A health promoting sports club framework: strategies from the field.

The application of the settings-based approach to sports clubs requires a context-specific framework to develop and operationalize health promotion interventions. Incorporating top-down and bottom-up perspectives into interventions increases their efficiency, success and sustainability. In 2020, the health promoting sports club (HPSC) model and intervention framework were created, including strategies and intervention components. A subsequent concept mapping study generated 35 statements from sports club stakeholders highlighting their needs when developing health promotion initiatives. This commentary integrates the concept mapping results into the HPSC model and intervention framework. The process added new sports club levels, updated existing and developed new intervention components, then classified them into the framework. The revised HPSC model has seven levels while the revised intervention framework includes 13 strategies and 69 intervention components. This revised HPSC framework provides sports club stakeholders, public health experts and researchers a means to develop and implement targeted health promotion interventions.

A RE-AIM framework analysis of a sports club health promotion MOOC: the PROSCeSS MOOC.

Acquisition of health promotion (HP) skills and knowledge is essential for interventions development in this field. In sports clubs (SC), little HP training exists even though it was requested by SC actors. In response, the PROSCeSS (PROmotion de la Santé au sein du Clubs SportifS) MOOC (Massive Open Online Course) was developed to support actors of HP in the SC in the development of HP interventions. The present study evaluates the MOOC's effectiveness and learning process. The RE-AIM framework, measuring reach, effectiveness, adoption, implementation and maintenance was used to structure this study. Surveys were sent before and after the MOOC to the 2814 learners. Among the 502 (18%) respondents to the pre-survey, 80% reported belonging to a SC as a coach (35%) or manager (25%). The 14% of pre-survey respondents who completed the post-survey increased their HP knowledge score by 42% and their confidence to implement HP actions by 6%. Results present the strategies considered most important and feasible by the learners and the main barriers to the implementation of HP actions in the SC. This study shows that MOOC appears to be an appealing (93% of learners were satisfied) and effective solution (as long as it is followed) to develop HP knowledge and skills of SC actors in HP, meeting their needs and constraints. Although improvements should be made (especially in terms of promoting adoption), this type of educational format should be encouraged to support the HP potential of SC.

Health promoting sports federations: theoretical foundations and guidelines.

Background: Researchers and policy-makers have highlighted that the potential for organized sports to promote health has been underexploited. Sports clubs have limited capacity to promote health due to their voluntary nature and have called for support from their national sports federations. The present article provides guidelines, based on the theoretical principles of health promoting sports clubs and an analysis of practical tools and proven strategies, to support national sports federations to invest in health promotion (HP). Methods: A qualitative iterative study was undertaken, based on five 2-h meetings of a group of 15 international researchers in HP in sports clubs. Notes and minutes from meetings, as well as shared outputs were analyzed based on the health promoting sports club framework. Results: Guidelines developed for national sports federations to promote health includes a definition of a health promoting sports federation (HPSF), a description of how the settings-based approach to HP adapts to national sports federations, as well as practical applications of health promoting sports club's intervention strategies. The analysis of existing tools also demonstrated that most tools are centered on a single dimension of health (social, mental, physical, spiritual or community), and often on a specific health topic. Furthermore, they do not cover HP as a continuous long-lasting process, but are generally short-term programs. The HPSF clarifies theoretical concepts, their practical implementation via case studies and outlines intervention components and tools useful for sports federations in their implementation of HP. Conclusion: The guidelines developed in this study are intended to facilitate national sports federations to acknowledge/understand, reinforce/underpin and foster current and further investment in HP.

Breast Cancer Survivors' Experiences of Managers' Actions During the Return to Work Process: A Scoping Review of Qualitative Studies.

PURPOSE: Managers' actions can facilitate the return to work (RTW) process for breast cancer survivors (BCS). However, data on BCS' experiences of managers' actions regarding RTW are dispersed across multiple qualitative studies and do not offer useful insights for managers to support employees returning to work. This study aimed to summarize and map managers' actions experienced by BCS over three RTW phases (before, during, after) and categorize them as facilitating or hindering RTW. METHODS: A scoping review of qualitative studies was conducted. Four databases (MEDLINE, PsycINFO, Cochrane Library, EMBASE) were systematically searched for articles published between 2000 and 2022. Studies and participant characteristics were extracted using an excel spreadsheet. A thematic analysis with a predominantly deductive and semantic approach was conducted. RESULTS: Twenty-nine studies were included after screening 1042 records. Five themes were generated from the data. Two themes addressed the phase 'before RTW': 'managers' interpersonal skills' and 'preparing for RTW'; three in the 'during RTW' phase: 'managers' interpersonal skills', 'offering work flexibility', and 'offering work accommodations', and only one, 'paying attention to follow-up', was addressed in the 'after RTW' phase. CONCLUSION: This review mapped managers' actions experienced by BCS in three phases of the RTW process. Results suggested that, according to BCS, managers need to mobilize specific skills to provide appropriate support during the RTW process. Further research is needed to better understand the skills underlying managers' actions facilitating the RTW process.

