The regulation of child labour in the sporting goods industry is the responsibility of both governments and corporations. The choice of sporting goods and uniforms, and the selection of sporting goods corporations as sponsors, are the responsibilities of national and international sport federations. The need to conform to the CRC by recognizing childhood as a period of growth and development, the regulation of conditions under which children practice and compete, and under which they are bought and sold (drafted, contracted, traded, etc.), are also responsibilities of governments, national and international sport federations and umbrella organizations such as the International Olympic Committee (IOC) (Donnelly & Petherick, 2004). The IOC has taken steps in recent years to achieve racial and gender equity in sports and to assist (through Olympic Solidarity) in the travel and training of athletes living in poverty. The status of children should be the next major international policy initiative in sport.

The first approach comes from the international medical community and is primarily for use in diagnosis, classification, treatment and insurance. The second approach is prominent among persons who dislike labels and subscribe to humanism (i.e. we are all human, we all fail, we all strive for personal bests and we all need one another). Now that the WHO conceptualizes disability as a conglomerate of person-environment interactions affecting function, the two approaches can be held concurrently. Practice, however, often lags behind theory, position statements of experts and research evidence.

15 Id. at 22.

16 Id.

17 Id.

18 Id. at 11.

19 See Resolution 56/168 http://www.un.org/esa/socdev/enable/disA56168e1.htm (last accessed August 17, 2006).

20 See http://untreaty.un.org/English/guide.txt (last accessed August 17, 2006).

21 Mary Lou Breslin and Silvia Yee, “Disability Rights and Policy: International and National Perspectives,” Transnational Publishers, at 18 (2002).

22 Id.

23 See Working Paper Submitted by Mexico, Article 16: “States Parties shall ensure that persons with disabilities have access to and the enjoyment of:

1. Recreational, cultural, and sports activities through adaptations which facilitate them the use of related facilities and services.
2. Their integration into routine sports activities and national as well as international competitions.
3. A system of scholarships or special incentives for cultural, artistic, and sports activities.”

http://www.un.org/esa/socdev/enable/rights/adhocmeetaac265w1e.htm, A/AC.265/WP.1 (last accessed August 29, 2006).

24 For the first time ever in an international treaty drafting process non-governmental organizations (NGO’s) were able to actively participate in discussions regarding the draft text. The forum created for the NGO voice was an International Disability Caucus (IDC), which appointed representatives to voice the collective NGO stand.

25 Elise Roy, “January 2004 Draft Working Group Disability Convention Text Critique” (distributed only at the United Nations) (March 2004).

26 See http://www.un.org/esa/socdev/enable/rights/ahcwgreporta24.htm (Last accessed August 29, 2006).

27 Please refer to page, 6 for the full text of these subclauses.

28 See http://www.un.org/esa/socdev/enable/rights/ahcwgreportax1.htm (Last accessed August 29, 2006).

29 See Report of the Third Session of the Ad Hoc Committee on a Comprehensive and Integral International Convention on the Protection and Promotion of the Rights and Dignity of People with Disabilities, A/AC.265/2004/5, (June, 9 2004).

30 A/RES/58/5, “Sport as a means to promote education, health, development and peace.”

31 Id.

32 Id.

33 Id.

34 Final Report International Year of Sport and Physical Education.
http://www.un.org/sport2005/a_year/IYSPE_Report_FINAL.pdf at 2, (2005)

35 Id.

36 The Year of Sport did hold a conference on Rehabilitation Through Physical Activity and Sport that addressed adapted sport and also focused on the psychological effects of the Southeast Asia tsunami. The Year of Sport also formed partnerships with the International Paralympic Committee and Special Olympics as well as had a small section on their website devoted to sport and disability. However, there were no tangible results felt as in the gender realm.

37 International Disability in Sport Working Group Goals and Objectives, internal memorandum (January 2006).

38 Id.

Training at moderate high altitude (HA; 1800 to 2400 m) is one of the few possibilities available to increase the performance more than by the normally given circumstances. To estimate the positive (or negative) effects of training at HA, personal experiences from the point of view of a direct monitoring of training play an important role. Besides the general difficulties of estimating the (positive/negative) effect of training at HA, only few objective data from training practice with top class athletes are available. The effect of training at HA with the goal to improve performance capacity in endurance sports is still under discussion in the sports sciences [2, 3].

