Staffan Janson - Academia.edu (original) (raw)
Papers by Staffan Janson
Acta Paediatrica, 2005
Aim: To investigate if an intervention with extra information and support in a group setting to p... more Aim: To investigate if an intervention with extra information and support in a group setting to parents of preschool children could improve adherence and clinical outcome. Methods: This is a controlled, prospective study where the parents of 60 newly diagnosed preschool asthmatic children aged 3 mo-6 y were randomized to either a control group or to an intervention that consisted of four group sessions in close connection with the diagnosis. The basic education on asthma and the written treatment plan were the same in both groups. The outcome measures were questionnaires to the parents and classification of the children according to symptoms and medication. The adherence rate and the burden of asthma were calculated with the help of diaries and weighing of the MDIs used between 12 and 18 mo after inclusion. Results: The follow-up rate was 85% after 18 mo. The parents' presence in the sessions was around 70%, with no gender difference. The parents' view on adherence issues improved significantly in the intervention group. In the control group, 30% had poor adherence compared to 8% in the intervention group (p = 0.015). Both the parents and the paediatricians underestimated the number of children with poor adherence. The children in the intervention group had significantly fewer exacerbation days during the last 6 mo-2.1 compared to 3.9 d/child-although they had lower inhaled steroid doses after 18 mo. An economic calculation showed that the intervention was profitable. Conclusion: This intervention resulted in an improvement in the parents' view on adherence, in the measured adherence rates and in the clinical outcome.
Objective.The popularity of rock climbing is increasing worldwide, both as a recreational physica... more Objective.The popularity of rock climbing is increasing worldwide, both as a recreational physical activity and as a competitive sport. By its nature, rock climbing is associated with injury risks. ...
The SOFIA study : a multi-disciplinary large scale longitudinal study ofsocial, behavioral and ph... more The SOFIA study : a multi-disciplinary large scale longitudinal study ofsocial, behavioral and physical development
Lakartidningen, 2014
Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corpora... more Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corporal punishment was looked upon as a normal part of upbringing in the 1960s, but today more than 90 % of all Swedish parents regard this as a deviant behavior. While the diagnostic tools for establishing of intentional injuries are continuously refined, neglect of children has been more difficult to define and describe. In later years, however, it has been obvious that neglect for many children is chronic and with long-term effects that are just as devastating as corporal punishment and sexual abuse. All over the world a more ecological view on family violence is developing, also taking into account countries' social, cultural and political conditions.
Lakartidningen, 2014
Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corpora... more Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corporal punishment was looked upon as a normal part of upbringing in the 1960s, but today more than 90 % of all Swedish parents regard this as a deviant behavior. While the diagnostic tools for establishing of intentional injuries are continuously refined, neglect of children has been more difficult to define and describe. In later years, however, it has been obvious that neglect for many children is chronic and with long-term effects that are just as devastating as corporal punishment and sexual abuse. All over the world a more ecological view on family violence is developing, also taking into account countries' social, cultural and political conditions.
J Brit Travel Health Ass, 2006
... 1991; 20 (6): 622-6. 3 Baker T, Hargarten S, Guptill K. The uncounted dead– American civilian... more ... 1991; 20 (6): 622-6. 3 Baker T, Hargarten S, Guptill K. The uncounted dead– American civilians dying overseas. Public Health Rep 1992; 107 (2): 155-9. 4 Paixao M, Dewar R, Cossar J, Covell R, Reid D. What do Scots die of when abroad? Scott Med J. 1991; 36: 114-6. 5 ...
J Brit Travel Health Ass, 2006
... 1991; 20 (6): 622-6. 3 Baker T, Hargarten S, Guptill K. The uncounted dead– American civilian... more ... 1991; 20 (6): 622-6. 3 Baker T, Hargarten S, Guptill K. The uncounted dead– American civilians dying overseas. Public Health Rep 1992; 107 (2): 155-9. 4 Paixao M, Dewar R, Cossar J, Covell R, Reid D. What do Scots die of when abroad? Scott Med J. 1991; 36: 114-6. 5 ...
