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HSC Core 1: HEALTH PRIORITIES

IN AUSTRALIA
Critical Question 1 - How are priority issues for Australias health
identified?
Measuring Health Status
Role of Epidemiology
The collection and analysis of the data used to make this assessment is known as
Epidemiology.
Measures of Epidemiology
Morbidity: The rates, distribution and trends of illness, disease and injury in a given
population.
Mortality: The number of deaths for a given cause in a given population, over a set timeperiod.
Infant Mortality: The number of deaths in the first year of life per 1000 live births.
Life Expectancy: An estimate of the number of years a person can expect to live at any
particular age.

Identifying Priority Health Issues


Social Justice Principles
Equity
Diversity
Supportive environments
Priority Population Groups
Prevalence of condition
Potential for prevention and early intervention
Costs to the individual and community
Direct individual costs include the financial burden that is associated with illness and
disability such as ongoing medical costs (hospital charges, medical professional fees,
medications, travel etc.) and loss of employment
In-direct individual costs include persistent pain and loss of quality of life, possible exclusion
from social activities, increased pressure on families to offer support and the emotional toll of
chronic illness
Direct community costs include the vast funding of the Australian health care system (which
is projected to markedly increase with an ageing and growing population). Most of this
supports primary health care and pharmaceuticals, and the nature of chronic illness tends to
require high degrees of medical intervention to manage them
In-direct community costs include the premature loss of contributing and valuable members
of society and the cost for employers in absenteeism, decreased productivity and re-training

Critical Question 2 - What are the priority issues for improving


Australias health?
These determinants can be categorised as either:
Sociocultural determinants (E.g. family, peers, media, religion and culture)
Socioeconomic determinants (E.g. education, employment and income)

Environmental determinants (E.g. geographical location and access to health services


and technology)

Groups experiencing health inequities


Aboriginal and Torres Strait Islander peoples
Socioeconomically disadvantaged (Low SES)
People living in rural and remote communities
Overseas-born people
Elderly
People with disabilities

High levels of preventable chronic disease, injury and mental health problems
Cardiovascular Disease
Nature
Cardiovascular Disease (CVD) refers to all diseases of the heart and blood vessels,
caused by a build up of fatty tissue inside the blood vessels (i.e. atherosclerosis) and the
hardening of the blood vessels (i.e. arteriosclerosis)
3 types of CVD include Coronary heart Disease, Cerebrovascular Disease, Peripheral
Vascular Disease
Extent
The leading cause of death and sickness
Both mortality and morbidity is decreasing for males and females
Risk Factors and Protective Factors
Non-Modifiable Risk
Modifiable Risk Factors
Factors
- Age: rates increase sharply - Smoking and alcohol abuse
over 65 years of age
- Diet high in fat, salt and
- Being male
sugar
- Family history
- Low physical activity levels
- High blood pressure and
cholesterol levels
- Being overweight
Determinants
Sociocultural
Determinants
- Family history
- Indigenous: higher rates of
all risk factors
- Males: less likely to engage
in preventative health
measures

Socioeconomic
Determinants
- Low levels of disposable
income
- Unemployed
- Low level of education

Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged communities
People who live in rural and remote regions of Australia
Elderly

Protective Factors
- Nutritious and balanced diet
- Daily physical activity
- Responsible use of alcohol
- No smoking
- Maintain healthy weight
- Control stress levels

Environmental
Determinants
- People who live in rural and
remote communities

Cancer
Nature
A group of diseases leading to the uncontrolled growth of abnormal body cells.
Skin, Breast and Lung cancers are of most concern to health authorities
Extent
Mortality and morbidity rates are both increasing.
The most commonly occurring cancer is non-melanoma skin cancer (which is mostly nonlife threatening). The most common life threatening cancers include: Men: prostate,
colorectal, lung and melanoma and Women: breast, colorectal, lung and melanoma
Risk Factors and Protective Factors
Non-Modifiable Risk
Modifiable Risk Factors
Factors
- Gender: specific cancers
- Exposure to carcinogens
- Age: leads to increased risk (cancer causing agents),
- Family history
such as smoke, asbestos,
- Genetic makeup e.g. being UV radiation from the sun
fair skinned
- Lifestyle behaviours, such
as smoking, alcohol misuse
and poor dietary habits

Determinants
Sociocultural
Determinants
- Smoking amongst young
females
- Tanning habits, such as
excessive sun exposure

Socioeconomic
Determinants
- Unemployed: higher rates
of smoking
- Low levels of education e.g.
awareness of warning signs
and personal testing

Protective Factors
- Avoid carcinogen e.g. Slip,
Slop, Slap, Wrap
- Personal screening habits
e.g. breast and testicular
- Public screening e.g. breast
mammograms and prostate
blood test
- Seeking early medical
intervention
Environmental
Determinants
- People who work outdoors
- People who live in rural and
remote communities
- Exposure to chemicals in
the workplace

Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged communities
People who live in rural and remote regions of Australia
Males and Females
Other minor groups include smokers, outdoor workers, young adults and people with fair
skin
Diabetes
Nature
A disease that affects the bodys ability to take glucose from the bloodstream to use it for
energy
Caused by a malfunctioning of the pancreas leading to insufficient insulin levels, the
hormone responsible for regulation of blood glucose levels (BGL)
3 types:

