Adult Team Research Articles

Internal training load and fitness profile between adult team versus junior team soccer players

The aim of the present study was to compare the fitness profiles and internal training loads between senior team and academy team soccer players during an in-season phase. Twenty-two professional soccer players from the senior team (n=12; 28.3<img width="12" alt="" height="20"> 2.0 years) and under 19 (U19) team (n=10; 18.0<img width="12" alt="" height="20"> 0.4 years) of the same club participated in the present study. High-intensity running performance, acceleration, maximal sprint, and change of direction (COD) ability were all tested during the mid-season break of a competitive season. Session rating of perceived exertion (sRPE) reflecting the internal training load during the entire first half of the season was being documented daily. Senior players showed small to moderate superiority in COD (1.8%, 90% confidence intervals [CI, -3.2; 7.1], ES: 0.24 [-0.44; 0.92]), maximal sprint (2.3%, [0.0; 4.7], ES: 0.81 [0.00; 1.63]) and acceleration (3%, [0.2; 5.8], ES: 0.96 [0.06; 1.85]). The U19 showed small better high-intensity intermittent running fitness (2.5%, [-1.2; 6.3], ES: 0.39 [-0.20; 0.97]). When analyzing internal training loads (from M-3 to M+3), the U19 showed small to very large higher sRPE values for all days (range; 8.2%; 229.3%, [-8.1; 328.3], ES range; 0.25; 2.70, [-0.26; 3.3]), except for match days (M), on which unclear trivial difference was observed (-1.5%, [-9.6; 7.5], ES -0.09 [-0.65; 0.46]). Our results showed that senior players and youth players had different fitness profiles and internal training loads during the first half of a competitive season; this should be taken into consideration when designing specific and individualized recovery and training sessions.

Asymptomatic Foot and Ankle Abnormalities in Elite Professional Soccer Players.

Background:Professional soccer players are often evaluated with asymptomatic lesions of the ankle and foot, and such abnormalities may eventually become clinically relevant.Purpose:To ascertain the prevalence of foot and ankle abnormalities in elite professional adult soccer players.Study Design:Case series; Level of evidence, 4.Methods:Professional adult male elite soccer players (n = 37) underwent magnetic resonance imaging (MRI) scans of both their feet and ankles. All competed for their respective national junior or adult soccer teams. MRI scans were performed with 1.5-T scanners and analyzed independently by 2 experienced radiologists.Results:The MRI scans of 86.5% of the players showed degenerative joint disease (DJD) in at least 1 of the joints of the foot and ankle. Articular cartilage lesions in the joints of the foot and ankle were evident in 42% of the scans. Of all lesions, 17% were grade 3 or 4 (Noyes and Stabler classification) cartilage lesions and accompanied by subchondral bone marrow edema. The greater the age, weight, and height of the players, the greater was the odds ratio of DJD of the ankle joint. Synovitis in at least 1 of the joints of the foot was detected in 64% of the MRI scans. Leg dominance significantly correlated with bone marrow edema of the talus.Conclusion:Elite professional soccer players are often evaluated with a high prevalence of asymptomatic osteochondral lesions with subchondral bone marrow edema in the foot and ankle. These osteochondral lesions may remain asymptomatic or, with the continuing high-intensity stresses that modern professional soccer demands of its athletes, may evolve and cause foot and ankle pain. It is unclear whether and which interventions can be implemented to prevent the occurrence of these abnormalities in the first place.

Internal and External Training Load in Under-19 versus Professional Soccer Players during the In-Season Period.

This study aimed to compare the training load of a professional under-19 soccer team (U-19) to that of an elite adult team (EAT), from the same club, during the in-season period. Thirty-nine healthy soccer players were involved (EAT [n = 20]; U-19 [n = 19]) in the study which spanned four weeks. Training load (TL) was monitored as external TL, using a global positioning system (GPS), and internal TL, using a rating of perceived exertion (RPE). TL data were recorded after each training session. During soccer matches, players’ RPEs were recorded. The internal TL was quantified daily by means of the session rating of perceived exertion (session-RPE) using Borg’s 0–10 scale. For GPS data, the selected running speed intensities (over 0.5 s time intervals) were 12–15.9 km/h; 16–19.9 km/h; 20–24.9 km/h; >25 km/h (sprint). Distances covered between 16 and 19.9 km/h, > 20 km/h and >25 km/h were significantly higher in U-19 compared to EAT over the course of the study (p = 0.023, d = 0.243, small; p = 0.016, d = 0.298, small; and p = 0.001, d = 0.564, small, respectively). EAT players performed significantly fewer sprints per week compared to U-19 players (p = 0.002, d = 0.526, small). RPE was significantly higher in U-19 compared to EAT (p = 0.001, d = 0.188, trivial). The external and internal measures of TL were significantly higher in the U-19 group compared to the EAT soccer players. In conclusion, the results obtained show that the training load is greater in U19 compared to EAT.

