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The strongest evidence that ague was malaria was successful treatment with chinchona an extract containing quinine from the bark of a South American tree which was introduced in the 16th century.

It was effective in controlling ague but not for preventing relapses once the patient stopped taking it, 24 a feature consistent with P vivax infection. The causes of this decline are believed to be multifactorial 17, 18 and include:. Drainage of swamps may have reduced the density of A atroparvus which are still present today in marshy areas to a low level. Better ventilated houses and living accommodation for humans and animals may have encouraged A atroparvus to attack cows and horses their preferred victims rather than humans. Introduction of wider windows meant lighter rooms which would have discouraged the shade loving mosquitoes.

Apart from a few cases when malaria was reimported, for example a local epidemic of vivax malaria after the return of soldiers during World War I on the Isle of Sheppey, the disease had disappeared from the UK by the beginning of the 20th century. For the past decade between and cases with 9—15 deaths are reported annually. Inevitably, even in the absence of global warming, increasing numbers of returning travellers to the UK will have malarial parasites in their blood.

Global warming will extend the geographical range of malaria-transmitting mosquitoes. For malaria to become indigenous there are four requirements. Completion of intramosquito parasite stages such that malaria can be secondarily transmitted to bitten humans. Initial outbreaks of indigenous malaria will probably be small and confined to a limited geographical area, most likely in marshy or coastal areas A atroparvus , the most likely mosquito vector favours brackish water 20 of south and east England. Return of indigenous malaria in the UK has not yet occurred. The greater availability of cheap tropical and subtropical travel will result in more primary infections of humans with blood that could infect home grown mosquitoes.

With increased global warming, occasional cases of secondary malaria will occur in UK residents who have not been abroad but the average tertiary spread will be to less than one other human and thus malaria will not establish itself for malaria to persist, on average a patient with malaria would have to transmit infection to at least one other human, otherwise the infection would die out.

Within the next few decades tertiary spread of infection may occur in the UK, with spread to at least one other person. Indigenous malaria will then be with us. You will be able to get a quick price and instant permission to reuse the content in many different ways. Skip to main content. We use cookies to improve our service and to tailor our content and advertising to you. More info You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our cookies policy. Log in via OpenAthens.

Log in using your username and password For personal accounts OR managers of institutional accounts. Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Log in via Institution. Malaria in the UK: Abstract There is strong evidence that malaria was once indigenous to the UK, that global warming is occurring, and that human activity is contributing to global warming.

Produce a wider geographical distribution.

The relationships between golf and health: a scoping review | British Journal of Sports Medicine

Increase feeding on humans. Shorten the period between infection and infectivity. Increase duration of feeding patterns. Increase the inoculation rate. Shakespeare — made frequent reference to ague and recognised the connection between ague and marshy areas: The causes of this decline are believed to be multifactorial 17, 18 and include: Use of quinine in the 19th century would have reduced human reservoirs of infection.

A fall in the price of chinchona enabling even the poor to buy. Returning travellers with primary infections. Appropriate mosquitoes to bite them. Summer temperatures to allow.

Also for these requirements to be met there must be: A failure of travellers to protect themselves against malaria. Suitable UK environments for mosquitoes. Secondary cases to be unrecognised and thus remain untreated. Secondary cases to be in turn bitten by UK mosquitoes in which Plasmodia become infectious to bitten humans tertiary cases. Climate change and greenhouse gases. Transactions of the American Geophysical Union ; Climate history and the modern world.

Northern hemisphere temperatures during the past millennium: Geophysical Research Letters ; Corrections to the Mann et al proxy database and northern hemispheric average temperature series. Energy and Environment ; Soon W , Baliunas S. Proxy climatic and environmental changes of the past years. Climate Research ; Intergovernmental Panel on Climate Change. Synthesis report, summary for policymakers. Cambridge University Press, The Wilson Quarterly Spring Oxford University Press, Climate change —impacts, adaptations and mitigation of climate change.

Climate change and vector-borne diseases: Global Environmental Change ; 5: Roberts LS , Janovy J, eds. Studies suggest that golf may improve proprioception, balance, muscle endurance and function particularly in the elderly, 57 , 70—74 while in younger players, no increase in muscle mass or bone mineral density has been seen.

Unlike most other sports, golf spectating offers the opportunity to walk around the field of play, rather than being restricted to a seat. The best available evidence suggests that playing golf may contribute to reduced mortality and increased life expectancy. This increase will also have further contributing factors, including other lifestyle factors. Playing sport several times per week is likely to benefit health more than playing one to two times per week. In providing moderate intensity physical activity, it is biologically plausible that golf could be expected to have beneficial effects in the prevention and treatment of chronic diseases, including ischaemic heart disease, type 2 diabetes, stroke, and colon and breast cancer.

