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The survey of the prevalence of chronic ankle instability in elite Taiwanese basketball athletes
(2021)
BACKGROUND: Ankle sprains are common in basketball. It could develop into Chronic Ankle Instability (CAI) causing decreased quality of life, functional performance, early osteoarthritis, and increased risk of other injuries. To develop a strategy of CAI prevention, localized epidemiology data and a valid/reliable tool are essential. However, the epidemiological data of CAI is not conclusive from previous studies and the prevalence of CAI in Taiwanese basketball athletes are not clear. In addition, a valid and reliable tool among the Taiwan-Chinese version to evaluate ankle instability is missing.
PURPOSE: The aims were to have an overview of the prevalence of CAI in sports population using a systematic review, to develop a valid and reliable cross-cultural adapted Cumberland Ankle Instability Tool Questionnaire (CAIT) in Taiwan-Chinese (CAIT-TW), and to survey the prevalence of CAI in elite basketball athletes in Taiwan using CAIT-TW.
METHODS: Firstly, a systematic search was conducted. Research articles applying CAI related questionnaires in order to survey the prevalence of CAI were included in the review. Second, the English version of CAIT was translated and cross-culturally adapted into the CAIT-TW. The construct validity, test-retest reliability, internal consistency, and cutoff score of CAIT-TW were evaluated in an athletic population (N=135). Finally, the cross-sectional data of CAI prevalence in 388 elite Taiwanese basketball athletes were presented. Demographics, presence of CAI, and difference of prevalence between gender, different competitive levels and play positions were evaluated.
RESULTS: The prevalence of CAI was 25%, ranging between 7% and 53%. The prevalence of CAI among participants with a history of ankle sprains was 46%, ranging between 9% and 76%. In addition, the cross-cultural adapted CAIT-TW showed a moderate to strong construct validity, an excellent test-retest reliability, a good internal consistency, and a cutoff score of 21.5 for the Taiwanese athletic population. Finally, 26% of Taiwanese basketball athletes had unilateral CAI while 50% of them had bilateral CAI. In addition, women athletes in the investigated cohort had a higher prevalence of CAI than men. There was no difference in prevalence between competitive levels and among play positions.
CONCLUSION: The systematic review shows that the prevalence of CAI has a wide range among included studies. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of CAI are required. The CAI epidemiological study should be prospective. Factors affecting the prevalence of CAI ability should be investigated and described. The translated CAIT-TW is a valid and reliable tool to differentiate between stable and unstable ankles in athletes and may further apply for research or daily practice in Taiwan. In the Taiwanese basketball population, CAI is highly prevalent. This might relate to the research method, preexisting ankle instability, and training-related issues. Women showed a higher prevalence of CAI than men. When applying the preventive measure, gender should be taken into consideration.
Prevalence and Predictors of Sexual Aggression Victimization and Perpetration in Chile and Turkey
(2017)
Background: Although sexual aggression is recognized as a serious issue worldwide, the current knowledge base is primarily built on evidence from Western countries, particularly the U.S. For the present doctoral research, Chile and Turkey were selected based on theoretical considerations to examine the prevalence as well as predictors of sexual aggression victimization and perpetration. The first aim of this research project was to systematically review the available evidence provided by past studies on this topic within each country. The second aim was to empirically study the prevalence of experiencing and engaging in sexual aggression since the age of consent among college students in Chile and Turkey. The third aim was to conduct cross-cultural analyses examining pathways to victimization and perpetration based on a two-wave longitudinal design.
Methods: This research adopted a gender-inclusive approach by considering men and women in both victim and perpetrator roles. For the systematic reviews, multiple-stage literature searches were performed, and based on a predefined set of eligibility criteria, 28 studies in Chile and 56 studies in Turkey were identified for inclusion. A two-wave longitudinal study was conducted to examine the prevalence and predictors of sexual aggression among male and female college students in Chile and Turkey. Self-reports of victimization and perpetration were assessed with a Chilean Spanish or Turkish version of the Sexual Aggression and Victimization Scale. Two path models were conceptualized in which participants’ risky sexual scripts for consensual sex, risky sexual behavior, sexual self-esteem, sexual assertiveness, and religiosity were assessed at T1 and used as predictors of sexual aggression victimization and perpetration at T2 in the following 12 months, mediated through past victimization or perpetration, respectively. The models differed in that sexual assertiveness was expected to serve different functions for victimization (refusal assertiveness negatively linked to victimization) and perpetration (initiation assertiveness positively linked to perpetration).
Results: Both systematic reviews revealed that victimization was addressed by all included studies, but data on perpetration was severely limited. A great heterogeneity not only in victimization rates but also in predictors was found, which may be attributed to a lack of conceptual and methodological consistency across studies. The empirical analysis of the prevalence of sexual aggression in Chile revealed a victimization rate of 51.9% for women and 48.0% for men, and a perpetration rate of 26.8% for men and 16.5% for women. In the Turkish original data, victimization was reported by 77.6% of women and 65.5% of men, whereas, again, lower rates were found for perpetration, with 28.9% of men and 14.2% of women reporting at least one incident. The cross-cultural analyses showed, as expected, that risky sexual scripts informed risky sexual behavior, and thereby indirectly increased the likelihood of victimization and perpetration at T2 in both samples. More risky sexual scripts were also linked to lower levels of refusal assertiveness in both samples, indirectly increasing the vulnerability to victimization at T2. High sexual self-esteem decreased the probability of victimization at T2 through higher refusal assertiveness as well as through less risky sexual behavior also in both samples, whereas it increased the odds of perpetration at T2 via higher initiation assertiveness in the Turkish sample only. Furthermore, high religiosity decreased the odds of perpetration and victimization at T2 through less risky sexual scripts and less risky sexual behavior in both samples. It reduced the vulnerability to victimization through less risky sexual scripts and higher refusal assertiveness in the Chilean sample only. In the Turkish sample only, it increased the odds of perpetration and victimization through lower sexual self-esteem.
Conclusions: The findings showed that sexual aggression is a widespread problem in both Chile and Turkey, contributing cross-cultural evidence to the international knowledge base and indicating the clear need for implementing policy measures and prevention strategies in each country. Based on the results of the prospective analyses, concrete implications for intervention efforts are discussed.