'More than likely the men come first. That's just very frustrating'. A qualitative exploration of contextual factors affecting the implementation of injury prevention initiatives and the provision of effective injury management in elite-level women's club football in Ireland.

OBJECTIVES: The aim of our study was to explore the contextual factors that affect the implementation of football injury prevention initiatives and the provision of effective injury management in the Irish Women's National League (WNL). METHODS: We used a criterion-based purposive sampling approach to recruit coaches (n=7), players (n=17) and medical personnel (n=8) representing eight of the nine clubs in the WNL to participate in one-to-one semistructured interviews. Our study was located within an interpretivist, constructivist research paradigm. The interview data were analysed using reflexive thematic analysis. RESULTS: The participants identified academic and work pressures, financial challenges, conflict with college football, inadequate facilities and gender inequity as being barriers to the implementation of injury prevention initiatives and the provision of effective injury management. Financial constraints within clubs were perceived to limit the provision of medical care and strength and conditioning (S&C) support and this was deemed to be associated with a heightened risk of injuries. CONCLUSION: Specific contextual factors were identified which curtail the implementation of injury prevention initiatives and the provision of effective injury management in elite-level women's club football in Ireland. Gender inequity was identified as one of the factors impacting the availability of high-quality medical care, S&C support, as well as access to training and match facilities. Our results provide new insights that could be used to inform the design and implementation of injury prevention and management initiatives for women football players in Ireland.

Injuries in elite-level women's football-a two-year prospective study in the Irish Women's National League.

We investigated the pattern of injuries in elite-level women's football in Ireland, during a two-season prospective injury surveillance study in the Women's National League (WNL). Seven out of the eight clubs (271 players) in the WNL were followed prospectively during the 2018 and 2019 seasons. The injury incidence rate in matches (19.2/1000 h) was 7.5 times higher than in training (2.5/1000 h). Players, on average, sustained 0.69 injuries per season (266 injuries/383 player seasons), which equates to 15 time-loss injuries per season for a squad of 22 players. The majority of the injuries sustained by players were lower extremity injuries (85%), of which, 46% had a non-contact injury mechanism. Muscle, ligament, and contusion injuries were the most common injury types, while the ankle, knee, and thigh were the most commonly injured body sites. The most common injuries sustained over the two seasons were lateral ankle sprains (13.9%), hamstring strains (12.4%), knee meniscus/cartilage injuries (7.5%), adductor strains (6%), quadriceps strains (4.5%), and ankle contusions (4.5%). The injuries with the highest injury burden were ACL injuries (59 days lost/1000 h), knee meniscus/cartilage injuries (23/1000 h), lateral ankle sprains (21/1000 h), hamstring strains (12/1000 h), MCL sprains (11/1000 h), and quadriceps strains (11/1000 h). There were 8 ACL tears documented over the 2 seasons, which accounted for 28% of all time lost to injury with a mean days lost per injury of 247. We recommend that clubs in the WNL in Ireland should implement injury risk mitigation strategies, with a particular focus on injuries with a high injury burden.

Development and validation of a multi-lingual online questionnaire for surveying the COVID-19 prevention and control measures used in global workplaces.

