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Smith C, Sewry N, Nolte K, Swanevelder S, Engelke N, van Kamp C, Jordaan E, Schwellnus M. Do five screening tools identify the same number of runners who require pre-exercise medical clearance? SAFER XXXIV. PHYSICIAN SPORTSMED 2024; 52:77-83. [PMID: 36722299 DOI: 10.1080/00913847.2023.2176161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/30/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Currently, there are five international screening tools that are recommended to identify individuals who require pre-exercise medical clearance to reduce the risk of medical encounters during exercise. Therefore, the aim was to determine the percentage of race entrants who are advised to obtain pre-exercise medical clearance and the observed agreement between these five different international pre-exercise medical screening tools. METHODS In all, 76,654 race entrants from the Two Oceans Marathon (2012-2015) that completed an online pre-race screening questionnaire. Five pre-exercise medical screening tools (American Heart Association (AHA), pre-2015 American College of Sport Medicine (ACSM), post-2015 ACSM, Physical Activity Readiness Questionnaire (PAR-Q), and the European Association of Cardiovascular Prevention and Rehabilitation (EACPR)) were retrospectively applied to all participants. The % (95%CI) race entrants requiring medical clearance identified by each tool and the observed agreement between tools (%) was determined. RESULTS The % entrants requiring medical clearance varied from 6.7% to 33.9% between the five tools: EACPR (33.9%; 33.5-34.3); pre-2015 ACSM (33.9%; 33.5-34.3); PAR-Q (23.2%; 22.9-23.6); AHA (10.0%; 9.7-10.2); post-2015 ACSM (6.7%; 6.5-6.9). The observed agreement was highest between the pre-2015 ACSM and EACPR (35.4%), for pre-2015 ACSM and PAR-Q (24.8%), PAR-Q and EACPR (24.8%), and lowest between the post-2015 ACSM and AHA (4.1%). CONCLUSION The percentage of race entrants identified to seek medical clearance (and observed agreement) varied considerably between pre-exercise medical screening tools. Further research should determine which tool has the best predictive ability in identifying those at higher risk of medical encounters during exercise.
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Affiliation(s)
- Chanel Smith
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Kim Nolte
- Division of Biokinetics and Sports Science, Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nina Engelke
- Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
| | - Calvin van Kamp
- Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
- Sport and Exercise Medicine, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa
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Mould-Quevedo JF, Pelton SI, Nguyen VH. Vaccine Effectiveness of Cell-Based Quadrivalent Influenza Vaccine in Children: A Narrative Review. Vaccines (Basel) 2023; 11:1594. [PMID: 37896996 PMCID: PMC10610859 DOI: 10.3390/vaccines11101594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Cell-based manufacturing of seasonal influenza vaccines eliminates the risk of egg-adaptation of candidate vaccine viruses, potentially increasing vaccine effectiveness (VE). We present an overview of published data reporting the VE and cost-effectiveness of a cell-based quadrivalent influenza vaccine (QIVc) in preventing influenza-related outcomes in the pediatric population. We identified 16 clinical studies that included data on the VE of a QIVc or the relative VE (rVE) of a QIVc versus an egg-based QIV (QIVe) in children and/or adolescents, 11 of which presented estimates specifically for the pediatric age group. Of these, two studies reported rVE against hospitalizations. Point estimates of rVE varied from 2.1% to 33.0%, with studies reporting significant benefits of using a QIVc against influenza-related, pneumonia, asthma, and all-cause hospitalization. Four studies reported rVE against influenza-related medical encounters, with point estimates against non-strain specific encounters ranging from 3.9% to 18.8% across seasons. One study evaluated rVE against any influenza, with variable results by strain. The other four studies presented VE data against laboratory-confirmed influenza. Three health economics studies focusing on a pediatric population also found the use of QIVc to be cost-effective or cost-saving. Overall, using a QIVc is effective in pediatric patients, with evidence of incremental benefits over using a QIVe in preventing hospitalizations and influenza-related medical encounters in nearly all published studies.
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Affiliation(s)
| | - Stephen I. Pelton
- Chobanian and Avedesian School of Medicine, Boston University, Boston, MA 02118, USA;
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Spagnolli A, Cenzato G, Gamberini L. Modeling the Conversation with Digital Health Assistants in Adherence Apps: Some Considerations on the Similarities and Differences with Familiar Medical Encounters. Int J Environ Res Public Health 2023; 20:6182. [PMID: 37372768 DOI: 10.3390/ijerph20126182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Digital health assistants (DHAs) are conversational agents incorporated into health systems' interfaces, exploiting an intuitive interaction format appreciated by the users. At the same time, however, their conversational format can evoke interactional practices typical of health encounters with human doctors that might misguide the users. Awareness of the similarities and differences between novel mediated encounters and more familiar ones helps designers avoid unintended expectations and leverage suitable ones. Focusing on adherence apps, we analytically discuss the structure of DHA-patient encounters against the literature on physician-patient encounters and the specific affordances of DHAs. We synthesize our discussion into a design checklist and add some considerations about DHA with unconstrained natural language interfaces.
