Revisiting the self-confidence and sport performance relationship: A systematic review with meta-analysis

© 2022 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/ijerph19116381Self-confidence is a common research topic, and most applied textbooks include interventions designed to enhance athlete confidence. Our purpose was to quantify the self-confidence and sport performance literature using meta-analytic techniques. We also examined potential risk of bias indicators, and the moderation effects of study quality, sport characteristics, timing of confidence measurement, and individual differences among participants. Following a review of two past meta-analyses, a systematic search of APA PsycArticles, ERIC, Psychology and Behavioral Sciences Collection, PsychINFO, and SPORTDiscus within the EBSCOhost platform, and some hand searching, 41 articles published between 1986 and 2020 met the inclusion criteria. Collectively, the included studies investigated 3711 athletes from 15 countries across 24 sports. The overall random effects estimate of the relationship (expressed as r) between self-confidence and performance was 0.25 (95% CI 0.19, 0.30), with little evidence of publication bias. The summed total risk of the individual study bias score did not moderate the confidence–performance relationship, whereas significant moderator effects emerged for individual sports (0.29) compared with team sports (0.14), objective (0.29) compared to subjective (0.14) performance measures, and 100% male (0.35) compared to 100% female (0.07) samples. In conclusion, the confidence–performance relationship is small in magnitude, nearly free of bias, and moderated by sport type, performance objectivity, and athlete sex.This research was funded by the Texas Tech University Office of the Vice-Provost and the Texas Tech University TrUE SPARK program. MS was funded by Texas Tech University Office of the Vice-Provost. CS and SC were funded by Texas Tech University TrUE SPARK program.Published versio

Beyond the COVID-19 Pandemic: Tips for Players and Athletes COVID-RECOVER

First paragraph: The aim of this guidance is to provide a framework for athletes to cope, thrive and engage in personal growth during the current pandemic. The COVID-19 pandemic has likely led to wide-scale disruption of your sporting trajectories for 2020. This has included the cancellation or postponement of sporting events, limits to group training due to social distancing, restrictions on use of sporting facilities and loss of face-to-face access to coaches and support personnel. In the context of a threat to public health, arguably sports competition sinks into lesser importance, but for athletes like you, for whom sport is a fulltime job or major life goal, or for those who identify sports competition as a key part of their identity, it is important to share recommendations based on evidence and theory on how to support athletes and players through this time. The unprecedented situation means that evidence from similar or related contexts and relevant theories needs to be used to extrapolate to COVID-19 and all its challenges. Each of the guidelines below should be viewed like a menu to choose from and try, test and review, and be seen as a road to discovery instead of passive prescription of activities. Our team of practitioners and researchers have collated the knowledge below based on four premises: 1. Psychological Strengths: As a performer on the sporting stage, you have, in all likelihood, developed many skills and habits to support your on-field performance. Pre-performance routines for penalty taking, for example, may include relaxation and focusing components which aid emotional regulation. This can be also applied to help you cope in world outside of sport (i.e. outside the bubble). Awareness of your repertoire of psychological skills and the ability to use them across different contexts is highly important. 2. Resilience: The capacity to mobilise resources both in advance and after a major challenge, is developed through our sporting challenges. In the face of a trauma, it is likely that resilience is the default rather than the exception. As an athlete, you have the ability to respond in an optimistic way to major stressors and engage in post-traumatic growth. Further, you have successful experiences from memory to call upon on which By doing this, you build a firm foundation on which to build your beliefs that you have sufficient resources to cope with COVID-19. 3. Individual Responses: It is important to acknowledge that athletes in different sports and at different levels of competition have developed diverse sets of abilities and competencies. Dual-career athletes (e.g. student-athletes) may have invested much of their effort in their sport despite study or work commitments, and injured athletes may be over-identifying with their sport as a predictable response to injury, in both cases making these athletes very vulnerable to major stressors. 4. Perception of Control: Loss of control is a major source of anxiety in a pandemic (see Mansell, 2020). Developing autonomy and a sense of control is a key part to feeling safe and secure. With COVID-19, the new habits that could help protect you such as physical isolation, hand hygiene, and avoiding touching your face can help you gain control in an uncertain world. And finding new ways to exercise, to work and to interact can open up a world of exciting possibilities. Athletes have shown an ability to develop positive habits and maintain self-control, skills transferable to meeting the present challenging circumstances

