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Burnout and its associated factors are a concern for U.S. athletic trainers, but no research has investigated it from an international perspective. We examined perceived stress, work–family conflict, burnout, coping, and self-care practices in Irish certified athletic therapists. Low burnout (41.0 ± 12.1) and moderate perceived stress levels (17.8 ± 6.2) were observed. Certified athletic therapists with children had significantly higher work–family conflict (p = .02, ) and time-based conflict (p ) than those without. Moderate resilient coping was noted (14.7 ± 2.5). Low burnout was found, likely due to the use of resilient coping strategies. Time was a limiting factor for both self-care and experiences of work–family conflict.

BACKGROUND: Injuries are frequent in hurlers and injury prevention exercise programmes implemented during their warm-up could play a role in reducing injury risk. OBJECTIVES: To determine whether a ten-week Activate GAA warm-up intervention improves outcomes (landing mechanics, dynamic postural control, quality of movement and hamstring and adductor strength) in hurlers. METHODS: A non-randomized controlled trial was implemented in adult male non-elite hurlers (intervention n=58; control n=59) and players were eligible if they were uninjured and currently playing with a non-elite hurling team. The landing error scoring system (LESS), Y balance test, overhead squat, single leg squat, hamstring strength test and adductor break test were assessed by one Certified Athletic Therapist pre- and post-intervention. The intervention group completed the Activate GAA warm-up prior to all training and games. Two participants were unable to complete post-testing due to injury in the control group only. RESULTS: The ANCOVA analysis revealed that the intervention group’s landing mechanics (LESS total score: p0.05). CONCLUSIONS: These findings support the use of the Activate GAA warm-up in non-elite adult male hurlers with improvements observed in landing mechanics, dynamic postural control and quality of movement. Randomised controlled trials to examine its effect on injury incidence along with consideration of long-term compliance are required.

Background: People with an intellectual disability who commit a criminal offence can be detained, by a court, in a forensic inpatient facility. There is limited understanding of how inpatients with an intellectual disability and their nurses navigate risk in U.K. forensic services.Methods: A traditional literature review design was followed to map evidence (2000–2021) around the forensic and health and wellbeing risks faced by inpatients with an intellectual disability, nurses' perceptions of managing risk, and patient experiences of informing risk assessment and management. Papers were analysed thematically.Results: Findings suggest that restrictive measures to mitigate forensic risks (e.g., violence) can exacerbate the risk of poor health and wellbeing outcomes. There was some limited evidence of direct patient involvement in risk assessment and management.Conclusion: Further research is required to explore how forensic inpatients with an intellectual disability can have input in care planning, risk assessment and management.

Whilst running is hugely popular, running-related injuries (RRIs) are prevalent. High impact loading has been proposed to contribute to RRIs, with accelerometers becoming increasingly popular in estimating segmental loading for injury detection and biofeedback training. However, there is a lack of research examining the reliability of measures of impact acceleration across short- and long-term time periods, both prior to and following exerted running. The aim of this study was to assess the absolute and relative reliability of shank and sacral impact accelerations over a short- and long-term time period. Peak (Peak

Community sports play an important role in maintaining sporting participation across all ages, from childhood to adulthood. Maintaining participation for females, however, can be a challenge. Injuries can negatively impact sporting participation, both in the short and long term. Thus, reducing the risk of injuries in community sports is essential. While there are developed injury prevention programs available, the uptake of such programs in community sports can be limited. Here, we outline how a female community sport in Ireland, namely, the Camogie Association, has developed and implemented an evidence-based strategy to improve the uptake of an injury prevention program nationally across all ages of their membership. We use the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) sports setting matrix as a guiding tool for evaluating this strategy. Varying settings and levels were targeted in this six-step implementation sequence, including the national sporting organisation, regional sporting organisations, alongside the individual coaches and players. The main outcomes of the strategy were that the Camogie Association formally adopted the developed injury prevention program (the Camogie Injury Prevention Program) and the adapted age appropriate programs from 8 years of age and upward. The Camogie Association also embedded this program within their coaching training course. The developed education workshop successfully improved coaches’ attitudes and perceived ability to implement the Camogie Injury Prevention Program. The majority (72.5%) of coaches, 4 weeks after conducting the workshop, had implemented the program, and 95% felt the program could be maintained over multiple seasons. This program may provide guidance to similar national or regional sporting bodies that want to embed injury prevention programs within their respective governing body and maximise the implementation of an injury prevention program by their coaches and players.

