Medicine and Health Sciences Commons^™

Alexithymia And Impulsivity In Combat Sports – A Tale Of Three Measures, Craig A. Harms, Oliver R. Barley

Research outputs 2022 to 2026

The purpose of this study was to compare the psychometric properties of two measures of alexithymia – the Toronto Alexithymia Scale (TAS-20) and the Perth Alexithymia Questionnaire (PAQ) – as well as the Barratt Impulsiveness Scale 11 measure of behavioural impulsivity because the psychometric properties of these scales have not been established in athletes. As part of a larger study, 298 participants completed an online survey that included the TAS-20, PAQ, and BIS 11, as well personal- (age and gender) and sport-specific (primary combat sport and level of competition) demographic measures. A unidimensional model was retained for the TAS-20. A …

Application Of Additive Manufacturing In The Development Of Polymeric Bioresorbable Cardiovascular Stents: A Review, Farhana Yasmin, Ana Vafadar, Majid Tolouei-Rad

Research outputs 2022 to 2026

Polymeric vascular bioresorbable stents (BRSs) have been widely used for the treatment of coronary artery diseases. While additive manufacturing (AM) is changing the landscape of the healthcare sector by enabling the realization of patient-specific stents with highly complex structures. There are, however, challenges associated with the use of polymeric BRS, particularly in-stent restenosis (ISR), related to its poor mechanical properties. Therefore, the aim of this review is to provide an overview of recent advancements in the development of polymeric BRSs designed to meet both mechanical and biological requirements. First, biopolymers as well as shape memory polymers (SMPs) that are suitable …

Implementing A Gerontological Nursing Competencies Programme In Aged Care: Participant Experiences, Victoria Traynor, Nicole Britten, Diane Gibson, Stephanie Munk, Lynn Chenoweth, Jolan Stokes, Tracey Moroney, Karen Strickland, Toni Donaghy, Kasia Bail

Research outputs 2022 to 2026

Aims: To explore the experience of registered nurses and their mentors in the implementation of the Gerontological Nursing Competencies in long-term aged care and the perceived effectiveness and suitability of the programme to support nurse development. Background: The global population is ageing and needs a reliable aged-care nursing workforce. Introduction: Opportunities for education and mentorship for newly qualified and experienced aged-care nurses warrant investigation. Methods: Qualitative evaluation using semi-structured focus groups was conducted following the implementation of the programme into five not-for-profit long-term aged-care organisations and analysed by a reflexive qualitative thematic approach and reported according to COREQ criteria. Results: …

Physiological Plateaus During Normal Labor And Birth: A Novel Definition, Marina Weckend, Kylie Mccullough, Christine Duffield, Sara Bayes, Clare Davison

Research outputs 2022 to 2026

Background: Diagnoses of labor dystocia, and subsequent labor augmentation, make one of the biggest contributions to childbirth medicalization, which remains a key challenge in contemporary maternity care. However, labor dystocia is poorly defined, and the antithetical concept of physiological plateaus remains insufficiently explored. Aim: To generate a definition of physiological plateaus as a basis for further research. Methods: This qualitative study applied grounded theory methods and comprised interviews with 20 midwives across Australia, conducted between September 2020 and February 2022. Data were coded in a three-phase approach, starting with inductive line-by-line coding, which generated themes and subthemes, and finally, through …

Sleep Discrepancy And Cognitive Function In Community-Dwelling Older Adults, Nadia Soh, Stephanie R. Rainey-Smith, James D. Doecke, Rodrigo Canovas, Romola S. Bucks, Melissa Ree, Michael Weinborn

Research outputs 2022 to 2026

This was the first study to use cluster analysis to characterise sleep discrepancy (the discordance between self-reported and objective sleep) across multiple sleep parameters, in community-dwelling older adults. For sleep efficiency, negative discrepancy (the tendency to self-report worse sleep than objectively-measured) was associated with poorer memory, independent of insomnia severity, depressive symptoms and objective sleep. This suggests a unique role for sleep discrepancy as a possible risk factor for future cognitive decline, and warrants the need for further research.

