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AimMedical and performance units are integral components of player development programmes in elite football academies. Nevertheless, the nature of the operational processes implemented by practitioners within clubs and national federations remains unexplored. The aim of the present study, therefore, was to survey elite youth professional football academies from around the world regarding the operational processes adopted by their medical and performance units.MethodsOf the 50 organizations invited, 10 national federations and 25 clubs took part in the survey resulting in a response rate of 70% (95% confidence interval, 56%−81%). The respondents represented three groups: senior club and academy management, performance, and medical staff.ResultsThe majority (60%−90%) of clubs and national federations reported strategic alignment between senior and academy medical and performance units as well as between academy medical and performance units. Survey responses indicated substantial heterogeneity in the composition and number of medical and performance professionals employed in academies. The majority of respondents agreed their medical and performance departments were effective in utilizing staff knowledge and external sources of knowledge to inform their practice (56%−80%). Performance staff (40%−50%) and physiotherapists (30%−32%) were deemed most influential in injury prevention programmes. During the return-to-play process, the influence of specific practitioners in the medical and performance units was dependent upon the phase of return-to-play. Shared decision-making was common practice amongst performance and medical staff in injury prevention and return-to-play processes. Medical and performance data were generally centralized across the first team and academy in majority (50%−72%) of clubs and national federations. Data were integrated within the same data management system to a higher degree in clubs (68%) vs. national federations (40%). Research and development activity were reported for most academies (50%−72%), and generally led by the head of performance (37%) or team doctor (21%). Research activities were largely undertaken via internal staff (~100%), academic collaborations (50%−88%) and/or external consultants and industry partnerships (77%−83%) in the national federation and clubs.ConclusionCollectively, these findings provide a detailed overview regarding key operational processes delivered by medical and performance practitioners working in elite football academies.

Background and study objectives Adequate sleep is essential to support preparation and recovery processes for training and competition in athletes. A limited number of studies have examined whether adolescents from the Middle-East meet the minimum age-specific recommendations ranging from 8 to 9 h of night sleep based on objective measurements. This study aimed to provide an objective description of routine sleep habits in elite youth football players from the Middle-East. Methods Using wrist-worn actigraphy, we examined objective measures of sleep over a 14-day surveillance period from fifty-nine, male, Middle-Eastern elite youth football players (age range: 12.1 to 16 years). Results The observed median sleep duration was approximately 5.5 to 6 h during weekdays and 6.5 to 7.5 h over weekend days. Sleep intermissions resulting in two or more periods of sleep accounted for 8% and 17% of the data during weekdays and weekends, respectively. Conclusions For the first time, we reported an objective quantification of sleep measures indicating that elite youth athletes from the Middle-East do not meet the age-specific sleep recommendations. Integration of sleep tracking into the routine training monitoring process can be valuable to inform decisions relevant to the adoption of potential multidisciplinary interventions to address sleep insufficiency and disorders in youth athletes.

Purpose: To examine the general perspectives of elite soccer players on the time course of perceived postmatch fatigue and the influence of away matches on subjective perceptions. Methods: Adopting a cross-sectional study design, we invited 371 subjects from 14 top-division European clubs competing in the Belgian First Division A, English Premier League, French Ligue 1, Italian Serie A, Portuguese Primeira Liga, Russian Premier League, and Swiss Premier League to take part in a short survey on general issues relating to postmatch fatigue measurement and tracking in professional soccer. Results: Three hundred male professional soccer players completed the short questionnaire. For perceptions relevant to the time course of postmatch fatigue, two-thirds of respondents (67%) indicated higher postmatch fatigue perceived 2 days (48 h) after an official competition. Among these respondents, a higher proportion of answers was observed in wide midfielders (74%), attackers (74%), and central midfielders (68%). Approximately two-thirds of respondents (63%) indicated more than usual and much more than usual perceived postmatch fatigue following away matches. Conclusions: For the first time, our investigation addressed practical aspects that remained unexplored and fundamental to the definition of an optimal player management process following a competition. From a practical standpoint, perspectives of individual elite soccer players substantiated the notion of implementing processes with dedicated recovery protocols within 48 hours postmatch and highlighted the need for differential strategies addressing the additional burden of away matches and travel.