Frequent golfers perceive their physical health to be better than infrequent golfers. Golf is associated with improvements in known risk factors for cardiovascular disease, including physical inactivity, 38 blood lipid and insulin—glucose levels, 57 , 66 , 85 body composition 57 , 85 and aerobic fitness, 57 although direct evidence and longitudinal trials assessing the medium-term and long-term impact of golf on coronary heart disease or cerebrovascular disease are lacking.

Introduction

Golf is reported as providing suitable exercise for patients with cardiac 43 , 86 , 87 and stroke rehabilitation. Golf can provide a sufficient stimulus to improve aerobic fitness, but higher intensity exercise generates significantly improved cardiovascular adaption compared to playing golf.

There is an increased incidence of acute cardiac events during participation in sport 89 and golf in particular. Regular participation in golf may improve lung function and maintain it in older adults. Quasi-experimental studies are united in describing overall positive effects on lipid profile.

Golf is associated with musculoskeletal benefits as well as accident and injury. Older golfers may gain improved balance, 70 , 71 , 73 muscular function 72 and strength 74 compared to controls, but no lower limb bone mineral density increase was found in male professional golfers. Injuries and accidents related to golf comprise the largest group of studies identified by the scoping review. A systematic review and other reviews describe golf as overall a moderate risk activity for injury compared to other sports. Prospective and retrospective epidemiological studies quote the incidence of injury in amateur golfers annually to be between Overall, the incidence of injury is moderate, and the rate of injury per hour played is low.

The most frequent cause of injury in amateur and professional golfers is volume of repetitive practice, , , , , while suboptimal swing biomechanics are a frequent — , and perhaps even leading cause in amateurs. Attention to these factors, and to an adequate warm up, 26 , — and physical conditioning 11 , 26 , , reduces risk of injury. Regarding limb injuries, the lead side the left arm and leg in a right-handed golfer is more often injured than the trail right side in a right-handed golfer. Golf is an infrequent cause of head and particularly ocular injury, but these injuries can be severe particularly in children.

Most paediatric golf-related injuries occur away from a golf course , with authors urging preventative strategies targeting improved education and supervision of children and safe storage of golf equipment. Although still infrequent, golf is reported to be the sport with the highest incidence of lightning strike in the USA with deaths, , and prevention strategies for players and courses outlined. Golf cart-related injuries, including from falls, collisions or limb entrapment, can occur 11 , , and can be severe.

No consistent evidence for the associations or effects of golf on mental illness was reported. Golf is associated with positive impacts on mental wellness. A small experimental study enrolling nine persons with severe and enduring mental illness tentatively reported a number of mental and social benefits for participants. Quantitative and qualitative studies have described benefits related to self and group identity — and social connections, many of which have been cultured long term. Self-efficacy, self-worth and physical activity levels improved after a golf intervention in participants with a disability in the USA.

In summary, a number of qualitative and quantitative studies describe improved wellness in golfers, but there are few controlled studies looking at golf and mental health. This study has identified research gaps in the existing literature on golf and health with future research priorities outlined in table 2.

Scoping reviews are comprehensive, but not exhaustive in identifying literature 16 recognising the balance between the breadth and depth of analysis. Scoping reviews are broad in nature and provide an overview of existing literature regardless of quality, providing a broader and more contextual overview than systematic reviews. Formal assessment of methodological quality is not undertaken when conducting a scoping review, 14 , 15 , and synthesis of the literature quantitatively, nor demonstration of a cause and effect nature for the found relationships is not possible. Golfers are likely different to non-golfers in many ways, with confounding factors a challenge to identify and adequately control.

Documented attempts were made throughout the design and conduct of this study to appraise and report evidence in an objective way. This scoping review identified over studies investigating the relationship between golf and health. Golf has been shown to provide moderate intensity aerobic physical activity and therefore could be expected to have the same beneficial effects on longevity, physical health, mental health and wellness associated with physical activity.

The best available evidence suggests that golf may contribute to reduced mortality. The existing evidence supports efforts to promote golf as a sport with overall health benefits. To maximise health benefits, golfers should walk the course rather than riding a golf cart. Research assessing golf's contribution to muscle strengthening recommendations, the relationships of golf on mental health, golf spectating and health, and the influencing of health behaviours in golfers, have been identified as priorities for further study.

Systematic reviews to further explore health effects of golf on specific conditions are also required. Scoping reviews provide a useful framework to collate and summarise information on a broad topic. Playing golf can provide moderate intensity physical activity and has overall positive associations with physical health and mental wellness, while golf may contribute to increased longevity. Disbenefits include mostly overuse injuries; accidents are rare, but deleterious consequences of them can be high. Priority areas for future research include the associations and effects of golf on mental health, golf's contribution to muscle strengthening, balance and falls prevention, and influencing health behaviours among golfers and potential golfers.