1. Insulin Dependent Diabetes (IDDM) Known as Type 1 usually presents early in life
and patients require insulin injections and must monitor diet and physical activity to
maintain a safe BGL
2. Non-Insulin Dependent Diabetes (NIDDM) Known as Type 2 usually presents later in
life, as a result of long-term poor health behaviours related to diet and exercise. Requires
medication and lifestyle modifications
3. Gestational Diabetes (GD) occurs during pregnancy
The long-term effect s of each type include vision problems, kidney disease, circulatory
issues in arms and legs and a strong link to CVD (similar risk factors)
Extent
Worlds fastest growing disease similar issues are evident in Australia
Prevalence increases with age, especially NIDDM Type 2
The age of onset is decreasing which is a growing concern, especially for young people.
Due to unhealthy lifestyles
3.5% of all Australians have Diabetes
Risk Factors and Protective Factors
Modifiable Risk Factors
Non-Modifiable Risk
Factors
- High blood pressure
- Over 55 years of age
- Having CVD or its risk
- Family History
factors
- Over 45 years with CVD
- Having diabetes in
risk factors
pregnancy
- Over 35 and being of
- Being overweight
Aboriginal, Chinese, India or
Pacific Islander descent
Determinants
Sociocultural
Determinants
- Indigenous 10-30% may
have diabetes much is
undiagnosed
- Being Chinese, Indian or
Pacific Islander
- Social acceptance of binge
drinking
- Ageing population
- Being time poor leads to
increased reliance on
convenient food

Socioeconomic
Determinants
- Low SES more likely to
have poor diet, drink
excessive alcohol, be
physically inactive and be
overweight
- Low education less
awareness of prevention
strategies and health lifestyle
behaviours

Groups at Risk
Elderly
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions
Mental Health Problems
Nature

Protective Factors
- Maintaining a healthy
weight
- A balanced and nutritious
diet, full of Low GI foods.
Eating 5-6 smaller meals per
day
- Healthy use of alcohol
- Daily physical activity
Environmental
Determinants
- Technology has lead to a
more passive society e.g.
popularity of video games
- People from rural and
remote and Indigenous
have difficulty in accessing
medical services
- Junk food advertising to
children

Any illness that negatively affects a persons emotional stability, perceptions, behaviour
and social well-being, such as depression, anxiety, addictions, obsessive compulsive
disorder, bipolar disorder, eating disorders and dementia
Extent
20% of people suffer form a mental health problem at some stage of life
Prevalence is increasing and much is unreported
18-24 years olds have the highest rates, especially substance abuse and depression
Risk Factors and Protective Factors
Modifiable Risk Factors
Non-Modifiable Risk
Factors
- Drug use
- Age increased risk of
- Chronic disease e.g.
dementia
arthritis
- Males suffer mostly
- Perceived self-worth and
depression and addictions
sense of identity
(substance abuse)
- Coping skills
- Females suffer mostly
Stressful situations e.g.
depression and anxiety
family breakdown and
- Uncontrolled life changes
occupational stress
e.g. death or abuse
- Grief
- Family history
Determinants
Sociocultural
Determinants
- Family breakdown lack of
support
- Difficult life circumstances
e.g. abuse
- ABTSI Increased alcohol
and drug abuse, and difficult
life circumstances
- Elderly people increased
social isolation and grief

Socioeconomic
Determinants
- Unemployed higher rates
of depression
- Low education risk factors
- People in financial distress
e.g. farmers during a drought

Protective Factors
- Social acceptance as
legitimate health concerns
- Awareness of social support
structures e.g. GP, online
help, telephone counseling
- Strong sense of
connectedness with family,
friends, work mates and
neighbours
- Personal resiliency skills

Environmental
Determinants
- Living in remote regions
lack of support and medical
services
- Stigma amongst males as
well as common stoical
attitudes
- Lack of emotional support
e.g. family breakdown

Groups at Risk
Elderly
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions
People born overseas, especially refugees
People with a disability
Respiratory Diseases
Nature
Common diseases that affect the respiratory system include: Asthma, Chronic Obstructive
Pulmonary Diseases, Hay fever
Extent
6 million Australians have a long-term respiratory disease

Morbidity rates are now decreasing, a result of reduced smoking


Mortality is also decreasing, due to effective education programs
Asthma is the leading burden of disease amongst children

Risk Factors and Protective Factors


Modifiable Risk Factors
Non-Modifiable Risk
Factors
- Use of preventative
- Environmental changes e.g.
medication for asthma
pollen in spring and cold and
- Exposure to environmental
dry weather patterns
hazards, e.g. chemicals
- Stress
- Passive smoking in homes
and cars
Determinants
Sociocultural
Determinants
- Indigenous Australians
higher rates of smoking
- Family history

Socioeconomic
Determinants
- Increased smoking amongst
low SES
- Low income less money
for preventative medication
- Low SES more likely to be
exposed to occupational
hazards

Protective Factors
- Awareness of personal
asthma triggers e.g. exercise
- Education about personal
prevention strategies and
plans for asthma attacks
- No smoking

Environmental
Determinants
- Higher rates of pollution in
cities
- People who live in remote
region are further from
emergency services
- Childrens exposure to
passive smoke

Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions
Smokers
Injury
Nature
There are many types of injuries, which affect all stages of life. They often result in lingterm harm of ones physical, emotional and social well being. Examples include:
1. Road injuries and Motor Vehicle Accidents (MVAs)
2. Suicide and self-harm
3. Injuries around the home e.g. poisonings, falls, drowning, cuts, fires
4. Workplace accidents
5. Acts of violence
6. Sports and recreational injuries
Extent
Leading cause of death in 1-44 years age group (particularly MVAs and suicide amongst
males)
Greatest cause of potential life lost under 65 years
Major cause of hospitalisation
Deaths from injuries are decreasing in frequency, especially MVAs