Indoor Air, 2010
The Dampness in Buildings and Health study (DBH) started in the year 2000 in Värmland, Sweden, wi... more The Dampness in Buildings and Health study (DBH) started in the year 2000 in Värmland, Sweden, with a baseline questionnaire sent to all children (n = 14,077) aged 1-6. Five years later, a follow-up questionnaire was sent to the children who were 1-3 years at baseline. A total of 4779 children participated in both the baseline and the follow-up studies and constitute the study population in this cohort study. The aim of this study was to examine the association between exposure to PVC-flooring in the child's and parent's bedroom in homes of children aged 1-3 and the incidence of asthma, rhinitis, and eczema during the following 5-year period. Adjusted analyses showed that the incidence of asthma among children was associated with PVC-flooring in the child's bedroom (AOR 1.52; 95% CI 0.99-2.35) and in the parent's bedroom (1.46; 0.96-2.23). The found risks were on borderline of significance and should therefore be interpreted with caution. There was further a positive relationship between the number of rooms with PVC-flooring and the cumulative incidence of asthma. PVC-flooring was found to be a stronger risk factor for incident asthma in multifamily homes when compared with single-family houses and in smoking families compared with non-smoking families and in women. These longitudinal data from the DBH study found an association between the presence of PVC-flooring in the home and incident asthma in children. However, earlier results from the DBH study have shown that PVC-flooring is one important source for phthalates in indoor dust, and exposure to such phthalates was found to be associated with asthma and allergy among children. This emphasizes the need for prospective studies that focus on the importance of prenatal and neonatal exposure to phthalates in the development of asthma and allergy in children.
Unemployment, secure, insecure employment and self-reported ill-health: A comparative study
Adventitious rooting is a quantitative genetic trait regulated by both environmental and endogeno... more Adventitious rooting is a quantitative genetic trait regulated by both environmental and endogenous factors. To better understand the physiological and molecular basis of adventitious rooting, we took advantage of two classes of Arabidopsis thaliana mutants altered in adventitious root formation: the superroot mutants, which spontaneously make adventitious roots, and the argonaute1 (ago1) mutants, which unlike superroot are barely able to form adventitious roots. The defect in adventitious rooting observed in ago1 correlated with light hypersensitivity and the deregulation of auxin homeostasis specifically in the apical part of the seedlings. In particular, a clear reduction in endogenous levels of free indoleacetic acid (IAA) and IAA conjugates was shown. This was correlated with a downregulation of the expression of several auxin-inducible GH3 genes in the hypocotyl of the ago1-3 mutant. We also found that the Auxin Response Factor17 (ARF17) gene, a potential repressor of auxin-in...
Acta Paediatrica, 2014
The United Nation’s Convention on the Rights of the Child states that the ‘family environment, in... more The United Nation’s Convention on the Rights of the Child states that the ‘family environment, in an atmosphere of happiness, love and understanding’ is best for the ‘full and harmonious development’ of the child’s personality. Despite the fact that this is probably foremost in the minds of most parents, many families find themselves in situations where they have great difficulty providing these basic needs for their children. This can be particularly difficult where one or both parents have to move a great distance from their home to earn a living, either within their own country or abroad. In the world’s richest countries, the term children left behind is used to describe inequalities in child well-being, mainly relating to material well-being, education and health. Scandinavia, the Netherlands and Switzerland are leading the way in promoting children’s health in these three dimensions, while other rich countries are allowing substantial groups of children to fall behind in their developmental potential (1). On a global level, UNICEF is using the same term to describe the conditions faced by children left behind in their local villages or towns, when their parents become migrant workers (2). However, UNICEF normally examines the same three dimensions when it is comparing the conditions of children left behind with children whose parents are not migrant workers. Overseas work and employment income are important in countries where unemployment is a large and persistent problem, as they increase households’ resources and support society in general by reducing the unemployment rate. Overseas working is particularly common in some East Asian countries, such as the Philippines, where about two million Filipino children (5%) have one or two parents working overseas (2). Indonesia, the world’s fourth largest country, was severely affected by the Asian economic crisis in 1997 and has become one of the largest suppliers of overseas workers, with 2–3% of the total child population being left behind. Female migrant workers, in particular, report high levels of abuse and exploitation, and this often results in contracts not being completed and aggravated individual or family financial problems. In other cases, where the employment works well, the money received can improve both family income and female emancipation. However, prolonged separation from parents can place a substantial psychological burden on children (3). The Swedish film director Lucas Moodysson described this dilemma in his 2009 film Mammoth, which featured a young, successful, hardworking New York couple who employed a Filipino lady to take care of their 7-year-old daughter, while the nanny’s two sons were taken care of by their grandmother in the Philippines. The oldest boy missed his mother so much that he tried different ways to earn the money so that she could come home, but he ended up being robbed and severely injured. The film faced culturally based criticism, blaming Western families for not taking care of their own children using cheap overseas labour. But this criticism missed the main point that working overseas in the late 1990s was provoked by the harsh policy of austerity, imposed on East Asian countries by the World Bank and the International Monetary Fund. The devastating effects on health and family relations in countries following this advice – Thailand, the Philippines and Indonesia – have been convincingly demonstrated by public health researchers from Oxford University, UK, and Stanford University, USA (4). There is good evidence from the Philippines, and scattered evidence from Indonesia and Thailand, that the migration of parents can improve the material conditions of children left behind. However, there are more than 100 000 children who have followed undocumented migrant parents into Thailand from Myanmar, Cambodia and Laos, who seem to face much greater difficulties than the children left at home by Filipino and Indonesian migrants. Following migrating parents in very poor circumstances obviously pose a severe risk to the children’s health and development (5). While overseas migration is now a common phenomenon in many parts of the world, it is possible that even more people are migrating within their own countries, primarily from rural to urban areas. Rapid urbanisation in Asia and Africa suggests that more than half of the world’s population now lives in urban areas. In China, uneven development and economic incentives are encouraging farmers to move to cities to find better job opportunities, despite the fact that they often face uncertain circumstances and limited access to social services. The number of rural parents who leave their children behind with family members to work in the cities has increased dramatically over the last decade. Research has indicated that left behind children in the countryside have high levels of social anxiety, but very few studies have compared these children with children in nonmigrating…
Nordic Journal of Social Research, 2013
Introduction: A dramatic increase in sicknesses absence in Sweden has led to a shift in the publi... more Introduction: A dramatic increase in sicknesses absence in Sweden has led to a shift in the public debate. Departing from the view of sickness absence as a result of a poor work environment and stress, the debate in the early 2000s became more concerned with the breakdown of norms and the abuse of sickness insurance. Sickness absence became the responsibility of the individual rather than of society. Aim: This study has sought to explore the consequences of being on sick leave with a musculoskeletal diagnosis, the experiences of encounters with rehabilitation professionals, and the attitudes towards sick-listing from the perspective of the sick-listed persons. Methods: Individual in-depth interviews were conducted in 2010 with eight women and nine men aged 33-60 who were on long-term sick leave (at least 60 days) with a musculoskeletal diagnosis. We analysed the data using a grounded-theory approach. Results: There was an obvious tension between work strategy as a societal norm and finding an acceptable life role when sick-listed. Four groups with partially differing experiences and perceptions crystallized out of the total population. These experiences and perceptions formed their choice of different acceptable life roles and strategies for gaining self-respect and the respect of others. Discussion: The fact that the four groups that emerged from our study experienced their sickness absence in different ways and their pathways back to work were different demonstrates the value of not considering those on sick leave with a musculoskeletal diagnosis as a homogeneous group. The results imply that rehabilitators should adopt a sensitive approach based on the sickness absentees' wishes and views since the latter spend much of their time and thought during their period of sickness on counteracting distrust in search of an acceptable life role to regain respect.
Journal of sports science & medicine, 2015
To ensure health and well-being for their athletes, sports organizations must offer preventive me... more To ensure health and well-being for their athletes, sports organizations must offer preventive measures against sexual abuse. The aim of this study was to design and evaluate feasibility of a research protocol for cross-sectional epidemiological studies of sexual abuse in athletics. Examination of the requirements on the study of sexual abuse in athletics was followed by iterated drafting of protocol specifications and formative evaluations. The feasibility of the resulting protocol was evaluated in a national-level study among elite athletics athletes (n = 507) in Sweden. The definition of sexual abuse, the ethical soundness of the protocol, reference populations and study of co-morbidity, and the means for athlete-level data collection were identified as particularly complex issues in the requirements analyses. The web-based survey defined by the protocol facilitates anonymous athlete self-reporting of data on exposure to sexual abuse. 198 athletes (39%) fully completed the feasib...
