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OBJECTIVES: Tackle-related injuries account for up to 67% of all match injuries in women's rugby union. The perspective of women players on tackle injury can help key stakeholders understand psychosocial determinants of tackle injury risk and prevention. We aimed to capture psychosocial processes that explain tackle injury experiences and behaviours in women's rugby union. METHODS: We conducted a qualitative study using a grounded theory approach. Adult women players, with at least 1-year senior level experience, were recruited from Europe, South Africa and Canada between December 2021 and March 2022. Data were collected through semistructured interviews and analysed in line with grounded theory coding procedures. RESULTS: Twenty-one players, aged 20-48 years with a mean 10.6 years of rugby playing experience, participated. In our analysis, we identified three categories central to participants' experiences of tackle injury: (1) embodied understandings of tackle injury, (2) gender and tackle injury risk and (3) influences on tackle injury behaviours. Participants reported a sense of fear in their experience of tackling but felt that tackle injuries were an inevitable part of the game. Tackle injury was described based on performance limitations. Tackle injury risks and behaviours were influenced by gendered factors perpetuated by relations, practices and structures within the playing context of women's rugby union. CONCLUSION: Women's tackle injury experiences were intertwined with the day-to-day realities of marginalisation and under preparedness. Grounded in the voices of women, we have provided recommendations for key stakeholders to support tackle injury prevention in women's rugby.
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Traumatismos en Atletas , Fútbol Americano , Adulto , Humanos , Femenino , Traumatismos en Atletas/prevención & control , Teoría Fundamentada , Rugby , Fútbol Americano/lesiones , Sudáfrica , IncidenciaRESUMEN
BACKGROUND: To assess whether concussion history adversely affects multisensory integration, we compared susceptibility to the Sound-Induced Flash Illusion (SIFI) in retired professional rugby players compared to controls. METHODS: Retired professional rugby players ((N = 58) and retired international rowers (N = 26) completed a self-report concussion history questionnaire and the SIFI task. Susceptibility to the SIFI (i.e., perceiving two flashes in response to one flash paired with two beeps) was assessed at three stimulus onset asynchronies (70 ms, 150 ms or 230 ms).Logistic mixed-effects regression modeling was implemented to evaluate how athlete grouping, previous concussion history and total number of years playing sport, impacted the susceptibility to the SIFI task. The statistical significance of a fixed effect of interest was determined by a likelihood ratio test. RESULTS: Former rugby players had significantly more self-reported concussions than the rower group (p < 0.001). There was no impact of athlete grouping (i.e., retired professional rugby players and retired international rowers), years participation in elite sport or concussion history on performance in the SIFI. CONCLUSION: A career in professional rugby, concussion history or number of years participating in professional rugby was not found to be predictive of performance on the SIFI task.
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Traumatismos en Atletas , Conmoción Encefálica , Fútbol Americano , Atletas , Traumatismos en Atletas/complicaciones , Humanos , Percepción , JubilaciónRESUMEN
OBJECTIVE: To investigate the incidence, prevalence, risk factors and morphological presentations of low back pain (LBP) in adolescent athletes. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Medline, Embase, CINAHL via EBSCO, Web of Science, Scopus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies evaluating the incidence and/or prevalence of LBP in adolescent athletes across all sports. RESULTS: There were 80 studies included. The pooled incidence estimate of LBP in adolescent athletes was 11% (95% CI 8% to 13%, I2=0%) for 2 years, 36.0% (95% CI 4% to 68%, I2=99.3%) for 12 months and 14% (95% CI 7% to 22%, I2=76%) for 6 months incidence estimates. The pooled prevalence estimate of LBP in adolescent athletes was 42% (95% CI 29% to 55%, I2=96.6%) for last 12 months, 46% (95% CI 41.0% to 52%, I2=56%) for last 3 months and 16% (95% CI 9% to 23%, I2=98.3%) for point prevalence. Potential risk factors were sport participation, sport volume/intensity, concurrent lower extremity pain, overweight/high body mass index, older adolescent age, female sex and family history of LBP. The most common morphology reported was spondylolysis. Methodological quality was deemed high in 73% of cross-sectional studies and in 30% of cohort studies. Common reasons for downgrading at quality assessment were use of non-validated survey instruments and imprecision or absence of LBP definition. SUMMARY/CONCLUSION: LBP is common among adolescent athletes, although incidence and prevalence vary considerably due to differences in study methodology, definitions of LBP and data collection. PROSPERO REGISTRATION NUMBER: CRD42020157206.
