Background: Preventive and scalable interventions, accessible to all, to counteract childhood obesity are urgently needed. We have recently developed a novel, digital parental intervention (MINISTOP 2.0 app) available in Swedish, Somali, Arabic and English. We have previously reported its positive effects on children's health behaviors and on parental self-efficacy. However, before introducing the app at scale in primary child healthcare, implementation aspects also need to be explored.

Aim: This study aims to explore and describe user experiences as well as acceptability and feasibility of the MINISTOP 2.0 app-based intervention in a diverse group of parents (end-users) and Swedish child healthcare nurses (implementers).

Methods: Individual interviews were conducted with Swedish- (n = 9), Somali- (n = 9), Arabic- (n = 5) and English-speaking (n = 1) parents as well as Swedish primary child healthcare nurses (n = 15). Data was analyzed using content analysis with an inductive latent approach.

Results: Parents described how the app facilitated behavior change through increased awareness regarding current diet and physical activity behaviors. Furthermore, the evidence-based app content further facilitated trust and behavior change. Both parents and nurses acknowledged the app's preventive potential and the potential for reaching parents with diverse backgrounds or in need of extra support.

Conclusion: The MINISTOP 2.0 app was perceived as a useful tool for health promotion both by parents and healthcare professionals, especially since it was adapted to several languages. These findings coupled with the previously shown beneficial effects on health behaviors support the large-scale implementation of the app in primary child healthcare.

A sports-related concussion (SRC) is most commonly sustained in contact sports, and is defined as a mild traumatic brain injury. An exercise-induced elevation of core body temperature is associated with increased brain temperature that may accelerate secondary injury processes following SRC, and exacerbate the brain injury. In a recent pilot study, acute head-neck cooling of 29 concussed ice hockey players resulted in shorter time to return-to-play. Here, we extended the clinical trial to include players of 19 male elite Swedish ice hockey teams over five seasons (2016-2021). In the intervention teams, acute head-neck cooling was implemented using a head cap for ≥45 min in addition to the standard SRC management used in controls. The primary endpoint was time from SRC until return-to-play (RTP). Sixty-one SRCs were included in the intervention group and 71 SRCs in the control group. The number of previous SRCs was 2 (median and interquartile range [IQR]: 1.0-2.0) and 1 (IQR 1.0-2.0) in the intervention and control groups, respectively; p = 0.293. Median time to initiate head-neck cooling was 10 min (IQR 7-15; range 5-30 min) and median duration of cooling was 45 min (IQR 45-50; range 45-70 min). The median time to RTP was 9 days in the intervention group (IQR 7.0-13.5 days) and 13 days in the control group (IQR 9-30; p < 0.001). The proportion of players out from play for more than the expected recovery time of 14 days was 24.7% in the intervention group, and 43.7% in controls (p < 0.05). Study limitations include that: 1) allocation to cooling or control management was at the discretion of the medical staff of each team, decided prior to each season, and not by strict randomization; 2) no sham cap was used and evaluations could not be performed by blinded assessors; and 3) it could not be established with certainty that injury severity was similar between groups. While the results should thus be interpreted with caution, early head-neck cooling, with the aim of attenuating cerebral hyperthermia, may reduce post-SRC symptoms and lead to earlier return-to-play in elite ice hockey players.

Background: Traumas to the head and neck are common in sports and often affects otherwise healthy young individuals. Sports-related concussions (SRC), defined as a mild traumatic brain injury (mTBI), may inflict persistent neck and shoulder pain, and headache, but also more complex symptoms, such as imbalance, dizziness, and visual disturbances. These more complex symptoms are difficult to identify with standard health care diagnostic procedures.

Objective: To investigate postural control in a group of former elite athletes with persistent post-concussive symptoms (PPCS) at least 6 months after the incident.

Method: Postural control was examined using posturography during quiet stance and randomized balance perturbations with eyes open and eyes closed. Randomized balance perturbations were used to examine motor learning through sensorimotor adaptation. Force platform recordings were converted to reflect the energy used to maintain balance and spectrally categorized into total energy used, energy used for smooth corrective changes of posture (i.e., <0.1 Hz), and energy used for fast corrective movements to maintain balance (i.e., >0.1 Hz).

Results: The mTBI group included 20 (13 males, mean age 26.6 years) elite athletes with PPCS and the control group included 12 athletes (9 males, mean age 26.4 years) with no history of SRC. The mTBI group used significantly more energy during balance perturbations than controls: +143% total energy, p = 0.004; +122% low frequency energy, p = 0.007; and +162% high frequency energy, p = 0.004. The mTBI subjects also adapted less to the balance perturbations than controls in total (18% mTBI vs. 37% controls, p = 0.042), low frequency (24% mTBI vs. 42% controls, p = 0.046), and high frequency (6% mTBI vs. 28% controls, p = 0.040). The mTBI subjects used significantly more energy during quiet stance than controls: +128% total energy, p = 0.034; +136% low-frequency energy, p = 0.048; and +109% high-frequency energy, p = 0.015.

Conclusion: Athletes with previous mTBI and PPCS used more energy to stand compared to controls during balance perturbations and quiet stance and had diminished sensorimotor adaptation. Sports-related concussions are able to affect postural control and motor learning.

Of the medals awarded at the 2022 Winter Olympics in Beijing, 24% were for events involving cross-country skiing, the biathlon and Nordic combined. Although much research has focused on physiological and biomechanical characteristics that determine success in these sports, considerably less is yet known about the resistive forces. Here, we specifically describe what is presently known about ski-snow friction, one of the major resistive forces. Today, elite ski races take place on natural and/or machine-made snow. Prior to each race, several pairs of skis with different grinding and waxing of the base are tested against one another with respect to key parameters, such as how rapidly and for how long the ski glides, which is dependent on ski-snow friction. This friction arises from a combination of factors, including compaction, plowing, adhesion, viscous drag, and water bridging, as well as contaminants and dirt on the surface of and within the snow. In this context the stiffness of the ski, shape of its camber, and material composition and topography of the base exert a major influence. An understanding of the interactions between these factors, in combination with information concerning the temperature and humidity of both the air and snow, as well as the nature of the snow, provides a basis for designing specific strategies to minimize ski-snow friction. In conclusion, although performance on “narrow skis” has improved considerably in recent decades, future insights into how best to reduce ski-snow friction offer great promise for even further advances.

One of the today’s greatest challenges is to adjust our behavior so that we can avoid a major climate disaster. To do so, we must make sacrifices for the sake of the environment. The study reported here investigates how anchors (extrinsic motivational-free information) and normative messages (extrinsic motivational information) influence people’s tradeoffs between travel time and carbon dioxide (CO2) emissions in the context of car travel and whether any interactions with environmental concern (an intrinsic motivational factor) can be observed. In this study, people received either a CO2, health or no normative message together with either a high anchor, a low anchor, or no anchor. People that received both a high anchor and a CO2 emission normative message were willing to travel for a longer time than those that only received a high anchor. If a low anchor was presented, no differences in willingness to travel for a longer time were found between the three different conditions of normative message groups, i.e., CO2 normative message, health normative message, or no normative message. People with higher concern for the environment were found to be willing to travel for a longer time than those with lower concern for the environment. Further, this effect was strongest when a high anchor was presented. These results suggest that anchors and normative messages are among the many factors that can influence people’s tradeoffs between CO2 emission and travel time, and that various factors may have to be combined to increase their influence over pro-environmental behavior and decisions.