BACKGROUND: Despite widespread COVID-19 vaccination programs, there is an ongoing need for targeted disease prevention and control efforts in high-risk occupational settings. This study aimed to develop, pilot, and validate an instrument for surveying occupational COVID-19 infection prevention and control (IPC) measures available to workers in diverse geographic and occupational settings. METHODS: A 44-item online survey was developed in English and validated for face and content validity according to literature review, expert consultation, and pre-testing. The survey was translated and piloted with 890 workers from diverse industries in Canada, Ireland, Argentina, Poland, Nigeria, China, the US, and the UK. Odds ratios generated from univariable, and multivariable logistic regression assessed differences in 'feeling protected at work' according to gender, age, occupation, country of residence, professional role, and vaccination status. Exploratory factor analysis (EFA) was conducted, and internal consistency reliability verified with Cronbach's alpha. Hypothesis testing using two-sample t-tests verified construct validity (i.e., discriminant validity, known-groups technique), and criterion validity. RESULTS: After adjustment for occupational sector, characteristics associated with feeling protected at work included being male (AOR = 1.88; 95% CI = 1.18,2.99), being over 55 (AOR = 2.17; 95% CI = 1.25,3.77) and working in a managerial position (AOR = 3.1; 95% CI = 1.99,4.83). EFA revealed nine key IPC domains relating to: environmental adjustments, testing and surveillance, education, costs incurred, restricted movements, physical distancing, masking, isolation strategies, and areas for improvement. Each domain showed sufficient internal consistency reliability (Cronbach's alpha ≥0.60). Hypothesis testing revealed differences in survey responses by country and occupational sector, confirming construct validity (p < 0.001), criterion validity (p = 0.04), and discriminant validity (p < 0.001). CONCLUSIONS: The online survey, developed in English to identify the COVID-19 protective measures used in diverse workplace settings, showed strong face validity, content validity, internal consistency, criterion validity, and construct validity. Translations in Chinese, Spanish, French, Polish, and Hindi demonstrated adaptability of the survey for use in international working environments. The multi-lingual tool can be used by decision makers in the distribution of IPC resources, and to guide occupational safety and health (OSH) recommendations for preventing COVID-19 and future infectious disease outbreaks.

A systematic review of reviews identifying UK validated dietary assessment tools for inclusion on an interactive guided website for researchers: www.nutritools.org.

Background: Health researchers may struggle to choose suitable validated dietary assessment tools (DATs) for their target population. The aim of this review was to identify and collate information on validated UK DATs and validation studies for inclusion on a website to support researchers to choose appropriate DATs.Design: A systematic review of reviews of DATs was undertaken. DATs validated in UK populations were extracted from the studies identified. A searchable website was designed to display these data. Additionally, mean differences and limits of agreement between test and comparison methods were summarized by a method, weighting by sample size.Results: Over 900 validation results covering 5 life stages, 18 nutrients, 6 dietary assessment methods, and 9 validation method types were extracted from 63 validated DATs which were identified from 68 reviews. These were incorporated into www.nutritools.org. Limits of agreement were determined for about half of validations. Thirty four DATs were FFQs. Only 17 DATs were validated against biomarkers, and only 19 DATs were validated in infant/children/adolescents.Conclusions: The interactive www.nutritools.org website holds extensive validation data identified from this review and can be used to guide researchers to critically compare and choose a suitable DAT for their research question, leading to improvement of nutritional epidemiology research.

Association between eccentric knee flexor strength and hamstring injury risk in 185 elite Gaelic football players.

Hamstring strains are the most common time-loss injury in elite Gaelic football affecting over 20% of players per season. Thus, there is a need to identify factors contributing to the onset of hamstring injuries in order to inform injury risk management strategies. The current study investigated whether eccentric knee flexor strength and between-limb imbalances were associated with increased risk of sustaining a time-loss hamstring injury in elite Gaelic football players. A total of 185 elite male players (26.9 ± 2.7 years, 86.4 ± 6.2 kg, 183.4 ± 5.6) were prospectively followed for 12 weeks from the day of testing. Injury data were provided by the team medical staff. Twenty-eight players (16%) sustained a time-loss hamstring injury following testing. Players that did not sustain a hamstring injury had greater average between-limb asymmetries (uninjured = 9.1%, 95% CI 7.8-10.1; injured = 5.1%, 95% CI 3.7-6.7; P = .001). Eccentric knee flexor strength profiles were not associated with increased or decreased risk of sustaining a hamstring injury and did not alter the post-test probability of sustaining a hamstring injury across the investigation period. These findings do not support the use of eccentric knee flexor strength metrics in managing hamstring injury risk in elite male Gaelic football players.

Are questionable research practices facilitating new discoveries in sport and exercise medicine? The proportion of supported hypotheses is implausibly high.