The elderly are prone to injuries such as falls, which has a significant impact on their
quality of life

Risk Factors and Protective Factors


Modifiable Risk Factors
Non-Modifiable Risk
Factors
- Driving behaviour and
- Age elderly are more at
attitudes
risk of falls
- Inadequate supervision of
- Gender higher rates of
children
risk taking behaviour and
Occupational hazards
suicide
Unsafe home environment
e.g. chemicals, pool fencing
and trip hazards
- Safe roads and effective
road laws
- Safe use of alcohol
Determinants
Sociocultural
Determinants
- Indigenous people suffer
more injuries
- Attitudes towards driving
and risk taking amongst
males
- Family breakdown, leading
to social isolation of young
people
- Societal pressure for
tougher road laws e.g. P
plate regulations
- Societal awareness of
hazardous environments

Socioeconomic
Determinants
- Low SES higher rates of
hospitalisation from injuries
- Low education less
awareness of dangers
around the home
- Low income makes it
harder to purchase safety
equipment
- MVAs are highest amongst
low SES populations

Protective Factors
- Minimising driving
distractions e.g. Mobile
phones and GPS
- Effective driver education
- Positive attitude towards
road and OHS rules and
regulations
- Home modifications for the
elderly
- Strong social support to
prevent suicide

Environmental
Determinants
- Workplace injuries are most
common in agricultural
settings
- Suicide is highest amongst
males from rural and remote
regions
- Unsafe home environment
of elderly people and children
can lead to increased risk of
injury

Groups at Risk
Elderly (Falls)
Indigenous Australians (MVAs and self-harm)
People from rural and remote regions (occupational injuries)
Children (poisoning and drowning)
Young Adults (MVAs, sport and recreational injuries and self-harm)
Males (Suicide and MVAs)

A growing and ageing population


A number of significant trends have been observed in Australias population in the last 50
years:
A decrease in the birth rate over this time
A decline in mortality rates, along with an increase in life expectancy

Sustained rates of immigration from overseas


The percentage of people aged over 70 years is set to double to 20% over the next forty
years. Also, the total population is expected to double to 40 million people in the same time.
Healthy Ageing
Enabling and empowering people to live a healthy, productive and contributing life for as
long as possible, is a key strategy of the government.
Increased Population Living with Chronic Disease and Disability
A larger elderly population inevitably leads to more people living with chronic disease and
disability.
Demand for Health Services and Workforce Shortages
To meet the demands placed upon our government and society by a growing and ageing
population, the full range of health services will need to expand dramatically. This increase
needs to include; more specialist health professionals and GPs, more primary and
emergency health services such as ambulances and public hospitals and more housing and
accommodation for people who require assistance with basic living needs.
Availability of Carers and Volunteers
Carers provide informal care of people living with chronic diseases and disability. The
contribution of volunteers is also recognised as essential in meeting the demands of our
ageing population. They assist with activities such as transport, shopping, meals on wheels
and social activities.

Critical Question 3 - What role do health care facilities and services


play in achieving better health for all Australians?
Health care in Australia
Range and types of health facilities and services
Category
Examples
Public health services
Cancer screening
Immunisation programs
Primary and community health care
GPs
Ambulance services
Royal Flying Doctor Service
Dental
Hospitals
Public
Private
Mental
Specialised health services
Specialised medical practitioners
Reproductive health
Mental health
Palliative care
Responsibility for health facilities and services
Health care provider
Facilities and/or services provided
Commonwealth Government
Formation of national health policies
Collection of taxes to finance the health system
Provision of funds to state/territory
governments

State/Territory Government

Local Government

Private organisations

Community groups

Special concern for ATSI


Pharmaceutical funding
Hospital services
Mental health
Home and community care
Family health services
Dental health
Womens health
Health promotion
Regulating health industry providers
Vary from state to state
Environmental control
Antenatal clinics
Meals on Wheels
Private hospitals
Dentists
Alternative health services (physiotherapy,
chiropractor, etc)
Local needs basis
Cancer Council, Dads in Distress, Diabetes
Australia, etc

Equity of access to health facilities and services


All Australians should have equal access to health care facilities and services. This is
achieved in Australia through Medicare.
Health care expenditure versus expenditure on early intervention and prevention
Health-care expenditure incorporates private health insurance, households, individuals and
all levels of government. In 2007-08 Health-care expenditure was $103.6 billion (Australias
Health 2010, AIHW). Less than 2% of this figure was spent on preventable services or health
promotion.
Reasons for increasing funding for preventative health strategies include:
Cost effectiveness
Improvement to quality of life
Containment of increasing costs
Use of existing resources
Reinforcement of individual responsibility
Maintenance of social equity
Reduced mortality and morbidity
Impact of emerging new treatments and technologies on health care, e.g. cost and
access, benefits of early detection
New treatments and technologies have the potential to significantly improve the health status
of Australians. Examples of developments in emerging treatments and technologies include:
development of new machinery, image technology in keyhole surgery, improvement in
materials, drug advancements, prosthetic limb development, artificial organs and transplant
technology.
Health insurance: Medicare and private

