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Concept: Elite


This paper considers the contemporary significance of white racism and its association with nationalist sentiment amongst a cohort late middle aged white Britons, using survey responses and qualitative interviews from the 1958 National Child Development Study. We have shown that although overt racism is very limited, a substantial minority of white Britons display ambivalent feelings which have the potential to be mobilised in racist directions. We argue against the view that disadvantaged white working class respondents are especially xenophobic, and show that racist views are not strongly associated with social position. In exploring the clustering of different nationalist and racist sentiments amongst economic and cultural elites, and comparing these with ‘disenfranchised’ respondents with little economic and cultural capital, we show that it is actually the elite who are most likely to articulate ‘imperial racism’. By contrast, the ‘disenfranchised’ articulate a kind of anti-establishment nationalism which is not strongly racist. We also show that the elite are strongly internally divided, with a substantial number of the cultural elite being strongly anti-racist and committed to multi-culturalism, so generating strong internal factionalism between elite positions. Our paper therefore underscores how intensifying inequalities have facilitated the volatility and variability of nationalist and racist sentiment.

Concepts: Anthropology, Race, Racism, Social class, Marxism, Fascism, Elite, Xenophobia


Lumbar disk herniation, degenerative disk disease, and spondylolysis are the most prevalent lumbar conditions that result in missed playing time. Lumbar disk herniation has a good prognosis. After recovery from injury, professional athletes return to play 82% of the time. Surgical management of lumbar disk herniation has been shown to be a viable option in athletes in whom nonsurgical measures have failed. Degenerative disk disease is predominately genetic but may be accelerated in athletes secondary to increased physiologic loading. Nonsurgical management is the standard of care for lumbar degenerative disk disease in the elite athlete. Spondylolysis is more common in adolescent athletes with back pain than in adult athletes. Nonsurgical management of spondylolysis is typically successful. However, if surgery is required, fusion or direct pars repair can allow the patient to return to sports.

Concepts: Disease, Spinal disc herniation, Surgery, Degenerative disc disease, Play, Professional sports, Elite


We aimed to systematically review the epidemiology of oral disease and trauma in the elite athlete population and to investigate the impact of oral health on sporting performance.

Concepts: Medicine, Public health, Epidemiology, Demography, Elite


Money is central in US politics, and most campaign contributions stem from a tiny, wealthy elite. Like other political acts, campaign donations are known to be socially contagious. We study how campaign donations diffuse through a network of more than 50000 elites and examine how connectivity among previous donors reinforces contagion. We find that the diffusion of donations is driven by independent reinforcement contagion: people are more likely to donate when exposed to donors from different social groups than when they are exposed to equally many donors from the same group. Counter-intuitively, being exposed to one side may increase donations to the other side. Although the effect is weak, simultaneous cross-cutting exposure makes donation somewhat less likely. Finally, the independence of donors in the beginning of a campaign predicts the amount of money that is raised throughout a campaign. We theorize that people infer population-wide estimates from their local observations, with elites assessing the viability of candidates, possibly opposing candidates in response to local support. Our findings suggest that theories of complex contagions need refinement and that political campaigns should target multiple communities.

Concepts: Politics, Donation, Humanitarian aid, The Other Side, Accountable Fundraising, Political corruption, Elite, Political campaign


The measurement of heart rate variability (HRV) is often considered a convenient non-invasive assessment tool for monitoring individual adaptation to training. Decreases and increases in vagal-derived indices of HRV have been suggested to indicate negative and positive adaptations, respectively, to endurance training regimens. However, much of the research in this area has involved recreational and well-trained athletes, with the small number of studies conducted in elite athletes revealing equivocal outcomes. For example, in elite athletes, studies have revealed both increases and decreases in HRV to be associated with negative adaptation. Additionally, signs of positive adaptation, such as increases in cardiorespiratory fitness, have been observed with atypical concomitant decreases in HRV. As such, practical ways by which HRV can be used to monitor training status in elites are yet to be established. This article addresses the current literature that has assessed changes in HRV in response to training loads and the likely positive and negative adaptations shown. We reveal limitations with respect to how the measurement of HRV has been interpreted to assess positive and negative adaptation to endurance training regimens and subsequent physical performance. We offer solutions to some of the methodological issues associated with using HRV as a day-to-day monitoring tool. These include the use of appropriate averaging techniques, and the use of specific HRV indices to overcome the issue of HRV saturation in elite athletes (i.e., reductions in HRV despite decreases in resting heart rate). Finally, we provide examples in Olympic and World Champion athletes showing how these indices can be practically applied to assess training status and readiness to perform in the period leading up to a pinnacle event. The paper reveals how longitudinal HRV monitoring in elites is required to understand their unique individual HRV fingerprint. For the first time, we demonstrate how increases and decreases in HRV relate to changes in fitness and freshness, respectively, in elite athletes.

