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Health is a pre-requisite for optimal performance yet the parameters which govern health and performance of elite female athletes are little understood. The aim of this study was to quantify the health status of elite female athletes, and understand sociocultural factors influencing that status. The survey addressed demographic, health and athletic performance history, training load, contraceptive use, sport-specific appearance and performance pressures, and communication barriers. Three hundred and fifty-seven elite New Zealand female athletes were recruited to complete an on-line survey. Two hundred and nineteen athletes completed the survey. Oligomenorrhea/amenorrhea had been diagnosed in only 12% of athletes compared with 50% of athletes not on hormonal contraception who reported symptoms consistent with this diagnosis. Stress fractures and iron deficiency were common and associated with oligomenorrhoea/amenorrhea (P = 0.002), disordered eating (P = 0.009) or menorrhagia (P = 0.026). Athletes involved in individual sports (P = 0.047) and with higher training volumes (P < 0.001) were more likely to report a medical illness. Seventy-three percent of athletes felt pressured by their sport to alter their physical appearance to conform to gender ideals with 15% engaging in disordered eating practices. Barriers to communicating female health issues included male coaches and support staff, and lack of quality information pertaining to health. Elite female athletes may fail to reach peak performance due to specific health issues and undiagnosed pathology. Sociocultural factors influence the effectiveness of support of female's health and performance. Organizational and cultural change is required if elite female athletes are to combine optimal health with best performance.

Objective To evaluate the impact of Zika virus on preparation and management of the New Zealand (NZ) Olympic team. Design Descriptive manuscript. Setting New Zealand Olympic Health team preparation and management during the Rio de Janeiro Olympic Games, 2016. Patients (or participants) New Zealand Olympic Team members. Interventions (or assessment of risk factors) This manuscript describes the approaches used by the NZ Olympic Health team to the minimization of risk from Zika virus. Main outcome measures Although descriptive of approach forms most of the article, the results of Zika virus serology are presented. Results The NZ Olympic Health team took a proactive approach to risk mitigation, including extensive education, clothing changes, mosquito spray, mosquito nets, and voluntary postexposure testing. No positive serology was observed in those tested. Conclusions The outbreak of Zika virus in Brazil, the associated complication of microcephaly, and the evolving understanding of virus transmission created significant uncertainty for NZ Olympic team members. The proactive approach taken by the health team to the mitigation of risk, combined with the anticipated low risk of arbovirus transmission over the period of the games, resulted in enhanced confidence from team members and no reports of positive serology.

Background Depression is a significant health issue. Recent athlete studies suggest depression is of similar prevalence to the general population, with risk factors such as retirement, concussion, and severe injury reported. The prevalence and identifiable risk factors amongst elite New Zealand athletes is unknown with no previous research in this field. Objective To assess the prevalence of self-reported symptoms of depression and daily life hassles in elite New Zealand athletes. Design A cross-sectional prospective epidemiological study. Setting The online anonymous survey was administered during a 2-month period from May to July 2015. Patients (or Participants) All current NZ athletes>18 years from funded sports invited. 210 started the questionnaire, with 187 completing all responses. Only complete responses analysed. Main Outcome Measurements Demographic and health history obtained. Symptoms of depression were measured by the Centre for Epidemiological Studies Depression Scale- Revised (CESD-R). Life stress measured by the Daily Hassles Questionnaire. Results 21% (n=39) reported symptoms of moderate depression. Of these 40% met the criteria for a Major Depressive Episode. Only 2 of the 39 athletes were currently taking an anti-depressant medication. Those contemplating retirement,and partaking in individual sport had significantly increased odds of experiencing depression with young age also associated. Reported life stressors were higher in females, individual sports, those in partial employment and in a centralized programme. Troubling thoughts about their future, and concerns about meeting high standards were the highest reported life stress. There was a significant correlation between higher level of life stress and experiencing depressive symptoms Conclusion This study supports that depressive symptoms are prevalent in elite New Zealand athletes. Multiple risk factors have been identified pertaining to symptoms of depression and life stressors. These concepts and variables warrant further exploration to enable appropriate screening and support for elite athletes.