Recent publications
Starting from the question: “How do mistakes arise in ethnography and how do they influence research trajectories?” this article makes a methodological and practical contribution to the literature on ethnography. I draw on three ethnographic studies spanning 2014 to 2020 carried out in sport organisations. Here, I consider mistakes as charged revelatory moments to unpack three interwoven aspects of mistakes: (a) wishful thinking, (b) the influence of social relationships, and (c) reflexivity. I make the case that mistakes will likely arise from extended participant observation periods. These mistakes can activate attention for similar mistakes in the future and thus limit attention to other unforeseen challenges. Further, I argue that no amount of planning, reading, preparation, and reflexivity can make researchers immune to mistakes when venturing into complex real-world settings and researching with people. Instead, they can lead to a deeper appreciation of the research context.
Wearable technologies open up new avenues for the assessment of individual physical activity behaviour. Particularly, free-living heart rate (HR) data assessed by optical sensors are becoming widely available. However, while an abundancy of scientific information and guidance exists for the processing of raw acceleration data, no universal recommendations for the utilization of continuous HR recordings during free-living conditions are available. Towards Intelligent Health and Well-Being: Network of Physical Activity Assessment (INTERLIVE®) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives towards developing best-practice recommendations in the context of consumer wearables and smartphones. The aim of this scoping review (following PRISMA-ScR procedures) and recommendations was to provide best-practice protocols for deriving individual physical activity profiles from continuous HR recordings by wearables. The recommendations were developed through an initial scoping review, grey literature searches of promotional material and user manuals of leading wearable manufacturers as well as evidence-informed discussions among the members of the INTERLIVE®-network. The scoping review was performed on the generic domains required for physical activity assessment, namely: (1) ‘assessment of maximal heart rate’, (2) ‘determination of basal and/or resting heart rate’ and (3) ‘heart rate-derived intensity zones’, for which we finally included a total of 72, 2 and 11 eligible papers, respectively. Gathering recent knowledge, we provide a decision tree and detailed recommendations for the analysis of free-living HR data to derive individual physical activity profiles. Moreover, we also provide examples of HR-metric calculations that help to illustrate data processing and reporting.
Exercise‐induced muscle damage (EIMD) is characterized by a severe and prolonged decline in force‐generating capacity. However, the precise cellular mechanisms underlying the observed long‐lasting decline in force‐generating capacity associated with EIMD are still unclear. We investigated in vivo force generation and ex vivo Ca²⁺‐activated force generation, Ca²⁺ sensitivity, and myofiber Ca²⁺ handling systems (SR and t‐tubules) in human biceps brachii before and 2, 48, and 96 h after eccentrically muscle‐damaging contractions and in non‐exercised control arm. The force‐generating capacity declined by 50 ± 13% 3 h after exercise and was still not recovered after 96 h. The force‐Ca relationship of skinned myofibers revealed an impaired maximal Ca²⁺‐activated force in MHC I‐fibers, but not MHC II‐fibers 48 h after exercise. Further, Ca²⁺ sensitivity was increased in MHC II‐fibers, which was reversed after incubation with a strong reductant. There was a biphasic increase in SERCA sulfonylation, and a parallel reduction in the SR Ca²⁺ uptake rate, with no effects on SR vesicle leak or SR vesicle Ca²⁺ release rate. T‐tubules showed a progressive increase in the density of longitudinal tubules by 96 h after exercise. In conclusion, MHC II‐fiber Ca²⁺ sensitivity was increased 48 h after exercise, attributed to changes in the REDOX status. 96 h after exercise SR vesicle Ca²⁺ uptake was impaired, and an increased number of longitudinal tubules were observed. These alterations may contribute to the impaired force generation evident at the late stage of recovery.
