scholarly journals In Response to COVID-19: Current Trends in Orthopaedic Surgery Sports Medicine Fellowships

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098700
Author(s):  
Jordan L. Liles ◽  
Richard Danilkowicz ◽  
Jeffrey R. Dugas ◽  
Marc Safran ◽  
Dean Taylor ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Skills Training ◽  
Cross Sectional Study ◽  
Surgical Skills ◽  
Human Interaction ◽  
Third Party ◽  
Service Needs ◽  
Case Volume ◽  
Cross Sectional ◽  
Sports Coverage

Background: The COVID-19 (SARS-COV-2) pandemic has brought unprecedented challenges to the health care system and education models. The reduction in case volume, transition to remote learning, lack of sports coverage opportunities, and decreased clinical interactions have had an immediate effect on orthopaedic sports medicine fellowship programs. Purpose/Hypothesis: Our purpose was to gauge the response to the pandemic from a sports medicine fellowship education perspective. We hypothesized that (1) the COVID-19 pandemic has caused a significant change in training programs, (2) in-person surgical skills training and didactic learning would be substituted with virtual learning, and (3) hands-on surgical training and case numbers would decrease and the percentage of fellows graduating with skill levels commensurate with graduation would decrease. Study Design: Cross-sectional study. Methods: In May 2020, a survey was sent to the fellowship directors of all 90 orthopaedic sports medicine fellowships accredited by the Accreditation Council for Graduate Medical Education; it included questions on program characteristics, educational lectures, and surgical skills. A total of 37 completed surveys (41%) were returned, all of which were deidentified. Responses were compiled and saved on a closed, protected institutional server. Results: In a majority of responding programs (89%), fellows continued to participate in the operating room. Fellows continued with in-person clinical visits in 65% of programs, while 51% had their fellows participate in telehealth visits. Fellows were “redeployed” to help triage and assist with off-service needs in 21% of programs compared with 65% of resident programs having residents rotate off service. Regarding virtual education, 78% of programs have used or are planning to use platforms offered by medical societies, and 49% have used or are planning to use third-party independent education platforms. Of the 37 programs, 30 reported no in-person lectures or meetings, and there was a sharp decline in the number of programs participating in cadaver laboratories (n = 10; 27%) and industry courses (n = 6; 16%). Conclusion: Virtual didactic and surgical education and training as well as telehealth will play a larger role in the coming year than in the past. There are effects to fellows’ exposure to sports coverage and employment opportunities. The biggest challenge will be how to maintain the element of human interaction and connect with patients and trainees at a time when social distancing is needed to curb the spread of COVID-19.

scholarly journals Eating Disorders in Top Elite Beach Handball Players: Cross Sectional Study

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 245
Author(s):  
Alejandro Martínez-Rodríguez ◽  
Manuel Vicente-Martínez ◽  
Javier Sánchez-Sánchez ◽  
Laura Miralles-Amorós ◽  
María Martínez-Olcina ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Young Adults ◽  
Body Composition ◽  
Sports Medicine ◽  
Eating Habits ◽  
Cross Sectional Study ◽  
Eating Attitudes ◽  
Sectional Study ◽  
Cross Sectional ◽  
Eat 26

(1) Background: The preoccupation with the increasing appearance of eating disorders (ED) in athletes continues to grow, especially in athletes who practice team sports. ED severely affects the eating habits of the athletes, who tend to use unhealthy approaches to control their body weight. The development of nutritional education and early interventions by training staff is essential, and these factors are widely perceived as beneficial in sports medicine. This study evaluates the frequency at which beach handball (BH) players develop ED, also comparing the differences by sex and age (junior: adolescents vs. senior: young adults). In addition, the relation between body composition variables and ED was studied. (2) Methods: A descriptive and cross-sectional study was carried out in 69 top elite handball players (36 males and 33 females) from the Spanish National BH Team; who were separated by age (junior: adolescents and senior: young adults). The athletes completed the Eating Attitudes Test in its 26 item version (EAT-26). (3) Results: The prevalence of ED indicated that 11% of females had a high possibility of developing an ED, and 3% of males. Regarding the EAT-26 total score and subscales, no significant differences were found between female and male participants, or between the junior and senior categories. The correlations showed an association between body composition, in terms of body mass index, and the EAT-26 total score in both males and females. In the case of males, the correlation was negative. (4) Conclusions: Although there are no significant differences between sex or categories, it has been found that elite athletes are a population that is at high risk of developing ED.