Competition Experience, Relative Age Effect and Average Age of the Senior World Events’ Medal-Winning Basketball Players

"The International Basketball Federation (FIBA) has changed its youth competition system in 2004, and due to this regulation, many players had the chance to compete every year at youth level and later, to elevate to the top. The purpose of our study was to inspect those medal-winning European basketball players who competed in the past 19 senior basketball world events. We analysed the tendencies of selection by dissecting the set-up of successful senior national teams. We investigated each one of the 281 European basketball players who won a medal during the analysed period (2000-2019). We collected data from the archive page of FIBA. Our goal was to see whether there was a relation between the youth competition experience and the minutes spent in senior world events. We used the Cramer Association Coefficient, Relative Age Effect and average age were also inspected. We found that participation in the national youth tournaments is important but not the most exclusive factor of selection. There are opportunities for success in the adult national teams for players who have covered alternative sports careers – the factor of national youth experience is not exclusive. We suppose that head coaches utilize older and more experienced players on the Olympic Games, the average ages of successful Olympic medal-winner teams are higher than other world events’ medallists. Despite the fact that we were not able to find statistically proven and associative relationship between national youth recruitment eligibility and the minutes in game spent by successful adult players, further research could be gap fillers in exploring key factors in adulthood efficiency. Keywords: talent selection, competition experience, FIBA, basketball players, sport career."

Older Adult Fatality Reviews: A Powerful Tool to Improve Policies, Protections, and Services

Older adult maltreatment is a serious problem that can hasten mortality and cause fatality. Child and Domestic Violence Fatality Review teams have made a major impact to improve protections, services, and system responses for victims. There are over 1300 child fatality review teams in 50 US states and 200 domestic violence fatality teams in 45 states. Older adult fatality reviews, in contrast, have not proliferated across the country, missing opportunities to bring interdisciplinary expertise together to resolve policy, protection, and services needed to prevent older adult premature deaths due to violence and abuse. Method: A mini mock review of a fatality of an older adult woman will demonstrate the possibilities of beginning Older Adult Fatality Review Board as recommended by the American Bar Association. Conclusion: Interdisciplinary older adult fatality review teams have been an underutilized tool to make changes in older adult mistreatment protection services and systems.

HGG-11. HIGH-GRADE GLIOMAS IN ADOLESCENTS AND YOUNG ADULTS HIGHLIGHT HISTOMOLECULAR DIFFERENCES WITH THEIR ADULT AND PAEDIATRIC COUNTERPARTS

BACKGROUNDConsidering that paediatric high-grade gliomas (HGGs) are biologically distinct from their adult counterparts, the objective of this study was to define the landscape of HGGs in adolescents and young adults (AYAs).METHODSWe performed a multicentric retrospective study of 112 AYAs from adult and paediatric Ile-de-France neurosurgical units, treated between 1998 and 2013 to analyse their clinicoradiological and histomolecular profiles. The inclusion criteria were age between 15 and 25-years, histopathological HGG diagnosis, available clinical data, pre-operative and follow-up MRI. MRI and tumoral samples were centrally reviewed. Immunohistochemistry and complementary molecular techniques such as targeted/next generation sequencing, whole exome sequencing and DNA-methylation analyses were performed to achieve an integrated diagnosis according to the 2016 WHO classification.RESULTSBased on 80 documented AYA patients, HGGs constitute heterogeneous clinicopathological and molecular groups, with a predominant representation of paediatric-subtypes (Histone H3-mutants, 40%) but also adult-subtypes (IDH-mutants, 28%) characterized by the rarity of oligodendrogliomas, IDH-mutant and 1p/19q co-deleted and the relative high frequency of “rare adult IDH mutations” (20%). H3G34-mutants (14%) represent the most specific subgroup in AYAs. In the H3K27-mutant subgroup, the non-brainstem diffuse midline gliomas are more frequent (66.7%) than diffuse intrinsic pontine gliomas (23.8%), contrary to children. We found that WHO grade has no prognostic value, but molecular subgrouping has major prognostic importance.CONCLUSIONSHGGs in AYAs could benefit from a more personalized neuro-oncological management, driven by molecular subtyping rather than age group. Collaborative efforts are needed from paediatric and adult neuro-oncology teams to improve the management of HGGs in AYAs.