Context Lack of education, stigma and negative self-attitudes are key barriers to help-seeking in Gaelic footballers. With the prevalence of mental health issues in Gaelic footballers and the increased risk of experiencing mental health issues following injury, mental health literacy (MHL) interventions are necessary. Objective To design and implement a novel MHL educational intervention program in Gaelic footballers. Design Controlled laboratory study. Setting Online. Patients or Other Participants Elite and sub-elite Gaelic footballers, including an intervention (n=70*; 25.1±4.5years) and control group (n=75; 24.4±6.0years). *[Eighty-five participants were recruited to the intervention group but n=15 dropped out after completing baseline measures.] Interventions A novel educational intervention program, ‘GAA and Mental Health–Injury and a Healthy Mind', was designed to address the key components of MHL and was underpinned by the Theory of Planned Behavior, and the Help-Seeking Model. The intervention was implemented online via a brief, 25-minute presentation. Main Outcome Measures Measures of stigma, help-seeking attitudes and MHL were completed by the intervention group at baseline, immediately post-attendance at the MHL program and 1-week and 1-month post-intervention. The control group completed the measures at similar time points. Results Stigma significantly decreased and attitudes to help-seeking and MHL significantly increased in the intervention group from baseline to post-intervention (p Conclusions Remote online delivery of a novel MHL educational program can effectively decrease mental health stigma, improve attitudes to help-seeking and increase the recognition and knowledge of mental health issues. Gaelic footballers with improved MHL may be better equipped to manage their mental health and cope with stressors, leading to improved mental health outcomes and overall mental wellbeing.

Injury and illness can occur in children. Since children spend a considerable amount of time in school, teachers must have the ability to assist when required. However, no research to date has examined Irish primary school teachers’ experiences, training and knowledge in first aid. An online survey (n = 587) examined Irish male and female primary school teachers previous first aid experiences, training and knowledge. Respondents generally showed high levels of both previous first aid training and exposure to events requiring first aid. In addition, most teachers knew the location of the school’s first aid equipment and were aware of their school’s first aid policy. However, many felt ill equipped to deal with these situations, particularly for serious incidents and over a third of teachers were not currently certified in first aid. While teachers displayed good overall knowledge, gaps were evident. The findings demonstrate the need to develop a multilevel school strategy to ensure teacher proficiency and school preparedness in managing situations requiring first aid.

Previous studies commonly utilized a multi-select checklist method to assess an athlete's ability to recognize true sports-related concussion (SRC) signs and symptoms (S&S) amongst incorrect distractor options. However, this may overinflate the evaluation of participants' knowledge since the multi-select method does not test athletes' ability to retrieve knowledge from their long-term memory. To test this hypothesis, an online survey was sent to registered members of the Japan Lacrosse Association (n=8,530) to examine differences in reported SRC S&S by an open-ended question and multi-select formats. We also examined whether previous exposure to SRC education and a history of SRC influenced athletes' SRC S&S knowledge. The number and proportions of responses by participants were calculated using descriptive statistics. Pearson's correlation was used to analyze the relationship between scores from two question formats. Unpaired sample t-tests were used to compare mean scores of each question format by previous SRC education and history of diagnosed SRC. Odds ratio was calculated to express the relationship between the proportion of correct answers by question format per symptom. The response rate of the survey was 35.9% (n=3,065) and revealed that scores from two question formats were correlated (r=0.34, 95%CI=0.31, 0.37; p