Health promoting sports clubs: from theory to intervention.

INTRODUCTION: Beyond the contribution of sports clubs to physical activity, an important health determinant, sports clubs can embrace the settings-based approach to health promotion, acting as health promoting sports clubs (HPSC). Limited research links the HPSC concept with evidence-driven strategies to provide guidance to develop HPSC interventions. METHODS: An intervention building a research system of the development of an HPSC intervention will be presented, including seven different studies, from literature review to intervention co-construction and evaluation. The different steps and their results will be presented as lessons learnt for settings-based intervention development. RESULTS: First, the evidence base showed a poorly defined HPSC concept, but 14 evidence-driven strategies. Second, concept mapping identified 35 sports clubs needs in regard to HPSC. Third, the HPSC model and intervention framework were designed using a participative research approach. Fourth, a measurement tool for HPSC was validated psychometrically. Fifth, capitalization of experience from eight exemplar HPSC projects was realized to test the intervention theory. Sixth, program co-construction was realized by involving sports club actors. Seventh, intervention evaluation was built by the research team. DISCUSSION: This HPSC intervention development is an example of building a health promotion program, implicating different types of stakeholders, and provide a HPSC theoretical model, HPSC intervention strategies, a program and toolkit, for sports clubs to implement health promotion and fully endorse their role in the community.

French validation of the e-PROSCeSS questionnaire: stakeholder perceptions of the health promoting sports club.

The health promoting sports club describes the development of the settings-based approach in sports clubs. Based on this model, a questionnaire was developed to measure health promotion perceptions in sports clubs (e-PROSCeSS). The objective of this study was to assess the psychometric properties of a French version of the e-PROSCeSS measurement tool. The questionnaire includes three scales measuring stakeholder's perceptions of club (macro), managers (meso) and coaches (micro) activities toward promoting health. Five steps were undertaken to assess perceptions. First, scales were translated into French. Second, each item's content clarity was tested in three populations: managers, coaches, sports participants. Third, descriptive statistics were analyzed for each scale. Fourth, confirmatory factorial analysis was used to select items for each level. Predictive validity found positive relationships between health promotion perceptions and managing/coaching positions, and negative relationships with drop-out intentions. Positive relationships were found between sports participants' perceptions of health promotion and their self-rated performance and quality of life, while negative relationships were detected with drop-out intentions. The French e-PROSCeSS subscales showed good psychometric properties in measuring health determinants at multiple levels. However, the tool did not measure health promotion as an overarching concept that questions its applicability in the sports club setting.

Development of a health-promoting sports club's intervention in France applying participatory action research.

The recognition of sports clubs (SC) as health-promoting settings is increasing, as well as the number of health promotion (HP) interventions implemented in this setting. However, minimal understanding of their development process and the persistent gap between theoretical knowledge and real-life practice is a major limitation to their implementation. This article describes a participatory research approach, implicating 29 stakeholders in sports and HP (6 HP researchers, 9 HP professionals, 6 representatives from regional and national sports organizations and 8 representatives from SC), leading to the co-construction of a health-promoting SC intervention. Stakeholders were mobilized through four stages: (i) analysis of effective programs, (ii) co-construction workshops, (iii) evaluation of relevance and acceptability, and (iv) beta-testing of a massive open online course (MOOC). A qualitative analysis was carried out on data collected through notetaking, recordings, transcripts, email exchanges and produced documents. This work led to the development of an HP intervention, including an MOOC, as well as a seven-step SC-tailored program. The convergence of theoretical knowledge and contextual real-life practice made it possible to respond to the specific needs and implementation problems encountered by SC actors and to develop acceptable strategies and tools.

