The Associated Impacts of Stress and Expectancy Upon the Elite Coach-Athlete Relationship in Individual Based Sports

This project of research presents a series of three studies that evolved over the duration of the body of work. Steered by existing research and the findings of each individual study, this project investigates associated impacts of stress and expectancy on the dynamics of interactions between coaches and athletes in elite level individual based sports. Specifically, the impacts of stress and expectancies on empathic accuracy. Study one explored the stress and coping experiences of six male elite athletics coaches in the UK. The findings indicated that coaches experienced a vast array of stressors, with stress increasing around competition. However, although participants acknowledged facilitative effects of experiencing stress (e.g., increased focus, motivation, & productivity), they also reported a number of perceived debilitative behavioural and communication changes towards their athletes at times of stress. For example, withdrawal and reduced interaction, concealing true feelings and emotions, and increased physical distance where possible. Experience, learning, and support were identified as the most effective coping strategies, and coaches reported limited use of effective psychological skills. While all emerging themes were deemed important, debilitative behavioural and communication changes towards athletes in response to increased stress, specifically around competition, was the most cited theme reported by all elite coaches. Thus, representing a strong indicator of the potential detrimental impact of stress on the dynamics of interactions between coaches and athletes in elite sport. To further investigate stress and coach-athlete interaction in elite sport, study two examined stress and empathic accuracy in coaches and athletes participating in elite level individual based sports. That is, how accurately coaches and athletes perceived the psychological condition of each other, moment-to-moment, over time, while experiencing stressors associated with different environments (i.e., training & competition). The results indicated that coaches and athletes experienced significantly increased stress during competition compared to training. Empathic accuracy for both coaches and athletes was also found to be higher in competition than in training. However, participants achieved relatively low to moderate levels of empathic accuracy throughout this study. Moreover, the elite coaches recorded varying levels of empathic accuracy with different athletes in their training groups. Finally, study three explored coach expectancies as a potential antecedent or barrier in determining levels of empathic accuracy achieved between coach and athlete. This study investigated the relationship between a coach’s expectancies and levels of empathic accuracy achieved by coach-athlete dyads from the same elite cycling training squad. Athletes’ perceptions of coach treatment were also investigated. Results showed coach-athlete dyads containing high expectancy athletes achieved higher empathic accuracy, compared to those involving low expectancy athletes. In addition, high expectancy athletes perceived the coach gave them less negative feedback, demanded a greater level of work from them, and held higher expectations for them compared to their low expectancy counterparts. These results suggested the coach’s behaviour might have been congruent with their expectations, which in turn may have affected levels of empathic accuracy achieved, and influenced perceived differential coach treatment. This project of research has contributed to researchers’ knowledge of the stress and coping experiences of elite coaches in the UK and thus presented key evidence to support the development of effective coping interventions for coaches working alongside world-class athletes. It has provided vital evidence of the potential impacts of stress on the dynamics of interactions between coaches and athletes in different environments, specifically extending broader literature on empathic accuracy through a longitudinal examination in a unique setting. Lastly, it has expanded the limited dialogue surrounding the relationship between a coach’s expectancies and the subsequent effectiveness of interpersonal perception with their athletes

It takes two: The experience of stress and associated impacts upon the coach-athlete relationship in elite athletics.

Stephen Pack, Judith Naseby, Elizabeth Scholefield, ‘It takes two: The experience of stress and associated impacts upon the coach-athlete relationship in elite athletics’, paper presented at the Annual Conference of the BPS Division Sport and Exercise Psychology, Manchester, UK, 16-17 December, 2013.Objective: To explore elite athletics coaches’ experiences of stress and its potential impact on the coach-athlete relationship. Design: A qualitative research design was employed. – underpinned by which philosophical standpoint? In-depth interviews encouraged individuals to provide detailed information that resonated at a personal level and captured the subjective meaning of experiencing this implies phenomenology stress in contextual situations. A semi-structured interview guide provided flexibility that facilitated exploration of unique points raised by participants. Method: Six male, UK based, elite athletics coaches aged between 32 and 57 years (46.5 ± 11.8 years), with 7 to 30 years (15.5 ± 9.9 years) elite coaching experience were interviewed face-to-face. All responses were recorded and transcribed verbatim. Results: Data was analysed using inductive and deductive qualitative content analysis. 18 (?) themes emerged – is ‘emerge’ appropriate to deductive and inductive approaches? detailing a variety of competitive and organisational stressors experienced by coaches (e.g. pressure, expectation, conflict and coaching responsibilities), with most debilitative? stress reported during competition. Stress was described as having debilitating and facilitating affects on both the coaches’ and athletes’ performance. Coaches explained how they withdrew from their athletes and coaching responsibilities at times of stress, through changes in body language, and communication. In response, athletes were reported to over-compensate how? , which often resulted in poor performance outcomes. However, experiencing stress was also described to increase responsiveness and productivity of the elite coaches. E.g.? Conclusions: Understanding and responding appropriately to stress in elite sport is paramount.- is this last sentence your focus? Coaches must be aware of how the affects of stress impact the coach-athlete relationship and thus potentially performance. Stress and responses that are below the ‘radar’, and why...Non peer reviewe

