Exercise in bushfire smoke for high performance athletes: A Position Statement from the Australian Institute of SportEndorsed by Australasian College of Sport and Exercise Physicians (ACSEP) and Sport Medicine Australia (SMA).

OBJECTIVES: The frequency of bushfires in Australia is increasing and it is expected bushfire smoke will become a more prevalent phenomenon impacting air quality. The objective of this position statement is to provide guidance to the sport sector regarding exercise in air affected by bushfire smoke. DESIGN: This is position statement from the Australian Institute of Sport, based on a narrative review of the literature regarding bushfire smoke and its effects on health and exercise performance. METHODS: A narrative review of scientific publications regarding the effects of bushfire smoke on health and exercise performance. RESULTS: Bushfire smoke has negative impacts on health and performance. Athletes exercising at high intensity over a prolonged duration will increase their exposure to air pollutants. Athletes with a history of elevated airway responsiveness are likely to be at increased risk of an adverse response to bushfire smoke exposure. CONCLUSIONS: Athletes, coaches, support staff and sport organisations should monitor air quality (PM2.5 concentration) and make appropriate adjustments to training duration and intensity.

The development and test-retest reliability of the periodic health evaluation for female athletes (PHE FA) survey.

OBJECTIVES: To develop and assess the test-retest reliability of a survey exploring Australian high-performance female athlete's perspectives toward the periodic health evaluation and their perceived health needs. METHODS: A structured three-phase method for survey development was used to develop the periodic health evaluation for female athletes (PHE FA) survey. Initially, a literature review and gap analysis was performed to identify themes and questions (Phase 1). Survey questions were developed covering demographic information (n = 9); sports-related medical screening (n = 19) and health needs and information (n = 7) (Phase 2). Test-retest reliability of the survey was then assessed (Phase 3). The survey was administered to a purposeful sample of seven high-performance level female athletes who completed the survey, on two separate occasions, 3 weeks apart via Checkbox© survey software (Checkbox Technology Inc., San Francisco, CA). Test-retest reliability was assessed using the intraclass correlation coefficient (ICC). RESULTS: The mean age of the athletes was 29 years (SD 4 years, range 24-34 years). All were able-bodied athletes and 71% participated in team sports. Eighty-six percent of athletes have competed in world championships and 71% were Olympians. The average ICC of all items was 0.998 (95% CI 0.997-0.998, p = 0.000) demonstrating excellent consistency of measures between the two time points.All the athletes preferred a Sport and Exercise Medicine Physician to conduct their PHE and 86% preferred a female doctor. The key topics of interest were pelvic floor health including incontinence (100%); fertility (86%); pregnancy (71%); and mental and emotional wellbeing (71%). Face-to-face education was the preferred option to receive health information. CONCLUSIONS: The PHE FA survey was co-created with an athlete and other key stakeholders. Excellent consistency of measures between the two time points was indicated by the high test-retest reliability of the PHE FA survey. Data collected using the PHE FA survey can contribute to informed evidence-based policies, and processes to support the health and wellbeing of female athletes.

Exploring Australian high-performance athletes' perceptions and experiences of sport participation during pregnancy and post-pregnancy: Development and test-retest reliability of the Mum-Alete Survey.

OBJECTIVES: To develop and assess the test-retest reliability of a survey exploring high-performance athletes' perceptions and experiences during and post-pregnancy. DESIGN: Cross-sectional mixed-methods survey. METHODS: A three-phase approach was employed to develop the Mum-Alete survey. Relevant domains and questions were identified through a review of the literature and gap analysis (Phase 1). The face and content validity were assessed during Phase 2. The survey was modified, and the final survey included 113 questions. The test-retest reliability was assessed during Phase 3. Seven athletes aged ≥18 years who were currently pregnant and/or given birth since 1 July 2016 were recruited. The survey was administered via Qualtrics and completed on two occasions. Intraclass correlation coefficient (ICC) were determined to assess test-retest reliability (excellent, good, moderate, and poor). RESULTS: The average ICC of all items was 0.962 (95% CI 0.957-0.966) demonstrating excellent test-retest reliability. The test-retest reliability was excellent for the demographic and general questions domain (ICC = 0.967 95% CI 0.955-0.977) and good for the exercise (ICC 0.762 95% CI 0.707-0.811), physical health (ICC 0.841 95% CI 0.810-0.868) and well-being (ICC 0.827 95% CI 0.784-0.865) domains. CONCLUSIONS: The high test-retest reliability of the survey indicates excellent consistency of measures between the two time-points.

