Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study.

BACKGROUND: Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes. PURPOSE: To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground/equipment. Baseline/acute injury characteristics-including Sports Concussion Assessment Tool-3 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)-were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP/URTP, respectively. RESULTS: Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground/equipment mechanism. Event type was significantly associated with injury mechanism [χ2(3) = 63; P < .001), such that more head-to-ball concussions occurred in practice sessions (n = 92 [51.1%] vs n = 36 [17.1%]) and more head-to-head (n = 65 [30.8%] vs n = 20 [11.1]) and head-to-body (n = 76 [36%] vs n = 33 [18.3%]) concussions occurred in competition. The primary position was significantly associated with injury mechanism [χ2(3) = 24; P < .004], with goalkeepers having no SRCs from the head-to-head mechanism (n = 0 [0%]) and forward players having the least head-to-body mechanism (n = 15 [19.2%]). LOC was also associated with injury mechanism (P = .034), with LOC being most prevalent in head-to-ground/equipment. Finally, AMS was most prevalent in head-to-ball (n = 54 [34.2%]) and head-to-body (n = 48 [30.4%]) mechanisms [χ2(3) = 9; P = .029]. In our multivariable models, the mechanism was not a predictor of TSS or RTP; however, it was associated with URTP (P = .044), with head-to-equipment/ground injuries resulting in the shortest mean number of days (14 ± 9.1 days) to URTP and the head-to-ball mechanism the longest (18.6 ± 21.6 days). CONCLUSION: The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.

Simultaneous in-air and underwater 3D kinematic analysis of swimmers: Feasibility and reliability of action sport cameras.

This study explored the potential of reconstructing the 3D motion of a swimmer's hands with accuracy and consistency using action sport cameras (ASC) distributed in-air and underwater. To record at least two stroke cycles of an athlete performing a front crawl task, the cameras were properly calibrated to cover an acquisition volume of 3 m in X, 8 m in Y, and 3.5 m in Z axis, approximately. Camera calibration was attained by applying bundle adjustment in both environments. A testing wand, carrying two markers, was acquired to evaluate the three-dimensional (3D) reconstruction accuracy in-air, underwater, and over the water transition. The global 3D accuracy (mean absolute error) was less than 1.5 mm. The standard error of measurement and the coefficient of variation were smaller than 1 mm and 1%, respectively, revealing that the camera calibration procedure was highly repeatable. No significant correlation between the error magnitude (percentage error during the test and the retest sessions: 1.2 to 0.8%) and the transition from in-air to underwater was observed. The feasibility of the hand motion reconstruction was demonstrated by recording five swimmers during the front crawl stroke, in three different tasks performed at increasing efforts. Intra-class correlation confirmed the optimal agreement (ICC>0.90) among repeated stroke cycles of the same swimmer, irrespective of task effort. Skewness, close to 0, and kurtosis, close to 3.5, supported the hypothesis of negligible effects of the calibration and tracking errors on the motion and speed patterns. In conclusion, we may argue that ASCs, equipped with a robust bundle adjustment camera calibration technique, ensure reliable reconstruction of swimming motion in in-air and underwater large volumes.

The relationship between nutrition knowledge and low energy availability risk in collegiate athletes.

OBJECTIVES: This was a pilot study that examined the relationship between nutrition knowledge and risk for low energy availability (LEA) in NCAA athletes. METHODS: Athletes (64.4 % female, 35.6 % male) completed the Abridged Nutrition for Sport Knowledge Questionnaire (A-NSKQ) and either the Low Energy Availability in Females Questionnaire (LEAF-Q) or Male Athlete Triad (MAT) screening questions. RESULTS: Females at risk for LEA had higher nutrition knowledge, demonstrated by higher A-NSKQ scores, than those classified as low risk (16.5 vs 14.5, p = 0.01). There was a very weak correlation between MAT and A-NSKQ scores (R2 = 0.012).

The Relationship Between Athlete Perceptions of Coaching Leadership Behaviors and Athlete Grit.