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Dolor de la Región Lumbar , Adolescente , Femenino , Humanos , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/etiología , Prevalencia , Incidencia , Estudios Transversales , Atletas , Factores de RiesgoRESUMEN
Women's participation in field collision sports is growing worldwide. Scoping reviews provide an overview of scientific literature in a developing area to support practitioners, policy, and research priorities. Our aim is to explore published research and synthesise information on the physical and technical demands and preparation strategies of female field collision sports. We searched four databases and identified relevant published studies. Data were extracted to form (1) a numerical analysis and (2) thematic summary. Of 2318 records identified, 43 studies met the inclusion criteria. Physical demands were the most highly investigated (n+=+24), followed by technical demands (n+= 18), tactical considerations (n+=+8) and preparatory strategies (n=1). The key themes embody a holistic model contributing to both performance and injury prevention outcomes in the context of female field collision sports. Findings suggest a gender data gap across all themes and a low evidence base to inform those preparing female athletes for match demands. Given the physical and technical differences in match-demands the review findings do not support the generalisation of male-derived training data to female athletes. To support key stakeholders working within female field collision sports there is a need to increase the visibility of female athletes in the literature.
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Rendimiento Atlético , Femenino , Masculino , Humanos , Atletas , Examen FísicoRESUMEN
BACKGROUND: Internationally, the COVID-19 pandemic severely curtailed access to hospital facilities for those awaiting elective/semi-elective procedures. For allergic children in Ireland, already waiting up to 4 years for an elective oral food challenge (OFC), the restrictions signified indefinite delay. At the time of the initiative, there were approx 900 children on the Children's Health Ireland (CHI) waiting list. In July 2020, a project was facilitated by short-term (6 weeks) access to an empty COVID stepdown facility built, in a hotel conference centre, commandeered by the Health Service Executive (HSE), Ireland. The aim of this study was to achieve the rapid roll-out of an offsite OFC service, delivering high throughput of long waiting patients, while aligning with existing hospital policies and quality standards, international allergy guidelines and national social distancing standards. METHODS: The working group engaged key stakeholders to rapidly develop an offsite OFC facility. Consultant paediatric allergists, consultant paediatricians, trainees and allergy clinical nurse specialists were seconded from other duties. The facility was already equipped with hospital beds, bedside monitors (BP, pulse and oxygen saturation) and bedside oxygen. All medication and supplies had to be brought from the base hospital. Daily onsite consultant anaesthetic cover was resourced and a resuscitation room equipped. Standardized food challenge protocols were created. Access to the onsite hotel chef facilitated food preparation. A risk register was established. RESULTS: After 6 weeks of planning, the remote centre became operational on 7/9/2020, with the capacity of 27 OFC/day. 474 challenges were commenced: 465 (98%) were completed and 9 (2%) were inconclusive. 135 (29%) OFCs were positive, with 25 (5%) causing anaphylaxis. No child required advanced airway intervention. 8 children were transferred to the base hospital. The CHI allergy waiting list was reduced by almost 60% in only 24 days. CONCLUSIONS: Oral food challenges remain a vital tool in the care of allergic children, with their cost saving and quality-of-life benefits negatively affected by a delay in their delivery. This project has shown it is possible to have huge impacts on a waiting list efficiently, effectively and safely with good planning and staff buy-in-even in a pandemic. Adoption of new, flexible and efficient models of service delivery will be important for healthcare delivery in the post-COVID-19 era.