Acta Paediatrica, 2005
Aim: To investigate if an intervention with extra information and support in a group setting to p... more Aim: To investigate if an intervention with extra information and support in a group setting to parents of preschool children could improve adherence and clinical outcome. Methods: This is a controlled, prospective study where the parents of 60 newly diagnosed preschool asthmatic children aged 3 mo-6 y were randomized to either a control group or to an intervention that consisted of four group sessions in close connection with the diagnosis. The basic education on asthma and the written treatment plan were the same in both groups. The outcome measures were questionnaires to the parents and classification of the children according to symptoms and medication. The adherence rate and the burden of asthma were calculated with the help of diaries and weighing of the MDIs used between 12 and 18 mo after inclusion. Results: The follow-up rate was 85% after 18 mo. The parents' presence in the sessions was around 70%, with no gender difference. The parents' view on adherence issues improved significantly in the intervention group. In the control group, 30% had poor adherence compared to 8% in the intervention group (p = 0.015). Both the parents and the paediatricians underestimated the number of children with poor adherence. The children in the intervention group had significantly fewer exacerbation days during the last 6 mo-2.1 compared to 3.9 d/child-although they had lower inhaled steroid doses after 18 mo. An economic calculation showed that the intervention was profitable. Conclusion: This intervention resulted in an improvement in the parents' view on adherence, in the measured adherence rates and in the clinical outcome.
Objective.The popularity of rock climbing is increasing worldwide, both as a recreational physica... more Objective.The popularity of rock climbing is increasing worldwide, both as a recreational physical activity and as a competitive sport. By its nature, rock climbing is associated with injury risks. ...
The SOFIA study : a multi-disciplinary large scale longitudinal study ofsocial, behavioral and ph... more The SOFIA study : a multi-disciplinary large scale longitudinal study ofsocial, behavioral and physical development
Lakartidningen, 2014
Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corpora... more Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corporal punishment was looked upon as a normal part of upbringing in the 1960s, but today more than 90 % of all Swedish parents regard this as a deviant behavior. While the diagnostic tools for establishing of intentional injuries are continuously refined, neglect of children has been more difficult to define and describe. In later years, however, it has been obvious that neglect for many children is chronic and with long-term effects that are just as devastating as corporal punishment and sexual abuse. All over the world a more ecological view on family violence is developing, also taking into account countries' social, cultural and political conditions.
Lakartidningen, 2014
Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corpora... more Sweden was the first country in the world to introduce a corporal punishment ban in 1979. Corporal punishment was looked upon as a normal part of upbringing in the 1960s, but today more than 90 % of all Swedish parents regard this as a deviant behavior. While the diagnostic tools for establishing of intentional injuries are continuously refined, neglect of children has been more difficult to define and describe. In later years, however, it has been obvious that neglect for many children is chronic and with long-term effects that are just as devastating as corporal punishment and sexual abuse. All over the world a more ecological view on family violence is developing, also taking into account countries' social, cultural and political conditions.
J Brit Travel Health Ass, 2006
... 1991; 20 (6): 622-6. 3 Baker T, Hargarten S, Guptill K. The uncounted dead– American civilian... more ... 1991; 20 (6): 622-6. 3 Baker T, Hargarten S, Guptill K. The uncounted dead– American civilians dying overseas. Public Health Rep 1992; 107 (2): 155-9. 4 Paixao M, Dewar R, Cossar J, Covell R, Reid D. What do Scots die of when abroad? Scott Med J. 1991; 36: 114-6. 5 ...
J Brit Travel Health Ass, 2006
... 1991; 20 (6): 622-6. 3 Baker T, Hargarten S, Guptill K. The uncounted dead– American civilian... more ... 1991; 20 (6): 622-6. 3 Baker T, Hargarten S, Guptill K. The uncounted dead– American civilians dying overseas. Public Health Rep 1992; 107 (2): 155-9. 4 Paixao M, Dewar R, Cossar J, Covell R, Reid D. What do Scots die of when abroad? Scott Med J. 1991; 36: 114-6. 5 ...