The Anatomy Of Body Shaming In Sports Coaching, Valeria Varea, Robert S. Primus, Natalie Barker-Ruchti, Mikael Quennerstedt

Research outputs 2022 to 2026

Stories of body shaming in sports coaching are becoming widespread, and can intentionally, unintentionally, or inadvertently be used in different sports coaching practices. These practices do not necessarily intend to harm athletes. The aim of this paper is to explore body critical and body sensitive sport coaching practices that have the potential to be shaming, or as we call it in the title, the ‘anatomy’ of body shaming. The study used photo elicitation interviews including vignettes for data generation with 12 coaches from nine different sports. The results demonstrate that body criticality and body sensitivity function in different subtle ways …

Dementia Awareness Raising Forum: Improving Attitudes Towards People Living With Dementia, Sheridan T. Read, Rosemary Saunders, Matthew A. Albrecht, Ravani Duggan

Research outputs 2022 to 2026

Stigma surrounding dementia is a significant issue affecting individuals and communities leading to discrimination towards those living with the condition. However, the changing paradigm in dementia support to living well with dementia can reduce this stigma and improve community attitudes. A community initiative aimed to address this evaluated the impact of a two-hour education forum involving 92 community members. Presentations from experts, including a person with dementia, addressed dementia-related human rights issues and initiatives to live well with dementia. Attendees completed the new Dementia Community Attitudes Questionnaire (DCAQ) aligned with the evolving paradigm of living well with dementia before and …

Effects Of A 6-Month Dual-Task, Power-Based Exercise Program On Cognitive Function, Neurological And Inflammatory Markers In Older Adults: Secondary Analysis Of A Cluster Randomised Controlled Trial, Jamie L. Tait, Rachel L. A. Duckham, Timo Rantalainen, Catherine M. Milte, Luana C. Main, Caryl A. Nowson, Kerrie M. Sanders, Dennis R. Taaffe, Keith D. Hill, Gavin Abbott, Robin M. Daly

Research outputs 2022 to 2026

Functional power-based exercise training can improve physical performance in older adults and cognitive training can improve measures of cognition, but their combined effects on cognition and related risk factors (neurological and inflammatory markers) remains uncertain. This 6-month cluster randomised controlled trial evaluated the effectiveness of dual-task functional power training (DT-FPT) on cognition and circulating neurological and inflammatory markers in older adults at increased falls risk, and whether intervention responses varied by apolipoprotein-E (ApoE) and brain derived neurotrophic factor (BDNF) polymorphisms. Three hundred residents aged ≥ 65 years at increased falls risk residing in 22 independent-living retirement communities, were randomised by …

Enhancing Nutrition Information Utilisation, Confidence, And Role Legitimacy And Adequacy Among Early Childhood Education Professionals Through Evidence-Based Online Training, Ruth Wallace, Ros Sambell, Shih Ching Fu, Johnny Lo, Elizabeth J. Cook, Amanda Devine

Research outputs 2022 to 2026

This study evaluated the effectiveness of an online short course based on the Health Promoting Schools Framework and specifically designed for Early Childhood Education and Care (ECEC) professionals. The short course aimed to enhance ECEC professionals’ nutrition knowledge, confidence, role legitimacy and adequacy to model healthy behaviours, teach healthy food habits and create health-promoting environments. Participants (n = 116) working at Australian ECEC services were assigned to control (n = 62) or intervention (n = 54) groups. Both groups completed a pre-intervention survey. The intervention group accessed the four-week course and completed the post-intervention survey. The control group completed a …

Exercise In Cancer Care For People With Lung Cancer: A Narrative Synthesis, Kellie Toohey, David Mizrahi, Nicolas H. Hart, Ben Singh, Pedro Lopez, Maddison Hunter, Robert U. Newton, Kathryn H. Schmitz, Diana Adams, Lara Edbrooke, Sandi Hayes

Research outputs 2022 to 2026

Objectives: Lung cancer is the second most common cancer diagnosed worldwide, resulting in significant physical and psychological consequences. In this narrative review, we explore the role of exercise as an adjunct therapy to counteract health issues experienced by people before, during and after treatment for lung cancer, and offer recommendations for exercise prescription and future research. Design: Narrative cornerstone review. Methods: A narrative review was conducted to explore the role of exercise in cancer care for people diagnosed with lung cancer. Results: Improvements in fitness, strength and quality of life have been demonstrated in people with lung cancer following participation …

The Development Of A Family-Led Novel Intervention For Delirium Prevention And Management In The Adult Intensive Care Unit: A Co-Design Qualitative Study, Gideon U. Johnson, Amanda Towell-Barnard, Christopher Mclean, Beverley Ewens

