Conceptualising safety culture for safeguarding children in sport

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonResearch over the past 30 years suggests that sport can provide a context in which children are subjected to several forms of maltreatment. Various countries, regions, sports and individual organisations have responded to this evidence, causing a proliferation of methods used to safeguard children from harm. However, one approach that is yet to be considered is the safety culture approach. This is despite its potential to address all of the potential risk factors of child maltreatment in sport, and its evidenced ability to tackle a wide range of safety concerns in fields as far-reaching as healthcare, aviation and energy production. Based on this, the aim of this thesis was to conceptualise safety culture in sport from a child safeguarding perspective. A total of 45 interviews and 7 focus groups were conducted with participants from five organisations which differed on the grounds of size, mission and geographical location. Data was analysed using thematic analysis. Findings suggested that safety culture in sport is influenced by the presence and nature of; safety management systems, committed leadership and stakeholder engagement. Findings also suggested that these factors have an interconnected relationship, which influences the nature and strength of the safety culture. These factors and their subsequent safety culture were also found to be influenced by a multitude of internal and external contextual factors. Therefore, the findings of this thesis are used to present the Safety Culture Model for Safeguarding Children. This is the first of its kind as both a model of safety culture in sport, and a safety culture model that specifically relates to safeguarding children. Practical implications and avenues for future research are also presented

Comparing the strategies used to maintain the coach-athlete relationship in Japan and the United Kingdom

The present study explored the strategies used to maintain the quality of the coach-athlete relationship amongst rowers in Japan and the United Kingdom. A total of 93 athletes from Japan (N = 49) and UK (N = 44) completed the Coach Athlete Relationship Maintenance Questionnaire (CARM-Q) and the Athlete Satisfaction Questionnaire (ASQ). The results of T-tests showed that (a) university rowers in the UK were significantly more satisfied with the coach-athlete relationship than those in Japan; (b) the athletes in Japan expressed higher scores on Preventative strategies than the ones in the UK; (c) the athletes in the UK expressed higher scores on all other CARM-Q subscales with the exception of Social Networks. The results of correlation analyses revealed positive associations between the use of maintenance strategies and athlete satisfaction. These findings evidence the importance of coaches using strategies to maintain the effectiveness of their relationship with athletes as well as the importance of researchers taking cultural factors into account

Asante Bekwai United Schools’ Arts and Crafts Centre: a Model of Technical/Vocational Education (TVE) Curriculum Diversification and Utilization of local Expertise in colonial Ghana (1940-1950)

The paper discusses the general organization and operation of Asante Bekwai United Schools’ Arts and Crafts Centre as a model of TVE in the country during the 1940s.  In particular, it focuses, inter alia, on the positive consequences of judiciously utilizing the “top-down change” and “bottom-up change” to use the words of  Fullan (2007) in TVE educational policy formulation and implementation in colonial Ghana.  This feat was achieved through the leadership efforts of  the British colonial administration, the four missionary bodies then  at Asante Bekwai (namely the Methodist Mission, the English Church Mission, the Catholic Mission and the Seventh-day Adventist Mission) the Asante Bekwai traditional authority and the Achimota College in Accra.  It further discusses the nature of the curriculum of the Centre and its utilization of local expertise in the teaching and learning process   It further discusses the effects of the income generation activities at the Centre.  In this endeavour, a critical analysis of relevant historical information retrieved from the Public Record and Archives Department (PRAAD) office in Asante Region of Ghana was undertaken by the authors. The study, inter alia, revealed that the collaboration between the Centre and stakeholders greatly contributed to the steady progress of the Centre. It was again observed   that the curriculum of the Centre was quite versatile; capable of equipping its beneficiaries to acquire relevant skills for productive livelihoods. The vibrant nature of the Centre was also evident by the fact that the income that was generated from the activities was used to procure some tools for the Centre. Undoubtedly, such an educational initiative was bound to grapple with teething challenges and it was anticipated that such challenges would be quickly addressed for smooth progress of the Centre. Future studies into such challenges and their remedies are thus encouraged. Keywords: Asante Bekwai; Arts and Crafts; mat weaving; pottery, curriculum, Achimot