Objective: There are few methods that focus on therapists' experiences of supervision. To facilitate the development of psychologist students, a supervisee-centred supervision, based on deliberate practice, feedback informed treatment and self-compassion, was introduced.

Methods: This study examines six supervisees’ experiences of a supervisee-centred supervision. A semi- structured interview was used for the collection of the data, which identified two main themes: Learning and Development and five associated sub-themes: structure and purposesfulness, prerequisites, experience-based learning, therapeutic skills and personal development.

Conclusion: The experience- and feedback-based approach was perceived as efficient, structured and goal oriented. This created high-focused activity and participation, a strong group dynamic and a good alliance with the supervisors, providing a good climate for learning and development. Focusing on performance and feedback was perceived as a potential obstacle that could create stress and anxiety.

Background

Research is limited about how the introduction of new ways of delivering and conducting occupational therapy, in accordance with expected changes in health care, is experienced by occupational therapists (OTs).

Aim

To explore how OTs experienced use of a new internet-based intervention, ‘Strategies for Empowering activities in Everyday life’ (SEE), focusing on supporting client resources to manage an active everyday life after stroke.

Material and methods

A focus group study with periodical repeated discussion was designed. Four sessions during a period of 22 months were conducted with a total of four OTs.

Result

Overall, the results reflected that the OTs experienced that the use of SEE for persons with stroke was a valuable complement to existing rehabilitation. The process of introducing SEE included a multifaceted transition involving context, intervention process and delivery that renewed occupational therapy.

Conclusion

These results indicate how the use of new internet-based interventions such as SEE can influence and support renewal of occupational therapy that extends beyond the particular intervention. Continued research is needed to explore more aspects of SEE feasibility.

Background Performance of high-intensity interval training (HIIT) by children and adolescents improves physical and health-related fitness, as well as cardiometabolic risk factors.

Objectives To assess the impact of HIIT performed at school, i.e. both in connection with physical education (intra-PE) and extracurricular sports activities (extra-PE), on the physical fitness and health of children and adolescents.

Methods PubMed and SPORTDiscus were searched systematically utilizing the following criteria for inclusion: (1) healthy children and adolescents (5–18 years old) of normal weight; (2) HIIT performed intra- and/or extra-PE for at least 5 days at an intensity ≥ 80% of maximal heart rate (HRmax) or peak oxygen uptake (VO2peak) or as Functional HIIT; (3) comparison with a control (HIIT versus alternative interventions); and (4) pre- and post-analysis of parameters related to physical fitness and health. The outcomes with HIIT and the control interventions were compared utilizing Hedges’ g effect size (ES) and associated 95% confidence intervals.

Results Eleven studies involving 707 participants who performed intra-PE and 388 participants extra-PE HIIT were included. In comparison with the control interventions, intra-PE HIIT improved mean ES for neuromuscular and anaerobic performance (ES jump performance: 5.89 ± 5.67 (range 1.88–9.90); ES number of push-ups: 6.22 (range n.a.); ES number of sit-ups: 2.66 ± 2.02 (range 1.24–4.09)), as well as ES fasting glucose levels (− 2.68 (range n.a.)) more effectively, with large effect sizes. Extra-PE HIIT improved mean ES for neuromuscular and anaerobic performance (ES jump performance: 1.81 (range n.a.); ES number of sit-ups: 2.60 (range n.a.)) to an even greater extent, again with large effect sizes. Neither form of HIIT was more beneficial for parameters related to cardiorespiratory fitness than the control interventions.

Conclusion Compared to other forms of exercise (e.g. low-to-moderate-intensity running or walking), both intra- and extra-PE HIIT result in greater improvements in neuromuscular and anaerobic performance, as well as in fasting levels of glucose in school children.

Data on orienting and habituation to irrelevant sound can distinguish between task-specific and general accounts of auditory distraction: Distractors either disrupt specific cognitive processes (e.g., Jones, 1993;Salamé & Baddeley, 1982), or remove more general-purpose attentional resources from any attentiondemanding task (e.g., Cowan, 1995). Tested here is the prediction that there is no further auditory distraction effect on immediate serial recall with increments in the number of distractors beyond the“changing-state point” of two discrete distractors. A Bayes factor analysis refutes this nil hypothesis: This prediction, a key element of the strong changing-state hypothesis, is shown to be less likely than two competing alternatives. Quantitative predictions for distraction as a function of the number of distracters are derived for an orienting-response (OR) and a stimulus-mismatch (SMM) hypothesis, representing general and task-specific accounts respectively. The data are shown to be more likely under the SMM hypothesis. Prospects for a parametric account of auditory distraction are considered. © 2021 American Psychological Association

Våra barn blir alltmer stillasittande, vilket får livslånga konsekvenser. En av de enklaste lösningarna står föräldrar i vägen för – på grund av rädsla. Föräldrarnas välvilja är i själva verket ett tydligt hot mot barnens hälsa, både i trafiken och genom livet. Sverige behöver en ny nationell rekommendation för aktiva skolresor, skriver åtta forskare och organisationer.

With the inclusion of play as a right, schools are urged to consider whether all children can access play opportunities in schoolyards. Refocusing on play as occupation is identified as an important way in which occupational therapists can contribute within schools. Greater knowledges of children’s play and teachers’ practices, in schoolyards in an Irish context, is required however to guide practices. This inquiry used interviews to explore with 10 primary school teachers, their practices, and experiences of children’s play in Irish schoolyards. Reflexive thematic analysis was used to generate three interrelated themes. These were a) Break(in)time: Play in schoolyards as different from other ways of doing within schools, b) play as producing inclusion and exclusion, c) and certainties and uncertainties produced in teachers’ everyday practices. This inquiry generated knowledges on the social nature of children’s play and teachers” practices in Irish schoolyards as negotiated processes, interacting with diverse intentions, and the particularities of each schoolyard. The consequences of individualizing choice were highlighted as central to the production of inclusion and exclusion in schoolyards. Greater consideration of how children’s play and teachers” practices occur as collective occupations, is proposed to advance inclusive schoolyards. 

Irish Traveller children, an ethnic indigenous minoritized community in Ireland are identified in Ireland’s play policy as at higher risk of exclusion from realising their right to play, alongside a reported absence of research on indigenous children’s play. This scoping review aimed to identify the breadth and scope of available research on representations of Irish Traveller children’s play and the factors influencing play opportunities. Applying the updated Joanna Briggs Institute methodological guidance, a systematic search was completed of nine databases. Thirty-five peer reviewed studies met the inclusion criteria, descriptive study information was charted and summarised and enabling and restricting factors influencing Irish Traveller children’s play were identified using an existing conceptual model. The scoping review findings revealed a limited focus within research on Irish Traveller children’s play. Included studies however, provided evidence of; the importance of feeling a sense of belonging and safety to enable Irish Traveller children’s access to preferred play opportunities, involving real life activities, physical play outdoors and play with others; Irish Traveller parents value and facilitation of play; and the significant restricting influence of racism on Irish Traveller children’s play .Limited knowledge on Irish Traveller children’s own perspectives on play and the need to address racism as a restricting influence on play in school and community environments are considered in relation to practice and further research. Discourses representing Irish Traveller children as marginalised, were problematized as reflective of culturist assumptions, and a shift towards understanding the situated nature of Irish Traveller children’s play, as a capability is proposed.