Research outputs 2022 to 2026

Aim: The aim of this study was to codesign a Family Members’ Voice Reorientation Intervention (FAMVR) for delirium prevention and management in critically ill adult patients through collaborative process with previous patients, families, and clinical staff. Background: Delirium is a common consequence of intensive care admission, and there is limited evidence to support family-led interventions to prevent or minimise delirium in intensive care. People with lived experience of intensive care are seldom involved in codesigning delirium prevention and management interventions despite the identified benefits of their involvement in delirium care. Design: Codesign qualitative study. Methods: The process of co-designing was …

Clinical Is The Pinnacle: Nurse Academics' Perspectives And Opinions Of Their Students Undertaking Mental Health Clinical Placements, Lorna Moxham, Kim Foster, Brenda Happell, Richard Lakeman, Michael Hazelton, John Hurley

Research outputs 2022 to 2026

Clinical placements form an integral and important part of preregistration nursing student learning. The theory–practice gap has been identified as problematic, with clinical experience being a key strategy to address this. Despite this, the perceptions of nurse academics teaching preregistration mental health nursing regarding clinical placements have not been widely explored. To garner perspectives and experiences of mental health clinical placements from nurse academics teaching mental health nursing to preregistration nursing students. A descriptive qualitative study involving 19 nurse academics from 13 metropolitan and regional Australian universities, who were involved in the design and delivery of preregistration mental health nursing …

Exercise And Sports Science Australia Updated Position Statement On Exercise For Preventing Falls In Older People Living In The Community, Anne Tiedemann, Daina L. Sturnieks, Elissa Burton, Jeannette M. Thom, Stephen R. Lord, Stacey Scott, Catherine Sherrington

Research outputs 2022 to 2026

Backgrounds: Falls affect a significant number of older Australians and present a major challenge to health care providers and health systems with over 380 older Australians hospitalised for a fall each day.

Objectives: This statement seeks to inform and guide exercise practitioners and health professionals in safe and effective prescription of exercise to prevent falls amongst community-dwelling older people.

Exercise prescription to prevent falls: Exercise is crucial for preventing falls in older age. Research evidence has identified that programmes which include functional balance and muscle strength training are the most effective in preventing falls. It is also important for exercise …

Impact Of Rurality On Health Care Utilization Among Australian Residents From 2009 To 2021, Engida Yisma, Martin Jones, Lee San Pauh, Sandra Walsh, Sara Jones, Esther May, Marianne Gillam

Research outputs 2022 to 2026

Purpose: In Australia, there is limited research regarding the effect of rurality on health care utilization using longitudinal data.

Methods: We analyzed data from four annual waves (2009, 2013, 2017, and 2021) of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) Survey to examine changes in the health care utilization over time among urban and rural residents. Poisson regression models estimated adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CIs) for rural versus urban residents, accounting for a range of health-related and sociodemographic characteristics. Health care utilization was measured using four key indicators: visits to family doctor …

Proximity To Cancer Rehabilitation And Exercise Oncology By Geography, Race, And Socioeconomic Status, Kathryn H. Schmitz, Kathryn Demanelis, Mary E. Crisafio, Mary A. Kennedy, Anna L. Schwartz, Anna Campbell, Jessica Gorzelitz, Kelley C. Wood, Christopher M. Wilson, Raymond L. Scalise, Alex Vincent

Research outputs 2022 to 2026

Background: Cancer rehabilitation and exercise oncology (CR/EO) have documented benefits for people living with and beyond cancer. The authors examined proximity to CR/EO programs across the United States with respect to population density, race and ethnicity, socioeconomic status, and cancer incidence and mortality rates.

Methods: This cross-sectional study was conducted in 2022–2023. Online searches were initiated to identify CR/EO programs. Geocoding was used to obtain latitudinal and longitudinal geospatial coordinates. Demographic data were abstracted from the 2020 5-year American Community Survey. Cancer incidence and mortality data were obtained from the Centers for Disease Control and Prevention. US 2013 Rural-Urban Continuum …

The Careful Project: Evaluating The Acceptability Of Local Virtual Reality Experiences As A Leisure Activity For Residents In Aged Care, Davina Porock, Patricia Cain, Christopher Young, Julieanne Hilbers, Maria Bomm, Manonita Ghosh, Mandy Stanley

