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Objectives: Student-athletes are unique in their undertaking of full-time academic and athletic roles. Their dual roles impose a multitude of responsibilities in their daily lives, yet little is known about the factors that may negatively impact their ability to effectively manage these responsibilities. Participants: Data from a large sample of Canadian varsity athletes (N = 1,353) were used for the present study. Methods: The association between stress and difficulties managing daily responsibilities, while simultaneously investigating the roles of sleep difficulties and sense of belonging as contributing factors was examined. Results: Findings indicated that the moderated mediation model was significant, revealing that sleep difficulties were a significant mediator in the relationship between stress and difficulties managing daily responsibilities and that sense of belonging moderated the relationship between stress and sleep difficulties. Conclusions: The results expose complex ways that student-athletes' performances (academic and athletic) can be impaired, signaling the need to develop strategic actions toward prevention and management of stress among student-athletes.

Background: EPA and DHA n-3 FA play crucial roles in both neurological and cardiovascular health and high dietary intakes along with supplementation suggest potential neuroprotection and concussion recovery support. Rugby athletes have a high risk of repetitive sub-concussive head impacts which may lead to long-term neurological deficits, but there is a lack of research looking into n-3 FA status in rugby players. We examined the dietary n-3 FA intake through a FFQ and n-3 FA status by measuring the percentage of n-3 FA and O3I in elite Canadian Rugby 7s players to show distribution across O3I risk zones; high risk, <4%; intermediate risk, 4 to 8%; and low risk, >8%., Methods: n-3 FA profile and dietary intake as per FFQ were collected at the beginning of the 2017-2018 Rugby 7s season in male ( n = 19; 24.84 ± 2.32 years; 95.23 ± 6.93 kg) and female ( n = 15; 23.45 ± 3.10 years; 71.21 ± 5.79 kg) athletes., Results: O3I averaged 4.54% ± 1.77, with female athlete scores slightly higher, and higher O3I scores in supplemented athletes (4.82% vs. 3.94%, p = 0.183), with a greater proportion of non-supplemented athletes in the high-risk category (45.5% vs. 39.1%). Dietary intake in non-supplemented athletes did not meet daily dietary recommendations for ALA or EPA + DHA compared to supplemented athletes., Conclusions: Overall, despite supplementation, O3I score remained in the high-risk category in a proportion of athletes who met recommended n-3 FA dietary intakes, and non-supplemented athletes had a higher proportion of O3I scores in the high-risk category, suggesting that dietary intake alone may not be enough and athletes may require additional dietary and n-3 FA supplementation to reduce neurological and cardiovascular risk.

Preventing and treating iron deficiency are important components in the nutritional care of female varsity athletes, as these interventions may improve aerobic endurance and athletic performance. We examined the factors associated with ferritin concentration in 30 female varsity athletes (18-30 years) at the University of British Columbia in Vancouver, Canada. Biochemical indicators of iron and inflammation status, dietary intake, supplementation practices, weight, height, and menstrual blood losses were assessed. Iron deficiency prevalence was 20% ( n = 6/30; inflammation-adjusted ferritin <15 μg/L). Multiple linear regression was used to assess the associations of a number of independent explanatory variables with log-transformed serum ferritin (μg/L) as the continuous outcome variable. A 1-unit increase in body mass index (BMI; kg/m 2 ) was associated with 22% (95% CI: 9%-37%) higher mean ferritin concentrations, and a 1-point increase in menstrual loss score was associated with 1% (95% CI: 1%-2%) lower ferritin concentrations. Hemoglobin and hepcidin concentrations, inflammation biomarkers, consumption of iron supplements in any form or dose for ≥3 days/week, and age were not significantly associated with ferritin concentrations in the final adjusted model. Novelty Estimated monthly menstrual losses and BMI were associated with serum ferritin concentrations in female athletes in our study. These are easy-to-measure, noninvasive measurements that should be considered in the assessment of risk of iron deficiency in female athletes.