What Is the Impact of Prior Authorization on the Incidence of Pediatric Tonsillectomy?

2020 ◽  
pp. 019459982096963
Author(s):  
Vanessa F. Torrecillas ◽  
Kaden Neuberger ◽  
Alexander Ramirez ◽  
Paul Krakovitz ◽  
Jeremy D. Meier
Keyword(s):  
Elective Surgery ◽  
Lag Time ◽  
Cross Sectional Study ◽  
Health Claims ◽  
Third Party ◽  
Prior Authorization ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean ◽  
The Impact

Objective Third-party payers advocate for prior authorization (PA) to reduce overutilization of health care resources. The impact of PA in elective surgery is understudied, especially in cases where evidence-based clinical practice guidelines define operative candidacy. The objective of this study is to investigate the impact of PA on the incidence of pediatric tonsillectomy. Study Design Cross-sectional study. Setting Health claims database from a third-party payer. Methods Any pediatric patient who had evaluation for tonsillectomy from 2016 to 2019 was eligible for inclusion. A time series analysis was used to evaluate the change in incidence of tonsillectomy before and after PA. Lag time from consultation to surgery before and after PA was compared with segmented regression. Results A total of 10,047 tonsillectomy claims met inclusion and exclusion criteria. Female patients made up 51% of claims, and the mean age was 7.9 years. Just 1.5% of claims were denied after PA implementation. There was no change in the incidence of tonsillectomy for all plan types ( P = .1). Increased lag time from consultation to surgery was noted immediately after PA implementation by 2.38 days (95% CI, 0.23-4.54; P = .030); otherwise, there was no significant change over time ( P = .98). Conclusion A modest number of tonsillectomy claims were denied approval after implementation of PA. The value of PA for pediatric tonsillectomy is questionable, as it did not result in decreased incidence of tonsillectomy in this cohort.

scholarly journals Poor Readability of AOSSM Patient Education Resources and Opportunities for Improvement

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711880538 ◽  
Author(s):  
Rafael Kakazu ◽  
Adam Schumaier ◽  
Chelsea Minoughan ◽  
Brian Grawe
Keyword(s):  
Patient Education ◽  
Grade Level ◽  
Sports Medicine ◽  
Cross Sectional Study ◽  
Reading Level ◽  
Eighth Grade ◽  
Cross Sectional ◽  
Education Resources ◽  
Reading Grade Level ◽  
Readability Formula

Background: Appropriate education on the disease processes associated with orthopaedic pathology can affect patient expectations and functional outcome. Hypothesis: Patient education resources from the American Orthopaedic Society for Sports Medicine (AOSSM) are too complex for comprehension by the average orthopaedic patient. Study Design: Cross-sectional study. Methods: Patient education resources provided by the AOSSM were analyzed with software that provided 10 readability scores as well as opportunities for improving readability. The readability scores were compared with the recommended eighth-grade reading level. Results: A total of 39 patient education resources were identified and evaluated. The mean ± SD reading grade-level scores were as follows: Coleman-Liau Index, 12.5 ± 1.11; New Dale-Chall Readability Formula, 10.9 ± 1.37; Flesch-Kincaid Grade Level, 9.9 ± 1.06; FORCAST Readability Formula, 11.4 ± 0.51; Fry Readability Formula, 12.8 ± 2.79; Gunning Fog Index, 11.9 ± 1.37; Raygor Readability Index, 13.1 ± 2.37; Simple Measure of Gobbledygook, 12.3 ± 0.90; Automated Readability Index, 11.2 ± 1.18; and New Automated Readability Index, 10.6 ± 1.27. After averaging the reading grade-level scores, only 1 patient education resource was found to be written at an 8th- to 9th-grade level, and 14 (36%) were written above a 12th-grade level. All scores were significantly different from the eighth-grade level ( P < .0065). The percentage of complex words and long words were 19.6% ± 2.67% and 41.4% ± 3.18%, respectively. Conclusion: Patient education resources provided by the AOSSM are at a significantly higher reading level than recommended. Simple changes can drastically improve these scores to increase health literacy and possibly outcome.