Coach leadership style has long been positively correlated with athlete experiences such as motivation, health (i.e., burnout), and performance outcomes (i.e., enhanced execution time to complete tasks) (24). More recently, grit (18) has been positively correlated with athlete experiences such as engagement (39) and decreased burnout (32). Given the impact coaches have on their athletes and the positive psychological benefits of grit, it is reasonable to explore the intersections of coaching behaviors and grit. As such, the purpose of the current study was to examine the relationship between athlete perceptions of coach leadership behaviors and athlete grit. Intercollegiate athletes completed measures of grit and the leadership behaviors of their coach. A significant positive relationship was observed between the grit perseverance subscale and the leadership behavior of training and instruction (r =.30, p < .05). Additional analyses revealed that athletes' perceptions of coach positive feedback significantly predicted their perseverance. Taken together, these findings suggest a link between positive coach feedback and athlete perseverance. Implications of these results for professional practice and future research are discussed.

Analysis of Player Performance and Financial Costs Associated With Implementation of an Updated National Hockey League Concussion Protocol: A Retrospective Comparative Study.

Background: An updated National Hockey League (NHL) concussion protocol (NHLCP) was established in the 2016-2017 season to mitigate the negative outcomes of sport-related concussions. However, few studies on the effects of implementing the NHLCP have been performed. Purpose: To define concussion incidence and investigate differences in NHL player performance after a concussion during periods before and after NHLCP implementation and assess the financial impact on NHL teams associated with NHLCP implementation. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective review of NHL players who sustained a concussion before (2000-2001 to 2015-2016 seasons) and after (2016-2017 to 2020-2021 seasons) implementing the NHLCP (pre-NHLCP and post-NHLCP groups). For each group, multiple performance metrics-including 30 days, 1 season, and 3 seasons before and after concussion-were compared for both groups. Return to play, total concussion cost, and association of return to play with cost were investigated using regression analysis. Results: A total of 452 players (423 skaters, 29 goalies) sustained concussions during the study period, including 331 players (315 skaters, 16 goalies) in the pre-NHLCP group and 121 players (108 skaters, 13 goalies) in the post-NHLCP group. For both groups, no significant differences in standard performance were observed during the 30-day and 1-season periods before and after concussion. The mean return to play was significantly higher in the pre-NHLCP group than in the post-NHLCP group (20.1 vs 15.7 days; P = .022). The mean adjusted player salary was not different between groups; nonetheless, the mean adjusted replacement player salary was significantly higher in the post-NHLCP group ($744,505 vs $896,942; P = .032). The mean cost of time missed did not differ between groups. The mean return to play time significantly decreased over the entire study period (R2 = 0.33; P = .005), and the mean return to play time was positively associated with cost R2 = 0.215; P = .030). Conclusion: Concussion incidence did not change after implementation of the updated NHLCP; nonetheless, players had significantly less missed time from injury after protocol implementation. Changes in player performance 30 days and 1 year before and after concussion injury were not different before and after NHLCP implementation. No differences were found in the financial cost of concussions between the pre- and post-NHLCP groups, and missed time was significantly correlated with mean cost from missed time.

More than Body Composition: A Darwinian Theory of Somatotype Applied to a DII Track and Field Outdoor Season.

This study presents somatotype data on a team sport with chronic and diverse sporting demands. The aims were to (1) characterize a somatotype profile for Division II (DII) track and field athletes (n=54) by sex, class, and events; (2) determine if somatotype changed across the season; (3) determine if changes differed based on class or sex; and, (4) assess potential differences in somatotype between sexes. Methods: Anthropometrics (height, weight, body composition, somatotype) were evaluated after a competitive indoor season and immediately before the outdoor conference championships (41 days). Body measurements were assessed using a bioelectrical impedance analysis device, skinfold assessment, boney breadths, and limb girths. Descriptive statistics are provided as well as results from two-way ANOVAs which evaluate differences in actual and change scores across sex and class. Results: Our DII track and field athletes were primarily endomorphic (scores displayed as ENDO, MESO, ECTO, respectively). Males were found to be primarily ENDO-MESO somatotypes (4.7, 4.1, 3.0), while females were dominantly ENDO (7.7, 2.9, 2.9). Upperclass were more ENDO-MESO balanced compared with lowerclass (5.8, 3.8, 2.8 vs 6.0, 3.5, 3.0). When investigated based on sex, class level, and event, the groups were similar. There was no meaningful change to ECTO scores across the season for males or females. Female athletes improved ENDO scores (-0.89%) and males and females improved MESO scores (14.29% and 5.29%, respectively), indicating adaptations can be accomplished despite the chronic demands of a competitive season. Conclusion: Our research offers practitioners information about the potential changes they may expect across a competitive track and field season.

