Previous research has shown deficits in vocal emotion recognition in sub-populations of individuals with hearing loss. As emotion recognition is an essential ability that affects social interaction, and in extension, can impact well-being, understanding vocal emotion recognition difficulties is a high priority research topic. Furthermore, it has been shown that although hearing aids improves word recognition, it does not improve emotion recognition. To explore emotion recognition and the effect of amplification in individuals with hearing loss, we examined recognition of vocal emotions expressed both verbally and non-verbally in middle-aged to older individuals with and without linear amplification (similar amplification across sound levels). Twenty-one experienced hearing aid users with bilateral mild-to-moderate hearing loss, and 20 individuals with normal hearing performed a vocal emotion recognition task on sentences and non-verbal vocalizations. The hearing loss group had poorer emotion recognition for both sentences (F(1,38)=15.24, p <0.001, η2p=0.29, without linear amplification, and F(1, 38)= 5.62, p=0.023, η2p=0.13, with linear amplification) and non-verbal vocalizations(F(1,38)= 25.18, p <0.001, η2p=0.40, without linear amplification, and F(1, 38)= 10.30, p=0.003, η2p=0.21, with linear amplification). However, linear amplification significantly improved the recognition of happiness (p < 0.001), which is distinguished by frequency parameters, for sentences. For non-verbal vocalizations, recognition of fear (p = 0.004) and anger (p = 0.004), were improved by linear amplification. Patterns of confusion were similar for the two groups, which may suggest that both groups perceived the emotions similarly, but that the degree of perceptual precision was lower in the hearing loss group. In sum, hearing loss negatively impacts vocal emotion recognition, but linear amplification can enhance recognition for some emotions.

Epidemiological studies suggest that psychiatric disorders are as prevalent amongst high-performance athletes as in general populations, challenging the myth of invulnerability. Despite efforts of sport organisations to highlight the significance of athletes' mental health, it is still many times tough to combine the sport performance ethos with a discourse on mental health. This narrative cornerstone review examines challenges related to definitions and classifications of athlete mental health in high-performance sports and how these influence assessments and the implementation of interventions. We discuss challenges with concept creep and psychiatrisation and outline their consequences for sport healthcare professionals. Based on this, we present a framework that aligns different categories of athlete mental health conditions (from the reduction of wellbeing to psychiatric disorders) with intervention types (from the provision of supporting environments to pharmacotherapy). We conclude that researchers and sport practitioners need to carefully consider conceptual creep and the risk of pathologising normal and healthy, albeit emotionally aversive, reactions to athlete lifeworld events when assessing athlete mental health. A clear separation of terminology denoting the athlete's resources to handle the lifeworld (including salutogenic factors) and terms describing psychiatric conditions and their management is necessary to avoid misguidance in intervention planning.

Enabling athletes to achieve peak performances while also maintaining high levels of health is contextually complex. We aim to describe what a health system is and apply the essential functions of stewardship, financing, provision of services and resource generation to an Australian high-performance sport context. We introduce a fifth function that health systems should not detract from athletes ability to achieve their sports goals. We describe how these functions aim to achieve four overall outcomes of safeguarding the health of the athletes, responding to expectations, providing financial and social protection against the costs of ill health, and efficient use of resources. Lastly, we conclude with key challenges and potential solutions for developing an integrated health system within the overall performance system in high-performance sport.

Objectives To examine whether universal prevention via a digital health platform can reduce the injury incidence in athletics athletes aged 12-15 years and if club size had an influence on the effect of the intervention. Methods This was a cluster randomised trial where young athletics athletes were randomised through their club following stratification by club size into intervention (11 clubs; 56 athletes) and control (10 clubs; 79 athletes) groups. The primary endpoint was time from baseline to the first self-reported injury. Intervention group parents and coaches were given access to a website with health information adapted to adolescent athletes and were encouraged to log in and explore its content during 16 weeks. The control group continued training as normal. Training exposure and injury data were self-reported by youths/parents every second week, that is, eight times. The primary endpoint data were analysed using the log-rank test. Cox proportional hazards regression was used to analyse the second study aim with intervention status and club size included in the explanatory models. Results The proportion of completed training reports was 85% (n=382) in the intervention group and 86% (n=545) in the control group. The injury incidence was significantly lower (HR=0.62; chi(2)=3.865; p=0.049) in the intervention group. The median time to first injury was 16 weeks in the intervention group and 8 weeks in the control group. An interaction effect between the intervention and stratification factor was observed with a difference in injury risk between athletes in the large clubs in the intervention group versus their peers in the control group (HR 0.491 (95% CI 0.242 to 0.998); p=0.049). Conclusions A protective effect against injury through universal access to health information adapted for adolescent athletes was observed in youth athletics athletes. The efficacy of the intervention was stronger in large clubs.