Questionable research practices (QRPs) are intentional and unintentional practices that can occur when designing, conducting, analysing, and reporting research, producing biased study results. Sport and exercise medicine (SEM) research is vulnerable to the same QRPs that pervade the biomedical and psychological sciences, producing false-positive results and inflated effect sizes. Approximately 90% of biomedical research reports supported study hypotheses, provoking suspicion about the field-wide presence of systematic biases to facilitate study findings that confirm researchers' expectations. In this education review, we introduce three common QRPs (ie, HARKing, P-hacking and Cherry-picking), perform a cross-sectional study to assess the proportion of original SEM research that reports supported study hypotheses, and draw attention to existing solutions and resources to overcome QRPs that manifest in exploratory research. We hypothesised that ≥ 85% of original SEM research studies would report supported study hypotheses. Two independent assessors systematically identified, screened, included, and extracted study data from original research articles published between 1 January 2019 and 31 May 2019 in the British Journal of Sports Medicine, Sports Medicine, the American Journal of Sports Medicine, and the Journal of Orthopaedic & Sports Physical Therapy We extracted data relating to whether studies reported that the primary hypothesis was supported or rejected by the results. Study hypotheses, methodologies, and analysis plans were preregistered at the Open Science Framework. One hundred and twenty-nine original research studies reported at least one study hypothesis, of which 106 (82.2%) reported hypotheses that were supported by study results. Of 106 studies reporting that primary hypotheses were supported by study results, 75 (70.8%) studies reported that the primary hypothesis was fully supported by study results. The primary study hypothesis was partially supported by study results in 28 (26.4%) studies. We detail open science practices and resources that aim to safe-guard against QRPs that bely the credibility and replicability of original research findings.

Cross-Sectional Investigation of Self-Reported Concussions and Reporting Behaviors in 866 Adolescent Rugby Union Players: Implications for Educational Strategies.

OBJECTIVE: To examine the self-recalled concussion and bell ringer (BR) prevalence, reporting rates, and reporting behaviors in adolescent rugby players. DESIGN: Cross-sectional survey. SETTING: School classroom. PARTICIPANTS: Adolescent male rugby players aged 12 to 18 years (n = 866). MAIN OUTCOME MEASURES: Concussion and BR prevalence, reporting rates, and reporting behaviors. RESULTS: The sample reported a concussion and BR prevalence rate of 40% and 69.9%, respectively. Of these athletes with a history, 38.4% and 86.4% suffered recurrent concussions and BRs, respectively. The total reporting rates per 1000 suspected concussions and BRs were 474.8 [95% confidence interval (CI), 415.4-534.3] and 238.7 (95% CI, 217.8-259.5), respectively. The athletes highlighted several barriers which hindered their truthful reporting of concussion, including "not thinking the injury is serious enough to report" (70%), "wanting to win the game" (38%), and "not wanting to miss future games or training" (48%). CONCLUSIONS: Educational interventions are an invaluable component within a socioecological framework aimed at improving the concussion reporting rates of adolescent athletes. The self-recalled prevalence, underreporting rates, and behaviors of the sample are alarming, which prompts the need to further explore their motivational beliefs behind their decision to underreport a potential concussion. The information obtained can be used to tailor personalized interventions for specific athlete samples.

Factors that Influence Session-Rating of Perceived Exertion in Elite Gaelic Football.

Malone, S, Hughes, B, Roe, M, Mangan, S, and Collins, K. Factors that influence session-rating of perceived exertion in elite Gaelic football. J Strength Cond Res 34(4): 1176-1183, 2020-The current investigation examined the relationships between external training load (TL) measures and the session rating of perceived exertion (s-RPE) within Gaelic football players. Furthermore, we examined the effect that player experience, playing position, and 1-km time trial (TT) performance had on perception of TL. Physical performance (total distance, high-speed distance, very high-speed distance, max velocity, total accelerations, and maximal velocity exposures) and perceived TL (s-RPE) data were collected from 45 elite intercounty Gaelic football players (mean ± SD age of 24.2 ± 2.9 years; height: 180 ± 7 cm; mass: 81 ± 7 kg) over a 1-year period this resulted in 4,095 individual training session data being collected. There were moderate to very large associations between s-RPE and distance measures. Post hoc analysis revealed that the 0-1-year group had a higher s-RPE TL than the 2-3-year (d = 0.84 ± 0.33, small), 4-6-year (d = 0.91 ± 0.30, small), and 7+ year (d = 0.81 ± 0.30, small) groups. Midfielders reported higher s-RPE when compared with all positions (d = 1.21 ± 0.21, moderate). Half-backs (d = 0.81 ± 0.30, small), and half-forwards (d = 0.84 ± 0.31, small) had a higher s-RPE TL than the full-backs and full-forwards when external TL was accounted for (d = 1.21 ± 0.58, moderate). When aerobic fitness was considered, a 1.2% AU increase in s-RPE TL per 1 second increase in TT time (90% confidence limits: 1.07-2.64) when external TL was held constant was observed. The current investigation has shown moderate to very large associations between s-RPE and distance measures. When experience and fitness were considered as potential moderators of TL, it was observed that a given external TL may result in different internal responses between athletes. This potentially leaves individuals at risk of overtraining or failing to elicit positive adaptation. It is therefore vital that coaches and trainers give consideration to these mediators of s-RPE TL.