The prevalence and socio-demographic risk factors of coexistence of stunting, wasting, and underweight among children under five years in Bangladesh: a cross-sectional study.

BACKGROUND: Childhood stunting, wasting and underweight are significant public health challenges. There is a gap in knowledge of the coexistence of stunting, wasting, and underweight among children under five years (under-5) in Bangladesh. This study aims to (i) describe the prevalence of the coexistence of stunting, wasting, and underweight and ii) examine the risk factors for the coexistence of stunting, wasting, and underweight among children under-5 in Bangladesh. METHODS: This study included 6,610 and 7,357 under-5 children from Bangladesh Demographic Health Surveys (BDHS) 2014 and 2017/18, respectively. The associations between the coexistence of stunting, wasting, and underweight and independent variables were assessed using the Chi-square test of independence. The effects of associated independent variables were examined using negative binomial regression. RESULTS: The prevalence of coexistence of stunting, wasting, and underweight gradually declined from 5.2% in 2014 to 2.7% in 2017/18. Children born with low birth weight ((adjusted incidence rate ratios, aIRR) 2.31, 95% CI 1.64, 3.24)); children of age group 36-47 months (aIRR 2.26, 95% CI 1.67, 3.08); children from socio-economically poorest families (aIRR 2.02, 95% CI 1.36, 2.98); children of mothers with no formal education (aIRR 1.98, 95% CI 1.25, 3.15); and children of underweight mothers (aIRR 1.73, 95% CI 1.44, 2.08) were the most important risk factors. Further, lower incidence among children with the coexistence of stunting, wasting, and underweight was observed in the 2017-18 survey (aIRR 0.59, 95% CI 0.49, 0.70) compared to children in the 2014 survey. CONCLUSIONS: One out of thirty-five under-5 children was identified to have coexistence of stunting, wasting, and underweight in Bangladesh. The burden of coexistence of stunting, wasting, and underweight was disproportionate among children born with low birth weight, socio-economically poorest, a mother with no formal education, and underweight mothers, indicating the need for individual, household, and societal-level interventions to reduce the consequences of coexistence of stunting, wasting, and underweight.

Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a highly infectious respiratory tract disease. The most common clinical manifestation of severe COVID-19 is acute respiratory failure. Respiratory rehabilitation can be a crucial part of treatment, but data lack for patients with COVID-19. This study investigates the effects of short-term respiratory rehabilitation (i.e., breathing exercises) on respiratory recovery among non-ICU hospitalised patients with COVID-19. METHODS: This was a quasi-experimental, pre-and post-test study. The study recruited 173 patients hospitalised with moderate to severe COVID-19. All the patients received standardised care for COVID-19, and 94 patients in the intervention group also received the intervention of breathing exercises, which included breathing control, followed by diaphragmatic breathing, deep breathing, or thoracic expansion exercise, and huffing (forced expiratory technique) and coughing. Data on the mean values of peripheral oxygen saturation (SpO2), need for oxygen therapy (litre/min), respiratory rate (breaths/minute), and heart rate (beats/minute) and were collected at baseline, 4 days, and 7 days after the baseline assessment. Analysis of variance on repeated measures was applied to compare the mean value of outcome measures of all the time points. RESULTS: The mean (± SD) age of the intervention (69.6% men) and control group (62.1% men) were 50.1 (10.5) and 51.5 (10.4) years, respectively. At 4-day of follow-up, SpO2 (96.6% ± 1.9 vs. 90.7% ± 1.8, P < 0.001), need for oxygen therapy (0.8 ± 2.6 vs. 2.3 ± 2.9, P < 0.001), respiratory rate (20.5 ± 2.3 vs. 22.3 ± 2.5, P < 0.001), and heart rate (81.2 ± 9.5 vs. 89.2 ± 8.9, P < 0.001) improved in the intervention group compared to the control group. At 7-day follow-up, differences remained significant concerning the oxygen saturation and the need for oxygen therapy (P < 0.001) between the groups. CONCLUSIONS: Our results indicate that breathing exercise, even for a short period, effectively improves specific respiratory parameters in moderate to severe COVID-19 patients. As a non-invasive and cost-effective respiratory rehabilitation intervention, breathing exercise can be a valuable tool for a health care system overwhelmed by the COVID-19 pandemic. These results should be considered preliminary until they are replicated in larger samples in different settings.