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COVID-19 , Pandemias , Alérgenos , Alergólogos , Niño , Humanos , SARS-CoV-2RESUMEN
INTRODUCTION: In rugby, the average player body mass has increased by approximately 25% since 1955. Visceral adipose tissue (VAT) is associated with low grade inflammation, and chronic diseases, such as cardiovascular diseases. The purpose of this study was to investigate changes in VAT in relation to other indices of body composition, across 1 season in professional rugby. METHODOLOGY: One hundred and sixteen male rugby union players' (age: 26.2 ± 4.6 y, BMI: 29.40 ± 3.22 kg.m2) total body composition dual energy X-ray absorptiometry scans from 4 time points across the season (baseline, preseason, midseason, and postseason) were analyzed. Players were grouped by playing position, forwards (nâ¯=â¯65) and backs (nâ¯=â¯51). Players followed individually tailored diet plans. RESULTS: Mean baseline VAT was 404.67 ± 229.43 g (forwards: 469.36 ± 263.16 g, backs: 311.40 ± 121.15 g). Total mass, lean mass, body fat percentage (%BF), and VAT were greater in forwards than backs at all 4 timepoints. Meaningful increases in VAT across the season, were observed in 37.5% of backs and 53.6% of forwards. There was a positive linear relationship between lean mass and total mass, up to 116.04 kg total mass. Beyond this threshold, lean mass accumulation reduced and %BF and VAT mass increased. There were significant relationships between %BF, VAT, and BMI (p < 0.001), but no physiological relevant pattern was discerned. CONCLUSIONS: Despite regular high-intensive exercise and individually tailored dietary control across a professional rugby season, players from both playing positions demonstrated increases in VAT, although the cause remains unknown. Our findings indicate the importance of monitoring VAT in athletes alongside standard measures of body composition. Additionally, our findings suggest there may be an upper threshold of body mass beyond which lean mass may not increase further and instead %BF and VAT are more likely to accumulate. Further research is required to identify how increasing player size may impact long-term cardiometabolic health given the known links between VAT and cardiometabolic risk.
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Fútbol Americano , Grasa Intraabdominal , Absorciometría de Fotón , Adulto , Atletas , Composición Corporal , Densidad Ósea , Humanos , Grasa Intraabdominal/diagnóstico por imagen , Masculino , Estaciones del Año , Adulto JovenRESUMEN
Objective: To assess the concurrent validity and test re-test reliability of the Michigan Traumatic Brain Injury Identification Method (MTBIIM). The psychometric properties of this concussion index were investigated by comparing the agreement between player self-reported diagnosed concussions and medical record diagnosed concussions among professional rugby union players.Study Design: Cross-sectional study i) validation and ii) test re-test reliability.Methods: The MTBIIM was administered via a structured interview to obtain the number and nature of player self-reported concussion histories from players, while contracted to the host club. Self-reported concussion history information was compared to medically recorded data captured between 2008 and 2017. A mixed-effects logistic regression model explored predictors of player self-report accuracy.Results: Data from 62 players (25.39[4.36] years) included 99 unique rugby related concussions. Medically documented concussions (n = 92) per player (1.48 [1.96]) were 30% more than the mean number of self-reported diagnosed (n = 63) concussions per player (1.02 [1.21] events). Overall, self-reported diagnosed concussions and medical record diagnosed concussion histories had a 'fair' level of agreement (k=0.274; SE [0.076]), p=.001). Self-reported lifetime concussion history was signicantly negatively correlated with recall of concussions.Conclusions: Initial concurrent validity of the MTBIIM was found to be fair with the average athlete under-reporting the number of clinically diagnosed concussions.
