Engaging Multiple Medical Epistemologies: Medical Professionals’ Distance Running Advice and Treatment

2020 ◽  
Vol 37 (3) ◽  
pp. 246-253
Author(s):  
Jennifer L. Walton-Fisette ◽  
Theresa A. Walton-Fisette
Keyword(s):  
Narrative Medicine ◽  
The United States ◽  
Medical Professionals ◽  
Clinical Judgments ◽  
Distance Running ◽  
Distance Runners ◽  
Clinical Observations ◽  
Embodied Experiences ◽  
Research Narrative ◽  
Evidenced Based

Distance running is a popular form of physical activity within the United States and the world. Many distance runners experience some form of injury, causing them to seek treatment and advice from a variety of medical professionals. The authors explored how a small group of medical professionals advised and treated patients in regard to engaging in distance running. The authors found that with diverse personal experiences in running, medical professionals are clearly impacted by their own embodied experiences of, and personal beliefs about, distance running in how they treat and advise patients. Therefore, they draw from diverse medical epistemologies in their clinical judgments, including their own embodied experiences, clinical observations, evidenced-based research, narrative medicine, and intersectionality.

Rights Discourse and Assisted Suicide

2001 ◽  
Vol 27 (1) ◽  
pp. 45-99
Author(s):  
Penney Lewis
Keyword(s):  
United States ◽  
Assisted Suicide ◽  
Public Awareness ◽  
The United States ◽  
Medical Professionals ◽  
Physician Assisted Suicide ◽  
Criminal Trials ◽  
Supreme Courts ◽  
Rights Discourse ◽  
Law Professors

The debate surrounding the legalization of assisted suicide has been galvanized in recent years by reports of specific cases of assisted suicide, primarily involving physicians such as Kevorkian and Quill, and by impassioned pleas for legalization and assistance in suicide from individuals suffering in the throes of terminal or agonizing diseases, such as Sue Rodriguez. Media attention on criminal trials of individuals accused of assisting in a suicide has heightened public awareness of the issue. The constitutionality of criminal prohibitions on assisted suicide has been tested in various jurisdictions, and has recently been considered by the Supreme Courts of both the United States and Canada. Following two narrowly unsuccessful attempts to enact dignified death provisions by referenda in Washington and California, Oregon voters passed the first of such proposed laws in November 1994, providing for physician-assisted suicide under certain specified conditions. Attempts to introduce legislation to legalize assisted suicide in other jurisdictions have been galvanized by the success in Oregon. A model statute has been drafted by a group of law professors, philosophers and medical professionals.

scholarly journals Comparison of Y-Balance Test Performance by maturation status in youth distance runners

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Mitchell J. Rauh ◽  
Micah C. Garcia ◽  
David M. Bazett-Jones ◽  
Jason T. Long ◽  
Kevin R. Ford ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Quadriceps Muscle ◽  
Limb Length ◽  
Distance Running ◽  
Distance Runners ◽  
Long Distance ◽  
Balance Test ◽  
Convenience Sample ◽  
Quadriceps Muscle Strength ◽  
Increased Risk

