Coaches. A missing link in the health care system

Effects of a notational analysis-based intervention on coaches' verbal behaviour according to physiological activation during competition

The aim of this study was to examine the effects of a notational analysis-based intervention on coaches' verbal behaviour considering their physiological activation during competition and game actions. Verbal behaviour, physiological activation (heart rate), and game actions of 4 handball coaches were recorded for a total of 28 matches. Each coach was recorded in 7 matches, three pre-interventions, two post-intervention, and two retention. Verbal behaviour was assessed using the Coach Analysis and Intervention System (CAIS: Cushion et al., 2012), and game actions were coded as positive or negative depending on their outcome. In total, 15223 verbal behaviours and 3780 game actions were recorded. The intervention programme sought to help coaches to provide constructive information (corrective feedback and instructions) after negative events or actions, encourage players (especially when the team is losing or playing badly), reduce the protests to the referee, and reduce or eliminate punishment to players. Chi-square analysis suggested that the intervention stimulated the intended changes in coaches' behaviour, and that these changes were retained for subsequent games. Verbal behaviour changed depending on the physiological activation. This study suggests that a brief (two-session) notation-based intervention can elicit changes in coaches' verbal behaviour during competition.

Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21st century

Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.

Behavioral Assessment and Interventions in Youth Sports

Behavioral assessment and interventions have found an increasing range of applications in both research and applied work with youth sport populations. Behavioral assessment has been used for both descIiptive and program evaluation purposes, and one of its major uses has been in the study of coaching behaviors and their effects on young athletes. Operant and cognitive-behavioral interventions have been targeted at both athletic and psychosocial outcomes, and they have proven to be effective in both areas. Unresolved issues and promising areas for future research are discussed, and it is concluded that the sport environment is an ideal naturalistic laboratory for behavioral research and interventions.

Pediatric first aid knowledge and attitudes among staff in the preschools of Shanghai, China

Background

Unintentional injury remains the leading cause of morbidity and mortality among children worldwide. The aims of this study were to assess a baseline level of first aid knowledge and overall attitudes regarding first aid among staff members in Shanghai preschools.

Methods

A cross-sectional study was carried out among the staff members at selected preschools. A stratified random sampling method was first used to identify suitable subjects. Data were obtained using a multiple-choice questionnaire. A standardized collection of demographics was performed and participants were given the aforementioned questionnaire to indicate knowledge of and attitudes toward first aid.

Results

1067 subjects completed the questionnaire. None of the surveyed employees answered all questions correctly; only 39 individuals (3.7%) achieved passing scores. The relative number of correct answers to specific questions ranged from 16.5% to 90.2%. In particular, subjects lacked knowledge regarding first aid for convulsive seizures (only 16.5% answered correctly), chemical injuries to the eye (23%), inhaled poison (27.6%), and choking and coughing (30.1%). A multiple linear regression analysis showed scores were significantly higher among staff members with more education, those who had received first aid training before or were already healthcare providers, younger employees, and staff members from rural districts. Most employees agreed that giving first aid was helpful; the vast majority felt that it was important and useful for them to learn pediatric first aid.

Conclusions

The level of first-aid knowledge among preschool staffs in Shanghai was low. There is an urgent need to educate staff members regarding first aid practices and the various risk factors relating to specific injuries.

A survey of injury knowledge and technical needs of junior Rugby Union coaches in Townsville (North Queensland)

Data of the injury knowledge and technical needs of registered coaches of junior Rugby Union teams in the Townsville district junior Rugby Union (North Queensland) were collected via a questionnaire mailed to coaches to determine the knowledge of the management, risk and protective factors of injury. A total of 35 completed self-administered questionnaires were returned in March 2003 for a response rate of 100%. Half of all coaches (54%, n=18) identified the upper limb of the tackler as the body part most likely to be injured in a tackle and one-quarter (26%, n=9) identified the lower limb of the ball carrier. Half (46%, n=16) of coaches identified rest/ice/compression/elevation as the treatment for soft tissue injury. The total injury knowledge score increased with the total number of seasons coached (Spearman's r(s)=0.401, p=0.017). Coaches with a current first aid qualification were more likely to identify rest/ice/compression/elevation as the treatment for soft tissue injury (Fishers Exact test, p=0.002). The results of this survey demonstrate that coaches of junior Rugby Union teams require education of the mechanisms of injury and procedures for the early management of minor and soft tissue in Rugby Union coaching courses.