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Traumatismos en Atletas , Conmoción Encefálica , Fútbol Americano , Atletas , Traumatismos en Atletas/epidemiología , Conmoción Encefálica/epidemiología , Estudios Transversales , Humanos , Michigan/epidemiología , Reproducibilidad de los Resultados , AutoinformeRESUMEN
OBJECTIVES: Rowing-related low back pain (LBP) is common but published management research is lacking. This study aims to establish assessment and management behaviours and beliefs of experienced and expert clinicians when elite and subelite rowers present with an acute episode of LBP; second, to investigate how management differs for developing and masters rowers. This original research is intended to be used to develop rowing-related LBP management guidelines. METHODS: A three-round Delphi survey was used. Experienced clinicians participated in an internet-based survey (round 1), answering open-ended questions about assessment and management of rowing-related LBP. Statements were generated from the survey for expert clinicians to rate (round 2) and rerate (round 3). Consensus was gained when agreement reached a mean of 7 out of 10 and disagreement was 2 SD or less. RESULTS: Thirty-one experienced clinicians participated in round 1. Thirteen of 20 invited expert clinicians responded to round 2 (response rate 65%) and 12 of the 13 participated in round 3 (response rate 92%).One hundred and fifty-three of 215 statements (71%) relating to the management of LBP in elite and subelite rowers acquired consensus status. Four of six statements (67%) concerning developing rowers and two of four (50%) concerning masters rowers gained consensus. CONCLUSION: In the absence of established evidence, these consensus-derived statements are imperative to inform the development of guidelines for the assessment and management of rowing-related LBP. Findings broadly reflect adult LBP guidelines with specific differences. Future research is needed to strengthen specific recommendations and develop best practice guidelines in this athletic population.
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Dolor Agudo , Dolor de la Región Lumbar , Deportes Acuáticos , Adulto , Consenso , Técnica Delphi , Humanos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/terapiaRESUMEN
BACKGROUND: Low back pain (LBP) is common in rowers. Understanding rowing biomechanics may help facilitate prevention and improve rehabilitation. OBJECTIVES: To define the kinematics and muscle activity of rowers and to compare with rowers with current or LBP history. DESIGN: Systematic review. DATA SOURCES: EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Scopus from inception to December 2019. Grey literature was searched. STUDY ELIGIBILITY CRITERIA: Experimental and non-experimental designs. METHODS: Primary outcomes were kinematics and muscle activity. Modified Quality Index (QI) checklist was used. RESULTS: 22 studies were included (429 participants). Modified QI score had a mean of 16.7/28 points (range: 15-21). Thirteen studies investigated kinematics and nine investigated muscle activity. Rowers without LBP ('healthy') have distinct kinematics (neutral or anterior pelvic rotation at the catch, greater hip range of motion, flatter low back spinal position at the finish) and muscle activity (trunk extensor dominant with less flexor activity). Rowers with LBP had relatively greater posterior pelvic rotation at the catch, greater hip extension at the finish and less efficient trunk muscle activity. In both groups fatigue results in increased lumbar spine flexion at the catch, which is greater on the ergometer. There is insufficient evidence to recommend one ergometer type (fixed vs dynamic) over the other to avoid LBP. Trunk asymmetries are not associated with LBP in rowers. CONCLUSION: Improving clinicians' and coaches' understanding of safe and effective rowing biomechanics, particularly of the spine, pelvis and hips may be an important strategy in reducing incidence and burden of LBP.
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OBJECTIVES: Low back pain (LBP) is common in rowers and leads to considerable disability and even retirement. The athlete voice can help clinicians to better understand sport-related pain disorders. We aimed to capture the lived experience of LBP in rowers. METHODS: Cross-sectional qualitative study using a grounded theory approach. Adult competitive rowers with a rowing-related LBP history were recruited in Australia and Ireland. Data were collected through interviews that explored: context around the time of onset of their LBP and their subsequent journey, experiences of management/treatment, perspectives around present beliefs, fears, barriers and expectations for the future. RESULTS: The 25 rowers (12 women/13 men) who participated were aged 18-50 years; they had a mean 12.1 years of rowing experience. They discussed a culture of concealment of pain from coaches and teammates, and fear of being judged as 'weak' because of the limitations caused by LBP. They reported fear and isolation as a result of their pain. They felt that the culture within rowing supported this. They reported inconsistent messages regarding management from medical staff. Some rowers reported being in a system where openness was encouraged-they regarded this a leading to better outcomes and influencing their LBP experience. CONCLUSIONS: Rowers' lived experience of LBP was influenced by a pervasive culture of secrecy around symptoms. Rowers and support staff should be educated regarding the benefits of early disclosure and rowers should be supported to do so without judgement.