Background: Distance running is a popular interscholastic sport, but also has an associated high risk of running-related injuries. Recent literature suggests that functional tests may help to identify athletes at increased risk of injury. The Y-Balance Test (YBT) is an objective measure used to assess functional muscle strength and balance and to expose asymmetries between tested limbs. Purpose: To determine if YBT performance was associated with maturation status in healthy, youth distance runners. We hypothesized that mid-pubertal (MP) runners would demonstrate less functional reach distance than pre-pubertal (PrP) or post-pubertal (PoP) runners. Methods: A convenience sample of 142 (Females: n=79, Males: n=63) uninjured youth runners (ages 13.5±2.7 years; weekly running distance: 18.2±20.4 km) were recruited from the local community. All runners met inclusion criteria, indicating that they were between 9 and 19 years old and participated in long-distance running activities such as school/club track and field, cross country, road races, trail running, and/or soccer. The runners completed a modified Pubertal Maturational Observation Scale (PMOS), then were screened for right (R) and left (L) anterior (ANT), posteromedial (PM) and posterolateral (PL) reach distances (cm) normalized by lower limb length (cm). Composite reach distance was calculated by the sum of the three reach distances divided by three times the limb length multiplied by 100 for R and L limbs. ANOVA with Bonferroni post hoc tests were used to compare maximum normalized reach distances for the three directions and composite reach distance by maturation status and sex. Results: Overall, 31.7% were classified as PrP status, 26.1% as MP, and 42.3% as PoP, with similar percentages by sex ( p=0.84). The only significant mean difference was found for R ANT maximum normalized reach distance between PrP and PoP ( p=0.02), indicating a greater normalized reach in PrP athletes. No significant mean differences were found for R or L PM and PL maximum normalized reach distances, or for R or L composite reach distances, by maturation status or when stratified by maturation and sex ( p>0.05). Conclusions: In this sample of youth runners, the YBT was only a discriminator of anterior reach distance between pre-pubertal and post-pubertal runners. As decreased anterior reach is associated with reduced quadriceps muscle strength and anterior knee pain, reduced anterior reach in post-pubertal runners may potentially signify an increased risk of sustaining a running-related injury. Thus, preventive efforts to ensure good functional quadriceps muscle strength may be merited.

scholarly journals Predisposing factors to lateral ankle injury in male comrades marathon runners

2009 ◽  
Vol 65 (1) ◽  
Author(s):  
J. Hiemstra ◽  
N. Naidoo
Keyword(s):  
Correlation Coefficient ◽  
Undergraduate Research ◽  
The United States ◽  
Ankle Injury ◽  
Ankle Injuries ◽  
Distance Runners ◽  
Marathon Runners ◽  
Lateral Ankle ◽  
Ankle Ligament ◽  
Lateral Ankle Ligament

Introduction: More than two million people experience ankle ligament traumaeach year in the United States. Half of these are severe ligament sprains, however verylittle is known about the factors that predispose individuals to these injuries. The purpose of this study, (which was conducted as an undergraduate research project),was to find a correlation between the characteristics of height, weight and limbdominance and lateral ankle ligament injuries. Method: A  retrospective study was conducted on 114 ultra distance runners whoparticipated in the 2006 Comrades Marathon. During race registration, the runners’ height and weight were measuredafter answering a questionnaire regarding their training. Results: 114 runners responded to the questionnaire. From this cohort, 38 (33.3%) had sustained previous lateral ankle injuries. Of these 38 injuries, 47.4% of the injuries occurred on the runner’s dominant limb and 36.8% occurred on thenon-dominant side. 15.8% of the runners sustained previous ankle injuries to both ankles. There was a low negative correlation coefficient of 0.24 with regards to weight as a risk factor. This indicated that the power of the correlationwas 5.93%. The study demonstrates that there is no correlation between an increase in weight and an increase in theincidence of ankle injury. The correlation coefficient indicated a low correlation between an increase in height and the incidence of ankle injury. However, the power of the correlation at 18.37% makes inaccurate any attempt to predict the height at which a runner would be at most risk for lateral ankle injury. Conclusion: Height and weight are not risk factors predisposing subjects to lateral ankle injury. In addition, the studyillustrated that there was no effect of limb dominance on the incidence of lateral ankle injury.

scholarly journals Delivering Evidence-Based Online Concussion Education to Medical and Healthcare Professionals: The Concussion Awareness Training Tool (CATT)

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Shelina Babul ◽  
Kate Turcotte ◽  
Maude Lambert ◽  
Gabrielle Hadly ◽  
Karen Sadler
Keyword(s):  
Qualitative Data ◽  
Healthcare Professionals ◽  
Medical Professionals ◽  
Awareness Training ◽  
Training Tool ◽  
Qualitative Feedback ◽  
Translation Practice ◽  
New Information ◽  
Evidenced Based ◽  
Medical And Healthcare