In discussing positive or negative effects of high altitude, we have to separate out: 1. General effects of adaptation during or after exposure to high altitude, which give an unspecific benefit. 2. Positive (or negative) training effects which can be similar during training at high altitude or at sea level; additional to this outcome, the training at high altitude can be influenced in a positive (or negative) way. 3. Effects and benefits of training which can be caused only by a stay under high altitude conditions. In most of the studies no differentiation has been made between these aspects, which makes it difficult to interpret under isolated points of view the benefits and / or failures of a stay under HA conditions. Besides these facts, there is the problem of interpreting those effects of a continuous stay versus a regular intermittent hypoxic exposure (LH – TL: Live high, train low; LL – TH; live low, train high) or even more so the effects of several new altitude training strategies like a) normobaric hypoxia via nitrogen dilution (nitrogen apartment), b) supplemental oxygen, c) hypoxic sleeping devices, and d) short-term intermittent hypoxic exposure.

Under general aspects, it should be helpful to outline the benefits of a permanent stay at HA under the aspects of an individual positive-responding athlete. According to these results, an increase of the total blood volume (BV) and a higher capacity for the transport of oxygen can be anticipated [1, 4, 5, 6]. The consequences of this effect can be interpreted by means of an approximation equation. Besides that, the maturation of the reticulocytes (RET) and their increase show a great individual variability (between 10% and 250%); the intra-individual variation in a later study (40% compared to 150% in one athlete) has probably a great influence for the individual increase in BV. The increase in BV is the basis for a positive development of performance during and after a training period at HA.

Therefore a calculation can be provided, focusing on the resulting effect of a higher transportation capacity which is caused by an increase of red blood cells in combination with a higher BV. As long as those effects are generating a systematic benefit in athletes responding positively (e.g. in many members of an elite rowing team) this seems to be at least an indication of a positive aspect of a prolonged or permanent stay at HA. For an intermittent stay or for the other new altitude training strategies (see above), consistent evidence cannot be shown as regular effects in top athletes.

Another influencing and probably the most important factor with regard to the benefit of a stay under hypoxic conditions is the stress presented to the muscle cell, possibly yielding a misleading adaptation of the muscle cell by an (inadequate) load of the training content. Therefore it should be necessary to focus more on individual aspects of the average volume and intensity in the total amount of training of athletes in middle-distance sport events [2]. Referring to our own findings, the intensities during a HA-training camp were significantly different. In particular, a medium to high intensive training (“speed training”) often did not lead to the anticipated long-term training effect or decreased the power output over a given period of time. Although dominant and solely not a specific problem under HA conditions, it seems to be one of the general problems of muscular mal-adaptation which can be negatively fortified under HA conditions, theoretically independent of which altitude training strategies have been chosen. It includes consideration of the actual subjective perceptions and their biological influences on the sport practitioner and incorporation of the traditional points of view (e.g. for periodization).

International travel is an essential part of the lives of elite athletes, both for purposes of competition and training. Long-haul flights entail crossing multiple time zones, and this causes jet lag, due to disruption of the normal circadian rhythm. Various pharmacological and behavioural approaches have been used to reduce some of the effects of jet lag in sports performers. This overview focuses on strategies used for the Sydney summer Olympics 2000 (10 time zones to the east from the UK), and looks forward to the Beijing 2008 Olympics (8 time zones to the east from the UK). Travel fatigue lasts for only a day or so, is associated with the conditions of the journey (such as the cramped nature of the seating), anxiety about travel, and disruption to the individual’s daily routine and can be separated from the jet lag phenomenon. For those who fly across multiple time zones the effects associated with jet lag are longer lasting, and can reduce motivation to train effectively and impact negatively on performance. The severity and duration of these problems depend on the direction of flight (eastwards or westwards), the number of time zones crossed, and the strategies used to alleviate them. Behavioural solutions for dealing with jet lag involve attention to lifestyle and activity. These methods are preferable to pharmacological means of treating the syndrome. There remains the issue of athlete compliance with any travel strategies, and a systematic educational programme can assist in securing acceptance of any recommendations.

