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Experiences of Youth Recreation Sport Organizations' Administrators with Implementation of Maryland Concussion Law by Donelle Damali Ainsworth-McKenna MHSA, The George Washington University, 2004 BS, Morgan State University, 2000 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University September 2015 There have been statewide concussion policies implemented in all 50 states and the District of Columbia to address the problem of sports-related concussions in youth athletes. The efforts to implement the requirements of these laws have mainly focused on high school athletics, despite evidence that pre-high school youth athletes who participate in organized community sports through recreation sport organizations are sustaining concussions at a similar rate as high school athletes. Thus, this study explored the implementation of the Maryland concussion law in youth sports recreation organizations in Laurel, Maryland that serve pre-high school youth athletes aged 5-14 years. A qualitative approach was utilized to conduct this study. Administrators of such youth sports and recreation organizations were interviewed to answer the central research question about how the Maryland concussion law is being implemented in youth sport recreation organizations in the state. The diffusion of innovations theory was the theoretical framework used to guide this study as well as to explore barriers to and facilitators of implementing this policy. NVivo software was used to analyze the data, and the results identified concussion training, guidelines, resources, and policing as integral to implementation of the policy. These findings can be used to inform policies, implementation, and best practices for this policy. Thus the individual and community implications for positive social change include behavior change to prevent, identify, and manage concussions in youth athletes to reduce the potential impact of concussions in youth athletes.

This study examined the relationship between intercollegiate participation and persistence in college. In addition, it explored the different factors that influenced student athletes' persistence patterns as compared to non-student athletes at residential liberal arts schools. Using data from the Wabash National Study of Liberal Arts Education (WNS), I first examined if student athletes were more likely to persist while controlling for background characteristics. Next, using Braxton's revised theory of student departure as a theoretical lens, I examined how eight factors (ability to pay, commitment of the institution to student welfare, communal potential, institutional integrity, proactive social adjustment, psychosocial engagement, social integration, and subsequent college commitment) influenced persistence in student athletes as compared to non-student athletes while controlling for students' backgrounds. The findings suggest that student athletes are more likely to persist. In addition, while Black students were more likely to persist than non-Black students as a whole, Black student athlete were less likely to persist than Black non-student athletes. Also, while some factors influenced student athletes and non-student athlete persistence patterns differently, no consistent pattern emerged. This study contributes to Braxton's model by suggesting classroom achievement, as measured by GPA, should be considered for inclusion in the model. Finally, this study has implications for administrators, especially those considering the use of athletics as an enrollment strategy.

The Fueling Station at Utah State University was created to provide pre-workout fueling and post-workout recovery foods to the Utah State University athletes. The athletes use an online survey to mark what foods they selected after each visit to the Fueling Station. There is a large amount of research on the lack of sports nutrition knowledge in collegiate athletes, but there is little information on the dietary intake of athletes, the education of athletes, and the education of macronutrient timing in athletes. A food labeling system named “Gain Your Edge” food labels that targeted the education of timing was created in the Utah State University Fueling Station. It lets athletes know which food choices might be the most appropriate choices for certain periods of timing (i.e. pre-workout versus post-workout). The Fueling Station was selected as an outlet for education because it reaches a large percentage of all Utah State athletes each week. The survey responses by the athletes were used to determine if the fueling station visits were appropriate or not appropriate based on the reported timing of eating, purpose of eating, and food selections. After four weeks of implementation, it was determined that the food labels did result in significant changes in percentage of appropriate fueling station visits for the athletes. However, almost all the athletes noticed the food labels, and more than 75% of the athletes said that the food labels influenced their food selection. This research project contributes important information about the patterns of use in a University-sponsored fueling station to the limited knowledge base of collegiate sports nutrition research.