Background: Although many runners train overground, measuring impact accelerations on a treadmill may be advantageous for researchers and clinicians. Previous investigations of peak and rate of acceleration (peakaccelrateaccel) during treadmill running compared to overground running have not examined both the relative consistency and absolute agreement of these measures, or the effect of treadmill stiffness. Research question: (1) Are peakaccel and rateaccel produced during running on a stiff and less stiff treadmill ‘representative’ of those produced during overground running? (2) Are peakaccel and rateaccel measured on treadmills of different stiffness ‘representative’ of each other? treadmills of different stiffness ‘representative’ of each other? Methods: Eighteen participants ran at a self-selected pace on three surfaces: Treadmill 1 (reduced stiffness), Treadmill 2 (increased stiffness) and overground on asphalt, whilst peakaccel and rateaccel were recorded at the shank and lower back. Relative consistency (ICC (3,1)), absolute agreement (Bland-Altman analysis) and systematic differences (ANOVA/Friedman’s Tests) were assessed. Results: ICCs revealed moderate to excellent relative consistency in peakaccel and rateaccel between surfaces, with higher consistency for measures at the lower back. Absolute agreement was low, with the Bland Altman limits of agreement exceeding the clinical acceptable range for all comparisons. For systematic differences in means, peakaccel and rateaccel at the shank were significantly higher overground than on either treadmill; with no difference evident at the lower back. No differences were found for surface with respect to shank or lower back peakaccel and rateaccel between treadmills. Significance: Moderate to excellent relative consistency of peakaccel and rateaccel between the surfaces suggests that using different surfaces in research involving rank ordering of participants by acceleration magnitude may be acceptable (e.g. prospective studies examining if impact accelerations are related to injury). However, low absolute agreement indicates that data collected on treadmills of different stiffness and overground should not be used interchangeably (e.g. running-retraining studies).

Background: Concussion nondisclosure and poor management after a concussion are a concern in Irish collegiate sports. How athletes perceive concussions and appraise their own concussion may affect their decisions and behaviors after a suspected concussion. However, this has yet to be examined in an Irish context. This study aimed to (1) establish concussion perceptions and associated anxiety in Irish collegiate athletes; (2) examine how sex, concussion, and mood disorder history influenced their perceptions; and (3) investigate factors associated with higher anxiety perceptions. Hypothesis: Irish collegiate athletes will display negative concussion perceptions and anxiety related to concussion, especially in female athletes and those without a concussion history. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Irish collegiate athletes [n = 268 (141 women,127 men), mean age = 21.5 ± 2.2 years] from high-risk sports completed a survey including the Perceptions of Concussion Inventory for Athletes (PCI-A), demographics, diagnosed concussion history, self-reported mood disorder history, and a concussion knowledge assessment. Differences in concussion perceptions by sex, concussion history, mood disorder history were examined using Mann-Whitney U tests, and factors associated with anxiety-related concussion perceptions were identified using multivariate logistic regression. Results: Over half (53.0%, n = 142) of participants reported concerns regarding concussion. The thoughts of sustaining a concussion made participants feel upset (63.4%, n = 170), fearful (47.7%, n = 128), and anxious (35.1%, n = 94). Women reported significantly higher anxiety ( P < 0.01, r = 0.23), effects ( P = 0.04, r = 0.12), and clarity ( P = 0.01, r = 0.16) perception scores. Participants with a diagnosed concussion history displayed greater symptom variability perception scores ( P = 0.04, r = 0.12), but lower anxiety ( P = 0.03, r = 0.13) and treatment ( P < 0.01, r = 0.19) beliefs on the PCI-A. No differences were observed for those with a history of a mood disorder ( P > 0.05). A significant multivariate model was established (χ2 = 55.44, P < 0.01), with female sex [odds ratio (OR) = 1.53], concussion history (OR = 0.63), effects (OR = 1.31), and treatment (OR = 1.15) subscales associated with greater anxiety. Conclusion: Concerns about sustaining a concussion are prevalent in Irish collegiate athletes. Women displayed more negative perceptions and those with a concussion history displayed fewer perceived benefits of treatment. Clinical Relevance: The findings support the need for concussion awareness campaigns to provide accurate concussion information to mitigate anxiety-related concussion perceptions and injury belief misconceptions.