Health care in Australia is provided by the public sector (Medicare) or through private health
insurance. Medicare is the health-care system for all Australians. Its aim is to provide equity
in terms of cost and access for health care services.
Funding for Medicare comes from income tax (1.5% of taxable income) and the Medicare
levy surcharge (1% for high income earners).
Every Australian is covered for 85% of the scheduled fee.
Bulk Billing allows patients to pay nothing and the doctor receives the scheduled fee from
Medicare.
People have the option of increasing the health insurance they have by taking out private
health insurance. The extra insurance covers private hospital and ancillary or extras (dental,
physiotherapy, naturopathy, etc).
Reasons for choosing private health insurance include:
- Shorter waiting times
- Hospital choice
- Own doctor of choice
- Ancillary benefits such as physiotherapy
- Peace of mind
- Private rooms in hospital
- Health cover while overseas
- Avoiding increase tax
To combat falling private health insurance numbers the Commonwealth Government has
implemented several schemes.
- 30% tax rebate for people with private health insurance
- 1% Medicare levy surcharge
- Lifetime health-care incentive with lower premiums to those who join before age 30
Medicare
Private health insurance
Payment
Commonwealth Government Commonwealth Government
Taxpayers
Individuals and families
Payment type
Income tax
Annual, monthly, fortnightly
Levy surcharge
premiums
Benefits
Basic public hospital services Hospital cover
Basic medical services
- Hospital services
Some specialist services
- Choice of doctor
85% of scheduled fee
- Choice of hospital
Availability of bulk billing
- Private or public hospital
Ambulance cover
Ancillary cover
- Physiotherapy
- Chiropractor
- Naturopathy, etc
Some special benefits such
as gym membership
Overseas cover

Complementary and alternative health care approaches


Reasons for growth of complementary and alternative health products and services
World Health Organization recognition
Recognition of Eastern cultures
Marketing strategies
Proven results for many when traditional medicine had failed

Desire for natural medicines


Holistic nature
Addition to ancillary benefits by private health insurers
Societal changes with multiculturalism
Societal changes with globalisation
Societal changes with demographics
Formal qualifications enhancing credibility
Range of products and services available
Alternative health-care approach
Acupuncture
Aromatherapy
Bowen therapeutic technique
Chiropractic
Herbalism
Homeopathy
Iridology
Massage
Meditation
Naturopathy

Description
Involves inserting needles into skin
Use of pure essential oils to influence the
mind, body or spirit
System of muscle and connective tissue
movements that realigns the body and
balances energy flow
Adjustments are made to the spine to realign
correct body function
Uses plants and herbs
System that recognises the symptoms are
unique to an individual
Analysis of the human eye to detect signs of
wellbeing or otherwise
Includes remedial, Swedish, sports
State of inner stillness
Holistic treatment aiming to treat the
underlying cause as well as the symptoms of
the illness

How to make informed consumer choices


It is important to investigate and critique health-care providers and services. This can
include: what is it they offer, what are the benefits, experience, qualifications, governing body
and cost.

Critical Question 4 - What actions are needed to address Australias


health priorities?
Health promotion based on the five action areas of the Ottawa Charter
The five action areas of the Ottawa Charter are:
- Developing personal skills
- Creating supportive environment
- Strengthening community action
- Reorienting health services
- Building healthy public policy
Levels of responsibility for health promotion
The Australian government, state and local governments, non-government organisations,
communities and individuals are all responsible for promoting health.
The benefits of partnerships in health promotion

The chance of successful health promotion is greatly increased when all levels of
government, non-government organisations, communities and individuals work together
towards one common goal.
How health promotion based on the Ottawa Charter promotes social justice
Health promotion to be effective needs to address the social justice principles (equity,
diversity and supportive environments).
Equity
Diversity
Supportive
environment
Developing personal skills
Mandatory PDHPE Access to Medicare Media campaigns
K - 10
Community based
support
Creating supportive
Provision of health Destigmatising
Legislative bans
environments
enhancing items
health conditions
Provision of health
enhancing items
Strengthening community
Lobby groups
Lobby groups
Lobby groups
action
Reorienting health services Health services for Language
Partnerships with
ATSI
assistance
the community
Building healthy public
Bulk billing
Abstudy
Health campaigns
policy
PBS
Health care card
The Ottawa Charter in action
Application of the Ottawa Charter requires critical analysis of the 5 areas of the Ottawa
Charter: developing personal skills, strengthening community action, creating supportive
environments, reorienting health services, building healthy public policy.
Examples of health promotions that are based on the Ottawa Charter to an extent include:
Closing the Gap, Fresh Tastes @ School, National Tobacco Strategy, National Action Plan
on Mental Health, Measure Up and Swap It Dont Stop It.

HSC Core 2: FACTORS AFFECTING


PERFORMANCE
Critical Question 1 - How does training affect performance?
Energy Systems

Source of fuel

Alactacid system
(ATP/PC)
Creatine phosphate

Lactic Acid
system
Carbohydrate
Glycogen

Efficiency of ATP
production

Less than 1 ATP


molecule

Approximately 2
ATP molecules

Duration

5 - 10 seconds

30 - 45 seconds

Cause of fatigue

Depletion of PC

By-products

None

Increased
accumulation of
hydrogen ions
Lactic acid

Process and rate of


recovery

PC replenishment
in
2 5 minutes

Removal of lactic
acid with active
recovery in 15 30
mins

Aerobic system
Carbohydrate
Fat
Protein
Glucose 36 ATP
molecules
Fatty acid 130
ATP molecule
Unlimited
depending upon
intensity
Depletion of fuel
sources
Carbon dioxide
water
Restoration of
glycogen up to 48
hours

Types of training and training methods


Aerobic
Aerobic training generally follows the FITT principle.
F = frequency at least 3 sessions per week are required for aerobic training to be effective.
Serious athletes may complete 12 sessions.
I = intensity usually measured using heart rate. Aerobic training usually occurs between
70% and 85% of max HR.
T = time will depend upon the intensity but needs to be at least 20 minutes duration.
T = type there are a range of training types one can utilise to develop aerobic capacity
Continuous training requires training without rest for at least 20 minutes.