Overuse injuries are common among competitive rhythmic gymnasts, with an estimated weekly prevalence of 37% and with the knees, lower back, and hip/groin as the most common injury locations. Reduced physical capacity (e.g., strength and flexibility) has been hypothesized to contribute to the high prevalence of overuse injuries. The primary objective of this trial was to assess if exercises targeting reduced physical capacity in the knees, lower back, and hip/groin reduce the prevalence of overuse injuries compared with usual training. Twenty‐three rhythmic gymnastics clubs were cluster‐randomized to an intervention group (IG: 12 clubs and 119 gymnasts) and a control group (CG: 11 clubs and 86 gymnasts). Included gymnasts had to be ≥ 12 years of age and training ≥ 3 days per week. The IG performed a targeted injury prevention program (IPP) during training/warm‐up for 8 months (November 2022 to June 2023). The CG performed usual training. The prevalence of overuse injuries in the targeted locations was measured monthly in both groups using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC‐H2). The response rate to OSTRC‐H2 was 94%. There was no difference in the prevalence of overuse injuries in the targeted locations between the two groups; odds ratio = 0.86 (95% CI 0.32 to 2.29); p = 0.77 for intervention vs. control. The results suggest that a targeted IPP alone is not enough to prevent overuse injuries in the knees, lower back, and hip/groin among competitive rhythmic gymnasts. Other measures (e.g., load management and proper training planning) might be targeted in future studies.
Trial Registration: ClinicalTrials.gov: NCT05506579
Introduction
The aim of this study was to investigate the associations between subjective and objective measures of stress and load in elite male handball players at both the group and individual levels.
Methods
In this 45-week prospective cohort study, 189 elite male handball players weekly reported their perceived stress and load across training, competition, academic, and work domains. Blood samples were collected five times during the 2022/23 season to measure cortisol and the free testosterone to cortisol ratio (FTCR). We derived a “load” variable as the sum of training, competition, academic and work hours and calculated acute, chronic, and acute-to-chronic ratio variables for both load and stress. Associations between subjective and objective measures were analyzed using Spearman’s rank correlation.
Results
Weak to moderate positive associations were found between load and perceived stress ( r = 0.19 to 0.46, p < 0.001), and between perceived stress and cortisol ( r = 0.10, p = 0.023). Weak negative associations were found between perceived stress and FTCR ( r = −0.18 to −0.20, p < 0.001) and between load and FTCR ( r = −0.13, p = 0.003). A total of 86% of athletes had positive associations between stress and load (47% weak, 34% moderate, 5% high); 78% between stress and cortisol (27% weak, 22% moderate, 29% high); and 63% demonstrated negative associations between FTCR and load (18% weak, 32% moderate, 13% high).
Conclusion
This study highlights the complexity between subjective and objective measures of stress and load in athletes. Understanding the link between these measures may help coaches and sports scientists streamline athlete monitoring. In cases where moderate to strong associations exist, subjective measures might serve as a reliable substitute for objective ones, making the monitoring process more time- and cost-efficient.
Introduction
Exercise- Induced Laryngeal Obstruction (EILO) can lead to disabling exercise related dyspnea and hamper participation in physical activity. In this study, we aimed to investigate the effects of a standardized speech therapy protocol as treatment for EILO.
Methods
Patients diagnosed with EILO at our institution were invited to participate. We compared laryngeal findings obtained during a continuous laryngoscopy exercise (CLE) test and questionnaire based self-reported breathing symptoms, before vs. after the treatment intervention. The laryngeal obstruction was characterized using a standardized CLE scoring system (0–12 points).
Results
A total of 28 patients were evaluated. Following speech therapy, the mean reduction in the CLE score was 1.5 (95% confidence interval: 1.1–2.0) points, with the improvement primarily associated with decreased glottic-level obstruction. Twenty-four (86%) patients reported reduced symptoms during exercise. A moderate correlation was observed between changes in CLE scores and subjective symptom improvements.
Conclusion
This study suggests that a standardized speech therapy protocol reduces observed laryngeal obstruction during the CLE test, with the most notable improvement occurring at the glottic level, alongside a parallel reduction in self-reported symptoms of EILO.