Ski mountaineering, a new Olympic winter sport involving both climbing and descending snowy slopes, requires considerable physical and technical abilities, as well as highly specialized equipment. Herein, we briefly describe this equipment and its influence on performance and consider potential future advances. Skis, boots, and bindings must be light enough to facilitate climbing uphill (in which as much as 85% of the total racing time is spent) and, at the same time, provide stability and safety in often-challenging descents. A skier must be able to easily and rapidly attach and remove the adhesive skins under the skis that provide grip while skiing uphill. Poles and their baskets must be designed optimally to transfer propulsive force and help maintain balance. Despite the popularity of ski mountaineering, research on this sport is scarce, and we indicate a number of areas wherein improvements in equipment could potentially advance both performance and safety. Such advances must be based on a better understanding of the biomechanics of ski mountaineering, which could be obtained with novel sensor technology and can be best achieved via more extensive collaboration between researchers, skiers and their coaches, and manufacturers of ski mountaineering equipment.

Ski mountaineering is a rapidly growing winter sport that involves alternately climbing and descending slopes and various racing formats that differ in length and total vertical gain, as well as their distribution of downhill and uphill sections. In recent years, both participation in and media coverage of this sport have increased dramatically, contributing, at least in part, to its inclusion in the 2026 Winter Olympics in Milano-Cortina. Here, our aim has been to briefly describe the major characteristics of ski mountaineering, its physiological and biomechanical demands, equipment, and training/testing, as well as to provide some future perspectives. Despite its popularity, research on this discipline is scarce, but some general characteristics are already emerging. Pronounced aerobic capacity is an important requirement for success, as demonstrated by positive correlations between racing time and maximal oxygen uptake and oxygen uptake at the second ventilatory threshold. Moreover, due to the considerable mechanical work against gravity on demanding uphill terrain, the combined weight of the athlete and equipment is inversely correlated with performance, prompting the development of both lighter and better equipment in recent decades. In ski mountaineering, velocity uphill is achieved primarily by more frequent (rather than longer) strides due primarily to high resistive forces. The use of wearable technologies, designed specifically for analysis in the field (including at elevated altitudes and cold temperatures) and more extensive collaboration between researchers, industrial actors, and coaches/athletes, could further improve the development of this sport.

Background

The absence of appropriate Swedish-language instrumentation to assess active commuting to school has largely hampered the study of the individual factors of the children, such as autonomy, competence, and relatedness to active commuting to school.

Purpose

Building upon self-determination theory, the objective of this research was to gather evidence of the validity and reliability of the Swedish version of the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) tool.

Methods

The cross-sectional and purposive sample included 273 children (51.28% girls) from urban areas.

Results

Confirmatory factor analysis underpinned the three-factor correlated model, which was invariant across gender. Evidence in support of discriminant and convergent validity and reliability was gathered. Criterion validity evidence was met by positive and significant predictions of autonomy, competence, and relatedness satisfaction on active commuting to and from school.

Conclusions

The Swedish version of the BPNS-ACS is a psychometrically robust measure of children’s perceptions of autonomy, competence, and relatedness satisfaction in active commuting to school and could be used to assess the effects of school-based interventions on need satisfaction for active commuting to school.

Although growing attention has been paid to motivation in explaining active travel to school among young people at the international level, no measures of motivation for active commuting to school (ACS) were found in Sweden. Guided by self-determination theory, this research aimed to adapt the Behavioral Regulation in Active Commuting to and from School (BR-ACS) questionnaire to the Swedish context and test the resulting version’s psychometric properties. The purposive and cross-sectional sample included 273 students (58 % girls, aged 10–12 years) from four Swedish urban schools. Results from confirmatory factor analyses psychometrically supported the six-factor correlated model (intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, and amotivation) and the hierarchical three-factor model (autonomous, controlled motivation, and amotivation), which were invariant across gender. Latent correlations underpinned a symplex-like pattern. Discriminant and convergent validity and reliability were gathered. Criterion validity evidence was met with positive associations from intrinsic motivation, integrated and identified regulation to ACS, and a negative relationship between amotivation and ACS. The Swedish version of the BR-ACS questionnaire is a valid and reliable measure of children’s motivation toward ACS.

Background and aims: The present systematic review and meta-analysis aimed to synthesize the available literature on the relationship between gaming motivations and gaming disorder symptoms. Specifically, to (1) explore what gaming motivation questionnaires and classifications are used in studies on gaming disorder symptoms and (2) investigate the relationship between motivational factors and symptoms of gaming disorder. Method: An electronic database search was conducted via EBSCO (MEDLINE and PsycINFO) and the Web of Science Core Collection. All studies using validated measurements on gaming disorder symptoms and gaming motivations and available correlation coefficients of the relationship between gaming disorder and gaming motivations were included. The meta-analyses were conducted using a random-effects model. Results: In total, 49 studies (k = 58 independent sub-samples), including 51,440 participants, out of which 46 studies (k = 55 sub-samples, n = 49,192 participants) provided data for the meta-analysis. The synthesis identified fourteen different gaming motivation instruments, seven unique motivation models, and 26 motivational factors. The meta-analysis showed statistically significant associations between gaming disorder symptoms and 23 out of 26 motivational factors, with the majority of the pooled mean effect sizes ranging from small to moderate. Moreover, large heterogeneity was observed, and the calculated prediction intervals indicated substantial variation in effects across populations and settings. Motivations related to emotional escape were robustly associated with gaming disorder symptoms. Discussion and conclusions: The present meta-analysis reinforces the importance of motivational factors in understanding problematic gaming behavior. The analysis showed significant heterogeneity in most outcomes, warranting further investigation.

Aim: A follow-up genome-wide association study (GWAS) in an extended cohort of rheumatoid arthritis (RA) patients starting low-dose methotrexate (MTX) treatment was performed to identify further genetic variants associated with alanine aminotransferase (ALT) elevation. Patients & methods: A GWAS was performed on 346 RA patients. Two outcomes within the first 6 months of MTX treatment were assessed: ALT >1.5-times the upper level of normal (ULN) and maximum level of ALT. Results: SPATA9 (rs72783407) was significantly associated with maximum level of ALT (p = 2.58 × 10-8) and PLCG2 (rs60427389) was tentatively associated with ALT >1.5 × ULN. Conclusion: Associations with SNPs in genes related to male fertility (SPATA9) and inflammatory processes (PLCG2) were identified.

This chapter considers an urbanising Arctic and the design of winter cities with a specific focus on Asian mobilities consumption. The chapter explores how Asian consumption mobilities can be seen as the outcome of interactions between the built environment of Arctic settlements, individuals and climate.

Special attention is placed on how the built environment of Arctic cities is modified and shaped by “winter”. The focus is placed on the theory of urban morphology, production of space and ongoing climate change. This is important in order to understand Asian tourist mobilities in Arctic settlements because these environments bring unexpected conditions and challenges for tourists’ perceptions of heritage sites and their mobility between them. The chapter concludes by presenting some urban design recommendations for Arctic cities that can assist in understanding and enabling Asian mobilities in a changing Arctic.

From March 2020, regulations and recommendations were implemented in Sweden to reduce the spread of COVID-19, which included limitations to public life. Overall, these sought to reduce activities that brought people together and in so doing, transitioned the relationship between cities and people into a new paradigm.