Fartlek training or speed play involves continuous exercise with sprints or a higher
intensity effort (e.g. Hill climb) interspersed throughout the session.
Aerobic interval training involves alternating repetitions of an exercise and a period of rest
or recovery.
Circuit training involves a series of exercises that are performed one after the other with
little or no rest in between each exercise.
Anaerobic
Anaerobic training involves exercise of high intensity and therefore short duration.
Interval training is a very common form of anaerobic training usually requiring maximal
effort. Generally the recovery rate ratio will determine the type of training and aims of the
sessions.
Speed, acceleration and agility are components that can be developed through anaerobic
training.
Plyometrics is a very common training style to develop anaerobic power. Plyometrics
involves exercises that produce an explosive muscular contraction.
Flexibility
Flexibility is the ability to move a muscle through its full range of motion. Good flexibility will
assist:
- Prevention of injury
- Improved coordination
- Muscular relaxation
- Decreasing muscle soreness
Static stretching the muscle is slowly and smoothly taken to the end of its range of motion
and held for approximately 30 seconds. This method is useful for rehabilitation, warm up and
cool down.
Dynamic stretching involves a series of movements that replicate game movements and
take the muscle through its full range of motion. It is popular for warm-ups.
Ballistic stretching involves a bouncing action at the end of the range of motion. This form
of stretching activates the stretch reflex. The force of the movement takes the muscle
beyond its preferred length. Therefore, this type of stretching has risks and is only
recommended for elite athletes.
PNF stretching proprioceptive neuromuscular facilitation involves lengthening a muscle
against a resistance. Generally it involves a static stretch, followed by an isometric
contraction then a period of rest before being repeated. Used often during rehabilitation.
Strength training
Strength is the maximal force generated by a single muscular contraction.
Hypertrophy an increase in the size of the muscle fibres and connective tissues
Isotonic involves exercises where the muscle shortens and lengthens
Isometric involves exercises where the muscle does not change length
Isokinetic involves exercises where the load remains constant throughout
Machine weights very popular method allowing for isotonic contractions and are very
simple to use. It is very easy to isolate muscle groups using this method of training.
Free weights include dumbbells, barbells, medicine balls and kettlebells. Allow a wide
range of exercises, muscle groups and types of contractions to be catered for. Good
techniques are needed to avoid injury.
Resistance bands are often used in rehabilitation but have become a popular form of
training lately due to their convenience. They allow for a range of contractions and a wide
range of muscle groups.
Stability balls have become popular of late. Their focus is to develop the core muscles and
majority of free weight exercises can be adapted to be performed incorporating the stability
ball.

Hydraulic resistance effort is made against an opposing force. Resistance is constant


through the entire movement.

Principles of training
Progressive overload
To continue to have training improvements, progressive overload needs to occur. The body
adapts to the training it undergoes. When this adaptation occurs the training needs to be
increased to stress the body beyond its current capabilities to achieve further training gains.
It also needs to be progressive so that the stress placed on the athlete does not cause injury
or fatigue. Overload can be achieved by increasing intensity, resistance, repetitions,
duration, frequency, etc.
Specificity
Exercise needs to be specific for the energy systems, muscles, movement patterns, etc
required for the athletes sport.
Reversibility
Training adaptations are lost once training ceases or lowers below the current capacity of
the athlete. A detraining effect results in the physiological adaptations gained through
training being reversed.
Variety
Completing the same or similar activities can lead to boredom which in turn may result in a
reduced training effort. Therefore it is important for training sessions to incorporate a range
of training types, settings, activities and drills.
Training thresholds
Training thresholds are the upper limits of a training zone and when passed take the athlete
to a new level.
The aerobic threshold (Lactate transition 1) is approx 70% of MHR. This level is sufficient to
cause a training effect.
The aerobic training zone is when athlete is working above the aerobic threshold and below
the anaerobic threshold.
The anaerobic threshold (Lactate transition 2 or Onset Blood Lactate Accumulation OBLA) is
approx 85% of MHR. Exercise beyond this point will see a marked increase of lactic acid
build up and therefore fatigue and the cessation of exercise.
Warm up and cool down
For most sports a warm up will last approximately 20 minutes. This will incorporate a general
warm up followed by a more specific warm up. The aim of the warm up is to prepare the
body both physically and mentally for optimal performance.
The general warm up will contain some running or aerobic activities and dynamic stretching.
The specific component of the warm up will contain activities relating to the sport.
The cool down is recommended to form part of the active recovery for the athlete. Generally
this will involve low intensity exercise. The aim of the cool down is to decrease blood lactate
levels and to minimise muscle soreness.

Physiological adaptations in response to training


Resting heart rate
Stroke volume

Adaptation
Decreased resting heart rate due to more
efficient stroke volume
Increased at rest and throughout exercise

Cardiac output
Oxygen uptake
Lung capacity
Haemoglobin level
Muscle hypertrophy
Effect on slow-twitch muscle fibres

Effect on fast-twitch muscle fibres

Increased maximal cardiac output


Increased due to an increase in capillaries,
myoglobin, mitochondria and enzyme
activity
Increased maximal ventilation but remains
relatively unchanged
Increased due to an increase in blood
plasma and RBC numbers
Increased size with resistance training
No change to percentage
Increased hypertrophy, capillary supply,
mitochondrial function, myoglobin content
enzymes and glycogen stores
No change to percentage
Increased ATP and PC supply, enzymes,
hypertrophy and lactic acid tolerance

Critical Question 2 - How can psychology affect performance?


