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Suicide and contributing mental health conditions in athletes are shared concerns within health care and society at large. This commentary focuses on suicide risk among athletes and the role of sports medicine professionals in preventing suicide and promoting mental health. In this commentary, we draw on the scientific literature and our clinical experiences to pose and answer these questions: Does suicide risk among athletes vary by sociodemographic factors (eg, sex, gender, race/ethnicity, family income, sexual orientation) or if injured? Do sociodemographic differences influence access to and benefits from services among athletes? How do I know my athletes are at risk for suicide? What do I do if one of my athletes shares with me that they have considered suicide? Within our commentary, we review the current literature and clinical practices regarding these questions and close with actionable suggestions and recommendations for future directions. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine the effects of attention–deficit/hyperactivity disorder (ADHD) –related psychostimulant use in the context of concussion risk and symptom recovery. Data were obtained from the National Collegiate Athletic Association Department of Defense Grand Alliance Concussion Assessment, Research, and Education (NCAA-DOD CARE) Consortium from 2014 to 2017. Relative to individuals without diagnosed ADHD (i.e., control), both ADHD diagnosis and the combination of ADHD diagnosis and psychostimulant use were associated with a greater risk of incurring a concussive injury. Following a concussive injury, ADHD diagnosis was associated with longer symptom recovery time relative to the control group. However, individuals with ADHD who use psychostimulants did not take longer to resolve symptoms than controls, suggesting that psychostimulants may have a positive influence on recovery. Regardless of time point, ADHD diagnosis was associated with an elevated number of concussion-related symptoms; however, this effect appears mitigated by having used ADHD-related psychostimulants. [ABSTRACT FROM AUTHOR]

IntroductionMethodsResultsConclusions\nKEY POINTSAthletes with concussions experience heterogeneous symptoms and clinical trajectories. Subclassification provides diagnostic clarity that may improve prognostication and individualized treatments.We hypothesized that endophenotypes of adolescent athletes with concussions differ based on sex and time since injury. Post-concussive testing was performed for athletes (n = 1385) in the North Texas Concussion Registry (ConTex) at four timepoints: acute [0–3 days post-injury (DPI)], subacute-early (4-7DPI), subacute-late (8-28DPI), and persistent (29+DPI). Six endophenotypes (cognitive, headache, ocular-motor, vestibular, affective, sleep) were constructed by allocating post-concussion testing data elements described by the Concussion Subtype Workgroup.Endophenotypes were defined using correlations between data elements and compared based on sex or time since injury. Correlograms revealed endophenotypes differed based on sex and time since injury. The affective endophenotype was dependent on the interaction between sex and time since injury and was more prevalent at the subacute-late and persistent timepoints. The sleep endophenotype became more prevalent at the persistent timepoint. Affective and sleep endophenotypes were interrelated with cognitive, vestibular, and headache endophenotypes at the persistent timepoint suggesting that dysregulated mood and sleep influence lingering symptoms.Adolescent symptom-based concussion endophenotypes differ based on sex and time since injury. Clinical consideration may improve identification of separate trajectories following sport-related concussion and provide targeted care. Athletes report concussion symptoms differently based on sex and time since injury.Persisting concussion symptoms are interrelated with dysregulated mood and sleep.Characterization of concussion endophenotypes should consider sex and post-injury timeline as factors.Athletes report concussion symptoms differently based on sex and time since injury.Persisting concussion symptoms are interrelated with dysregulated mood and sleep.Characterization of concussion endophenotypes should consider sex and post-injury timeline as factors. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic had a significant impact on daily life. Research has shown that high school student-athletes were especially vulnerable to the pandemic and its associated restrictions. Teachers at sports high schools were likewise affected by the pandemic. Studies of student-athletes’ and teachers’ experiences of the pandemic are found separately but not in combinations. Based on the reconceptualized uncertainty in illness theory (RUIT), this paper explored how student-athletes and teachers at certified sports-oriented high schools in Sweden experienced uncertainty concerning the pandemic and how it impacted their everyday life experiences, personal development, and well-being. A re-analysis based on an abductive qualitative content analysis of student-athletes, and teachers in two published studies was investigated. The analysis resulted in four categories: ‘Social life in uncertain times,’ ‘Uncertainty affects health and well-being,’ ‘Rapid changes, uncertainty, and adaptation,’ and ‘Learning for an uncertain future’. Throughout the student-athletes and teachers’ stories, the pandemic had a negative impact on their well-being, but they also stressed that they had learned several things for the future, as discussed using the RUIT as a lens. The combined experiences of these interrelated groups provide unique knowledge about their everyday life experience, personal development, and well-being and suggest that future research would benefit from studying different support structures for dealing with future global adversities. [ABSTRACT FROM AUTHOR]

Sport-related concussions (SRCs) are prevalent in high school (HS) sports, though the determinants of, and relationships between concussion symptoms in this population remain relatively unknown. We analysed SRC data captured within the HS RIO injury surveillance system during 2014/15-2018/19. We used Generalized Estimating Equations to simultaneously assess covariate predictors of symptom presentations and identify pairwise symptom associations and employed multivariable ordinal logistic regressions to determine symptom resolution time (SRT) predictors. Among the 8,969 concussions assessed, headaches (94.3%) and dizziness (73.3%) were the most prevalently reported symptoms. In 5,953 boys' concussion assessed, class year, event type and injury mechanism emerged as determinants of various concussion symptoms, while in 3,016 girls' concussions assessed, class year, event type, injury mechanism, and sport type emerged as significant symptom determinants. In both groups, difficulty concentrating, sensitivity to light, sensitivity to noise, and disorientation were symptoms with the strongest associations with other symptoms. Odds of longer SRT were higher with greater endorsement (i.e. counts) of the subset of symptoms with strongest cross-domain associations (ORadj. = 1.35; 95% CI = [1.30, 1.40]). Our findings provide valuable information for informing sideline and follow-up clinical concussion assessment algorithms in high school athletes. [ABSTRACT FROM AUTHOR]

Purpose: Our purpose was to represent a rare cohort of female collision sport athletes and investigate the association between sport type (collision, contact, and noncontact), symptoms, and performance on baseline neurocognitive assessments. Methods: We conducted a cross-sectional study using baseline computerized neurocognitive scores (Immediate Postconcussion Assessment and Cognitive Testing [ImPACT]) of 75,128 female high school student-athletes (age, 15.27 ± 1.05 yr) playing multiple sports. The dependent variables were verbal memory, visual memory, visual motor speed, reaction time, and total symptom score. The independent variable was sport type, categorized as collision, contact, noncontact, adjusted for the effect of the following covariables: age, concussion history, and comorbidities (learning disability, ADHD, psychiatric condition, headaches, migraines, speech therapy, special education, and repeating one of more years of school) using multivariable regression models. Results: Female collision sport athletes reported significantly higher symptoms (9.81 ± 12.63) at baseline compared with contact (5.78 ± 9.25) or noncontact (6.39 ± 9.74) sport athletes (P < 0.001). Using noncontact sports as a reference, there was no significant association between collision sport participation and cognitive composite scores (verbal memory: β = −0.57, 95% confidence interval = −1.80 to 0.66, P = 0.38; visual memory: β = −0.83, 95% confidence interval = −2.46 to 0.79, P = 0.31; visual motor speed: β = −0.21, 95% confidence interval = −1.01, 0.59, P = 0.61; reaction time: β = 0.01, 95% confidence interval = −0.01 to 0.02, P = 0.29). Conclusions: Participation in collision sports appears to be associated with baseline symptoms but not neurocognitive functioning among female adolescent athletes. [ABSTRACT FROM AUTHOR]