The perspective of current and retired world class, elite and national athletes on the inclusion and eligibility of transgender athletes in elite sport.

There has been limited empirical study allowing athletes to voice their opinions on transgender participation in elite sport. This study surveyed 175 national, elite and world class athletes eligible to compete in the female category regarding transgender inclusion and eligibility. The study compared current Olympic versus current Olympic Recognised sports, elite versus world class, and current versus retired Olympic sport athletes. Most athletes favoured biological sex categorisation (58%) and considered it unfair for trans women to compete in the female category, except for precision sports. This view was held most strongly by world class athletes regarding their own sport (77% unfair, 15% fair). For trans men inclusion in the male category, most athletes considered it fair, except for Olympic sport athletes regarding contact sports (49% unfair, 27% fair) and sports heavily reliant on physical capacity (53% unfair, 29% fair). Notwithstanding those views, athletes (81%) believed sporting bodies should improve inclusivity for transgender athletes. Opinion varied somewhat according to career stage, competitive level and sport type. Nevertheless, athletes in the present study favoured categorisation by biological sex and did not support trans women eligibility for the female category in sports reliant on performance-related biological factors that differ between sexes.

Optimal homeostatic stress to maximize the homogeneity of adaptations to interval interventions in soccer players.

This study examined the uniformity of adaptations in cardiorespiratory fitness and bio-motor abilities by analyzing individual responses to measures representing the mentioned qualities. Twenty-four male well-trained soccer players (Age = 26 ± 4 years; stature = 181 ± 3.8; Weight = 84 ± 6.1) were randomized to two groups performing short sprint interval training [sSIT (3 sets of 10 × 4 s all-out sprints with 20 s of recovery between efforts and 3 min of rest intervals between sets)] or a time-matched small-sided game [SSG (3 sets of 3 v 3 efforts in a 20 × 15 m area with 3 min of relief in-between)]. Before and after the 6-week training period, aerobic fitness indices, cardiac hemodynamics, and anaerobic power were assessed through a graded exercise test utilizing a gas collection system, noninvasive impedance cardiography, and a lower-body Wingate test, respectively. Also, sport-specific bio-motor abilities were determined by measuring linear speed, change of direction, and jumping ability. Comparing inter-individual variability in the adaptive changes by analyzing residuals in individual adaptations indicated that sSIT induces more uniform changes in the first and second ventilatory threshold (VT1 & VT2), stroke volume, and peak power output across team members than SSG. SSG also yielded lower proportions of responders in V˙O2⁡max, VT1, VT2, peak, and average power output compared to sSIT. Additionally, the coefficient of variation in mean group changes in measures of aerobic fitness and bio-motor abilities in response to sSIT were lower than in SSG. Short sprint interval training induces more homogenized adaptations in measures of cardiorespiratory fitness and anaerobic power than small-sided games across team members.

Somatotype and bioelectrical impedance vector analysis of Italian CrossFit® practitioners.

