The upcoming Paris 2024 Olympic and Paralympic Games could face environmental challenges related to heat, air quality and water quality. These challenges will pose potential threats to athletes and impact thousands of stakeholders and millions of spectators. Recognising the multifaceted nature of these challenges, a range of strategies will be essential for mitigating adverse effects on participants, stakeholders and spectators alike. From personalised interventions for athletes and attendees to comprehensive measures implemented by organisers, a holistic approach is crucial to address these challenges and the possible interplay of heat, air and water quality factors during the event. This evidence-based review highlights various environmental challenges anticipated at Paris 2024, offering strategies applicable to athletes, stakeholders and spectators. Additionally, it provides recommendations for Local Organising Committees and the International Olympic Committee that may be applicable to future Games. In summary, the review offers solutions for consideration by the stakeholders responsible for and affected by the anticipated environmental challenges at Paris 2024.

The popularity of surfing has increased exponentially, reaching its recent debut in the Olympic Games. However, surfing suffers from a relative immature technological market, while in other sports some technologies such as global navigation satellite systems (GNSSs) have become an essential work material for strength and conditioning and head coaches. This article aims to systematically review surfers\' time-motion demands based on GNSSs. A systematic review of relevant articles was carried out using five main databases (PubMed, ProQuest Central, SCOPUS, SPORTDiscus, and FECYT (Web of Sciences, CCC, CIDW, KJD, MEDLINE, RSCI, and SCIELO)) until 23 March 2024. From the 238 studies initially found, 9 were included in the qualitative synthesis. In these, GNSS devices were employed with male (n = 143) and female (n = 28) surfers from different levels during competition and training situations. The studies show that the intermittent nature of the sport is evident, with substantial periods spent paddling and waiting punctuated by relatively brief high-intensity efforts when riding waves at high speeds. Notable differences emerged between competition and training demands, suggesting potential mismatches in how athletes currently prepare compared to event requirements. These novel insights allow quantifying surfing\'s harsh physiological requirements and could guide conditioning practices to better meet the sport\'s unique characteristics across populations. Therefore, training should emulate the lengthy aerobic capabilities needed for the paddling volumes observed, while also targeting the anaerobic systems to meet the repeated high-intensity surf riding efforts. However, inconsistencies in methods and reporting practices limit direct comparisons and comprehensive profiling of the sport\'s physical characteristics.

Freshwater sports involve a wide range of practices leading to contact with soil and water that can entail exposure to agents of potential infectious diseases. The pathogens can be multiple (bacteria, parasites, viruses, fungi), and be either well-known or more unfamiliar and exotic. We conducted a literature review to describe various infections contracted following exposure to water and mud during freshwater sport activities. Out of the 1011 articles identified, 50 were finally included. Our findings encompassed bacterial infections (leptospirosis and gastrointestinal infections); parasitic infections (schistosomiasis, cercarial dermatitis); viral infections (norovirus and other gastrointestinal viruses; seaweed contamination; and fungal infections. These infections were reported in various countries worldwide among diverse freshwater sport activities, including swimming, surfing, kayaking, as well as extreme sports such as adventure races and mud runs. Water sports in freshwater can expose participants to infectious risks according to geographical location and type of sport. Because regular sport practice is beneficial for health, freshwater sports should not be avoided due to potential exposure to pathogens; that much said, certain precautions should be taken. In addition to adoption of preventive measures, participants should be informed about infectious risks and seek medical advice if symptoms appear after exposure. Current guidelines for assessment of bathing water quality do not suffice to ensure comprehensive evaluation of freshwater quality. Event organizers are called upon to pay close attention to environmental factors and meteorological events, to conduct timely sensitization campaigns, and to enforce appropriate safety measures.

OBJECTIVE: We aimed to describe spinal biomechanics and injury patterns in rowing.
METHODS: In this systematic literature review, a Google and PubMed literature search was undertaken using keywords \"rowing,\" \"biomechanics,\" and \"spine.\"
RESULTS: Relevant articles were reviewed and synthesized to describe biomechanics, injury patterns, treatment options, and techniques for injury prevention.
CONCLUSIONS: Rowing has increased in popularity throughout the United States. Up-to-date knowledge of rowing biomechanics and spinal injury patterns is necessary for prompt diagnosis and appropriate treatment of the injured rowing athlete.