Inclusivity in Pre-Assessment Support

An attainment gap persists between our UK domiciled white students and students of Black, Asian and Minority Ethnic groups (BAME), despite the best efforts of the inclusive curriculum framework. It has previously been identified that use of academic language can be a contributing factor to lower attainment for BAME students (Open University Annual Report, 2013) and that they may be less likely to access support (Stuart et al., 2011). I set up a SADRAS project in collaboration with students and staff to investigate the use of pre-assessment support in Sport Science courses at Kingston University and explored students’ preferences, to determine whether differences were evident between BAME and white students. Results suggested differences in both use of academic support and preferences between student groups, with availability and location highlighted as constraints of use for BAME students. The results of this preliminary study were presented at the Advance HE Assessment and Feedback Symposium, leading to further dissemination at an invited seminar with the Open University STEM Pedagogy Group (eSTEeM). I am now extending the research with a second SADRAS project, extending the analysis to undergraduate students throughout the SEC Faculty

Men, Mental Health and Elite Sport: a Narrative Review

Mental health in elite sport is receiving more publicity due to an increase in male athletes sharing their personal experiences. Sports injury is recognised as the major risk factor for psychological distress amongst male athletes, although anecdotally this may be that athletes are more likely to discuss their emotional wellbeing when related to the injury they are experiencing. Stress can be amplified within elite sport and the pressure they experience in relation to competition and performance can be exacerbated by adverse life events. This ongoing stress does not end when their sporting career does, it can follow them into retirement. The physical and psychological demands placed upon them by the sporting environment may predispose athletes to developing depression. As an athlete's symptoms of mental illness intensify, their performance can be negatively affected leaving them vulnerable and exposed to further symptoms of common mental disorders. The pressure of performance can also expose male athletes to overtraining syndrome which can be difficult to distinguish from depression. Male athletes are more vulnerable to eating disorders compared with males in the general population and they do have anxieties, particularly around their bodies, but find it difficult to disclose their concerns. In addition to this, male athletes are more likely to use substances, including opioids to improve both sport and non-sport performance.Despite the prevalence of common mental disorders in male athletes, stigma still exists, and although some athletes discuss their issues publicly after their career has ended, the majority of athletes prefer to remain silent. There remains a view that athletes who seek help for psychological problems may be seen as weak. Although there is an improvement in help-seeking attitudes within elite sport, further research and education is needed to encourage men to talk about their mental health, share their experiences and to enjoy a greater sense of emotional wellbeing

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Evaluating the impacts of working towards the International Safeguards for Children in Sport

This paper is closed access until 4 June 2021.In this paper, the authors evaluate a global strategy to safeguard children against abuse in sport. The experiences of people within 32 of the organisations who were working towards the International Safeguards for Children in Sport were captured over a two-year study. At the organisational level, self-audits demonstrated that progress was made during the project by deliverers (who worked directly with children) from having 45% to 64% of the Safeguards fully in place. Governors (who governed other organisations which worked directly with children) improved on the same figure from 25% to 53%. Progress was also identified using the concept of Activation States through in-depth interviews at the start and end of the project. Positive changes were found at the personal level with respect to people’s feelings, knowledge and behaviours related to safeguarding as well as how safeguarding is discussed in the organisation. Group discussions also revealed changes with respect to how children, coaches, parents and the broader community were behaving with respect to safeguarding. An increase in the number of disclosures was also identified as an important impact of the project. The International Safeguards for Children in Sport are now endorsed by 125 organisations who work with a total of over 35 million children. The implications of these findings are discussed along with the future directions of work in this area

Evaluating the impacts of working towards the International Safeguards for Children in Sport

In this paper, the authors evaluate a global strategy to safeguard children against abuse in sport. The experiences of people within 32 of the organisations who were working towards the International Safeguards for Children in Sport were captured over a two-year study. At the organisational level, self-audits demonstrated that progress was made during the project by deliverers (who worked directly with children) from having 45% to 64% of the Safeguards fully in place. Governors (who governed other organisations which worked directly with children) improved on the same figure from 25% to 53%. Progress was also identified using the concept of Activation States through in-depth interviews at the start and end of the project. Positive changes were found at the personal level with respect to people’s feelings, knowledge and behaviours related to safeguarding as well as how safeguarding is discussed in the organisation. Group discussions also revealed changes with respect to how children, coaches, parents and the broader community were behaving with respect to safeguarding. An increase in the number of disclosures was also identified as an important impact of the project. The International Safeguards for Children in Sport are now endorsed by 125 organisations who work with a total of over 35 million children. The implications of these findings are discussed along with the future directions of work in this area