Objectives: CrossFit® is a high-intensity sport characterized by various workouts that require strength, speed, endurance, or agility, impacting participants' body composition. This observational study aimed to determine the morphological (anthropometrical and bioelectrical) profile of CrossFit® athletes and to compare them with other athletic populations. Methods: Anthropometrical measurements and bioelectrical vector analysis (classic and specific approaches) were performed on 145 CrossFit® practitioners (107 men aged 30.7 ± 8.4 years and 38 women aged 28.1 ± 6.7 years). Each participant's relative somatotype was calculated and compared between sexes and with a Spanish CrossFit® athletes' group. Resistance-reactance graphs and Hotelling's T2 test were applied to characterize the sample, compare them with an athletes' reference population, and identify differences between somatotype groups. Results: The most represented somatotype in both groups was the balanced mesomorph (male 3.5-5.2 - 1.7 and female 4.4-4.5 - 1.8). Compared with Spanish CrossFit® athletes, significant differences were denoted for men but not women (SAD = 2.3). The bioelectrical graphs indicated that the distribution of CrossFit® athletes is quite heterogeneous and within average values for the athlete's reference. The mesomorphic and endomorphic components were associated with a higher phase angle. Conclusions: CrossFit® practitioners predominantly present a mesomorphic component and show a body type like other power athletes, although with less pronounced characteristics. The somatotype may influence the vector's position in the RXc graphs. This study provided the bioelectrical tolerance ellipses for CrossFit® practitioners in classic and specific approaches for the first time.

Self-management including exercise, education and activity modification compared to usual care for adolescents with Osgood-Schlatter (the SOGOOD trial): protocol of a randomized controlled superiority trial.

BACKGROUND: Osgood-Schlatter is the most frequent growth-related injury affecting about 10% of physically active adolescents. It can cause long-term pain and limitations in sports and physical activity, with potential sequela well into adulthood. The management of Osgood-Schlatter is very heterogeneous. Recent systematic reviews have found low level evidence for surgical intervention and injection therapies, and an absence of studies on conservative management. Recently, a novel self-management approach with exercise, education, and activity modification, demonstrated favorable outcomes for adolescents with patellofemoral pain and Osgood-Schlatter in prospective cohort studies. AIM: The aim of this trial is to assess the effectiveness of the novel self-management approach compared to usual care in improving self-reported knee-related function in sport (measured using the KOOS-child 'Sport/play' subscale) after a 5-month period. METHODS: This trial is a pragmatic, assessor-blinded, randomized controlled trial with a two-group parallel arm design, including participants aged 10-16 years diagnosed with Osgood-Schlatter. Participants will receive 3 months of treatment, consisting of either usual care or the self-management approach including exercise, education, and activity modification, followed by 2 months of self-management. Primary endpoint is the KOOS-child 'Sport/play' score at 5 months. This protocol details the planned methods and procedures. DISCUSSION: The novel approach has already shown promise in previous cohort studies. This trial will potentially provide much-needed level 1 evidence for the effectiveness of the self-management approach, representing a crucial step towards addressing the long-term pain and limitations associated with Osgood-Schlatter. TRIAL REGISTRATION: Clinicaltrials.gov: NCT05174182. Prospectively registered December 30th 2021. Date of first recruitment: January 3rd 2022. Target sample size: 130 participants.

Return to Sport, Re-injury and Performance After the Anterior Cruciate Ligament Reconstruction: Evaluating the Role of International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) Scoring Systems.

Introduction Anterior cruciate ligament (ACL) tears are common injuries that can considerably impact an individual's quality of life and athletic performance. In these cases, surgical reconstruction of the ligament can be considered to restore stability to the knee. This study aims to investigate the time taken for individuals to return to sport post-ACL reconstruction, assess the rate of re-injury and evaluate the reliability of the International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) scoring systems in predicting a return to sport at the pre-injury level. Methods In this retrospective study, a total of 104 patients who underwent ACL reconstruction between January 2016 and December 2022 by one surgical team at Mater Dei Hospital, Malta were evaluated using a self-administered questionnaire. The questionnaire was based on different components including the sport practised at the time of injury, sport engagement classification, return to sport, the ability to return to pre-injury levels of performance and re-injury. The participants then had to fill in IKDC and KOOS evaluation forms. Results In this study, 73% (n=76) of individuals successfully returned to sport after ACL reconstruction, with no significant difference being found between professional and recreational athletes (Chi-squared=0.00455, p=0.95). After reconstruction, 31.7% (n=33) of participants experienced an ipsilateral or contralateral ACL tear, with those returning to sport within six months showing a fivefold increase in re-injury risk compared to individuals who returned at eight or 12 months, suggesting a significant association between return duration and re-injury. The relationship between scoring systems and return to sport at the pre-injury level of performance was analysed using binary logistic regression, revealing that achieving scores of 85.6 or higher in IKDC or 89 or higher in KOOS meant having a 95% probability of returning to sport at the pre-injury level. Conclusions By considering these scoring systems with other post-operative criteria, clinicians can offer a more customised rehabilitation plan tailored to each patient who undergoes ACL reconstruction.

