An exploration of the relationship between educational background and the coaching behaviours and practice activities of professional youth soccer coaches

This paper is closed access until 12 December 2019.Background and purpose: Despite the proliferation in recent years of higher education establishments offering tertiary-level study in the field of sports coaching, there is a lack of research into the impact of such courses on coaching practice. The behaviours employed and activities used by coaches during practice sessions is an area where one might expect to see such impact, indeed certain studies have tentatively noted the educational qualifications of coaches and suggested that this may play a role in the application of behaviours more aligned with player learning. The purpose of this study was therefore to compare youth soccer coaches with and without tertiary-level qualifications, examining their coaching behaviours and practice activities. Method: The participants were 10 male professional youth soccer coaches aged 24–55 with an average of 13 years coaching experience. Five of the coaches had completed undergraduate degree courses related to sport coaching. All of the coaches worked with players aged under 9 to under 18 in the youth academy of an English professional soccer club. Systematic observation of coach behaviour and practice activities was carried out using the Coach Analysis and Intervention System (Cushion et al. 2012), while follow-up interviews were used to elicit the coaches’ perceptions of, and rationale for, their behaviour. Findings: The observation data showed that graduate coaches used significantly more divergent questioning than non-graduate coaches, while the interview data revealed a general trend for graduate coaches to show greater self-awareness of behaviours and changes in behaviour between practice types. Graduate coaches also provided more comprehensive rationales, for example, seeing silence as a means of facilitating player decision-making as well as for observation. In contrast to previous research, sessions featured a higher proportion of playing form than training form activities and at over 20% of session duration, the ‘other’ practice state was a prominent feature of contact time with players. While some coaches saw ‘other’ as wasted time, graduate coaches identified this as an opportunity for group discussion and social interaction. The study adds to existing data about coach behaviours and practice activities, providing evidence that education background may indeed influence coaching practice

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Unresolved Issues in the Forensic Use of DNA Profiling

The enormous amount of genetic diversity in humans allows for a powerful form of individual identification. This “DNA profiling”; is based on the fact that sites within the human genome have variable numbers of tandem repeats (VNTRs) and has been hailed in forensic sciences as the greatest discovery since fingerprinting. The techniques involved are virtually the same as those used in all molecular biology laboratories. A major difference however is that in forensic science DNA samples can be less than ideal in both quality and quantity. Furthermore, in basic molecular biology the origin of the sample is known while in forensic testing it is not. Thus, the challenge is to reconcile a “match”; between a crime scene DNA sample and one from a suspect(s). Presently, a debate exists regarding the use of the unmodified product rule versus a more conservative ceiling principle approach to calculate the probability of a coincidentally matching DNA profiles. The latter was endorsed in a recently published report by the prestigious National Research Council but has not received widespread support from testing laboratories. Further exacerbating the debate over how much weight should be attached to DNA profile evidence is a lack of widely accepted standards for forensic laboratories especially in the areas of proficiency testing, publication of error rates and laboratory personnel certification

Unresolved Issues in the Forensic Use of DNA Profiling

The enormous amount of genetic diversity in humans allows for a powerful form of individual identification. This “DNA profiling”; is based on the fact that sites within the human genome have variable numbers of tandem repeats (VNTRs) and has been hailed in forensic sciences as the greatest discovery since fingerprinting. The techniques involved are virtually the same as those used in all molecular biology laboratories. A major difference however is that in forensic science DNA samples can be less than ideal in both quality and quantity. Furthermore, in basic molecular biology the origin of the sample is known while in forensic testing it is not. Thus, the challenge is to reconcile a “match”; between a crime scene DNA sample and one from a suspect(s). Presently, a debate exists regarding the use of the unmodified product rule versus a more conservative ceiling principle approach to calculate the probability of a coincidentally matching DNA profiles. The latter was endorsed in a recently published report by the prestigious National Research Council but has not received widespread support from testing laboratories. Further exacerbating the debate over how much weight should be attached to DNA profile evidence is a lack of widely accepted standards for forensic laboratories especially in the areas of proficiency testing, publication of error rates and laboratory personnel certification