Talent identification (TID) and development (TDE) are large fields in professional soccer and in science. However, TID and TDE processes in youth academies have not been assessed in detail. As such, our aim was to survey professional clubs from around the world about their youth academy TID and TDE processes, with 29 clubs responding to the survey. TID and TDE processes changed as a function of player age. TID processes involved finding the best players locally and regionally, but for older players the search widened to nationally and internationally for the needs of the first team. Clubs used a multidisciplinary approach to TID, but more so with older players. Median number of academy players was 80, 100, and 66 players at 8-11 years, 12-16 years, and 17-21 years, respectively. Annual player turnover in the most recent season (selections/de-selections) was 29% across all age groups, with competition from other clubs cited as a limitation to TID. TDE processes involved weekly matches and 3-5 training sessions per week led by experienced, well-qualified coaches, with most clubs providing players with academic education, residency and transportation services. Our findings extend previous research assessing professional soccer youth academy TID and TDE processes by quantifying worldwide practices.

Training and competition loads have emerged as modifiable composite risk factors of non‐contact injury. Hamstring strains are the most common injuries in football with substantial burden on the individual player and club. Nevertheless, robust evidence of a consistent load‐hamstring injury relationship in professional football is lacking. Using available data from the Qatar Stars League over three competitive seasons, this study investigated the separate and combined effects of perceived exertion and session duration on hamstring injury occurrence in a sample of 30 outfield football players. Load variables were calculated into 7‐day, 14‐day, 21‐day, 28‐day periods of data, and week‐to‐week changes for average ratings of perceived exertion (RPE; au) score and session‐RPE (s‐RPE; session‐duration urn:x-wiley:09057188:media:sms13591:sms13591-math-0001 score), plus the cumulative training and match minutes and s‐RPE, respectively. Conditional logistic regression models estimated load‐injury relationships per 2‐within‐subject standard deviation increments in each candidate variable. Associations were declared practically important based on the location of the confidence interval in relation to thresholds of 0.90 and 1.11 defining small beneficial and harmful effects, respectively. The uncertainty for the corrected odds ratios show that typically high within‐subject increments in each candidate variable were not practically important for training‐ and match‐related hamstring injury (95% confidence intervals range: 0.85 to 1.16). We found limited exploratory evidence regarding the value of perceived exertion and session duration as etiological factors of hamstring injury in Middle‐East professional football. Monitoring remains valuable to inform player load management strategies, but our exploratory findings suggest its role for type‐specific injury risk determination appears empirically unsupported.

This study investigated the positional differences in physical performance of elite youth footballers in a tournament scenario and the influence of team success and opponent quality on team physical and technical performance. Match performance observations were collected using a semi-automated multi-camera tracking system across 2 elite under-17 international club tournaments from all players and teams (n = 1,457 individual cases). Teams were classified based on their final tournament ranking as top (1–4 ranking), middle (5–8 ranking) and bottom (9–12 ranking). Technical performance measures were expressed in absolute terms and relative to the time the team was in ball possession. Positional differences in physical performance and the influence of team success and opponent quality on team match performance were identified using a generalised linear mixed model. Positional differences were similar to that observed in elite senior players. Top ranking teams performed a greater number of absolute and...

Premature ejaculation and dysregulation of emotions: research and clinical implications - The alexithymia construct describes a cluster of cognitive and affective characteristics initially observed among patients with classic psychosomatic diseases and later among patients with various medical and psychiatric disorders. The salient features of the construct are: difficulty in identifying and in describing subjective feelings, difficulty in distinguishing between feelings and the bodily sensations of emotional arousal, constricted imaginative activity and externally oriented cognitive style. This study shows significantly higher alexithymia levels in patients with lifelong PE than in controls (p < 0.001). Moreover, alexithymia level is positively correlated with PE severity (p < 0.001). Alexithymia, assessed at base-line, could be a useful predictor of treatment outcome and could contribute to the therapeutic orientation. In the clinical relationship special attention should be paid to the patient’s alexithymic difficulties. Body-oriented techniques, relaxation training, focalized body awareness, hypnosis, imaginative methods and combined pharmacological- psychological treatments could be particularly indicated in the treatment of alexithymic patients with PE. The partner’s involvement is generally important in both the diagnostic process and the treatment of PE, but is particularly indicated if the EP patient presents alexithymic features. Key words: premature ejaculation, alexithymia, emotions, treatment, psychotherapy, psychological factors.

Summary The alexithymia construct describes a cluster of cognitive and affective characteristics initially observed among patients with classic psychosomatic diseases and later among patients with various medical and psychiatric disorders. The salient features of the construct are: difficulty in identifying and in describing subjective feelings, difficulty in distinguishing between feelings and the bodily sensations of emotional arousal, constricted imaginative activity and externally oriented cognitive style. This study shows significantly higher alexithymia levels in patients with lifelong premature ejaculation (PE) than in controls (p