Beyond the COVID-19 Pandemic: Tips for Players and Athletes COVID-RECOVER

First paragraph: The aim of this guidance is to provide a framework for athletes to cope, thrive and engage in personal growth during the current pandemic. The COVID-19 pandemic has likely led to wide-scale disruption of your sporting trajectories for 2020. This has included the cancellation or postponement of sporting events, limits to group training due to social distancing, restrictions on use of sporting facilities and loss of face-to-face access to coaches and support personnel. In the context of a threat to public health, arguably sports competition sinks into lesser importance, but for athletes like you, for whom sport is a fulltime job or major life goal, or for those who identify sports competition as a key part of their identity, it is important to share recommendations based on evidence and theory on how to support athletes and players through this time. The unprecedented situation means that evidence from similar or related contexts and relevant theories needs to be used to extrapolate to COVID-19 and all its challenges. Each of the guidelines below should be viewed like a menu to choose from and try, test and review, and be seen as a road to discovery instead of passive prescription of activities. Our team of practitioners and researchers have collated the knowledge below based on four premises: 1. Psychological Strengths: As a performer on the sporting stage, you have, in all likelihood, developed many skills and habits to support your on-field performance. Pre-performance routines for penalty taking, for example, may include relaxation and focusing components which aid emotional regulation. This can be also applied to help you cope in world outside of sport (i.e. outside the bubble). Awareness of your repertoire of psychological skills and the ability to use them across different contexts is highly important. 2. Resilience: The capacity to mobilise resources both in advance and after a major challenge, is developed through our sporting challenges. In the face of a trauma, it is likely that resilience is the default rather than the exception. As an athlete, you have the ability to respond in an optimistic way to major stressors and engage in post-traumatic growth. Further, you have successful experiences from memory to call upon on which By doing this, you build a firm foundation on which to build your beliefs that you have sufficient resources to cope with COVID-19. 3. Individual Responses: It is important to acknowledge that athletes in different sports and at different levels of competition have developed diverse sets of abilities and competencies. Dual-career athletes (e.g. student-athletes) may have invested much of their effort in their sport despite study or work commitments, and injured athletes may be over-identifying with their sport as a predictable response to injury, in both cases making these athletes very vulnerable to major stressors. 4. Perception of Control: Loss of control is a major source of anxiety in a pandemic (see Mansell, 2020). Developing autonomy and a sense of control is a key part to feeling safe and secure. With COVID-19, the new habits that could help protect you such as physical isolation, hand hygiene, and avoiding touching your face can help you gain control in an uncertain world. And finding new ways to exercise, to work and to interact can open up a world of exciting possibilities. Athletes have shown an ability to develop positive habits and maintain self-control, skills transferable to meeting the present challenging circumstances

School-level factors associated with the sustainment of weekly physical activity scheduled in Australian elementary schools: an observational study

Background We aimed to: (1) identify school-level factors associated with the sustainment of weekly physical activity (PA) scheduled in elementary schools following withdrawal of effective implementation support; and (2) determine teacher’s perceived usefulness of suggested strategies for sustaining the scheduling of weekly PA. Methods A secondary exploratory analysis was employed of data from the intervention arm (n = 31 schools) of a randomised controlled trial. Self-report survey data from 134 classroom teachers in New South Wales, Australia, collected following withdrawal of initial implementation support (follow-up T1) and six-months following completion of support (follow-up T2) were used. The outcomes of sustainment of weekly overall PA and energisers (short classroom PA breaks) scheduled were measured via teachers’ completion of a daily activity logbook, with results presented as the difference in mean minutes of PA and energisers scheduled at T1 and T2. An adapted version of the Program Sustainability Assessment Tool (PSAT) was used to measure capacity for program sustainability across seven key domains at follow-up T2. Linear mixed regressions were conducted to evaluate associations between school-level sociodemographic characteristics (e.g., school size, remoteness, and type), teacher-reported school factors (i.e., seven adapted PSAT domains) and the sustainment of PA and energisers scheduled across the school week. Perceived usefulness of 14 proposed sustainability strategies was measured via the teacher survey at follow-up T2 and reported descriptively. Results No school-level factor was statistically associated with the sustainment of overall weekly PA or energisers scheduled. Teacher-reported factors in two PSAT domains – ‘strategic planning’ and ‘program evaluation’ were statistically negatively associated with the sustainment of weekly energisers scheduled (− 6.74, 95% CI: − 13.02; − 0.47, p = 0.036 and − 6.65, 95% CI: − 12.17; − 1.12, p = 0.019 respectively). The proposed support sustainability strategy – ‘provision of PA equipment packs that enable energisers or integrated lessons’ was perceived useful by the most teachers (85%). Conclusions Further research is required to explore additional contextual-specific, and end-user appropriate factors associated with schools’ sustainment of weekly PA scheduled. This will help accurately inform the development of strategies to address these determinants and support the sustainment and long-term benefits of school-based health interventions more broadly

Barriers and facilitators influencing the sustainment of health behaviour interventions in schools and childcare services: a systematic review