Research outputs 2022 to 2026

Objectives: The aim of this project was to evaluate the feasibility and acceptability of virtual reality (VR) as a leisure activity for people living in residential aged care. Virtual reality experiences may offer alternatives for residents with limited mobility, or during times when older people are unable to leave residential care. Methods: The intervention used VR videos delivered via a head-mounted device. Video content was created by a local artist specifically for use with older Western Australian adults and used local content. VR sessions were videotaped for analysis. The evaluation included structured observation of video content to assess mood and …

The Impact Of The Covid-19 Pandemic On Nurses' And Junior Doctors' Workloads, Gemma Doleman, Annemarie De Leo, Dianne Bloxsome

Research outputs 2022 to 2026

Aims: To explore the impact of the COVID-19 pandemic on nurses' and junior doctors' workload, changes to direct care and the impact of workload on resource allocation. Design: Mixed-method design was used. Methods: Data were collected from direct observation, hospital administrative database and a survey. Nurses and junior doctors were observed on two COVID-19 wards and one non-COVID-19 ward using a semi-structured observation schedule. Survey data were collected from nurses and junior doctors that had worked on the COVID-19 ward during the pandemic. Patient data were collected from Web Patient Administration System during the period of March–August 2021 and compared …

Supporting People Bereaved By Suicide In The South West Region Of Western Australia: Report, Colleen M. Carlon

Research outputs 2022 to 2026

This paper reports on the practices of service providers in working with people and communities bereaved by suicide in regional contexts. For people bereaved by suicide experiences of grief, trauma and stigma and the questioning of why someone has died create a complex mix of need and emotion that can leave people vulnerable to complicated grief and poor physical and mental health. These effects may also be exacerbated by stigma in social and communal contexts. As such experiences of suicide grief are different to other forms of grief and loss, effectively supporting people and communities bereaved by suicide requires knowledge …

A Brief History Of Antenatal Colostrum Expression, And Where To From Here, Therese A. O’Sullivan, Connie N. Ihlein

Research outputs 2022 to 2026

The practice of antenatal colostrum expression (ACE), or the extraction of colostrum from the breasts during pregnancy, has an interesting history and continues to evolve. This narrative review aims to describe how perception and practices of ACE have changed over time, summarise the evidence on ACE in maternal and infant care, and highlight areas for future research. The literature demonstrates that ACE is safe for low-risk women when done from around 36 weeks’ gestation. Women should be reassured that the skill of hand expressing is a valuable tool post-birth, regardless of whether they are able to collect colostrum antenatally or …

An Integrative Review Of Specialised Nursing Career Frameworks To Develop A Nursing Career Framework For Registered Nurses Working In Aged Care, Sachini Thennakoon, Seng Giap Marcus Ang, Victoria Traynor, Karen Strickland

Research outputs 2022 to 2026

Aim: The aim of this study is to synthesise literature on specialised nursing career frameworks to inform the development of an aged care nursing career framework. Design: An integrative review was conducted. Method: The review followed Whittemore and Knafl's five-step integrative review method. To appraise the quality of the studies, the Quality Appraisal for Diverse Studies tool for peer-reviewed articles and the ACCODS (Authority, Accuracy, Coverage, Objectivity, Date, and Significance) checklist for grey literature were used. Data were extracted and synthesised using the constant comparison method. Data Source: The electronic databases of CINAHL, Medline, PsycINFO and Google Scholar were searched …

Through The Looking Glass; Midwifery Students' Experience Of Ethical Issues: A Feminist Explanatory Case Study, D. Bygraves, K. Wissemann, K. Buchanan

Research outputs 2022 to 2026

Background: The ethical component in midwifery education is governed by international professional values, codes, and ethical principles. The aim of midwifery education is to encourage students to develop a lifelong commitment to ethical practice within their midwifery role and scope. However, little evidence is available on the experiences of midwifery students and how they navigate ethical issues in maternity systems. Aim: To present a case study from a midwifery students' perspective that demonstrates observed ethical issues and to provide analysis of the ethical issues identified. Design: A Single explanatory case study design with a feminist lens applied. Explanatory case studies …