scholarly journals A study on nomophobia and its correlation with sleeping difficulty and anxiety among medical students in a medical college, Telangana

2019 ◽  
Vol 6 (5) ◽  
pp. 2074 ◽  
Author(s):  
Nagapraveen Veerapu ◽  
Ravi Kumar Baer Philip ◽  
Hanisha Vasireddy ◽  
Sowmya Gurrala ◽  
Swathi Tapaswi Kanna
Keyword(s):  
Medical Students ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Cross Sectional Study ◽  
Psychological Problems ◽  
Human Interaction ◽  
Cross Sectional ◽  
General Anxiety Disorder ◽  
General Anxiety ◽  
Athens Insomnia Scale

Background: Social media and digital communication have become a part of life. Many things were made easy through online connectivity. The mobile phones not only connects people at anytime, anywhere and with anybody, but also movable and portable. Mobile phones when used extensively may cause a number of physical and psychological problems. Nomophobia (NO-MObile phone-PHOBIA) is one of the psychological problems related to exclusive use of mobile phone. It is the fear/anxiety of being away from mobile phone contact. The objectives are to study grading of nomophobia and to find out any correlation exits between nomophobia and sleeping difficulty and anxiety among medical students.Methods: A cross sectional study is conducted for duration of 6 months among medical students using semi-structured questionnaire. Nomophobia questionnaire (NMP-Q) is used to assess nomophobia, Athens insomnia scale is used to assess sleeping difficulty and general anxiety disorder- 7 Item scale is used to assess general anxiety.Results: The study showed that out of 364 students, 62 (17%) have mild, 234 (64.3%) have moderate and 68 (18.7%) have severe nomophobia. There is a weak positive correlation between nomophobia and sleeping difficult and anxiety.Conclusions: There problem of nomophobia is alarming; there is a need to reduce nomophobia, and to evolve effective strategies to enhance human interaction.

The Top 50 Most Cited Publications in Meniscus Research

2021 ◽  
Author(s):  
Kyle N. Kunze ◽  
Aidan Haddad ◽  
Alexander E. White ◽  
Matthew R. Cohn ◽  
Robert F. LaPrade ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Citation Rate ◽  
Cross Sectional Study ◽  
Collective Knowledge ◽  
Cross Sectional ◽  
Anterior Cruciate Ligaments ◽  
Time Period ◽  
Wide Range ◽  
Anterior Cruciate

AbstractInjuries to the menisci of the knee are common in orthopedic sports medicine. Bibliometric studies can identify the core literature on a topic and help further our collective knowledge for both clinical and educational purposes. The purpose of the current study was to (1) identify and describe the 50 most cited articles in meniscus research over an 80-year time period to capture a wide range of influential articles and (2) identify the “citation classics” and milestone articles related to the meniscus of the knee. The Science Citation Index Expanded subsection of the Web of Science Core Collection was systematically searched for the 50 most cited meniscus articles. Data pertaining to bibliometric and publication characteristics were extracted and reported using descriptive statistics. The top 50 articles were published between the years 1941 and 2014 and collectively cited 13,152 times. The median (interquartile [IQR]) number of total citations per article was 203.5 (167.0–261.8), while the median citation rate was 9.6 (7.4–13.9) citations per year. The most cited article was “Knee joint changes after meniscectomy,” published in 1948. The article with the highest citation rate of 78.4 citations per year was “The long-term consequence of anterior cruciate ligaments and meniscus injuries – osteoarthritis,” published in 2007. The majority of articles were clinical outcome studies (n = 28, 56%). The top 50 most cited meniscus articles represent a compilation of highly influential articles which may augment reading curriculums and provide a strong knowledge base for orthopaedic surgery residents and fellows. The decade with the most articles was the 2000s, representing a recent acceleration in meniscus-based research. This is a level IV, cross-sectional study.