Motivation
Positive and negative
Positive motivation is the desire to be successful in a pursuit that will result in happiness,
satisfaction and pleasure. An example of this is for a high jumper to hope to compete at the
Olympics.
Negative motivation is the desire to be successful with the aim of avoiding unpleasant
consequences. The motivation is to avoid something bad happening as opposed to a
positive outcome. An example is training hard and playing trying to avoid being dropped from
the team.
Intrinsic and extrinsic
Intrinsic motivation is internal motivation. It is emphasised by feelings of satisfaction and
enjoyment. It is self-sustaining and is usually associated with an orientation towards the task.
This type of motivation promotes longevity as external factors are not driving the athlete, for
example continuing to play football despite regularly being in a lower grade and losing.
Extrinsic motivation is motivation that comes from external sources. This includes things like
trophies, money and praise. It tends to have an outcome orientation. This generally does not
promote longevity as the money and praise are not often sustainable. Extrinsic rewards can
deter from intrinsic motivation.

Anxiety and arousal


Trait and state anxiety
Anxiety is a negative emotional state. It is the result of perceiving situations as threatening.
State anxiety is feelings of tension related to a specific event or moment in time. For
example an athlete prior to the start of a 100m race feels nervous and anxious. The tension
and anxiousness is related to the event, the bigger event the bigger the anxiety.
Trait anxiety is a behavioural or personality disposition to display anxiety and to perceive
various situations as threatening. A person with high trait anxiety often displays high state
anxiety in competitive situations.
Sources of stress
Stress is the imbalance between what is expected of a person and their perceived ability to
meet those expectations. When there is a large imbalance then the person becomes

stressed. There are many sources of stress and these include: financial concerns, selection
concerns, injury concerns, contract concerns, crowds, preparation and expectations.
Optimal arousal
Optimal arousal is the physical and emotional response related to a specific moment or
event. Arousal is important for successful sporting performance, however, not all athletes or
sports require the same level of arousal. An archer requires a different level of arousal (calm
and quiet) compared to a weightlifter (pumped up).
Optimal arousal is generally described utilising the inverted u hypothesis. As arousal
increases so does performance until optimal arousal and this performance is reached. If
arousal continues past this point (over arousal) then performance declines.
High
Performance
Low
Low

High
Level of arousal

Psychological strategies to enhance motivation and manage anxiety


Concentration/attention skills (focusing)
The ability to focus on appropriate cues is essential for an athlete. Shutting out distractions
and irrelevant cues will assist the athlete to perform at a higher level.
Strategies for focusing or regaining focusing can include music, cues, set routines, training
for distractions and focus training. Athletes often train to replicate as much as possible the
same environment as game day to ensure their focus is on the important cues at the crucial
time.
Mental rehearsal/visualisation/imagery
This involves creating mental images or pictures of the upcoming event, action or skill. This
allows the athlete to experience (success) prior to the actual event. This allows the athlete to
feel confident due to the fact that it is as if the athlete has been in this position previously
and therefore knows how to feel and react and more importantly can picture a successful
outcome.
Athletes may use various methods of mental rehearsal. One method is as spectators
watching themself perform the skill and the other is from their internal view as they are
actually performing the skill.
Mental rehearsal needs to be as realistic as possible for it to be effective. Therefore the
detail, timing and settings all need to replicate the real event.

Relaxation techniques
Over-aroused and anxious athletes benefit greatly from having a range of relaxation
strategies available to them. Relaxation will lower breathing rates, heart rate, blood pressure
and muscle tension leading to greater control and focus.
Examples of relaxation include listening to music, massage, watching TV or a movie,
controlled breathing exercises, yoga, Pilates, meditation and hypnosis.
Goal-setting
Setting long term and short term goals can assist an athlete greatly to remain focused. The
goals of an athlete can be about the outcome of their performance (e.g. winning gold at the

Olympics) or the process (e.g. swimming a personal best at the Olympics).Short term goals
should contribute to achieving the long term goal.

Critical Question 3 How can nutrition and recovery strategies


affect performance?
Nutritional Considerations
All athletes must ensure that the food and drink they consume will support maximum
performance. These considerations are as important for both training and actual competition.
They also apply to both before and after intense physical activity. The primary aims of good
nutrition are:
Adequate fuel reserves, such as maximum glycogen stores for triathletes
Repair of damaged body tissue from training, such as increasing protein intake for
strength training
Prevention of dehydration, through adequate fluid intake
Optimal functioning of all body systems (e.g. Immune System), by meeting the
recommended dietary intakes for all nutrients, such as vitamins and minerals
Pre-performance Nutrition
Changes to an athletes regular diet may be necessary in the days and hours leading up to
an intense training session and competition. This is to ensure the required fuel reserves are
full and the athlete is well hydrated. Knowing what and how much to eat, as well as when to
eat, will enable the body to perform intense physical activity.
The last significant meal should be eaten 3-4 hours prior to the event. It should contain at
least 100 grams of carbohydrates, be low in fat and fibre and have a small amount of
protein. At least 500 mL of water should also be consumed. A light meal can also be eaten 12 hours prior, which should consist of some high GI Carbohydrates, as well as more fluid.
Carbohydrate Loading
Endurance athletes require more carbohydrates than other athletes, and may need to
increase their intake for 3-4 days leading up to an event. By maximising muscle and liver
glycogen reserves, they ensure that glycogen is used as a primary fuel for as long as
possible.
Hydration
To avoid the negative effects of dehydration on sporting performance, athletes should overcompensate for their projected fluid needs. For a normal person, 2 litres of fluids should be
consumed daily; therefore a person who is expecting to perform intense physical activity
should drink at least 3 litres in the 24 hours leading up to an event.
During Performance
Continued hydration is the main priority during physical activity. Small amounts of fluid
should be consumed at all possible times, such as time-outs, half time and stoppages
(150mL per 15 minutes). For endurance events, lasting longer than 60 minutes, refuelling
may also be necessary. This is best achieved by eating concentrated forms of glucose such
as energy gels, bananas, sports bars or sports drinks.
Post Performance
The primary aim of post-exercise recovery is to return all body systems as quickly as
possible to their pre-event condition. The specific details of what to eat and when will depend
on the duration and intensity of the activity itself. The primary aims of the first 12 24 hours
after intense exercise are:
Restore depleted glycogen