Blood Biomarker Profiles In Young-Onset Neurocognitive Disorders: A Cohort Study, Oneil G. Bhalala, Jessica Beamish, Dhamidhu Eratne, Patrick Summerell, Tenielle Porter, Simon M. Laws, Matthew J.Y. Kang, Aamira J. Huq, Wei Hsuan Chiu, Claire Cadwallader, Mark Walterfang, Sarah Farrand, Andrew H. Evans, Wendy Kelso, Leonid Churilov, Rosie Watson, Nawaf Yassi, Dennis Velakoulis, Samantha M. Loi

Research outputs 2022 to 2026

Introduction: Young-onset neurocognitive symptoms result from a heterogeneous group of neurological and psychiatric disorders which present a diagnostic challenge. To identify such factors, we analysed the Biomarkers in Younger-Onset Neurocognitive Disorders cohort, a study of individuals < 65 years old presenting with neurocognitive symptoms for a diagnosis and who have undergone cognitive and biomarker analyses. Methods: Sixty-five participants (median age at assessment of 56 years, 45% female) were recruited during their index presentation to the Royal Melbourne Hospital Neuropsychiatry Centre, a tertiary specialist service in Melbourne, Australia, and categorized as either early-onset Alzheimer’s disease (n = 18), non-Alzheimer’s disease neurodegeneration (n = 23) or primary psychiatric disorders (n = 24). Levels of neurofilament light chain, glial fibrillary acidic protein …

Do Anxiety, Depression, Fear Of Movement And Fear Of Achilles Rupture Correlate With Achilles Tendinopathy Pain, Symptoms Or Physical Function?, George White, Fletcher Bright, Ebonie K. Rio, Ruth L. Chimenti, Myles C. Murphy

Research outputs 2022 to 2026

Objectives: To determine if psychological factors, such as anxiety, depression, fear of movement and fear of rupture are associated with increased tendon-related disability, quantified by the Tendinopathy Severity Assessment-Achilles (TENDINS-A). Design: Cross-sectional. Setting: Online Qualtrics survey. Participants: Sixty-eight participants (54% female) with Achilles tendinopathy and a mean (standard deviation) age of 40.1 (12.6) years. Main Outcome Measures: The TENDINS-A (including subscales of pain; symptoms such as stiffness; physical function), Patient Health Questionnaire-9, General Anxiety Disorder-7, Tampa Scale for Kinesiophobia and fear of tendon rupture. Associations were evaluated using generalised linear models (adjusting for age and sex), with significance accepted when …

Evaluating The Efficacy Of A Serious Game To Deliver Health Education About Invasive Meningococcal Disease: Clustered Randomized Controlled Equivalence Trial, Lauren Bloomfield, Julie Boston, Martin Masek, Lesley Andrew, Donna Barwood, Amanda Devine

Research outputs 2022 to 2026

Background: Invasive meningococcal disease (IMD) is a serious, vaccine-preventable infectious disease that can be life-threatening. Teaching adolescents about the early detection and prevention of IMD can be challenging in a school environment, with educators reporting they lack confidence or expertise to cover this in the classroom environment. Professional guest educators are an alternative to cover specialist topics such as IMD; however, time and resourcing constraints can mean that these educators are not always available. Serious games may be an alternative to face-to-face education, where complex health information may be delivered via self-directed gameplay. Objective: This study aims to develop a …

Exploring Non-Invasive Brain Stimulation Effects On Physical Outcomes In People With Parkinson’S Disease: An Umbrella Evidence Mapping Review With Meta-Analyses, Dale M. Harris, Christopher Latella, Nicholas Tripodi, Steven J. O’Bryan

Research outputs 2022 to 2026

Background: Non-invasive brain stimulation (NIBS) is sometimes used alongside medication to alleviate motor symptoms in people with Parkinson’s disease (PD). However, the evidence supporting NIBS’s effectiveness for improving motor function in PD patients is uncertain.

Objective: This umbrella review aims to synthesize recent systematic reviews and meta-analyses that have evaluated the effectiveness of NIBS in improving motor function in people with PD, with a key focus being to examine the quality of the evidence presented. Methods: The review protocol was registered in PROSPERO (CRD42022380544) and conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy was …

Feasibility And Psychometric Quality Of Smartphone Administered Cognitive Ecological Momentary Assessments In Women With Metastatic Breast Cancer, Ashley M. Henneghan, Emily W. Paolillo, Kathleen M. Van Dyk, Oscar Y. Franco-Rocha, Soyeong Bang, Rebecca Tasker, Tara Kaufmann, Darren Haywood, Nicolas H. Hart, Raeanne C. Moore

