Head Acceleration Event Exposure During Elite Men’s and Women’s Rugby Union Training

Objectives The aim of this study was to describe the incidence and magnitude of head acceleration events (HAEs) during elite men’s and women’s rugby union training for different contact training levels and drill types. Method Data were collected during the 2022–23 and 2023–24 seasons from 203 men and 125 women from 13 clubs using instrumented mouthguards (iMGs) during in-season training. One author reviewed the training videos to identify the contact level and drill type. HAE incidence was calculated per player minute. Results For men’s forwards and backs, only 4.7% and 5.8% of HAEs were ≥ 25 g and ≥ 1.5 Krad/s2, and 3.4% and 4.4% for women’s forwards and backs, respectively. The incidence of ≥ 5 g and ≥ 0.4 Krad/s2 was highest during full-contact training for men’s forwards (0.20/min) and backs (0.16/min) and women’s forwards (0.10/min). HAE incidence was 2–3 times higher during repetition-based compared with game-based training drills for men’s forwards (0.25/min vs 0.09/min) and backs (0.22/min vs 0.09/min) and women’s forwards (0.09/min vs 0.04/min) and backs (0.08/min vs 0.03/min). HAE incidences were halved when repetition-based training drills used pads compared with no pads for men’s forwards (0.21/min vs 0.44/min) and backs (0.17/min vs 0.30/min), and women’s forwards (0.06/min vs 0.14/min) and backs (0.06/min vs 0.10/min). Conclusion The average HAE incidence (~ 13–20% of weekly HAEs) and magnitude during an in-season training week is very low compared with matches. Opportunities to materially reduce HAE exposure in training are likely more limited than previously assumed. Future research on HAE load and injury, and understanding players’ specific weekly training exposure, may inform effective individual player management

Evaluating the Probability of Head-Acceleration Events in Elite Men’s and Women’s Rugby Union Match-Play: The Impact of Tackle Height and Body Position

Background Head acceleration events (HAEs) are an increasing concern in collision sports owing to potential negative health outcomes. Objectives The objective of this study is to describe the probabilities of HAEs in tackles of differing heights and body positions in elite men’s and women’s rugby union. Methods Instrumented mouthguards (iMGs) were worn in men’s (n = 24 teams, 508 players, 782 observations) and women’s (n = 26 teams, 350 players, 1080 observations) rugby union matches. Tackle height (i.e. point of contact on ball-carrier) and body positions of tacklers and ball-carriers were labelled for all tackles in which a player wore an iMG. HAEs from the initial impact were identified. Mean player, tackler and ball-carrier exceedance probabilities for various peak linear and angular acceleration thresholds were estimated from ordinal mixed-effects models. Results Contact with ball-carriers’ head/neck resulted in the highest mean HAE probabilities for both sexes. The probability of an HAE to the ball-carrier decreased as tackle height lowered. The highest probability for the tackler was initial contact to the ball-carriers upper leg. Body position influenced the probability of HAEs, with falling/diving ball-carriers resulting in higher mean probabilities. When a player, regardless of role, was bent-at-waist, elevated HAE probabilities were observed in men’s competitions. Women’s data demonstrated similar probabilities of an HAE for all body positions. Conclusions Initial contact to the ball-carrier’s head/neck had the highest chance of an HAE, whilst role-specific differences are apparent for different tackle heights and body positions. Future player-welfare strategies targeting contact events should therefore consider HAE mechanisms along with current literature

Lessons learnt in other people's classrooms

Third Angel was a theatre company born out of interdisciplinary practice, and created by theatre graduates Rachael Walton and myself, who then trained as teacher and film-maker, respectively. Without identifying it as interdisciplinary, what we were interested in from the outset was collaboration. Drawing on the expertise and experience of a varied group of practitioners, our stated aim was to make something none of us would have made on our own. Something more than the sum of its parts. Our unstated (at the time) aim was to demonstrate that theatre was more than plays. We were interested in cross-art form work – ‘multi-media’ was the in phrase at the time; when an idea reminded us of a film or novel, it seemed worth pursuing; if it reminded us of a piece of theatre we had seen, it would often get forgotten about. This chapter reflects on two decades of collaboration between Third Angel and a number of scientists and specialists from other disciplines. These collaborations produced projects in theatre, live art, film, video, and participation, which were presented throughout the UK and internationally. We did not specifically set out to make interdisciplinary work: we followed our curiosity and discovered that ethos as we travelled. We were believers in the value of serendipity in a devising process, and recognised that we did not know what we did not know. We were always interested in collaborating with people with different approaches, born out of different experiences to our own. When we wanted to learn more about a subject, we approached people who knew more than us and, always fascinated by other people’s workshops and studios, we asked if we could go and visit them in the place they worked. We began to value spending time, literally and metaphorically, in other people’s classrooms

How Construction can deliver innovation faster

This was a Q&A event with the CIOB magazine Construction Managemen

A ‘major breakthrough’, yet potentially ‘entirely ineffective’? Experts’ opinions about the ‘total ban’ on unhealthy food marketing online in the UK’s Health and Care Act (2022)