Background. Medical and healthcare professionals report an important gap in their training and knowledge on concussion diagnosis and management. The Concussion Awareness Training Tool (CATT) for medical professionals provides evidenced-based training and resources, representing an important effort to fill this gap. The goal of the current article was to summarize and describe the general uptake of the 2018 relaunch of the CATT for medical professionals and to present results of a quality assurance/quality improvement (QA/QI) assessment including qualitative feedback from medical and healthcare professionals. Methodology. Tracking completions via certificates and Google Analytics were used to measure uptake over the first two years following the 2018 relaunch and promotion of CATT for medical professionals. Medical and healthcare professionals who had completed the CATT from the time of the relaunch on June 11, 2018, to July 31, 2019, were invited via e-mail to participate in the survey-based QA/QI assessment. Both quantitative and qualitative data were collected. Results. Year 1 saw 8,072 pageviews for the CATT for medical professionals landing page, increasing to 9,382 in Year 2. Eighty-nine medical and healthcare professionals who had completed the CATT for medical professionals participated in the QA/QI assessment. Results showed that 85% of respondents reported learning new information about concussion; 73% reported changing the way they diagnose, treat, or manage concussion; and 71% reported recommending the CATT to colleagues. Qualitative data also indicated highly favourable opinions and experiences. Conclusions. The CATT for medical professionals has demonstrated promise as a tool to promote knowledge translation practice and help fill the gap in concussion training and knowledge reported by medical and healthcare professionals.

scholarly journals Criminal Liability of Medical Profecionals Negligience: Comparative Analysis

2020 ◽  
Vol 38 (Especial II) ◽  
pp. 251-263
Author(s):  
Kateryna Danchenko ◽  
Olga Taran
Keyword(s):  
Comparative Method ◽  
Criminal Liability ◽  
The United States ◽  
Medical Professionals ◽  
The European Union ◽  
Judicial Decision ◽  
Criminal Proceedings ◽  
Medical Office ◽  
The Us ◽  
The Impact

The purpose of this article is to study the criminal liability of medical professionals in cases of suspension, in accordance with jurisprudence in Ukraine, the European Union and the United States of America (USA). He made the comparative method. According to the investigation, the number of criminal proceedings in Ukraine by the authority and misconduct of medical doctors is about 2% per population, my figure that rises to 30% in Europe and is the stable yes in the US and is 28%. 32%. The main objective of the article is often area identify specializations in the medical office occurs with the mayor based on Ukrainian jurisprudence (data from Ukraine’s only state judicial decision register from 2016 to 2019). In addition, the study analyses the impact of the main influences on the ability of medical professionals for their professional functions. From counting the results show that surgeons, gynecologists, paramedics, and anesthesiologists are the most prone to deviation and medical error. Key proposed criteria have been proposed as medical errors differ from medical writing.

scholarly journals Injuries and Training Practices in Competitive Adolescent Distance Runners: A Retrospective Cross-Sectional Study

2021 ◽  
Vol 3 ◽  
Author(s):  
Robert H. Mann ◽  
Carly D. McKay ◽  
Bryan C. Clift ◽  
Craig A. Williams ◽  
Alan R. Barker
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
Prevention Measures ◽  
Sectional Study ◽  
Distance Running ◽  
Distance Runners ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Body Regions