Despite maintaining a high daily training availability, a quarter of athletes start the season injured and three quarters experience injury in an Australian State Academy of Sport.

OBJECTIVES: To 1) investigate the incidence, prevalence, burden and characteristics of injuries; and 2) explore the frequency of physiotherapy and medical servicing for elite sports academy athletes over a 12-month season. DESIGN: Prospective cohort study. METHODS: Medical attention and time-loss injuries were prospectively recorded by Physiotherapy and Medical (Sports Physician) staff for 94 athletes (72.3% females). The number of linked physiotherapy and medical servicing appointments was also recorded. Injury incidence rates (IIR), point and period prevalence, and injury burden were calculated and compared by athlete gender, sport, and categorisation (performance level) using incidence rate ratios (IRR). RESULTS: The number of injuries reported was 193 in 71 (75.5%) athletes. The IIR was 2.1 (95%CI: 1.8 to 2.4) injuries per 365 days, with no gender difference observed (IRR: 1.1, 0.8 to 1.4). The injury burden was 43.5 (95%CI: 37.8 to 50.1) days absent per 365 days. More than one-quarter (point prevalence, 26.6%) of athletes commenced the season with an injury. In-season injury risk was 2.5 fold greater in athletes who started the season with an injury compared to athletes who started the season without an injury (IRR: 2.5, 1.9 to 3.4). The majority (81.2%) of the 1164 appointments recorded were physiotherapy, with an overall 4.3:1.0 physiotherapy to medical appointment ratio. CONCLUSIONS: One in four athletes began the elite pathway season with a pre-existing injury, while also demonstrating a 2.5 fold greater risk of subsequent injury in the scholarship period. Sports should not assume their athletes are uninjured at the beginning of their scholarship. Injury profiles, and physiotherapy and medical servicing varied across sports. To reduce health as a barrier in the successful transition of talented young athletes to elite athletes, injury management strategies at the commencement of recruitment and throughout the scholarship should be prioritised in the development pathway.

The Relationship Between Cricket Participation, Health, and Wellbeing: A Systematic Scoping Review.

Summarising and synthesising the evidence on cricket health and wellbeing can help inform cricket stakeholders and navigate future research directions. The purpose of this study was to investigate the relationship between cricket participation, health and wellbeing at all ages and playing standards, and identify research gaps in the existing literature. A scoping review was performed from inception to March, 2020. Studies were included if they assessed a construct related to health and/or wellbeing in cricketers, available in English. 219 articles were eligible. Injury incidence per 1,000 player exposures ranged from 1.8-5.7 injuries. 48% of former cricketers experienced persistent joint pain. However, former cricketers reported greater physical activity levels and mental-components of quality of life compared to the general population. Heat injury/illness and skin cancer are concerns and require further research. Cricket participation is associated with an inherent injury risk, which may have negative implications for musculoskeletal health in later life. However, cricket participation is associated with high quality of life which can persist after retirement. Gaps in the literature include prospective studies on health and wellbeing of cricketers, female cricketers, injury prevention strategies, and the impact of cricket participation on metabolic health and lifetime physical activity.

Prevalence and incidence of injuries among female cricket players: a systematic review and meta-analysis.