Background: Despite the recognised benefits of sport, participation is often reported to be low for youth with intellectual disability (ID). The current study was the first to longitudinally examine sport retention in this population, a critical aspect of ensuring participation., Methods: Study participants were parents/caregivers of athletes with ID involved in community Special Olympics (SO), 11-22 years of age (N = 345). Participants completed an online survey in 2012 that included caregiver demographic and athlete intrapersonal, interpersonal and broader contextual variables. Retention rates for 2019 were determined using the SO provincial registration lists., Results: Of the 345 survey participants, 81.7% remained active athletes in 2019. Caregiver demographic and athlete intrapersonal factors were largely unrelated to retention. In contrast, retention was associated with the frequency and number of sports athletes participated in, the perceived psychosocial gains of SO involvement and the environmental supports that were available to facilitate participation; frequency of sport participation was the strongest predictor of remaining a registered athlete., Conclusions: This study has implications for future initiatives aimed at increasing sport retention in a population that struggles to be engaged in sport. Efforts should focus on the athlete experience and sport-specific factors. Coaches and caregivers can foster positive experiences and play an important role in continued sport participation., (© 2020 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Competing Interests: Competing interests: None declared.

Background: The prevalence of asthma among athletes with intellectual disabilities, and the asthma knowledge levels of their coaches, is unknown., Methods: Special Olympics Canada athletes completed a demographic questionnaire (n = 208). Athletes who identified as having ever or current asthma completed the Asthma Control Questionnaire and the Mini Asthma Quality of Life Questionnaire and were measured for height, weight and lung function (n = 73). National level coaches (n = 27) completed a questionnaire pertaining to asthma knowledge., Results: The prevalence of ever and current asthma were 35.5% (n = 73) and 21.1% (n = 44), respectively. Athletes with asthma reported that they had inadequately controlled asthma, but good quality of life. Coaches correctly answered 43% true/false questions on the survey, indicating suboptimal asthma knowledge., Conclusions: Athletes with intellectual disabilities appear to have a greater prevalence of asthma than the general population; however, coaches of these athletes appear to have limited knowledge pertaining to asthma and exercise-induced asthma., (© 2018 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Background: Injuries to the ulnar collateral ligament (UCL) of the elbow are of major concern in baseball; however, the epidemiology of these injuries among National Collegiate Athletic Association (NCAA) athletes is poorly described., Purpose: To determine the incidence of UCL injuries in NCAA baseball and investigate the risk factors involved., Study Design: Descriptive epidemiology study., Methods: All UCL injuries for academic years 2009-2010 through 2013-2014 were extracted from the NCAA Injury Surveillance Program database. The incidence was calculated for different positions, activity, time in game, competition status, and injury characteristics and compared via injury risk ratios to determine risk factors for injury occurrence. The NCAA provides sampling weights based on division and year. For all other injury characteristic analysis, unweighted data were used., Results: Over the course of the 2009-2010 to 2013-2014, 20 UCL injuries were reported in the NCAA Injury Surveillance Program over 177,992 athletic exposures (AEs) for an overall incidence of 1.12 per 10,000 AEs (95% CI, 0.63-1.62). Eighty-five percent occurred during throwing, and 100% were new injuries. Of the injuries sustained during games, 28.6% occurred early (warm-up through third inning) and 71.4% late (fourth inning or later), with a risk ratio of 1.3 for late-game injuries (95% CI, 0.24-6.44). Of those injured, 45.0% were able to return to play by the next season, while the remainder were out for at least 7 days. Injury was season ending for 15% of athletes (0.17 per 10,000 AEs), and 15% of athletes required surgery., Conclusion: UCL injury is a potentially season-ending, even career-ending, injury among NCAA baseball players. Additionally, while more injuries occurred later in games, the current study revealed no significant difference in injury rates with respect to time in game. Last, the authors found a higher reported rate of extensive time away from sport after UCL injury than previously published studies on this patient population.