Repair damaged muscle tissue


Rehydrate the athlete

Supplementation
Supplementation is the process of eating additional nutrients to account for a deficiency in
an athletes diet. In most cases, sports nutritionists generally prefer to make regular dietary
modifications.
Vitamins and Minerals
Vitamins are chemical compounds, which can only be sourced through dietary intake. They
enable the normal functioning of the body and promote growth and development. Vitamins
are available in a wide range of foods, which is why a diverse range of food is needed to
meet the RDIs of each one.
Minerals are also chemical compounds, which play a similar role in the body. They are also
normally sourced through the food eaten in a regular diet, but can be supplemented if
needed. Deficiencies of some minerals can have a direct and adverse effect on the health
and performance of certain athletes. Minerals of significance include:
Iron
Calcium
Protein
Protein is required for the growth, repair and maintenance of muscle tissue. Athletes must
ensure they eat sufficient amounts of protein to aid recovery and promote growth of muscle
tissue. This is especially important for athletes who are undertaking strength training or highintensity interval training. Good food sources of protein include lean meat, dairy products,
nuts and eggs.
Caffeine
Caffeine is a stimulant, which speeds up the Central Nervous System. It is normally
consumed through chocolate, coffee, cola drinks and advertised energy drinks. It is also
available in the form a caffeine tablets. The supposed benefits of caffeine for athletes include
increased alertness, decreased perception of fatigue and the mobilisation of fat cells leading
to glycogen-sparing. Possible negative side effects include an elevated heart rate, overarousal and uncontrolled muscle twitches leading to decreased fine-motor control. In highdoses, it also acts as a diuretic, leading to dehydration.
Creatine
Creatine is a fuel source, which is stored in skeletal muscles. It is produced partly in the
body cells, but regular intake of protein, especially from meat sources, ensures the RDI for
Creatine is achieved. Its role is to assist in the production of Creatine Phosphate, which is
the fuel source for the replenishment of ADP back into ATP. This is commonly known as the
ATP-CP Energy System, which provides for ATP regeneration during short bouts of powerful,
high-intensity exercise, such as 100m sprints or shot-put. Athletes who either train for these
types of sports or undertake a heavy resistance-training program, may achieve training
benefits such as increased lean muscle mass and improved performance levels.

Recovery Strategies
Physiological Strategies
Both active recovery exercises and appropriate nutrition are important factors in restoring the
body to a pre-event condition, allowing the athlete to prepare for the next training session or
game as quickly as possible. Examples include:
Hydration

Nutrition
Cool Down
Stretching

Neural Strategies
Intense physical activity is very taxing on the muscular system, but also the Central and
Peripheral Nervous System. These neural strategies are aimed at relaxing the body and
muscles, reducing the perception of localised muscle fatigue as well as decreasing general
mental fatigue.
Hydrotherapy
Massage
Tissue Damage Strategies
Following intense physical activity and competition, it is common for athletes to suffer from a
variety of levels of tissue damage. This can range from microscopic muscle tears as a result
of heavy resistance training, to bruises and minor sprains and strains, right through to more
significant soft-tissue injuries.
Cryotherapy
Psychological Strategies
The pressure involved in participating in elite sport can be immense, and this can come from
both internal and external sources. For an athlete to maintain good mental and emotional
health, as well as manage their levels of motivation and anxiety, a range of personal
strategies can be employed to achieve this
Relaxation
Sleep

Critical Question 4 - How does the acquisition of skill affect


performance?
Stages of Skill Acquisition
Cognitive Stage
This stage is characterised be the learner developing an understanding of the task
requirements.
Associative Stage
This stage is characterised by the need for the athlete to practise the skill, until a correct
motor pattern is established in the mind and body.
Autonomous Stage
In this stage, the athlete is able to perform the skills automatically, without intentional thought
about the task requirements.
Characteristics of the Learner
Personality
Innate personality traits can have a significant effect on an athlete in all stages of skill
acquisition. Examples of relevant traits include confidence, motivation, a positive outlook,
self-discipline, focus, enthusiasm, competiveness and whether you are an introvert or an
extrovert.
Heredity

Certain genetic features can provide a varying degree of advantage with regard to the
potential for success. Specific inherited factors, which may be influential, include:
Muscle Fibre Type

Body Shape
Gender

Confidence
Whilst this is a personality trait, it stands alone as making a significant contribution to
sporting success at the elite level
Prior Experience
Certain sports have common characteristics, which can enable a person to transfer their
ability from one sport, and quickly adapt and learn the specific skills and tactics in another
sport. Some factors that can be transferred from one sport to another include:
Motor patterns