Background: Distance running is one of the most popular sports around the world. The epidemiology of running-related injury (RRI) has been investigated in adults, but few studies have focused on adolescent distance runners.Objectives: (1) To provide descriptive epidemiology of RRI (risks, rates, body regions/areas, and severity) and examine the training practices (frequency, volume, and intensity) of competitive adolescent distance runners (13–18 years) in England, and (2) to describe potential risk factors of RRI.Methods: A cross-sectional study design was used. Adolescent distance runners (n = 113) were recruited from England Athletics affiliated clubs. Participants voluntarily completed an online questionnaire between April and December 2018. At the time of completion, responses were based on the participant's previous 12-months of distance running participation. Incidence proportions (IP) and incidence rates (IR) were calculated.Results: The IP for “all RRI” was 68% (95% CI: 60–77), while the IR was 6.3/1,000 participation hours (95% CI: 5.3–7.4). The most commonly injured body areas were the knee, foot/toes, and lower leg; primarily caused by overuse. The number of training sessions per week (i.e., frequency) significantly increased with chronological age, while a large proportion of participants (58%) self-reported a high level of specialisation.Conclusions: RRI is common in competitive adolescent distance runners. These descriptive data provide guidance for the development of RRI prevention measures. However, analytical epidemiology is required to provide better insight into potential RRI risk factors in this specific population.

scholarly journals An Analysis of Methodologies That Can Be Used to Validate if a Perioperative Surgical Home Improves the Patient-centeredness, Evidence-based Practice, Quality, Safety, and Value of Patient Care

2013 ◽  
Vol 119 (6) ◽  
pp. 1261-1274 ◽  
Author(s):  
Thomas R. Vetter ◽  
Nataliya V. Ivankova ◽  
Lee A. Goeddel ◽  
Gerald McGwin ◽  
Jean-Francois Pittet
Keyword(s):  
Perioperative Care ◽  
Healthcare Delivery ◽  
Standard Of Care ◽  
The United States ◽  
Surgical Patients ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Perioperative Surgical Home ◽  
Future Demands ◽  
Evidenced Based

Abstract Approximately 80 million inpatient and outpatient surgeries are performed annually in the United States. Widely variable and fragmented perioperative care exposes these surgical patients to lapses in expected standard of care, increases the chance for operational mistakes and accidents, results in unnecessary and potentially detrimental care, needlessly drives up costs, and adversely affects the patient healthcare experience. The American Society of Anesthesiologists and other stakeholders have proposed a more comprehensive model of perioperative care, the Perioperative Surgical Home (PSH), to improve current care of surgical patients and to meet the future demands of increased volume, quality standards, and patient-centered care. To justify implementation of this new healthcare delivery model to surgical colleagues, administrators, and patients and maintain the integrity of evidenced-based practice, the nascent PSH model must be rigorously evaluated. This special article proposes comparative effectiveness research aims or objectives and an optimal study design for the novel PSH model.

scholarly journals Catharsis – Philosophical and Spiritual Aspects of Long-Distance Running

2016 ◽  
Vol 56 (1) ◽  
pp. 42-52
Author(s):  
Marcel Nemec
Keyword(s):  
Physical Activity ◽  
Personality Traits ◽  
Regular Physical Activity ◽  
Distance Running ◽  
Distance Runners ◽  
Way Of Life ◽  
Long Distance ◽  
Long Distance Running

Summary The purpose of the study was to identify and analyze the occurrence of cathartic states in a sample of long-distance runners. Data collected via questionnaires were used to evaluate quantitative variables complemented by heuristics while aiming at qualitatively categorize the areas of cathartic states in the context of philosophical and spiritual aspects of long-distance running. The study findings objectify philosophical and spiritual aspects affecting personalities of long-distance runners. The study findings have shown that catharsis represents a relevant philosophical and spiritual aspect affecting long-distance running. We assume that authentic experience of catharsis and its effects motivates runners to perform regular physical activity. The analysis of philosophical and spiritual aspects of long-distance running has revealed a multi-spectral holistic relevance based on the transfer affecting a specific way of life, spectrum of values, ethical personality traits, and also the quality of long-distance runners’ lives.

Abstract 205: Does Overuse of Telemetry Impede Cost-effective Patient Care?

