Andrew Murray

Major limitations in knowledge of physical activity guidelines among UK medical students revealed: implications for the undergraduate medical curriculum

Background Education of health professionals is a key element of the wider strategy to increase societys physical activity levels. To date, no study has directly assessed UK medical students’ knowledge of physical activity guidelines or their ability/willingness to prescribe exercise. Methods A questionnaire survey of final year medical students in Scottish Universities was conducted prior to a presentation on the current UK guidelines. Results Completed questionnaires (n=177) represented 37% of the final year cohorts. Physical inactivity was incorrectly perceived to be the least important risk factor to global mortality. 40% stated they were aware of current guidelines, but in a forced choice, 68% were able to correctly identify them for adults. In comparison, 97% correctly identified the UKs alcohol guidelines. 52% stated they felt adequately trained to give physical activity advice to the general public. Conclusions The medical students in this study underestimated the risk of physical inactivity, and did not know the physical activity guidelines as well as other health promotion guidelines. A large proportion remained unconfident about giving physical activity advice. Improved education of this group is required.

Why healthcare professionals should know a little about infographics

Infographics is an abbreviated term for an information graphic. Information is presented in a logical manner, similar to storytelling, using data visualisations, text and pictures.1 Statistically, the most successful infographics, in terms of number of ‘shares’ on social media, contain an average of 396 words2 and a combination of data visualisations (bar graphs, line graphs and pie charts) and illustrations. Although 396 words may seem like an inadequate amount of text for researchers to convey their findings comprehensively, when considering this in the infographics context, the saying, ‘a picture tells a thousand words’, comes to mind. Three days after learning new information, we are likely to remember up to 6.5 times more through learning from an infographic than by reading text alone.1 Many industries, such as the business, food, …

Sports concussion: time for a culture change.

INTRODUCTION The “concussion problem” in sport can no longer be ignored. Concussion has long been perceived as a benign condition part and parcel of sporting activity. However, emerging scientific reports suggesting long-term cognitive, psychiatric, and neurobehavioral problems associated with concussion have raised public concern and resulted in intense recent media focus. There is now sound science to implicate concussion (and repeated concussive episodes) with significant chronic morbidity. This expanding evidence base has also indicated that many of these potential sequelae can be prevented through timely recognition and appropriate management. Much is being done to improve the prevention, recognition, and management of concussion by sporting authorities. However, these are unlikely to have considerable impact without a fundamental cultural change in the perception of this condition by all those involved in sport.

The relationships between golf and health: a scoping review

Objective To assess the relationships between golf and health. Design Scoping review. Data sources Published and unpublished reports of any age or language, identified by searching electronic databases, platforms, reference lists, websites and from consulting experts. Review methods A 3-step search strategy identified relevant published primary and secondary studies as well as grey literature. Identified studies were screened for final inclusion. Data were extracted using a standardised tool, to form (1) a descriptive analysis and (2) a thematic summary. Results and discussion 4944 records were identified with an initial search. 301 studies met criteria for the scoping review. Golf can provide moderate intensity physical activity and is associated with physical health benefits that include improved cardiovascular, respiratory and metabolic profiles, and improved wellness. There is limited evidence related to golf and mental health. The incidence of golfing injury is moderate, with back injuries the most frequent. Accidental head injuries are rare, but can have serious consequences. Conclusions Practitioners and policymakers can be encouraged to support more people to play golf, due to associated improved physical health and mental well-being, and a potential contribution to increased life expectancy. Injuries and illnesses associated with golf have been identified, and risk reduction strategies are warranted. Further research priorities include systematic reviews to further explore the cause and effect nature of the relationships described. Research characterising golfs contribution to muscular strengthening, balance and falls prevention as well as further assessing the associations and effects between golf and mental health are also indicated.

The enemy of the feet: blisters in ultraendurance runners.

BACKGROUND Blisters are the most common dermatologic problem in ultraendurance runners. Their incidence, localization, pain scores, and risk factors in field conditions are poorly understood. METHODS We conducted an observational field-based cohort study during the 5-day multistage 2010 and 2011 Al Andalus Ultimate Trail (219 km). Daily postrace data on blister frequency, localization, severity, and preventive measures from 50 ultramarathon runners were collected through the direct interview technique. RESULTS After 4 days of running (182 km), blisters occurred in 76% of the participants (P < .001 versus stage 1) compared with 34% after day 1, 54% after day 2, and 72% after day 3 (P < .001 versus stage 1). Most of the blisters formed on the toes (65%) (P < .001), followed by blisters on other locations of the foot: the ball of the foot (16%), heel (14%), and sole (5%). Blisters were more painful toward the end of the race, and those on the sole and heel tended to be the most painful, although this did not reach statistical significance. Prophylactic measures studied (type and fabric of socks; application of antiperspirants, talcum powder, or lubricant to feet; and prophylactic taping) did not show any reduction in blister rates. The only predictive marker for reduced blister incidence was previous ultramarathon experience in men (r = -0.44, P < .05). CONCLUSIONS Blisters are extremely common in multistage ultramarathon races. Race experience in male ultramarathon runners is associated with reduced blister rates.