Key words: Behaviour, pharmacology, promoting readjustment, time-zone transitions.

Circadian rhythmicity in human physiology has been extensively reported. The internal timing mechanism that mediates this rhythm (the body clock) is located within the anterior of the hypothalamus in the suprachiasmatic nucleus (SCN). The purpose of circadian rhythms is to prepare the body for waking in the light and for sleeping when it is naturally dark. Temporal isolation studies, wherein subjects are kept in caves or isolation chambers and in conditions of a constant environment, have shown that one of the inherent characteristics of the body clock is that it free-runs with a period of ~24.5 hours, so it tends to become phase delayed. This inexact timing mechanism is set to an exact 24-hour day by so-called zeitgebers (time givers); these include the light-dark cycle, the sleep-wake cycle, rhythms in socialisation, feeding and, possibly, based on some recent evidence, rhythms of activity and exercise.

Jet lag is caused by the sluggish readjustment of the circadian timing mechanism to the new environment. Table 1 illustrates this adjustment for a flight from the UK to Beijing, China (8 time zones eastwards). Other explanations for jet lag include 1) the hassle of the flight, 2) the new lifestyle, food and culture at the destination, 3) the excitement of attending important events, and 4) the length of the flight. However, jet lag can be induced in an isolation chamber (where no travel has been undertaken), is found after returning home back to a normal routine, and its severity is related to the number of time zones crossed, not the flight length. The symptoms of jet lag include the following: fatigue; sleep disturbance (either the inability to get to sleep or an earlier waking time); inappropriately timed hunger or loss of appetite; losses of concentration and drive; and headaches. The net result is a likely decrease in training effect and performance.

How long does it take to get over jet lag? Unlike travel fatigue, which an individual normally takes less than 24 hours to recover from, recovery from jet lag depends on the direction of travel and the number of time zones crossed. Generally, symptoms are more severe and readjustment takes longer the greater the number of time zones involved. Eastward travel is less well tolerated than westward, due to the inherent property of the body clock to run slightly slow. Further, after an eastward journey across 10 time zones, current guidelines suggest that, for the purposes of the use of light as a readjustment strategy, it should be treated as a transition of 14 hours to the west. This tendency for the body clock to adjust by a delay rather than an advance after crossing 10-12 time zones in an easterly direction (where destination time is advanced by 10-12 hours with regard to departure time) is termed an antidromic effect.

There is some evidence that older individuals, who are generally less fit, take longer to readjust than younger, fitter individuals (9). This superiority is not necessarily the case in well-motivated and experienced travellers (10).

The problems of jet lag can be reduced and managed by suitable planning before the flight, actions during it, and after arrival at the destination. Many Olympic squads are given formal advice, normally in the form of a booklet as a complement to personal counselling. In the case of the Great Britain Olympic team (Team GB), this advice was the culmination of two years research, in which a “dry run” was conducted the year before the 2000 Games, and each athlete who participated received a feedback report on his/her adjustment. This targeting and specific educational programme prior to the Games led to a good compliance of staff and athletes at the preparation camp in the Gold Coast (Australia), and identified those individuals who had severe symptoms and a slower than average rate of adjustment.

For complete adaptation, current advice suggests that athletes should schedule their arrival well in advance of competition, allowing one day for each time zone travelled to the west and 1.5 days for each time-zone travelled in an easterly direction (4). This allowance may be an overestimation and would be impractical, as it would require an athlete travelling from the UK to arrive 15 days prior to the 2000 Games. The athletes spend longer than this period at the “preparation camp”. It has prompted a more realistic suggestion of leaving one day for each time zone crossed in either westward or eastward journeys (9).