The Synthesis of Waltherione F and Its Analogues with Modifications at the 2- and 3-Positions as Potential Antitrypanosomal Agents.

Chagas disease also know as American Trypanosomiasis (AT) is a tropical parasitic disease endemic in South America, is caused by Trypanosoma cruzi, which is transmitted by the blood-sucking insect vectors called triatomine bugs. Quinoline alkaloids from the root extract of Waltheria indica are known to possess antitrypanosomal activity. Waltherione F, one of those alkaloids, was synthesised in 5 steps in 11 % overall yield. We report here the first X-ray crystallographic confirmation of the structure of Waltherione F 3. A key step in the sequence utilised the Conrad-Limpach synthesis for the formation of the quinolin-4(1H)-one ring system. Our synthetic strategy was designed to enable the modification of the 2- and 3-positions of the scaffold, allowing the generation of a diverse library of analogues to support our on-going medicinal chemistry program that is looking for new agents to tackle this devastating disease.

Hamstring injuries in elite Gaelic football: an 8-year investigation to identify injury rates, time-loss patterns and players at increased risk.

BACKGROUND: Hamstring injuries occur frequently in field sports, yet longitudinal information to guide prevention programmes is missing. AIM: Investigate longitudinal hamstring injury rates and associated time loss in elite Gaelic football, while identifying subgroups of players at increased risk. METHODS: 38 data sets from 15 elite male Gaelic football teams were received by the National Gaelic Athletic Association (GAA) Injury Surveillance Database between 2008 and 2015. Injury and exposure data were provided by the team's medical staff via an online platform. RESULTS: 391 hamstring injuries were sustained accounting for 21% (95% CI 20.0% to 21.7%) of all injuries. Prevalence was 21% (95% CI 19.2% to 23.4%). Incidences were 2.2 (95% CI 1.9 to 2.4) per 1000 exposure hours, and 7.0 (95% CI 6.5 to 7.1) times greater in match play than in training. Typically each team sustained 9.0 (95% CI 7.0 to 11.0) hamstring injuries per season affecting the: bicep femoris belly (44%; 95% CI 39.4% to 48.7%); proximal musculotendinous junction (13%; 95% CI 9.8% to 16.3%); distal musculotendinous junction (12%; 95% CI 8.6% to 14.9%) and semimembranosis/semitendinosis belly (9%; 95% CI 6.3% to 11.7%). ∼36% (95% CI 31.5% to 41.0%) were recurrent injuries. Mean time loss was 26.0 (95% CI 21.1 to 33.0) days, which varied with age, injury type and seasonal cycle. Hamstring injuries accounted for 31% (95% CI 25.8% to 38.2%) of injury-related time loss. Previously injured players (rate ratio (RR)=3.3), players aged 18-20 years (IRR=2.3) or >30 years (RR=2.3), as well as defensive (IRR=2.0) and midfield players (RR=1.5), were most at risk of sustaining a hamstring injury. Comparisons of 2008-2011 with 2012-2015 seasons revealed a 2-fold increase in hamstring injury incidences. Between 2008 and 2015 training incidence increased 2.3-fold and match-play incidences increased 1.3-fold. CONCLUSIONS: Hamstring injuries are the most frequent injury in elite Gaelic football, with incidences increasing from 2008-2011 to 2012-2015. Tailoring risk management strategies to injury history, age and playing position may reduce the burden of hamstring injuries.

Positional Anthropometric and Performance Profile of Elite Gaelic Football Players.