Indoor Air, 2010
The Dampness in Buildings and Health study (DBH) started in the year 2000 in Värmland, Sweden, wi... more The Dampness in Buildings and Health study (DBH) started in the year 2000 in Värmland, Sweden, with a baseline questionnaire sent to all children (n = 14,077) aged 1-6. Five years later, a follow-up questionnaire was sent to the children who were 1-3 years at baseline. A total of 4779 children participated in both the baseline and the follow-up studies and constitute the study population in this cohort study. The aim of this study was to examine the association between exposure to PVC-flooring in the child's and parent's bedroom in homes of children aged 1-3 and the incidence of asthma, rhinitis, and eczema during the following 5-year period. Adjusted analyses showed that the incidence of asthma among children was associated with PVC-flooring in the child's bedroom (AOR 1.52; 95% CI 0.99-2.35) and in the parent's bedroom (1.46; 0.96-2.23). The found risks were on borderline of significance and should therefore be interpreted with caution. There was further a positive relationship between the number of rooms with PVC-flooring and the cumulative incidence of asthma. PVC-flooring was found to be a stronger risk factor for incident asthma in multifamily homes when compared with single-family houses and in smoking families compared with non-smoking families and in women. These longitudinal data from the DBH study found an association between the presence of PVC-flooring in the home and incident asthma in children. However, earlier results from the DBH study have shown that PVC-flooring is one important source for phthalates in indoor dust, and exposure to such phthalates was found to be associated with asthma and allergy among children. This emphasizes the need for prospective studies that focus on the importance of prenatal and neonatal exposure to phthalates in the development of asthma and allergy in children.
Unemployment, secure, insecure employment and self-reported ill-health: A comparative study
Adventitious rooting is a quantitative genetic trait regulated by both environmental and endogeno... more Adventitious rooting is a quantitative genetic trait regulated by both environmental and endogenous factors. To better understand the physiological and molecular basis of adventitious rooting, we took advantage of two classes of Arabidopsis thaliana mutants altered in adventitious root formation: the superroot mutants, which spontaneously make adventitious roots, and the argonaute1 (ago1) mutants, which unlike superroot are barely able to form adventitious roots. The defect in adventitious rooting observed in ago1 correlated with light hypersensitivity and the deregulation of auxin homeostasis specifically in the apical part of the seedlings. In particular, a clear reduction in endogenous levels of free indoleacetic acid (IAA) and IAA conjugates was shown. This was correlated with a downregulation of the expression of several auxin-inducible GH3 genes in the hypocotyl of the ago1-3 mutant. We also found that the Auxin Response Factor17 (ARF17) gene, a potential repressor of auxin-in...
Acta Paediatrica, 2014
The United Nation’s Convention on the Rights of the Child states that the ‘family environment, in... more The United Nation’s Convention on the Rights of the Child states that the ‘family environment, in an atmosphere of happiness, love and understanding’ is best for the ‘full and harmonious development’ of the child’s personality. Despite the fact that this is probably foremost in the minds of most parents, many families find themselves in situations where they have great difficulty providing these basic needs for their children. This can be particularly difficult where one or both parents have to move a great distance from their home to earn a living, either within their own country or abroad. In the world’s richest countries, the term children left behind is used to describe inequalities in child well-being, mainly relating to material well-being, education and health. Scandinavia, the Netherlands and Switzerland are leading the way in promoting children’s health in these three dimensions, while other rich countries are allowing substantial groups of children to fall behind in their developmental potential (1). On a global level, UNICEF is using the same term to describe the conditions faced by children left behind in their local villages or towns, when their parents become migrant workers (2). However, UNICEF normally examines the same three dimensions when it is comparing the conditions of children left behind with children whose parents are not migrant workers. Overseas work and employment income are important in countries where unemployment is a large and persistent problem, as they increase households’ resources and support society in general by reducing the unemployment rate. Overseas working is particularly common in some East Asian countries, such as the Philippines, where about two million Filipino children (5%) have one or two parents working overseas (2). Indonesia, the world’s fourth largest country, was severely affected by the Asian economic crisis in 1997 and has become one of the largest suppliers of overseas workers, with 2–3% of the total child population being left behind. Female migrant workers, in particular, report high levels of abuse and exploitation, and this often results in contracts not being completed and aggravated individual or family financial problems. In other cases, where the employment works well, the money received can improve both family income and female emancipation. However, prolonged separation from parents can place a substantial psychological burden on children (3). The Swedish film director Lucas Moodysson described this dilemma in his 2009 film Mammoth, which featured a young, successful, hardworking New York couple who employed a Filipino lady to take care of their 7-year-old daughter, while the nanny’s two sons were taken care of by their grandmother in the Philippines. The oldest boy missed his mother so much that he tried different ways to earn the money so that she could come home, but he ended up being robbed and severely injured. The film faced culturally based criticism, blaming Western families for not taking care of their own children using cheap overseas labour. But this criticism missed the main point that working overseas in the late 1990s was provoked by the harsh policy of austerity, imposed on East Asian countries by the World Bank and the International Monetary Fund. The devastating effects on health and family relations in countries following this advice – Thailand, the Philippines and Indonesia – have been convincingly demonstrated by public health researchers from Oxford University, UK, and Stanford University, USA (4). There is good evidence from the Philippines, and scattered evidence from Indonesia and Thailand, that the migration of parents can improve the material conditions of children left behind. However, there are more than 100 000 children who have followed undocumented migrant parents into Thailand from Myanmar, Cambodia and Laos, who seem to face much greater difficulties than the children left at home by Filipino and Indonesian migrants. Following migrating parents in very poor circumstances obviously pose a severe risk to the children’s health and development (5). While overseas migration is now a common phenomenon in many parts of the world, it is possible that even more people are migrating within their own countries, primarily from rural to urban areas. Rapid urbanisation in Asia and Africa suggests that more than half of the world’s population now lives in urban areas. In China, uneven development and economic incentives are encouraging farmers to move to cities to find better job opportunities, despite the fact that they often face uncertain circumstances and limited access to social services. The number of rural parents who leave their children behind with family members to work in the cities has increased dramatically over the last decade. Research has indicated that left behind children in the countryside have high levels of social anxiety, but very few studies have compared these children with children in nonmigrating…
Nordic Journal of Social Research, 2013
Introduction: A dramatic increase in sicknesses absence in Sweden has led to a shift in the publi... more Introduction: A dramatic increase in sicknesses absence in Sweden has led to a shift in the public debate. Departing from the view of sickness absence as a result of a poor work environment and stress, the debate in the early 2000s became more concerned with the breakdown of norms and the abuse of sickness insurance. Sickness absence became the responsibility of the individual rather than of society. Aim: This study has sought to explore the consequences of being on sick leave with a musculoskeletal diagnosis, the experiences of encounters with rehabilitation professionals, and the attitudes towards sick-listing from the perspective of the sick-listed persons. Methods: Individual in-depth interviews were conducted in 2010 with eight women and nine men aged 33-60 who were on long-term sick leave (at least 60 days) with a musculoskeletal diagnosis. We analysed the data using a grounded-theory approach. Results: There was an obvious tension between work strategy as a societal norm and finding an acceptable life role when sick-listed. Four groups with partially differing experiences and perceptions crystallized out of the total population. These experiences and perceptions formed their choice of different acceptable life roles and strategies for gaining self-respect and the respect of others. Discussion: The fact that the four groups that emerged from our study experienced their sickness absence in different ways and their pathways back to work were different demonstrates the value of not considering those on sick leave with a musculoskeletal diagnosis as a homogeneous group. The results imply that rehabilitators should adopt a sensitive approach based on the sickness absentees' wishes and views since the latter spend much of their time and thought during their period of sickness on counteracting distrust in search of an acceptable life role to regain respect.
Journal of sports science & medicine, 2015
To ensure health and well-being for their athletes, sports organizations must offer preventive me... more To ensure health and well-being for their athletes, sports organizations must offer preventive measures against sexual abuse. The aim of this study was to design and evaluate feasibility of a research protocol for cross-sectional epidemiological studies of sexual abuse in athletics. Examination of the requirements on the study of sexual abuse in athletics was followed by iterated drafting of protocol specifications and formative evaluations. The feasibility of the resulting protocol was evaluated in a national-level study among elite athletics athletes (n = 507) in Sweden. The definition of sexual abuse, the ethical soundness of the protocol, reference populations and study of co-morbidity, and the means for athlete-level data collection were identified as particularly complex issues in the requirements analyses. The web-based survey defined by the protocol facilitates anonymous athlete self-reporting of data on exposure to sexual abuse. 198 athletes (39%) fully completed the feasib...