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2.
J Athl Train ; 54(4): 361-373, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31017807

RESUMO

CONTEXT: Implementation of health and safety best practices for the leading causes of sudden death and catastrophic injury has been shown to mitigate risk. However, to our knowledge, no authors have examined progress toward health and safety policy implementation at the state level. OBJECTIVE: To investigate the progress made by state secondary school leaders in developing and implementing health and safety policies (ie, exertional heat stroke, sudden cardiac arrest, concussion, emergency action plans) and to explore perceived barriers to and strategies for implementation. DESIGN: Mixed-methods study. SETTING: State high school athletics associations and sports medicine advisory committees. PATIENTS OR OTHER PARTICIPANTS: Collaborative Solutions for Safety in Sport meeting attendees participated in this study. Thirty-five state leaders (current role experience = 8 ± 6 years) completed the survey. Ten of the 35 participated in follow-up interviews. DATA COLLECTION AND ANALYSIS: A survey assessing progress on health and safety policy implementation was administered. Respondents indicated whether their state had implemented a policy, made progress without implementation, or made no progress. We conducted follow-up telephone interviews so they could expand on the survey responses. The data were analyzed using descriptive statistics and the general inductive approach. RESULTS: A total of 89% of respondents reported their states made progress on or implemented health and safety policies during the 2015-2016 academic year. Barriers to policy implementation included cost, a lack of understanding regarding policies versus recommendations, the content and value of policy change, and a false sense of security. Strategies for implementation included varying approaches to change, education of all constituents, and collaborative relationships among key stakeholders. CONCLUSIONS: Although a majority of respondents reported progress in implementing health and safety policies in their states, perceived barriers pointed to the need for the continued education of state leaders in charge of developing and implementing health and safety policies. Despite these barriers, collaboration among key stakeholders is crucial to successful implementation of best-practice policies in secondary school athletics.


Assuntos
Traumatismos em Atletas/prevenção & controle , Morte Súbita/prevenção & controle , Implementação de Plano de Saúde/métodos , Liderança , Serviços de Saúde Escolar/normas , Medicina Esportiva/organização & administração , Esportes/normas , Adolescente , Traumatismos em Atletas/epidemiologia , Criança , Pré-Escolar , Feminino , Política de Saúde , Humanos , Incidência , Masculino , Estudos Retrospectivos , Instituições Acadêmicas , Medicina Esportiva/normas , Estados Unidos/epidemiologia
5.
J Athl Train ; 54(1): 106-114, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30721095

RESUMO

CONTEXT: Health care systems are increasing their emphasis on interprofessional collaborative practice (IPCP) as a necessary component to patient care. However, information regarding the challenges athletic trainers (ATs) perceive with respect to participating in IPCP is lacking. OBJECTIVE: To describe collegiate ATs' perceptions of challenges to and resources for participation in IPCP. DESIGN: Qualitative study. SETTING: College and university. PATIENTS OR OTHER PARTICIPANTS: The response rate was 8% (513 ATs [234 men, 278 women, 1 preferred not to disclose sex], years in clinical practice = 10.69 ± 9.33). DATA COLLECTION AND ANALYSIS: Responses to survey-based, open-ended questions were collected through Qualtrics. A general inductive qualitative approach was used to analyze data and establish relevant themes and categories for responses. Multianalyst coding and an external auditor confirmed coding saturation and assisted in triangulation. RESULTS: Challenges were reported in the areas of needing a defined IPCP team structure, respect for all involved health care parties, and concerns when continuity of care was compromised. Communication was reported as both a perceived challenge and a resource. Specific resources seen as beneficial to effective participation in IPCP included communication mechanisms such as shared patient health records and educational opportunities with individuals from other health care professions. CONCLUSIONS: As ATs become more integrated into IPCP, they need to accurately describe and advocate their roles, understand the roles of others, and be open to the dynamic needs of team-based care. Development of continuing interprofessional education opportunities for all relevant members of the health care team can help to delineate roles more effectively and provide more streamlined care with the goal of improving patient outcomes.


