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I-Min Lee, Eric J. Shiroma, Kelly R. Evenson, Masamitsu Kamada, Andrea Z. LaCroix and Julie E. Buring

Physical activity helps prevent non-communicable diseases, the major cause of death in the United States (US), and insufficient activity has been estimated to cause as many deaths globally each year as does smoking ( Lee et al., 2012 ). Current guidelines, released by the US Department of Health

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Nicholas L. Parsons and Michael J. Stern

The purpose of this paper is to determine how the collective memory of a baseball player’s contributions to his sport changes posthumously. We seek to examine if levels of veneration accorded to an athlete depend on whether he is alive or deceased, the timing of his death, and type of death he experienced. Building upon theories of cultural valorization, we propose that collective efforts to remember retired athletes are greater if those athletes have passed on. More explicitly, we argue that a player’s death supplements his lifetime achievements in posthumous efforts to construct and maintain his memory. We analyze the history of voting conducted by the Baseball Writers Association of America (BBWAA) on players eligible for induction into the National Baseball Hall of Fame. The results suggest that a variety of performance and recognition measures affect the amount of votes a player receives. As predicted, dying and age of death exert a powerful influence on votes received toward entry into the National Baseball Hall of Fame. However, when hitters and pitchers are analyzed separately, we find partial support for our propositions.

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Elizabeth I. Drewniak, David B. Spenciner and Joseph J. Crisco

Sudden death resulting from ventricular fibrillation (VF) caused by a nonpenetrating chest wall impact, known as commotio cordis (CC), is the second leading cause of death among young athletes. To date, seven young athletes wearing chest protectors have died from CC. The purpose of this study was to determine whether a relationship exists between mechanical properties of chest protectors and occurrence of VF, previously determined by Weinstock et al., using an established swine model. A servo-hydraulic material tester was used to determine properties of the chest protectors, including displacement, permanent deformation, stiffness, and area of pressure distribution. These properties were then compared with the occurrence of VF. We found that a decreased proportion of hits resulting in VF was significantly associated (R 2 = 0.59, p = 0.001) with an increase in the area of pressure distribution. These findings are a limited, but crucial, first step in understanding the prevention of this complex and perplexing phenomenon.

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Caroline A. Macera and Wilma Wooten

This review summarizes information on the rate of injury among adolescents who participate in specific sports or recreational activities. Injury-related mortality is high among adolescents, accounting for over 75% of the deaths occurring among those between 15 and 19 years of age, with about 5% of these deaths attributed to sports injuries. Several difficulties were encountered in conducting this review. There was no standard definition for injury, resulting in widely diverse operational definitions. The underlying denominator and time period used to obtain rates also varied widely. In spite of these difficulties, several sports were identified as particularly dangerous due to the nature of the injury: football for males and gymnastics for females. Consistent injury definitions and larger prospective studies are needed to confirm these rates and to identify risk factors.

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Clemens von Schacky, Maximilian Kemper, Robert Haslbauer and Martin Halle

The Omega-3 Index is defined as erythrocyte eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and represents an individual’s status in these two marine omega-3 fatty acids. A target range of 8 to 11% has been suggested, because values below predispose to cardiovascular events, especially sudden cardiac death, as well as to suboptimal brain function, like prolonged reaction times or even depression. Compared with the general population, elite athletes have an increased incidence of sudden death. The Omega-3 Index has not yet been investigated in elite athletes. In an exploratory approach, we determined the Omega-3 Index in 106 consecutive German national elite winter endurance athletes presenting for preparticipation screening, using a well-established analytical procedure (HS-Omega-3 Index). Surprisingly, only one athlete had a value within the target range, but all others had values <8%. We conclude that we have identified a deficiency of EPA and DHA in these elite athletes. This deficiency presents a potential option for prevention of cardiovascular events such as sudden cardiac death, and improving aspects of brain function. It will be important to scrutinize our finding by more thorough epidemiologic studies and appropriate intervention trials.