In this study, we examined knowledge and understandingof sport-related injuries among youth athletics (track andfield) athletes and assessed their needs in managing anyhealth problems. Qualitative data were collected via 12focus groups with youth athletes (16–19 years) studying atSwedish sports high schools with an athletics specialism. Allfocus group discussions were audiorecorded and transcribedbefore being analysed using a thematic analysis approach.Four researchers independently reviewed the transcripts,generated codes and developed themes. Three overarchingthemes related to the athletes’ knowledge and understandingof sport-related injury were developed: (1) awareness ofinjuries, (2) perception of injuries, and (3) factors contributingto injuries. The youth athletes were typically uncertain abouthow to acknowledge a sport-related injury. They expressed thatknowledge about injuries was obtained in part by reflecting onthe lived experiences of their peers. It was also demonstratedthat there appears to be a ‘culture of acceptance’ regardinginjury occurrence. In contrast, causes of injuries were viewedas dependent on multiple factors (eg, lack of context-specificknowledge about training practices). Regarding athletes’needs in managing injuries, an additional three themes weredeveloped: (1) creating functioning elite sports environments,(2) application of knowledge and (3) fostering athletes. Anapparent lack of structure and organisation related to theschool environment was identified as an important issueto review to create opportunities for sustainable athleticdevelopment. The study identified areas that can be improvedin Swedish sports high schools with an athletic specialism andcould be applied in other youth sports contexts. The resultsof this study guide school stakeholders, alongside the sportgoverning bodies who have the mandate to influence activitiesin youth sports contexts, whereby special attention should bedirected towards improving the social environment for youthathletes.

Psykiskt mående och prestation går hand i hand och för en långsiktig och hållbar elitidrottskarriär är båda delarna centrala och ofta sammanflätade. Det finns idag ett ökat intresse från idrotten att fördjupa sin kunskap kring psykisk hälsa, samtidigt tycker många att det är ett svårt ämne att få grepp om. I denna artikel försöker vi sammanfatta viktig grundläggande kunskap inom området, för dig som jobbar med eller kommer i kontakt med elitidrottare.

This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18-19 years from Athletics athletes (n = 1322) originating from Africa, Asia, Europe, Oceania, and the Americas. We hypothesised that sports-related and non-sports-related stressors in interaction with structural vulnerability instigate depression. Path modelling using Maximum likelihood estimation was employed for the data analysis. Depression caseness and predisposition were determined using the WHO-5 instrument. Thirty-six percent of the athletes (n = 480) returned complete data. Eighteen percent of the athletes reported lifetime physical abuse, while 11% reported sexual abuse. Forty-five percent of the athletes had recently sustained an injury. The prevalence of depression caseness was 5.6%. Pathways to depression caseness were observed from female sex (p = 0.037) and injury history (p = 0.035) and to predisposition for depression also through exposure to a patriarchal society (p = 0.046) and physical abuse (p < 0.001). We conclude that depression in a global population of young athletes was as prevalent as previously reported from general populations, and that universal mental health promotion in youth sports should include provision of equal opportunities for female and male participants, injury prevention, and interventions for abuse prevention and victim support.

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Background Athletes competing in athletics (track and field) at international level may be participating with underlying undiagnosed life-threatening cardiovascular conditions. Our objective was to analyse variations in pre-participation cardiac evaluation prevalence among athletes participating in two International Association of Athletics Federations (IAAF) World Athletics Championships, with regard to the human developmental level and global region of their home countries, as well as athletes’ age category, gender, event group and medical insurance type.

Design Cross-sectional web-based survey.MethodsA total of 1785 athletes competing in the IAAF World Under 18 Championships Nairobi 2017 and World Championships London 2017 were invited to complete a pre-participation health questionnaire investigating the experience of a pre-participation cardiac examination.

Results A total of 704 (39%) of the athletes participated. Among these, 59% (60% of women; 58% of men) reported that they had been provided at least one type of pre-participation cardiac evaluation. Athletes from very high income countries, Europe and Asia, showed a higher prevalence of at least one pre-participation cardiac evaluation.

Conclusions The prevalence of pre-participation cardiac evaluation in low to middle income countries, and the African continent in particular, needs urgent attention. Furthermore, increases in evaluation prevalence should be accompanied by the development of cost-effective methods that can be adopted in all global regions.

OBJECTIVES: To investigate whether self-reported health complaints and choice of heat stress prevention strategies during the taper predicted peaking at an athletics championship in hot conditions.

DESIGN: Cohort study.

METHODS: Data on health and heat stress prevention were collected before the 2015 World Athletics Championship in Beijing, China. Peaking was defined using the athlete's pre-competition ranking and final competition rank. Baseline and endpoint data were fitted into multiple logic regression models.

RESULTS: Two hundred forty-five (29%) of 841 eligible athletes participated. Both sprint/power (Odds ratio (OR) 0.33 (95% Confidence interval (CI) 0.11 to 0.94), P=0.038) and endurance/combined events (OR 0.38 (95% CI 0.14 to 1.00), P=0.049) athletes having sustained concern-causing health complaints during the taper were less likely to peak. Endurance/combined events athletes who chose pre-cooling to mitigate heat stress were less likely to peak (OR 0.35 (95% CI 0.15 to 0.80), P=0.013), while sprint/power athletes reporting a sudden-onset injury complaint during the taper displayed increased peaking (OR 4.47 (95% CI 1.28 to 15.59), P=0.019).

CONCLUSIONS: Health complaints that caused the athlete concern during the taper were predictive of failure to peak at a major athletics competition. Sprint/power athletes who experienced an acute injury symptom during the taper appeared to benefit from rest. Pre-cooling strategies seem to require further validation during real-world endurance/combined events. It appears that athletics athletes' self-reported health should be monitored during the taper, concerns addressed, and heat stress prevention strategies individually tested before championships in hot conditions.