The surprising role of marital status on sport second-screening: demographic influences during the 2022 world cup viewing in Israel.

To better understand what characterizes those who use a second screen while watching sport, the study examine a variety of demographic factors influencing browsing device trends before, during ("second screen"), and after sports games. It does so by utilizing survey data from Israeli viewers of the 2022 World Cup using a convenience sample (N = 242). In line with our hypotheses, those with higher education and higher reported income were more likely to browse devices for information around and during games. Against our hypothesis, young adults were less likely to engage in browsing before, during and after the games, possibly because they tend to watch games with friends or in public places. Divorced and single individuals are more likely to engage in multi-platform browsing and second-screening during sport games vs. married participants, who tended to watch the games with friends or in public places. The results are the first to indicate the important role of marital status in second-screening during sport games. Overall, they depict a picture of the average second-screener as a non-married older male with higher income and education, thus indicating that higher intellect combined with non-marital status, thus potentially more spare time as well as possibly higher levels of loneliness and during games are linked to sport second-screening. The results are the first to highlight the important role of marital status over young age on the tendency to second screen during sport games.

Development of Mental Toughness among Basketball Sports School Students.

The development of mental toughness in student athletes within sports schools is crucial for identifying strengths and improving weaknesses to optimize performance. This study aimed to assess the effectiveness of a mental toughness development program for basketball sports school students. Sixty-two male student athletes, aged 15.83 ± 0.37 years, participated, with 30 in the experimental group and 32 in the control group. They completed the Mental Toughness Questionnaire 48 (MTQ48) before and after the 6-week intervention program. Pearson's correlations were calculated for study variables. A repeated measures MANOVA followed by one-way ANOVA analyzed differences in mental toughness skills between groups and over time. Results showed a significant effect of the intervention program on mental toughness skills, with small and medium effect sizes. Post-program, the experimental group exhibited higher levels of various skills compared to controls, including skills related to challenge, commitment, emotional control, life control, overall control, self-confidence in interpersonal interactions, self-confidence in one's abilities, overall self-confidence, and total MTQ48. These findings underscore the utility of interventions for enhancing mental toughness among basketball sports school students, emphasizing the importance of tailored approaches in such intervention programs.

Adaptation and Validation of the 3 × 2 Achievement Goals Questionnaire in a Population of Athletes.

(1) Background: Sport goals, although widely recognised as crucial for motivation and performance in sport, are multifaceted and can be difficult to measure directly. The present research aims to validate the 3 × 2 achievement goals questionnaire of Mascret in Spanish in a population of athletes. (2) Method: By using a latent factor approach, it is possible to identify the underlying dimensions of these goals and to better understand how they are structured. For this purpose, this questionnaire has been translated and compared with the life satisfaction scale. An exploration of the multifaceted nature of sport goals has been carried out using structural equation modelling. A total of 580 athletes (463 males and 216 females, M = 21.5, SD = 2.36) from different sport disciplines and from 12 autonomous communities in Spain participated in the research. (3) Results: The results show that the questionnaire presents a high scale reliability and that all items contribute significantly to the internal consistency of the scale. (4) Conclusions: The adaptation of this scale to the Spanish population of athletes can be a valid and useful tool to measure and understand motivation and goals in the sport context.

Are Dryland Strength and Power Measurements Associated with Swimming Performance? Preliminary Results on Elite Paralympic Swimmers.

