Creating optimally safe and enjoyable youth sporting experiences within the United Kingdom.

Considering recent research and reports, much attention has been given to understanding and addressing issues of abuse in sport. Similarly, attention has been given to enhancing children's psychosocial experiences within sport. However, to-date, consideration of these two elements together, that is minimising abuse and enhancing enjoyment, has been minimal. Thus, the purpose of the current study was to explore perceptions of the process through which an optimally safe and enjoyable sporting experience can be created for young people. A Straussian grounded theory methodology was used to develop a substantive theory detailing the process through which an optimally safe and enjoyable sporting experience is created for young people in sport. Interviews were conducted with 19 young people, six parents, nine coaches, and five individuals in safeguarding roles. The interviews were analysed through open and axial coding, followed by theoretical integration. The resultant theory highlighted that establishing positive relationships between all young people and key individuals in a physically and developmentally safe environment was a fundamental requirement for fostering an optimally safe and enjoyable sporting experience. Achieving this required consideration of factors both in the immediate and broad sporting context. Specifically, support from sports organisations, access to continuing professional development opportunities, and a network of safeguarding experts are required in the broader environment. While within the immediate sporting environment, visibly displayed and appropriately implemented safeguarding policies and procedures; open, honest, and respectful interactions; shared goals and expectations between parents, coaches, and young people, and; trusting and supportive friendships with shared experiences are required.

Consequences of comorbid sleep apnea in the metabolic syndrome--implications for cardiovascular risk.

STUDY OBJECTIVES: Metabolic syndrome (MetSyn) increases overall cardiovascular risk. MetSyn is also strongly associated with obstructive sleep apnea (OSA), and these 2 conditions share similar comorbidities. Whether OSA increases cardiovascular risk in patients with the MetSyn has not been investigated. We examined how the presence of OSA in patients with MetSyn affected hemodynamic and autonomic variables associated with poor cardiovascular outcome. DESIGN: Prospective clinical study. PARTICIPANTS: We studied 36 patients with MetSyn (ATP-III) divided into 2 groups matched for age and sex: (1) MetSyn+OSA (n = 18) and (2) MetSyn-OSA (n = 18). MEASUREMENTS: OSA was defined by an apnea-hypopnea index (AHI) > 15 events/hour by polysomnography. We recorded muscle sympathetic nerve activity (MSNA - microneurography), heart rate (HR), and blood pressure (BP - Finapres). Baroreflex sensitivity (BRS) was analyzed by spontaneous BP and HR fluctuations. RESULTS: MSNA (34 +/- 2 vs 28 +/- 1 bursts/min, P = 0.02) and mean BP (111 +/- 3 vs. 99 +/- 2 mm Hg, P = 0.003) were higher in patients with MetSyn+OSA versus patients with MetSyn-OSA. Patients with MetSyn+OSA had lower spontaneous BRS for increases (7.6 +/- 0.6 vs 12.2 +/- 1.2 msec/mm Hg, P = 0.003) and decreases (7.2 +/- 0.6 vs 11.9 +/- 1.6 msec/mm Hg, P = 0.01) in BP. MSNAwas correlated with AHI (r = 0.48; P = 0.009) and minimum nocturnal oxygen saturation (r = -0.38, P = 0.04). CONCLUSION: Patients with MetSyn and comorbid OSA have higher BP, higher sympathetic drive, and diminished BRS, compared with patients with MetSyn without OSA. These adverse cardiovascular and autonomic consequences of OSA may be associated with poorer outcomes in these patients. Moreover, increased BP and sympathetic drive in patients with MetSyn+OSA may be linked, in part, to impairment of baroreflex gain.