AbstractObjective: The long-term health of former athletes with a history of multiple concussions and/or repetitive head impact (RHI) exposure has been of growing interest among the public. The true proportion of dementia cases attributable to neurotrauma and the neurobehavioral profile/sequelae of multiple concussion and RHI exposure among athletes has been difficult to determine. Methods: Across three exposure paradigms (i.e. group comparisons of athletes vs. controls, number of prior concussions, and level of RHI exposure), this review characterizes the prevalence of neurodegenerative/neurological disease, changes in cognitive and psychiatric function, and alterations on neuroimaging. We highlight sources of variability across studies and provide suggested directions for future investigations. Results: The most robust finding reported in the literature suggests a higher level of symptom endorsement (general, psychiatric, and cognitive) among those with a greater history of sport-related concussion from adolescence to older adulthood. Pathological processes (e.g. atrophy, tau deposition, and hypometabolism) may be more likely to occur within select regions (frontal and temporal cortices) and structures (thalamus and hippocampus). However, studies examining concussion(s) and RHI exposure with imaging outcomes have yet to identify consistent associations or evidence of a dose-response relationship or a threshold at which associations are observed. Discussion: Studies have not observed a simple dose-response relationship between multiple concussions and/or RHI exposure with cognitive, psychiatric, or in vivo neurobiological outcomes, particularly at lower levels of play. The relationship between prior concussion and RHI exposure with long-term outcomes in former athletes is complex and likely influenced by ­several non-injury-related factors. [ABSTRACT FROM AUTHOR]

Abstract\nLay summaryIn Canada, high school sport is a popular activity used to foster the physical and psychosocial development of student-athletes. Despite the popularity of high school sport, social justice inequities (e.g., racism, ableism) continue to shape student-athletes’ experiences. Given that the mission of School Sport Canada (i.e., the national governing body of school sport) is to facilitate the “total development of student athletes through interscholastic sport”, there is a need to study the way coaches think about and act for social justice. Thus, the purpose of the study was to profile the social justice activism and allyship of Canadian high school coaches. Semi-structured interviews were conducted virtually (i.e., via Zoom) with 28 Canadian high school sport coaches. Interview data were subjected to reflexive thematic analysis, which led to the development of two coach profiles based on the two continua model for life skills teaching (Camiré, 2023). The two coaching profiles – the normative coaching approach (i.e., general disinterest in social justice) and the transformative coaching approach (i.e., proactive social justice activism through a developed critical consciousness) – are contrasted across four overarching themes (a) I’m (Not) Confident, I (Don’t) Understand; (b) (Un)intentionally (Re)acting; (c) You See Excuses, I See Obstacles to be Toppled; and (d) (Dis)engaged and (Non)autonomous Education. Findings have practical implications for centering social justice in coach education, for developing critical praxis related to activism and allyship, and for instigating systemic policy changes that can make the Canadian school sport system safer, more equitable, and more inclusive for all participants.Interviews were conducted with 28 Canadian high school sport coaches and were subsequently analyzed to form two profiles: the normative coaching approach (i.e., disinterest in social justice) and the transformative coaching approach (i.e., social justice activism). Findings suggest the need to shift toward a transformative approach in Canadian high school sport coaching. Implications for PracticeOne-size-fits-all approaches to social justice-oriented coach education are inappropriate.Tailored educational resources should be developed for coaches in consideration of their level of social justice literacy and critical consciousness.Transformative social justice changes in high school sport require more than coach-level interventions. Such changes must also include amendments to school policy, sport culture, and potentially sport structure.One-size-fits-all approaches to social justice-oriented coach education are inappropriate.Tailored educational resources should be developed for coaches in consideration of their level of social justice literacy and critical consciousness.Transformative social justice changes in high school sport require more than coach-level interventions. Such changes must also include amendments to school policy, sport culture, and potentially sport structure. [ABSTRACT FROM AUTHOR]

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by attention problems, excessive activity, and impulsivity - occurring in approximately 13% of children 12–17 years of age, and as many as 16% of older adolescents 18–22 years of age, with a greater prevalence in boys than girls. ADHD frequently co-occurs with specific learning disorder (LD), a neurodevelopmental disorder characterized by difficulties learning and using academic skills, such as reading, writing, and mathematics. Taken together, ADHD and/or LD are common among high school students and college students and can influence performance on computerized tests used in concussion management. However, normative data for widely used computer-based measures used in concussion management do not include reference samples with ADHD and/or LD. Previous research has documented the expected frequency of obtaining low scores on computer-based neuropsychological test measures among healthy, uninjured individuals, but few studies have examined the frequency of obtaining low scores in athletes with neurodevelopmental diagnoses, such as ADHD and/or LD. This study examined the frequency of low scores (i.e., multivariate base rates) on the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) for youth and young adults with self-reported ADHD and/or LD. Methods: The sample included 174,878 adolescent and young adult student-athletes who completed pre-season baseline neurocognitive assessments, who were assigned to the following independent groups: ADHD only (n = 45,215), LD only (n = 54,223), ADHD and LD (n = 45,737), No ADHD or LD (n = 47,684; "control athletes"). Results: Base rates of low scores were stratified by high school (e.g., 13–18) and collegiate age (e.g., 19–22) and sex. It was common for student athletes (all ages) with LD alone (i.e., 30–37%), or with both ADHD and LD (i.e., 24–31%), to obtain at least two low ImPACT composite scores, but not three low composite scores. However, it was relatively uncommon for control athletes (those without ADHD or LD) (i.e., 12–14%) or older athletes (ages 19–22) with ADHD (i.e., 14–15%) to obtain two (or more) low scores. Discussion: Having information relating to the base rates of low scores among uninjured athletes enhances the interpretation of ImPACT results among the broader population of student-athletes with and without neurodevelopmental disorders. [ABSTRACT FROM AUTHOR]

Research that has examined the association between specialization and injury in basketball has been limited to cross-sectional or retrospective studies. To determine whether specialization is a risk factor for injury among high school basketball athletes. Prospective cohort study. Basketball players from 12 high schools participating in the National Athletic Treatment, Injury, and Outcomes Network Surveillance Program (NATION-SP) were recruited before the 2022–2023 interscholastic basketball season. One-hundred thirty athletes (mean age ± SD = 15.6 ± 1.3; girls' basketball: n = 68 [52.3%]). Before the start of the school basketball season, participants completed a questionnaire that had questions regarding participation in various specialized sport behaviors. During the basketball season, the school's athletic trainer reported all athlete-exposures and injuries (regardless of time loss) for participating athletes into NATION-SP. Injury incidence and incidence rate ratios (IRRs) with 95% CIs were calculated for the specialized sport behaviors previously described. No difference in injury risk between highly specialized and low specialized athletes was found (IRR [95% CI] = 1.9 [0.9, 3.7]). Players who participated in basketball year round were twice as likely to sustain an injury than those who did not play year round (IRR [95% CI] = 2.1 [1.1, 3.6]). Similarly, players who reported participating in basketball skills camps were at increased risk of injury compared with athletes who did not participate in basketball skill camps (IRR [95% CI] = 2.5 [1.2, 5.7]). Injury risk related to sport specialization in basketball may be specific to certain behaviors such as year-round play and participation in skills camps. Validated measures of comprehensive sport activity are needed to better measure specialization in youth sports to better determine injury risk related to sport specialization and develop injury prevention programs for basketball athletes. [ABSTRACT FROM AUTHOR]