Some of the factors that can be changed relatively easily are the time of flight departure, and hence time of arrival, and the decision whether or not to incorporate a stopover to break up the journey. Arriving as close to night-time in the new time zone as schedules allow promotes adjustment indirectly due to the accumulation of fatigue during the flight; this tactic aids sleep during the first night-time at the destination, and the sleep-wake cycle acts as a zeitgeber. If the journey (such as one from the UK to the East coast of Australia) is broken up, with a stopover in Singapore for a few days, this break aids adjustment at the final destination, as it gives the body clock a chance to adjust partially when exposed to the environment at the place of stopover. In practice, this break in the journey involves extra hassle for the athlete in terms of maintaining quality of training. Also, it could add complications such as heat and humidity in the stopover environment, and these present their own problems for the athlete.

Generally, adjustment of sleep-wake habits prior to the flight could in theory begin to alter the normal circadian rhythm in the desired direction prior to departure. This strategy involves sending the athlete to bed earlier and getting him/her up earlier for an eastward journey, and to retire and rise later for a westward journey. The strategy for a westward flight is tolerated more easily than that for a flight to the east as, when sent to bed earlier (eastward flight), athletes find it hard to get to sleep until the normal time (biological time) - and then are expected to wake earlier than usual. As a result, some sleep deprivation occurs. In order to avoid disrupting the circadian rhythm unduly and allow the athlete to continue to train normally, an adjustment of the sleep-wake cycle by no more than 1-2 hours and for no more than 1-2 days is recommended.

Generally, when onboard the idea is to change as much as possible the behaviour of the athlete to that appropriate to destination time in terms of activity, sleep and wakefulness, and eating meals. These strategies should be conveyed to the cabin crew, to avoid confusion and inappropriate times of waking the athlete, for example for meals. Further, there is a need to replenish the fluid loss due to the dry environment on the plane. Diuretics such as those containing caffeine or alcohol should be avoided during the flight, as they are diuretics and would accentuate dehydration. Due to the increase in incidence of deep vein thrombosis associated with inactivity in a cramped environment, performing isometric exercises, and leaving the seat periodically to walk around the plane, are advised.

There has recently been some interest in the use of massage and deep breathing. Neither of these strategies has been shown to aid adjustment at the destination, though the value of massage to stimulate blood flow after travel is not to be discouraged. The two general approaches to readjustment are pharmacological and behavioural. The use of chronobiotics such as melatonin, which directly shifts the body clock or indirectly aids adjustment due to the hypnotic properties that aid getting to sleep at the new night-time, has received some attention in research on jet lag. There has been some concern with appropriate timing of melatonin to aid in readjustment after an easterly transition across 10 time zones. Further, when strict control of light-avoidance and exposure is not adhered to, the effectiveness of melatonin is reduced (1). The current position statement of the British Olympic Association advises athletes against using melatonin. Furthermore, in the UK, pure melatonin is available only when prescribed by a physician (8).

The behavioural strategy involves the appropriate use of the zeitgebers (time-givers) that aid entrainment – the light-dark and the sleep-wakefulness cycles, diet and meal-times, and activity and exercise. There is little scientific evidence to support the value of diet in promoting clock adjustment, the suggestion being to consume protein in the morning and carbohydrate at night-time, in order to promote arousal and sleep, respectively. In implementing adjustment strategies aimed at shifting the human circadian rhythm, an indirect marker for the body clock is used. This reference point is the body temperature minimum. Rectal temperature shows its peak value at ~18:00 hours and a minimum at 06:00 hours, and this 24-hour profile can be described well by a cosine curve (see Figure 1). Light is the strongest zeitgeber, and the effect of light depends upon the time of exposure, as described by a phase-response curve (2, 3, 5). Exposure to light during the 6 hours before the temperature minimum results in a delay, and in the 6 hours after the temperature minimum a phase advance. Exposure to bright light at other times results in no phase shift, and this is referred to as a “dead-zone”. If a phase-delaying strategy is used, in the case of a 10 time-zone transition to the east (UK to the east coast of Australia), this would mean exposure to light between 10:00-16:00 hours (local time) on day 1 and avoiding light between 16:00-22:00 hours. On day 2, as the body temperature minimum would have delayed by about one hour to 17:00 h by local time), the next day’s light exposure would be between 11:00-17:00 hours and avoidance between 17:00-23:00 hours, and so on for subsequent days. If a phase-advance strategy were used for the same journey, then light would be avoided before 16:00 hours for the 2-3 days in the new time-zone. It is generally found that readjustment tends to follow an exponential function, with greater adjustment occurring in the first few days (12).