Major challenges facing sport psychology researchers, practitioners, coaches, and athletes include understanding mental toughness and knowing how to train for it. Athletes and coaches have long identified mental toughness as an important attribute for performance. Practitioners have devised training approaches for mental toughness—often based on anecdotal notions of what mental toughness is and how it should be developed. The research available on mental toughness is scarce, with only a few recent but limited advances. Fundamental to the challenge of understanding and training mental toughness, there is a critical need for research to develop a model of mental toughness that is not based on anecdote, but rather on sound research methods and theoretical underpinnings. Following on from conceptualisation, there is a need to develop an instrument to measure mental toughness. Taken together, a conceptual model and a measurement approach are the tools needed by researchers to develop and test mental toughness training programs. The purpose of this thesis was to address some of these issues by capitalising on the strengths of both qualitative and quantitative methods to: (a) critically examine a popular test of mental toughness; (b) determine specific characteristics of mental toughness and understand the interrelationship between those characteristics; (c) develop a model of mental toughness that draws together specific characteristics; (d) produce a mental toughness definition; (e) develop the Mental Toughness Inventory, a robust and valid instrument that demonstrates a sound factor structure, strong reliabilities, and invariance across gender, age, and level of competition (i.e., demonstrating within-network validity); and (f) determine the relative congruence between scores on the Mental Toughness Inventory and theoretically related constructs (i.e., demonstrating between-network validity). In line with these aims, Study 1 evaluated the psychometric properties of an existing, popular, and yet unsubstantiated test of mental toughness—the Psychological Performance Inventory (PPI). Given the breadth and depth of mental toughness as evidenced by the literature, the PPI was not expected to provide a reasonable model. Instead, the study was intended to inform the researcher on the psychometric strengths of the PPI and guide the development of a new measure of mental toughness throughout the remainder of the thesis. The PPI was examined using both within-network and between-network validity checks and responses from 263 student-athletes in Years 7–12 (12 to 19 years of age). Study 2 was a qualitative study that examined the interview data of over 30 elite sportspeople to determine the characteristics of mental toughness. The purpose of this study was to develop a conceptual model and definition of mental toughness that draws together all the characteristics in a way that adds meaning and clarity to the concept. The purpose of Studies 3 and 4 was to construct, refine, and validate the Mental Toughness Inventory (MTI)—a measure of mental toughness emanating from the findings of Studies 1 and 2. Studies 3 and 4 critically examined the construct validity of the MTI using both within-network and between-network validation on the basis of responses from institution-based athletes (from sports programs such as those run by the Australian Institute of Sport) and school-based athletes (from a selective sports high school). Furthermore, Studies 3 and 4 provided the scope to examine invariance of the mental toughness factor structure across groups, group mean-level differences, and interaction effects. The results of Study 1 provided a number of insights into the status of the PPI, raised an interesting conundrum regarding the interface between conceptualisation and instrumentation, and provided guidance for instrument development that would become the empirical basis of subsequent quantitative studies. The qualitative results of Study 2 unearthed a multidimensional model of mental toughness, containing 12 first-order factors each of which contribute to a higher order (or Global) mental toughness factor. The 12 mental toughness characteristics identified are: self-efficacy, potential, mental self-concept, value, personal bests, commitment, stress minimisation, perseverance, positive comparisons, positivity, task familiarity, and task focus. Study 3 involved the construction of the Mental Toughness Inventory (MTI), with results revealing excellent validity from a within-network perspective (including confirmatory factor analysis, goodness of fit, internal reliability, and invariance across groups). Study 4 results revealed that MTI factors correlated more strongly with theoretically-related concepts and less strongly with unrelated concepts—thus demonstrating between-network validity (convergent and discriminant). Study 4 also revealed a number of significant main effects of age (favouring older athletes), gender (favouring male athletes) and group (a contextual effect where institution-based athletes rate themselves more ―rigorously relative