Sports clubs (SC) can promote health beyond the offer of physical activity and sport by acting on health determinants (economic, social, environmental and organizational). To this end, interventions can be implemented. This study presents the way in which researchers and field actors can collaborate to develop adapted interventions. Involving 29 sport and health promotion (HP) actors (6 HP researchers, 9 HP professionals, 6 representatives from regional and national sports organizations, and 8 representatives from SC), four stages were set up to develop a Massive Open Online Course (MOOC) and an SC-tailored program: (i) analysis of effective programs, (ii) co-construction workshops, (iii) evaluation of relevance and acceptability, and (4) beta-testing of the MOOC. The results of these stages were qualitatively analyzed and allowed for the development of content, tools and planning consistent with the realities faced by SC. This work presents ways in which field actors and researchers can collaborate to develop acceptable strategies and tools to promote health.

Evaluation of implementation and effects of a health-promoting sports club intervention using a mixed-method design: PROSCeSS protocol.

Public authorities and academics have advocated for applying been advocating for the application of the setting-based approach to sports clubs. However, studies have shown that existing health promotion (HP) interventions in sports clubs poorly understand and apply this approach. Moreover, methods used to evaluate these interventions do not inform their implementation process, limiting the generation effectiveness' proofs. This study aims at evaluating the implementation process and effectiveness of an HP intervention in sports clubs (PROmotion de la Santé dans les ClubS de Spor; PROSCeSS), based on the health-promoting sports club (HPSC) model. A type 3 hybrid design, using a multiphase mixed-method: QUAN→QUAL→ QUAN+QUAL (qual)→QUAL (quan+qual), will be used. Phase A will be a pre-post-quantitative study with one HP officer, five managers and five coaches from 30 sports clubs exploring the effects of the PROSCeSS intervention on HP perceptions and health literacy. Phase B will be focus groups with participants from HP initiatives that the 30 sports clubs will have previously put in place to detect changes in health. Phase C will explain the results of phases A and B by choice of strategies and adherence to standardised steps, measured through semistructured interviews and implementation data collection. Phase D will cross-reference the semistructured interviews, the sports club characteristics questionnaire and the implementation data collection to study the relationships between the context and the implementation process. This protocol will identify 'what works', 'for whom', in 'what context' in terms of HPSC and clarify which intervention components are more effective at improving HP. This evaluation design will help to develop appropriate approaches to evaluate HP interventions.

Development of the health promoting sports club-national audit tool.

BACKGROUND: Sports clubs have requested support from national governing authorities to invest in health promotion (HP), by developing policies, guidelines and dedicated funding. This article outlines the development of a national audit tool to review policies development and implementation to support HP in sports clubs. METHODS: A five-step process was undertaken by an international project team: (i) a rapid literature review to identify items assessing policies in physical activity, HP and sports, (ii) a thematic analysis to categorize items, (iii) a Delphi method to analyze item relevance, country specificity, reformulation, validation and organization, (iv) face validity through an online survey and in-depth interviews with expert representatives on physical activity and sports and (v) audit tool finalization though project team consensus. RESULTS: Eight sources were reviewed with 269 items identified. Items were coded into 25 categories with 3 broad themes: policies, actors and settings-based approach. The Delphi study extracted and refined 50 items and categorized them into 10 sections. After revisions from 22 surveys and 8 interviews, consensus was reached by the international project team on 41 items categorized into 11 sections: Role of ministry or department; Policies; Communication; Implementation and Dissemination; Evaluation and Measurement methods; Sub-national-level policies; Funding and Coordination; Participative approach; Actors and Stakeholders; National sporting events; Case studies and Implicated stakeholders. CONCLUSION: To progress HP in the sports club context it is necessary to understand existing national-level policies. This national audit tool will aid in monitoring and assessing national policies for health promoting sports clubs.

Capitalization of Health Promotion Initiatives within French Sports Clubs.

The settings-based approach to health promotion within sports clubs is a growing field of research. Evidence of health promotion intervention effectiveness in scientific literature is scarce, and little is known about their implementation mechanisms. The present study explores how promising health promotion interventions in eight French sports clubs are developed, and how the health promoting sports club's intervention planning framework is applied. A method to collect Experiential Knowledge in health promotion was used, based on two iterative interviews to analyze intervention mechanisms and completed with document analysis. A deductive analysis using the health promoting sports club intervention planning framework was then undertaken. Among the 14 evidence-driven strategies, 13 were implemented in sports clubs (min = 9; max = 13). Policies were not targeted by any of the interventions. Key competencies of the managers of these health promotion interventions were identified: (1) having a deep understanding of the public and environment, (2) acquiring a high capacity to mobilize internal and external human resources, (3) possessing communication skills and (4) having an ability to write grant applications. By using evidence-driven strategies and intervention components, sports professionals can use this experiential knowledge to create successful and sustainable interventions.