The study explores public usage of an Arctic city during the pandemic to understand how COVID-19 altered people’s ‘social life’. Data was collected in the Arctic city of Luleå, by structured questionnaires and semi-structured interviews. These indicate that: 1) a significant reduction in city visits, 2) multi-faceted city visits were reduced to single task based visits, 3) a significant reduction in leisure based activities, 4) an increase in digitalization of work, retail and leisure activities, 5) perceptions of responsibility, guilt, boredom and minimizing social networks were reported, and 6) post-pandemic, people questioned the ability of cities to bounce back.

The survey and interviews show that in the Arctic city of Luleå, restrictions put in place to reduce spread of the infection had a significant impact on public life and use of the public realm, which is in accordance with research from outside the Arctic.

The conclusion is that in the short term, the role of urban centres in daily life was reduced and the role of digitalisation for work, goods and services was rapidly advanced. However, the research also shows that the ‘social dimension’ of Arctic cities - to see other people and take part of civic life on site - was not easy to replace and is valued by the community.

Understanding how different levels of immersion influence the experiences of flow and presence can shed light on the intricate interplay between these constructs and provide valuable insights into the factors that contribute to engaging and immersive gameplay. The independent variable, immersion, was manipulated in three conditions (high, moderate, and low) in a between-subject design within the video game Minecraft. Participants were asked to complete 15 min of gameplay and then fill out the questionnaires concerning flow and presence. The experiment was conducted remotely on a video-sharing platform. Bayesian analysis revealed an effect of immersion level on flow, while no evidence of an effect was found for the experience of presence. This study provides evidence in favor of a relation between flow and immersion while supporting a presumed double dissociation of immersion from presence. Future research using a Bayesian approach is encouraged to build further knowledge on this research topic.

The present study investigated the role of quality coach–athlete relationships and coaching efficacy on coaches’ well-being and performance. We examined whether coaches’ direct and meta-perspectives of the coach–athlete relationship quality predicted dimensions of coaches’ efficacy, hedemonic and eudaimonic well-being, and coach-related performance. A total of 233 male and female Swedish coaches from various team and individual sports completed the Coach–Athlete Relationship Questionnaire, the Coaching Efficacy Scale, Positive and Negative Affect Scale, Subjective Vitality Scale, and a one-single item developed to measure perceived coach performance. Structural equation modelling analyses revealed that quality coach–athlete relationships as defined by closeness, commitment, and complementarity associated with all four dimensions of coach efficacy. While coach–athlete relationship quality was linked with coaches’ positive affect, vitality, and satisfaction with coaching performance, only the motivational dimension of coach efficacy was associated with indicators of coach well-being and coach-related performance. Further analyses showed that the motivational dimension of coach efficacy explained the link between coach–athlete relationship quality, well-being, and coach-related performance. Overall, the findings extended the coach efficacy model by investigating the coach–athlete relationship as a predictor and coach well-being as an outcome. Our findings emphasize the importance of relationships for coaches’ efficacy and well-being.

The correlates of coach-athlete relationship quality have been the focus of research for over a decade; however, little is known about the mediating and moderating mechanisms underlying these associations. The present study conducted a moderated mediation analysis to examine (a) the mediating role of communication strategies (via COMPASS) on the association between the quality of the coach-athlete relationship and athlete psychological needs satisfaction and (b) whether individual differences in athletes&apos; attachment style (secure, anxious, avoidant) moderates the mediational relationship. 350 Swedish athletes representing a range of sports and competition levels completed a multi-section questionnaire. Mediation and moderation analysis partially found that coach-athlete relationship quality and athletes basic psychological needs were associated via the COMPASS strategies of support, motivation, assurance and openness. It was also found that athletes secure attachment with their coach significantly moderated the mediated effects of motivation and support. These findings highlight the practical utility of motivation, support, openness and assurance strategies in enhancing the quality of the coach-athlete relationship. Moreover, these findings demonstrate that the attachment orientation of athletes towards their coaches play a significant role in determining what communication strategies to use to enhance both the relationship quality and an athlete&apos;s competence, autonomy and relatedness.

Objectives:  The purpose of the present study was to examine differences in cognitive and physical performance, affective states, perceived exertion, and physiological responses between trials with cognitive, physical, or combined cognitive and physical load.

Design:  Randomised cross-over trial.

Methods:  Highly trained competitive orienteers (n = 15 men; n = 10 women) completed three randomised trials comprised of: (1) sport-specific cognitive tests; (2) 35-minute cycling time trial; and (3) combined sport-specific cognitive tests and 35-minute cycling time trial. Measures taken during the trials recorded affective states, perceived exertion, heart rate, blood lactate, cycling watts, as well as working memory, updating, planning and decision making.

Results:  No significant differences in cognitive performance accuracy were observed within or across trials although reaction times improved within trials and were fastest in the combined trial. Blood lactate, heart rate, perceived exertion, negative affective states, and watts were highest in the physical trial.

Conclusions:  The combined load of undertaking sport-specific cognitive tests and a cycling time trial did not influence cognitive performance accuracy. Athletes produced greater watts when completing the physical task independently compared with the combined trial, however psychophysiological responses were worse. Further investigation is warranted to determine whether athletes' attentional focus underpins psychophysiological responses to dual-task sport performance.

A three-dimensional motion capture system (MoCap) and the Garmin Running Dynamics Pod can be utilised to monitor a variety of dynamic parameters during running. The present investigation was designed to examine the validity of these two systems for determining ground contact times while running in place by comparing the values obtained with those provided by the bilateral force plate (gold standard). Eleven subjects completed three 20-s runs in place at self-selected rates, starting slowly, continuing at an intermediate pace, and finishing rapidly. The ground contact times obtained with both systems differed significantly from the gold standard at all three rates, as well as for all the rates combined (p < 0.001 in all cases), with the smallest mean bias at the fastest step rate for both (11.5 ± 14.4 ms for MoCap and −81.5 ± 18.4 ms for Garmin). This algorithm was developed for the determination of ground contact times during normal running and was adapted here for the assessment of running in place by the MoCap, which could be one explanation for its lack of validity. In conclusion, the wearables developed for monitoring normal running cannot be assumed to be suitable for determining ground contact times while running in place.

In track cycling sprint events, optimal cadence PRopt is a dynamic aspect of fatigue. It is currently unclear what cadence is optimal for an athlete’s performance in sprint races and how it can be calculated. We examined fatigue-induced changes in optimal cadence during a maximal sprint using a mathematical approach. Nine elite track cyclists completed a 6-s high-frequency pedaling test and a 60-s isokinetic all-out sprint on a bicycle ergometer with continuous monitoring of crank force and cadence. Fatigue-free force-velocity (F/v) and power-velocity (P/v) profiles were derived from both tests. The development of fatigue during the 60-s sprint was assessed by fixing the slope of the fatigue-free F/v profile. Fatigue-induced alterations in PRopt were determined by non-linear regression analysis using a mono-exponential equation at constant slope. The study revealed that PRopt at any instant during a 60-s maximal sprint can be estimated accurately using a mono-exponential equation. In an isokinetic mode, a mean PRopt can be identified that enables the athlete to generate the highest mean power output over the course of the effort. Adding the time domain to the fatigue-free F/v and P/v profiles allows time-dependent cycling power to be modelled independent of cadence. 