Creating health through physical activity

In Scotland we aim to increase life expectancy by 5 years in the next 10 years and decrease health inequalities. These ambitions are bold. If life expectancy trends continue, Scotland will fall further behind the rest of Western Europe. Although premature mortality continues to fall, the trajectory of our improvement is currently more modest than that being achieved by other countries. And despite all efforts, health inequalities continue to grow. The gap between the rich and the poor is widening, with the richest 20% now living 10 years longer than the poorest 20% in Scotland. Albert Einstein defined insanity as ‘doing the same thing over and over again and expecting a different result.’ The excess mortality in Scotland requires something new to be done. It may partly stem from the social breakdown and loss of jobs when heavy industry (dominated by shipbuilding, coal mining and steel) declined, particularly in West Central Scotland in the latter half of the 20th century. Those affected were given housing and benefit, and remained predominantly in the region. Although the collapse of heavy industry happened in other countries in Europe, for example, Katowice in Poland, alternative suitable work was found and the sense of control, and community that goes with purpose and employment was preserved. The net result is that Scotlands excess mortality when compared with the rest of Europe can be partly attributed to causes such as violence, drug misuse, alcohol excess and suicide. Interestingly, similar patterns of excess mortality have been noticed in other population groups …

Turning people into couch potatoes is not the cure for sports concussion

In little more than a decade, concussion has become one of the biggest issues taxing modern sport. Incidents of apparently concussed athletes in footballs World Cup and in recent Six Nations’ rugby matches have generated unparalleled column inches in the press, comment on social media and challenging review articles;1 the clear suggestion is that something is wrong in sport, and young brains are at risk. With the Rugby World Cup under way, yet more scrutiny of further high profile incidents is inevitable. In the USA, heightened anxiety over sports concussion has caused participation levels to fall. Similar reactions are likely to follow in other countries. Is this reaction justified? What is the risk of losing the proven benefits of participation in sport compared with the risks of sports concussion? Concussions are common in contact sports. Data in rugby union suggest approximately one player per match at community level will sustain a head injury requiring medical attention,2 with around one concussion in every 2.5 matches at the elite level.3 Symptoms vary, and may include headache, visual disturbance …

Do all health care professionals have a responsibility to prescribe and promote regular physical activity: or let us carry on doing nothing.

Physical inactivity’s propensity to cause preventable morbidity and mortality grossly is under-recognized by both the public and by health care professionals. If health care professionals are serious about doing the best for every patient every patient visit, then we must be skilled in assessing physical activity levels as well as providing appropriate advice and must be able to guide patients through options and to activity. We have a professional duty and responsibility to know and deliver best treatments as well as keep ourselves up to date with and strive for the current best practice. Physical activity is central to health, and doing nothing is not a responsible option for our patients or health care professionals. More importantly, there is an urgent need for all health care professionals to embrace physical activity and strive for systems change, at governmental, organizational, educational, and medical leadership levels.

Tomorrow's doctors want more teaching and training on physical activity for health

Physical activity (PA) promotes good health, and the challenge of physical inactivity is a major global issue.1 PA levels in the UK remain low, with many not achieving the Chief Medical Officers recommendation of at least 150 min per week of moderate-intensity PA.2 With limited funds and increasing rates of non-communicable disease, the NHS is prioritising more cost-effective preventive approaches.3 PA is preventive and cost-effective. Doctors have an important role in PA promotion as they provide a point of contact for individuals who are healthy, at risk or have diagnosed chronic illnesses. Doctors are also trusted sources of health information.4 ,5 Therefore, training of medical professionals is key to strategies for increasing PA levels.5 ,6 Tomorrows doctors should be adequately trained to discuss, advise and engage in the topic of PA. PA promotion and prescription should be a fundamental element for all medical school curricula. Despite this, in 2015, many medical schools including the University of Edinburgh (UoE) Medical School had no PA content on the …

Infographic. Golf and health

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