scholarly journals Impact of Insurance and Practice Type on Access to Orthopaedic Sports Medicine

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712093369
Author(s):  
Weilong Shi ◽  
Albert Anastasio ◽  
Ndeye F. Guisse ◽  
Razan Faraj ◽  
Omolola P. Fakunle ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Cruciate Ligament ◽  
Private Insurance ◽  
Meniscal Tear ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Orthopaedic Practice ◽  
Telephone Calls ◽  
Appointment Availability

Background: The Patient Protection Affordable Care Act has expanded Medicaid eligibility in recent years. However, the provisions of the act have not translated to improved Medicaid payments for specialists such as orthopaedic surgeons. The number of health care practitioners who accept Medicaid is already decreasing, with low reimbursement rates being cited as the primary reason for the trend. Hypothesis: Private practice orthopaedic groups will see patients with Medicaid or Medicare at lower rates than academic orthopaedic practices, and business days until appointment availability will be higher for patients with Medicaid and Medicare than those with private insurance. Study Design: Cross-sectional study. Methods: Researchers made calls to 2 regular-sized orthopaedic practices, 1 small orthopaedic practice, and 1 academic orthopaedic practice in each of the 50 states in the United States. Callers described a scenario of a recent injury resulting in a bucket-handle meniscal tear and an anterior cruciate ligament tear seen on magnetic resonance imaging at an outside emergency department. For a total of 194 practices, 3 separate telephone calls were made, each with a different insurance type. Data regarding insurance acceptance and business days until appointment were tabulated. Student t tests or analysis of variance for continuous data and χ2 or Fisher exact tests for categorical data were utilized. Results: After completing 582 telephone calls, it was determined that 31.4% (n = 59) did not accept Medicaid, compared with 2.2% (n = 4) not accepting Medicare and 1% (n = 1) not accepting private insurance ( P < .001). There was no significant association between type of practice and Medicaid refusal ( P = 0.12). Mean business days until appointment for Medicaid, Medicare, and private insurance were 5.3, 4.1, and 2.9, respectively ( P < .001). Conclusions: Access to care remains a significant burden for the Medicaid population, given a rate of Medicaid refusal of 32.2% across regular-sized orthopaedic practices. If Medicaid is accepted, time until appointment was significantly longer when compared with private insurance.

scholarly journals Sports-Related Emergency Preparedness in Oregon High Schools

2017 ◽  
Vol 9 (2) ◽  
pp. 181-184 ◽  
Author(s):  
Samuel T. Johnson ◽  
Marc F. Norcross ◽  
Viktor E. Bovbjerg ◽  
Mark A. Hoffman ◽  
Eunwook Chang ◽  
...  
Keyword(s):  
High Schools ◽  
Emergency Preparedness ◽  
Sports Medicine ◽  
Best Practice ◽  
Cross Sectional Study ◽  
Early Defibrillation ◽  
Policy Changes ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Practice Recommendations

