 54 years. Comprehensive questionnaires about hearing were administered. Air- (250-8000 Hz) and bone-conduction (500-4000 Hz) audiometric thresholds of both ears, together with transient evoked and spontaneous otoacoustic emissions, were measured. Factors predicting severity of tinnitus were assessed in Cox proportional hazard models. After multivariate adjustment, factors significantly associated with severe tinnitus were hearing loss (relative risk [RR] 2.9), dizziness (RR 2.0), head injury (RR 2.0), sinus and middle ear infections (RR 1.9), and mastoiditis (RR 3.9). Associations with mild tinnitus included age (RR 0.8), hearing loss (RR 1.4) and history of dizziness (RR 1.5), meningitis (RR 2.2), and migraine (RR 1.5). Knowledge of these factors could contribute to improved tinnitus management.