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Affiliation(s)
- Anna Spagnolli
- Department of General Psychology, University of Padua, 35131 Padua, Italy
- Human Inspired Technologies Research Centre, University of Padua, 35131 Padua, Italy
| | - Giulia Cenzato
- Department of General Psychology, University of Padua, 35131 Padua, Italy
- Human Inspired Technologies Research Centre, University of Padua, 35131 Padua, Italy
| | - Luciano Gamberini
- Department of General Psychology, University of Padua, 35131 Padua, Italy
- Human Inspired Technologies Research Centre, University of Padua, 35131 Padua, Italy
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Davis S, Higgs P, Jones L, Greenslade L, Wilson J, Low JT. "I am in other people's hands as regards my health" A sociological critique of health care encounters of people with cirrhosis. A secondary analysis. Chronic Illn 2023; 19:102-117. [PMID: 34812061 PMCID: PMC9841472 DOI: 10.1177/17423953211058422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES People with cirrhosis are encouraged to participate in shared decision-making with their doctors, but studies suggest that doctors limit the amount of information that is shared. In this study we explore the presence of medical power in clinical encounters in 2015 from a patient perspective and highlight its effects on healthcare interactions. METHODS Qualitative semi-structured interviews were conducted with ten people with cirrhosis attending a tertiary liver transplant centre in southern England. We explored their understanding of their disease and prognosis, and their participation in decision-making. Using the lens of medical power as a framework, we analysed findings into thematic sentences to summarise key ideas whilst preserving the complexity of identified concepts. RESULTS Three key concepts explained patient perspectives of their communication with doctors: (1) portraying a positive image to doctors, (2) avoiding confrontation with doctors, (3) feeling powerless in the face of doctors' medical knowledge. These concepts show deeper dynamic issues of power during healthcare encounters, illustrated by participants' reluctance to voice their concerns and express themselves, challenge decisions, or seek information. CONCLUSION People with cirrhosis struggle to articulate their concerns or challenge decisions on their care and treatment and may worry about potential consequences. Our findings demonstrate the continuing persistence of issues of power at play in contemporary health care.
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Affiliation(s)
- Sarah Davis
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Paul Higgs
- Division of Psychiatry, University College London, London, UK
| | - Louise Jones
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | | | - Jo Wilson
- Department of Palliative Care, 4965Royal Free London NHS Foundation Trust, London, UK
| | - Joseph Ts Low
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
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Derricks V, Johnson IR, Pietri ES. Black (patients') lives matter: Exploring the role of identity-safety cues in healthcare settings among Black Americans. J Health Psychol 2023; 28:30-47. [PMID: 35570659 DOI: 10.1177/13591053221090850] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Two online experiments investigated whether hypothetical physicians' use of an identity-safety cue acknowledging systemic injustice (a Black Lives Matter pin) improves Black Americans' evaluations of the physician and feelings of identity-safety. Across studies, findings showed that when a White physician employed the identity-safety cue, Black Americans reported stronger perceptions of physician allyship and increased identity-safety (e.g. trust). As predicted, use of the identity-safety cue produced smaller or non-significant effects when employed by a Black physician. These benefits emerged regardless of physicians' perceived motivation for employing the cue (e.g. whether the physician was personally motivated to employ the cue or his medical practice encouraged use of the cue; Study 2). Furthermore, analyses revealed that exposure to the identity-safety cue promoted a greater sense of identity-safety for Black Americans due to increased perceptions that the physician is an ally for Black individuals. Implications of identity-safety cues for racially discordant medical interactions are discussed.