This study aimed to identify the relationship between dryland tests and swimming performance in elite Paralympic swimmers. Fifteen competitive swimmers (age: 27.4 ± 5.4 years, height: 1.70 ± 6.8 m, body mass: 67.9 ± 9.2 kg; 9 males, 6 females) performed a lat pull-down and a bench press incremental load test to determine maximum power (Pmax), the strength corresponding to maximum power (F@Pmax), and the barbell velocity corresponding to maximum power (V@Pmax) from the force-velocity and power-velocity profiles. These outcomes were also normalized by the athlete's body mass. Swimming performance was carried out from the best result in a 100 m freestyle race registered during an international competition. Lat pull-down F@Pmax was significantly associated with 100 m freestyle chronometric time (ρ = -0.56, p < 0.05), and lat pull-down V@Pmax presented a relationship with mean swimming velocity (ρ = 0.71, p < 0.01). Similarly, bench press F@Pmax and the normalized F@Pmax were significantly related to the mean swimming velocity (ρ = -0.51, ρ = -0.62, p < 0.05). Stepwise multiple regression showed that lat pull-down V@Pmax, bench press normF@Pmax, and V@Pmax accounted for 40.6%, 42.3%, and 65.8% (p < 0.05) of the mean swimming velocity variance. These preliminary results highlighted that simple dryland tests, although with a moderate relationship, are significantly associated with 100 m freestyle swimming performance in elite Paralympic swimmers.

Dryland Performance Tests Are Not Good Predictors of World Aquatics Points in Elite Male and Female Swimmers.

Background: Swim performance can be reliant on strength and power. Standardisation of swim performance in different events, distances, and sexes can be completed using World Aquatics points, allowing for ranking of swimmers. The aim of this retrospective cross-sectional study was to assess whether relationships between World Aquatics points and dryland markers of performance existed in male and female elite swimmers separately and combined. Methods: Dryland tests included Optojump® photoelectric cell countermovement jump, countermovement jump reach with a Vertec® system, standing broad jump using a tape measure, repetition maximum testing in the barbell back squat, barbell deadlift, and barbell bench press. Swim performance data and dryland test data on elite male (n = 38) and female (n = 20) Scottish swimmers from 2009-2017 were collected. Swim performance data were converted to World Aquatics federation points, and Bayesian linear regression analyses examined relationships between World Aquatics points and dryland performance tests: countermovement jump height (cm) using an Optojump® photoelectric cells system, countermovement jump height (cm) using a Vertec® device, standing broad jump distance (cm), relative strength (load lifted (kg) per kg of body mass) in the barbell bench press (kg/kg), barbell back squat (kg/kg), barbell deadlift (kg/kg). Results: The Bayesian estimates of change of World Aquatics points for a unit change in jump-based measures were: Optojump®-men = 0.6, women = 0.6, combined = 0.4; Vertec®-men = 4.3, women = -1.6, combined = 2.4; standing broad jump-men = 0, women = 0, combined = 0.4. Strength-based measures were: barbell back squat-men = 2.3, women = 22, combined = -2.5; barbell deadlift-men = -5; barbell bench press-men = 41.8. Conclusions: Dryland performance tests are not good predictors of World Aquatics points and should rather be used for assessing training quality and monitoring injury risks.

A rare case of Baker's cysts with hematoma of the lower calf treated with arthroscopic internal drainage combined with intramuscular dissection.

Popliteal cysts, also termed Baker's cysts, are clinically common cystic lesions in the popliteal fossa. Typically, the contents of a ruptured cyst tend to spread into the myofascial interfaces in any direction, most commonly inferomedially or into a palpable superficial position. However, to our knowledge, reports of Baker's cysts dissecting into the deep intermuscular septum of the lower calf are extremely rare. We present here the details of the successful treatment through arthroscopy combined with lower calf incision of a patient who sustained hematoma of the knee and lower calf secondary to Baker's cyst rupture. Given the rarity of this disease in China, we present this case report to improve our understanding of the disease and avoid misdiagnosis and provide evidence for its clinical treatment, management, and prognosis.