to strong contextual effects, which need to be carefully considered when assessing and developing mental toughness. For sporting organisations, this research points to a number of things that can be done at an institutional level—particularly in relation to creating an environment that is most likely to facilitate the positive development of various components of mental toughness. Finally, for research and continued theorising about mental toughness, the findings from this thesis support viewing mental toughness as a combination of cognitive, behavioural, and emotive processes that work together in combating adversity or pressure. Taken together, the conceptualising and empirical works conducted in this study are proposed to advance the field of research—creating opportunities to study the effectiveness of interventions designed to enhance mental toughness. Furthermore, the results provide practitioners, coaches, and athletes with a concrete understanding of mental toughness such that they are better equipped to devise training approaches and to handle pressure and adversity en route to athletic success. / Doctor of Philosophy (PhD)

The use of complementary and alternative medicines and therapies (CAM) in Australia and across the world is becoming increasingly prevalent. The most recent survey conducted by MacLennon et al. in 2004 [2] identified that more than half the general Australian population had used some form of CAM in the previous 12 months before the survey was conducted.[2-4] Up until now, the prevalence of CAM use among elite Australian athletes was unknown. As athletes are constantly looking to gain an advantage over their competitors through physical or psychological interventions or through the application of new technologies, it was hypothesised that the use of CAM in this group would be higher in athletes than in the general population. After surveying 497 elite Australian athletes we found that 93% of this specific population utilised at least one CAM within their lifetime. The 10 CAM (as defined by the Therapeutics Goods Administration) used most frequently were sports drinks, massage, sports bars, cereal bars, multivitamins, aloe vera, sports gels, Pilates, caffeine and yoga. There were no significant differences identified between specific sporting groups- football codes, court sports, field sports, water sports and others, with all groups reporting high usage. Sports physicians, family, coaches and friends were identified as the main sources for product information, with health food shops, sports dieticians and sports physicians being the predominant providers of the actual product. Four CAM sold on the Australian market which purported to decrease the symptoms of delayed onset muscle soreness (DOMS), or reported anti-inflammatory properties which could impact of the inflammatory response associated with DOMS were studied. Lyprinol® (an anti-inflammatory agent), topical Arnica (for symptomatic relief of soft tissue trauma), Tienchi Ginseng (proposed to relieve symptoms of DOMS) and Devil’s Claw (an analgesic and anti-inflammatory agent) were the chosen CAM. Four separate randomised, double blind placebo controlled studies comprising of 20 subjects per study were carried out with the same DOMS inducing methodology (downhill treadmill running) employed. All subjects in each of the four studies had their performance (counter movement and squat jump, maximal force), pain (visual analogue scale and muscle tenderness) and blood parameters (high sensitivity C-reactive protein, interleukin-1A, interleukin-6, tumour necrosis factor-K, creatine kinase and myoglobin) analysed seven times over five days. Lyprinol® did not affect performance, pain or blood markers of muscle damage and inflammation analysed in this study. Despite Lyprinol® being marketed as having “potent anti-inflammatory” properties, Lyprinol® did not demonstrate any antiinflammatory properties in our sample group at a dose of 200mg daily for two months, and did not alter any of the markers of inflammation after a downhill running protocol. A significant difference was identified in quadriceps muscle tenderness between the topical Arnica and placebo groups 72 hours after the downhill running protocol. This indicated that the topical Arnica group experienced less quadriceps pain at this time point, though this was not reflected in the quadriceps visual analogue scale results. There were significant differences identified between the topical Arnica and placebo groups for muscle tenderness in the gastrocnemius and tumour necrosis factor-K concentration at baseline. Further statistical analysis assessing relative changes from baseline did not demonstrate any statistically significant differences between the groups for either of these parameters. We therefore conclude that the symptomatic relief of soft tissue trauma claimed from a topical Arnica product sold in Australia was not conclusively demonstrated in this study. The single, isolated significant difference identified in quadriceps tenderness does not conclusively, from this study, indicate