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Decepción , Dolor de la Región Lumbar/psicología , Deportes Acuáticos/lesiones , Adolescente , Adulto , Australia , Estudios Transversales , Revelación , Femenino , Teoría Fundamentada , Humanos , Irlanda , Dolor de la Región Lumbar/etiología , Masculino , Persona de Mediana Edad , Cultura Organizacional , Influencia de los Compañeros , Factores de Riesgo , Aislamiento Social , Deportes Acuáticos/psicología , Adulto JovenRESUMEN
OBJECTIVE: To summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement. DATA SOURCES: Five databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS). RESULTS: Among 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment; no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments. CONCLUSIONS: While several treatments for LBP in athletes improved pain and function, it was unclear what the most effective treatments were, and for whom. Exercise approaches generally reduced pain and improved function in athletes with LBP, but the effect on RTS is unknown. No conclusions regarding the value of manual therapy (massage, spinal manipulation) or biomechanical modifications alone could be drawn because of insufficient evidence. High-quality RCTs are urgently needed to determine the effect of commonly used interventions in treating LBP in athletes.
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Atletas , Evaluación de la Discapacidad , Dolor de la Región Lumbar/terapia , Volver al Deporte , Adolescente , Adulto , Anciano , Sesgo , Ciclismo , Críquet , Terapia por Ejercicio/métodos , Femenino , Golf , Hockey , Humanos , Dolor de la Región Lumbar/diagnóstico , Masculino , Artes Marciales , Masaje/métodos , Persona de Mediana Edad , Manipulaciones Musculoesqueléticas , Dimensión del Dolor/métodos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Resultado del Tratamiento , Adulto JovenRESUMEN
PURPOSE: To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus statement to inform clinical practice. METHODS: There were four synthesis steps that informed the consensus statement. In step one, seven expert clinicians and researchers established the scope of the consensus statement and conducted a survey of experienced and expert clinicians to explore current practice. In step two, working groups examined current evidence relating to key scope questions and summarised key issues. In step three, we synthesised evidence for each group and used a modified Delphi process to aid in the creation of the overall consensus statements. Finally, in step four, we combined information from step three with the findings of the clinician survey (and with athlete and coach input) to produce recommendations for clinical practice. RESULTS: The scope of the consensus statement included epidemiology; biomechanics; management; the athlete's voice and clinical expertise. Prevention and management of LBP in rowers should include education on risk factors, rowing biomechanics and training load. If treatment is needed, non-invasive management, including early unloading from aggravating activities, effective pain control and exercise therapy should be considered. Fitness should be maintained with load management and progression to full training and competition. The role of surgery is unclear. Management should be athlete focused and a culture of openness within the team encouraged. CONCLUSION: Recommendations are based on current evidence and consensus and aligned with international LBP guidelines in non-athletic populations, but with advice aimed specifically at rowers. We recommend that research in relation to all aspects of prevention and management of LBP in rowers be intensified.
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Traumatismos en Atletas/prevención & control , Traumatismos en Atletas/terapia , Dolor de la Región Lumbar/prevención & control , Dolor de la Región Lumbar/terapia , Deportes Acuáticos/lesiones , Adulto , Consenso , Técnica Delphi , Medicina Basada en la Evidencia , Humanos , Encuestas y Cuestionarios , Investigación Biomédica TraslacionalRESUMEN
The purpose of this study was to investigate longitudinal body mass and body composition changes in one professional rugby union team (n=123), (i) according to position [forwards (n=58) versus backs (n=65)], analysis of players with 6 consecutive seasons of DXA scans (n=21) and, (iii) to examine differences by playing status [academy and international], over 7 years. Players [mean age: 26.8 y, body mass index: 28.9+kg.m2] received DXA scans at fourtime points within each year. A modest (but non-significant) increase in mean total mass (0.8 kg) for professional players was reflected by increased lean mass and reduced body fat mass. At all-time points, forwards had a significantly greater total mass, lean mass and body fat percentage compared to backs (p<0.05). Academy players demonstrated increased total and lean mass and decreased body fat percentage over the first 3 years of senior rugby, although this was not significant. Senior and academy international players had greater lean mass and lower body fat percentage (p<0.05) than non-international counterparts. Despite modest increases in total mass; reflected by increased lean mass and reduced fat mass, no significant changes in body mass or body composition, irrespective of playing position were apparent over 7 years.