Background: Best practice recommendations for sports-related emergency preparation include implementation of venue-specific emergency action plans (EAPs), access to early defibrillation, and first responders—specifically coaches—trained in cardiopulmonary resuscitation and automated external defibrillator (AED) use. The objective was to determine whether high schools had implemented these 3 recommendations and whether schools with a certified athletic trainer (AT) were more likely to have done so. Hypothesis: Schools with an AT were more likely to have implemented the recommendations. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: All Oregon School Activities Association member school athletic directors were invited to complete a survey on sports-related emergency preparedness and AT availability at their school. Chi-square and Fisher exact tests were used to analyze the associations between emergency preparedness and AT availability. Results: In total, 108 respondents (37% response rate) completed the survey. Exactly half reported having an AT available. Only 11% (95% CI, 6%-19%) of the schools had implemented all 3 recommendations, 29% (95% CI, 21%-39%) had implemented 2, 32% (95% CI, 24%-42%) had implemented 1, and 27% (95% CI, 19%-36%) had not implemented any of the recommendations. AT availability was associated with implementation of the recommendations (χ2 = 10.3, P = 0.02), and the proportion of schools with ATs increased with the number of recommendations implemented (χ2 = 9.3, P < 0.01). Schools with an AT were more likely to implement venue-specific EAPs (52% vs 24%, P < 0.01) and have an AED available for early defibrillation (69% vs 44%, P = 0.02) but not more likely to require coach training (33% vs 28%, P = 0.68). Conclusions: Despite best practice recommendations, most schools were inadequately prepared for sports-related emergencies. Schools with an AT were more likely to implement some, but not all, of the recommendations. Policy changes may be needed to improve implementation. Clinical Relevance: Most Oregon high schools need to do more to prepare for sports-related emergencies. The results provide evidence for sports medicine professionals and administrators to inform policy changes that ensure the safety of athletes.

scholarly journals Outcomes in the Orthopaedic Sports Medicine Fellowship Match, 2010-2017

2018 ◽  
Vol 6 (5) ◽  
pp. 232596711877184 ◽  
Author(s):  
Mary K. Mulcahey ◽  
Meghan K. Hayes ◽  
Christopher M. Smith ◽  
Matthew J. Kraeutler ◽  
Jeffrey D. Trojan ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Cross Sectional Study ◽  
Fellowship Program ◽  
Cross Sectional ◽  
Match Process ◽  
Match Rate ◽  
Fellowship Programs ◽  
The Mean ◽  
Orthopaedic Society ◽  
American Orthopaedic

Background: Sports medicine is one of the most competitive fellowships in orthopaedic surgery. Despite its popularity, fellowship applicants have limited understanding of the orthopaedic sports medicine fellowship match process. Purpose: To define key outcomes in the orthopaedic sports medicine fellowship match, including the overall match rate, number of programs filled, and number of applicants ranked by programs that filled between 2010 and 2017. Study Design: Cross-sectional study. Methods: This study utilized data regarding the orthopaedic sports medicine fellowship match collected by the American Orthopaedic Society for Sports Medicine (AOSSM) from 2010 through 2017. Applicant data included number of applicants, number of matched and unmatched applicants, and percentage of applicants matching into their top choices. Fellowship program data included number of programs participating in the match and number of applicants ranked by filled and unfilled programs. Results: Between 2010 and 2017, the mean number of orthopaedic sports medicine fellowship applicants was 244.8. On average, 92.0% of applicants matched into a fellowship program. The mean number of programs participating in the fellowship match was 92.9, with a mean of 219.9 accredited positions and 5.4 nonaccredited positions. Over the time period studied, a mean of 75.8% of programs matched all available positions. Programs that matched fully ranked 9.0 applicants per position, on average, compared with a mean of 6.5 applicants ranked per position among programs that did not fully match ( P = .0016). Conclusion: From 2010 to 2017, the number of applicants, positions available, overall match rate, and number of programs participating in the orthopaedic sports medicine fellowship match have remained consistent. The mean number of applicants per position ranked by fully matched fellowship programs was 9.0 compared with a mean of 6.5 applicants per position ranked by programs that did not fully match. These data may be helpful as we look to the future of orthopaedic sports medicine fellowship positions and the match process. In addition, this study reveals characteristics that divide sports medicine fellowship programs that fully match from those that do not. Applicants and/or fellowship program directors may utilize this information to modify their approach to the match process going forward.

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