efficacy for the use of this topical Arnica for the relief of soft tissue trauma. Tienchi Ginseng demonstrated the most promising outcomes, with statistically significant differences identified in performance and inflammatory markers in favour of Tienchi Ginseng. Though it cannot be conclusively deemed beneficial for DOMS from this study alone, Tienchi Ginseng warrants further research with larger sample sizes and a similar muscle damage protocol. Finally, Devil’s Claw did not demonstrate beneficial outcomes in regards to DOMS within this study. It actually demonstrated some, perhaps detrimental effects, upon analysis of performance and inflammatory markers. We are unsure of the mechanisms behind these findings, particularly when considering the proposed anti-inflammatory effects of Devil’s Claw. From the literature, Devil’s Claw appears to be beneficial in chronic musculoskeletal conditions however it does not seem to impact on muscle damage and pain resulting from DOMS inducing exercise. The questionnaire study has demonstrated that there is a high usage of CAM among elite Australian athletes, an area up until now that has been unexplored. The onset of CAM use within the Australian athletic population, and the prevalence of CAM use by other professional Australian athletes would be an area to explore in the future. In regards to products which specifically claim to benefit athletes suffering soft tissue trauma such as DOMS, convincing evidence for specific product use was not demonstrated in these studies. Further research involving greater sample sizes may reveal more definitive outcomes, specifically in regards to the use of Tienchi Ginseng. / Doctor of Philosophy (PhD)

Most advice for improving physiological strain in the heat includes maintaining hydration using long-term acclimation protocols (>10 days). Therefore, the major aims of this thesis were to examine; (i) effectiveness of short term (5-day) heat acclimation (STHA) with moderately and highly trained athletes; (ii) fluid regulatory strain has a thermally-independent role in heat adaptation; and, (iii) impact of STHA on a marker of thermotolerancè (inducible heat shock protein 70; HSP70). Ten moderately trained males completed heat acclimation (Acc) under controlled hyperthermia (rectal temperature 38.5�C) for 90-min on five consecutive days (T[a] = 40�C, 60% RH), on two occasions separated by a five-week washout, in a cross-over design. One Acc was undertaken with euhydration (fluid replenishment; EUH) and one with dehydration (no fluid intake; DEH) during daily Acc bouts. Participants completed an exercising heat stress test (HST) one week before, then on the 2nd day after Acc for both regimes. HST involved cycling at 40% PPO for 90 min (T[a] = 35�C, 60% RH), 10 min rest and a ramp protocol (2% PPO each 30 s) to volitional fatigue. HSTs were further completed 1, 2, and 3 wks after Acc to track the acclimation decay. On a later occasion eight highly trained male rowers were heat acclimated under the same protocol but with DEH acclimation only and a rowing-specific HST (2000 m rowing performance test). Plasma volume (PV) at rest and cardiac output (Q̇) during HSTs were measured using CO and CO₂ rebreathing, respectively. A number of plasma constituents were measured: PV, AVP, aldosterone, HSP70, total protein, albumin, Na⁺, K⁺, Cl⁻ and osmolality. Short term heat acclimation resulted in physiological adaptation and enhanced exercise capacity for moderately trained participants. Compared to EUH permissive DEH during Acc bouts conferred larger acclimation-induced increases in resting PV by 4.1% (95%CI: -1.5 to 9.8%; p=0.06), Q̇[F]. (4.2: 0.7 to 7.8 mlmin⁻� 100 ml⁻�; p0.009), FVC (0.06: 0.02 to 0.10 ml 100ml Tissue⁻�mmHg⁻�; p=0.006), end-exercise V[s] (45.9: 3.6 to 84.4 mL; p=0.02) and decreased end-exercise f[c] by 17% (19: -29 to 9 b�min⁻�; p=0.08). Cardiovascular adaptations except PV persisted for one wk, but not two wks after Acc indicating that cardiovascular-related benefits from STHA may not be mediated by hypervolaemic responses per se. The highly trained athletes had functional heat adaptations of similar magnitude to lesser fitness-adapted participants across DEH acclimation, including resting PV expansion (4.5: 0.7 to 8.3%) and increased performance (-4.0: -6.3 to 0.6[s]; p=0.02). Plasma total protein-corrected HSP70 concentration increased from rest to end-exercise across acclimation (p=0.001). There was a greater change from rest to end-exercise on day one versus day five Acc (p=0.05), indicating a reduced stress-induced increase and a protective adaptive change. There were weak to moderate relationships between hydration indices in dynamic circumstances indicating that there is no single measure to accurately assess hydration status. In conclusion, short-term (5-day) heat acclimation was effective with adaptations more pronounced after fluid regulatory strain from a dehydration acclimation regime. Similar findings were found using highly trained and lesser- fitness adapted participants. Thermotolerance was increased by dehydration acclimation.