Research outputs 2022 to 2026

Objective: Metastatic breast cancer (MBC) is associated with burdensome side effects, including cognitive changes that require ongoing monitoring. Cognitive ecological momentary assessments (EMAs) allow for assessment of individual cognitive functioning in natural environments and can be administered via smartphones. Accordingly, we sought to establish the feasibility, reliability, and validity of a commercially available cognitive EMA platform. Methods: Using a prospective design, clinical cognitive and psychosocial assessments (cognitive batteries; patient reported outcomes) were collected at baseline, followed by a 28-day daily EMA protocol that included self-ratings for symptoms and mobile cognitive tests (memory, executive functioning, working memory, processing speed). Satisfaction and …

Game-Based Learning Contributions To Clinical Leadership In Times Of Resource Scarcity, Scott James Andrews, Olivia Gallagher, Alecka Miles, Carol Crevacore, Jessica Watson, Sean Cashman, Wyatt De Souza, Martin Masek, Julie Boston, Lisa Holmes, Brennen Mills

Research outputs 2022 to 2026

Background: Early progression of Registered Nurses into leadership roles is commonplace in clinical settings. Student nurses can prepare for leadership by gaining exposure through simulation-based learning. A novel and expanding modality are Game-based learning (GBL) simulation.

Aim: To understand if a GBL simulation is useful in preparing student nurses for leadership roles during times of resource scarcity, student nurses were asked to evaluate a novel GBL simulation requiring learners to manage patient triage and hospital resources during a pandemic.

Methods: The study design leveraged Kirkpatrick's Training Evaluation Model. Nursing students (n = 74) from one university in Perth, Western Australia, …

Intrapartum Hydration Assessment And Management: A Cross-Sectional Survey Of Australian And New Zealand Maternity Units, Brianne G. Mcintyre, Debbie Massey, Nigel Lee, Lauren Kearney

Research outputs 2022 to 2026

Background: Hydration assessment and management during labour play an important role in maternal and newborn outcomes. Studies indicate that clinical practice is inconsistent, with limited consensus evident in clinical guidelines. Current practices in fluid management across public and private maternity units within Australia and New Zealand remain unknown. Respondents highlighted the importance of maternal hydration assessment and management to well-being. However, inconsistencies were noted in the documentation, medication use and adherence to clinical protocols. Aim: Our study aimed to investigate unit-level clinical practice regarding intrapartum hydration assessment and management across Australian and New Zealand private and public hospitals. The scope …

Return To On-Snow Performance In Ski Racing After Anterior Cruciate Ligament Reconstruction, Nathaniel Morris, Ricardo Da Silva Torres, Mark Heard, Patricia Doyle Baker, Walter Herzog, Matthew J. Jordan

Research outputs 2022 to 2026

Background: The individual variation in on-snow performance outcomes after anterior cruciate ligament (ACL) reconstruction (ACLR) in elite alpine ski racers has not been reported and may be influenced by specific injury characteristics. Purpose: To report the performance statistics of elite ski racers before and after ACLR and to identify surgical and athlete-specific factors that may be associated with performance recovery. Study Design: Descriptive epidemiological study. Methods: International Ski and Snowboard Federation (FIS) points, FIS ranking, average placing, and average percentage behind the winning time in each race were calculated for 30 national and provincial team ski racers at 1 year …

The Physiological Consequences Of And Recovery Following The Australian Special Forces Selection Course, Angela C. Uphill, Kristina L. Kendall, Bradley A. Baker, Stuart N. Guppy, Hannah M. Brown, Michael Vacher, Bradley C. Nindl, G. Gregory Haff

Research outputs 2022 to 2026

This study aimed to determine the energy requirements, physiological consequences, and recovery rate from the Australian Special Forces Selection Course. Ninety-three male soldiers (mean ± SD, 28.1 ± 3.6 years, 1.81 ± 0.1 m, 85.1 ± 8.1 kg) vol-unteered for this study. Body composition via dual-energy X-ray absorptiometry, hormones and resting metabolic rate were assessed before, immediately after, and at 1, 3, 5, and 8 weeks post-course. Energy expenditure, assessed via doubly-labelled water during the first 10 days of the course significantly exceeded energy intake (expenditure: 7680 ± 1095 kcal. day–1, in-take: 3859 ± 704 kcal. day– 1). Body mass …