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Affiliation(s)
- Veronica Derricks
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, USA
| | - India R Johnson
- Department of Psychology, Butler University, Indianapolis, IN, USA
| | - Evava S Pietri
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
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6
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Sewry N, Wiggers T, Schwellnus M. Medical Encounters Among 94,033 Race Starters During a 16.1-km Running Event Over 3 Years in the Netherlands: SAFER XXVI. Sports Health 2022; 15:210-217. [PMID: 35384779 PMCID: PMC9950983 DOI: 10.1177/19417381221083594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There are limited data on the medical encounters (MEs) occurring during mass community-based running events of shorter distances (10-21.1 km). The aim of this study was to determine the incidence and nature of MEs during the largest mass participation running event in the Netherlands. HYPOTHESIS We hypothesize that the incidence and nature of MEs will be similar to other running events. STUDY DESIGN Descriptive epidemiological study over 3 years of a 16.1-km (10-mile) running event. LEVEL OF EVIDENCE Level 4. METHODS We investigated a total of 94,033 race starters at the 2017-2019 Dam tot Damloop (16.1 km), a point-to-point road race from Amsterdam to Zaandam, the Netherlands. All MEs were recorded by race medical staff on race day each year. MEs were retrospectively coded by severity, organ system, and final specific diagnosis (2019 consensus statement definition on mass community-based events). Incidence (I) per 1000 starters (95% CIs) were calculated for all MEs and serious/life-threatening MEs. RESULTS The overall incidence (per 1000 starters) of all MEs was 2.75 (95% CI, 2.44-3.11), the overall incidence of serious/life-threatening MEs was 1.20 (95% CI, 1.00-1.45; 44% of MEs). Heat illnesses accounted for most MEs: hypothermia I = 0.54 (95% CI, 0.41-0.71) and hyperthermia I = 0.46 (95% CI, 0.34-0.62). Central nervous system MEs were also common (dizziness/nausea, I = 0.79; 95% CI 0.63-0.99), followed by the cardiovascular system MEs (exercise-associated postural hypotension, I = 0.36; 95% CI, 0.26-0.51). CONCLUSION The overall incidence of MEs was low compared with longer-distance races (21.1-90 km), but the incidence and relative frequency of serious/life-threatening MEs (44% of all MEs) was much higher. Heat illness (hypothermia and exertional heat stroke) accounted for most serious/life-threatening MEs. CLINICAL RELEVANCE There is a need to implement prevention strategies and interventions by specialized medical practitioners in this and similar events.
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Affiliation(s)
- Nicola Sewry
- Sport, Exercise Medicine and Lifestyle
Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South
Africa,International Olympic Committee (IOC)
Research Centre, South Africa,Nicola Sewry, PhD, Sport,
Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences,
University of Pretoria, South Africa, Sports Campus, Burnett Street, Hatfield,
Pretoria 0020, South Africa ()
(Twitter: @NSewry)
| | - Tom Wiggers
- Department of Sports Medicine,
TopSupport, Sint Anna Hospital, Geldrop, The Netherlands
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle
Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South
Africa,International Olympic Committee (IOC)
Research Centre, South Africa
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7
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Yona A, Haim A, Friger M, Chechik TG, Loewenthal N, Hershkovitz E. Visits at the primary clinic do not reduce ketoacidosis rates at presentation in type 1 diabetes mellitus. Acta Paediatr 2021; 110:995-1000. [PMID: 32815212 DOI: 10.1111/apa.15542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/06/2020] [Accepted: 08/17/2020] [Indexed: 11/30/2022]
Abstract
AIM The rate of diabetic ketoacidosis at time of diagnosis of type 1 diabetes remains high. We examined whether visits to a primary care clinic up to a month prior to diagnosis of new onset diabetes affected ketoacidosis rates. METHODS Retrospective chart review of children who were diagnosed with type 1 diabetes from January 1, 2010, to December 31, 2014. Data collection included demographics, age at diagnosis, number of visits to the primary care clinic during the month prior the diagnosis, relevance to diabetes and outcome of those visits and the presence of ketoacidosis at diagnosis. We examined the relationship between the rate of ketoacidosis at diagnosis and the number of visits in the clinic, and to the demographic characteristics. RESULTS Of 159 patients, 115 visited their clinic in the month prior to diagnosis of type 1 diabetes. The rate of ketoacidosis at diagnosis was similar between those who visited the clinic and those who did not (37.4% compared to 38.6%). There was no difference in ketoacidosis rates between the different ethnic and socio-economic groups. CONCLUSION Medical encounters in the month prior to diagnosis of type 1 diabetes did not reduce ketoacidosis rates in children.