Shovlin, A, Roe, M, Malone, S, and Collins, K. Positional anthropometric and performance profile of elite gaelic football players. J Strength Cond Res 32(8): 2356-2362, 2018-The aim of the current investigation was to evaluate the variation in the anthropometric and performance characteristics of elite Gaelic football players with respect to position. One hundred forty-eight elite Gaelic footballers underwent anthropometric (height, body mass, sum of 7 skinfolds, and % adipose tissue) and performance (counter movement jump [CMJ] height, CMJ peak power, CMJ relative peak power, squat jump [SJ] height, SJ peak power, SJ relative peak power, 5-, 10-, and 20-m sprint times, and Yo-Yo Intermittent Recovery Test Level 2 [Yo-YoIRT2]) during "the early in-season" phase. Data were split into 5 positional groups (full back, half back, midfield, half forward, and full forward). Higher adipose tissue percentage estimate was observed in full forwards when compared with the half backs (p = 0.001), midfielders (p = 0.035), and half forwards (p = 0.021). Full forwards had significantly greater SJ (p = 0.036) and CMJ (p = 0.013) when compared with the midfielders with no other positional differences observed. No significant variation in sprint times was observed across the positions. When Yo-YoIRT2 was considered, full forwards and full backs completed significantly lower distances compared with the middle 3 positional lines of half backs, midfielders, and half forwards (p = 0.00). The current study is the first to provide normative data for anthropometric and performance values of elite Gaelic football players which in turn can be used by coaches to generate appropriate training regimes to maximize position-specific preparation for competitive match-play.

Decrements in Neuromuscular Performance and Increases in Creatine Kinase Impact Training Outputs in Elite Soccer Players.

Malone, S, Mendes, B, Hughes, B, Roe, M, Devenney, S, Collins, K, and Owen, A. Decrements in neuromuscular performance and increases in creatine kinase impact training outputs in elite soccer players. J Strength Cond Res 32(5): 1342-1351, 2018-The aim of the current investigation was to understand the impact of pretraining neuromuscular performance and creatine kinase (CK) status on subsequent training performance in elite soccer players. Thirty soccer players (age: 25.3 ± 3.1 years; height: 183 ± 7 cm; mass: 72 ± 7 kg) were involved in this observational study. Each morning before training, players completed assessments for neuromuscular performance (countermovement jump; CMJ) and CK levels. Global positioning technology provided external load: total distance, high-speed distance, sprint distance, accelerations, decelerations, average metabolic power, explosive distance, and high metabolic power distance (>25.5 W·kg). Mixed-effect linear models revealed significant effects for CK and CMJ Z-score on total high-speed distance, very high-speed distance, accelerations, decelerations, explosive distance, and maximal velocity. Effects are reported with 90% confidence limits. A CK Z-score of +1 corresponded to a -5.5 ± 1.1, -3.9 ± 0.5, -4.3 ± 2.9%, -4.1 ± 2.9%, -3.1 ± 2.9%, and -4.6 ± 1.9%, reduction in total high-speed distance, very high-speed distance, accelerations, decelerations, explosive distance, and maximal velocity, respectively. Countermovement jump Z-score of -1 corresponded to a -3.5 ± 1.1, -2.9 ± 0.5, -2.1 ± 1.4, -5.3 ± 2.9%, -3.8 ± 2.9%, -1.1 ± 2.9%, and -5.6 ± 1.2% reduction in these external load measures. Magnitude-based analysis revealed that the practical size of the effect of a pretraining CMJ Z-score of -1 and CK Z-score of +1 would have on total high-speed distance, very high-speed distance, high metabolic power distance (>25.5 W·kg), accelerations, decelerations, explosive distance, and maximal velocity was likely negative. The results of this study suggest that systematic pretraining monitoring of neuromuscular and muscle stress within soccer cohorts can provide coaches with information about the training output that can be expected from individual players during a training session.

DIET@NET: Best Practice Guidelines for dietary assessment in health research.