Human blood autoantibodies in the detection of colorectal cancer

Colorectal cancer (CRC) is the second most common malignancy in the western world. Early detection and diagnosis of all cancer types is vital to improved prognosis by enabling early treatment when tumours should be both resectable and curable. Sera from 3 different cohorts; 42 sera (21 CRC and 21 matched controls) from New York, USA, 200 sera from Pittsburgh, USA (100 CRC and 100 controls) and 20 sera from Dundee, UK (10 CRC and 10 controls) were tested against a panel of multiple tumour-associated antigens (TAAs) using an optimised multiplex microarray system. TAA specific IgG responses were interpo- lated against the internal IgG standard curve for each sample. Individual TAA specific responses were examined in each cohort to determine cutoffs for a robust initial scoring method to establish sensitivity and specificity. Sensitivity and specificity of combinations of TAAs provided good discrimination between cancer-positive and normal serum. The overall sensitivity and specificity of the sample sets tested against a panel of 32 TAAs were 61.1% and 80.9% respectively for 6 antigens; p53, AFP, K RAS, Annexin, RAF1 and NY-CO16. Furthermore, the observed sensitivity in Pittsburgh sample set in different clinical stages of CRC;stageI(n=19),stageII(n=40),stageIII(n=34)andstageIV(n=6)wassimilar (73.6%, 75.0%, 73.5% and 83.3%, respectively), with similar levels of sensitivity for right and left sided CRC. We identified an antigen panel of sufficient sensitivity and specificity for early detection of CRC, based upon serum profiling of autoantibody response using a robust multiplex antigen microarray technology. This opens the possibility of a blood test for screening and detection of early colorectal cancer. However this panel will require further validation studies before they can be proposed for clinical practice

NEUROlogical Prognosis After Cardiac Arrest in Kids (NEUROPACK) study: protocol for a prospective multicentre clinical prediction model derivation and validation study in children after cardiac arrest

Introduction Currently, we are unable to accurately predict mortality or neurological morbidity following resuscitation after paediatric out of hospital (OHCA) or in-hospital (IHCA) cardiac arrest. A clinical prediction model may improve communication with parents and families and risk stratification of patients for appropriate postcardiac arrest care. This study aims to the derive and validate a clinical prediction model to predict, within 1 hour of admission to the paediatric intensive care unit (PICU), neurodevelopmental outcome at 3 months after paediatric cardiac arrest. Methods and analysis A prospective study of children (age: >24 hours and <16 years), admitted to 1 of the 24 participating PICUs in the UK and Ireland, following an OHCA or IHCA. Patients are included if requiring more than 1 min of cardiopulmonary resuscitation and mechanical ventilation at PICU admission Children who had cardiac arrests in PICU or neonatal intensive care unit will be excluded. Candidate variables will be identified from data submitted to the Paediatric Intensive Care Audit Network registry. Primary outcome is neurodevelopmental status, assessed at 3 months by telephone interview using the Vineland Adaptive Behavioural Score II questionnaire. A clinical prediction model will be derived using logistic regression with model performance and accuracy assessment. External validation will be performed using the Therapeutic Hypothermia After Paediatric Cardiac Arrest trial dataset. We aim to identify 370 patients, with successful consent and follow-up of 150 patients. Patient inclusion started 1 January 2018 and inclusion will continue over 18 months. Ethics and dissemination Ethical review of this protocol was completed by 27 September 2017 at the Wales Research Ethics Committee 5, 17/WA/0306. The results of this study will be published in peer-reviewed journals and presented in conferences. Trial registration number NCT03574025

Genomic investigations of unexplained acute hepatitis in children

Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children

Representative antigen panels selected for all sample sets.

<p>The figure shows the autoantibody responses of the CRC patients (n = 131), healthy controls (n = 131), autoimmune (n = 21), IBD (n = 9) and allergy (n = 10) cohorts to a panel of TAA(s): data shows reactivity to AFP (A), Annexin (B), KRas (C), P53 (D), RAF1 (E) and NY-CO16 (F).</p

Technical development in microarray.

<p><b>A-C</b>: Demonstration of improvements in array background for a serum sample with high background signal when purified IgG (<b>B</b>) is used in place of whole serum (<b>A</b>). These arrays were processed at the same time and scanned under the same conditions. (<b>C</b>) displays the average background measurements taken from empty spots in both slides when the whole serum was used and when the purified IgG was used (n = 35). D-G: Effects of TAA denaturation of serum antibody binding. Representative antigens (<b>D</b>: AFP, <b>E</b>: APCN, <b>F</b>: SOX2 and <b>G</b>: P53) were printed as native protein or after heat-denaturation in the presence of 20mMDTT. Serum samples (n = 42) from a CRC cohort were used to examine alterations in autoantibody reactivity between the native and denatured TAAs. The mean of the signal from each TAA (4 replicates) is presented (n = 4).</p

A representative analysis of a selection of TAAs by Western blot (WB) and Silver stain.

<p>Samples were run on 4–20% precast polyacrylamide gels with a broad range protein markers. The 4 antigens (Gankyrin, H-Ras, RalA, and HCC1) were then either probed with anti-His antibody (<b>A</b>) or silver stained (<b>B</b>). Silver stain was used to check the purity of the antigens. The expected molecular weight of the examined antigens, Gankyrin, H-Ras, RalA, and HCC1 are 25, 40, 22 and 64 kDa respectively. The similar bands obtained before and after buffer exchange by both WB and silver stain indicate that the buffer exchange technique had no effect on the integrity of the antigens. <b>C</b>: Silver stain of 4 TAAs: Annexin, P53, KRAS and RAF1 (the expected molecular weight are 39, 53, 57 and 73 kDa respectively).</p