Injury rates have remained high in ladies Gaelic football over the last decade and treatment costs continue to increase significantly. Injury prevention programmes are a proposed solution and their efficacy has been demonstrated in Gaelic games, however, anecdotally their adoption is low. The aim of this study was to determine the barriers and facilitators to uptake, implementation, and long-term adoption of an injury prevention strategy for adult Ladies Gaelic football players and coaches.Semi-structured interviews were conducted with 23 participants (13 coaches, 10 players). Four coaches were at intercounty level and nine were at club level, while two players competed at intercounty and club level and eight played solely at club level. The interviews were audio-recorded, transcribed verbatim and thematically analysed.Stakeholder attitudes, accessibility, education, communication, and injury prevention programme characteristics were perceived as key barriers to an injury prevention strategy succeeding. Injury prevention promotion, injury prevention programme characteristics, leadership, and communication, were identified as the main factors that would facilitate the success of a strategy.By utilising the views of stakeholders, the initial uptake, adherence, and long-term adoption of an injury prevention strategy in Ladies Gaelic football may be maximised.

Whyte, EF, Heneghan, B, Feely, K, Moran, KA, and O'Connor, S. The effect of hip extension and Nordic hamstring exercise protocols on hamstring strength: A randomized controlled trial. J Strength Cond Res 35(10): 2682-2689, 2021-Lower and between-limb asymmetrical eccentric hamstring isokinetic strength may be associated with hamstring injuries, which mainly affect the biceps femoris. The 45° hip extension exercise (HEE) strengthens the hamstrings in the lengthened position where the biceps femoris experiences greatest loading during high-speed running. However, the effect of an HEE program on eccentric hamstring isokinetic strength has not been investigated or compared with the Nordic Hamstring Exercise (NHE) program. Twenty-four male, varsity, Gaelic footballers (22.4 ± 2.7 years; 182.1 ± 6.0 cm; 84.4 ± 7.9 kg) were randomly allocated to an HEE or NHE 4-week program. Isokinetic (60°·s-1) eccentric peak torque, functional hamstring-to-quadriceps ratio, and between-limb eccentric strength (absolute and percentage) asymmetries were recorded before and after intervention. Muscle soreness scores were reported after exercise using a visual analogue scale. A mixed between-within analysis of variance investigated group (HEE vs. NHE) by time (pre vs. post) interaction effects, and any main effects. An independent-samples t-test compared muscle soreness scores between the NHE and HEE groups. No interaction or group main effects were found. Main effects for time were observed on dominant and nondominant limbs for eccentric peak torque (p0.001, η2 = 0.21, p = 0.01, η2 = 0.51, respectively) and functional hamstring quadriceps ratio (p = 0.03, η2 = 0.59, p0.0001, η2 = 0.26, respectively). There were no main effects for time between-limb eccentric peak torque or percentage asymmetries (p = 0.41, η2 = 0.03, p = 0.20, η2 = 0.07, respectively), or differences in muscle soreness scores (p0.05). A 4-week HEE program increases eccentric hamstring isokinetic strength similar to a NHE program, which may be useful as part of a hamstring injury prevention program.

Objective To understand the incidence and burden of injury of student-athletes in four of the most popular collegiate sports. Design Prospective cohort study. Setting Collegiate sport. Participants Gaelic football, hurling/Camogie, soccer and Rugby (n = 672; male = 416, female = 256) student-athletes. Main outcome measure Injury incidence, burden of injury and total, match and training injury rates, and their 95% confidence intervals were calculated. The frequencies and proportions were also calculated. An injury was defined as any physical condition that prevents a student-athlete from full participation for a period greater than 24 h. Results Over a quarter (0.266) of student-athletes sustained an injury in the academic season. Male student-athletes had a higher injury rate than females (21.6 vs 11.3 injuries/1000 h). Rugby (20.8 injuries/1000 h) had the highest injury rates with hurling/Camogie (6.3 injuries/1000 h) the lowest. Lower extremity injuries were predominant (68.8%) with ankle sprains demonstrating a large burden for all sports (20.6-280.2 days absent/1000 h). Hamstring strains (13.7-118.4 days absent/1000 h) had a large burden for all sports except male Rugby. Knee sprains had a large burden on the female Gaelic footballer (84.8 days absent/1000 h). Sprinting (27.4%) and the tackle (20.1%) were the most common mechanism of injury. Injuries were predominantly moderate (8-28 days) or severe (>28 days) (84.7%). Conclusion Injury reduction needs to be prioritised in the student-athlete, particularly in males. Specific focus is required on the lower extremity, especially in the hamstring muscles and ankle joint owing to the large burden of injury.