OBJECTIVE: The objective of the review was to describe the incidence and prevalence of injuries among female cricket players of all ages, participating in all levels of play. INTRODUCTION: Cricket, a bat-and-ball sport, is becoming popular among women of all ages and abilities worldwide. However, cricket participation carries a risk of injury. Injuries negatively affect sport participation, performance, and short- and long-term health and well-being. Injury prevention, therefore, is the key to safe, long-term cricket participation as a physical activity goal. Epidemiological data are needed to underpin evidence-based injury-prevention strategies. INCLUSION CRITERIA: Studies reporting incidence and prevalence of injuries in female cricket players of all ages, participating in all levels of play, were included in this review, including studies that report data by sex or by sport. Studies were excluded if they did not have enough data to calculate prevalence or incidence, did not distinguish female injury data from male injury data, focused on athletes participating in other sports, or focused on case studies. METHODS: A systematic review and meta-analyses were conducted according to the JBI and PRISMA 2020 guidelines. MEDLINE, SPORTDiscus, Physiotherapy Evidence Database (PEDro), EBSCO MasterFILE Premier, EBSCO CINAHL Complete, ProQuest Health and Medical Complete, Scopus, and ScienceDirect were systematically searched from inception to August 2021. Additionally, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov were searched. EBSCO MegaFile Premier, OpenGrey (SIGLE), WorldCat, Grey Matters, Grey Literature, and Google Scholar were searched for gray literature. Full-text articles that met the inclusion criteria were critically appraised using tools from JBI, and were extracted and synthesized in narrative summary and tabular format. Three meta-analyses were conducted: injury incidence rates, injury prevalence proportions, and injury incidence proportions. Heterogeneity was assessed using the I2 statistic and the random-effects model. RESULTS: Of the 7057 studies identified, 4256 were screened after duplicates were removed. A total of 23 studies met the inclusion criteria. Risk of bias was low for 21 studies. The injury incidence rate for elite cricket was 71.9 (SE 21.3, 95% CI 30.2-113.6) injuries per 1000 player hours, time-loss injury incidence rate was 13.3 (SE 4.4, 95% CI 4.6-22.0) injuries per 1000 player hours, and non-time-loss injury incidence rate was 58.5 (SE 16.9, 95% CI 25.6-91.7) injuries per 1000 player hours. The injury prevalence proportion for community to elite cricket was 65.2% (SE 9.3, 95% CI 45.7-82.3) and the injury prevalence proportion for community cricket was 60% (SE 4.5, 95% CI 51.1-68.6). The injury incidence proportion for community cricket was 5.6 (SE 4.4, 95% CI 0.1-18.3) injuries per 10,000 participants. Elite cricket players were more frequently injured than community cricket players. The most prevalent body regions injured were the shoulder and knee, and most were sustained by fast bowlers. Injuries to the hand, wrist, and fingers had the highest incidence and were most sustained by fielders. CONCLUSIONS: The study's findings can help stakeholders (including players, coaches, clinicians, and policymakers) make informed decisions about cricket participation by informing and implementing strategies to promote cricket as a vehicle for positive public health outcomes. This review also identified gaps in the available evidence base, and addressing these through future research would enhance women's cricket as a professional sport. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020166052.

Illness prevalence and symptoms in youth floorball players: a one-season prospective cohort study involving 471 players.

OBJECTIVE: To describe weekly illness prevalence and illness symptoms by sex in youth floorball players during one season. DESIGN: Prospective cohort study. SETTING: Players who were registered to play community level floorball during the 2017-2018 season (26 weeks) in two provinces in southern Sweden. PARTICIPANTS: 471 youth players aged 12-17 years. Mean (SD) age for 329 male players 13.3 (1.0) years and 142 female players 13.7 (1.5) years. PRIMARY AND SECONDARY OUTCOME MEASURES: Weekly self-reported illness prevalence and illness symptoms according to the 2020 International Olympic Committee's consensus recommendations. RESULTS: 61% of youth floorball players reported at least one illness week during the season, with an average weekly illness prevalence of 12% (95% CI 10.8% to 12.3%). The prevalence was slightly higher among females (13%, 95% CI 11.6% to 14.3%) than males (11%, 95% CI 9.9% to 11.7%), prevalence rate ratio 1.20 (95% CI 1.05 to 1.37, p=0.009). In total, 49% (53% male, 43% female) of illness reports indicated that the player could not participate in floorball (time loss), with a mean (SD) absence of 2.0 (1.7) days per illness week. Fever (30%), sore throat (16%) and cough (14%) were the most common symptoms. Female players more often reported difficulty in breathing/tight airways and fainting, and male players more often reported coughing, feeling tired/feverish and headache. Illness prevalence was highest in the peak winter months (late January/February) reaching 15%-18% during this period. CONCLUSIONS: Our novel findings of the illness prevalence and symptoms in youth floorball may help direct prevention strategies. Athletes, coaches, parents and support personnel need to be educated about risk mitigation strategies. TRIAL REGISTRATION NUMBER: NCT03309904.