The UK’s Health and Care Act (2022; paused until 2025) includes a globally novel ban on paid-for online advertising of food and beverage products high in saturated fat, salt and sugar (HFSS), to address growing concerns about the scale of digital marketing and its impact in particular on children’s food and beverage preferences, purchases and consumption. This study aimed to understand the potential impact of the novel ban (as proposed in 2020) on specified forms of online HFSS advertising, through the lens of interdisciplinary expertise. We conducted semi-structured interviews via videoconference with eight purposively selected UK and global digital marketing, food and privacy experts. We identified deductive and inductive themes addressing the policy’s scope, design, implementation, monitoring and enforcement through iterative, consensual thematic analyses. Experts felt this novel ‘breakthrough’ policy has potential to substantially impact global marketing by establishing the principle of no HFSS advertising online to consumers of all ages, but they also identified substantive limitations that could potentially render it ‘entirely ineffective’, for example, the exclusion of common forms of digital marketing, especially brand marketing and marketing integrated within entertainment content; virtual/augmented reality, and ‘advertainment’ as particularly likely spaces for rapid growth of digital food marketing; and technical digital media issues that raise significant barriers to effective monitoring and compliance. Experts recommended well-defined regulations with strong enforcement mechanisms. These findings contribute insights for effective design and implementation of global initiatives to limit online HFSS food marketing, including the need for government regulations in place of voluntary industry restrictions

Application of the systemic lessons learned knowledge model to learning in complex projects: How project practitioners are shaping their learning

Learning in projects is frequently emphasized in practice and the literature for knowledge creation, yet there is limited research on how project practitioners articulate learning particularly in complex projects. This study applies the Systemic Lessons Learned Knowledge model to investigate how project practitioners conceptualize learning in complex projects. The research method consisted of narrative inquiry which is considered insightful and useful in acquiring data through storytelling. The research establishes how beyond the alignment of the people and system elements (learning, culture, social, technology, process, and infrastructure), an awareness of complex project attributes can positively influence project practitioners’ learning capability. This study also identifies and discusses the enablers and challenges of transferring lessons learned into knowledge

Post-concussion symptom burden and dynamics: Insights from a digital health intervention and machine learning

Individuals who sustain a concussion can experience a range of symptoms which can significantly impact their quality of life and functional outcome. This study aims to understand the nature and recovery trajectories of post-concussion symptomatology by applying an unsupervised machine learning approach to data captured from a digital health intervention (HeadOn). As part of the 35-day program, patients complete a daily symptom diary which rates 8 post-concussion symptoms. Symptom data were analysed using K-means clustering to categorize patients based on their symptom profiles. During the study period, a total of 758 symptom diaries were completed by 84 patients, equating to 6064 individual symptom ratings. Fatigue, sleep disturbance and difficulty concentrating were the most prevalent symptoms reported. A decline in symptom burden was observed over the 35-day period, with physical and emotional symptoms showing early rates of recovery. In a correlation matrix, there were strong positive correlations between low mood and irritability (r = 0.84), and poor memory and difficulty concentrating (r = 0.83). K-means cluster analysis identified three distinct patient clusters based on symptom severity. Cluster 0 (n = 24) had a low symptom burden profile across all the post-concussion symptoms. Cluster 1 (n = 35) had moderate symptom burden but with pronounced fatigue. Cluster 2 (n = 25) had a high symptom burden profile across all the post-concussion symptoms. Reflecting the severity of the clusters, there was a significant relationship between the symptom clusters for both the Rivermead (p = 0.05) and PHQ-9 (p = 0.003) questionnaires at 6-weeks follow-up. By leveraging digital ecological momentary assessments, a rich dataset of daily symptom ratings was captured allowing for the identification of symptom severity clusters. These findings underscore the potential of digital technology and machine learning to enhance our understanding of post-concussion symptomatology and offer a scalable solution to support patients with their recovery

Investigating the Construction Professionals’ Perspective on the New Building Safety Act in the UK: A Sentiment Analysis of Media Data

Existing research on constructional professional attitudes towards fire safety and evacuation has predominantly employed traditional methodologies. While these methods have provided valuable insights, they are limited in their ability to capture the full spectrum of the stakeholders. Moreover, a significant gap exists in the literature regarding the broader population’s concerns about how the industry experts perceives and responds to building safety regulations, particularly in the context of new legislation like the Building Safety Act (BSA) 2022. To address these gaps, this study adopts a novel approach by analysing social media data, specifically YouTube, to capture a wider range of public sentiments towards the BSA 2022. A total of 3577 data points reflecting the general public’s views were gathered, processed, and examined using sentiment analysis, k-means clustering and Latent Dirichlet Allocation text mining techniques for topic modelling. Findings reveal nine clusters each for the positive and negative sentiments. The overall findings reveal that the public expressed positive sentiments (20 %), negative sentiments (4 %), and neutral sentiments (76 %) towards BSA 2022. The study posits recommendations from the public’s sentiments for policy makers to leverage