BACKGROUND: Dietary assessment is complex, and strategies to select the most appropriate dietary assessment tool (DAT) in epidemiological research are needed. The DIETary Assessment Tool NETwork (DIET@NET) aimed to establish expert consensus on Best Practice Guidelines (BPGs) for dietary assessment using self-report. METHODS: The BPGs were developed using the Delphi technique. Two Delphi rounds were conducted. A total of 131 experts were invited, and of these 65 accepted, with 48 completing Delphi round I and 51 completing Delphi round II. In all, a total of 57 experts from North America, Europe, Asia and Australia commented on the 47 suggested guidelines. RESULTS: Forty-three guidelines were generated, grouped into the following four stages: Stage I. Define what is to be measured in terms of dietary intake (what? who? and when?); Stage II. Investigate different types of DATs; Stage III. Evaluate existing tools to select the most appropriate DAT by evaluating published validation studies; Stage IV. Think through the implementation of the chosen DAT and consider sources of potential biases. CONCLUSIONS: The Delphi technique consolidated expert views on best practice in assessing dietary intake. The BPGs provide a valuable guide for health researchers to choose the most appropriate dietary assessment method for their studies. These guidelines will be accessible through the Nutritools website, www.nutritools.org .

Yo-Yo Intermittent Recovery Test Performance in Subelite Gaelic Football Players From Under Thirteen to Senior Age Groups.

Roe, M and Malone, S. Yo-Yo intermittent recovery test performance in subelite Gaelic football players from under thirteen to senior age groups. J Strength Cond Res 30 (11): 3187-3193, 2016-Gaelic football is indigenous to Ireland and has similar locomotion profiles to soccer and Australian Football. Given the increasing attention on long-term player development, investigations on age-related variation in Yo-Yo intermittent recovery test level 1 (Yo-YoIR1) performance may provide useful information in talent identification, program design, and player monitoring. Therefore, the aim of this study was to evaluate Yo-YoIR1 performance across Gaelic football age groups. Male participants (n = 355) were recruited from division one, Gaelic football teams. Participants were allocated to one of the 7 groups according to respective age groups from under 13 (U13), under 14, under 15 (U15), under 16 (U16), minor, under 21 (U21), to senior age groups. Total Yo-YoIR1 distance (m) increased progressively from U13 (885 ± 347 m) to U16 (1,595 ± 380 m) equating to a rate of change of 180.2%. In comparison to U13, total distance at minor (1,206 ± 327 m) increased by 136.4%. Subsequent increases were observed in U21 (1,585 ± 445 m) and senior players (2,365 ± 489). Minimum (800-880 m) and maximum (2,240-2,280 m) total distances were comparable for U15, U16, and U21 players. Differences in total distance (m) for all age groups were statistically significant when compared to U13 players (p < 0.002). In comparison to U13 players, the magnitude of differences between age groups for total distance was deemed to be large (effect size > 0.8). Similar trends were observed for maximum velocity and estimated V[Combining Dot Above]O2max. The evolution of Yo-YoIR1 performance in Gaelic football players from adolescents to adulthood highlights how maturation may influence sport-related running ability. Changes in Yo-YoIR1 performance should be closely monitored to optimize interventions for individuals transitioning across age groups.

Development and validation of a biomechanically fidelic surgical training knee model.

Knee arthroplasty technique is constantly evolving and the opportunity for surgeons to practice new techniques is currently highly dependent on the availability of cadaveric specimens requiring certified facilities. The high cost, limited supply, and heterogeneity of cadaveric specimens has increased the demand for synthetic training models, which are currently limited by a lack of biomechanical fidelity. Here, we aimed to design, manufacture, and experimentally validate a synthetic knee surgical training model which reproduces the flexion dependent varus-valgus (VV) and anterior-posterior (AP) mechanics of cadaveric knees, while maintaining anatomic accuracy. A probabilistic finite element modeling approach was employed to design physical models to exhibit passive cadaveric VV and AP mechanics. Seven synthetic models were manufactured and tested in a six-degree-of-freedom hexapod robot. Overall, the synthetic models exhibited cadaver-like VV and AP mechanics across a wide range of flexion angles with little variation between models. In the extended position, two models showed increased valgus rotation (<0.5°), and three models showed increased posterior tibial translation (<1.7 mm) when compared to the 95% confidence interval (CI) of cadaveric measurements. At full flexion, all models showed VV and AP mechanics within the 95% CI of cadaveric measurements. Given the repeatable mechanics exhibited, the knee models developed in this study can be used to reduce the current reliance on cadaveric specimens in surgical training.