Objectives: To document the distribution of sociodemographic markers (race and relative access to wealth) in athletes participating at the summer and Winter Olympic Games (OGs)., Study Design: Cross-sectional descriptive epidemiological study., Methods: Sociodemographic data were collected from publically available resources for all athletes representing four countries (Canada, United States of America, Great Britain and Australia) at the 2014 Sochi Winter OGs and 2016 Rio Summer OGs. The prevalence of white and privately educated athletes were identified for each sport, country, and team with consideration and comparison to the general population. Access indices (i.e. the combined race socio-economic access index [CAI]) were developed to describe the relative distribution of white and privately educated athletes representing each sport, country and team compared to the respective general population., Results: A total of 568 winter and 1643 summer athletes were included in this study. Privately educated athletes constituted 30.3% and 32.7% of winter and summer athletes, respectively; while 94.9% of winter and 81.7% of summer athletes were white. The CAIs of the Canadian, American, British and Australian winter Olympic teams were 0.52, 0.42, 0.61 and 0.45, respectively. The CAIs, for the Canadian, American, British and Australian summer Olympic teams were 0.89, 1.13, 0.82 and 0.83, respectively. Summer and winter sports with the greatest and least racial and socio-economic biases were identified., Conclusion: Racial and socio-economic biases were identified in both summer and winter Olympic sports; predominantly favouring white and privately educated Olympic athletes. These findings prompt further inquiry into barriers for sport-specific participation and advancement, in addition to the practice of providing substantial public resources in support for Olympic sports and athletes., (Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Objective: To determine what proportion of patients experience an exacerbation of their symptoms as a result of premature return to play (RTP) and return to learn (RTL) following sport-related concussions., Design: Retrospective study of electronic medical records from the office-based practice of one family and sport medicine physician who had systematically provided recommendations for cognitive and physical rest based on existing consensus recommendations. Two blinded authors independently reviewed each chart, which included Sport Concussion Assessment Tool (SCAT) and SCAT2 symptom self-report forms to determine whether an athlete had returned to play or learn prematurely. If there was a discrepancy between the 2 reviewers then a third author reviewed the charts., Setting: A sport medicine and family practice in Ontario. The physician assessed sport-related concussions after self-referral or referral from other primary care physicians, teams, and schools., Participants: A total of 170 charts of 159 patients were assessed for sport-related concussion during a 5-year period (April 2006 to March 2011). All participants were students who were participating in sports at the time of injury. There were 41 concussions in elementary students, 95 concussions in high school students, and 34 concussions in college or university students., Main Outcome Measures: Premature RTP and RTL were defined as chart records documenting the recurrence or worsening of symptoms that accompanied the patients' RTP or RTL. Measures were compared using the earliest available SCAT forms and self-reporting., Results: In 43.5% of concussion cases, the patient returned to sport too soon and in 44.7% of concussion cases, the patient returned to school too soon. Patients with a history of previous concussion required more days of rest before being permitted to participate in any physical activity than those patients without a previous history of concussion. Elementary school students required fewer days of rest before being permitted to return to any physical activity compared with high school students and college or university students., Conclusion: Currently, physicians recommend restrictions on mental and physical activity following sport-related concussion. This is done without clear guidelines as to what cognitive rest entails for students. Further research is required to determine how to implement a management plan for student athletes to facilitate complete recovery after concussion., (Copyright© the College of Family Physicians of Canada.)

Background: The relative age effect (RAE) has been reported for a number of different activities. The RAE is the phenomena whereby players born in the first few months of a competition year are advantaged for selection to elite sports. Much of the literature has identified elite male athletics, such as the National Hockey League (NHL), as having consistently large RAEs. We propose that RAE may be lessened in the NHL since the last examination., Methods: We examined demographic and selection factors to understand current NHL selection biases., Results: We found that RAE was weak and was only evident when birth dates were broken into year halves. Players born in the first half of the year were relatively advantaged for entry into the NHL. We found that the RAE is smaller than reported in previous studies. Intraplayer comparisons for multiple factors, including place of birth, country of play, type of hockey played, height and weight, revealed no differences. Players who were not drafted (e.g., free agents) or who played university hockey in North America had no apparent RAE., Conclusion: We found little evidence of an RAE in the current NHL player rosters. A larger study of all Canadian minor hockey intercity teams could help determine the existence of an RAE.

