The type and extent of travel for professional footballers undertaking national team duties for a national football federation.

Elite football (soccer) involves club, continental and international fixtures, requiring players to undertake extensive travel [1]. For a national football federation, this includes the transport of players between club and camp/tournament commitments, which is often a point of contention between respective organisations [2]. Partly this contention results from the effects of travel, whereby jet lag and travel fatigue can negatively affect physical performance [3-5] and athlete wellbeing [6, 7]. Given the scarcity of data on elite players following travel, an initial step for any national football federation is to understand the volume and nature of travel undertaken by national team players. Such insight may better identify the schedule, timelines and needs of athletes' post travel. Better awareness of these travel needs can help maximise availability for training and minimise the impact of travel related stresses on performance or wellbeing. However, the regularity and volume of travel to national football team commitments has not previously been described. Further, travel demands are likely to vary significantly based on the location of the athlete and the national team camp. For countries outside of Europe, such as Australia, the travel demands and ensuing effects on player preparation can be substantial for both arrival into national team and on return to clubs [7]. Hence, detailed information regarding the type, frequency, and extent of travel for national team duties is important to aid in planning optimal travel schedules and interventions to assist players for international or club duty.

Football-specific extension of the IOC consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020.

Several sports have published consensus statements on methods and reporting of epidemiological studies concerning injuries and illnesses with football (soccer) producing one of the first guidelines. This football-specific consensus statement was published in 2006 and required an update to align with scientific developments in the field. The International Olympic Committee (IOC) recently released a sports-generic consensus statement outlining methods for recording and reporting epidemiological data on injury and illness in sport and encouraged the development of sport-specific extensions.The Fédération Internationale de Football Association Medical Scientific Advisory Board established a panel of 16 football medicine and/or science experts, two players and one coach. With a foundation in the IOC consensus statement, the panel performed literature reviews on each included subtopic and performed two rounds of voting prior to and during a 2-day consensus meeting. The panel agreed on 40 of 75 pre-meeting and 21 of 44 meeting voting statements, respectively. The methodology and definitions presented in this comprehensive football-specific extension should ensure more consistent study designs, data collection procedures and use of nomenclature in future epidemiological studies of football injuries and illnesses regardless of setting. It should facilitate comparisons across studies and pooling of data.

Cooling strategies for firefighters: Effects on physiological, physical, and visuo-motor outcomes following fire-fighting tasks in the heat.

OBJECTIVES: Due to the nature of firefighting, most effective cooling interventions to reduce heat strain and optimise performance are not practically viable. This study quantified the effects of two practical cooling strategies, co-designed with subject-matter experts, on physiological strain and physical, perceptual, and visuo-motor performance during simulated firefighting in the heat. DESIGN: Randomised cross-over. METHODS: On three occasions 14 firefighters completed an 80-min simulation in a hot-humid environment (32.0[0.9]°C, 59[3]%RH) including two 20-min firefighting tasks in full protective clothing, each followed by 20-min seated recovery. Recovery involved removal of protective clothing and one of three interventions - control (CON; ambient-temperature water consumption), basic (BASIC; cool-water consumption, ambient-forearm immersion/towels, fan), and advanced (ADV; ice-slushy consumption, cool-forearm immersion/ice packs, misting-fan). Thermal (core temperature) and cardiovascular (heart rate, arterial pressure) responses were measured throughout, whilst physical (handgrip/balance), visuo-motor (reaction time/memory recall) and perceptual (fatigue/thermal sensation/comfort) measures were assessed pre- and post-trial. RESULTS: Compared to CON, core temperature was lower in BASIC and ADV following the second task (ADV: 37.7[0.4]; BASIC: 38.0[0.4]; CON: 38.3[0.4]°C) and recovery protocol (ADV: 37.5[0.3]; BASIC: 37.7 [0.3] CON: 38.3[0.4]°C). This was paralleled by lowered heart rate, rate pressure product, and thermal sensation following the recovery protocols, in the ADV and BASIC condition compared to CON (p < .05). No physical or visuo-motor outcomes differed significantly between conditions. CONCLUSION: Whilst these observations need to be extended to field conditions, our findings demonstrate that two novel cooling interventions developed in collaboration with subject-matter experts offered benefits for reducing thermal strain and optimising firefighter safety.

The relationship between team-level and league-level injury rate, type and location in a professional football league.