Figure 2 shows the working example of a possible advantage of adjustment by a phase delay (14 hours) rather than advance after a time-zone transition of 10 hours. Peak performance generally occurs in the evening and the temperature minimum, associated with greater sleepiness and lowest performance, is found towards the end of sleep. The cosine curve has been transposed onto the local time in the new time-zone, with complete adjustment shown. Immediately after arrival, peak temperature and performance will be at about 04:00 hours and the minimum temperature value and worst performance at 16:00 hours. If a phase delay occurs, peak performance is delayed through the day such that it occurs later each day and sleepiness prevails through the evening. This adaptation means that there is some time of the day when high-quality training can take place during the process of adjustment. By contrast, an advance of the body clock by 10 hours moves the peaks of temperature and performance through the night-time in the new time–zone, and the temperature minimum and maximum sleepiness occur in the morning and afternoon. This timing indicates a theoretical advantage with adjustment by a delay rather than an advance after an eastward journey across 10 time zones. It also is more convenient with regard to light exposure for individuals arriving in the early morning in the new time-zone. There are, however, difficulties in translating theory to practice. In the field study before the Sydney Olympics, referred to above, adjustment was consistent with a delay for 35/85 individuals, with that of an advance of the body clock for 23/85 and for 27/85 it was unclear as to whether adjustment was by an advance or delay (7, 11). Such a separation of adjustment would have made it difficult to manage daily preparations in Australia after arrival. Therefore, with the additional consideration of departure and arrival times and keeping the teams as a whole entity, a ‘phase-advance’ strategy was chosen for all, involving light-avoidance in the morning, no morning training for 3-4 days, and a lie-in in bed for the first three days. This strategy worked well prior to the 2000 Summer Olympics.

Those athletes who were the more compliant tended to adjust faster than those who were resistant; the “poor adjusters” tended to be led by coaches and managers who were resistant to the advice, but rather stuck to “what they always did”, irrespective of the multiple time-zone transition. Training at a lower intensity and duration than normal for the first couple of days after arrival was advocated, to help reduce possible problems with injury. Exercise can take place outdoors at times advocated for light exposure, and tactics might be discussed indoors when light should be avoided. One of the problems at the destination is “anchor sleep” which refers to a short sleep period at the time the individual would normally have been asleep if living on home time. Such sleep contrives to “anchor” circadian rhythms to home time and this opposes adaptation to the new local time. For this reason, napping is not advocated for the first few days after arrival at the destination. On restarting normal training practices, the coach should monitor the athletes whilst they are not fully adjusted, and everybody’s expectations of performance should reflect this lack of full adjustment. When educating the athlete as to what jet lag is and what strategies should be adopted to minimise it, the encouragement of perseverance, compliance and a positive attitude helps to promote adjustment to the new time zone.

Essential planning and preparation include a comprehensive programme that starts prior to travel and includes coping strategies that apply both onboard and after arrival. The first question regarding UK and European athletes travelling to Beijing is ‘should they attempt to advance the body clock by 8 hours or delay it by 16 hours?’ Unlike the Sydney Games, where a delay of 14 hours was at least feasible, an 8-hour advance (for the Beijing Games) would be easier to achieve than a 16-h delay; behaviour to promote such an advance should be advocated. The behavioural approach of light exposure and avoidance, coupled with outdoor exercise and indoor discussions when appropriate, will be paramount in achieving this aim. The strategy can be implemented by raising awareness of the issues involved, and by providing clear guidelines on the actions required and the behaviour patterns to be avoided. The use of drugs such as hypnotics or melatonin is not advocated – although those athletes that already do use these means will not be advised against continuing to do so, but they should be monitored by their sports physician. Further, it is good practice to send key athletic support staff to the destination before the athletes’ arrival, to ensure they are prepared for the athletes and not getting over jet lag themselves when they have to be fully alert for work.

Key points:

This is a stage of decision as well, whether to implement a strategy and resources indispensable to the development of this plan.