BACKGROUND: Youth swimming performance is determined by several physiological, biomechanical and anthropometric characteristics. This review aimed to identify physical performance determinants of youth swimming performance, assessing strength, power, anaerobic, aerobic and body composition measures. ̇ METHODS: Searches were conducted in electronic databases (PubMed and Web of Science) using keywords relating to swimming and physiological measures, supplemented by citation searching of similar reviews. A total of 843 studies were identified in the initial search. The following inclusion criteria were used: participants were competitive/trained swimmers; swimming time-trial or event was conducted; data was provided on one or more physiological parameters; study was published in English and peer-reviewed. A total of 43 studies met the inclusion criteria. Risk of bias was assessed using Joanna Briggs Institute (JBI) checklist.
RESULTS: Cross-sectional studies scored between 4-8 and randomised-controlled trials scored 8-9 on their respective JBI checklists. Youth swimming performance was determined by muscle strength, muscle power, lean body mass, anaerobic and aerobic metabolism measures in most studies, where improved performance values of these variables were conducive to swimming performance. Body fat percentage did not have a clear relationship in youth swimming performance.
CONCLUSIONS: Findings of this review suggest that greater levels of muscle strength, muscle power and lean body mass are favourable in swimming performance, with muscle strength and muscle power particularly beneficial for start and turn performance. Anaerobic and aerobic metabolism measures were good determinants of swimming performance, with middle- and long-distance events more influenced by the latter. Body fat percentage has a nuanced relationship with swimming performance, where further investigation is required. Findings were inconsistent across studies, potentially due to unidentified confounding factors.
CONCLUSIONS: • Greater muscular strength and power qualities, anaerobic and aerobic capacities, and lean body mass are conducive to swimming performance. • Body fat percentage has a nuanced relationship with swimming performance. • Practitioners should consider general strength and power training as a useful tool to enhance performance in their youth competitors.

In swimming, the beneficial effects of the in-water warm-up are often undermined by the long transition periods before competition (≥ 20 min). For that reason, studies comparing the effects of in-water warm-ups followed by dryland activities have been conducted in the swimming literature. This has brought conflicting evidence due to large combinations of supervised and unsupervised warm-up procedures used. Therefore, a scoping review was performed to discuss (1) why warm-up strategies are important for competitive swimming; to identify (2) what are the different warm-up approaches available in the literature, and; to establish (3) what are the main conclusions, considerations and gaps that should be addressed in further research to provide clearer guidance for interventions. The search was conducted on PubMed, Web of Science, Scopus, and SPORTDiscus databases. To be considered eligible, studies must have assessed acute short-term responses of warm-up procedures in swimmers by using randomized controlled trials or pre-post study designs. A total of 42 articles were included in this review. The effectiveness of warm-up responses was evaluated based on the inclusion or not of warm-up, the type of conditioning activity (in-water exercise, in-water exercise combined with dryland or dryland exercise only), its duration, and intensity. (1) Warm-up mechanisms have been mainly related to temperature changes associated to cardiovascular adaptations and short-term specific neuromuscular adaptations. Thus, maintaining muscle activity and body temperature during the transition phase immediately prior to competition could help swimmers\' performance; (2) the most common approach before a race usually included a moderate mileage of in-water warm-up (~ 1000 m) performed at an intensity of ≤ 60% of the maximal oxygen consumption, followed by dryland protocols to keep the muscle activity and body temperature raised during the transition phase. Dryland activities could only optimize performance in sprint swimming if performed after the in-water warm-up, especially if heated clothing elements are worn. Using tethered swimming and hand-paddles during warm-ups does not provide superior muscular responses to those achieved by traditional in-water warm-ups, possibly because of acute alterations in swimming technique. In contrast, semi-tethered resisted swimming may be considered as an appropriate stimulus to generate post-activation performance enhancements; (3) nothing has yet been investigated in backstroke, butterfly or individual medley, and there is a paucity of research on the effects of experimental warm-ups over distances greater than 100 m. Women are very under-represented in warm-up research, which prevents conclusions about possible sex-regulated effects on specific responses to the warm-up procedures.

Surfing has rapidly grown in popularity as the sport made its debut at the Tokyo 2020 Olympic Games. Surfing injuries are becoming more relevant with the globalisation and increasing risks of the sport, but despite this, little is known about surfing injuries or prevention strategies in either the competitive or recreational surfer. Prior research demonstrates that surfers are injured at a frequency of 0.74-1.79 injuries per 1000 hours of surfing. We reviewed the literature for the incidence, anatomical distribution, type and underlying mechanism of acute and overuse injuries, and discuss current preventative measures. This review finds that skin injuries represent the highest proportion of total injuries. Acute injuries most frequently affect the head, neck and face, followed by the lower limbs. Being struck by one\'s own board is the most common mechanism of injury. Non-contact acute ligament injuries have increased as surfing manoeuvres have become more acrobatic and overuse musculoskeletal injuries are highly correlated with paddling. However, there is a paucity of research for surfing injuries, and studies on overuse musculoskeletal injuries and prevention are disproportionally under-represented. Most of the prior studies are limited by small sample sizes, poor data collection methodology and geographical constraints. Further research is needed to establish preventative measures for both acute and overuse surfing injuries and to ensure the increasing popularity of surfing is met with an improved understanding of sport risks and safety. Specifically, we recommend research be prioritised regarding the efficacy of training programmes to prevent surfing-related overuse musculoskeletal injuries.