Tactics and strategies


Skills
Components of Fitness

Ability
Some people seem to have a natural ability at sport, which is most evident in the rate that
they move through the stages of skill acquisition. They almost seem to be dominant in any
game they play. Some of the factors that may underpin this phenomenon include spatial
awareness (awareness of who and what is around them), kinaesthetic sense (awareness of
the bodys position in space), tactical awareness (awareness of what equipment should feel
like as it makes contact with the body), coordination (ability to move multiple limbs with
timing and precision e.g. hand-eye or foot-eye coordination), fast reaction time and
perceptive senses (enhanced sensitivity of the senses, especially during fast-paced sports)

The Learning Environment


The Nature of Skill
Skills can be categorised based on the following.
Closed Skills are performed in a leaning environment which is unchanging, stable and
predictable
Open Skills are performed in a leaning environment which is changing, less stable and
somewhat unpredictable
Gross Motor Skills require the use of large muscle groups to produce a less refined
movement
Fine Motor Skills require the use of small muscle groups to produce a precise and
accurate movement
Self-paced skills are performed when the athlete chooses to, such as when to bowl the
cricket ball or when to commence a high jump attempt
Externally paced skills are not at the discretion of the athlete, and they must perform the
skill based on forces out of their control, such as hitting a baseball or being a goalkeeper
in hockey
Discrete skills have a clearly defined beginning and end, such as a golf shot, a 100m
sprint or a pass in football

Serial Skills are a combination of a range of discrete skills into one whole movement.
Team sports are require serial skills as an athlete is constantly using a variety of skills in
competition
Continuous Skills have no clear beginning or end, and the point at which they start or
end is at the discretion of the athlete, such as going for a run or swim

The Performance Elements


Decision making

Strategic and tactical development

The Practice Method


Massed Practice is characterised by periods of continuous practice with short rest
intervals. This is suitable for activities that are fun, of moderate intensity or for highly
motivated athletes. Suitable examples include golf putting or goalkeeping
Distributed Practice is characterised by shorter periods of work with more regular periods
of rest. This is suitable for monotonous or difficult activities, for high-intensity activities
that cause excessive or where motivation is low. This would suit activities such as waterskiing or tackling in rugby league
Whole Practice involves practicing the complete skill in its entirety. This suits advanced
learners or for skills that cannot be broken down into sub-components that can be
practiced in isolation, such as archery or sailing
Part Practice involves isolating the various sub-components, practicing each and then
combining it all together in a complete movement. This is suitable for very complex skills
such as pole vault, or for beginners who are in the cognitive stage
Feedback
Intrinsic Feedback information that is received internally through the senses by the
performer. As a learner continues to improve, they should be developing the ability to
detect and correct their own errors. A Refined kinaesthetic sense is critical in enabling
them to analyse the feel of the movement
Extrinsic Feedback information that is received from an external source, such as a
coach, the crowd or video analysis
Concurrent Feedback is feedback that is received during the performance, and is
closely aligned with intrinsic feedback. The athlete may be able to adjust the current
movement as it is being executed, such as a batter adjusting their shot selection as the
ball swings unexpectedly. Or they can adjust the skill the next time it is executed
Delayed Feedback is feedback that is received after the completion of the skill. It can
be either intrinsic, via video analysis, or through an extrinsic source such as a coach.
Sometimes this feedback can arrive days later during a video analysis session
Knowledge of Results information concerning the outcome or success of the skill, such
as whether ball was in or not. This information can then be used to analyse why the skills
was successful or not. This is most useful for beginners as the develop their basic motor
patterns
Knowledge of Performance information concerning the actual technique or the patterns
of play. This is used more so by learners in the autonomous stage and can arrive from
both extrinsic and extrinsic sources. Coaches of elite athletes must be very competent in
carefully analysing performances to detect and help correct even minor errors. Also in
team sports, the coach must be very good at analysing the play and identifying areas of
strengths and weakness in both teams, and communicating relevant feedback and
strategies for the team

Assessment of Skill and Performance


Characteristics of a Skilled Performance
There are a number of observable differences between a skilled and unskilled performance.
Kinaesthetic Sense
Anticipation
Consistency
Technique
Mental Approach
Objective and Subjective Performance Measures
There are a range of tests that can be used in order to make a measurement or an appraisal
as to the quality of performance.
Objective Measurement Where an assessment is not based on human interpretation or
analysis, the test is described as objective. Sporting examples include high jump, the
100m sprint and the score in a team sport. These measurements are the most fair and
reliable in terms of who the winner was. However, they may not provide enough
information for a complete analysis of the technique or performance
Subjective Measurement Assessment that relies on personal opinions and judgment is
described as subjective. Some sports rely solely on a subjective measurement, such as
in diving or gymnastics. The analysis of technique or tactical performance also relies on
subjective measures, as the coach makes a personal interpretation
Validity and Reliability of tests
The assessment of sporting performances must measure what it actually intends to measure
(validity) and also ensure the same results are achieved regardless of who, where or when
the test is administered (reliable).
Personal versus Prescribed Judging Criteria
When a subjective measurement is to be made of any sporting performance, some degree
of criteria is used which enables a more complete and fair appraisal. To increase the
objectivity required for official competition, prescribed criteria are developed by the judges or
governing body. These involve rating scales, checklists and scoring systems that minimise
the chance of error or bias affecting the results. Commitment and degree of difficulty