Concepts: Natural selection, Cardiology, Exercise, Assessment, Integer, Adaptation, Elite


The effect of precollegiate orthopaedic surgery on injury risk in the elite collegiate athlete is unknown.

Concepts: Surgery, Orthopedic surgery, Knee replacement, Reconstructive surgery, Orthopedics, Elite


Context  White coat ceremonies (WCCs) are widely prevalent as a celebration of matriculation in medical schools. Critics have questioned whether these ceremonies can successfully combine the themes of professionalism and humanism, as well as whether the white coat is an appropriate symbol. Objectives  This study aimed to add a process of empirical assessment to the discussion of these criticisms by analysing the content and messages communicated during these ceremonies. Methods  Multiple qualitative methods were used to discern the core meanings expressed in a sample of 18 ceremonies through the analysis of artefacts, words, phrases, statements and narratives. Out of a stratified random sample of 25 US schools of medicine conducting WCCs in 2009, 18 schools submitted video, audio and written materials. Results  All ceremonies followed the same general format, but varied in their content, messages and context. Ceremonies included five principal descriptions of what is symbolised by the white coat, including: commitment to humanistic professional care; a reminder of obligations and privileges; power; the student’s need to ‘grow’, and the white coat as a mantle. Statements about obligations were made three times more frequently than statements about privileges. Key words or phrases in WCCs mapped to four domains: professionalism; morality; humanism, and spirituality. Spoken narratives focused on humility and generosity. Conclusions  The WCCs studied did not celebrate the status of an elite class, but marked the beginning of educational, personal and professional formation processes and urged matriculants to develop into doctors ‘worthy of trust’. The ceremonies centred on the persons entering the vocation, who were invited to affirm its calling and obligations by donning a symbolic garb, and to join an ancient and modern tradition of healing and immersion in their community. The schools' articulated construct of the white coat situated it as a symbol of humanism. This study’s findings may clarify and guide schools' choices in designing their own WCCs.

Concepts: Scientific method, Medicine, Simple random sample, Physician, Sentence, Medical school, Philosophy of life, Elite


Recent research suggests that psychological needs can influence the political attitudes of ordinary citizens, often outside of their conscious awareness. In this paper, we investigate whether psychological needs also shape the spending priorities of political elites in the US. Most models of policymaking assume that political elites respond to information in relatively homogeneous ways. We suggest otherwise, and explore one source of difference in information processing, namely, threat sensitivity, which previous research links to increased support for conservative policy attitudes. Drawing on a sample of state-level policymakers, we measure their spending priorities using a survey and their level of threat sensitivity using a standard psychophysiological measure (skin conductance). We find that, like ordinary citizens, threat sensitivity leads even state-level policymakers to prioritize spending on government polices that are designed to minimize threats.

Concepts: Psychology, Consciousness, Policy, Government, Maslow's hierarchy of needs, Elite


Rotator cuff injuries are a common cause of pain and dysfunction for the elite athlete and can result in time loss from participation. This review highlights the current management of these injuries.

Concepts: Causality, Management, The Current, Rotator cuff, Rotator cuff tear, Elite


This case study reports the results of a 12-year (2005-2016) follow-up study of two Olympic champion rowers. The rowers were prospective athletes at the junior level when the study began, and we monitored their relevant physiological and performance data annually. Our findings indicated that their V̇O2max gradually increased up to about 22 years of age and leveled off at a value of approximately 7 l·min(-1) with minimal fluctuations thereafter. However, the variables that directly influence the V̇O2max changed. There was an age-related decline in maximal heart rate of about 0.5 beats·year(-1), while oxygen pulse, which serves as an indirect measure of stroke volume, correspondingly increased by about 1 ml O2·beat(-1) per year, allowing the athletes to maintain exceptional V̇O2max values. Maximal minute power of the studied rowers, derived each year from their ramp-wise tests, closely resembled the mean power output sustained during the 2000-m all-out tests on a rowing ergometer. A 12-year improvement of 28% and 33% occurred for the mean power output sustained over 2000 and 6000-m on a rowing ergometer, respectively. The findings contribute to the body of knowledge on athletes representing the true elites of their respective sports.

Concepts: Sociology, Pulse, Value, Heart rate, Rowing, Indoor rower, Elite