The aims of the present study were to (1) investigate the participation trends for the origin of athletes competing in 100-km ultra-marathons and (2) determine the nationalities of athletes achieving the fastest 100-km race times worldwide. Race times and nationality from 112,283 athletes (15,204 women and 97,079 men) from 102 countries who completed a 100-km ultra-marathon worldwide between 1998 and 2011 were investigated using single- and multi-level regression analyses. The number of finishers increased exponentially, both for women and men. Most of the finishers (73.5%) were from Europe, in particular, France (30.4%). The number of finishers from Japan, Germany, Italy, Poland and the United States of America increased exponentially during the studied period. For women, runners from Canada became slower while those from Italy became faster over time. For men, runners from Belgium, Canada and Japan became slower. Between 1998 and 2011, the ten best race times were achieved by Japanese runners for both women with 457.1 (s = 28.8) min and men with 393.4 (s = 9.6) min. To summarise, most of the finishers in 100-km ultra-marathons originated from Europe, but the best performances belong to Japanese runners. Although East African runners dominate running up to a marathon, Japanese were the best in 100 km.

This study investigated the effects of a self-compassion intervention on negative cognitive states and self-compassion in varsity women athletes. Athletes who self-identified as being self-critical were randomly assigned to a self-compassion intervention (n = 29) or attention control group (n = 22). The self-compassion intervention consisted of a psychoeducation session and writing components completed over a 7-day period. Measures of self-compassion, state self-criticism, state rumination, and concern over mistakes were collected pretreatment, at 1 week posttreatment, and at a 4-week follow-up. A mixed factorial MANOVA with follow-up post hoc tests demonstrated moderate-to-strong effects for the intervention at posttest and follow-up (Wilks's Λ = .566, F (8, 42) = 4.03, p < .01, η2 = .43). The findings demonstrate the effectiveness of the self-compassion intervention in managing self-criticism, rumination, and concern over mistakes. Fostering self-compassionate mind frames is a potential coping resource for women athletes dealing with negative events in sport.

Objective: To determine the nutritional intake of Canadian high-performance athletes., Design: Prospective survey study., Setting: Canadian sport center athletes., Participants: Three hundred twenty-four high-performance athletes (114 males and 201 females; mean age 21.3 +/- 13 years) from 8 Canadian sport centers participated in the study., Intervention: Subjects prospectively completed 3-day dietary records, reporting all food, fluid, and supplement consumption., Main Outcome Measures: Dietary records were analyzed for total calories, macronutrients, and micronutrients for food alone and food plus supplements for all subjects collectively and according to gender and competitive event., Results: Average daily energy intake was 2533 +/- 843 Kcal/day with males consuming more calories than females (2918 +/- 927 and 2304 +/- 713 Kcal/day, respectively; P < 0.05). Both genders consumed below recommended levels. Carbohydrate, protein, and fat accounted for 53%, 19%, and 28% of daily calorie intake, respectively. Average daily carbohydrate and protein intake was 5.1 +/- 1.8 and 1.8 +/- 0.6 g/kg body weight, respectively. Protein intake, but not carbohydrate intake, met recommendations. Supplementation significantly increased athletes' energy, total carbohydrate, protein, and fat intake. Of 17 micronutrients assessed, intake ranged between 120% and 366% of recommended daily intake with food alone and between 134% to 680% of recommended daily intake with supplements., Conclusions: Canadian high-performance athletes do not consume adequate energy or carbohydrates. However, their intake of micronutrients exceed current recommended daily intakes, even when supplements are not considered, indicating that athletes make high-quality food choices. Supplementation significantly increased energy, macronutrient, and micronutrient intake.