We assessed HIV and syphilis infection among MSM and TGW attending Silom Community Clinic from 2017 to 2019. Walk-in and referral clients completed a registration application including a question on gender identity. We compared the prevalence of HIV, syphilis, and HIV and syphilis coinfection among TGW and MSM. In a total of 1050 clients, 276 (26.3%) were TGW and 774 (74.7%) were MSM. Among TGW clients, HIV prevalence was 29.8%, syphilis prevalence was 38.4%, and coinfection prevalence was 18.5%. Comparing prevalence among TGW to MSM, the adjusted prevalence ratio (aPR) for HIV was 1.8 (95% CI:1.4-2.3), for syphilis was 1.2 (95% CI:1.0-1.4), and for HIV and syphilis coinfection was 2.1 (95% CI:1.4-2.9). The prevalence of syphilis was higher than HIV among TGW, with a PR of 1.3 (95% CI:1.1-1.6), and among MSM, with a PR of 1.4 (95% CI:1.2-1.7). TGW age 15-21 years had an HIV prevalence of 16.9% and syphilis prevalence of 30.8%. After adjusting for age, referral, and sexual behaviors, TGW remain significantly associated with HIV and syphilis prevalence. There is a substantial burden of HIV and HIV/syphilis co-infection among TGW. HIV/STI prevention are needed for TGW, including linkage to HIV care.

Context: Deficits in the hip range of motion are associated with hip and groin injuries. Accurate and reliable goniometric measurements are important in identifying those at risk of injury and determining the efficacy of treatment interventions. Smartphone goniometric applications are regularly used to assess joint ranges of motion; however, there is limited knowledge on the reliability of this method in relation to the hip, particularly between clinicians with different levels of experience. Objective: To determine the intratester and intertester reliability of a smartphone clinometer application for the assessment of hip goniometric measurements in healthy volunteers by an experienced and novice clinician. Design: Reliability study. Setting: University Athletic Therapy facility. Participants: Physically active, university students. Main Outcome Measures: The study determined the intra- and intertester (experienced vs novice clinician) reliability of goniometric measurements of the hip joint (modified Thomas test and seated hip internal and external rotation) using a smartphone goniometric application. Intraclass correlation coefficients (ICCs), standard error of measurement, and minimal detectable change at a 95% confidence interval were used to assess reliability. Results: Goniometric measurements demonstrated good to excellent relative intratester reliability for the modified Thomas test (ICC = .94), external rotation (ICC = .93–.95), and internal rotation (ICC = .80–.81). Intertester reliability for expert and novice clinicians was also excellent for the modified Thomas test (ICC = .98), external rotation (ICC = .95), and internal rotation (ICC = .92). Intratester and intertester standard error of measurement and minimal detectable change at 95% confidence interval values were similar for both testers and ranged from 1.9° to 3.6° and 5° to 10.1° and from 1.1° to 2.3° and 2.9° to 6.5°, respectively. Conclusion: Smartphone-based goniometric measurements of hip range of motion have high intratester and intertester reliability for novice and expert clinicians. It may be a useful, simple, and inexpensive resource for clinicians.

Fear avoidance and low confidence in their ability to return to sport can impede athletes' subsequent recovery and return to sport. This study aimed to identify fear avoidance and confidence in readiness to return to sport following injury in Irish collegiate athletes. Male (416) and female (256) athletes from 24 field-sport teams at one university were prospectively followed for one season. The Athlete Fear Avoidance Questionnaire (AFAQ) and pain on the Visual Analogue Scale was completed following a time-loss injury. Prior to return to sport, participants completed the AFAQ and the Injury Psychological Readiness to Return to Sport (I-PRRS). We recorded 179 injuries. Fear avoidance was evident post-injury (21.8 ± 6.7), and the mean total I-PRRS score was 48.4 ± 8.9. Those with severe injuries presented with higher fear avoidance and lower confidence. Higher pain was associated with greater fear avoidance following injury (r = 0.32, p 0.0001), prior to return to sport (r = 0.38, p 0.0001), and with lower confidence (r = -0.27, p 0.0001). Low confidence and fear avoidance was identified, particularly in those with a severe injury or high pain levels. Identifying, and providing psychosocial support to athletes experiencing, these issues is recommended.