Medical care delivery in international football: perceived best practice and challenges. An interview-based study of national team clinicians

ObjectivesTo determine the incidence and characteristics of injury and illness in English men’s and women’s senior and youth international football.MethodsTime-loss injuries and illnesses, alongside match and training exposure, were collected across 8 seasons (2012–2020) in youth (U15, U16, U17, U18, U19) and senior (U20, U21, U23, senior) English men’s and women’s international teams. Analysis of incidence, burden, and severity of injury and illness was completed. Sex-specific comparisons were made between the senior and youth groups, and across the 8 seasons of data collection.ResultsIn men’s international football, 535 injuries were recorded (216 senior; 319 youth) during 73,326 h of exposure. Overall, match injury incidence (31.1 ± 10.8 injuries/1000 h) and burden (454.0 ± 195.9 d absent/1000 h) were greater than training injury incidence (4.0 ± 1.0 injuries/1000 h) and burden (51.0 ± 21.8 d absent/1000 h) (both P < 0.001). In women’s international football, 503 injuries were recorded (senior: 177; youth: 326) during 80,766 h of exposure and match injury incidence (27.6 ± 11.3 injuries/1000 h) and burden (506.7 ± 350.2 days absent/1000 h) were greater than training injury incidence (5.1 ± 1.8 injuries/1000 h) and burden (87.6 ± 32.8 days absent/1000 h) (both P < 0.001). In women’s international football, a group × season interaction was observed for training injury incidence (P = 0.021), with the senior group recording a greater training injury incidence during the 2015–2016 season compared to the youth group (14.4 vs 5.7 injuries/1000 h; P = 0.022). There was no difference in injury severity between match and training for men’s (P = 0.965) and women’s (P = 0.064) international football.ConclusionsThe findings provide a comprehensive examination of injury and illness in English men’s and women’s senior and youth international football. Practitioners will be able to benchmark their team’s injury and illness incidence and characteristics to the match-play and training information provided in the present study.

Competitive sport can serve as a trigger for sudden cardiac death (SCD). The majority of athletes who die suddenly have previously unsuspected structural heart disease. Medical evaluation before competition offers the potential to identify cardiovascular abnormalities in asymptomatic athletes. Consensus on the ideal screening programme has not been reached. So, a cardiovascular pre-competition screening of elite football players was developed and implemented prior to the 2006 FIFA World Cup Germany to detect SCD risk factors. Medical history, physical examination, 12-lead resting- and exercise electrocardiogram (ECG) and echocardiography results of the players were recorded on a standardised form by the team physicians and submitted after the final match for retrospective evaluation by two blinded independent cardiologic reviewers. Response rate was 82% (605 of 736 players). Completeness and quality of the recordings and examination methods differed amongst teams. In 25 players (4.8%), the examining physicians evaluated the resting ECG as pathological. Suspicious echocardiographic findings demanding further investigations to rule out serious cardiovascular disease existed in 1% of the players. Cardiovascular pre-competition screening proved feasible in international elite football teams, but turned out to be vital to ensure high quality of data, particularly with regard to stress testing and echocardiography. The screening concept was revised mainly to improve completeness and quality of data acquisition. Resting ECG and echocardiography were retained, but it is questionable if exercise testing should be included in this context.

Emerging From Behind the Workstation.