Purpose: Following short-term all-out exercise, the maximal rate of glycolysis is frequently assessed on the basis of the maximal rate of lactate accumulation in the blood. Since the end of the interval without significant accumulation (talac) is 1 of 2 denominators in the calculation employed, accurate determination of this parameter is crucial. Although the very existence and definition of talac, as well as the validity of its determination as time-to-peak power (tPpeak), remain controversial, this parameter plays a key role in anaerobic diagnostics. Here, we describe a novel approach to determination of talac and compare it to the current standard. Methods: Twelve elite track cyclists performed 3 maximal sprints (3, 8, and 12 s) and a high-rate, low-resistance pedaling test on an ergometer with monitoring of crank force and pedaling rate. Before and after each sprint, capillary blood samples were taken for determination of lactate accumulation. Fatigue-free force–velocity and power–velocity profiles were generated. talac was determined as tPpeak and as the time point of the first systematic deviation from the force–velocity profile (tFf). Results: Accumulation of lactate after the 3-second sprint was significant (0.58 [0.19] mmol L−1; P < .001, d = 1.982). tFf was <3 seconds and tPpeak was ≥3 seconds during all sprints (P < .001, d = − 2.111). Peak power output was lower than maximal power output (P < .001, d = −0.937). Blood lactate accumulation increased linearly with increasing duration of exercise (R2 ≥ .99) and intercepted the x-axis at ∼tFf. Conclusion: Definition of talac as tPpeak can lead to incorrect conclusions. We propose determination of talac based on tFf, the end of the fatigue-free state that may reflect the beginning of blood lactate accumulation.

Background: During maximal cycling sprints, efficiency (η) is determined by the fiber composition of the muscles activated and cadence-dependent power output. To date, due to methodological limitations, it has only been possible to calculate gross efficiency (i.e., the ratio of total mechanical to total metabolic work) in vivo without assessing the impact of cadence and changes during exercise. Eliminating the impact of cadence provides optimal efficiency (ηopt), which can be modeled as a function of time. Here, we explain this concept, demonstrate its calculation, and compare the values obtained to actual data. Furthermore, we hypothesize that the time course of maximal power output (Pmax) reflects time-dependent changes in ηopt. Methods: Twelve elite track cyclists performed four maximal sprints (3, 8, 12, 60 s) and a maximal-pedaling test on a cycle ergometer. Crank force and cadence were monitored continuously to determine fatigue-free force-velocity profiles (F/v) and fatigue-induced changes in Pmax. Respiratory gases were measured during and for 30 min post-exercise. Prior to and following each sprint, lactate in capillary blood was determined to calculate net blood lactate accumulation (ΔBLC). Lactic and alactic energy production were estimated from ΔBLC and the fast component of excess post-exercise oxygen consumption. Aerobic energy production was determined from oxygen uptake during exercise. Metabolic power (MP) was derived from total metabolic energy (WTOT). ηopt was calculated as Pmax divided by MP. Temporal changes in Pmax, WTOT, and ηopt were analyzed by non-linear regression. Results: All models showed excellent quality (R2 > 0.982) and allowed accurate recalculation of time-specific power output and gross efficiency (R2 > 0.986). The time-constant for Pmax(t) (τP) was closely correlated with that of ηopt (τη; r = 0.998, p < 0.001). Estimating efficiency using τP for τη led to a 0.88 ± 0.35% error. Conclusions: Although efficiency depends on pedal force and cadence, the latter influence can be eliminated by ηopt(t) using a mono-exponential equation whose time constant can be estimated from Pmax(t).

Background: Maximal force-velocity (F/v) profiles for track cyclists are commonly derived from ergometer sprints using an isovelocity or isoinertial approach. Previously, an attempt was made to derive maximal F/v profiles from a single maximal 65-m sprint on the cycling track. Hypothesising that this approach may not accurately reflect the fatigue-free F/v profile, we propose an alternative procedure and compare it to the previous method. Moreover, we test for the impact of gear ratio on diagnostic results.

Methods: Twelve elite track cyclists completed a high-cadence low-resistance pedalling test on a freestanding roller (motoric test) and two series of three maximal 65-m sprints on a cycling track with different gear ratios. F/v profiles were calculated based on the measured crank force and cadence either during the first 6–7 revolutions (≤6 s) on the track (model I) or were derived from the first 3–4 revolutions (≤3 s) on the track combined with 1 or 2 fatigue-free cycles at cadences above 160 rpm from the motoric test (model II).

Results: Although both models exhibit high-to-excellent linearity between force and velocity, the extrapolated isometric force was higher (1507.51 ± 257.60 N and 1384.35 ± 276.84 N; p < 0.002; d = 2.555) and the slope steeper (−6.78 ± 1.17 and −5.24 ± 1.11; p < 0.003, d = −2.401) with model I. An ICC of 1.00 indicates excellent model consistency when comparing the F/v profiles (model II) derived from the different geared sprints.

Conclusions: Assuring fatigue-free measurements and including high-cadence data points in the calculations provide valid maximal F/v and P/v profiles from a single acceleration-sprint independent of gear ratio.

Female athletes train and compete under the potential influence of hormonal fluctuations during the menstrual cycle or during use of various hormonal contraceptives. Dysmenorrhea and premenstrual symptoms are common in the general population, as well as side effects of hormonal contraceptives. More detailed knowledge concerning prevalence and perceived impact of these symptoms on training and performance in different sports is required. The aim of the study was to 1) characterize perceptions of training and performance during the menstrual cycle phases and by hormonal contraceptive use in a large population of female athletes; 2) explore whether symptoms experienced are related to perceived performance; and 3) examine potential differences in these factors between athletes at different levels of performance. The study was based on self-reported data from 1,086 athletes from 57 sports at different performance levels via a web-based questionnaire. Thirty-seven percent (n = 407) of the athletes did not use hormonal contraceptives. In this group, menstrual cycle related symptoms were common across all athlete levels, particularly dysmenorrhea (74%, n = 300) and premenstrual symptoms (78%, n = 318), which also influenced perceived performance of aerobic fitness, muscle strength, mental sharpness, balance, and sleep quality. Sixty-three percent (n = 679) of the athletes used various hormonal contraceptives and 40% (n = 272) perceived a variety of side-effects. Physical performance was experienced equally independent of time-point of the pill-chart except for the period of inactive pills, which was associated with more negative impact. Nonetheless, only 18% (n = 191) of the athletes considered menstrual cycle or hormonal contraceptive issues when planning their training or competitions. These results indicate that greater focus is needed to identify and effectively treat different menstrual cycle and hormonal contraceptive related symptoms on an individual level.

Inattention and proclivity for distraction are symptoms of adult ADHD that hamper productivity in study and work environments. The topic of this dissertation is mechanisms of distraction and facilitation of attention in ADHD. This thesis includes three studies. The following overarching questions are addressed in each study respectively: (1) Is computerized cognitive training (CCT) an intervention which improves overall cognitive outcomes in adults with ADHD, (2) Are there differences depending on ADHD symptom severity and distraction in auditory or vibro-tactile sensory modalities, and (3) Is background white noise a shield from distraction for those with ADHD during a short-term memory task?