OBJECTIVES: To describe the relationship between team- and league-level variability of injury rate, type, and location over 6 seasons in professional Australian football (A-League). DESIGN: Prospective epidemiological study. METHODS: Injury incidence, type and location were collected from all A-League teams (n = 10) for 6 consecutive seasons (2012/13 to 2017/18) via a standardised injury surveillance system. Intra-class correlation and coefficient of variation were calculated to assess the between-season variability of injury measures for each team. To determine the relationship between team-level injury variability on league-level injury rates, Marginal Coefficient of Determination to Coefficient of Determination were then calculated from generalised linear mixed models. This allowed determination between season trends, where league-level injury incidence, type- and location rates as the response variables, season as the predictor variable and teams as random intercepts. RESULTS: The majority of teams showed poor to moderate correlations for between-season injury rates (intra-class correlation: r = 0.319-0.831), but also showed low-moderate variability between-seasons for injury rate (coefficient of variation 34 ±â€¯22%). League injury rates were stable, though were reduced in 2015/16 compared to 2012/13 (ß = 0.738; p = 0.011). Joint/Ligament injuries had coinciding significant reduction in 2015/16 (p = 0.001). The model variance showed the reduction of Joint/Ligament injuries was league-wide rather than team-specific (Marginal Coefficient of Determintion = 0.23; Coefficient of Determination = 0.23). CONCLUSIONS: In the A-League, low between-season injury rate variability from teams contributed to a stable league-level injury trend over seasons. A reduction in league injury rate in 2015/16 was mirrored by league-wide Joint/Ligament injury rates, without specific effect by team.

Children's immunity at risk.

Young children who have spent much of their lives under coronavirus restrictions now seem more vulnerable to a number of other conditions, finds Donna Lu.

Australian firefighters perceptions of heat stress, fatigue and recovery practices during fire-fighting tasks in extreme environments.

OBJECTIVES: The aim of this study was to assess current perceptions of heat stress, fatigue and recovery practices during active duty in Australian firefighters. DESIGN: Prospective survey. METHODS: 473 firefighters from Fire and Rescue New South Wales completed a two-part, 16-item survey. Questions included perceptions of the operational activities and body areas associated with the most heat stress, the most mentally and physically demanding activities, and levels of fatigue felt. Further questions focussed on the use and importance of recovery practices, effectiveness of currently used heat-mitigation strategies and additional cooling strategies for future use. RESULTS: Around a third of firefighters (62%) reported structural fire-fighting as the hottest operational activities experienced, followed by bushfire-fighting (51%) and rescue operations (38%). The top three responses for which body-parts get the hottest ranked as 'the head' (58%), 'the whole body' (54%) and 'the upper back' (40%), respectively. The majority of firefighters (~90%) stated they always or sometimes use the opportunity to recover at an incident, with the top three being 'sit in the shade' (93%), 'cold water ingestion (drinking)' (90%) and 'removing your helmet, flash hood and jacket' (89%). Firefighters reported higher usefulness for more easily deployed strategies compared to more advanced strategies. Limited age and gender differences were found, although location of active service differences were present. CONCLUSION: These findings may inform future research, and translation to operational directives for recovery interventions; including exploration of protective gear and clothing, education, resources and provision of cooling methods, as well as recovery aid development.

When will life return to normal?

We start the new year with effective coronavirus vaccines, but the end of the pandemic is still a way off. So what will life be like in 2021, as we glimpse the beginning of the end of the crisis, ask Graham Lawton, Michael Le Page, Donna Lu, Clare Wilson and Adam Vaughan.

The financial and performance cost of injuries to teams in Australian professional soccer.

OBJECTIVES: To determine the relationship between injury incidence, player-salary cost and team performance in the professional Australian soccer league. DESIGN: Prospective observational cohort study. METHODS: Injury incidence, player-salary cost and team performance data were collected from the 10-club A-League competition (n=27 matches/season) over 6 seasons from 2012/13. Player-salary cost of injury was calculated from the salary cap, injury-induced missed matches and player exposure, and trends were reported from Poisson regressions. Team performance was determined from ranking, points, goals (scored, conceded and difference) and match outcome (win, loss or draw) per season and analysed via a mixed-effects Poisson models to estimate association with injury. RESULTS: Nine-hundred-and-sixteen injuries resulted in 3148 missed matches. Injury incidence remained stable apart from a decrease in 2015/16 (p=0.01). Missed matches were significantly higher in season 2013/14 (55.1 [50.7-59.9]; p<0.01) and 2014/15 (71.4 [66.4-76.8]; p<0.001) compared to 2012/13, without differences between other seasons. Player-salary cost ranged between AUD$187,990-AUD$332,680/team, peaking in 2014/15 (p<0.01). Multi-collinearity was detected for team performance variables except for matches lost. Teams who finished the season with greater positive goal differences were associated with 1% less injuries (p=0.003). Similarly, more missed matches were associated with 1% less league points and losses (p<0.001). CONCLUSIONS: Player-salary costs remained stable, concomitant with stable injury rates and missed matches. Despite injury being associated with goals difference, points and match losses; the magnitude of these relationships are small and team performance is more complex than injury occurrence alone. Injury prevention remains necessary for reducing injury-induced player-salary costs; however, additional services are required to improve team performance.