How young people interpret and engage with nature is an important consideration within our current biodiversity and climate crises. What remains less clear are the ways in which online, networked, spaces underpin young people's relationships with nature, and what consequences these spaces may have for in‐person nature interactions.
Given the ubiquitousness of networked spaces in society, it has been argued that day‐to‐day life is increasingly ‘postdigital’, in that we may no longer distinguish meaningful differences between our online and offline worlds. Therefore, it is necessary to examine this collapsing physical‐digital binary in the context of young people's in‐person interactions with nature to examine the effectiveness of this theoretical perspective.
Utilising ethnographically situated, participant‐as‐observer methods, this qualitative multiple case study generated data across three rural residential outdoor education centres in England, Scotland and Wales, with young people aged 12–17. Participants were visiting the residential centres from urban schools in England and Scotland, with each group spending 5 days at their respective centre.
Reflexive thematic analysis of fieldnote data revealed that young people had previously constructed their understandings and interpretations of what nature ‘is’ through networked environments such as Instagram, TikTok and Minecraft. These networked constructions often contextualised young people's direct, in‐person interactions with nature and demonstrated ways in which these online spaces influenced how nature was perceived and understood. The case is presented for interpreting the findings from a postdigital ‘networked baselines’ perspective.
The findings will resonate with practitioners and policymakers concerned with the relationships between young people, networked spaces and nature connectedness. Alongside this, given the editorial discussion on the impacts of ‘nature on screen’ from Silk et al. (2021) in People and Nature, this paper provides a set of empirical findings on how young people's organic engagements with nature on‐screen provided a degree of foundational knowledge about what nature is, what nature is for and how nature should be engaged with.
Read the free Plain Language Summary for this article on the Journal blog.
Background : Life expectancy free of cancer (LEFC) is a novel measure that considers both morbidity and mortality and could be a useful metric for disease surveillance and risk communication. We aimed to examine the association between physical activity and LEFC in British adults. Methods : This was a prospective cohort study of 292,559 apparently healthy UK Biobank participants (mean [SD] age, 56.0 [8.1] y, 51% women). Participants were categorized based on self-reported physical activity as “no activity” (0 min/wk), “insufficiently active” (10–599 metabolic equivalent-min/wk), “active” (600–1199 metabolic equivalent-min/wk), and “very active” (>1200 metabolic equivalent-min/wk). Hazard ratios from multistate models for transitions between 3 states (cancer-free, cancer diagnosis, and all-cause mortality) were used to calculate differences in predicted remaining LEFC across physical activity levels for men and women at ages 45 and 65 years. Results : During a median follow-up of 11.0 years, we recorded 13,143 cancer cases for men and 10,255 for women, and 6488 deaths for men and 3739 for women. At age 45, “insufficiently active,” “active,” and “very active” had a higher LEFC by 2.35, 2.46, and 2.76 years compared with “no activity,” and by 1.44, 1.62, and 1.84 years at age 65. In women, the “insufficiently active,” “active,” and “very active” had a higher LEFC by 1.09, 1.42, and 1.59 years at age 45, and by 1.25, 1.54, and 1.71 years at age 65. Conclusions : Engaging in physical activity, even below recommended levels, appears to extend cancer-free years of life. Promoting physical activity is an important strategy for cancer prevention.