The majority of the previous literature investigating injuries in surfing have focused on acute or traumatic injuries. This systematic review appears to be the first to investigate the literature reporting on chronic and gradual-onset injuries and conditions in surfing populations. A search strategy was implemented on five databases in June 2020 to locate peer-reviewed epidemiological studies on musculoskeletal injuries or non-musculoskeletal conditions in surfing. A modified AXIS Critical Appraisal Tool was used to appraise all included texts. Extracted data included key information relevant to the epidemiology of the injuries and conditions. Twenty journal articles were included with the majority rated as good quality and a substantial agreement between raters (k = 0.724). Spine/back (29.3%), shoulder (22.9%), and head/face/neck (17.5%) were the most frequently reported locations of musculoskeletal injury, whilst the most common mechanism of injury was paddling (37.1%). Exostosis was the most frequently described injury or condition in surfing populations, with the most common grade of severity reported as mild obstruction. The key findings of injury type, location, severity, and mechanism can be used to develop relevant injury management and prevention programs for the surfing population, with an emphasis on chronic or gradual-onset spine/back and shoulder injuries, paddling technique, and education on the development and management of exostosis.

To comprehensively and critically appraise the clinical benefits and engineering designs of functional electrical stimulation (FES)-rowing for management of individuals with spinal cord injury (SCI).
Electronic database searches were conducted in Cumulative Index to Nursing & Allied Health Literature, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Excerpta Medica database, Emcare, Medline, PubMed, Scopus, and Web of Science databases from inception to May 12, 2020.
Search terms used were synonyms of \"spinal cord injury\" for Population and \"Electric Stimulation (Therapy)/ and rowing\" for Intervention. Two reviewers independently assessed articles based on the following inclusion criteria: recruited individuals with SCI; had aerobic FES-rowing exercise as study intervention; reported cardiovascular, muscular, bone mineral density, or metabolic outcomes; and examined engineering design of FES-rowing systems. Of the 256 titles that were retrieved in the primary search, 24 were included in this study.
Study characteristics, quality, participants\' characteristics, test descriptions, and results were independently extracted by 2 reviewers. The quality of studies was assessed with the Downs and Black checklist.
Comparison of peak oxygen consumption (V̇o2peak) rates showed that V̇o2peak during FES-rowing was significantly higher than arm-only exercise; FES-rowing training improved V̇o2peak by 11.2% on average (95% confidence interval, 7.25-15.1), with a 4.1% (95% confidence interval, 2.23-5.97) increase in V̇o2peak per month of training. FES-rowing training reduced bone density loss with increased time postinjury. The rowing ergometer used in 2 studies provided motor assistance during rowing. Studies preferred manual stimulation control (n=20) over automatic (n=4).
Our results suggest FES-rowing is a viable exercise for individuals with SCI that can improve cardiovascular performance and reduce bone density loss. Further randomized controlled trials are needed to better understand the optimal set-up for FES-rowing that maximizes the rehabilitation outcomes.

Despite drowning being a leading cause of unintentional injury worldwide, gaps in the data still exist. One area where limited data is available to guide lifeguards, police, search and rescue agencies, accident and forensic investigators, ocean scientists, and the coroner, is how far from the last known point (displacement) a missing person is likely to be found, and the time frame for this to occur. This lack of certainty can exacerbate the emotional toll on family, friends, and rescuers. This study aimed to describe body recovery times and displacement for fatal coastal drowning incidents in New Zealand. Using DrownBase™, the National Coronial Information System, and media reports, data were extracted for all fatal coastal-missing-person drowning incidents from 2008 to 2017. A total of 219 cases were selected. Almost all incidents involved males (92%) and minority groups (e.g., Māori and Pasifika) were over-represented. Older adults (> 42 years) were more likely to be engaged in boating, whereas for younger adults (≤ 42 years), it was swimming. Most missing persons were described as good swimmers (51%) and wearing everyday clothing (48%), yet only 4% wore a lifejacket. Most incidents were observed (63%), and rescue was attempted in 86% of cases. Most bodies (58%) were recovered within 24h, and only 15% were not found (9%) or not reported (6%). Most missing persons (64%) were either found in the same location (57%) or <1km from where they entered the water (7%). The quality of on-scene data limited some analysis, and the results of this study may not apply to all aquatic locations. Improved data collection could inform real-time predictive modelling of where and when a missing person might be found. The involvement of forensic and ocean scientists in future study design to widen applicability to these domains is also recommended. Fewer lives would be lost to drowning, however, if safer practices were adopted when recreating or working in, on, or around water.