The concept of culture and its relationship to athletic training beliefs and practices is virtually unexplored. The changing demographics of the United States and the injuries and illnesses of people ...from diverse backgrounds have challenged health care professionals to provide culturally competent care.
To assess the cultural competence levels of certified athletic trainers (ATs) in their delivery of health care services and to examine the relationship between cultural competence and sex, race/ethnicity, years of athletic training experience, and National Athletic Trainers' Association (NATA) district.
Cross-sectional survey.
Certified member database of the NATA.
Of the 13 568 ATs contacted, 3102 (age = 35.3 +/- 9.41 years, experience = 11.2 +/- 9.87 years) responded.
Participants completed the Cultural Competence Assessment (CCA) and its 2 subscales, Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behavior (CCB), which have Cronbach alphas ranging from 0.89 to 0.92. A separate univariate analysis of variance was conducted on each of the independent variables (sex, race/ethnicity, years of experience, district) to determine cultural competence.
The ATs' self-reported scores were higher than their CCA scores. Results revealed that sex (F(1,2929) = 18.63, P = .001) and race/ethnicity (F(1,2925) = 6.76, P = .01) were indicators of cultural competence levels. However, we found no differences for years of experience (F(1,2932) = 2.34, P = .11) or NATA district (F(1,2895) = 1.09, P = .36) and cultural competence levels.
Our findings provide a baseline for level of cultural competence among ATs. Educators and employers can use these results to help develop diversity training education for ATs and athletic training students. The ATs can use their knowledge to provide culturally competent care to athletes and patients and promote a more holistic approach to sports medicine.
Background
The purpose of this study was to identify if knowledge of concussion differences exists between communities that service underserved, African-American athletes compared to white athletes, ...and to explore differences in concussion knowledge between African-American and white athletes with and without access to an athletic trainer.
Methods
Five hundred seventy-seven adolescent athletes ranging in age from 13 to 18 from 14 schools in the USA completed a one-time pencil and paper survey instrument. Data were collected from September 2014 to April 2015. All athletes included in the study received concussion education implemented (i.e., Centers for Disease Control and Prevention (CDC) Heads UP documents) by state concussion law. Knowledge of concussion scores were determined by summing the total correct responses to the 35 questions. Race (white or African-American) and access to an athletic trainer were the independent variables explored.
Results
White high school athletes have increased concussion knowledge compared to African-American athletes (
p
< 0.001). African-American athletes less frequently recognized all correct signs and symptoms of concussion compared to white athletes. African-American athletes with access to an athletic trainer have more knowledge than African-American athletes without access to an athletic trainer (
p
= 0.003).
Conclusions
White athletes had more concussion knowledge than African-American athletes; however, African-Americans that had access to an athletic trainer at their respective school were more likely to identify the signs and symptoms of concussion compared to African-Americans that did not have access to an athletic trainer. This further accentuates the health disparity that occurs in high school athletics, in regard to the presence of an athletic trainer and their influence on an athlete’s health and safety.
Background: Researchers have begun to focus on age and sex differences in concussion outcomes. Results suggest that younger athletes and female athletes may take longer to recover from a concussion. ...However, little is known about the interactive effects of age and sex on symptoms, neurocognitive testing (NCT), and postural stability.
Hypothesis/Purpose: The purpose of the study was to examine sex and age differences in symptoms, NCT, and postural stability following concussion. We hypothesized that high school and female athletes would have worse symptoms, NCT, and postural stability than college and male athletes, respectively.
Study Design: Cohort study; Level of evidence, 2.
Methods: A total of 296 concussed athletes from a multistate, 2-year study were enrolled in this study. Participants completed the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) and Post-Concussion Symptom Scale (PCSS) at baseline and again at 2, 7, and 14 days after concussion. Participants completed the Balance Error Scoring System (BESS) at 1, 2, and 3 days after concussion.
Results: Female athletes performed worse than male athletes on visual memory (mean, 65.1% and 70.1%, respectively; P = .049) and reported more symptoms (mean, 14.4 and 10.1, respectively) after concussion (P = .035). High school athletes performed worse than college athletes on verbal (mean, 78.8% and 82.7%, respectively; P = .001) and visual (mean, 65.8% and 69.4%, respectively; P = .01) memory. High school athletes were still impaired on verbal memory 7 days after concussion compared with collegiate athletes (P = .001). High school male athletes scored worse on the BESS than college male athletes (mean, 18.8 and 13.0, respectively; P = .001). College female athletes scored worse on the BESS than high school female athletes (mean, 21.1 and 16.9, respectively; P = .001).
Conclusion: The results of the current study supported age differences in memory and sex differences in memory and symptoms and an interaction between age and sex on postural stability after concussion that warrant consideration from clinicians and researchers when interpreting symptoms, specific components of NCT, and postural stability tests. Future research should develop and assess interventions tailored to age and sex differences and include younger (<14 years) participants.
Sex differences in sport-related concussion long-term outcomes Covassin, Tracey; Savage, Jennifer L.; Bretzin, Abigail C. ...