Disparity in Anterior Cruciate Ligament injury management: A case series review across six National Health Service Trusts

Background Effective management of anterior cruciate ligament (ACL) injuries requires a comprehensive approach, from initial assessment, through treatment, rehabilitation, and discharge, however no gold standard care pathway exists to help guide clinicians. This case series provides an overview of current ACL injury management processes in six National Health Service (NHS) Trusts. Methods This study utilised a retrospective case series design within six NHS Trusts in the Yorkshire region of the United Kingdom. Using a standard operating procedure, each Trust selected ten consecutive ACL injured patients (≥ 16 years), managed either surgically or non-surgically. Data relating to the patient injury journey, patient and injury characteristics, key pathway events, rehabilitation management, outcome measures, and discharge, were collected. Data was anonymised and analysed using descriptive statistics. Results Reviews covered 55 patients, median age 25.5 years, (41 males, 14 females). Median time to specialist assessment from injury was 12 days (Interquartile Range [IQR] 6 to 20 days), with 43 patients managed operatively, and 12 non operatively. The median number of physiotherapy sessions was 21 (IQR 9 to 29.5), with outcome measures being variably used across Trusts. Trusts using patient reported outcome measures (PROMS) consistently with their patients provided more physiotherapy appointments (34.5 and 27) and achieved higher return to sport (RTS) rates. Time from injury to discharge varied with a median of 421 (IQR 249 to 546) days. Discharge criteria were applied inconsistently across Trusts, with 31% of cases not using specific criteria. However, Trusts using standardised discharge criteria showed better RTS outcomes, with 27 (61%) patients successfully returning to sport. Conclusions This case series review highlighted some good practice in initial ACL management across six NHS Trusts in the Yorkshire region. However, from time to MRI diagnosis to discharge, substantial variation in care is observed. Whether treated operatively or non-operatively, for patients aiming to RTS, this was achieved with greater consistency when more physiotherapy appointments were undertaken, outcome measures and PROMs were used, and specific discharge criteria was utilised. Future larger pathway investigation studies incorporating causative and predictive analysis studies on a national scale are required to determine whether similar trends are observed in a wider ACL injured population, which could help to improve national pathways for patients and clinicians working towards ensuring more positive and standardised patient-related ACL injury outcomes

A Pilot Randomized Controlled Trial Testing the Feasibility and Acceptability of Helping Ease Anxiety and Depression after Stroke (HEADS: UP): An Online Mindfulness-Based Intervention for Stroke Survivors

Objectives The purpose of this study was to assess feasibility and acceptability of a stroke-specific mindfulness-based intervention called Helping Ease Anxiety and Depression after Stroke (HEADS: UP). Method This study was a mixed-methods pilot randomized controlled trial comparing HEADS: UP to treatment as usual (TAU). HEADS: UP is a 9-week mindfulness intervention for stroke survivors. UK (United Kingdon)-based stroke survivors were recruited and attended HEADS: UP Online. Psychological functioning outcomes measures and other data were collected online at pre-intervention (Week 0), post-intervention (Week 9), and follow-up (months 3 and 6). Participants were randomized 1:1 to either HEADS: UP or TAU. Results Sixty-two participants completed baseline questionnaires and were randomized to HEADS: UP (n = 30) or TAU (n = 32). Retention rates were as follows: HEADS: UP (n = 25, 83.30%) versus TAU (n = 25, 78.10%) at post-intervention, HEADS: UP (n = 24, 80%) versus TAU (n = 26, 81.30%) at 3-month follow-up, and HEADS: UP (n = 20, 66.70%) versus TAU (n = 25, 78.10%) at 6-month follow-up. The mean age for HEADS: UP was 56.0 years versus 56.80 for TAU. The HEADS: UP group was 30% male, while the TAU group was 56% male. Depression Anxiety Stress Scales (DASS)-21 total mean score for HEADS: UP improved in the direction of expected effect (baseline 46.20, SD (standard deviation) = 24.00; post-intervention 24.00, SD = 16.10) indicating recovery versus no reliable change for TAU (baseline 36.10, SD = 18.70; post-intervention 31.60, SD = 20.40). HEADS: UP and TAU scores continued to improve over time. Between-group effect sizes (Cohen’s d) at post-intervention were large for BAI (Beck Anxiety Inventory) (d = 0.91), DASS-21 total (d = 0.89), and BDI (Beck Depression Inventory)-II (d = 0.86), highlighting the potential of HEADS: UP for improving depression and anxiety symptoms. At the six-month follow-up, the attrition rate was higher in the HEADS: UP group (33.30%) compared with TAU (21.90%). Conclusions HEADS: UP is feasible and acceptable and has potential to improve depression and anxiety symptoms for stroke survivors. Preregistration ClinicalTrials.gov: NCT04985838