As most young athletes do not end up making a living in sport, and professional athletic careers are relatively short, adolescent athletes need to think about and plan their future outside of sport. The present longitudinal study examined the future-oriented hopes and goals of adolescent student-athletes in Finland at the beginning and end of sport high school. Gender differences in these hopes and goals were also examined. The sample consisted of 381 student-athletes (51% females, 49% males) in the autumn of the first year of high school and 351 student-athletes (50% females, 50% males) in the spring of the third year, who filled in a questionnaire at both measurement points. A total of 11 goal categories consisting of 49 subcategories were identified using directed content analysis. Changes across time and gender differences in these hopes and goals were examined using the "N-1" chi-squared test. The results showed that sport-related hopes and goals were the most common at both measurement points. However, only 51% and 27% of the participants mentioned dual careers in their goals for the future at the beginning and end of high school, respectively. The female participants reported statistically significantly more goals related to education and a dual career and statistically significantly fewer goals related to sport than males. Further, male participants reported statistically significantly more often not knowing their future hopes and goals than females. [ABSTRACT FROM AUTHOR]

Objective: To determine the incidence rates (IRs) of catastrophic injuries and exertional medical events in lacrosse athletes. Methods: Catastrophic injuries and exertional medical events in lacrosse in the US among youth or amateur, high school and college athletes were analysed from the National Center for Catastrophic Sport Injury Research (NCCSI R) database from 1982/83 to 2019/20. Frequencies, IRs per 100,000 athlete-seasons (AS) with 95% confidence intervals (CIs), and incidence rate ratios (IRRs) with 95% CIs were calculated. Participation data were gathered from the National Federation of State High School Associations (NFHS), National Collegiate Athletic Association (NCAA) and USA Lacrosse. Results: Sixty-nine catastrophic events (16 youth or amateur, 36 high school and 17 college; 84% male) occurred in US lacrosse from 7/1/1982 to 6/30/2020. Thirty-six percent of all incidents were fatal. The overall IR was 0.5 per 100,000 AS (95% CI: 0.4-0.7). There were 15 cases of non-traumatic sudden cardiac arrests (SCA s) and 15 incidents of commotio cordis. Fatality rates from SCA and commotio cordis decreased 95% (IRR = 0.05; 95% CI: 0, 0.2) from 1982/83-2006/07 to 2007/08-2019/20. Incidence rates were higher for collegiate versus high school 1982/83-2019/20 (IRR = 3.2; 95% CI: 1.8, 5.7) and collegiate versus youth 2005/06-2019/20 (IRR = 8.0; 95% CI: 3.0, 21.4) level. Contact with a stick or ball (41%) and contact with another player (20%) were the primary mechanisms of injury. Conclusions: The incidence of catastrophic events during lacrosse was higher among collegiate than high school or youth athletes. SCA from an underlying cardiac condition or from commotio cordis was the most common catastrophic event. Fatality rates from catastrophic injuries have declined significantly over the study period, perhaps driven by protective measures adopted by lacrosse governing bodies. [ABSTRACT FROM AUTHOR]

Background/Objectives: Sport persistence can be coded as an indicator of sport performance and commitment, incorporating personality traits such as resilience, adaptive coping, and positive personality traits. Thus, athletes do not merely persist in sporting activities but are qualitatively committed to them. Methods: In the present research, we used a qualitative methodology to investigate the factors underlying sport persistence, using Bronfenbrenner's socio-ecological model. In total, 133 high school and college student-athletes were surveyed in a semi-structured interview study. We set the following research question: How do the factors involved in developing sport persistence vary across athletes' gender, level of study, and level and type of sport? Data were analyzed along the lines of grounded theory. ATLAS.ti and IBM SPSS 22.0 statistical software were used for the analysis. Results: Our analysis divided individual motivation into intrinsic (health promotion, habituation, becoming a competitive athlete, self-improvement, self-actualization, relaxation, and sport enjoyment) and extrinsic motivation (family-related motivation, coach, social relationships, competition, livelihood, recognition). The cross-tabulation analysis revealed that contrary to the general trend, no significant differences can be experienced in the core motivational patterns contributing to sport persistence. However, significant differences could be detected concerning the level of education, level of sporting activity, and type of sport. Conclusions: Our findings not only shed light on the unique factors underlying sport persistence, but also challenge the trends observed in traditional sport motivation analyses. This insight could potentially revolutionize how we approach youth sport promotion and physical activity among young people, making our research highly relevant and impactful. [ABSTRACT FROM AUTHOR]

Background/Objectives: Sport persistence is the embodiment of sports performance and mental toughness. It refers to our attempts concerning the performance plateau, failures, injuries, or even the resolution and processing of stressful situations associated with success and positive events. In our research, we used qualitative methods based on Bronfenbrenner's socio-ecological model to investigate the factors influencing sport persistence among high school and university athletes. Methods: The research was based on semi-structured interviews with 133 athletes. ATLAS.ti software and the grounded theory methodology were applied for data analysis. Our analysis grouped the responses according to Bronfenbrenner's categorisation system, highlighting motivational factors at the microsystem level. Our research question was as follows: What kind of factors dominate the development of sport persistence among adolescent (high school) and young adult (university) athletes along Bronfenbrenner's dimension of the microsystem? Results: Regarding the microsystem, family, peers, and coaches were mentioned as influential factors. Concerning the family, general, person-specific, family value-related, future-oriented, introjected, and disadvantage-compensating motivational components were identified. General, individual, community and relational factors were identified concerning peers. Concerning the coach, general, individual, community, and coach personality-driven motivational segments were detected. Conclusions: By recognising the complex interplay of systemic factors, we can design interventions targeting these factors at various socio-ecological levels, promoting youth sports and increasing physical activity among young people. These findings instil hope and motivation for the future of sports and physical activity. [ABSTRACT FROM AUTHOR]