Background Sustainment has been defined as the sustained use or delivery of an intervention in practice following cessation of external implementation support. This review aimed to identify and synthesise factors (barriers and facilitators) that influence the sustainment of interventions (policies, practices, or programmes) in schools and childcare services that address the leading risk factors of chronic disease. Methods Seven electronic databases and relevant reference lists were searched for articles, of any design, published in English, from inception to March 2020. Articles were included if they qualitatively and/or quantitatively reported on school or childcare stakeholders’ (including teachers, principals, administrators, or managers) perceived barriers or facilitators to the sustainment of interventions addressing poor diet/nutrition, physical inactivity, obesity, tobacco smoking, or harmful alcohol use. Two independent reviewers screened texts, and extracted and coded data guided by the Integrated Sustainability Framework, an existing multi-level sustainability-specific framework that assesses factors of sustainment. Results Of the 13,158 articles identified, 31 articles met the inclusion criteria (8 quantitative, 12 qualitative, 10 mixed-methods, and 1 summary article). Overall, 29 articles were undertaken in schools (elementary n=17, middle n=3, secondary n=4, or a combination n=5) and two in childcare settings. The main health behaviours targeted included physical activity (n=9), diet (n=3), both diet and physical activity (n=15), and smoking (n=4), either independently (n=1) or combined with other health behaviours (n=3). Findings suggest that the majority of the 59 barriers and 74 facilitators identified to impact on intervention sustainment were similar across school and childcare settings. Factors predominantly relating to the ‘inner contextual factors’ of the organisation including: availability of facilities or equipment, continued executive or leadership support present, and team cohesion, support, or teamwork were perceived by stakeholders as influential to intervention sustainment. Conclusions Identifying strategies to improve the sustainment of health behaviour interventions in these settings requires a comprehensive understanding of factors that may impede or promote their ongoing delivery. This review identified multi-level factors that can be addressed by strategies to improve the sustainment of such interventions, and suggests how future research might address gaps in the evidence base. Trial registration This review was prospectively registered on PROSPERO: CRD42020127869 , Jan. 2020

Global Mapping of DNA Methylation in Mouse Promoters Reveals Epigenetic Reprogramming of Pluripotency Genes

DNA methylation patterns are reprogrammed in primordial germ cells and in preimplantation embryos by demethylation and subsequent de novo methylation. It has been suggested that epigenetic reprogramming may be necessary for the embryonic genome to return to a pluripotent state. We have carried out a genome-wide promoter analysis of DNA methylation in mouse embryonic stem (ES) cells, embryonic germ (EG) cells, sperm, trophoblast stem (TS) cells, and primary embryonic fibroblasts (pMEFs). Global clustering analysis shows that methylation patterns of ES cells, EG cells, and sperm are surprisingly similar, suggesting that while the sperm is a highly specialized cell type, its promoter epigenome is already largely reprogrammed and resembles a pluripotent state. Comparisons between pluripotent tissues and pMEFs reveal that a number of pluripotency related genes, including Nanog, Lefty1 and Tdgf1, as well as the nucleosome remodeller Smarcd1, are hypomethylated in stem cells and hypermethylated in differentiated cells. Differences in promoter methylation are associated with significant differences in transcription levels in more than 60% of genes analysed. Our comparative approach to promoter methylation thus identifies gene candidates for the regulation of pluripotency and epigenetic reprogramming. While the sperm genome is, overall, similarly methylated to that of ES and EG cells, there are some key exceptions, including Nanog and Lefty1, that are highly methylated in sperm. Nanog promoter methylation is erased by active and passive demethylation after fertilisation before expression commences in the morula. In ES cells the normally active Nanog promoter is silenced when targeted by de novo methylation. Our study suggests that reprogramming of promoter methylation is one of the key determinants of the epigenetic regulation of pluripotency genes. Epigenetic reprogramming in the germline prior to fertilisation and the reprogramming of key pluripotency genes in the early embryo is thus crucial for transmission of pluripotency

Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis

This article describes the rationale, aims, and methodology of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). This is the largest international collaboration to date that will develop algorithms to predict trajectories and outcomes of individuals at clinical high risk (CHR) for psychosis and to advance the development and use of novel pharmacological interventions for CHR individuals. We present a description of the participating research networks and the data processing analysis and coordination center, their processes for data harmonization across 43 sites from 13 participating countries (recruitment across North America, Australia, Europe, Asia, and South America), data flow and quality assessment processes, data analyses, and the transfer of data to the National Institute of Mental Health (NIMH) Data Archive (NDA) for use by the research community. In an expected sample of approximately 2000 CHR individuals and 640 matched healthy controls, AMP SCZ will collect clinical, environmental, and cognitive data along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech and facial expression samples, novel measures derived from digital health technologies including smartphone-based daily surveys, and passive sensing as well as actigraphy. The study will investigate a range of clinical outcomes over a 2-year period, including transition to psychosis, remission or persistence of CHR status, attenuated positive symptoms, persistent negative symptoms, mood and anxiety symptoms, and psychosocial functioning. The global reach of AMP SCZ and its harmonized innovative methods promise to catalyze the development of new treatments to address critical unmet clinical and public health needs in CHR individuals

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570