Gold amides as anticancer drugs: synthesis and activity studies.

Modular gold amide chemotherapeutics: Access to modern chemotherapeutics with robust and flexible synthetic routes that are amenable to extensive customisation is a key requirement in drug synthesis and discovery. A class of chiral gold amide complexes featuring amino acid derived ligands is reported herein. They all exhibit in vitro cytotoxicity against two slow growing breast cancer cell lines with limited toxicity towards normal epithelial cells.

Players', Head Coaches', And Medical Personnels' Knowledge, Understandings and Perceptions of Injuries and Injury Prevention in Elite-Level Women's Football in Ireland.

BACKGROUND: To manage injuries effectively, players, head coaches, and medical personnel need to have excellent knowledge, attitudes, and behaviours in relation to the identification of risk factors for injuries, the implementation of injury prevention initiatives, as well as the implementation of effective injury management strategies. Understanding the injury context, whereby specific personal, environmental, and societal factors can influence the implementation of injury prevention initiatives and injury management strategies is critical to player welfare. To date, no qualitative research investigating the context of injuries, has been undertaken in elite-level women's football. The aim of our study was to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish Women's National League (WNL) to injury prevention and injury management. METHODS: We used qualitative research methods to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish WNL to injury prevention and injury management. Semi-structured interviews were undertaken with 17 players, 8 medical personnel, and 7 head coaches in the Irish WNL. The data were analysed using thematic analysis. Our study is located within an interpretivist, constructivist research paradigm. RESULTS: The participants had incomplete knowledge of common injuries in elite-level football, and many held beliefs about risk factors for injuries, such as menstrual cycle stage, which lacked evidence to support them. Jumping and landing exercises were commonly used to reduce the risk of injuries but evidence-based injury prevention exercises and programmes such as the Nordic hamstring curl, Copenhagen adduction exercise, and the FIFA 11+ were rarely mentioned. Overall, there was dissatisfaction amongst players with their medical care and strength and conditioning (S & C) support, with resultant inadequate communication between players, head coaches, and medical personnel. CONCLUSION: Poor quality and availability of medical care and S & C support were considered to be a major obstacle in the effective implementation of injury risk reduction strategies and successful return-to-sport practices. More original research is required in elite-level women's football to explore injury risk factors, injury prevention initiatives, and contextual return-to-sport strategies, so that players, head coaches, and medical personnel can use evidence that is both up-to-date and specific to their environment.

Exploring key informants' perceptions of Covid-19 vaccine hesitancy in a disadvantaged urban community in Ireland: Emergence of a '4Cs' model.

AIM: The aim of this study was to explore key informants' views on and experiences with Covid-19 vaccine hesitancy in a Dublin community with a high concentration of economic and social disadvantage and to identify feasible, community-centred solutions for improving vaccination acceptance and uptake. METHODS: Qualitative, semi-structured interviews were carried out at a local community-centre and a central hair salon. Twelve key informants from the target community were selected based on their professional experience with vulnerable population groups: the unemployed, adults in recovery from addiction, the elderly, and Irish Travellers. Inductive thematic framework analysis was conducted to identify emergent themes and sub-themes. RESULTS: Drivers of vaccine hesitancy identified by key informants largely fell under the WHO '3Cs' model of hesitancy: lack of confidence in the vaccine and its providers, complacency towards the health risks of Covid-19, and inconvenient access conditions. Covid-19 Communications emerged as a fourth 'C' whereby unclear and negative messages, confusing public health measures, and unmet expectations of the vaccine's effectiveness exacerbated anti-authority sentiments and vaccine scepticism during the pandemic. Community-specific solutions involve the provision of accurate and accessible information, collaborating with community-based organizations to build trust in the vaccine through relationship building and ongoing dialogue, and ensuring acceptable access conditions. CONCLUSIONS: The proposed Confidence, Complacency, Convenience, Covid-19 Communications ('4Cs') model provides a tool for considering vaccine hesitancy in disadvantaged urban communities reacting to the rapid development and distribution of a novel vaccine. The model and in-depth key informants' perspectives can be used to compliment equitable vaccination efforts currently underway by public health agencies and non-governmental organizations.