Assuntos
Atitude do Pessoal de Saúde , Relações Interprofissionais , Medicina Esportiva/organização & administração , Atletas , Comunicação , Educação Continuada/organização & administração , Educação Profissionalizante/organização & administração , Escolaridade , Feminino , Humanos , Masculino , Assistência ao Paciente/métodos , Percepção , Pesquisa Qualitativa , Comportamento Social , Estudantes , Inquéritos e Questionários , Universidades
6.
J Athl Train ; 54(1): 99-105, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30676786

RESUMO

CONTEXT: Emergency action plans (EAPs) are policies that improve response times and ensure access to emergency equipment for the management of patients with acute injuries and medical conditions, yet the extent to which EAP standards are adopted and implemented is unknown. OBJECTIVE: To describe the extent of EAP adoption and implementation in secondary school (SS) athletics with athletic trainer (AT) services in the United States. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A national sample of ATs (n = 9642) was invited to participate in a Web-based questionnaire. MAIN OUTCOME MEASURE(S): Twelve components of EAP minimum best practices were derived from the "National Athletic Trainers' Association (NATA) Position Statement: Emergency Planning in Athletics." Emergency action plan components were analyzed using descriptive statistics with 95% confidence intervals (CIs) around proportions. Contingency tables (2 × 2) were used to calculate odds ratios (with 95% CIs) to assess adoption of the components (dichotomized as yes or no), employment factors (eg, full time versus part time, employed by clinic/district), and access to emergency equipment. RESULTS: The response rate for the questionnaire was 13.2% (n = 1273). A majority of ATs (89.1%) reported having an EAP; however, only 9.9% described implementing all 12 components cited in the NATA position statement. Athletic trainers stated that they created the EAP in 62.8% (95% CI = 60.1%, 65.4%) of schools with an EAP. Athletic trainers employed full time were at greater odds of adopting 9 or more components of the EAP compared with ATs employed part time (odds ratio = 2.42 [95% CI = 1.66, 3.53]). A total of 85.7% of ATs noted access to an automated external defibrillator. CONCLUSIONS: Although a majority of SSs had EAPs, the EAPs were often incomplete and lacked the necessary components for full compliance with the NATA position statement. These findings demonstrate the need for efforts to promote the adoption and implementation of comprehensive EAPs in SS athletics.


Assuntos
Serviços Médicos de Emergência/organização & administração , Serviços de Saúde Escolar/organização & administração , Medicina Esportiva/organização & administração , Adulto , Traumatismos em Atletas/terapia , Doença Catastrófica/terapia , Connecticut , Estudos Transversais , Desfibriladores/estatística & dados numéricos , Serviços Médicos de Emergência/normas , Feminino , Humanos , Masculino , Planejamento de Assistência ao Paciente/organização & administração , Serviços de Saúde Escolar/normas , Instituições Acadêmicas/estatística & dados numéricos , Esportes/fisiologia , Medicina Esportiva/normas , Inquéritos e Questionários , Estados Unidos
7.
Rheum Dis Clin North Am ; 45(1): 53-66, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30447746

RESUMO

Rheumatology has evolved rapidly over the past 20 years. The availability of numerous treatment interventions has dramatically altered patient outcomes and revitalized the specialty. At the same time, the economics of medical practice is challenging the practicing rheumatologist to seek more efficient and more attractive models of care delivery. These models of care must be attractive not only to rheumatologists and their patients but also to other interested parties as well, such as payers, government agencies, and accreditation bodies.