How Hubei fought the virus.

Doctors on the front line in the Chinese province where the coronavirus outbreak started tell Donna Lu about their experiences treating covid-19.

Remaining hopeful.

Jane Goodall has tirelessly fought for a better world for humans and wildlife, and with covid-19 she says there are reasons to stay positive, finds Donna Lu.

Inside Wuhan's lockdown.

Hubei residents are trying to stay positive as hospitals attempt to treat thousands infected by the new coronavirus, reports Donna Lu.

Injury epidemiology in Australian male professional soccer.

OBJECTIVES: To describe the injury epidemiology of the Australian male professional soccer league (A-League) over 6 consecutive seasons. DESIGN: Prospective observational cohort study. METHODS: Match-loss injury data was collected from each A-League club (n=10) for each competition match (n=27/season) over 6 seasons (2012/13-2017/18). Injuries were collected weekly through a standardised protocol and were classified by setting, mechanism, severity, the type and location on the body. Generalised Linear Models were used to estimate the injury incidences (injury/round/season), whilst rate ratios were reported for total injuries and within abovementioned injury classifications. RESULTS: Overall injury incidence was not significantly different ranging from 4.8 (95%CI:4.1-5.8) to 6.7 (95%CI:5.8-7.8) between seasons 2012/13 to 2017/18 (p>0.05). Match injuries remained stable whilst training injuries decreased across the 6 seasons (exp(ß) 0.59[95%CI:0.36-1.0]; p=0.04). Respectively, contact and non-contact injuries were not significantly different across the 6 seasons, although non-contact injuries were more common than contact injuries (p>0.05). Mild severity injuries decreased (exp(ß) 0.64 [95%CI:0.4-0.9];p=0.02), whilst moderate severity injuries increased (exp(ß) 1.7 [95%CI:1.0-2.8];p=0.04) in season 2017/18 compared to 2012/13. The most common injuries were at thigh (23-36%), of which the majority were hamstring injuries (54%-65%) of muscle/tendon type (50-60% of total injuries/season). Injuries remained stable across the seasons by type and location (p>0.05 and p>0.05, respectively). CONCLUSIONS: Injury rates, mechanisms, locations and types have remained relatively stable over recent seasons of the A-League. Current Australian professional soccer league medical practices may have contributed to the stability of injury rates.

Scams, lies and online hate.

The coronavirus pandemic has infected the internet with misinformation.

Huge surge in UK cases.

Almost 3000 new cases reported in a day as the number of infections in people younger than 40 rises sharply, reports Donna Lu.

Your questions answered.

From immunity to vaccines and face coverings, Jessica Hamzelou, Graham Lawton, Michael Le Page, Donna Lu and Adam Vaughan have the answers.

How China is beating covid-19.

The country at the epicentre of the coronavirus pandemic now sees few cases and deaths. Donna Lu investigates the numbers and what's behind them.

Effects of Long-Haul Transmeridian Travel on Subjective Jet-Lag and Self-Reported Sleep and Upper Respiratory Symptoms in Professional Rugby League Players.

PURPOSE: To examine the effects of 24-h travel west across 11 time zones on subjective jet-lag and wellness responses together with self-reported sleep and upper respiratory symptoms in 18 professional rugby league players. METHODS: Measures were obtained 1 or 2 d before (pretravel) and 2, 6, and 8 d after travel (post-2, post-6, and post-8) from Australia to the United Kingdom (UK) for the 2015 World Club Series. RESULTS: Compared with pretravel, subjective jet-lag remained significantly elevated on post-8 (3.1 ± 2.3, P < .05, d > 0.90), although it was greatest on post-2 (4.1 ± 1.4). Self-reported sleep-onset times were significantly earlier on post-2 than at all other time points (P < .05, d > 0.90), and large effect sizes suggested that wake times were earlier on post-2 than on post-6 and post-8 (d > 0.90). Although significantly more upper respiratory symptoms were reported on post-6 than at pretravel (P < .05, d ˃ 0.90), no incidence of injury and negligible changes in wellness and muscle strength and range of motion (P > .05, d < 0.90) were evident after travel. CONCLUSIONS: Results suggest that westward long-haul travel between Australia and the UK exacerbates subjective jet-lag and sleep responses, along with upper respiratory symptoms, in professional rugby league players. Of note, the increase in self-reported upper respiratory symptoms is a reminder that the demands of long-haul travel may be an additional concern in jet-lag for traveling athletes. However, due to the lack of sport-specific performance measures, it is still unclear whether international travel interferes with training to the extent that subsequent competition performance is impaired.