To promote safe supplement use, athletes are advised to choose third‐party tested (TPT) supplements to minimise doping risk. This study evaluated changes in knowledge on supplements in US high school athletes from a 2‐week online supplement education programme. One group of sophomores (ED, n = 48) completed a Canvas course on safe supplement use, based on the Theory of Planned Behaviour, while the other group of freshmen (NOED, n = 38) did not. Participants completed questionnaires pre‐ and post‐intervention to assess practical knowledge of finding and ordering TPT supplements, familiarity with World Anti‐Doping Agency (WADA) banned substances and decision‐making in supplement purchasing. Chi‐Square and McNemar tests were applied with significance set at p ≤ 0.05. Pre‐intervention no differences were found between groups (ages 14–17 years, 39.5% female) for any knowledge questions (p = 0.18). Post‐intervention, ED participants were more likely to know where to find (58.3% vs. 39.5%, p = 0.041), and order (62.5% vs. 28.9%, p = 0.001) TPT supplements, and more athletes in ED (72.9%) than NOED (40.0%) reported deciding to purchase supplements themselves (p = 0.015). Parents were less influential in ED (75.0% vs. 92.1%, p = 0.019). Importantly, positive changes over time were larger for ED versus NOED in knowing where to find (28% vs. 13%, p = 0.04) and order (28% vs. 7%, p < 0.001) TPT supplements and WADA familiarity (19% vs. 5%, p = 0.01). Within‐group changes showed ED improved on all practical knowledge questions (p = <0.001–0.008), whereas NOED only increased in knowing where to find TPT supplements (p = 0.003). These findings suggest an online educational programme may enhance practical knowledge of safe supplement use among high school athletes. [ABSTRACT FROM AUTHOR]

Emerging evidence from neurophysiological brain vital sign studies show repeatable sensitivity to cumulative subconcussive impairments over a season of contact sports. The current study addressed the need for research comparing a low-contact control group to high-contact group. Importantly, the study also expanded the scope of neurophysiological changes related to repetitive head impacts to include female athletes in addition to male athletes. In total, 89 high school student athletes underwent 231 brain vital sign scans over a full calendar year. The results replicated prior subconcussive cognitive impairments (N400 delays) and sensory impairments (N100 amplitude reductions) in male athletes and demonstrated similar subconcussive impairments for the first time in female athletes. While there was no significant subconcussive difference between female and male athletes, female athletes show overall larger responses in general. The findings demonstrated that subconcussive impairments are detectable in a controlled experimental comparison for both female and male high school athletes. The study highlights the opportunity to monitor subconcussive changes in cognitive processing for both female and male athletes to help advance prevention, mitigation and management efforts aimed at reducing athletes' risk of potential long-term negative health outcomes related to cumulative exposure to repetitive head impacts. [ABSTRACT FROM AUTHOR]

The Modified Balance Error Scoring System (mBESS) remains the standard balance tool for evaluating sport-related concussion. Discrepancies between error and objective sway scoring remain a topic of assessment measures. The purpose was to examine sex differences between error and sway index scores and association between scores on the mBESS in collegiate and high school athletes. 119 athletes completed the mBESS on a Biodex BioSway. Measures consisted of mBESS errors and sway index scores produced by the BioSway. No sex differences were observed on mBESS errors and sway index scores by competition level and the overall sample. Moderate associations were observed between error and sway index scoring for single and tandem stances. [ABSTRACT FROM AUTHOR]

Background: Injury characteristics of high school track and field throwing athletes in the United States are not well studied. Understanding epidemiology of injuries is important to identify treatment and prevention strategies. Objective: To describe injury rates and patterns in U.S. high school track and field throwing events from a longitudinal national sports injury surveillance system. Design: Descriptive epidemiology study. Setting: Data were provided by the National High School Sports Related Injury Surveillance System, High School RIO (Reporting Information Online). Methods: Athletic trainers reported injury and exposure data through the High School RIO website on a weekly basis. An athlete exposure (AE) was defined as one athlete participating in one school‐sanctioned practice or competition. Throwing events of discus, shot put, and javelin were analyzed in this study. Main Outcome Measures: Injury rate, rate ratios (RR), injury proportion ratios (IPR). Participants: U.S. high school athletes. Results: A total of 267 track and field throwing injuries occurred during 5,486,279 AEs. Overall, the rate of injuries in competition was higher than in practice (RR 1.35, 95% confidence interval [CI] 1.01–1.80). In practice, the rate of injuries was higher for girls than boys (RR 1.53, 95% CI 1.12–2.08). The most frequently injured body part was the shoulder (21.7%), followed by the ankle (16.5%) and knee (12.0%). The most common types of injury were muscle strains (26.14%) and ligament sprains (25%). Recurrent injuries accounted for a higher proportion of chronic injuries compared to new injuries (IPR 1.85, 95% CI 1.16–2.97). Conclusion: This study described injury characteristics of high school track and field throwing athletes from 2008 to 2019. Based on our results, injury prevention may be particularly important for female throwers with prior injury. [ABSTRACT FROM AUTHOR]

Over the past decade, brain impacts sustained by athletes resulting in concussion has become the most discussed sports injury. This has led to numerous rule changes, equipment development to better protect athletes, and changes in how contact sports are coached and played. The appreciation that sports concussion is not limited to professional contact sports like football, boxing, and ice hockey has resulted in a broader understanding of the role of repetitive brain impact in many other sports played at all levels of competition and at all ages. The term "being in the concussion protocol" has become a recognized term for players and fans alike. Concussion education is currently required in virtually all levels of sport for coaches and trainers, with many leagues and sports federations requiring athlete education as well. This is a significant step in the right direction, but much is yet to be learned. To date, despite progress being made through innovative research and significant investment of resources, there is no cure for concussion, only strategies for treatment of symptoms. Prevention, adhering to established return-to-play criteria, and close clinical monitoring post-injury remain the most effective interventions. Many of the post-acute symptoms of sports concussion present as emotional and cognitive behavioral complaints. The goal of this article is to present an overview of sports concussion for clinical psychiatrists and to emphasize the need to consider brain impact when evaluating and treating athletes with mental health issues. [Psychiatr Ann. 2024;54(11):e313–e316.] [ABSTRACT FROM AUTHOR]

Context: Previous research has demonstrated that using a multicomponent approach to ankle injury preventions can significantly reduce ankle injuries; however, these studies lack specific intervention recommendations. Objective: To evaluate the exercise components of prevention programs on ankle injuries specifically in high school athletes. Secondary objectives were to assess the overall effectiveness of prevention programs on ankle injuries in this population and how compliance and education may impact success. Data Sources: A total of 5 databases were searched through September 26, 2022. Study Selection: Study inclusion criteria included randomized control trials (RCTs) investigating exercise interventions in high school athletes aged 13 to 19 years, participation in sports competition, reporting of injury incidence, and specific exercise interventions used. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 1. Data Extraction: Pooled overall ankle injury incidence rate ratio and 95% CIs were calculated using random-effects meta-analysis. Results: A total of 10 studies were included, of which 9 used multicomponent exercise interventions and 1 used only balance training. Of the 10 studies, 3 demonstrated statistically significant reduction in ankle injuries. When data from all 10 studies were pooled and analyzed, there was a statistically significant overall reduction (incidence rate ratio, 0.74; 95% CI 0.60-0.91) in ankle injuries when comparing intervention groups with controls. Conclusion: The most effective injury prevention programs included multiple components, emphasized strengthening and agility exercises, and promoted high adherence to the intervention. The importance of coach and player education on how and why to perform an injury prevention program as well as the frequency and duration of programs was also important. Exercise-based injury prevention programs may reduce ankle injury incidence in youth athletes by 26% when pooling data from a multitude of sport types/settings. [ABSTRACT FROM AUTHOR]