Assuntos
Prática de Grupo/organização & administração , Ortopedia/organização & administração , Prática Privada/organização & administração , Reumatologia/organização & administração , Doenças Autoimunes/terapia , Terapia por Infusões no Domicílio , Humanos , Imagem por Ressonância Magnética , Doenças Musculoesqueléticas/terapia , Terapia Ocupacional/organização & administração , Fisioterapia/organização & administração , Medicina Esportiva/organização & administração , Ultrassonografia
8.
J Sports Med Phys Fitness ; 59(3): 481-488, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29877672

RESUMO

BACKGROUND: Regular participation in sport, exercise and physical activity (PA) is associated with positive health outcomes and form a mainstay of British public health policies. However, regular participation in sport and exercise can result in sport related injury (SRI) which, in turn, is a key cause of exercise cessation. The integration of Sport and Exercise Medicine (SEM) in the English National Health Service (NHS) aims to provide a specialist service for public populations and thus reduce the impact of SRI on exercise cessation and associated negative health outcomes. More broadly it aims to both support PA health promotion policies and improve healthcare organisations efficiencies through providing the most condition-appropriate treatment. METHODS: This qualitative interview study examines patients' (N.=19) experiences of accessing and receiving SEM treatment within the English NHS. RESULTS: The research demonstrates that referral pathways into SEM were often prolonged, characterised by multiple general practitioner (GP) visits and referrals into other musculoskeletal services, demonstrating an inefficient use of healthcare resources. Prolonged pathways fostered only limited recovery back to previous PA levels and other negative health behaviours, yet on accessing the SEM clinic, patients experienced progressive rehabilitation back into sport and exercise participation. CONCLUSIONS: This study highlights the importance of more fully integrating SEM services into public healthcare as a way of improving the organisational capacity of healthcare in treating SRI and ensuring that citizens comply with state interventions which orchestrate health management through raising PA levels across the population.


Assuntos
Satisfação do Paciente , Medicina Esportiva/organização & administração , Traumatismos em Atletas/reabilitação , Inglaterra , Feminino , Promoção da Saúde , Humanos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , Encaminhamento e Consulta/organização & administração , Medicina Estatal/organização & administração
9.
Eur Heart J ; 39(40): 3664-3671, 2018 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-30165596

RESUMO

Current guidelines of the European Society of Cardiology advocate regular physical activity as a Class IA recommendation for the prevention and treatment of cardiovascular disease. Despite its undisputed multitude of beneficial effects, competitive athletes with arterial hypertension may be exposed to an increased risk of cardiovascular events. This document is an update of the 2005 recommendations and will give guidance to physicians who have to decide on the risk of an athlete during sport participation.


Assuntos
Atletas , Hipertensão , Medição de Risco/métodos , Medicina Esportiva , Traumatismos em Atletas , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/prevenção & controle , Humanos , Hipertensão/fisiopatologia , Hipertensão/terapia , Exame Físico , Guias de Prática Clínica como Assunto , Fatores de Risco , Esportes , Medicina Esportiva/métodos , Medicina Esportiva/organização & administração
12.
J Athl Train ; 53(1): 88-97, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29251534

RESUMO

CONTEXT: An organizational climate is largely based on an employee's perceptions of the working conditions in which he or she engages regularly. A multifaceted concept, the organizational climate is often formed by perceptions of employee welfare, rewards, and support. Achieving work-life balance is also a part of the climate. OBJECTIVE: To learn collegiate athletic trainers' perceptions of organizational climate and specifically how it may pertain to their work-life balance. DESIGN: Phenomenologic study. SETTING: Collegiate practice setting. PATIENTS OR OTHER PARTICIPANTS: Thirty athletic trainers working in the collegiate athletics setting took part in 1-on-1 phone interviews. The participants were 30.5 (interquartile range [IQR] = 7.75) years old and had been certified for 7 (IQR = 5) years and at their current position for 4 (IQR = 3) years. DATA COLLECTION AND ANALYSIS: Participants completed a phone interview that followed a semistructured framework. All transcribed interviews were analyzed using a phenomenologic approach. Researcher triangulation, expert review, and data saturation were used to establish credibility. RESULTS: Athletic trainers working in the collegiate athletics setting who had positive perceptions of their work-life balance described their organizational climate as family friendly. Our participants' supervisors allowed for autonomy related to work scheduling, which provided opportunities for work-life balance. These athletic trainers believed that they worked in a climate that was collegial, which was helpful for work-life balance. In addition, the importance of placing family first was part of the climate. CONCLUSIONS: The perceptions of our participants revealed a climate of family friendliness, supervisor support, and collegiality among staff members, which facilitated the positive climate for work-life balance. The mindset embraced the importance of family and recognized that work did not always have to supersede personal priorities.