Systematic reviews to further explore the cause and effect nature of the relationships described are merited. The authors wish to thank Marshall Dozier, the head librarian for population health at the University of Edinburgh, representatives of the World Golf Foundation, the Royal and Ancient, and the European Tour for their support in identifying suitable studies, and Maria Stokes, Evan Jenkins, Scott Murray and Ruth McQuillan for their advice regarding methodological considerations. Contributors All authors have contributed to the development of the research questions and study design.

AM and LD developed and conducted the search strategy and data extraction. All authors developed the first and subsequent drafts of the manuscript. All authors reviewed and approved the manuscript. The World Golf Foundation agreed to publish findings whether positive, negative, or no associations or effects were found.

Provenance and peer review Not commissioned; externally peer reviewed. You will be able to get a quick price and instant permission to reuse the content in many different ways. Skip to main content. We use cookies to improve our service and to tailor our content and advertising to you.

More info You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our cookies policy. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts. Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Latest content Current issue Archive Authors About. Log in via Institution. The relationships between golf and health: Abstract Objective To assess the relationships between golf and health.

Golf Health Exercise Evidence based review Sport Introduction The objective of this scoping review is to map the literature on golf and health and to examine the relationships and effects of golf on physical and mental health. Methods We adopted the established five-stage scoping review process proposed by Arksey and O'Malley, incorporating adaptions from Levac et al , and the Joanna Briggs Institute 14—16 as per our published protocol. Identify the research question Considering the populations, concepts and contexts of interest enabled a broad research question to be formulated: Identifying relevant studies The following explicit inclusion and exclusion criteria were developed through researcher discussion and expert consultation: Research articles not limited by geographical location, language or setting.

All age groups and both sexes of participants. Studies focusing on biomechanics, or improved performance in golf. Search strategies and databases Step 1: Identify key words and index terms The title, abstract and index terms used to describe the articles identified in step 1 were analysed.


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Further searching of references and citations A search was conducted of the reference list of the most relevant identified articles while authors of relevant primary comprehensive, scoping or systematic reviews were contacted for further information. Extracting the results Charting tables to record and assimilate extracted data from included studies were developed. Data extraction categories Author s. Study population and sample size if applicable. Intervention type, comparator, details of these. Duration of the intervention. Outcomes and details of these eg, how measured. Key findings that relate to the scoping review research questions.

Results and discussion Descriptive analysis A review flow diagram see figure 1 details the results from the search, and study selection processes. Included studies by year of publication In keeping with wider bibliometric trends in sport and health research, figure 2 highlights a substantial chronological increase in the number of papers relating to golf and health, with an associated increase in the range of study designs and research questions. Geography of included studies Research studies were identified from 24 countries and in 9 languages. View inline View popup. Type of study Study design The studies varied considerably in terms of study design and primary focus.

Thematic summary Key concepts and evidence available Participation Golf is a sport played by 55 million people in countries, by males and females across the life-course. Golf and physical activity Golf can contribute to physical activity as a leisure time or recreational activity, while work and occupation yields physical activity for modest numbers of professional players and caddies.

Golf and physical health In providing moderate intensity physical activity, it is biologically plausible that golf could be expected to have beneficial effects in the prevention and treatment of chronic diseases, including ischaemic heart disease, type 2 diabetes, stroke, and colon and breast cancer.

Respiratory system Regular participation in golf may improve lung function and maintain it in older adults. Metabolic health Quasi-experimental studies are united in describing overall positive effects on lipid profile. Musculoskeletal health Golf is associated with musculoskeletal benefits as well as accident and injury. Golf and injury Injuries and accidents related to golf comprise the largest group of studies identified by the scoping review.

Mental health A small experimental study enrolling nine persons with severe and enduring mental illness tentatively reported a number of mental and social benefits for participants. Mental wellness Quantitative and qualitative studies have described benefits related to self and group identity — and social connections, many of which have been cultured long term. Further research priorities This study has identified research gaps in the existing literature on golf and health with future research priorities outlined in table 2. Limitations Scoping reviews are comprehensive, but not exhaustive in identifying literature 16 recognising the balance between the breadth and depth of analysis.

Special Relationship

Conclusions This scoping review identified over studies investigating the relationship between golf and health. Golf is played by over 50 million people of all ages worldwide. What this study adds? Acknowledgments The authors wish to thank Marshall Dozier, the head librarian for population health at the University of Edinburgh, representatives of the World Golf Foundation, the Royal and Ancient, and the European Tour for their support in identifying suitable studies, and Maria Stokes, Evan Jenkins, Scott Murray and Ruth McQuillan for their advice regarding methodological considerations.

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