Although psychological distress has been shown to increase during adolescence, participation in organized activities may have protective effects. The present study aimed to identify whether there is a relationship between high school student-athletes' breadth of participation in organized activities and psychological distress, using a latent class analysis. Canadian adolescent-athletes (n = 930) in Grades 11 and 12 completed an online survey that measured: (a) high school sport participation, (b) community sport participation, (c) nonsport extracurricular activities participation, and (d) psychological distress. The latent class analysis indicated that a two-class model (i.e., Class 1 = narrower breadth, low distress; Class 2 = wider breadth, moderate distress) was most appropriate. Results indicated that despite the divergent probability of organized activity participation, participants in both classes had a low to moderate probability of presenting elevated levels of psychological distress. However, levels of psychological distress were still higher than other Canadian adolescent populations, suggesting that overscheduling could be of concern. Gender and time (i.e., prior/during COVID-19 pandemic) were significant covariates in the model. [ABSTRACT FROM AUTHOR]

Context: Studies have illustrated that overuse injuries occur in adolescent athletes more often than previously reported. The general purpose of this study was to provide a thorough report of secondary school athletic trainers encounters, practices, and perceptions of overuse injury in adolescent athletes. Design: Cross-sectional. Methods: An anonymous online questionnaire was distributed via email to athletic trainers in the secondary school setting. The questionnaire was sent to participants during the summer of 2021 and 430 participants (highest educational degree earned: master's degree = 66%) completed the survey. Various survey methods were used to evaluate athletic trainers (1) demographics, (2) estimations about what percentage of injuries evaluated and treated were classified as overuse, (3) methods for treating overuse injuries, (4) confidence in treating overuse injuries and the complete implementation of their treatment plan, (5) perceptions of various barriers to treating overuse injuries, and (6) perception as to why patients did not want to reduce activity to treat their overuse injuries. Results: Participants reported that about half of all evaluations and treatments in a year were overuse injuries and they were "fairly" or "completely" confident (90%) in their ability to treat these injuries. The most common treatments cited were stretching (91%) and reducing activity (90%). Only 61% of participants were "fairly" or "completely" confident in the complete implementation of their treatment plan. Participants believed that patients' reluctance to reduce sport activities (82% "moderate" or "extreme" barrier) was the most significant barrier to treatment. Participants cited athletes' avoidance of missing games as the most common reason athletes were reluctant to reduce sporting activity. Conclusions: Participants felt confident in treating overuse injuries yet faced significant barriers in treating these injuries. Clinicians should be prepared to have conversations about the importance of reducing sporting activity to allow proper healing for overuse injuries in adolescent athletes. [ABSTRACT FROM AUTHOR]

Purpose: Symptom scores commonly measured following concussion were compared between male and female adolescents with (Hx+) and without (Hx−) a history of concussion, pre and post physical exertion testing. Methods: Eighty (males [n = 60; Hx+ = 19], female [n = 20; Hx+ = 5]) high school students (ages 15–17 y) completed the Buffalo Concussion Treadmill Test once and the modified shuttle run test twice. Symptom scores were collected using the 22-point Symptom Evaluation Scale on the Sport Concussion Assessment Tool (version 5) immediately pre and post physical exertion testing. Results: The symptoms most reported during preexertional testing were fatigue/low energy, feeling slowed down, and nervous/anxious, whereas feeling slowed down, fatigue/low energy, "pressure in head" (males only), and headache (females only) were most frequently reported during postexertion testing. Conclusion: An understanding of the common exertion-related symptoms at baseline in a laboratory or field-based setting in adolescents may be advantageous for clinicians as they manage individual recovery postconcussion. This is particularly important during an adolescent's recovery and return to play when exertional testing may be implemented, especially since symptoms were reported pre and post exertional testing in both males and females regardless of concussion history. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to identify the 50 most-cited publications relating to lacrosse since 1990 and conduct a bibliometric analysis of the identified studies Methods: Clarivate Analytics Web of Science database was queried to identify all publication titles, abstracts, and keywords for the term 'lacrosse' on 9 June 2023. The resulting articles were sorted by total number of citations. Titles and abstracts were included based on their relevance to lacrosse. Once the 50 most cited articles were identified, each article was further analyzed to obtain author name, publication year, country of origin, journal name, article type, research topic, competition level, total number of citations, and the level of evidence. Citation density (total number of citations/years since publication) was calculated and recorded for each of the most-cited studies. Results: The 50 most-cited articles were cited 4237 of times with an average of 84 citations per article. The most cited article was cited 637 (15.0%) times. The articles came from 2 different countries, with the United States and Australia comprising 49 and 1 articles, respectively. All articles were published in English. The American Journal of Sports Medicine published the most articles (n = 21, 42.0%). The most studied topic was concussion/traumatic brain injury (n = 18) followed by studies assessing all injuries (n = 7). Collegiate-level lacrosse was the most studied level of competition (n = 22), while high school-level followed (n = 12). Conclusions: The majority of the 50 most-cited articles related to lacrosse since 1990 focus on the prevalence, diagnosis and identification of concussion/traumatic brain injury in high school and collegiate-level athletes. These articles are predominantly epidemiological or cohort studies with Level III or IV evidence that almost unanimously originate from the United States. [ABSTRACT FROM AUTHOR]

ABSTRACT Despite a growing number of young adults developing skin cancers, little is known about the sun‐protective behavior of high school athletes exposed to high levels of UV radiation, such as junior tennis players. To investigate the frequency and quality of their sun protective behaviors, a web‐based, anonymous survey was conducted among tennis players at high school varsity matches and United States Tennis Association tournaments in Southern California. Although 92.6% of the 81 respondents indicated they play during peak sun intensity hours, 46.9% stated they do not regularly wear sunscreen, 27.2% do not routinely wear hats or visors, only 9.9% wear protective eyewear, and 4.9% wear UV‐protective clothing; furthermore, 87.5% of junior tennis players stated they are not very familiar with skin cancer, but 73.8% would like to learn more about it. The results of this study demonstrate a lack of consistent sun protective behavior among junior tennis players, providing a rationale for the development of targeted educational campaigns to increase skin cancer risk awareness and more effective sun‐protective behavior. [ABSTRACT FROM AUTHOR]

Participation in high school sports has physical, physiological, and social development benefits, while also increasing the risk of acute and overuse injuries. Risk of sport-related overuse injury differs between boys and girls. To investigate differences in overuse injuries among US high school athletes participating in the gender-comparable sports of soccer, basketball, and baseball/softball. Descriptive epidemiology study using a nationally representative sample from the High School Reporting Information Online (RIO) database. High schools. Athletes with overuse injuries during the 2006–2007 through 2018–2019 academic years. National estimates and rates of overuse injuries were extrapolated from weighted observed numbers with the following independent variables: sport, gender, academic year, class year, event type, body site, diagnosis, recurrence, activity, and position. Among an estimated 908 295 overuse injuries nationally, 43.9% (n = 398 419) occurred in boys' soccer, basketball, and baseball, whereas 56.1% (n = 509 876) occurred in girls' soccer, basketball, and softball. When comparing gender across sports, girls were more likely to sustain an overuse injury than boys (soccer, injury rate ratio [IRR]: 1.37, 95% CI = 1.20–1.57; basketball, IRR: 1.82, 95% CI = 1.56–2.14; baseball/softball, IRR: 1.21, 95% CI = 1.04–1.41). Most overuse injuries in soccer and basketball for both genders occurred to a lower extremity (soccer: 83.9% [175 369/209 071] for boys, 90.0% [243 879/271 092] for girls; basketball: 77.0% [59 239/76 884] for boys, 80.5% [81 826/101 709] for girls), whereas most overuse injuries in baseball and softball were to an upper extremity (72.5% [81 363/112 213] for boys, 53.7% [73 557/136 990] for girls). For boys' baseball, pitching (43.5% [47 007/107 984]) was the most common activity associated with an overuse injury, which differed from the most common activity of throwing (31.7% [39 921/126 104]) for girls' softball. Gender differences observed in this study can help guide future strategies that are more specific to gender and sport to reduce overuse injuries among high school athletes. [ABSTRACT FROM AUTHOR]

