Student Athlete Activism in a Millennial World

College student athletes are among the most recognized students in their communities, across the country, and in some cases around the world. Their voices hold a significant esteem, and they can impact many societal and political issues. Some have postulated that college student-athletes are hesitant to be a part of these politics, but during the past few years, many have taken stands through social media and through protests on their campuses that have been in opposition to the stances of their coaches, their university's administration, and their teammates. Many, however, challenge the role that student athletes have in these protests. This chapter will explore the history of student athlete activism and its developmental aspects, highlight the more recent instances of such activism, and finally discuss how university administration and others can support and be responsive to the concerns that are expressed by this unique set of students.

Cardiac abnormalities in athletes after SARS-CoV-2 infection: a systematic review

ObjectivesQuantification of pericardial/myocardial involvement and risks of sudden cardiac arrest/sudden cardiac death (SCA/SCD) after SARS-CoV-2 infection in athletes who return to sports.DesignSystematic review on post-SARS-CoV-2 infection pericardial/myocardial manifestations in athletes.Data sourcesCombinations of key terms in Medline, Embase and Scopus (through 2 June 2021).Eligibility criteria for selecting studiesInclusion: athletes, with cardiovascular magnetic resonance (CMR) or echocardiography after recovery from SARS-CoV-2 infection, including arrhythmia outcomes. Exclusion: study population ≥1 individual comorbidity and mean age <18 or >64 years. Quality assessment was performed using Joanna Briggs Institute Critical Appraisal tools checklists.ResultsIn total, 12 manuscripts (1650 papers reviewed) comprising 3131 athletes (2198 college/student athletes, 879 professional athletes and 54 elite athletes) were included. The prevalence of myocarditis on echocardiography and/or CMR was 0%–15%, pericardial effusion 0%–58% and late gadolinium enhancement (LGE) 0%–46%. Weighted means of diagnosed myocarditis were 2.1% in college/student athletes and 0% in elite athletes. The prevalence of LGE was markedly lower in studies with high-quality assessment scores (3%–4%) versus low scores (38%–42%). A single study reported reversibility of myocardial involvement in 40.7%. No important arrhythmias were reported. Ten studies (n=4171) reporting postrecovery troponin T/I found no clear relationship with cardiac abnormalities.Summary/conclusionAthletes have an overall low risk of SARS-CoV-2 pericardial/myocardial involvement, arrhythmias and SCA/SCD. Rates of pericardial/myocardial abnormalities in athletes are highly variable and dependent on study quality. Troponin screenings seem unreliable to identify athletes at risk for myocardial involvement. Prospective athlete studies, with pre-SARS-CoV-2 imaging (CMR), including structured follow-up and arrhythmia monitoring, are urgently needed.

Stress, anxiety, binge drinking, and substance use among college student-athletes: A cross-sectional analysis

The immense pressure faced by college student-athletes to balance participation in sports with other responsibilities can contribute to unhealthy coping behaviors including alcohol and drug use. We administered online surveys to 188 college student-athletes to examine stress, athletics-related anxiety, and perceived control of stress as predictors of binge drinking, substance use, and associated risk behaviors. Participants rated athletics as the second greatest source of stress in their lives, trailing only academics. Athletics-related anxiety was a significant predictor of cannabis use and substance-related risk behaviors, and represents an understudied area in the literature. Reports of alcohol and drug use in our sample were comparable to national surveys of student-athletes, but opioid misuse was troublingly high. Participants over the age of 21 and males were more likely to report substance use and risk behaviors. Athletes are susceptible to orthopedic injury and associated pain, which may lead to early exposure to opioids with high potential for abuse. Interventions for this population must target social contributors to substance use among student-athletes, opioid prescription and misuse as a gateway to opioid use disorders, and untreated anxiety as a potential driver of substance use, including anxiety associated with athletic performance.