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Vinicius Coneglian Santos, Adriana Cristina Levada-Pires, Sâmia Rocha Alves, Tânia Cristina Pithon-Curi, Rui Curi and Maria Fernanda Cury-Boaventura


To investigate the effects of docosahexaenoic-(DHA)-rich fish oil (FO) supplementation on lymphocyte function before and after a marathon race.


Twenty-one athletes participated in this study. Eight marathon runners were supplemented with 3 g of FO daily for 60 d (FO group), and 13 athletes were not supplemented (C group). The following measures of lymphocytes were taken before and after the marathon: cell proliferation, cytokine production (IL-2, IL-10, TNF-α, and IL-4), and signs of cell death.


In the C group, the marathon had no effect on lymphocyte proliferation, DNA fragmentation, or mitochondrial membrane polarization; however, the marathon increased phosphatidylserine externalization (by 2.5-fold), induced a loss of plasma membrane integrity (by 20%), and decreased IL-2, TNF-α, and IL-10 production (by 55%, 95%, and 50%, respectively). FO supplementation did not prevent lymphocyte death induced by the marathon, as indicated by cell viability, DNA fragmentation, and phosphatidylserine externalization. However, FO supplementation increased lymphocyte proliferation before and after the marathon, and before the race, FO supplementation decreased IL-2, TNF-α, and IL-10 production in concanavalin-A-stimulated lymphocytes (by 55%, 95%, and 58%, respectively) compared with cells from the C group. The production of cytokines was not altered before or after the race in the FO group.


DHA-rich FO supplementation increased lymphocyte proliferation and prevented a decrease in cytokine production, but it did not prevent lymphocyte death induced by participation in the marathon. Overall, DHA rich-FO supplementation has beneficial effects in preventing some of the changes in lymphocyte function induced by marathon participation.

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John J. Miller and John T. Wendt

On October 23, 2010 in the city of Fujairah, east of Dubai, United Arab Emirates (UAE), United States medal winning swimmer Fran Crippen failed to finish the Fédération Internationale de Natation (FINA) 10 Kilometer Marathon Swimming World Cup open water race. The conditions of the water and exterior temperature were relevant factors contributing to the death of Fran Crippen. A discussion of risk communication, as an integral part of the risk management process, describes how this tragedy could have been avoided. This case study will address how the proper authorities could have employed the risk communications to prevent this tragedy.

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Stephen P. Sayers

Duchenne muscular dystrophy (DMD) is a disease affecting muscle fiber integrity in boys that leads to progressive weakness in skeletal muscle and premature death. Currently, there is no known cure for the disease. Different interventions have been explored to delay the progression of the disease and improve the quality of life for the DMD patient. Physical activity is one treatment that has generated controversy due to the increased mechanical stress placed on the muscle during contraction. This review explores the literature in animal models and human DMD patients and evaluates the known theoretical risks and benefits of increased physical activity in DMD patients.

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Jonatan R. Ruiz, Carmen Fiuza-Luces, Nuria Garatachea and Alejandro Lucia

For centuries, the general consensus has been that vigorous, competitive exercise was harmful and shortened life expectancy. Recent data from prospective cohort studies conducted on marathon runners, professional cyclists, and Olympic athletes indicate, however, that regular intense endurance-exercise training has protective benefits against cardiovascular disease and premature death. There are still important questions to be answered, such as what is the optimal dose, in terms of both duration and intensity of training or competition, beyond which the health benefits of regular exercise stabilize or might even potentially disappear.

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Konstantinos Koukouris

Disengagement from sport is examined from a phenomenological perspective. This perspective permits committed adult athletes to explain in their own time and their own words why they ceased participating in formally organized competitive sport. Thirty-four former advanced and elite athletes were interviewed. The constructed case study method provides the opportunity to examine causal relationships among all factors leading to disengagement from sport, and follows a “holistic” method of analyzing interviews (cognitive mapping). Former athletes identified the problem of settling into a job and financial constraints as the primary factors influencing their disengagement from sport. Most athletes left sport voluntarily and experienced elements of rebirth rather than social death.