AbstractObjective: This study explored the extent to which college athletic coaches endorse mental illness microaggressions toward their student-athletes and the importance of mental toughness in sports, and how these impact support for help-seeking among student-athletes. Methods: Fifty-eight coaches at Northeastern U.S. colleges in the National Collegiate Athletic Association completed an online survey, including measures of mental illness microaggressions, mental toughness, and questions about vignettes portraying scenarios with a physically injured athlete and an athlete with anxiety. Results: Multivariate analyses revealed that endorsement of mental illness microaggressions was negatively related to willingness to refer an athlete with anxiety to counseling services and positively related to willingness to allow a physically injured athlete to return to play. However, mental toughness was not predictive of microaggressions or vignette responses. Conclusions: Endorsement of mental illness microaggressions appears to be related to how coaches respond to athletes experiencing a mental health issue or physical injury. [ABSTRACT FROM AUTHOR]

Background: Sport schools are popular environments for simultaneously delivering education and sport to young people. Previous research suggests sport school involvement to have impact (i.e. the positive/negative, intended/unintended and long/short-term outcomes, results and effects) on student athlete's holistic (i.e. academic, athletic, psychosocial and psychological) development. However, previous research is limited by (1) cross-sectional methods, (2) limited multidimensional assessments, (3) lack of consideration for athlete characteristics (e.g. sex) and (4) failure to evaluate how sport school features affect student-athlete impacts. Objectives: The study, using a mixed methods case study approach, aims to (1) longitudinally evaluate the impact of sport school involvement on the holistic development of student athletes, (2) evaluate the impact on holistic development by student-athlete characteristics and (3) explore the features and processes of the sport–school programme that drive/facilitate holistic impacts. Methods: A longitudinal mixed methods design was employed across one full academic school year (33 weeks). Six data-collection methods (i.e. online questionnaire, physical fitness testing battery, academic assessment grades, log diaries, field notes/observation and timeline diagram/illustration) were used to assess the academic, athletic, psychosocial and psychological impacts for 72 student athletes from one sport school in the United Kingdom (UK). Results: Student athletes developed positive long-term holistic overall impacts (i.e. academically, athletically and personally), including maintaining stable and relatively high levels of sport confidence, academic motivation, general recovery, life skills, resilience and friends, family and free time scores. Despite positive impacts, juggling academic and sport workload posed challenges for student athletes, having the potential to lead to negative holistic impacts (e.g. fatigue, stress and injury). Positive and negative impacts were linked to many potential features and processes of the sport school (e.g. academic and athletic support services versus insufficient training load build-up, communication, coordination, flexibility and planning). Furthermore, when considering student-athlete characteristics, females had lower sport confidence, higher general stress and body image concerns and less general recovery than males and student athletes who played sport outside the school had lower general recovery. Conclusions: This mixed method, longitudinal study demonstrated sport school involvement resulted in many positive academic (e.g. good grades), athletic (e.g. fitness development), psychosocial (e.g. enhanced confidence) and psychological (e.g. improved resilience) impacts attributed to the academic and athletic support services provided. However, juggling heavy academic and athletic workloads posed challenges leading to negative impacts including fatigue, pressure, stress and injury. Furthermore, holistic impacts may be sex dependent and further support may be required for female student athletes in sport school environments. Overall, these findings demonstrate the complex nature of combining education and sport commitments and how sport schools should manage, monitor and evaluate the features of their programme to maximise the holistic impacts of sport–school student athletes. [ABSTRACT FROM AUTHOR]

The identification, management, and prevention of concussion across all competitive sports and athletic populations has been a notable topic of research over the last decade. Soccer is no exception, with over a billion participants worldwide. In soccer, 3 distinct subsets of head injuries are often the contributors to concussion: head-to-equipment, head-to-surface, and head-to-player collisions. Recognition of concussion is crucial, and ideally made on the sideline during competitive play. Recently updated screening tools include the SCAT6 and ChildSCAT6, which are widely utilized at all levels of play. Management of concussion is divided into on-field and in clinic management. initial management includes removal from the field of play. There is increased emphasis on earlier incorporation of exercise prescription as a means to improve recovery in the concussed athlete. while few objective diagnostic tests exist to identify concussion, many are in development, most notably advanced imaging and biomarker modalities. [ABSTRACT FROM AUTHOR]

Background Functional performance tests (FPT) have been used with athletes following an injury to determine readiness to return-to-play (RTP), usually using limb symmetry indices to the contralateral limb or a baseline score. There is not a consensus as to which criterion scores are best compared. Hypothesis/Purpose This study aimed to compare common functional performance test scores from injured athletes at the time of release to RTP to both preseason baseline scores and to the contralateral limb. It was hypothesized that using baseline scores for comparison would be more responsive to residual deficits following injury than using the contralateral limb. Study Design Prospective longitudinal cohort study Methods High school athletes (n=395) from all varsity sports completed a battery of FPTs including the Y-Balance Test (YBT), single limb hop tests and T-Test for agility (TT) during their preseason to establish baseline data. Injured athletes (n=19) were re-tested using all FTP's again at the time of RTP. Paired t-tests were used to detect if significant (p<0.05) residual deficits were present at time of RTP when compared to baseline and to contralateral scores on FPTs. Results Differences in YBT scores were found in the anterior direction only (p=0.021) when comparing RTP to preseason, but there were no differences when compared to RTP data for the contralateral limb. Differences were detected with the single leg hop test (p = 0.001) when comparing the RTP to preseason and were also detected in both the single leg hop (p= 0.001) and triple hop (p=0.018) when compared to the contralateral limb. Differences in TT scores were detected when comparing RTP to preseason for cutting first with both the unaffected (p = 0.019) and affected (p = 0.014) limbs. Conclusions The YBT in the anterior direction and the TT are better able to detect residual deficits when comparing RTP to preseason scores. Hop tests are better able to detect deficits when compared to the contralateral limb. These results could make preseason testing more efficient when creating a reference for determining RTP readiness following lower extremity injury. [ABSTRACT FROM AUTHOR]