A New Approach to Bridging Content Gaps in the Clinical Curriculum

BACKGROUND: In 2004-05 Tulane University School of Medicine implemented a longitudinal Interdisciplinary Seminar Series composed of small-group interactive exercises to address topics that are often overlooked during the clinical education of medical students. The series utilizes five adult learning principles. METHODS: Each of 13 seminars is offered at a fixed time slot, repeated two to six times per year. Students are required to attend a minimum of five seminars, of their choice, during years three and four. Students access an online pre-enrollment system that maximizes learning opportunities by limiting the number of participants. Seminars emphasize active learning with small-group problem-solving exercises and multiple interactive techniques. Clinical vignettes, standardized patients, journal articles, and case-based learning are among the learning methods. RESULTS: Seminar evaluations showed strong support in program content and effectiveness (mean = 4.47 on a five-point scale), facilitators (4.63), and learning opportunities (4.51). Additionally, students strongly endorsed individual seminars to classmates (4.47). Twelve of 13 (92%) seminars received scores higher than 4.0 for program content and effectiveness, facilitators and learning opportunities. CONCLUSIONS: The Interdisciplinary Seminar Series has been a valuable addition to the Tulane clinical curriculum. Students report that the success of the series is due to: (a) their ability to select seminars based on their individualized interests and needs; and (b) faculty development of student-centered seminars with active learning opportunities. This Seminar Series differs from interclerkship initiatives at other medical schools where topics are offered less frequently and to a class as a whole. Tulane\u27s program is a longitudinal intervention with multiple opportunities for student participation during their clinical education. Seminars are repeated to allow greater flexibility in student scheduling. Seminar discussions are rich in content since attendees include both third- and fourth-year students with variable levels of clinical skills and experiences

A New Approach to Bridging Content Gaps in the Clinical Curriculum

BACKGROUND: In 2004-05 Tulane University School of Medicine implemented a longitudinal Interdisciplinary Seminar Series composed of small-group interactive exercises to address topics that are often overlooked during the clinical education of medical students. The series utilizes five adult learning principles. METHODS: Each of 13 seminars is offered at a fixed time slot, repeated two to six times per year. Students are required to attend a minimum of five seminars, of their choice, during years three and four. Students access an online pre-enrollment system that maximizes learning opportunities by limiting the number of participants. Seminars emphasize active learning with small-group problem-solving exercises and multiple interactive techniques. Clinical vignettes, standardized patients, journal articles, and case-based learning are among the learning methods. RESULTS: Seminar evaluations showed strong support in program content and effectiveness (mean = 4.47 on a five-point scale), facilitators (4.63), and learning opportunities (4.51). Additionally, students strongly endorsed individual seminars to classmates (4.47). Twelve of 13 (92%) seminars received scores higher than 4.0 for program content and effectiveness, facilitators and learning opportunities. CONCLUSIONS: The Interdisciplinary Seminar Series has been a valuable addition to the Tulane clinical curriculum. Students report that the success of the series is due to: (a) their ability to select seminars based on their individualized interests and needs; and (b) faculty development of student-centered seminars with active learning opportunities. This Seminar Series differs from interclerkship initiatives at other medical schools where topics are offered less frequently and to a class as a whole. Tulane\u27s program is a longitudinal intervention with multiple opportunities for student participation during their clinical education. Seminars are repeated to allow greater flexibility in student scheduling. Seminar discussions are rich in content since attendees include both third- and fourth-year students with variable levels of clinical skills and experiences

Surviving Hurricane Katrina Reconstructing the Educational Enterprise of Tulane University School of Medicine

Hurricane Katrina was one of the greatest natural disasters to ever strike the United States. Tulane University School of Medicine, located in downtown New Orleans, and its three major teaching hospitals were flooded in the aftermath of the storm and forced to close. Faculty, students, residents, and staff evacuated to locations throughout the country. All critical infrastructure that normally maintained the school, including information technology, network communication servers, registration systems, and e-mail, became nonoperational. However, on the basis of experiences learned when Tropical Storm Allison flooded the Texas Medical Center in 2001, Baylor College of Medicine, University of Texas-Houston, University of Texas Medical Branch in Galveston, and Texas A&M School of Medicine created the South Texas Alliance of Academic Health Centers, which allowed Tulane to move its education programs to Houston. Using Baylor\u27s facilities, Tulane faculty rebuilt and delivered the preclinical curriculum, and clinical rotations were made available at the Alliance schools. Remarkably, the Tulane School of Medicine was able to resume all educational activities within a month after the storm. Educational reconstruction approaches, procedures employed, and lessons in institutional recovery learned are discussed so that other schools can prepare effectively for either natural or man-made disasters. Key disaster-response measures include designating an evacuation/command site in advance; backing up technology, communication, financial, registration, and credentialing systems; and establishing partnership with other institutions and leaders