Managing technical staff

BackgroundThe National Health Service (NHS) seems appropriately placed to be an exemplar employer in providing effective and proactive workplace health and wellbeing services for its staff. However, NHS staff sickness absence costs an estimated £2.4 billion. Evidence suggests staff health and wellbeing services delivered in the NHS can improve health, productivity and sickness absence and yet the adoption of these services remains a challenge, with few examples nationally. This research aimed to explore the perceptions of NHS senior leaders and health and wellbeing practitioners regarding barriers and facilitators to implementing workplace health and wellbeing services for staff in the NHS.MethodsSemi-structured interviews were conducted with NHS staff, consisting of four senior leaders, four heads of department and three health and wellbeing practitioners in one region of the UK. Interviews were transcribed verbatim and analysed using thematic analysis.ResultsThemes describe the experience of delivering workplace health and wellbeing services in the NHS, and barriers and facilitators to implementation from senior decision makers. Barriers to implementation of services include; a busy and pressurised environment, financial constraints and reluctance to invest in staff health and wellbeing. Barriers to staff engagement were also reported and include difficulty of access to health and wellbeing services and lack of time. Initiating services were facilitated by financial incentives, a supportive organisational structure and culture that takes a preventative, rather than reactive, approach to staff health and wellbeing. Facilitators to implementing health and wellbeing services include a coherent, strategic approach to implementation, effective communication and advertisement, being creative and innovative with resources and conducting a needs analysis and evaluation before, during and after implementation.ConclusionsBarriers to the successful initiation and implementation of health and wellbeing services in the NHS are numerous and range from front-line logistical issues with implementation to high-level strategic and financial constraints. Adopting a strategic and needs-led approach to implementation and ensuring thorough staff engagement are amongst a number of factors that facilitate implementation and help overcome barriers to initiation of wellbeing programmes in the NHS. There is a need for a culture that supports staff health and wellbeing in the NHS.

Increasing evidence of the effects of the COVID-19 pandemic on healthcare workers’ mental health and wellbeing has prompted concerns about the longer-term impacts on healthcare delivery and health workforce sustainability. For rural health services and communities, the pandemic has compounded existing challenges including workforce shortages, potentially leading to further health inequalities. This qualitative interview study aimed to explore factors within and external to the health service environment that influenced health service staff mental health and wellbeing in rural and regional Victoria, Australia, during the first two years of the COVID-19 pandemic (2020-2021). Participants were recruited from nine publicly funded rural and regional health services. Semistructured interviews were conducted via videoconference, audio-recorded, and transcribed. Data were analysed using a five-stage framework approach. Eighteen health service staff from four rural areas participated in the study. A range of factors that were perceived by participants to influence their wellbeing were identified. These were coded to four main themes: (1) rural community relations, (2) the nature of the health workplace, (3) self-care and supportive networks, and (4) public health measures and the unpredictable nature of the pandemic. Factors coded to these themes were described as both positive and negative influences on health staff mental health and wellbeing. Optimising the mental health and wellbeing of rural health staff is imperative to the sustainability of this workforce during and beyond the COVID-19 pandemic. Rural health services must consider the community and health service (meso-level), individual (microlevel), and broader pandemic context (macrolevel) when developing and implementing strategies to promote staff wellbeing. Strategies must encompass the development of senior leadership capabilities, mechanisms to support effective leadership, and optimal communication processes within health services. Given the potential for community support to positively influence rural health staff wellbeing, community engagement should be a feature of health service wellbeing strategies.

SOCIOECONOMICS OF OPHTHALMIC SURGICAL CARE IN THE NEW MILLENNIUM

Purpose: This paper examines the crucial role of healthcare administrators in the United Arab Emirates (UAE) in ensuring both disaster preparedness and staff well-being.&#x0D; Methodology: It uses mixed methods to review the literature on emergency medical teams in disaster response and the prevalence and impact of burnout among healthcare workers. It also explores factors and interventions to prevent and reduce burnout in the UAE context.&#x0D; Findings: Key findings are that administrators have a vital role in preparedness and need strategies for service continuity and quality. They also need to address staff burnout and its impact on patient care by implementing interventions to prevent and reduce it.&#x0D; Unique Contribution to Theory, Practice and Policy: The paper proposes recommendations for healthcare administrators in the UAE to improve their disaster preparedness and staff well-being strategies based on evidence and best practices. Disaster preparedness and staff well-being are interrelated in healthcare administration, affecting patient care quality and safety. Administrators should integrate well-being initiatives into preparedness planning and leverage related resources and expertise. Recommendations for healthcare organizations include enhancing preparedness efforts, prioritizing staff well-being, and integrating related interventions for positive implications on staff and patient health and well-being, organizational resilience and performance, and community resilience. The paper emphasizes administrators' important roles in promoting preparedness and staff well-being in the UAE context.

Aims and ObjectivesThis qualitative study aims to establish the existence and impact of patient-to-staff incivility on staff wellbeing and patient care in the Emergency Department (ED). BackgroundResearch has indicated that...