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Affiliation(s)
- Assaf Yona
- Paediatric Endocrinology & Diabetes Unit Soroka University Medical Center Be’er Sheva Israel
| | - Alon Haim
- Paediatric Endocrinology & Diabetes Unit Soroka University Medical Center Be’er Sheva Israel
- Faculty of Health Sciences Ben‐Gurion University of the Negev Be’er Sheva Israel
| | - Michael Friger
- Faculty of Health Sciences Ben‐Gurion University of the Negev Be’er Sheva Israel
| | - Tzila Gartzia Chechik
- Paediatric Endocrinology & Diabetes Unit Soroka University Medical Center Be’er Sheva Israel
| | - Neta Loewenthal
- Paediatric Endocrinology & Diabetes Unit Soroka University Medical Center Be’er Sheva Israel
- Faculty of Health Sciences Ben‐Gurion University of the Negev Be’er Sheva Israel
| | - Eli Hershkovitz
- Paediatric Endocrinology & Diabetes Unit Soroka University Medical Center Be’er Sheva Israel
- Faculty of Health Sciences Ben‐Gurion University of the Negev Be’er Sheva Israel
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8
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Simonsen TP, Duff C. Healing architecture and psychiatric practice: (re)ordering work and space in an in-patient ward in Denmark. Sociol Health Illn 2020; 42:379-392. [PMID: 31657031 DOI: 10.1111/1467-9566.13011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Healing architecture is a defining feature of contemporary hospital design in many parts of the world, with psychiatric in-patient facilities in Denmark at the forefront of this innovation. The approach rests on the contention that designed clinical spaces and the particular dispositions they express may promote patient recovery. Although the idea that health may be spatially mediated is well-established, the means of this mediation are far from settled. This article contributes to this debate by analysing medical encounters in the context of a new purpose-built psychiatric hospital opened in Slagelse, Denmark in late 2015 as an example of healing architecture for the region. Grounded in qualitative research conducted in two wards between 2016 and 2017, we explore the key material and social effects of the hospital's healing architecture, and the spaces and practices it enacts. Following the work of Michael Lynch, we consider both the designed 'spatial order' of the in-patient wards and the 'spatial orderings' unfolding therein with a particular interest in how order is accomplished in psychiatric work. With much of the existing discussion of healing architectures focusing on their impacts on patient wellbeing, we consider how healing architectures may also be transforming psychiatric work.
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Affiliation(s)
- Thorben P Simonsen
- Department of Organization, Copenhagen Business School, Frederiksberg, Denmark
| | - Cameron Duff
- Centre for People, Organisation and Work, RMIT University, Melbourne, VIC, Australia
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9
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Killops J, Schwellnus M, Janse van Rensburg DC, Swanevelder S, Jordaan E. Medical encounters, cardiac arrests and deaths during a 109 km community-based mass-participation cycling event: a 3-year study in 102 251 race starters-SAFER IX. Br J Sports Med 2019; 54:605-611. [PMID: 31371337 DOI: 10.1136/bjsports-2018-100417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND There are few data on medical encounters, including deaths during mass-participation cycling events. OBJECTIVE To determine the incidence and nature of medical encounters during a community-based mass-participation cycling event. DESIGN Cross-sectional study across three annual events. SETTING 2012-2014 Cape Town Cycle Tour (109 km), South Africa. PARTICIPANTS 102 251 race starters (male=80 354, female=21 897). METHODS Medical encounters (moderate, serious life-threatening, sudden cardiac arrest/death), using the 2019 international consensus definitions, were recorded on race day for 3 years as incidence rates (IR per 1000 starters; 95% CI). Overall illness-related (by organ system) or injury-related (by anatomical region) encounters, and severity were recorded. RESULTS We recorded 539 medical encounters (IR 5.3; 4.8 to 5.7). The IR was 3.2 for injuries (2.9 to 3.6), 2.1 for illnesses (1.0 to 2.4) and 0.5 for serious life-threatening medical encounters (0.4 to 0.7). In the 3-year study, we encountered three cardiac arrests and one death (2.9 and 1.0 per 100 000 starters, respectively). Injury IRs included upper limb (1.9; 1.6 to 2.1), lower limb (1.0; 0.8 to 1.0) and head/neck (0.8; 0.6 to 1.0). Illness IRs included fluid/electrolyte abnormalities (0.6; 0.5 to 0.8) and the cardiovascular system (0.5; 0.4 to 0.6). CONCLUSION In a 109 km community-based mass-participation cycling event, medical encounters (moderate to severe) occurred in about 1 in 200 cyclists. Injury-related (1/300 cyclists) encounters were higher than illness-related medical encounters (1 in about 500). Serious life-threatening medical encounters occurred in 1/2000 cyclists. These data allow race organisers to anticipate the medical services required and the approximate extent of demand.