The health promoting sports club model: an intervention planning framework.

Researchers and policymakers acknowledge sports clubs (SCs) as health promoting settings. Limited research links the health promoting sports club (HPSC) concept with evidence-driven strategies to provide SCs guidance to develop health promotion (HP) interventions. As implementation science insists on theoretically grounded interventions, the present work's objective was to provide SCs an evidence-driven intervention framework for planning, developing and implementing HP initiatives. Four iteratively sequenced steps were undertaken: (i) investigation of 'health promoting' indicators, (ii) adaptation of the HPSC concept to create the HPSC model, (iii) formulation of published evidence-driven guidelines into strategies and implementable intervention components (ICs) and (iv) merging the HPSC model with the ICs to create an intervention planning framework for SCs. First, researchers drafted five HPSC indicators. Second, they defined three SC levels (macro, meso and micro) and four health determinants (organizational, environmental, economic and social) to create an HPSC model. Third, researchers used published guidelines to develop 14 strategies with 55 ICs. Fourth, three workshops (one each with French master-level sport students, French sport and health professionals and Swedish sport and health professionals) had participants classify the ICs into the model. The HPSC model and intervention framework are starting points to plan, select and deliver interventions to increase SC HP. This planning framework is usable in several ways: (i) clubs can apply strategies to achieve specific goals, (ii) clubs can target specific levels with corresponding ICs and (iii) ICs can be used to address particular health determinants.

Knowledge, Attitudes, Beliefs, and Treatment Burden Related to the Use of Levothyroxine in Hypothyroid Pregnant Women in the United States.

Background: The use of prescribed medications during pregnancy is a challenge and an underestimated source of treatment burden. Levothyroxine (LT4) for the treatment of overt and subclinical hypothyroidism is extensively prescribed during pregnancy. To this end, we aimed to explore the patients' perceived benefits and risks, knowledge, beliefs, attitudes, and related burden of LT4 therapy during pregnancy. Methods: In this cross-sectional study, we surveyed pregnant women who were treated with LT4 during pregnancy from January 1, 2019, to December 31, 2019, in a tertiary academic medical center of the United States. The anonymous online survey included questions to gather demographic data and multiple-choice questions regarding the benefits and risks, knowledge, beliefs, attitudes, and burden related to LT4 use during pregnancy. Results: Sixty-four pregnant women (mean age 31.5 years) completed the study survey (response rate: 96%): 62% were diagnosed with hypothyroidism more than 12 months before pregnancy, 16% less than or about 12 months before pregnancy, and 22% during pregnancy. We found that one-third of pregnant women using LT4 had a feeling of uneasiness/anxiety due to their hypothyroidism diagnosis. About half of the respondents (45%) reported that they did not receive an explanation by their clinician regarding the maternal/fetal risks of uncontrolled hypothyroidism or the benefits of adequate control. Finally, two in three patients expressed various concerns of LT4-related treatment burden. Conclusions: Our findings support the need for increased effective communication and tailored counseling to address fears, anxiety, and uncertainties about the benefits and risks of LT4 use in pregnancy. For patients with clear benefits from LT4 treatment in pregnancy, it could help to overcome their concerns, promote adherence, and decrease adverse maternal/fetal outcomes. For patients with no clear benefits established, clinicians need to be aware of LT4-related treatment burden in pregnancy and implement patient-centered approaches in their clinical practices.

Measuring Health Promotion in Sports Club Settings: A Modified Delphi Study.

Settings-based approaches have become an increasing health promotion focus since the World Health Organization's 1986 Ottawa Charter. While schools, cities, and prisons have implemented this approach, its development within sports environments is recent. Sports are a popular leisure-time activity, requiring validated tools to measure health promotion activity. This study's aim was to develop a measurement tool based on international consensus that measures perceptions of health promotion within sports clubs. It is grounded in the settings-based approach and builds on theory from previous works expanding their context and knowledge. An online, three-round international Delphi study was conducted, inviting experts in sports and health fields to participate in designing the tool. Round 1 created a collaborative list of items; Round 2 validated items based on relevance, importance, and feasibility; and the final round classified items into one determinant category-social, cultural, environmental, or economic. Panelists (69 experts) from 13 countries participated, creating a final list of 62 items at 3 organizational levels; the sports club level included 23 items, the officials level retained 20 items, and the coaching level contained 19 items. This study provides several innovations: (1) applying the settings-based approach to health promotion within sports clubs, (2) defining each club level (sports club, official, coaching) and determinants (social, cultural, environmental, economic) within 3-levels, (3) creating a tool that measures perceptions of health-promotion activities per level and determinant, and (4) obtaining expert consensus on included items. These advancements allow further research on promoting health within sports clubs.