The relationships between selected sprint specific bounding exercises and sprint performance were analysed using fourteen sprint athletes (7 elite performers, 7 sub-elite performers). Subjects were required to perform sprints over 60m, Counter Movement Jumps with and without loading (20kg), High Speed Alternate Leg Bounding over 30m and High Speed Single Leg Hopping over 20m. All athletes were subject to anthropometric measurement (Height, Weight and Leg Length). Of all variables measured, the Elite group were significantly better (p<0.001) in Counter Movement Jump, Time to 60m, Time from 30m to 60m and in their Maximal Running Velocity. Linear regressions were carried out on all variables that correlated with Time to 30m (Acceleration Phase) and Maximal Running Velocity at both the pO.OOl and p<0.01 level of significance. This allowed several prediction tables to be compiled that had performance measures (sprints and jumps) that could be used as testing measures for sprint athletes to determine their Acceleration Phase and Maximal Running Velocity. A stepwise multiple regression demonstrated that Time to 60m was the best predictor of Maximal Running Velocity. Time to 60m, Leg length, High Speed Alternate Leg Bounding and Sprint Stride Rate were the best predictors of the Acceleration Phase. A Stepwise cross-validation linear discriminant function analysis was used to determine the best predictors from both sprint and jump measures that would distinguish an athlete as an elite or sub-elite performer. From sprint variables, Time to 60m and Time to 30m were the two variables that best placed a sprint subject in either the Elite or Sub-elite group. From the bounding variables, Counter Movement Jump and the Ground Contact Time of the High Speed Alternate Leg Bounding were the two variables that best placed a sprint subject in either the Elite or Sub-elite group. The present study suggests that Time to 60m is the best predictor of Maximal Running Velocity and Acceleration Phase. Counter Movement Jumping and High speed Alternate Leg Bounding are also useful tools in developing and testing elite sprint athlete performance.

This thesis is a biographical case study of Olympic, World and Commonwealth sculling champion Peter Antonie, whose career at the elite or high performance level spanned some 23 years � from 1977 to 2000. The thesis examines the exploits of an oarsman and sculler regarded within his sport as one of Australia�s greatest ever, despite his being considered physically disadvantaged at every phase of his career. Antonie was, most notably, a man of small stature � widely considered a handicap at the level of rowing to which he aspired, and at which he ultimately succeeded. The study also examines what it was, despite those perceived disadvantages, that drove him to excel. The thesis further examines, in thematic form, parallel developments within Australian rowing and sculling in the quarter of a century in which Peter Antonie competed. This was a period during which fundamental changes were seen in Australian sport, notably in the areas of funding and administration, and which saw a transformation from amateur to professional participation at the Olympic, Commonwealth Games and world championships levels. There were also marked changes to high performance rowing as a result of technological advances that produced new types of equipment, and scientific developments that brought new training and selection methodologies. The research was carried out as part of a systematic attempt to examine and investigate Peter Antonie�s reputation, particularly as it compares with his better-known contemporaries, the so-called Oarsome Foursome, and to analyse that reputation in light of the administrative developments in Australian rowing and Australian sport. The historical approach used was the biographical method of research and analysis, with the preferred technique the obtaining of oral testimony from 50 interviewees, some of whom were interviewed more than once. The research clearly indicated that throughout his career Peter Antonie continually defied assumptions about his potential, particularly where science-based preconceptions about talent identification were concerned, and achieved success far beyond initial expectations. As a result his achievements, nationally and globally, are perhaps unparalleled, and he is held in the highest regard, particularly by the higher profile Oarsome Foursome. Despite this accolade, however, Antonie�s public profile remains very low, to the extent that beyond the rowing fraternity he is virtually unknown. Despite, too, rowing�s status as an Olympic sport and the commensurate increases in funding during Antonie�s career, he himself maintains a fundamentally amateur approach to his participation in rowing and is critical of several facets of its current �professional� administration. Despite, too, rowing and sculling once being among Australia�s major sports a hundred or so years ago, within contemporary Australian society it has a low profile, a situation which, given that current administration, appears likely to continue. Problems encountered during the research included some diffidence on the part of an essentially humble and self-effacing subject and a lack of literature relating to Antonie and his sport. But these were to an extent offset by the enthusiasm displayed for the project by other interviewees. The results of the research are significant in that, like the subject, they defy some precepts concerning facets of Australian rowing and sculling, which in turn might encourage further investigation.