Physical activity and sedentary behaviour in current and former recreational and elite cricketers: a cross-sectional study.

OBJECTIVE: Former sports participants do not necessarily maintain high levels of physical activity (PA) across their lifespan. Considering physical inactivity in former athletes is associated with an increased susceptibility to inactivity-related chronic diseases, research into PA behaviours in cricketers of all playing-standards is needed. The objective was to (1) describe PA and sedentary behaviour in current and former cricketers, and (2) determine the odds of current, former, recreational and elite cricketers meeting PA guidelines and health-enhancing PA (HEPA) compared with the general population. STUDY DESIGN: Cross-sectional survey. SETTING: Questionnaire response, UK. PARTICIPANTS: 2267 current and former cricketers (age: 52±15 years, male: 97%, current: 59%, recreational: 45%) participated. Cricketers were recruited through the Cricket Health and Wellbeing Study and met eligibility requirements (aged ≥18 years; played ≥1 year of cricket). PRIMARY AND SECONDARY OUTCOMES: Age-matched and sex-matched data from Health Survey for England 2015 (n=3201) was used as the general population-based sample. The International Physical Activity Questionnaire Short-Form assessed PA. Logistic regression, adjusted for age, sex, body mass index, alcohol consumption, smoking, education and ethnicity were used to meet the second aim. RESULTS: 90% of current and 82% of former cricketers met UK PA guidelines. Current (OR 1.26, 95% CI 1.06 to 1.49)) and elite (OR 1.35, 95% CI 1.01 to 1.78) cricketers had greater odds of meeting UK PA guidelines, and elite cricketers had greater odds of HEPA (OR 1.19, 95% CI 1.02 to 1.42), compared with the general population. Former cricketers had reduced odds (OR 0.78, 95% CI 0.62 to 0.99) of meeting the UK PA guidelines compared with the general population. CONCLUSIONS: Elite cricketers had a greater odds of meeting the PA guidelines and HEPA, compared with the general population. Former cricketers demonstrated reduced odds of meeting the PA guidelines compared with the general population. Strategies are needed to transition cricketers to an active lifestyle after retirement, since former cricketers demonstrated reduced odds of meeting the PA guidelines compared with the general population.

Urban-rural differences in the associated factors of severe under-5 child undernutrition based on the composite index of severe anthropometric failure (CISAF) in Bangladesh.

INTRODUCTION: Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. METHODS: This study extracted the children dataset from the 2017-18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. RESULTS: The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children's birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition. CONCLUSION: Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.

Prevalence and incidence of injuries among female cricket players: a systematic review protocol.

OBJECTIVE: The objective of this systematic review is to describe the incidence and prevalence of injuries in female cricket players participating in recreational-, school-, club-, and elite-level cricket. INTRODUCTION: Recent investments in women's cricket, stand-alone tournaments, and increased visibility through new broadcasting milestones has increased participation in many countries. With increased participation of women in cricket comes increased risk of injury. Epidemiological data are needed to underpin evidence-based injury-prevention strategies. No systematic review or meta-analysis of injuries is currently available to provide a comprehensive overview of synthesized findings to make the evidence accessible. INCLUSION CRITERIA: Studies on female cricket players of all ages and participating in all levels of cricket will be included. Studies that contain data on only male cricket players will be excluded. Studies where data from female cricket players can be distinguished from male players will be included. Injuries sustained when playing cricket, that are self-reported or diagnosed by a health care professional will be included. Definitions of injury including, but not limited to, medical-attention injuries, general time-loss injuries, or player-reported injuries will be considered. METHODS: MEDLINE, SPORTDiscus, Physiotherapy Evidence Database (PEDro), EBSCO MasterFILE Premier, EBSCO CINAHL Complete, ProQuest Health and Medical Complete, Scopus, and ScienceDirect will be systematically searched from inception to the present. Cochrane Central Register of Controlled Trials and ClincalTrials.gov will be searched as well as gray literature databases. Retrieval of full-text studies, assessment of methodological quality, and data extraction will be performed independently by two reviewers. If possible, meta-analyses will be performed. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020166052.