Evaluation of radically open dialectical behaviour therapy in an adult community mental health team: effectiveness in people with autism spectrum disorders.

Radically open dialectical behaviour therapy (RO DBT) is a transdiagnostic treatment designed to address disorders associated with overcontrol, including autism spectrum disorders (ASD). To date, no studies have reported on the effectiveness of RO DBT for people with ASD. Forty-eight patients were referred to a RO DBT programme, of whom 23 had a diagnosis of ASD. Outcome was measured using the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE) and the Questionnaire about the Process of Recovery. The intervention was effective, with a medium effect size of 0.53 for improvement in CORE global distress. End-point CORE global distress score was predicted from initial severity and a diagnosis of ASD. Participants with a diagnosis of ASD who completed the therapy had significantly better outcomes than completing participants without an ASD diagnosis. These findings provide preliminary support for RO DBT as an effective intervention for ASD in routine settings.

The four I's of adolescent transition in type 1 diabetes care: A qualitative study.

To explore adolescent perspectives on programme design in the transition to adult care. We conducted five focus groups on adolescents with type 1 diabetes nearing the age of transition to adult care. Study participants also completed an embedded survey where they rated a wide range of potential transition interventions. Focus group transcripts were analysed with three iterations of line-by-line coding to triangulate themes and subthemes. Four themes were identified: Individualization-how to personalize the transition experience (having choices in the transition experience, meeting adult provider before transition and specific transition preparation); Identity-how the world relates to my diabetes (stigma of type 1 diabetes, confusion with type 2 diabetes, diagnosis disclosure and resilience); Interconnection-how my support system can help me with my diabetes (peer support, near peer support, parental support, loss of bond with paediatric team and fear of not having a bond with adult team); and Impediment-how my diabetes limits me (self-care takes work and time, unpredictability and restrictiveness, and emotional burden). Highly rated interventions from the survey included: good communication between the paediatric and adult teams, medical summary of past diabetes care, and having paediatric and adult teams in the same building. The design of future transition interventions for adolescents with type 1 diabetes should address the issues of Individualization, Identity, Interconnection and Impediment. Collaborative processes between paediatric and adult providers were also rated as important strategies to facilitate the transition to adult care.

Specialised early intervention teams (extended time) for recent-onset psychosis.

Specialised early intervention teams (extended time) for recent-onset psychosis.

Specialised early intervention teams for recent-onset psychosis.

Specialised early intervention teams for recent-onset psychosis.

Report on the Adult Congenital Heart Disease Multidisciplinary Team Meeting Held During the COVID-19 Pandemic

Report on the Adult Congenital Heart Disease Multidisciplinary Team Meeting Held During the COVID-19 Pandemic

Collaboration pédiatre-adulte dans la chirurgie des tumeurs musculosquelettiques

Orthopaedic surgery I has a key role on the medical pathway of adolescent and young-adult (AYA) patients with musculo-skeletal tumor from diagnosis, tumor resection, musculo-skeletal immediate or delayed reconstruction, to dealing with late complications and sequelae following reconstruction during childhood. Administrative authorizations, organization by health authorities as well as training courses are quite different for adult and pediatric surgery. However, surgery for musculo-skeletal tumors in AYA patients have neither adult nor pediatric specifities; resection-reconstruction rules and technics are the same for adult or pediatric patients, with nevertheless lower complication rate and more biologic reconstructions for the youngest, and more prosthetic reconstructions for the oldest. Late complications after bone and soft-tissue reconstructions in childhood and musculo-skeletal deformation after surgery and/or radiotherapy in childhood need the vision from "adult" orthopaedic teams for long and very long term success of the surgical project with a good knowledge of pediatric technics previously used. Thus, formal shared time and transition care are necessary between pediatric and adult surgical teams to prepare long-term follow-up of these childhood cancer survivors. Participation to the same specialized Multi-Disciplinary Board, scientific society gathering adult and pediatric surgeons, clinical trials with no age-limitation might help to erase barriers and to ease collaboration between adult and pediatric ortho-oncologic teams.