Definition and outcome of a curriculum to prevent disordered eating and body-shaping drug use

Almost one half of male and female students participate in high school-sponsored athletics, and high school also is a time when classroom health promotion curricula are less effective. The Athletes Training and Learning to Avoid Steroids is a sport team-centered drug-use prevention program for male high school athletes, which has been shown to reduce alcohol and illicit drug use. Just as anabolic steroid use is associated with male athletes, female sport participants may be at a greater risk for disordered eating and body-shaping drug use. Extending sport team-centered programs to young women athletes required defining and ranking factors related to developing those harmful behaviors. Survey results from a cross-sectional cohort of female middle and high school student athletes were used to identify and prioritize potential curriculum components, including mood and self-esteem, norms of behavior, perceptions of healthy body weight, effects of media depictions of women, and societal pressures to be thin. The derived sport team-centered program was prospectively assessed among a second group of female student athletes from 18 high schools, randomized to receive the intervention or the usual care control condition. The Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) intervention is a scripted, coach-facilitated, peer-led 8-session program, which was incorporated into a team's usual training activities. The ATHENA program significantly altered the targeted risk factors and reduced ongoing and new use of diet pills and body-shaping substances (amphetamines, anabolic steroids, and sport supplements). These findings illustrate the utility of a structured process to define curriculum content, and the program's positive results also confirm the sport team's potential as a vehicle to effectively deter health-harming behaviors.

In conversation: high school students talk to students about tobacco use and prevention strategies

The purpose of this multi-site qualitative study is to explore how adolescents talk about tobacco use. Sixty-six students in four high schools became co-researchers and led focus group interviews with 205 fellow students. From the interviews, the authors develop a story line that reports how adolescents begin smoking, how smoking becomes a pervasive influence, how attitudes form about smoking, what it means to be a smoker, and, ultimately, student suggestions for tobacco use prevention. Embedded within this story line are complex questions and contradictions. We explore whether peers really are influential, if the media is important, whether smoking is a matter of personal choice, if schools actually promote tobacco use, and whether adolescents can quit smoking.

Guidelines for school and community programs to promote lifelong physical activity among young people. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and prevention

Regular physical activity is linked to enhanced health and to reduced risk for all-cause mortality and the development of many chronic diseases in adults. However, many U.S. adults are either sedentary of less physically active than recommended. Children and adolescents are more physically active than adults, but participation in physical activity declines in adolescence. School and community programs have the potential to help children and adolescents establish lifelong, healthy physical activity patterns. This report summarizes recommendations for encouraging physical activity among young people so that they will continue to engage in physical activity in adulthood and obtain the benefits of physical activity throughout life. These guidelines were developed by CDC in collaboration with experts from universities and from national, federal, and voluntary agencies and organizations. They are based on an in-depth review of research, theory, and current practice in physical education, exercise science, health education, and public health. The guidelines include recommendations about 10 aspects of school and community programs to promote lifelong physical activity among young people policies that promote enjoyable physical activity and social environments that encourage and enable physical activity; physical education curricula and instruction; health education curricula and instruction; extracurricular physical activity programs that meet the needs and interests of students; involvement of parents and guardians on physical activity instruction and programs for young people; personnel training; health services for children and adolescents; developmentally appropriate community sports and recreation programs that are attractive to young people; and regular evaluation of physical activity instruction, programs, and facilities.

Considerations in child and adolescent athletes

Excessive efforts to groom competitive and elite athletes from a very young age may expose children to significant external pressure to perform inappropriate training regimes, sometimes at the expense of their health and psychological well-being. It is essential for the physician to recognize the special physiologic, anatomic, and psychological issues of the child and adolescent athlete and to balance the benefits of appropriate participation in sports and exercise with the risks of physical and psychological injury.