Assuntos
Relações Interprofissionais , Papel Profissional , Pesquisa Qualitativa , Medicina Esportiva/organização & administração , Esportes/psicologia , Estudantes , Universidades , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
15.
Apunts, Med. esport (Internet) ; 52(196): 139-147, oct.-dic. 2017. graf, ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-170292

RESUMO

El presente estudio tiene como objetivo describir las características del programa «Menorca borina't» («Menorca muévete») diseñado para promocionar la actividad física y el ejercicio físico a fin de mejorar la salud de la población. El programa liderado desde el Gabinete de Medicina Deportiva del Consell Insular de Menorca, se estructura en 4 niveles de actuación que abarcan las siguientes áreas: educativa (intervenciones dirigidas a las escuelas y aulas de educación primaria); comunitaria (acciones que abarcan diferentes sectores de la sociedad, destacando la creación de una red de rutas urbanas saludables e intervenciones relacionadas con la movilidad sostenible); prescripción de ejercicio físico (colaboración con atención primaria para prescribir ejercicio físico en sujetos con factores de riesgo cardiovascular), y científico-académica (labor de formación continuada para profesionales sanitarios). El fomento y la dinamización de estas estrategias interdependientes es de esperar que redunden en un beneficio a escala global en la salud de la población (AU)


The objective of the present study is to describe the characteristics of the 'Minorca borina't' ('Minorca move yourself'') program, which was designed to promote physical activity and exercise to improve the population's health. The program led by the Department of Sports Medicine of Minorca Insular Council was divided into four levels of performance, which include the following areas: educational (interventions directed at schools and primary education classrooms); community (actions encompassing different sectors of society, including the development of urban healthy walking routes and interventions related to sustained mobility); prescription of physical exercise (cooperation with Primary Care Centres for prescribing physical exercise to subjects with cardiovascular risk factors); and scientific-academic (continuing education activities for healthcare personnel). Intensifying and promoting these interdependent strategies is expected to result in global benefits to population health (AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Promoção da Saúde/organização & administração , Exercício/fisiologia , Medicina Esportiva/organização & administração , Qualidade de Vida , Comportamento Sedentário , Atenção à Saúde , Comportamento Alimentar/fisiologia , Nível de Saúde
16.
Curr Sports Med Rep ; 16(4): 280-288, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28696992

RESUMO

Interest and participation in triathlon has grown rapidly over the past 20 yr and with this growth, there has been an increase in the number of new events. To maximize the safety of participation, triathlons require medical directors to plan and oversee medical care associated with event participation. Provision of proper medical care requires knowledge of staffing requirements, common triathlon medical conditions, impact of course design, communication skill, and a familiarity of administrative requirements. These guidelines serve as a tool for triathlon medical and race directors to improve race safety for athletes.


