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Antiplatelet therapy in the era of percutaneous coronary intervention with drug-eluting balloons
(2011)
The high rate of restenosis associated with percutaneous coronary intervention (PCI) procedures can be reduced with the implantation of metallic stents into the stenotic vessels. The knowledge that neointimal formation can result in restenosis after stent implantation led to the development of drug-eluting stents (DES) which require long lasting antiplatelet therapy to avoid thrombotic complications. In the last years, the drug-eluting balloon (DEB) technology has emerged as an alternative option for the treatment of coronary and peripheral arteries. Clinical studies demonstrated the safety and effectiveness of DEB in various clinical scenarios and support the use of paclitaxel-eluting balloons for the treatment of in-stent restenosis, of small coronary arteries and bifurcations lesions. The protocols of DEB studies suggest that the dual antiplatelet therapy with aspirin and clopidogrel of four weeks after DEB is safe and effective.
High class students in the universities, the rest in the other institutions of higher education
(2011)
In Germany, different types of university-level institutions are available for tertiary education: traditional universities (Universitaten) and-since the 1970s-universities of applied science (Fachhochschulen) as well as universities of cooperative education (Berufsakademien). The present study investigates differences in key areas related to students' academic choices and success: do students at different types of university differ significantly in terms of cognitive performance, personality or social background? We compared N = 1.230 students at traditional universities, universities of applied science, and universities of cooperative education (Baden-Wurttemberg Cooperative State University) on the basis of a large scale longitudinal study in the German federal state of Baden-Wurttemberg. Students of the different university types differed significantly in all three key areas (cognitive performance, personality, and social background) within the fields of technical sciences and economics. We determine the relative importance of these key areas for differences between university types and we discuss the implications of our findings.
Efforts to break the link between the school type attended and the qualification awarded are seen an important step in the modernization of Germany's tracked secondary school system. However, it remains disputed whether these efforts have reduced social disparities or in fact increased them. This study examined the transition from lower secondary education in academic- and intermediate-track schools to upper secondary education in general and vocational gymnasium schools in the state of Baden-Wurttemberg. When indicators of parental social background and school-leaving qualifications were controlled, the opening of upper secondary education was found to be associated with a decrease in the social selectivity of upper secondary education for intermediate-track students. At the same time, for those intermediate-track students who were entitled to enter upper secondary education, social background had predictive effects on the transition decision; however, the overall size of these effects was low.
According to the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) published in 2009, only 5% to 8% of the 15-17-year-old adolescents reach the current recommendations on health-enhancing physical activity This result (besides others in the survey) rests on data measured with the 25-item physical activity questionnaire for children and adolescents (MoMo-AFB). The present study compares two different methods of assessing physical activity with the purpose of testing the validity of the MoMo-AFB self-report. First, we measured the physical activity status of 73 15 to 18-year-old pupils (32 boys and 41 girls) over seven days via objective accelerometry (ActiGraph GT1M), then the pupils completed the MoMo-AFB for the same (previous) period. Results show that using the MoMo-AFB leads to higher levels of self-reported physical activity than measuring it with accelerometers. Furthermore, only the MoMo-AFB subscale MVPA (moderate-to-vigorous physical activity), that uses two single items to decide whether the health-enhancing physical activity recommendation is reached or failed, corresponds statistically significantly with the accelerometry data. For all other subscales (e.g. school- or leisure time activity), we found no agreement. Further research, first of all on the measurement quality of the MoMo-AFB but also on the physical (in)activity status of children and adolescents, is needed.
Using a large representative database (12,902 matches from the top professional football league in Germany), I show that the number (441) of two-penalty matches is larger than expected by chance, and that among these 441 matches there are considerably more matches in which each team is awarded one penalty than would be expected on the basis of independent penalty kick decisions (odds ratio=11.2, relative risk=6.34). Additional analyses based on the score in the match before a penalty is awarded and on the timing of penalties, suggest that awarding a first penalty to one team raises the referee's penalty evidence criterion for the same team, and lowers the corresponding criterion for the other team.