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Composición Corporal , Índice de Masa Corporal , Rugby , Absorciometría de Fotón , Adulto , Humanos , Estudios Longitudinales , Masculino , Rugby/fisiología , Estaciones del AñoRESUMEN
Axial spondyloarthropathy (axSpA) is associated with an increased prevalence of osteoporosis, but no recommendations exist to guide management. This systematic review and meta-analysis aim to assess the efficacy of pharmacological and non-pharmacological interventions on bone mineral density (BMD) in axSpA. Electronic databases were searched from inception to June 2019 for randomised controlled trials (RCTs) and quasi (q)-RCTs with pharmacological and non-pharmacological interventions. Independent reviewers undertook screening, and risk of bias and quality assessments. Primary outcomes of interest were BMD at spine and hip. Eight studies (two RCTs and six qRCTs) were included (602 participants). Moderate level evidence favoured alendronate over placebo at femoral neck [mean difference (MD) 2.01, 95% CI 0.67 to 3.35], but there was low-level evidence showing no effect at the spine. There was moderate level evidence showing no effect of tumour necrosis factor inhibitors (TNFi) on BMD at total hip (MD - 0.01, 95% CI - 0.06 to 0.04). Very low-level evidence demonstrated no effect of TNFi on spine or femoral neck. Moderate level evidence favoured neridronate over infliximab at the spine (MD 3.26, 95% CI 1.14 to 5.38), but low-level evidence showed no effect at the total hip (MD 2.75, 95% CI - 0.21 to 5.71). There were no eligible studies investigating the efficacy of non-pharmacological interventions. We conditionally recommend alendronate for management of low BMD in axSpA. The balance of evidence does not recommend the use of TNF-inhibitors for treating low BMD. There is a lack of high-quality evidence guiding clinicians treating osteoporosis in axSpA.
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Conservadores de la Densidad Ósea/uso terapéutico , Osteoporosis/tratamiento farmacológico , Espondiloartritis/complicaciones , Inhibidores del Factor de Necrosis Tumoral/uso terapéutico , Adulto , Densidad Ósea/efectos de los fármacos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/complicaciones , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
OBJECTIVES: We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching. ELIGIBILITY CRITERIA: Studies evaluating prevalence of LBP in adult athletes across all sports. RESULTS: Eighty-six studies were included (30 732, range 20-5958, participants), of which 45 were of 'high' quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%-80% (95% CI 27% to 58%, I2=97%). Lifetime prevalence across 13 studies was 63%; range 36%-88% (95% CI 51% to 74%, I2=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%-94% (95% CI 41% to 61%, I2=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6-4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport. CONCLUSION: LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.
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Physical activity (PA) and exercise programmes are recommended for the management of fibromyalgia. Despite positive effects on symptoms and function, PA promotion remains a significant clinical challenge. Behaviour change theories and techniques are recommended as part of complex health interventions; their integration into interventions aimed at PA behaviour in people with fibromyalgia is not known. This review explored behaviour change interventions targeting PA in adults with fibromyalgia. A systematic review was conducted; randomized and quasi-randomized controlled trials with at least one behaviour change intervention targeting PA were included. MEDLINE/OVID, EMBASE, PEDro, PsychINFO, CINAHL, Scopus, Web of Science, the Cochrane Central Register of Controlled Trials and relevant conference abstracts were searched. Two authors independently screened studies for inclusion and performed risk of bias assessments. Articles were reviewed for their use of behaviour change theory and behaviour change techniques (BCTs). The search identified 2491 records, from which eight studies (1416 participants) were included. PA and exercise behaviours were the primary focus of four interventions and were components of broader interventions in four studies. Behaviour change theories informed four interventions. Thirty-two different BCTs were used across studies. Five studies reported improvements in PA either post-intervention or at follow-up. Two studies used objective PA measures and seven studies used self-report measures. Short-term benefits in pain, quality of life, and physical fitness were also observed. Behaviour change interventions targeting PA in people with fibromyalgia have had limited success to date. With significant variations in intervention designs, the optimal intervention remains unknown.