The maximal oxygen uptake (V̇O2max) is typically higher in endurance‐trained adolescents than in non‐endurance‐trained peers. However, the specific mechanisms contributing to this remain unclear, as well as the impact of training during this developmental stage. This study aims to compare V̇O2max and cardiovascular functions between 12‐year‐old endurance athletes and non‐endurance‐trained over a 14‐month period. Anthropometrics, V̇O2max, hemoglobin mass (Hbmass), blood volume (BV), and left‐ventricular morphology were assessed four times over the 14 months in a group of young cross‐country skiers (END, n = 42, age: 12.4 ± 0.5, girls: n = 27) and a group of controls (CON, n = 26, age: 12.3 ± 0.3, girls: n = 15). Throughout the 14‐month follow‐up, END did more weekly training than CON (7.0 ± 2.3 vs. 2.5 ± 2.4 h, p < 0.001), with only END conducting endurance training. END had ~18% higher V̇O2max relative to fat‐free mass (FFM) than CON (p < 0.001). Stroke volume (SV) and left ventricular end‐diastolic volume (LV EDV) relative to FFM were also higher for END than CON (p < 0.001 and 0.004), while no significant differences were found for Hbmass and BV. No significant interaction was seen for group and time for V̇O2max (p = 0.352–0.767) or any cardiovascular parameters (p = 0.131–0.956) in absolute measures or relative to FFM. In conclusion, the END group exhibited higher V̇O2max, LV EDV, and SV compared to the CON group, with no significant difference in BV and Hbmass. Despite substantial differences in training volume, the progression of these variables over the 14‐month period was similar in both groups.
Nutritional epidemiology aims to link dietary exposures to chronic disease, but the instruments for evaluating dietary intake are inaccurate. One way to identify unreliable data and the sources of errors is to compare estimated intakes with the total energy expenditure (TEE). In this study, we used the International Atomic Energy Agency Doubly Labeled Water Database to derive a predictive equation for TEE using 6,497 measures of TEE in individuals aged 4 to 96 years. The resultant regression equation predicts expected TEE from easily acquired variables, such as body weight, age and sex, with 95% predictive limits that can be used to screen for misreporting by participants in dietary studies. We applied the equation to two large datasets (National Diet and Nutrition Survey and National Health and Nutrition Examination Survey) and found that the level of misreporting was >50%. The macronutrient composition from dietary reports in these studies was systematically biased as the level of misreporting increased, leading to potentially spurious associations between diet components and body mass index.
Introduction
Repetitive head impacts (RHI) in sports may represent a risk factor for long-term cognitive and neurological sequelae. Recent studies have identified an association between playing football at the top level and an elevated risk of cognitive impairment and neurodegenerative disease. However, these were conducted on men, and there is a knowledge gap regarding these risks in female athletes. This study aims to investigate the effect of head impacts on brain health in female former top-level football players.
Methods and analysis
This is a prospective cohort study, enroling female former football players and top-level athletes from sports without an inherent risk of RHI. All participants are born in 1980 or earlier. We plan to perform follow-up assessments at least three times over 20 years.
The protocol includes neurocognitive assessments, self-reported neurocognitive outcomes, neurological examination, advanced brain MRI, and fluid biomarkers.
Ethics and dissemination
The study has been approved by the South-East Regional Ethics Committee for Medical Research in Norway (2023/178330) and the Norwegian Agency for Shared Services in Education and Research (SIKT). A Data Protection Impact Assessment was developed by the research group and approved by SIKT and the Norwegian School of Sport Sciences. We will disseminate the results through peer-reviewed publications, academic conference presentations and webinars. We will communicate with the public and key stakeholders in football worldwide to inform and promote the development and implementation of potential preventive measures based on our study findings.
School sport programs for lower secondary school in Finland (i.e., Grades 7–9) show great promise in helping student athletes prepare for careers in both sport and academic pursuits. However, it has also been found that participation in these programs is highly competitive and demanding and may result in poor mental health outcomes like burnout for some students. The purpose of the current study was to investigate how burnout in sport and school in Finnish lower secondary school students was associated with gender, age, training loads, level of competition, and sport type. A sample of 856 lower secondary school students (Grades 7–9, ages 13–15 years old) completed measures of sport and school burnout and provided information on their demographics and sport. Gender, age, training loads, level of competition, and sport type predicted a small but significant portion of variance in sport‐related exhaustion, cynicism, and inadequacy, and in school‐related exhaustion, but not school cynicism or inadequacy. Females and student athletes with higher training loads generally reported higher levels of burnout, while only a small number of effects related to age, competition level, and type of sport were observed. Lower secondary sports schools in Finland might aim to understand the difficulties encountered by student athletes, particularly females and those with higher training loads. This understanding can guide them in taking informed, practical measures to safeguard the mental health of these students and optimize their performance both academically and athletically.