Study I is a systematic review and meta-analysis of CCT interventions for adults with ADHD, following a pre- post-test design for randomized controlled trials. Nine intervention studies are included in the systematic review, with the resulting meta-analysis for overall cognitive outcomes showing a very small benefit of the CCT intervention. Study I also included sub-analyses of three outcome categories according to the Cattell-Horn-Carol framework of cognition: cognitive speed, executive functions, and short-term memory. None of these individual meta-analyses resulted in significant improvements. 

Participants took part in a cross-modal visual oddball task with auditory and vibro-tactile distractors in Study II. Forty-five participants were divided into two groups for the analysis: one group with low ADHD symptoms and one group with high ADHD symptoms. Findings did not show a relationship between ADHD symptom status and distraction in either auditory or vibro-tactile modality, despite both groups showing the expected slowed reactions on deviant trials. A sensitivity analysis showed that the high symptom group exhibited 0.5 % more missed trials compared to the low symptom group, possibly due to mind wandering in this non-forced-choice task.

For Study III, serial recall data was collected from sixty-six individuals with ADHD and sixty-six healthy control participants, who were tested with white background noise and no background noise conditions. The results showed that participants with ADHD were more likely to get distracted by auditory omission deviants in continuous background white noise, whereas healthy controls were more likely to get distracted by auditory addition deviants in the condition without background noise. Also, the individuals with ADHD on average did not exhibit a typical primacy effect across serial recall items. Overall, the results of the three studies in this dissertation point to some areas for improvement for adults with ADHD where targeted behavioral interventions might be useful in the future.

Objective: Treatments for adults with attention-deficit hyperactivity disorder (ADHD) are understudied, compared to children and adolescents with the same condition. In this systematic review and random-effects meta-analysis, we aim to evaluate the outcomes of computerized cognitive training (CCT) interventions in randomized controlled trials (RCTs) including adults with ADHD.

Method: Cognitive outcomes and ADHD symptom severity were analyzed separately. In addition, the Cattell–Horn–Carroll (CHC) theory of cognitive abilities was used to categorize outcome variables into subdomains, which were analyzed separately in a subsequent analysis.

Results: The results revealed a small positive change in overall cognitive functioning, a measure of all cognitive outcomes in each study, for individuals who took part in CCT compared to controls (k = 9, Hedge’s g = 0.235, 95% CI [0.002, 0.467], p = 0.048, τ2 = 0.000, I2 = 0.000). However, neither symptom severity nor specific cognitive outcomes (executive functioning, cognitive speed, or working memory) showed a significant improvement.

Conclusions: We analyzed the risk of bias in the chosen studies and discuss the findings in terms of effect size. It is concluded that CCT has a small positive effect in adults with ADHD. Due to the lack of heterogeneity in intervention designs across the included studies, increased heterogeneity in future studies could help inform clinicians about the aspects of CCT, such as training type and length, that are most beneficial for this group.

To improve work productivity and concentration when undertaking daily tasks, such as studying or engaging in mentally difficult activities, some individuals prefer to work in the presence of background auditory noise such as music, nature sounds, or even white noise. We investigated the impact of background white noise on short-term serial recall performance in adults with (n = 66) and without (n = 66) ADHD whereby variation in other traits that could potentially influence performance (anxiety and depression) was controlled. The potential decline of the impact of task-irrelevant sound across trials (e.g., habituation) and serial position effects were also explored. Participants completed the verbal working memory task in the presence of continuous white noise sequences that were occasionally interrupted by a period of quiet (omission deviant), and continuous quiet sequences that were occasionally interrupted by a period of white noise (addition deviant). Addition deviants were more disruptive for non-ADHD individuals than ADHD individuals, while omission deviants were more disruptive for ADHD individuals than non-ADHD individuals. A direct implication of this interaction is, in order to limit distractions, adults with ADHD should refrain from listening to continuous background white noise if there is a likelihood of a break in sound stimulation, whereas adults without ADHD should avoid quiet auditory backgrounds in which a rare or unexpected sound may occur. Further, exploratory findings show the absence of a serial position primacy effect for adults self-reporting ADHD compared to adults without ADHD.

The purpose of this study was to investigate whether symptoms of attention deficit hyperactivity disorder (ADHD) impact distraction by unexpected deviant sounds and vibrations. The hypothesis was that there would be a difference between individuals with low and high ADHD symptom severity in deviance distraction. In a cross-modal oddball task, we measured the impact of to-be-ignored deviating auditory and vibro-tactile stimuli in 45 adults who were 18 years or older, and self-reported ADHD symptoms using the screening tool of the adult ADHD self-report scale (ASRS). Results did not show a difference between groups with low and high symptoms of ADHD in their propensity for distraction in any modality using both frequentist and Bayesian methods of analysis. The impact of the deviating sounds and vibrations on performance were similar between groups. However, the amount of missed trials, which possibly reflects mind wandering or attention away from the focal task, was higher in the high symptom group (0.5 % difference in missing data between groups). The findings indicate a difference in missed responses between groups, despite no differences in the likelihood of distraction being indicated between vibro-tactile and auditory modalities. Overall, the complexity of adult ADHD symptomatology, especially behavioral differences in attentional control is reflected in the results of this study.

Purpose

The aim was to illuminate the experiences of stroke survivors returning to everyday life in the year following stroke, in the context of client-centred rehabilitation.

Methods

Four men who participated in a client-centred rehabilitation program were followed during the first year after stroke. Semi-structured interviews were conducted, allbut the first in the participants’ home. The data were analysed using a grounded theory approach.

Results

The results revealed a process with the overarching core category; The “new” self becomes reality through challenging everyday experiences, and five main categories driving the process: 1) Striving for structure in a “new” chaotic world, 2) Homecoming an ambiguous experience, 3) Reaching the “new” self through reflections of self-understanding, 4) Socialising in new circumstances, and 5) Realising a new reality.

Conclusions

While in hospital, stroke survivors can have unrealistic expectations. When at home they can begin to realise their actual capacity . To find a “new” self after a stroke can involve time-consuming and taxing processes of reflections of self-understanding. Engagement in self-selected meaningful and valued activities can support stroke survivors’ reconstruction of the “new” self but not all stroke survivors may succeed in finding their “new” self during the first year after stroke.

The aim of this study was to investigate occupational cognitive complexity of main lifetime occupation in relation to level and 15-year change in episodic memory recall in a sample of older adults (≥ 65 years, n = 780). We used latent growth curve modelling with occupational cognitive complexity (O*NET indicators) as independent variable. Subgroup analyses in a sample of middle-aged (mean: 49.9 years) men (n = 260) were additionally performed to investigate if a general cognitive ability (g) factor at age 18 was predictive of future occupational cognitive complexity and cognitive performance in midlife. For the older sample, a higher level of occupational cognitive complexity was related to a higher level of episodic recall (β = 0.15, p < .001), but the association with rate of change (β = 0.03, p = .64) was not statistically significant. In the middle-aged sample, g at age 18 was both directly (β = 0.19, p = .01) and indirectly (via years of education after age 18, ab = 0.19) predictive of midlife levels of occupational cognitive complexity. Cognitive ability at age 18 was also a direct predictor of midlife episodic recall (β = 0.60, p ≤ 0.001). Critically, entry of the early adult g factor attenuated the association between occupational complexity and cognitive level (from β = 0.21, p = .01 to β = 0.12, p = .14). Overall, our results support a pattern of preserved differentiation from early to late adulthood for individuals with different histories of occupational complexity.