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Terapia Conductista , Terapia por Ejercicio , Ejercicio Físico , Fibromialgia/rehabilitación , HumanosRESUMEN
Mental health peer support is an evidence-based approach called for by Canada's mental health strategy that presents health leaders with an opportunity to transform mental health service experiences, improve health outcomes, and lower overall system costs. Originally offered in community settings, peer support has been expanding to clinical settings, but challenges to integration exist. This qualitative case study of peer support in clinical settings in Canada and Norway examines the perceived value of peer support and change management strategies that health leaders, managers, staff, and peer support providers can use to support integration of peer support in existing healthcare teams in clinical settings. Recommended strategies for health leaders include adopting a gradual approach to integration, building champions, demonstrating value, focusing on resistant groups, adopting a continuous improvement approach, setting peer support as an organizational priority, and linking peer support to patient-centred care.
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Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Grupo Paritario , Apoyo Social , Canadá , Humanos , Liderazgo , Trastornos Mentales/psicología , Modelos Organizacionales , NoruegaRESUMEN
Key Message Powdery mildew resistance in two strawberry mapping populations is controlled by both stable and transient novel QTL of moderate effect. Some low transferability of QTL across wider germplasm was observed. The obligate biotrophic fungus Podosphaera aphanis is the causative agent of powdery mildew on cultivated strawberry (Fragaria × ananassa). Genotypes from two bi-parental mapping populations 'Emily' × 'Fenella' and 'Redgauntlet' × 'Hapil' were phenotyped for powdery mildew disease severity in a series of field trials. Here, we report multiple QTL associated with resistance to powdery mildew, identified in ten phenotyping events conducted across different years and locations. Six QTL show a level of stable resistance across multiple phenotyping events; however, many other QTL were represented in a single phenotyping event and therefore must be considered transient. Subsequent screening of identified QTL across a validation set determined whether identified QTL remained closely linked to the associated resistance gene in the wider germplasm. Furthermore, a preliminary association analysis identified a novel conserved locus for further investigation. Our data suggest that resistance is highly complex and that multiple, primarily additive, sources of quantitative resistance to powdery mildew exist across strawberry germplasm. Utilisation of the reported markers in marker-assisted breeding or genomic selection would lead to improved powdery mildew-resistant strawberry cultivars, particularly where the studied parents, progeny and close pedigree material are included in breeding germplasm.
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Resistencia a la Enfermedad/genética , Fragaria/genética , Enfermedades de las Plantas/genética , Sitios de Carácter Cuantitativo , Ascomicetos , Mapeo Cromosómico , Fragaria/microbiología , Ligamiento Genético , Genotipo , Fenotipo , Fitomejoramiento , Enfermedades de las Plantas/microbiologíaRESUMEN
OBJECTIVES: Examine the effects of match play and a season of training on serum S100B concentration in male professional rugby players. To assess the influence of contact play, values were compared with age- and fitness-matched athletes not involved in a contact sport. METHODS: Over a 2-year period, blood samples were collected from 38 players in pre-season, end of season, and post-matches (within 2 h). A control group of rowers (n = 15) was assessed pre- and post-training. RESULTS: S100B concentration changed significantly over a season (χ2(2) = 17.636, p < 0.0005); post-match values were significantly increased from baseline (early season: Z = -3.670, p < 0.0005; late season: Z = -3.408, p = 0.001). There were no significant differences in S100B concentrations between pre-seasons (Z = -1.601, p = 0.109), or between end of season and subsequent pre-season (Z = -0.330, p = 0.741). While comparable at baseline, samples taken from rugby players post-match were significantly increased compared with samples taken from rowers post-exercise (U = 47.0, p < 0.0005). CONCLUSION: Exercise has a significant effect on circulating S100B in elite male athletes, with levels following rugby matches significantly higher than following non-contact sport. This elevation in S100B is temporary, with a return to baseline values after periods without play.