Assuntos
Ciclismo , Assistência à Saúde/organização & administração , Diretores Médicos , Corrida , Medicina Esportiva/organização & administração , Natação , Aniversários e Eventos Especiais , Humanos , Guias de Prática Clínica como Assunto
17.
J Athl Train ; 52(8): 785-794, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28650700

RESUMO

CONTEXT: Athletic training facilities have been described in terms of general design concepts and from operational perspectives. However, the size and scope of athletic training facilities, along with staffing at different levels of intercollegiate competition, have not been quantified. OBJECTIVE: To define the size and scope of athletic training facilities and staffing levels at various levels of intercollegiate competition. To determine if differences existed in facilities (eg, number of facilities, size of facilities) and staffing (eg, full time, part time) based on the level of intercollegiate competition. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: Athletic trainers (ATs) who were knowledgeable about the size and scope of athletic training programs. MAIN OUTCOME MEASURE(S): Athletic training facility size in square footage; the AT's overall facility satisfaction; athletic training facility component spaces, including satellite facilities, game-day facilities, offices, and storage areas; and staffing levels, including full-time ATs, part-time ATs, and undergraduate students. RESULTS: The survey was completed by 478 ATs (response rate = 38.7%) from all levels of competition. Sample means for facilities were 3124.7 ± 4425 ft2 (290.3 ± 411 m2) for the central athletic training facility, 1013 ± 1521 ft2 (94 ± 141 m2) for satellite athletic training facilities, 1272 ± 1334 ft2 (118 ± 124 m2) for game-day athletic training facilities, 388 ± 575 ft2 (36 ± 53 m2) for athletic training offices, and 424 ± 884 ft2 (39 ± 82 m2) for storage space. Sample staffing means were 3.8 ± 2.5 full-time ATs, 1.6 ± 2.5 part-time ATs, 25 ± 17.6 athletic training students, and 6.8 ± 7.2 work-study students. Division I schools had greater resources in multiple categories (P < .001). Differences among other levels of competition were not as well defined. Expansion or renovation of facilities in recent years was common, and almost half of ATs reported that upgrades have been approved for the near future. CONCLUSIONS: This study provides benchmark descriptive data on athletic training staffing and facilities. The results (1) suggest that the ATs were satisfied with their facilities and (2) highlight the differences in resources among competition levels.


Assuntos
Medicina Esportiva , Instalações Esportivas e Recreacionais , Adulto , Benchmarking , Estudos Transversais , Feminino , Humanos , Masculino , Administração de Recursos Humanos/métodos , Alocação de Recursos , Esportes/normas , Medicina Esportiva/economia , Medicina Esportiva/organização & administração , Instalações Esportivas e Recreacionais/organização & administração , Instalações Esportivas e Recreacionais/normas , Inquéritos e Questionários , Estados Unidos
18.
J Genet Couns ; 26(6): 1292-1300, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28578465

RESUMO

Sickle cell trait (SCT) is usually benign. However, there are some conditions that may lead to SCT-related problems and put athletes with the trait at particular risk. In 2010 the National Collegiate Athletic Association (NCAA) issued a policy that required all Division I (DI) student-athletes to confirm their SCT status or sign a liability waiver to opt out of testing. Athletic trainers and team physicians play key roles in the policy implementation and we examined their perceptions and practices. Between December 2013 and March 2014 we interviewed 13 head athletic trainers and team physicians at NCAA Division I colleges and universities in North Carolina. We used an interview guide with open-ended questions covering knowledge of SCT, historical screening and education practices, current implementation, and policy benefits and challenges. Participants were knowledgeable about SCT and thought the policy was beneficial in providing SCT health information to and for student-athletes. Schools varied in provision of genetic counseling, offering the waiver, SCT tests administered, and other aspects. Challenges included: insufficient guidance from the NCAA; financial considerations; and misunderstanding of the relationships of race and ancestry to SCT risk. Athletic staff found the policy valuable, but felt it needs clarity and standardization.


Assuntos
Atletas/estatística & dados numéricos , Atitude do Pessoal de Saúde , Programas de Rastreamento/estatística & dados numéricos , Traço Falciforme/diagnóstico , Atletas/psicologia , Feminino , Humanos , Masculino , North Carolina , Traço Falciforme/prevenção & controle , Medicina Esportiva/organização & administração , Estudantes/estatística & dados numéricos , Estados Unidos , Universidades , Adulto Jovem
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