During the 2022 Winter Paralympic Games in Beijing, the Para snow-sport events will be held at high altitudes and in possibly cold conditions while also requiring adjustment to several time zones. Furthermore, the ongoing COVID-19 pandemic may lead to suboptimal preparations. Another concern is the high rate of injuries that have been reported in the Para alpine and snowboard events. In addition to these challenges, Para athletes various impairments may affect both sports-specific demands and athlete health. However, the group of Para snow-sport athletes is an understudied population. Accordingly, this perspective paper summarises current knowledge to consider when preparing for the Paralympic Games in Beijing and point out important unanswered questions. We here focus specifically on how sport-specific demands and impairment-related considerations are influenced by altitude acclimatisation, cold conditions, travel fatigue and jetlag, complications due to the COVID-19 pandemic, and injury prevention and sports safety considerations. As Para athletes with spinal cord injury, limb deficiency, cerebral palsy and visual impairment account for the majority of the Para snow-sport athletes, the focus is mainly on these impairment groups. In brief, we highlight the extra caution required to ensure athlete health, performance and sports safety among Para athletes participating in the snow-sport events in the 2022 Beijing Paralympic Games. Although there is an urgent need for more high-quality research focusing on Para winter athletes, we hope these non-consensus recommendations will help prepare for the 2022 Beijing Paralympic Winter Games.

Objectives

To investigate the accuracy of visual assessments made by physical therapists of lumbo-pelvic movements during the squat and deadlift and how much movement is considered injurious.

Design

Quantitative Cross-sectional.

Participants

14 powerlifters, 10 Olympic weightlifters and six physical therapists.

Setting

The lifters were recorded simultaneously by video and an inertial measurement unit (IMU) system while performing squats and deadlifts. The physical therapists assessed the videos and rated whether specific lumbo-pelvic movements were visible during the lifts and whether the movement amplitude was considered injurious.

Main outcome measures

The nominal visual assessments, if there was a movement and if it was considered injurious, were compared to the degrees of movement attained from the IMU system.

Results

During the squat, a posterior pelvic tilt of ≥34° was required to visually detect the movement. For other lumbo-pelvic movements, there was no significant difference in the amount of movement between those who were assessed as moving or not moving their lumbo-pelvic area, nor was there a difference in movement amplitude between those who were assessed as having an increased risk of injury or not.

Conclusions

Physical therapists did not consistently detect lumbo-pelvic movements during squats and deadlifts when performed by competitive lifters.

Background: As a strategy to maintain postural control, the stiffening strategy (agonist-antagonist co-contractions) is often considered dysfunctional and associated with poor physical capacity. The aim was to investigate whether increased stiffening is associated with unsuccessful postural control during an unpredictable surface perturbation, and which sensory and motor variables that explain postural stiffening.

Methods: A sample of 34 older adults, 75.8 ± 3.8 years, was subjected to an unpredicted surface perturbation with the postural task to keep a feet-in-place strategy. The participants also completed a thorough sensory- and motor test protocol. During the surface perturbation, electromyography was measured from tibialis anterior and gastrocnemius to further calculate a co-contraction index during the feed-forward and feedback period. A binary logistic regression was done with the nominal variable, if the participant succeeded in the postural task or not, set as dependent variable and the co-contraction indexes set as independent variables. Further, the variables from the sensory and motor testing were set as independent variables in two separate Orthogonal Projections of Latent Structures (OPLS)-models, one with the feed-forward- and the other with the feedback co-contraction index as dependent variable.

Results: Higher levels of ankle joint stiffening during the feedback, but not the feed-forward period was associated with postural task failure. Feedback stiffening was explained by having slow non-postural reaction times, poor leg muscle strength and being female whereas feed-forward stiffening was not explained by sensory and motor variables.

Conclusions: When subjected to an unpredicted surface perturbation, individuals with higher feedback stiffening had poorer postural control outcome, which was explained by poorer physical capacity. The level of feed-forward stiffening prior the perturbation was not associated with postural control outcome nor the investigated sensory and motor variables. The intricate causal relationships between physical capacity, stiffening and postural task success remains subject for future research.

As we age there are natural physiological deteriorations that decrease the accuracy and flexibility of the postural control system, which increases the risk of falling. Studies have found that there are individual differences in the ability to learn to manage repeated postural threats. The aim of this study was to investigate which factors explain why some individuals are less proficient at adapting to recurrent postural perturbations. Thirty-five community dwelling older adults performed substantial sensory and motor testing and answered surveys regarding fall-related concerns and cognitive function. They were also subjected to three identical surface perturbations where both kinematics and electromyography was captured. Those that were able to adapt to the third perturbation were assigned to the group “Non-fallers” whereas those that fell during all perturbations were assigned to the group “Fallers”. The group designation dichotomized the sample in a hierarchical orthogonal projection of latent structures— the discriminant analysis model. We found that those who fell were older, had poorer physical performance, poorer strength and longer reaction times. The Fallers’ postural control strategies were more reliant on the stiffening strategy along with a more extended posture and they were less skillful at making appropriate feedforward adaptations prior to the third perturbation.

BACKGROUND: The sprint is one of the two ski-mountaineering disciplines that will be held at the coming Milano Cortina 2026 Winter Olympics (Italy). To date little information exists on this novel Olympic discipline.

METHODS: We characterized retrospectively the participation and performance in international male and female ski mountaineering sprint races from November 2012 to April 2022. Potential associations between sex and season with participation, as well as between sex, period, round and final ranking with parameters of performance were examined with linear-mixed models.

RESULTS: The minimal performance time required for success (i.e., being eligible for the next round/winning a medal) decreased progressively from the qualifications (Qs) to the final (F). Finalists adopted a conservative strategy in the Qs, improving their performance in the quarter-finals (QFs) and semifinals (SFs). The best and second-best male skier and the best female skier improved their performances even further in the F, which appears to be a key feature for success. For women, the number of participants and level of competition increased over the decade, whereas male participation did not. During the last two seasons, male sprint winners performed relatively more slowly in the preliminary rounds leaving more room for improvement in the F, which could reflect increased specialization in this discipline.

CONCLUSIONS: Our findings provide novel insights into ski-mountaineering sprint races that can guide competition strategies and could be of considerable importance in connection with the Milano Cortina 2026 Winter Olympics (Italy).

Children generally do not meet the recommendation of 60 min of daily physical activity (PA); therefore, active school transportation (AST) is an opportunity to increase PA. To promote AST, the involvement of parents seems essential. Using the theory of planned behavior (TPB), the aim was to develop and validate the PILCAST questionnaire to understand parents’ intentions to let their child cycle or walk to school. Cross-sectional sampling was performed, where 1024 responses were collected from parents. Confirmatory factor analysis indicated acceptable fit indices for the factorial structure according to the TPB, comprising 32 items grouped in 11 latent constructs. All constructs showed satisfying reliability. The regression analysis showed that the TPB explained 55.3% of parents’ intentions to let the child cycle to school and 20.6% regarding walking, increasing by a further 18.3% and 16.6%, respectively, when past behavior was added. The most influential factors regarding cycling were facilitating perceived behavioral control, positive attitudes, subjective and descriptive norms, and for walking, subjective and descriptive norms. The PILCAST questionnaire contributes to a better understanding of the psychological antecedents involving parents’ decisions to let their child cycle or walk to school, and may therefore provide guidance when designing, implementing and evaluating interventions aiming to promote AST.