Food and beverage selection in children's sports arenas in Norway: a cross-sectional study.

OBJECTIVE: To assess the selection of foods and beverages in children's sports arenas in Norway. DESIGN: A cross-sectional study design with a digital questionnaire was used. Descriptive statistics were used to present the results. Moreover, Pearson's χ2 tests examined the factors that could aid in distinguishing clubs with healthy or unhealthy consumables. SETTING: Children's sports clubs in Norway. PARTICIPANTS: Representatives from 301 children's sports clubs in Norway answered the questionnaire between September and November 2021. RESULTS: In total, 89·4% of the participating sports clubs (n 301) offered soda drinks with sugar. Most of the sports clubs (88 %) reported to offer batter-based cakes such as pancakes and waffles and 63·8 % offered cakes. Furthermore, 47·5% sold hot dishes with processed meat, such as hamburgers and hot dogs. More than 80% of the sports clubs offered sweets and snacks, while 44·5% did not offer fruits, vegetables and/or berries. Notably, the important factors that distinguished sports clubs with healthier food selections from those with unhealthier selections were the presence of guidelines for the food offered and purchase agreements with food suppliers. CONCLUSIONS: Educational, governmental guidelines for the promotion of healthy eating and establishing agreements with suppliers of healthier foods could help to overcome barriers to unhealthy food selection.

Testing general sociocultural and coach-related appearance pressures as the factors associated with disordered eating in competitive female athletes participating in various sports.

The aim of the present study was to test the sociocultural Petrie and Greenleaf's (2007) model of disordered eating (DE) in competitive female athletes. Specifically, we tested a model of general sociocultural and coach-related pressures towards body weight and appearance of female athletes as the factors associated with athletes' DE through the mediators such as internalization of appearance ideals and overweight preoccupation. 515 athletes participated in this study. The mean age of the sample was 19.0 ± 5.9 years. Athletes were provided with study measures on general sociocultural and coach-related appearance and body weight pressures, internalization of appearance ideals, overweight preoccupation and DE. Path analyses showed that general sociocultural pressures were associated with DE directly and through internalization of appearance ideals and overweight preoccupation. Pressures from coaches were associated with DE through overweight preoccupation and through the internalization of appearance ideals and overweight preoccupation. The models were invariant across body weight sensitivity in sports and age groups. These results inform DE prevention for female athletes. It is important to increase resistance to sociocultural pressures and pressures from coaches in DE prevention programmes for female competitive athletes of all ages and participating in sports irrespective of sports group (weight-sensitive or less weight-sensitive).

Exploring the influence of context on social norms around Australian parents' food provision using story completion.

OBJECTIVE: To explore the differences in social norms around parents' food provision in different provision contexts and by demographics. DESIGN: Qualitative study using story completion methodology via an online survey in September 2021. Adults 18+ with or without children were randomised to one of three story stems focusing on food provision in different contexts; food provision at home (non-visitor), with visitors present and with the involvement of sport. Stories were coded and themed using thematic analysis. A content analysis was performed to determine count and frequency of codes in stories by participant demographics and story assumptions. SETTING: Australia. PARTICIPANTS: Adults (n 196). RESULTS: Nine themes were identified from the data resulting in four social norms around providing healthy foods and justifying non-adherence to healthy eating guidelines, evolution of family life and mealtime values, the presence of others influencing how we engage with food provision and unhealthy foods used as incentives/rewards in sport. Following content analysis, no differences of themes or norms by participant demographics or story assumptions were found. CONCLUSIONS: We identified pervasive social norms around family food provision and further identified how contextual factors resulted in variations or distinct norms. This highlights the impact context may have on the social norms parents face when providing food to their children and the opportunities and risks of leveraging these social norms to influence food choice in these contexts. Public health interventions and practitioners should understand the influence of context and social environments when promoting behaviour change and providing individualised advice. Future research could explore parents' experiences of these norms and to what extent they impact food choice.