The impact of in-season national team soccer play on injury and player availability in a professional club

This study investigated the impact of in-season national team duty on injury rates and player availability in a professional soccer club. Time-loss injuries and exposure time during club and national team duties were recorded prospectively over 5 seasons (2009–2014). A time-loss injury was sustained by 37.7% of squad members participating in national duty, all injuries occurring in match-play. The incidence (per 1000 h exposure) for national team player match-play injuries did not differ (P = 0.608) to that for all players in club competitions: 48.0 (95% CI 20.9–75.5) vs. 41.9 (95% CI 36.5–47.4), incidence rate ratio = 1.2 (CI: 0.8–2.4). The majority (58%) of national team injuries resulted in a layoff ≤1 week. Of all working days lost to injury generally, 5.2% were lost through injury on national duty. Injury incidence in the week following national duty was comparable (P = 0.818) in players participating or not: 7.8 (95% CI 3.6–12.0) vs. 7.1 (95% CI: 4.6–9.6), incidence rate ratio = 1.1 (CI: 0.7–2.7). While approximately 40% of participating players incurred a time-loss injury on national duty, no training injuries were sustained and injuries made up a negligible part of overall club working days lost to injury. Following duty, players had a similar injury risk to peers without national obligations

Monitoring of post-match fatigue in professional soccer: Welcome to the real world

Participation in soccer match-play leads to acute and transient subjective, biochemical, metabolic and physical disturbances in players over subsequent hours and days. Inadequate time for rest and regeneration between matches can expose players to the risk of training and competing whilst not entirely recovered. In professional soccer, contemporary competitive schedules can require teams to compete in-excess of 60 matches over the course of the season while periods of fixture congestion occur prompting much attention from researchers and practitioners to the monitoring of fatigue and readiness to play. A comprehensive body of research has investigated post-match acute and residual fatigue responses. Yet the relevance of the research for professional soccer contexts is debatable notably in relation to the study populations and designs employed. Monitoring can indeed be invasive, expensive, time-inefficient and difficult to perform routinely and simultaneously in a large squad of regularly competing players. Uncertainty also exists regarding the meaningfulness and interpretation of changes in fatigue response values and their functional relevance, and practical applicability in the field. The real-world need and cost-benefit of monitoring must be carefully weighed up. In relation to professional soccer contexts, this opinion paper intends to: 1) debate the need for PMF monitoring, 2) critique the real-world relevance of the current research literature, 3) discuss the practical burden relating to measurement tools and protocols and the collection, interpretation and application of data in the field, and, 4) propose future research perspectives

Medical Image sharing: What do the public see when reviewing radiographs? A pilot study.

Introduction Policymakers wish to extend access to medical records, including medical imaging. Appreciating how patients might review radiographs could be key to establishing future training needs for healthcare professionals and how image sharing could be integrated into practice. Method A pilot study in the UK using a survey was distributed to adult participants via the online research platform Prolific. All subjects were without prior professional healthcare experience. Participants reviewed ten radiographs (single projection only) and were asked a two-stage question. Firstly, if the radiograph was ‘normal’ or ‘abnormal’ and secondly, if they had answered ‘abnormal’, to identify the abnormality from a pre-determined list featuring generic terms for pathologies. Results 50 participants completed the survey. A mean of 65.8% of participants were able to correctly identify if radiographs were normal or abnormal. Results in relation to the identification of a pathology were not as positive, but still notable with a mean of 46.4% correctly identifying abnormalities. Qualitative data demonstrated that members of the public are enthralled with reviewing radiographs and intrigued to understand their performance in identifying abnormalities. Conclusion In the pilot, members of the public could identify if a radiograph is normal or abnormal to a reasonable standard. Further detailed interpretation of images requires supportive intervention. This pilot study suggests that patients can participate in image sharing as part of their care. Image sharing may be beneficial to the therapeutic relationship, aiding patient understanding and enhancing consultations between healthcare professional and patient. Further research is indicated

Interprofessional practice in the intensive treatment unit during the Covid-19 pandemic; the reflections of an advanced practitioner radiographer

Background The onset of the Covid-19 pandemic in March 2020 posed significant challenges to the National Health Service (NHS) in the United Kingdom (UK). Existing workforce shortages were further exacerbated with staff absence, and the need to redeploy staff into frontline clinical areas became a necessity. Purpose The exploration of the experiences of an Advanced Practitioner Radiographer volunteering in the Intensive Treatment Unit (ITU) during the Covid-19 pandemic. Method Interview using Microsoft Teams© involving one participant facilitated by two researchers using a semi-structured interview schedule. Discussion Redeployment to ITU has allowed individuals to work outside of their normal scope of practice. The non-hierarchical structure within teams, focussed minds and demonstrated interprofessional collaboration at its best, ensuring the best patient care was delivered to those critically affected by the virus. Conclusion The interprofessional practice demonstrated in ITU during the pandemic should be applied to future learning and training opportunities, to develop individuals and prepare for future pandemics

Going 'meta': a systematic review of metacognition and functional neurological disorder.

In functional neurological disorder (FND), there is a fundamental disconnect between an apparently intact nervous system and the individuals' ability to consistently perform motor actions, perceive sensory signals and/or access effective cognition. Metacognition, the capacity to self-evaluate cognitive performance, appears highly relevant to FND pathophysiology. Poor metacognition is a potential mechanism via which abnormal models of self and the state of the world could arise and persist unchecked. There is therefore a justified enthusiasm that studies of metacognition may give substance to FND's intangible nature. However, many assume an impairment in metacognition even though experimental studies are still in their infancy. This systematic review provides an analytical checkpoint of the evidence after the first five years of experimental work. We firstly summarize current methods for testing metacognition, prerequisite knowledge that allows readers to independently evaluate the evidence. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we then screened the 21 articles on this topic and review the experimental data of the eight studies that specifically tested metacognition in subjects with FND. Questionnaire metrics used to estimate global metacognition and general confidence in FND revealed a mixed picture of low or normal confidence. Of the five studies that used performance-controlled metrics, the gold-standard to estimate local metacognition in FND, four found metacognition to be equivalent to healthy controls and one paper supported impaired metacognition. We consequently try and broaden the debate and discuss alternative headline scenarios. We review how positive studies may offer insight and debate whether null studies could represent false negatives. However, since most studies find equivalent metacognition to controls, we also discuss whether metacognition could be intact and how this could inform mechanistic models of FND and have potential clinical utility. In summary, this review highlights signal of interest within the data, exposes current limitations and flags the many open questions