Pre-injury migraines might be a risk factor for prolonged recovery after sport-related concussion (SRC). We sought to examine whether a pre-injury history of migraines is associated with worse recovery following SRC in collegiate athletes. Data were collected through a prospective concussion surveillance system in 11 National Collegiate Athletic Association (NCAA) Division III college athletic programs between September 2014 and March 2020. Our primary independent variable, pre-injury migraines, were self-reported by the athletes. Between those with and without migraines, the outcomes of days to return-to-learn (RTL) without academic accommodations and return-to-play (RTP) were compared using Mann–Whitney U tests. Each athlete's RTL and RTP status was dichotomized (i.e., returned vs. not returned) at various time points for RTL (i.e., 7/14/21/28 days) and RTP (i.e., 14/21/28/56 days). Chi-squared tests were performed to compare the proportions of RTL and RTP status between groups. Multivariable regressions analyzed potential predictors of RTL and RTP adjusting for age, gender, prior concussions, other health conditions, and symptom severity. Of 1409 athletes with an SRC, 111 (7.9%) had a pre-injury history of migraines. Compared with those without migraines, those with migraines had longer median (interquartile range [IQR]) days to RTL (migraines = 7.0 [3.0–12.3] vs. no migraines = 5.0 [2.0–10.0], U = 53,590.5, p = 0.022). No differences were found in RTP between the two groups (migraines = 16.0 [10.0–33.0] vs. nχo migraines 15.0 [11.0–23.0], U = 38,545.0, p = 0.408). Regarding RTL, significantly lower proportions of athletes in the migraine group had fully RTL, without accommodations, at ≤14 days (77.5% vs. 85.2%, χ2 = 4.33, p = 0.037), ≤21 days (85.3% vs. 93.0%, χ2 = 7.99, p = 0.005), and ≤28 days (88.2% vs. 95.6%, χ2 = 10.60, p = 0.001). Regarding RTP, a significantly lower proportion of athletes in the migraine group RTP at ≤28 days (72.0% vs. 82.7%, χ2 = 5.40, p = 0.020) and ≤56 days (84.0% vs. 93.0%, χ2 = 8.19, p = 0.004). In a multivariable model predicting RTL that was adjusted for age, gender, acute concussion symptoms, and other health variables (e.g., attention-deficit/hyperactivity disorder [ADHD], history of mental health difficulties), pre-injury history of migraine was associated with longer RTL (β = 0.06, p = 0.030). In a multivariable model predicting RTP, pre-injury history of migraine was not associated with RTP (β = 0.04, p = 0.192). In collegiate athletes, pre-injury migraine history was independently associated with longer RTL but not RTP. When comparing the proportions of those with successful RTP by days, significantly lower proportions of those with migraines showed successful RTP at ≤28 days and ≤56 days. Futures studies should study the generalizability of our findings in other school levels. [ABSTRACT FROM AUTHOR]

Objective To examine baseline neurocognitive functioning among adolescent athletes on the autism spectrum based on self-reported level of academic performance. Method Participants in this cross-sectional, observational study were 6,441 adolescent athletes with a self-reported diagnosis of autism who completed pre-season neurocognitive testing using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT); 4,742 reported a co-occurring learning disorder (LD), and 6,612 individuals without autism or LD were included as a control group. The majority (57%) self-reported Average Academic Performance, 39% Above Average, and 4% Below Average performance. Results Athletes with self-reported autism (with or without LD; 12.2%) were 2.74x (95% CI: 2.17–2.82) more likely to fall below cutoffs for ImPACT Embedded Invalidity Indicators (EVIs), with a significant interaction between self-reported Diagnosis and Academic Performance; individuals with co-occurring autism and LD who reported Below Average Academic Performance had the greatest likelihood of scoring below cutoffs (22%), followed by ASD without LD (14.8%) and Controls (14.6%) with Below Average Academic Performance. Analyses of variance (ANOVAs) revealed main effects of Diagnosis and Academic Performance on neurocognitive performance, with interactions on all ImPACT Composite Scores except Processing Speed. Conclusion Athletes with self-reported ASD are more likely to fall below ImPACT EVIs and score worse on ImPACT, with greater likelihood/worse performance related to level of academic functioning. Academic performance should be considered when interpreting neurocognitive testing data, to best index neuropsychological functioning associated with concussion in this population. The current findings highlight the importance of individual participant baseline neuropsychological testing for individuals on the autism spectrum. [ABSTRACT FROM AUTHOR]

Objective The first objective was to establish the respective factor structures of a concussion perceptions inventory that was adapted for youth athletes (ages 8–14 years) and their parents from the Perceptions of Concussion Inventory for Athletes. The second objective was to understand the associations between the concussion perceptions of youth athlete–parent dyads. Method In this cross-sectional study, 329 parent–youth athlete dyads completed a respective concussion perception inventory. Mean age of youth respondents was 10.9 ± 1.8 years (70.1% male) and mean age of parent respondents was 40.5 ± 13.6 years (60.9% female). Results Exploratory factor analyses revealed unique 7-factor structures for both the youth athlete and parent inventories (youth athlete: anxiety, clarity, treatment, permanent injury, symptom variability, long-term outcomes, and personal control; parent: anxiety, clarity, treatment, permanent injury, symptom variability, and long-term outcomes, and affect others). Weak associations were found between dyads on the 5 factors that were composed of identical items (anxiety, clarity, treatment, permanent injury, and symptom variability). Conclusions Findings suggest that this adapted inventory has adequate psychometric properties to be used in the study of the concussion perceptions of youth athletes and their parents. Weak correlations across the concussion perceptions in the dyads suggest that parents and children hold different concussion perceptions and this should be considered in instrument selection of future studies. [ABSTRACT FROM AUTHOR]

Youth with intellectual and developmental disabilities (IDD) aspire to participate in a variety of activities after high school, such as attaining paid employment, enrolling in postsecondary education, being involved in their communities, living independently, and building friendships. However, complex and longstanding transition barriers require comprehensive solutions that are tailored to a local community's unique needs and available resources so that local youth with IDD may achieve their desired outcomes. This article presents "virtual community conversations" as a promising approach for bringing together local communities to tackle barriers to good outcomes for residents with IDD. Attendees were able to effectively generate innovative recommendations for addressing issues in their local communities. We offer recommendations for enhancing and extending implementation of this approach. [ABSTRACT FROM AUTHOR]

Anemia is a common condition in long-distance runners (LDRs). Recently, not only iron deficiency (ID) but also energy deficiency has been considered as a risk factor for anemia in athletes but no evidence has yet been established. The aim of this study was to investigate the prevalence of anemia and ID and the influence of body mass index (BMI) on anemia in high-school LDRs. The participants were 406 male and 235 female elite Japanese LDRs who competed in the All-Japan High-School Ekiden Championship 2019. They submitted their anthropometric data and results of a blood test within five days after the competition. The prevalence of anemia and ID and the influence of BMI on anemia were assessed retrospectively. Mean hemoglobin concentrations (Hb) were 14.8 ± 0.9 g/dl in males and 13.2 ± 0.9 g/dl in females. The prevalence of anemia (Hb < 14 g/dl in males and < 12 g/dl in females) was significantly higher in males (16.3%) than females (6.4%), but males also showed higher prevalence of non-iron deficiency anemia (NIDA) than females (11.6% and 3.0%, respectively). No significant gender difference was found in the prevalence of iron deficiency anemia (IDA) (4.7% in males and 3.4% in females). ID (serum ferritin level < 25 ng/ml) was significantly more prevalent in females (37.4%) than males (18.5%). A binary logistic regression analysis revealed that low BMI was a contributor to anemia in females (odds ratios: 0.577 (95% CI: 0.369–0.901), p = 0.012). In Japanese high-school LDRs, one in six males was anemic, but most males did not have ID. Conversely, one-third of females were diagnosed with ID. Lower BMI was identified as a risk for anemia in females, suggesting that leanness may also lead to anemia in females. [ABSTRACT FROM AUTHOR]