Temporal trends of cardiovascular health factors among 366 270 French adults.

AIMS: We aimed to investigate time trends in cardiovascular health (CVH) metrics in the population at large, as well as in important subgroups. METHODS AND RESULTS: In this study, we used a community-based sample of 366 270 adults from France who had a standardized examination to assess cardiovascular risk factors between 1992 and 2011 (20 years). Cardiovascular health metrics categorized into ideal, intermediate, and poor categories were computed using smoking, physical activity, body mass index, total cholesterol, blood glucose, and blood pressure. Matching on age, sex, and depression across 5-year periods (1992-96, 1997-2001, 2002-06, and 2007-11) was performed in order to correct for the sociodemographic differences between the examinations at different periods of times. Mean age across all four time periods was 44.7 (SD 13) years and 38% (138 228) were women. Overall, few participants (≤3.5%) met all six ideal CVH metrics at any time point. The prevalence of meeting ≥5 ideal CVH metrics increased from 6.7% in 1992-96 to 15.0% in 2007-11 (P < 0.001). A significant improvement in CVH (meeting ≥5 ideal CVH metrics) from 1992 to 2011 was observed among younger (from 7.5% to 16.6%) and older individuals (from 1.3% to 4.2%), men (from 4.4% to 11.8%) and women (from 10.4% to 20.1%), those with low (from 9.1% to 10.4%) and high education status (from 15% to 18.1%) and those with (from 5.1% to 12.7%) and without depressive symptoms (from 6.8% to 15.1%). However, the rate of improvement was steepest in the most affluent group in comparison with those with lower socio-economic status. CONCLUSION: Overall CVH improved from 1992 until 2006 and slightly decreased between 2006 and 2011 in French adults. From 1992 until 2006, the improvement in CVH was less pronounced among those with low socio-economic status as compared to those with a higher socio-economic status.

The age-performance relationship in the general population and strategies to delay age related decline in performance.

The age-performance relationship describes changes in the organism's structural and functional capabilities over the course of the lifespan. The typical, empirical pattern is an asymmetrical inverted-U shape association with peak capacity occurring early in life. This process is well described in the literature, with an increasing interest in features that characterize this pattern, such as the rate of growth, age of peak performance, and rate of decline with aging. This is usually examined in cohorts of individuals followed over time with repeat assessments of physical or cognitive abilities. This framework ought to be integrated into public health programs, embedding the beneficial (such as physical or cognitive training) or adverse effects (such as chronic diseases or injuries) that respectively sustain or limit capabilities. The maintenance of physical or cognitive performances at older ages would result in both optimal health and promote resistance to disabling conditions and chronic diseases, such as obesity and type 2 diabetes. The causes of accelerated degeneration of health optima are mainly: sedentary and unhealthy lifestyles -including poor nutrition-, exposure to environmental pollutants, and heterogeneity in aging. Better knowledge of optima, compatible with or required for good health, should also allow for establishing ideal conditions for longevity.

Health Promotion Interventions in Sports Clubs: Can We Talk About a Setting-Based Approach? A Systematic Mapping Review.

Many researchers and authorities have recognized the important role that sports clubs can play in public health. In spite of attempts to create a theoretical framework in the early 2000s, a thorough understanding of sports clubs as a setting for health promotion (HP) is lacking. Despite calls for more effective, sustainable, and theoretically grounded interventions, previous literature reviews have identified no controlled studies assessing HP interventions in sports clubs. This systematic mapping review details how the settings-based approach is applied through HP interventions in sports clubs and highlights facilitators and barriers for sports clubs to become health-promoting settings. In addition, the mapped facilitators and barriers have been used to reformulate previous guidelines of HP in sports clubs. Seven databases were searched for empirical research published between 1986 and 2017. Fifty-eight studies were included, principally coming from Australia and Europe, describing 33 unique interventions, which targeted mostly male participants in team sports. The settings-based approach was not yet applied in sports clubs, as more than half of the interventions implemented in sports club targeted only one level of the socio-ecological model, as well as focused only on study participants rather than the club overall. Based on empirical data, the analysis of facilitators and barriers helped develop revised guidelines for sports clubs to implement settings-based HP. This will be particularly useful when implementing HP initiatives to aid in the development of sports clubs working with a whole setting approach.