Rugby Health and Well-Being Study: protocol for a UK-wide survey with health data cross-validation.

INTRODUCTION: Rugby football (Union and League) provides physical activity (PA) with related physical and mental health benefits. However, as a collision sport, rugby research and media coverage predominantly focus on injuries in elite players while the overall impact on health and well-being remains unclear. This study aims to provide a greater understanding of the risks and benefits of rugby participation in a diverse sample of men and women, current and former rugby Union and League players from recreational to the elite level of play. We will explore: (1) joint-specific injuries and concussion; (2) joint pain and osteoarthritis (OA); (3) medical and mental health conditions; (4) PA and sedentary behaviour and (5) well-being (quality of life, flourishing and resilience). METHODS AND ANALYSIS: The Rugby Health and Well-being Study is designed in two phases: (1) a UK-wide cross-sectional survey and (2) cross-validation using health register data from Scotland. Participants will be at least 16 years old, current or former rugby players who have played rugby for at least one season. We will report standardised, level of play-, sex- and age-stratified prevalence of joint injury, concussion, medical conditions and PA. We will describe injury/concussion prevention expectations and protective equipment use. Rugby-related factors associated with injury, pain, OA, PA, health and well-being will be explored in regression models. We will compare joint pain intensity and duration, elements of pain perception and well-being between recreational and elite players and further investigate these associations in regression models while controlling for confounding variables. In the second phase, we will validate self-reported with health register data, and provide further information on healthcare use. ETHICS AND DISSEMINATION: The Yorkshire and the Humber-Leeds East Research Ethics Committee (REC reference: 19/HY/0377) has approved this study (IRAS project ID 269424). The results will be disseminated through scientific publications, conferences and social media.

Professional Athletes Have Poorer Sleep Quality and Sleep Hygiene Compared With an Age-Matched Cohort.

OBJECTIVE: To study sleep quality and sleep hygiene in professional athletes and an age-matched cohort. DESIGN: Cross-sectional study. SETTING: Professional athletes and a sport medicine center. PARTICIPANTS: Professional rugby, netball and football athletes (n = 184) and attendees to a sport medicine center (n = 101). INTERVENTIONS: Participants completed an online survey. MAIN OUTCOME MEASURES: Sleep Hygiene Index (SHI) and Pittsburgh Sleep Quality Index (PSQI). RESULTS: Forty-five percent (n = 128) of respondents were aged between 18 and 24 years, 54% (n = 154) were men and 65% (n = 184) were professional athletes. The sleep duration of the professional athletes (mean rank 134.3, n = 181) was greater than the age-matched cohort (mean rank = 154.4, n = 101), U = 7835.0, z = -2.3, P = 0.02; however, they reported more sleep disturbance (mean ranking = 148.0, n = 181) than the age-matched cohort (mean rank = 129.8, n = 101), U = 7960.5 z = -2.5, P = 0.01, 2-tailed. Professional athletes had worse sleep regularity (mean rank = 152.3, n = 183) compared with the age-matched cohort (mean rank = 124.6, n = 101), U = 7448.5, z = -2.7, P = 0.006, 2-tailed, had an inferior sleep environment (mean rank = 149.5, n = 183) compared with the age-matched cohort (mean rank = 129.8, n = 101), U = 7959.5, z = -2.0, P = 0.047, and had more naps (mean rank = 156.2, n = 183) compared with the age-matched cohort (mean rank = 117.6, n = 101), U = 6729.0, z = -4.2, P = 0.00 0, 2-tailed. CONCLUSIONS: Professional athletes reported poorer sleep quality and sleep hygiene compared with an age-matched cohort, and difficulty falling asleep following competition. It is likely this is due to the stress of competition, training, and traveling. Because sleep plays an important role in postexercise recovery and has an impact on injury and athletic performance, it is important to have strategies to support better sleep quality and sleep hygiene in athletes.

