Challenges that healthcare practitioners experience in the comprehensive assessment of patients with non-communicable diseases: a preliminary investigation.

BACKGROUND: Resource allocation and access to comprehensive treatment in the public healthcare sector are always under pressure. This pressure takes the form of staff shortages, treatment models and the holistic care of patients, compromising basic healthcare in South Africa. OBJECTIVES: The study's aim was to determine the challenges that healthcare practitioners experience while assessing patients with non-communicable diseases, in private and public healthcare sectors in the Gauteng Province of South Africa. METHODS: The research design was exploratory and contextual. Qualitative data were collected through focus groups and semi-structured interviews among healthcare practitioners (n = 12). Data analysis took place using Atlas.ti 8.4 Windows (2020). Inter-rater reliability (r = 93.68%) was calculated to ensure the rigour and validity of the results. RESULTS: From the discussion, four themes emerged: 1) limited consultation time; 2) overwhelming economic impact and healthcare cost for facilities and patients; 3) holistic patient care encompassing physical, mental and socioeconomic components; and 4) lack of patient education due to time constraints experienced by healthcare practitioners. CONCLUSION: Consultation times are reduced due to a shortage of medical staff, patient numbers, equipment, and poor working conditions. By improving these conditions, patients across all socioeconomic groups will be better assisted, treated, and educated, benefiting from equal access and quality healthcare.

Pacing characteristics of whole and part-game players in professional rugby union.

Contemporary theories on players' intensity distribution in team sports suggest that they regulate their outputs using pacing strategies. There is currently limited information on how movement patterns and pacing strategies of rugby union players in different position groups (forwards and backs) vary when exposed to different bout types (whole game, starter or finisher). Global positioning system (GPS) and accelerometer data were collected from 100 professional match participations to determine temporal effects on movement patterns. For forwards, finishers (players who entered the game as substitutes) demonstrated significantly greater high-speed running distance (% difference, ± 90%CI; magnitude-based inference and effect size) (↑ 55, ±17%; very likely large) and acceleration frequency (↑ 78, ±59%; very likely large) than whole game players. For backs, starters (players who started the game and were later substituted) displayed greater high-speed running distance than whole game players (↑ 27, ±21%; ES = likely medium) but this difference did not achieve statistical significance (p = .07). Forwards displayed "slow-positive" pacing strategies regardless of bout type, while backs displayed "flat" pacing strategies. Forwards and backs adopt different pacing strategies regardless of bout type, with forwards demonstrating progressively greater performance decrements over the course of the match. These findings reflect differing physical demands, notably contact and running loads, of players in different positions.

Perceived Hindrances Experienced by Sport Coaches in South Africa.

The purpose of this study was to examine perceived hindrances encountered by sport coaches in the Gauteng Province of South Africa. A total of 224 sport coaches (122 males and 102 females) were purposively recruited to participate in this study. An exploratory factor analysis was used to assess the factor structure of the Perceived Hindrance Scale. The results of this study indicated the following as major hindrances encountered by sport coaches: "Lack of support systems for women players", "Lack of support for women coaches from superiors", "Low salary", "Lack of opportunities for promotion", "Difficulties with parents/spectators" and "Lack of job security". Recommendations on strategies to overcome these perceived hindrances are discussed.

Impact of Fatigue on Positional Movements During Professional Rugby Union Match Play.

PURPOSE: In team sports, fatigue is manifested by a self-regulated decrease in movement distance and intensity. There is currently limited information on the effect of fatigue on movement patterns in rugby union match play, particularly for players in different position groups (backs vs forwards). This study investigated the effect of different match periods on movement patterns of professional rugby union players. METHODS: Global positioning system (GPS) data were collected from 46 professional match participations to determine temporal effects on movement patterns. RESULTS: Total relative distance (m/min) was decreased in the 2nd half for both forwards (-13%, ±8%, ES = very likely large) and backs (-9%, ±7%, ES = very likely large). A larger reduction in high-intensity-running distance in the 2nd half was observed for forwards (-27%, ±16%, ES = very likely medium) than for backs (-10%, ±15%; ES = unclear). Similar patterns were observed for sprint (>6 m/s) frequency (forwards -29%, ±29%, ES = likely small vs backs -13% ±18%, ES = possibly small) and acceleration (>2.75 m/s2) frequency (forwards -27%, ±24%, ES = likely medium vs backs -5%, ±46%, ES = unclear). Analysis of 1st- and 2nd-half quartiles revealed differing pacing strategies for forwards and backs. Forwards display a "slow-positive" pacing strategy, while the pacing strategy of backs is "flat." CONCLUSIONS: Forwards suffered progressively greater performance decrements over the course of the match, while backs were able to maintain performance intensity. These findings reflect differing physical demands, notably contact and running loads, of players in different positions.