The present study examined the associations of transformational leadership behaviors and team cohesion with the psychological health (life satisfaction, positive and negative affect, and burnout) of athletes and the indirect relationship of basic psychological needs. The sample consisted of 252 (boys) players aged between 13 and 15. The model data fit was also verified. The results demonstrated that the transformational leadership behaviors of coaches were indirectly related to athletes' psychological health. Team cohesion was related to athletes' psychological health both directly and indirectly. Basic psychological needs played an indirect role in these relationships. Transformational leadership and team cohesion have important implications for the healthy development of young people. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, and associated stay-at-home orders, instigated far-reaching disturbances in the lives of student-athletes, which included school closures and sport cancellations. The purpose of the study was to examine first-hand student-athletes' pandemic-related experiences with screen time and mental health. A total of 22 Canadian high school student-athletes were individually interviewed in 2021. Interviews occurred online via videoconferencing and were subjected to a reflexive thematic analysis, which led to the creation of three themes: (a) pandemic life is a major grind, (b) screen time during COVID times: I feel guilty, but what else can I do? and (c) mental health during COVID times: mostly pain, but there is a silver lining. Results are discussed in terms of their implications for research and practice as it pertains to formulating endemic initiatives best supporting the many student-athletes confronting the psychosocial aftereffects of having lived through a global pandemic. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to examine perceptual-cognitive skills across age, gender and elite levels of badminton adolescent athletes. Methods: A total of 57 badminton athletes divided into junior high school athletes (age = 13.36 ± 1.14 years, females = 22, males = 11) and senior high school athletes (age = 16.25 ± 0.84 years, females = 11, males = 13) were evaluated using a cognitive component skills approach. Elite levels were classified as semi-elite (n = 29, score = 3.23) and competitive elite (n = 28, score = 5.84) levels. Each group completed a cognitive test, including an evaluation of their capacity for Corsi block-tapping (CCT) and spatial priming tasks (SPT). Results: No gender effects were found in the perceptual skills of the adolescent players, and the age effect was consistent across gender. For the elite levels, the perceptual-cognitive skills of SPT of reaction time was performed equally in the groups of semi-elite and competitive players, however, in the CCT Span of working-memory (WM), competitive-elite players outperformed semi-elite players. Conclusion: We found that perceptual-cognitive skills of WM play crucial roles in the open-skill sports of badminton. Thus, when developing advanced skills to higher elite levels in adolescent players, perceptual-cognitive skills should be considered. [ABSTRACT FROM AUTHOR]

Abstract\nLay summaryTo develop positive coach-athlete relationships, coaches can acknowledge and support their players’ sociocultural backgrounds (e.g., ethnicities, genders, races). This is particularly important in connecting with marginalized athletes as the history of sport is intertwined with identity politics, racism, and exclusion. To date, little is known about the role of race in coach-athlete relationships from the perspectives of marginalized individuals. The purpose of the current study was to explore the coach-athlete relationships of Black, Canadian university football players and their coaches from the players’ perspectives. We conducted semi-structured interviews with nine Black football players from five Canadian universities coached by individuals of different racial backgrounds. Using a reflexive thematic analysis, we co-created two overarching themes addressing participants’ racialized experiences inside and outside of sport, including their understanding of Blackness, as well as perceptions on how to improve coaches’ cultural literacies. From our findings, we understood that most Black athletes developed strong connections with their Black coaches compared to White or non-Black coaches of color that were characterized by feelings of trust and the ability to express their cultural identity freely. Athletes highlighted the importance of coaches acquiring or strengthening their cultural competency, and provided examples, advice, and descriptions of what they believed constituted an effective coach. By exploring racial aspects of coach-athlete relationships, this study contributes to coaching science literature and cultural sport psychology by emphasizing the need for coaches to develop cultural competency aptitudes when working with diverse athletes.This article examines the importance of cultural awareness when building coach-athlete relationships from the perspective of Black football players in Canadian universities. We discussed the participants’ racialized experiences in sport contexts, the role of race in building coach-athlete relationships, and the importance of improving the cultural literacy of coaches.IMPLICATIONS FOR PRACTICECoaches looking to improve their approaches to building relationships with and meeting the cultural needs of Black athletes should consider engaging in cultural competency education to enhance their knowledge and coaching behaviors.Sport organizations and governing bodies should create more opportunities for coaches and other sport personnel to engage in formal cultural competency education to build knowledge about the intersectionally diverse athletes they work with.Sport scholars should actively seek to expand upon the literature regarding the ways in which race affects the coach-athlete relationship to offer modes of support for athletes who identify as Black.Coaches looking to improve their approaches to building relationships with and meeting the cultural needs of Black athletes should consider engaging in cultural competency education to enhance their knowledge and coaching behaviors.Sport organizations and governing bodies should create more opportunities for coaches and other sport personnel to engage in formal cultural competency education to build knowledge about the intersectionally diverse athletes they work with.Sport scholars should actively seek to expand upon the literature regarding the ways in which race affects the coach-athlete relationship to offer modes of support for athletes who identify as Black. [ABSTRACT FROM AUTHOR]

Background: Despite the many benefits of school meals, not all students participate. One reason students may not participate in school meals is because they instead purchase breakfast or lunch from food outlets located around schools that mostly carry unhealthy items. This study examined whether school participation in the Community Eligibility Provision (CEP), which allows qualifying schools to serve free meals to all students, moderated the association between the community food environment around schools and student meal participation. Methods: This study employed a longitudinal repeated-measures design using school-level data collected between 2014 and 2020 within four low-income school districts (n = 126 schools) in the US. We obtained meal participation data from state records and created a measure characterizing the community food environment within 0.25 miles of schools (characterized as low-density of unhealthy food outlets vs. high-density of unhealthy food outlets) through a latent class analysis. Regression analysis estimated associations between community food environments, CEP participation, and participation rates in school breakfast and school lunch, assessed in separate models. Results: While no moderating effect of school CEP status was observed for breakfast or lunch participation, school breakfast participation was predicted to be 4% lower in high-density food environments than in low-density environments (P-value =.049) among non-CEP schools, and there was no difference in participation by the community food environment among CEP-participating schools. Differences in breakfast participation by the community food environment among non-CEP schools were mostly attributable to middle/high schools, with participation predicted to be 10% lower in high-density environments than in low-density environments among non-CEP middle/high schools (P-value <.001), whereas such a difference in participation was not observed among non-CEP elementary schools. Conclusions: Negative associations between food environment around schools and school breakfast participation were observed only among middle and high schools not participating in CEP, suggesting that policy actions to increase access to free school meals may benefit students, particularly older children and adolescents. [ABSTRACT FROM AUTHOR]