The relationships between rugby union, and health and well-being: a scoping review.

OBJECTIVE: To scope the relationships between rugby union, and health and well-being. DESIGN: Scoping review. DATA SOURCES: Published and unpublished reports of any age, identified by searching electronic databases, platforms and reference lists. METHODS: A three-step search strategy identified relevant published primary, secondary studies and grey literature, which were screened using a priori inclusion criteria. Data were extracted using a standardised tool, to form (1) a numerical analysis and (2) a thematic summary. RESULTS AND DISCUSSION: 6658 records were identified, and 198 studies met the inclusion criteria. All forms of rugby union can provide health-enhancing physical activity (PA). 'Non-contact' and wheelchair rugby in particular provide a wide range of physical and mental health and well-being benefits. The evidence is either mixed or unclear in relation to 'contact' rugby union and its effects on a range of physical health domains. Injury and concussion incidence rates are high for contact rugby union relative to other sports. CONCLUSIONS: A wide range of stakeholders as well as existing and potential participants can use this information to make a more informed decision about participating in and promoting rugby union as a health-enhancing activity. Industry and policy-makers can use this review to inform policies and strategies that look to increase participation rates and use rugby union as a vehicle to contribute positively to population health. Further research understanding rugby union's contribution to PA as well as to muscle-strengthening and balance is indicated, as well as research examining more health and well-being outcomes across more diverse cohorts.

A deep dive into testing and management of COVID-19 for Australian high performance and professional sport.

The purpose of testing for any communicable disease is to support clinicians in the diagnosis and management of individual patients and to describe transmission dynamics. The novel coronavirus is formally named SARS-CoV-2 and the clinical disease state resulting from an infection is known as COVID-19. Control of the COVID-19 pandemic requires clinicians, epidemiologists, and public health officials to utilise the most comprehensive, accurate and timely information available to manage the rapidly evolving COVID-19 environment. High performance sport is a unique context that may look towards comprehensive testing as a means of risk mitigation. Characteristics of the common testing options are discussed including the circumstances where additional testing may be of benefit and considerations for the associated risks. Finally, a review of the available technology that could be considered for use by medical staff at the point of care (PoC) in a high-performance sporting context is included.

The Australian Institute of Sport framework for rebooting sport in a COVID-19 environment.

Sport makes an important contribution to the physical, psychological and emotional well-being of Australians. The economic contribution of sport is equivalent to 2-3% of Gross Domestic Product (GDP). The COVID-19 pandemic has had devastating effects on communities globally, leading to significant restrictions on all sectors of society, including sport. Resumption of sport can significantly contribute to the re-establishment of normality in Australian society. The Australian Institute of Sport (AIS), in consultation with sport partners (National Institute Network (NIN) Directors, NIN Chief Medical Officers (CMOs), National Sporting Organisation (NSO) Presidents, NSO Performance Directors and NSO CMOs), has developed a framework to inform the resumption of sport. National Principles for Resumption of Sport were used as a guide in the development of 'the AIS Framework for Rebooting Sport in a COVID-19 Environment' (the AIS Framework); and based on current best evidence, and guidelines from the Australian Federal Government, extrapolated into the sporting context by specialists in sport and exercise medicine, infectious diseases and public health. The principles outlined in this document apply to high performance/professional, community and individual passive (non-contact) sport. The AIS Framework is a timely tool of minimum baseline of standards, for 'how' reintroduction of sport activity will occur in a cautious and methodical manner, based on the best available evidence to optimise athlete and community safety. Decisions regarding the timing of resumption (the 'when') of sporting activity must be made in close consultation with Federal, State/Territory and/or Local Public Health Authorities. The priority at all times must be to preserve public health, minimising the risk of community transmission.