O14 Transitions in diagnosis and between services in juvenile idiopathic arthritis: living and learning

O14 Transitions in diagnosis and between services in juvenile idiopathic arthritis: living and learning

Management of delirium superimposed on dementia in a dementia service

Delirium is associated with significant adverse outcomes, including prolonged length of hospital stay, increased dependency and increased mortality but there is a paucity of data pertaining to the management of delirium superimposed on dementia (DSD) in dementia specialist services. Here, the authors discuss their results from measuring the current practice in the management of DSD in a UK dementia specialist unit and an older adult community crisis and home treatment team service and the subsequent action plan formulated to improve patient care.

389TF Targeted Cross-Over Education for Flight Nurses in Transition from Dedicated Pediatric and Adult Teams to Generalist Flight Teams

389TF Targeted Cross-Over Education for Flight Nurses in Transition from Dedicated Pediatric and Adult Teams to Generalist Flight Teams

SC342 - Transitional urology for spina bifida patients: a 8 year experience from a multidisciplinary pediatric – adult team

SC342 - Transitional urology for spina bifida patients: a 8 year experience from a multidisciplinary pediatric – adult team

Transition of care from paediatric to adult age for rare chronic disorders: an Italian experience

Abstract Background Transition of care represents the transfer from child to adult care. An effective transition maintains continuity of care and presents better clinical outcomes. Thanks to improved survivorship of chronic paediatric patients to adulthood, this process has assumed growing relevance. Aim of the study was to evaluate quality and effectiveness of transition of care model of one of the biggest Hospitals of Northern Italy, that has organised a common structured model, differentiated according to patients' clinical and social complexity. Methods The sample consisted of patients with chronic rare diseases transited within the Hospital in the years 2016-2019. To analyse the evolution of all pathologies, for each patient the medical record was consulted; questionnaires were then administered to patients to investigate their illness perception and quality of life. Results The average age at transition of the retrospective study patients was 19.8±4.7 years. For most disorders, 100% of patients made the first post-transition visit. More than 90% of patients who did not make further post-transition visits were patients with Neurofibromatosis 1. Only 7 out of 18 patients with NF1 continued their treatment to the indicated specialist. One-year drop-out was 13%. Regarding the perception of one's own illness, 78% of respondents consider their health status from good to excellent, but more than 30% of respondents believe not to have currently adequate psychological and social support. Conclusions Transition of care represents an important phase in chronic diseases management. The proposed model assures a multidisciplinary approach, involving all specialists of both paediatric and adult teams. Preliminary data were positive and showed how this model could be an example for other institutions in Europe. Anyway, the transition model might be still be improved. Our data underlined the importance of a complete taking charge, with peculiar attention to psychological and social support. Key messages The study shows to the European Healthcare Providers the importance of a personalized planning of transition of care, that considers the complexity of clinical situation and concomitant social issues. A successful strategy of transition of care requires a multidisciplinary approach, that guarantees a complete taking charge, with peculiar attention to psychological and social support.

Does teaching on specific ASD adaptations improve knowledge and skills in an Adult Community Treatment Team?

An evaluation of whether providing staff with specific autism adaptations teaching would enable them to feel more competent and confident in making adaptations for autistic service users. A needs assessment was carried out, followed by an evaluated teaching session.

The adult multidisciplinary respiratory neuromuscular clinic.

Many neuromuscular disorders (NMD) are complicated by respiratory failure. These patients are best managed in a multidisciplinary outpatient clinic to provide timely access to the various disciplines they require. The key mainstay of treatment of respiratory failure in patients with NMD is noninvasive ventilation, supported by secretion clearance, speech and language therapy, optimisation of nutrition and the maintenance of mobility. Patients with specific conditions may also require cardiology, neurology, orthopaedics, urology and psychological services. The respiratory NMD multidisciplinary team should also provide access to palliative care, and caregiver health and wellbeing should also be reviewed at clinical reviews. The future of care for the respiratory NMD patient will increasingly involve home services and telehealth and the clinic should be equipped and resourced to deliver these. Although not all health systems will be able to provide all elements of the multidisciplinary team discussed here, this review provides the “ideal” recipe for the adult multidisciplinary team and the evidence base underpinning this from which a clinic can be developed.Educational aimsTo provide an overview of the care of an adult neuromuscular disorder patient presenting to the multidisciplinary respiratory clinic.To provide the evidence base for establishing the different elements of the multidisciplinary respiratory clinic.

Reflecting on transitions between Forensic CAMHS and the Adult Forensic Community Team

Reflecting on transitions between Forensic CAMHS and the Adult Forensic Community Team