Background
Although anthracycline-related cardiotoxicity is widely studied, only a limited number of echocardiographic studies have assessed cardiac function in breast cancer survivors (BCSs) beyond ten years from anthracycline treatment, and the knowledge of long-term cardiorespiratory fitness (CRF) in this population is scarce. This study aimed to compare CRF assessed as peak oxygen uptake (V̇O2), cardiac morphology and function, and cardiovascular (CV) risk factors between long-term BCSs treated with anthracyclines and controls with no history of cancer.
Methods
The CAUSE (Cardiovascular Survivors Exercise) trial included 140 BCSs recruited through the Cancer Registry of Norway, who were diagnosed with breast cancer stage II to III between 2008 and 2012 and had received treatment with epirubicin, and 69 similarly aged activity level-matched controls. All the participants underwent blood sampling, blood pressure measurements, echocardiography and cardiopulmonary exercise testing from October 2020 to August 2022.
Results
BCSs were aged 59 ± 6 years and had received a cumulative dose of 357 (243 to 366) mg/m² of epirubicin on average 11 ± 1 years before inclusion. There was no difference between BCSs and controls with respect to peak V̇O2 (27.6 ± 5.4 mL/kg/min vs. 27.1 ± 5.4 mL/kg/min, P = 0.25), 2D left ventricular ejection fraction (57 ± 3% vs. 57 ± 3%, P = 0.43), left ventricular global longitudinal strain (-20.5 ± 1.0% vs. -20.6 ± 1.0%, P = 0.46) or the proportion with N-terminal pro-brain natriuretic peptide ≥ 125 (22% vs. 20%, P = 0.93). The proportions with hypertension, dyslipidemia or diabetes did not differ between the groups.
Conclusion
We found that CRF, cardiac function, and CV risk profile in BCSs examined a decade after treatment with anthracyclines were similar to that in women with no history of cancer.
Trial registration
clinicaltrials.gov (NCT04307407) https://clinicaltrials.gov/ct2/show/NCT04307407.
The study examined burnout profiles in adolescent student-athletes based on sport and school burnout symptoms. We explored whether psychological distress, self-esteem, athletic identity, and student identity were associated with these profiles, accounting for age, gender, and type of sport. Participants included 642 student-athletes from Grades 8–10 (age 12–14, 57% males and 43% females) in eight Norwegian sport schools. Using latent profile analysis, we identified five profiles: mild sport and school burnout (46%), high burnout (22.5%), well-functioning (17.9%), predominantly school burnout (8.6%), and predominantly sport burnout (5%). Female student-athletes and those in Grades 9–10 were more at risk. Low self-esteem and high psychological distress increased the likelihood of burnout in sport and school, while a strong student identity seemed to protect against school burnout. These findings suggest that combining competitive sport with education at an early age may put student-athletes at risk for burnout symptoms in sport and school.
Background
The rate of subjective failure after isolated primary posterior cruciate ligament reconstruction (PCL-R) is relatively high, requiring an improved understanding of factors associated with inferior outcomes.
Purpose
To determine the association between patient and injury-related factors and total (surgical and clinical) failure at 2 years after PCL-R based on data from the Swedish National Knee Ligament Registry (SNKLR) and the Norwegian Knee Ligament Registry (NKLR).
Study Design
Cohort study; Level of evidence, 3.
Methods
Patients with primary isolated PCL-R registered between January 1, 2004 (NKLR), or January 1, 2005 (SNKLR), and December 31, 2020, were included. The primary study outcome was the risk of PCL-R failure at the 2-year follow-up, either surgical (≤2 years of index surgery) or clinical (Knee injury and Osteoarthritis Outcome Score [KOOS] Quality of Life subscale [QoL] <44) failure. Risk factors for failure were estimated utilizing univariable and multivariable logistic regression analyses.