Age-Related Upper Limits in Physical Performances.

Maximal physical performances are powerful and accurate biomarkers in the understanding of age-related changes during the aging process. Previous studies have characterized age-related changes from Caenorhabditis elegans to Homo sapiens. We characterized changes in this pattern for H. sapiens, decade by decade, from 1970 to 2017. Using 286,916 performances related to age from the world's best performances in each age group, we measured the relative change of 10 different running and jumping events for both women and men. We compared the change in sexual dimorphism with age and showed that the gender gap in maximal performance regarding age increases gradually, especially after the age of 50. Between 1970 and 2017, the performances for all age groups in all events have slightly progressed. However, during the last decades, the relative progression of the best performances for all age groups has decreased in both range and frequency, suggesting that age-related maximal physical performances for H. sapiens are reaching their physiological limits.

Coming Out as Transgender: Navigating the Social Implications of a Transgender Identity.

This study examines transgender coming-out narratives. Most previous studies of coming out as transgender have relied on psychological stage models of identity development, with little empirical verification. This study uses identity theory to reframe transgender coming out as a primarily external, ongoing, and socially situated process. The data were collected from 20 transgender people residing in the Minneapolis-St. Paul, Minnesota metro area through interviews and focus groups. The analyses reveal that coming out as transgender requires navigating others' gender expectations, others' reactions, and the threat of violence. The results indicate that transgender individuals do not simply decide to "come out of the closet" and then stay out. Rather, they make strategic decisions regarding the enactment of gender and gender identity disclosure based on specific social contexts. Coming out as transgender is best conceptualized as an ongoing, socially embedded, skilled management of one's gender identity.

Understanding how outcomes are measured in workplace physical activity interventions: a scoping review.

BACKGROUND: An inverse relationship exists between physical activity and many non-communicable diseases, such as obesity. Given the daily time spent, a logical domain to reach an adult population for intervention is within and around the workplace. Many government bodies, including the World Health Organization (WHO), include worksite health promotions (WHPs) targeted at increasing physical activity as a public health intervention. The aim of this scoping review was to determine what was measured (outcomes) and how they were measured (evaluation tools) during workplace physical activity interventions in order to identify gaps and implications for policies and practice. METHODS: A scoping review was executed in April 2017 via PubMed, SPORTDiscus, EBSCOhost and the Cochrane Library. This search included articles published between January 2008 to February 2017 in order to coincide with the WHO's Global Plan of Action on Worker's Health. Extracted information was arranged into data collection grids. Cross-analysis of measured outcomes with their corresponding evaluation tools was completed. A quality assessment based on study design was executed. RESULTS: Identification of 732 records was made and ultimately 20 studies and reviews that met criteria were selected. Researchers themed 9 primary measured outcomes. Studies utilized various forms of both objective and subjective evaluation methods. Three primary evaluation methods were categorized: biologic, electronic and declarative tools. The researchers discovered 92 unique tools: 27 objective and 65 subjective, within these parameters. CONCLUSION: Study quality, measurement tools and data collection were heterogeneous making analysis of effect comparisons problematic and unreliable. Much of the published research does not employ robust statistical analysis making effects difficult to ascertain. Considering the variety of both measured outcomes and evaluation tools, only educated inferences can be made as to the effectiveness and efficiency of WHPs. More standardized measurement practices are therefore suggested for assessment efficiency.

Hypercalcemia, hyperkalemia and supraventricular tachycardia in a patient with subcutaneous fat necrosis.

BACKGROUND: Subcutaneous fat necrosis (SCFN) is a rare, self-limiting condition that has been associated with several complications including hypercalcemia. CASE PRESENTATION: We present the case of a 6-week-old male who presented to his pediatrician with a dime-sized erythematous nodule consistent with SCFN, who was also found to have supraventricular tachycardia (SVT). Laboratory findings revealed hypercalcemia and hyperkalemia. Extensive evaluation for the electrolyte disturbances revealed no other etiology. This case reinforces that SCFN should be considered in newborns with hypercalcemia of unknown etiology. Additionally, this case is the first to suggest a connection between SCFN and hyperkalemia. Electrolyte abnormalities can potentially contribute to arrhythmogenesis and may have triggered the arrhythmia in our patient. CONCLUSIONS: Our case highlights the importance of remaining vigilant in the workup of atypical rashes of the infant, which should include early assessment of serum electrolytes.