Background Athlete's heart as an adaptation to long-time and intensive endurance training can vary considerably between individuals. Genetic polymorphisms in the cardiological relevant insulin-like growth factor 1 (IGF1) signalling pathway seem to have an essential influence on the extent of physiological hypertrophy.
Objective Analysis of polymorphisms in the genes of IGF1, IGF1 receptor (IGF1R) and the negative regulator of the cardiac IGF1 signalling pathway, myostatin (MSTN), and their relation to left ventricular mass (LVM) of endurance athletes.
Methods In 110 elite endurance athletes or athletes with a high amount of endurance training (75 males and 35 females) and 27 male controls, which were examined by echocardiographic imaging methods and ergometric exercise-testing, the genotypes of a cytosine-adenine repeat polymorphism in the promoter region of the IGF1 gene and a G/A substitution at position 3174 in the IGF1R gene were determined. Additionally, a mutation screen of the MSTN gene was performed.
Results The polymorphisms in the IGF1 and the IGF1R gene showed a significant relation to the LVM for male (IGF1: p=0.003; IGF1R: p=0.01), but not for female athletes. The same applies to a previously unnoticed polymorphism in the 1 intron of the MSTN gene, whose deletion allele (AAA -> AA) appears to increase the myostatic effect (p=0.015). Moreover, combinations of the polymorphisms showed significant synergistic effects on the LVM of the male athletes.
Conclusions The authors' results argue for the importance of polymorphisms in the IGF1 signalling pathway in combination with MSTN on the variant degree of physiological hypertrophy of male athletes.
Spielberger's (1972) Trait-State-Anxiety theory distinguishes between anxiety as a trait (A-trait) - involving a stable characteristic of a person to react with anxiety in response to varying situations and anxiety as a state (A-state), a situation-dependent reaction to a stimulus perceived as threatening. Using a general instead of a sport-specific measure, a previous study provided only mixed support for core predictions of the theory as related to sports (Schwenkmezger, 1985). With the aid of enhanced instruments and statistical methods, we tested these predictions again. The multidimensional and competition-specific assessment of anxiety results in support for the assumption of a stable A-trait and a fluctuating A-state, whereby the A-trait not only predicts the intensity of A-states but also the A-state variability. The repeated assessment of A-states prior to two competitions reveals a rather low relative consistency (i.e., interindividual differences across measurements were only moderately stable). Especially this latter finding suggests that, in order to gain a full understanding of the experience of competitive anxiety in athletes, sport psychologists should not only assess competitive A-traits, but also repeatedly measure competitive A-states.
Mindfulness and acceptance describe the skills necessary to experience emotions and thoughts (e.g., performance-interfering cognitions) consciously and without judging them. This article introduces the mindfulness and acceptance approach and its potential in the context of competitive sports. Definitions as well as research results related to mechanisms of action and differential psychological aspects are given and the efficacy of the approach in the field of clinical psychology is reviewed. The rationale and implementation of the mindfulness-acceptance-commitment approach, an approach adapted for performance enhancement, is illustrated. Finally, evidence from psychotherapy research is presented, and a recommendation for the use of mindfulness and acceptance in the context of competitive sports is given.
Quality management of sport psychology care in competitive sports - (no) effect without acceptance?!
(2011)
In the past decade quality management (QM) has grown to be one of the most important topics in the area of applied sport psychology. There we discuss structures, processes, and results concerning QM, considering the QM model of the European Foundation of Quality Management (EFQM). In terms of results, quality can be defined in three areas: the coaching process itself (e. g., satisfaction and well-being of coach and client), psychological skills (e. g., efficacy of techniques used by the client), and health, personality, as well as sport performance (e. g., client's motor behavior in training and competition). Measures and processes to improve and ensure quality in these three areas are discussed as being dependent on four types of determinants: associated institutions, sport psychologists (i.e., individual competence and valence of tasks), coaching character, and socio-economic factors. As key processes of QM in this complex structure, both orientation to stakeholders and communication about quality and QM measures are identified.