International journal of psychophysiology,
October 2018, 2018-10-00, 20181001, Letnik:
132, Številka:
Pt A
Journal Article
Recenzirano
Approximately 1.6 to 3.8 million recreational and sports-related concussions (SRC) occur each year in the Unites States. Research suggest that female athletes are at a greater risk for a SRC compared ...to male athletes competing in comparable sports (i.e., soccer, basketball). Moreover, female athletes have reported more total symptoms and greater neurocognitive impairments following a SRC. Female athletes have been found to report greater symptom provocation as measured by the Vestibular/Ocular Motor Screening (VOMS), and increased brain activation compared to males. There is a scarcity of research on long-term effects of SRC in male and female athletes. Therefore, the aim of this review article is to summarize the existing literature on sex differences in acute and sub-acute SRC outcomes.
Mandated concussion education has aimed to improve student-athlete knowledge; however, some collegiate student-athletes continue to not disclose concussion. Concussion knowledge may not be the only ...factor influencing reporting, as student-athlete sex, sport, and pressure from external stakeholders (eg, coaches, teammates, fans, parents or family) have all been documented as influencing collegiate concussion-reporting behavior.
To examine factors associated with concussion nondisclosure in collegiate student-athletes.
Cross-sectional study.
Four National Collegiate Athletic Association Division I and two Division II universities.
A total of 1125 collegiate student-athletes completed the survey, and 741 provided viable responses and were included for data analysis.
We used a 10- to 15-minute electronic or paper-and-pencil survey that asked about personal and sport demographics, diagnosed concussions and nondisclosed concussion history, concussion knowledge, and level of agreement regarding pressure to play after a head impact experienced during collegiate sport participation. Significant univariable factors were entered into a multivariable logistic regression analysis.
Sex (P = .005), sport-risk type (P < .001), diagnosed concussion history (P < .001), concussion knowledge (P = .017), and pressure from coaches (P < .001), teammates (P < .001), fans (P = .024), and parents or family (P = .003) were factors associated with concussion nondisclosure in individual univariable logistic regressions. After we conducted multivariable analyses, male sex (P = .001), high concussion-risk sport participation (P = .048), diagnosed concussion history (P < .001), increased concussion knowledge (P = .013), and experiencing pressure from coaches to continue playing after sustaining a hit to the head (P = .002) were factors associated with concussion nondisclosure in collegiate student-athletes.
Our results suggest that concussion-education programs should go beyond the identification of signs and symptoms to include the dangers of continuing to play, long-term consequences, and transparency about concussion protocols. Comprehensive concussion-education programs should involve coaches and athletes to improve the reporting culture.
The aim of this study is to consolidate studies of physiological measures following sport-related concussion (SRC) to determine if a time course of postinjury altered neurobiology can be outlined. ...This biological time course was considered with respect to clinically relevant outcomes such as vulnerability to repeat injury and safe timing of return to physical contact risk.
Systematic review.
PubMed, CINAHL, Cochrane Central, PsychINFO.
Studies were included if they reported original research on physiological or neurobiological changes after SRC. Excluded were cases series <5 subjects, reviews, meta-analyses, editorials, animal research and research not pertaining to SRC.
A total of 5834 articles were identified, of which 80 were included for full-text data extraction and review. Relatively few longitudinal studies exist that follow both physiological dysfunction and clinical measures to recovery.
Modalities of measuring physiological change after SRC were categorised into the following: functional MRI, diffusion tensor imaging, magnetic resonance spectroscopy, cerebral blood flow, electrophysiology, heart rate, exercise, fluid biomarkers and transcranial magnetic stimulation. Due to differences in modalities, time course, study design and outcomes, it is not possible to define a single 'physiological time window' for SRC recovery. Multiple studies suggest physiological dysfunction may outlast current clinical measures of recovery, supporting a buffer zone of gradually increasing activity before full contact risk. Future studies need to use generalisable populations, longitudinal designs following to physiological and clinical recovery and careful correlation of neurobiological modalities with clinical measures.
The purpose of this study was to examine, using a dose-response model, sex differences in computerised neurocognitive performance among athletes with a history of multiple concussions.
Retrospective ...with randomly selected concussion cases from four levels/numbers of previous concussion.
Multicentre analysis of NCAA student-athletes.
Subjects included a total of 100 male and 88 female NCAA athletes.
Sex and four mutually exclusive groups of self-reported concussion history: (1) no history of concussion, (2) one previous concussion, (3) two previous concussions, (4) three or more previous concussions.
Neurocognitive performance as measured by a computerised neurocognitive test battery (Immediate Postconcussion Assessment Cognitive Testing (ImPACT)).
A dose-response gradient was found for two or more previous concussions and decreased neurocognitive performance. Females with a history of two and three or more concussions performed better than males with a history of two (p=0.001) and three or more concussions (p=0.012) on verbal memory. Females performed better than males with a history of three or more concussions (p=0.021) on visual memory. Finally, there was a significant difference for sex on both motor processing speed and reaction-time composite scores. Specifically, males performed worse than females on both processing speed (p=0.029) and reaction time (p=0.04).
The current study provided partial support for a dose-response model of concussion and neurocognitive performance decrements beginning at two or more previous concussions. Sex differences should be considered when examining the effects of concussion history on computerised neurocognitive performance.
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