Leadership experiences of elite football team physicians during the COVID-19 pandemic: a pilot study.

OBJECTIVES: The purpose of this study was to explore the leadership experiences of elite football team physicians during the COVID-19 pandemic. METHODS: A pilot-study based on a cross-sectional design by means of an electronic survey was conducted. The survey relied on 25 questions divided into distinct sections including among others professional and academic experience, leadership experiences and perspectives. RESULTS: A total of 57 physicians (91% male; mean age: 43 years) gave their electronic informed consent and completed the survey. All participants agreed that the demands of their role had increased during the COVID-19 pandemic. Fifty-two (92%) participants reported that they felt they were expected to take more of a leadership role during the COVID-19 pandemic. Eighteen (35%) reported feeling under pressure to make clinical decisions which were not in keeping with best clinical practice. Additional roles, duties and demands expected of team doctors during the COVID-19 pandemic were subdivided into communication, decision-making, logistical, and public health demands. CONCLUSION: The findings from this pilot study suggest that the way in which team physicians at professional football clubs operate has altered since the onset of the COVID-19 pandemic, with greater demands placed on leadership skills including decision-making, communication and ethical stewardship. This has potential implications for sporting organisations, clinical practice and research.

The exchange of health and performance information when transitioning from club to National football teams: A Delphi survey of National team practitioners.

OBJECTIVES: To establish agreement in National team contexts when players transition from club to National team about (i) what medical and physical information to collect, (ii) how to use information (iii) identifying challenges to collection and (iv) collection methods. DESIGN: Delphi survey. METHODS: A series of sequential online questionnaires were sent to heads of medical and performance of the 32 National teams following the FIFA 2018 World Cup. Two separate Delphi's; 'Medical' and 'Physical' were administered. The 'Medical' respondent was the person responsible for player health. 'Physical' referred to the person responsible for physical performance. Content analyses were performed, with subsequent rounds designed according to responses of the previous. Agreement was considered at ≥70%. RESULTS: Twenty-three Medical (72%) and 14 (44%) Physical heads participated in Round 1 (3 rounds total). Seventeen Medical and 12 Physical respondents completed all rounds. Medical information agreed upon injury epidemiology, screening and injury treatment strategies. Physical information included training/match-loads, fatigue, wellness and current exercise programmes. Both Medical and Physical agreed information should be used to plan and individualise player programmes. Additionally medical information should guide coaches' national team selection. Communication, willingness to share and quality/completeness of information were agreed as main challenges. Medical and Physical respondents agreed a standardised reporting form and electronic shared database as best option to collect information. CONCLUSIONS: Our findings highlight the importance of health and performance information exchange between national and club teams. Further, this exchange should be cooperative, symbiotic and a two-way process to assist with improving player health.

Epidemiologic investigation of lead poisoning in trumpeter and tundra swans in Washington State, USA, 2000-2002.

An observational study was conducted to determine the proportionate mortality of wild trumpeter (Cygnus buccinator) and tundra (Cygnus columbianus columbianus) swans that died during the winters of 2000-02 in northwestern Washington State, USA. Among 400 swans necropsied, 81% were lead poisoned (302/365 trumpeter swans; 20/35 tundra swans). Mortality started in mid-November and peaked from late December through mid-February; swan mortality that was not associated with lead poisoning was uniformly lower throughout the winter months. Lead poisoning was 24 times more likely to be the cause of death in swans found in Whatcom County compared to swans found in other locations in northwestern Washington State (95% CI: 12.7, 47.0). Mortality attributable to lead poisoning was twice as likely in adults as in juveniles (95% CI: 1.0, 4.2). Aspergillosis was documented in 62 trumpeter and two tundra swans, including 37 swans in which mortality was caused by lead poisoning. Males were twice as likely as females to have aspergillosis (95% CI: 1.1, 3.8). Traumatic injuries were documented in 37 trumpeter and seven tundra swans, including seven trumpeter swans with concurrent lead poisoning. Dead swans found outside Whatcom County were four times more likely to have traumatic injuries compared to those found in Whatcom County (95% CI: 1.6, 10.0). Overall, lead-poisoned swans were significantly less likely to have concurrent aspergillosis or traumatic injuries. There was no apparent association between grit ingestion (total mass or mass categorized by size) and lead poisoning or number of lead shot. Not surprisingly, lead-poisoned swans were more likely to have one or more lead shot compared to swans that died from other causes (OR 294; 95% CI: 92, 1,005); lead-poisoned swans were also more likely to have one or more nontoxic shot compared to swans that were not poisoned (OR 63; 95% CI: 19, 318). The source(s) of shot are unknown but likely are in or near Whatcom County, Washington.