Preseason Functional Movement Screen Component Tests Predict Severe Contact Injuries in Professional Rugby Union Players.

Tee, JC, Klingbiel, JFG, Collins, R, Lambert, MI, and Coopoo, Y. Preseason Functional Movement Screen component tests predict severe contact injuries in professional rugby union players. J Strength Cond Res 30(11): 3194-3203, 2016-Rugby union is a collision sport with a relatively high risk of injury. The ability of the Functional Movement Screen (FMS) or its component tests to predict the occurrence of severe (≥28 days) injuries in professional players was assessed. Ninety FMS test observations from 62 players across 4 different time periods were compared with severe injuries sustained during 6 months after FMS testing. Mean composite FMS scores were significantly lower in players who sustained severe injury (injured 13.2 ± 1.5 vs. noninjured 14.5 ± 1.4, Effect Size = 0.83, large) because of differences in in-line lunge (ILL) and active straight leg raise scores (ASLR). Receiver-operated characteristic curves and 2 × 2 contingency tables were used to determine that ASLR (cut-off 2/3) was the injury predictor with the greatest sensitivity (0.96, 95% confidence interval [CI] = 0.79-1.0). Adding the ILL in combination with ASLR (ILL + ASLR) improved the specificity of the injury prediction model (ASLR specificity = 0.29, 95% CI = 0.18-0.43 vs. ASLR + ILL specificity = 0.53, 95% CI = 0.39-0.66, p ≤ 0.05). Further analysis was performed to determine whether FMS tests could predict contact and noncontact injuries. The FMS composite score and various combinations of component tests (deep squat [DS] + ILL, ILL + ASLR, and DS + ILL + ASLR) were all significant predictors of contact injury. The FMS composite score also predicted noncontact injury, but no component test or combination thereof produced a similar result. These findings indicate that low scores on various FMS component tests are risk factors for injury in professional rugby players.

Coaches' Preferences for Continuing Coaching Education in South Africa.

The purpose of this study was to examine coaches' preferences for continuing coaching education. The sample consisted of 122 male and 102 female coaches from the Gauteng Province of South Africa who were purposively recruited to participate in this study. The results of this study showed that the coaches wanted to learn more about motivational techniques, advanced instructional drills, advanced first aid, goal setting, character building and conditioning drills. The results further indicated that sport coaches would be more likely to continue their coaching education if they had a desire to coach at a high level, if topics were relevant and if courses were in line with league requirements and were available online. The practical implications of the findings for the development of coaching education programmes in South Africa were discussed.

Shoulder injury incidence and severity through identification of risk factors in rugby union players.

OBJECTIVE: This study aimed to analyze shoulder injury incidence and severity to reduce players' risk of sustaining injuries and missing playing time. METHODS: Ninety-five South African Premier team rugby Union players (mean: 25 years of age) took part in the study with injury data collected through the use of injury reports. RESULTS: This study found that approximately two of every five participants sampled incurred a primary shoulder injury with dislocation being the most prevalent. Twenty-one (80.8%) of the participants that experienced a primary shoulder injury also sustained a secondary shoulder injury with rotator cuff tears being most predominant. Only three players were found to have suffered tertiary shoulder injuries. The injuries were mainly related to tackling during training and matches. Twenty players were found to have adhered to a strength and conditioning program prior to their injuries and 14 of the injured participants received or adhered to a prehabilitation program. Eight of the injured players also suffered from recurrent injuries with dislocations being the most common. CONCLUSIONS: RESULTS indicated that specific positions in rugby are at higher risk of shoulder injuries than others and that with the correct preventive measures put in place, the severity of injuries can be reduced.