Behavioural counselling to increase consumption of fruit and vegetables in low income adults : randomised trial

Objective To measure the effect of brief behavioural counselling in general practice on patients’ consumption of fruit and vegetables in adults from a low income population. Design Parallel group randomised controlled trial. Setting Primary health centre in a deprived, ethnically mixed inner city area. Participants 271 patients aged 18-70 years without serious illness. Intervention Brief individual behavioural counselling based on the stage of change model; time matched nutrition education counselling. Main outcome measures Self reported number of portions of fruit and vegetables eaten per day, plasma β carotene, α tocopherol, and ascorbic acid concentrations, and 24 hour urinary potassium excretion. Assessment at baseline, eight weeks, and 12 months. Results Consumption of fruit and vegetables increased from baseline to 12 months by 1.5 and 0.9 portions per day in the behavioural and nutrition groups (mean difference 0.6 portions, 95% confidence interval 0.1 to 1.1). The proportion of participants eating five or more portions a day increased by 42% and 27% in the two groups (mean difference 15%, 3% to 28%). Plasma β carotene and α tocopherol concentrations increased in both groups, but the rise in β carotene was greater in the behavioural group (mean difference 0.16 μmol/l, 0.001 μmol/l to 1.34 μmol/l). There were no changes in plasma ascorbic acid concentrations or urinary potassium excretion. Differences were maintained when analysis was restricted to the 177 participants with incomes ≤ £400 (€596, $640) a week. Conclusions Brief individual counselling in primary care can elicit sustained increases in consumption of fruit and vegetables in low income adults in the general population

Youth sport: Friend or Foe?

Participation in youth sport has been promoted as part of a healthy lifestyle, with benefits for physical fitness, social development, and mental wellbeing. Yet, sport carries an inherent risk of injury, which for young athletes may have both immediate and long-term consequences. Amidst significant public debate about the pros and cons of youth sport, this review considers the physiological, psychological, and social factors that inform decisions around youth sport participation. With particular emphasis on growth and maturation, early sport specialization, and injury prevention, it highlights the unique features of the youth sport environment that can influence lifelong musculoskeletal health and physical activity behaviour. Though there have been few robust, longitudinal studies, current evidence suggests that sport has positive effects on child and adolescent wellbeing when maturity status and training load are managed appropriately. © 2019 Elsevier Lt

Injuries in elite men’s Rugby Union:An updated (2012-2020) meta-analysis of 11,620 match and training injuries

BACKGROUND: The most recent meta-analytic review of injuries in elite senior men’s Rugby Union was published in 2013. The demands of the game at the elite level are continually changing alongside law amendments and developments in player preparation. As such, an updated meta-analysis of injury data in this setting is necessary. OBJECTIVE: To meta-analyse time-loss injury data in elite senior men’s Rugby Union between 2012 and 2020. METHODS: Electronic databases were searched using the keywords ‘rugby’ and ‘inj*’. Nineteen studies met the inclusion criteria. Injury incidence rate data were modelled using a mixed-effects Poisson regression model. Days missed data were modelled using a general linear mixed model. RESULTS: The included data encompassed a total of 8819 match injuries and 2801 training injuries. The overall incidence rate of injuries in matches was 91 per 1000 h (95% confidence interval (CI) 77–106). The estimated mean days missed per match injury was 27 days (95% CI 23–32). The overall incidence rate of match concussions was 12 per 1000 h (95% CI 9–15). The overall incidence rate of training injuries was 2.8 per 1000 h (95% CI 1.9–4.0). Playing level was not a significant effect modifier for any outcome. CONCLUSIONS: The injury incidence rate and mean days missed per injury in the present meta-analysis were higher, but statistically equivalent to, the 2013 meta-analysis (81 per 1000 h and 20 days, respectively). The injury incidence rate for match injuries in elite senior men’s Rugby Union is high in comparison to most team sports, though the training injury incidence rate compares favourably. The tackle event and concussion injuries should continue to be the focus of future preventative efforts. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40279-021-01603-w

Detecting injury risk factors with algorithmic models in elite women’s pathway cricket

This exploratory retrospective cohort analysis aimed to explore how algorithmic models may be able to identify important risk factors that may otherwise not have been apparent. Their association with injury was then assessed with more conventional data models. Participants were players registered on the England and Wales Cricket Board women’s international development pathway (n=17) from April 2018 to August 2019 aged between 14–23 years (mean 18.2±1.9) at the start of the study period. Two supervised learning techniques (a decision tree and random forest with traditional and conditional algorithms) and generalised linear mixed effect models explored associations between risk factors and injury. The supervised learning models did not predict injury (decision tree and random forest area under the curve [AUC] of 0.66 and 0.72 for conditional algorithms) but did identify important risk factors. The best-fitting generalised linear mixed effect model for predicting injury (Akaike Information Criteria [AIC]=843.94, conditional r-squared=0.58) contained smoothed differential 7-day load (P<0.001), average broad jump scores (P<0.001) and 20 m speed (P<0.001). Algorithmic models identified novel injury risk factors in this population, which can guide practice and future confirmatory studies can now investigate

Patterns of training volume and injury risk in elite rugby union: an analysis of 1.5 million hours of training exposure over eleven seasons

Rugby union is a popular team sport that demands high levels of physical fitness and skill. The study aim was to examine trends in training volume and its impact on injury incidence, severity and burden over an 11-season period in English professional rugby. Data were recorded from 2007/08 through 2017/18, capturing 1,501,606 h of training exposure and 3,782 training injuries. Players completed, on average, 6 h 48 minutes of weekly training (95% CI: 6 h 30 mins to 7 h 6 mins): this value remained stable over the 11 seasons. The mean incidence of training-related injuries was 2.6/1000 player-hours (95% CI: 2.4 to 2.8) with a mean severity rising from 17 days in 2007/08 to 37 days in 2017/18 (Change/season = 1.773, P &lt;0.01). Rate of change in severity was dependent on training type, with conditioning (non-gym-based) responsible for the greatest increase (2.4 days/injury/season). As a result of increasing severity, injury burden rose from 51 days absence/1000 player-hours in 2007/08 to 106 days’ absence/1000 player-hours in 2017/18. Despite the low incidence of injury in training compared to match-play, training accounted for 34% of all injuries. Future assessments of training intensity may lead to a greater understanding of the rise in injury severity.</p

Padded headgear does not reduce the incidence of match concussions in professional men's rugby union:a case-control study of 417 cases

Concussion is the most common match injury in rugby union. Some players wear padded headgear, but whether this protects against concussion is unclear. In professional male rugby union players, we examined: (i) the association between the use of headgear and match concussion injury incidence, and (ii) whether wearing headgear influenced time to return to play following concussion. Using a nested case-control within a cohort study, four seasons (2013–2017) of injury data from 1117 players at the highest level of rugby union in England were included. Cases were physician-diagnosed concussion injuries. Controls were other contact injuries (excluding all head injuries). We determined headgear use by viewing video footage. Sixteen percent of cases and controls wore headgear. Headgear use had no significant effect on concussion injury incidence (adjusted odds ratio=1.05, 95% CI: 0.71–1.56). Median number of days absent for concussion whilst wearing headgear was 8 days, compared with 7 days without headgear. Having sustained a concussion in the current or previous season increased the odds of concussion more than four-fold (odds ratio=4.55, 95% CI: 3.77–5.49). Wearing headgear was not associated with lower odds of concussions or a reduced number of days' absence following a concussion