Insufficient physical activity among children is a critical issue and health promoting initiatives are required to reverse this trend. In response to the current situation, a school-based intervention aiming to increase physical activity with the aid of active school transportation (AST) was implemented in one municipality in northern Sweden. By adopting the framework of the Theory of Planned Behavior, we aimed to analyse beliefs among parents whose children were or were not involved in the AST intervention. All municipality schools were included. There were 1024 responses from parents, comprising 610 who responded either &apos;yes&apos; or &apos;no&apos; to participating in the intervention. An adjusted linear regression analysis showed that children&apos;s intervention participation was significantly associated with more positive beliefs towards AST among parents. These results indicates that it is possible to influence beliefs that are important in the parental decision-making process by the use of an AST intervention. Therefore, to make children´s active transport to school the more favorable choice for parents, it seems to be worthwhile to not only give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.Not enough physical activity among children is an important issue and health promoting initiatives are needed to reverse this trend. In response to the current situation, a school-based intervention aiming to increase physical activity using active school transportation (AST) was implemented in one municipality in northern Sweden. Using the Theory of Planned Behaviour framework, we aimed to analyse beliefs among parents whose children were or were not involved in the AST intervention. Children’s participation in the intervention was significantly associated with more positive beliefs towards AST among parents. These results indicate that it is possible to influence beliefs that are important in the parental decision-making process by the use of an AST intervention. Therefore, to make children’s active transport to school the more favourable choice for parents, it seems to be worthwhile to not only give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.

Whether a higher aerobic fitness is associated with increased expression of antioxidant enzymes and their regulatory factors in skeletal muscle remains unknown. Although oestrogens could promote a higher antioxidant capacity in females, it remains unknown whether a sex dimorphism exists in humans regarding the antioxidant capacity of skeletal muscle. Thus, the aim was to determine the protein expression levels of the antioxidant enzymes SOD1, SOD2, catalase and glutathione reductase (GR) and their regulatory factors Nrf2 and Keap1 in 189 volunteers (120 males and 69 females) to establish whether sex differences exist and how age, VO2max and adiposity influence these. For this purpose, vastus lateralis muscle biopsies were obtained in all participants under resting and unstressed conditions. No significant sex differences in Nrf2, Keap1, SOD1, SOD2, catalase and GR protein expression levels were observed after accounting for VO2max, age and adiposity differences. Multiple regression analysis indicates that the VO2max in mL.kg LLM−1.min−1can be predicted from the levels of SOD2, Total Nrf2 and Keap1 (R = 0.58, P < 0.001), with SOD2 being the main predictor explaining 28 % of variance in VO2max, while Nrf2 and Keap1 explained each around 3 % of the variance. SOD1 protein expression increased with ageing in the whole group after accounting for differences in VO2max and body fat percentage. Overweight and obesity were associated with increased pSer40-Nrf2, pSer40-Nrf2/Total Nrf2 ratio and SOD1 protein expression levels after accounting for differences in age and VO2max. Overall, at the population level, higher aerobic fitness is associated with increased basal expression of muscle antioxidant enzymes, which may explain some of the benefits of regular exercise.

When high-intensity exercise is performed until exhaustion a “functional reserve” (FR) or capacity to produce power at the same level or higher than reached at exhaustion exists at task failure, which could be related to reactive oxygen and nitrogen species (RONS)-sensing and counteracting mechanisms. Nonetheless, the magnitude of this FR remains unknown. Repeated bouts of supramaximal exercise at 120% of VO2max interspaced with 20s recovery periods with full ischaemia were used to determine the maximal FR. Then, we determined which muscle phenotypic features could account for the variability in functional reserve in humans. Exercise performance, cardiorespiratory variables, oxygen deficit, and brain and muscle oxygenation (near-infrared spectroscopy) were measured, and resting muscle biopsies were obtained from 43 young healthy adults (30 males). Males and females had similar aerobic (VO2max per kg of lower extremities lean mass (LLM): 166.7 ± 17.1 and 166.1 ± 15.6 ml kg LLM−1.min−1, P = 0.84) and anaerobic fitness (similar performance in the Wingate test and maximal accumulated oxygen deficit when normalized to LLM). The maximal FR was similar in males and females when normalized to LLM (1.84 ± 0.50 and 2.05 ± 0.59 kJ kg LLM−1, in males and females, respectively, P = 0.218). This FR depends on an obligatory component relying on a reserve in glycolytic capacity and a putative component generated by oxidative phosphorylation. The aerobic component depends on brain oxygenation and phenotypic features of the skeletal muscles implicated in calcium handling (SERCA1 and 2 protein expression), oxygen transport and diffusion (myoglobin) and redox regulation (Keap1). The glycolytic component can be predicted by the protein expression levels of pSer40-Nrf2, the maximal accumulated oxygen deficit and the protein expression levels of SOD1. Thus, an increased capacity to modulate the expression of antioxidant proteins involved in RONS handling and calcium homeostasis may be critical for performance during high-intensity exercise in humans.

Symptoms of vestibular dysfunction such as dizziness and vertigo are common after sports-related concussions (SRC) and associated with a worse outcome and a prolonged recovery. Vestibular dysfunction after SRC can be because of an impairment of the peripheral or central neural parts of the vestibular system. The aim of the present study was to establish the cause of vestibular impairment in athletes with SRC who have persisting post-concussive symptoms (PPCS). We recruited 42 participants—21 athletes with previous SRCs and PPCS ≥6 months and 21 healthy athletic age- and sex-matched controls—who underwent symptom rating, a detailed test battery of vestibular function and 7T magnetic resonance imaging with diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) of cerebellar white matter tracts, and T1-weighted imaging for cerebellar volumetrics. Vestibular dysfunction was observed in 13 SRC athletes and three controls (p = 0.001). Athletes with vestibular dysfunction reported more pronounced symptoms on the Dizziness Handicap Inventory (DHI; p < 0.001) and the Hospital Anxiety and Depression Scale (HADS; p < 0.001). No significant differences in DTI metrics were found, while in DKI two metrics were observed in the superior and/or inferior cerebellar tracts. Cerebellar gray and white matter volumes were similar in athletes with SRC and controls. Compared with controls, pathological video head impulse test results (vHIT; p < 0.001) and cervical vestibular evoked myogenic potentials (cVEMP; p = 0.002) were observed in athletes with SRC, indicating peripheral vestibular dysfunction and specifically suggesting injury to the inferior vestibular nerve. In athletes with persisting symptoms after SRC, vestibular dysfunction is associated with injury to the inferior vestibular nerve.

We aimed to investigate whether selective head–neck cooling could shorten recovery after sports-related concussions (SRCs). In a nonrandomized study of 15 Swedish professional ice hockey teams, 29 concussed players received immediate head and neck cooling for ≥30 min (initiated at 12.3 ± 9.2 min post-SRC by a portable cooling system), and 52 SRC controls received standard management. Players receiving head–neck cooling had shorter time to return-to-play than controls (7 vs 12.5 days, p < 0.0001), and 7% in the intervention group versus 25% in the control group were out of play for ≥3 weeks (p = 0.07). Immediate selective head–neck cooling is a promising option in the acute management of SRC that should be addressed in larger cohorts.