ObjectiveThe benefits of internal whistleblowing or speaking-up in the healthcare sector are significant. The a priori assumption that employee whistleblowing is always beneficial is, however, rarely examined. While recent research...

Health Care Reform and Care at the Behavioral Health--Primary Care Interface

The outbreak of COVID-19, resulting from widespread transmission of the SARS-CoV-2 virus, represents one of the foremost current challenges to societies across the globe, with few areas of life remaining untouched. Here, we detail the immediate impact that COVID-19 has had on the teaching and practice of anatomy, providing specific examples of the varied responses from several UK, Irish and German universities and medical schools. Alongside significant issues for, and suspension of, body donation programmes, the widespread closure of university campuses has led to challenges in delivering anatomy education via online methods, a particular problem for a practical, experience-based subject such as anatomy. We discuss the short-term consequences of COVID-19 for body donation programmes and anatomical education, and highlight issues and challenges that will need to be addressed in the medium to long term in order to restore anatomy education and practice throughout the world.

BackgroundResearch has demonstrated a bidirectional relationship between physical function and depression, but studies on their association in migrant populations are scarce. We examined the association between mental health symptoms and mobility limitation in Russian, Somali and Kurdish migrants in Finland.MethodsWe used data from the Finnish Migrant Health and Wellbeing Study (Maamu). The participants comprised 1357 persons of Russian, Somali or Kurdish origin aged 18–64 years. Mobility limitation included self-reported difficulties in walking 500 m or stair climbing. Depressive and anxiety symptoms were measured using the Hopkins Symptom Checklist-25 (HSCL-25) and symptoms of somatization using the somatization subscale of the Symptom Checklist-90 Revised (SCL-90-R). A comparison group of the general Finnish population was selected from the Health 2011 study.ResultsAnxiety symptoms were positively associated with mobility limitation in women (Russians odds ratio [OR] 2.98; 95% confidence interval [CI] 1.28–6.94, Somalis OR 6.41; 95% CI 2.02–20.29 and Kurds OR 2.67; 95% CI 1.41–5.04), after adjustment for socio-demographic factors, obesity and chronic diseases. Also somatization increased the odds for mobility limitation in women (Russians OR 4.29; 95% CI 1.76–10.44, Somalis OR 18.83; 95% CI 6.15–57.61 and Kurds OR 3.53; 95% CI 1.91–6.52). Depressive symptoms were associated with mobility limitation in Russian and Kurdish women (Russians OR 3.03; 95% CI 1.27–7.19 and Kurds OR 2.64; 95% CI 1.39–4.99). Anxiety symptoms and somatization were associated with mobility limitation in Kurdish men when adjusted for socio-demographic factors, but not after adjusting for obesity and chronic diseases. Finnish women had similar associations as the migrant women, but Finnish men and Kurdish men showed varying associations.ConclusionsMental health symptoms are significantly associated with mobility limitation both in the studied migrant populations and in the general Finnish population. The joint nature of mental health symptoms and mobility limitation should be recognized by health professionals, also when working with migrants. This association should be addressed when developing health services and health promotion.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1629-1) contains supplementary material, which is available to authorized users.

516Diplomatic relations — Immunities and privileges — Member of technical and administrative staff — Extent of immunity — Member of technical and administrative staff accused of child abuse — Proceedings to protect child — Whether barred by immunityJurisdiction — Immunity — Diplomatic immunity — Vienna Convention on Diplomatic Relations, 1961 — Technical and administrative staff — Inviolability of the private residence — European Convention on Human Rights, 1950, Article 3 — The law of England

Who is Scottish? What is Scottish? What does Scottish mean in the sporting context? International football's 'Tartan Army' of Scottish supporters is commonly viewed as amongst the most vociferous, loyal, entertaining and best behaved of supporters. This paper uses Scottish international football to explore expressions of Scottishness amongst those who regularly follow the Scottish international team. As the country's most significant and popular sport, a survey of the international football supporters partly acts as a gauge of who subscribes to current as well as dominant notions of Scottish national identities and what these mean in the context of this section of Scottish opinion. As well as assisting in an exploration of Scottish identities, this research provides comment on some of the social, religious, national and political nuances involved in Scottish football generally.