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Affiliation(s)
- Jannelene Killops
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa .,Research Centre, International Olympic Committee (IOC), Pretoria, South Africa
| | - Dina Christina Janse van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Tygerberg, South Africa.,Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
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10
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Schwellnus M, Kipps C, Roberts WO, Drezner JA, D'Hemecourt P, Troyanos C, Janse van Rensburg DC, Killops J, Borresen J, Harrast M, Adami PE, Bermon S, Bigard X, Migliorini S, Jordaan E, Borjesson M. Medical encounters (including injury and illness) at mass community-based endurance sports events: an international consensus statement on definitions and methods of data recording and reporting. Br J Sports Med 2019; 53:1048-1055. [PMID: 30796105 DOI: 10.1136/bjsports-2018-100092] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 02/04/2019] [Accepted: 02/08/2019] [Indexed: 12/19/2022]
Abstract
Mass participation endurance sports events are popular but a large number of participants are older and may be at risk of medical complications during events. Medical encounters (defined fully in the statement) include those traditionally considered 'musculoskeletal' (eg, strains) and those due to 'illness' (eg, cardiac, respiratory, endocrine). The rate of sudden death during mass endurance events (running, cycling and triathlon) is between 0.4 and 3.3 per 100 000 entrants. The rate of other serious medical encounters (eg, exertional heat stroke, hyponatraemia) is rarely reported; in runners it can be up to 100 times higher than that of sudden death, that is, between 16 and 155 per 100 000 race entrants. This consensus statement has two goals. It (1) defines terms for injury and illness-related medical encounters, severity and timing of medical encounters, and diagnostic categories of medical encounters, and (2) describes the methods for recording data at mass participation endurance sports events and reporting results to authorities and for publication. This unifying consensus statement will allow data from various events to be compared and aggregated. This will inform athlete/patient management, and thus make endurance events safer.
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Affiliation(s)
- Martin Schwellnus
- Faculty of Health Sciences, Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa.,Director, IOC Research Centre of South Africa, Pretoria, Gauteng, South Africa
| | | | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota, St Paul, Minnesota, USA
| | | | | | - Chris Troyanos
- International Institute for Race Medicine (IIRM), Boston, Massachusetts, USA
| | - Dina Christina Janse van Rensburg
- Section Sports Medicine and Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa
| | - Jannelene Killops
- Section Sports Medicine, Faculty of Health Sciences, Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa
| | - Jill Borresen
- Sport, Exercise Medicine and Lifestyle Institute, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Mark Harrast
- Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Paolo E Adami
- IAAF Health and Science Department, International Association of Athletics Federations (IAAF), Rome, Italy
| | | | - Xavier Bigard
- Union Cycliste Internationale (UCI), Aigle, Switzerland
| | | | - Esme Jordaan
- Biostatistics Unit, Medical Research Council, Parow, South Africa
| | - Mats Borjesson
- Neuosciences and Physiology, Goteborgs Universitet Sahlgrenska Akademin, Goteborg, Sweden.,Ostra Sjukhuset, Goteborg, Sweden
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11
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Abstract
In this article, I analyze the birth stories of Black women living in the United States. Their birth stories describe various forms of racism during medical encounters while they were pregnant or during labor and delivery. In the global women's health arena, the issues raised are viewed as obstetric violence. However, obstetric racism-as both an occurrence and analytic-best captures the particularities of Black women's reproductive care during the pre- and post-natal period. Obstetric racism is a threat to positive birth outcomes. I argue that birth workers including midwives and doulas, mediate obstetric racism and stratified reproductive outcomes.
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Affiliation(s)
- Dána-Ain Davis
- Center for the Study of Women and Society, Graduate Center, City University of New York, New York, USA
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12
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Dávila-Torres J, Cruz-Vega F, Loría-Castellanos J, Franco-Bey R, Quiroz-Vasquez L, Cruz-Flores P. [Surgical Medical Meetings in the Mexican Social Security Institute: 17 years of existence]. CIR CIR 2014; 82:690-698. [PMID: 25393870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Surgical Medical Meetings Program aims to make highly specialized medical services to the marginalized rural population. Surgical Medical Encounters highlight the experience and results of an innovative strategy characterized by continuous improvement and the desire to continue transcending health for the most vulnerable populations. During 17 years of its inception, it is interesting to describe the evolution and achievements of the program.
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Affiliation(s)
- Javier Dávila-Torres
- Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, México DF, Mexico
| | - Felipe Cruz-Vega
- Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, México DF, Mexico.
| | | | - Rubén Franco-Bey
- Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, México DF, Mexico
| | - Laura Quiroz-Vasquez
- Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, México DF, Mexico
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