Results
Among the 189 included patients (36.0% from the SNKLR and 64.0% from the NKLR), the rate of 2-year surgical failure was 5.8%, while the rate of clinical failure was 45.0%. Multivariable analysis showed a negative association between the baseline KOOS QoL and the risk of PCL-R failure (OR, 0.74; 95% CI, 0.57-0.97; P = .027). Univariable analysis indicated a positive association between traffic-related injury mechanism and PCL-R failure risk (OR, 3.11; 95% CI, 1.48-6.50; P = .0026), with a further positive association shown in the adjusted (OR, 6.08; 95% CI, 2.00-18.50; P = .0015) and multivariable (OR, 6.11; 95% CI, 2.01-18.55; P = .0014) models. An area under the curve of 0.70 (95% CI, 0.60-0.80) was reported for the final multivariable model, implying at best poor to acceptable ability of the model to estimate PCL-R failure risk based on the variables considered.
Conclusion
Patients with isolated primary PCL-R had a high (45%) rate of short-term clinical failure, and traffic-related injury was associated with increased odds of failure. No modifiable risk factors were determined as potential predictors of failure. Clinicians treating patients with isolated PCL-R associated with a traffic-related injury mechanism should be aware of a >6-fold increased odds of revision surgery and inferior knee-related quality of life at short-term follow-up.
Humans have, throughout history, faced periods of starvation necessitating increased physical effort to gather food. To explore adaptations in muscle function, 13 participants (7 males and 6 females) fasted for seven days. They lost 4.6 ± 0.3 kg lean and 1.4 ± 0.1 kg fat mass. Maximal isometric and isokinetic strength remained unchanged, while peak oxygen uptake decreased by 13%. Muscle glycogen was halved, while expression of electron transport chain proteins was unchanged. Pyruvate dehydrogenase kinase 4 (PDK4) expression increased 13-fold, accompanied by inhibitory pyruvate dehydrogenase phosphorylation, reduced carbohydrate oxidation and decreased exercise endurance capacity. Fasting had no impact on 5’ AMP-activated protein kinase (AMPK) activity, challenging its proposed role in muscle protein degradation. The participants maintained muscle strength and oxidative enzymes in skeletal muscle during fasting but carbohydrate oxidation and high-intensity endurance capacity were reduced.
Prospectively collected injury surveillance data are essential for designing and implementing injury prevention programmes. We investigated the incidence, characteristics and patterns of professional football injuries in Qatar, providing details on the most observed injuries’ burden. We prospectively recorded individual time-loss injuries and training/match exposure from 17 professional football teams in Qatar during 8 seasons (2014/15 to 2021/22). Injury definitions and data collection procedures followed the 2006 consensus statement and results reported according to the 2020 IOC consensus statement on football injuries and methodology of epidemiological studies on injuries, respectively. In total, 1466 players with 4789 registered injuries were followed. The overall injury burden was 129 [95% CI: 128–130] days/1000 h. Over the 8 seasons there was a significant decreasing trend in the incidence of gradual onset injuries (p = 0.0012) and a non-significant decreasing trend for suddenonset match injuries (p = 0.063). The injury burden for match injuries was greater than the burden resulting from training injuries (460 [95% CI: 460–460] vs 56 [95% CI: 55–57] days/1000 h, p < 0.0001). There was no difference in time loss between index and recurrent injuries. Hamstring muscle strain represented the most frequent injury with a median of 11 (inter-quartile 5–20) days to return to play (RTP). ACL complete tear was the most impactful injury, in term of return to play, with a median of 200 (116–253) days to RTP. Re-injuries constituted 10.8% (4.7% of exacerbations). Mean illness incidence was 1.1 (SD = 0.4) illness/1000 hours, representing 5 illnesses per squad per season, with no variation over time. Qatari professional football is characterized by an overall injury pattern and risk similar to Asian and European norms. There was a significant decreasing trend in the incidence of gradual onset injuries and a non-significant decreasing trend for sudden-onset match injuries.
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