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Kenneth B Brownell ◽  
Sowjanya Yenigalla ◽  
Parth Shah ◽  
Evan B Kudron ◽  
Abasin Amanzai ◽  
...  
Keyword(s):  
Quality Care ◽  
Tertiary Care ◽  
Total Duration ◽  
Heart Association ◽  
Cost Effective ◽  
The United States ◽  
Cardiac Monitoring ◽  
High Quality ◽  
Healthcare Expenditures ◽  
Evidenced Based

Background: Telemetry was first introduced in the 1950s in cardiac intensive care units (ICU) and has since expanded to beyond the ICU setting. With this expansion, concerns regarding the overutilization of telemetry have emerged. In response to these concerns, the American Heart Association (AHA) and the American College of Cardiology (ACC) released guidelines for evidenced-based telemetry utilization in 2004. Following this publication, numerous studies have shown that a significant number of non-ICU patients on telemetry do not meet evidenced-based indications leading to costly overutilization of a valuable resource. This overutilization is expensive in both the direct costs of equipment and labor as nurses spend an average of 20 minutes per patient day on telemetry related tasks. As healthcare expenditures in the United States continue to rise, efforts are needed to contain these rising costs if we wish to continue to provide high quality, affordable care. Methods: Using the electronic medical record (EMR) at our urban, tertiary-care, 482 bed teaching hospital, we performed an observational study looking at all admissions to a medical floor that were ordered telemetry in June 2019. We investigated if telemetry was ordered based upon the 2004 AHA guidelines. We then examined the total duration of telemetry utilized for non-AHA guideline indications. Next, we applied the average additional daily cost of $53.44, as reported in the literature, for monitored vs. non-monitored patients and then calculated an estimated total monthly expenditure for inappropriate use to cardiac monitoring. Annual costs were then projected based upon this figure. Results: There were 395 patients admitted in June 2019. After all inclusion criteria were applied, our sample consisted of 226 patients. Seventy-nine of these patients had telemetry ordered for an AHA guideline-based indication, while 147 patients had telemetry ordered for a non-AHA guideline indication for a total of 711 patient days, which adds $37,995.84 to monthly healthcare expenditures. Of the 147 patients that had telemetry ordered for non-AHA guideline indications, only one patient had a documented benefit, which was the detection of new-onset paroxysmal atrial fibrillation. Conclusions: Telemetry monitoring is frequently overused for patients admitted to non-critical care services. An effort to educate House Staff about the indications for ordering telemetry based on AHA guidelines can reduce healthcare-associated costs and help provide cost-effective, high-quality care to our patients.

scholarly journals The incidence and management of workplace violence among medical professionals in the United States: A methodological pilot study

2019 ◽  
Vol 8 (1) ◽  
pp. 56
Author(s):  
Ashleigh Chinelo Oguagha ◽  
Jing Chen
Keyword(s):  
United States ◽  
Workplace Violence ◽  
Healthcare Workers ◽  
Online Survey ◽  
Health Sector ◽  
Medical Personnel ◽  
The United States ◽  
Medical Professionals ◽  
Psychological Violence ◽  
Physical And Psychological Violence

This study aimed to investigate workplace violence (WPV) experienced by medical professionals in the United States as well as individual and managerial actions following violent episodes and further, predict estimators of WPV. A modified version of the Workplace Violence in the Health Sector: Country Case Studies Research Instruments Survey Questionnaire was used to assess the incidence and management of workplace violence experienced by healthcare workers. Medical personnel from two social aggregation websites were recruited to participate in an online survey. 226 valid questionnaires were received. 48.5\% and 76.1\% of respondents, respectively, experienced physical and psychological violence in the past year. Risk factors for violence included occupation, patient population, ethnicity, and higher levels of anxiety regarding violence in hospitals. Overall, 17.7\% of reported incidents were investigated, 52.4\% of cases saw no consequences meted out to perpetrators and 51.7\% of victims suffered from negative emotions or aftereffects following a violent episode. Only 30.1\% of victims formally reported their experience with violence. The prevalence of violence was high and medical professionals were negatively affected by violence; however, formal reporting of episodes was low and measures combating violence were inadequate. Harsher penalties for perpetrators of violence are needed and hospitals need to implement guidelines that track the management of violence. 

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