scholarly journals Factors Influencing Coaches’ Decisions about Concussion on the Sidelines of Youth Sports

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S23.3-S24
Author(s):  
Ann Guernon ◽  
Christina Papdimitriou
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Practice Guidelines ◽  
Best Practice ◽  
Youth Sports ◽  
Return To Play ◽  
Health Concern ◽  
Sports Organizations ◽  
Factors Influencing ◽  
Health Initiatives

ObjectiveIdentify coach reported factors influencing decisions about potential concussion in youth sports.BackgroundYouth concussion in sport is an established public health concern. Coaches are the primary stakeholders deciding about removal from play for suspected concussion on the sidelines of competition and practice in most youth sports organizations. Estimates indicate over 2 million adults coach youth sports. Legislation across the U.S. and guidance from the Centers for Disease Control and the Concussion in Sport Group recommend players with suspected concussion be removed from play and not return prior to medical clearance and a graduated return to play protocol be followed.Design/MethodsQualitative semi-structured 1:1 interviews with coaches of youth community or school sponsored athletic programs in Illinois. Interview data was analyzed according to a constructivist grounded theory methodology employing constant comparative methods with an inductive approach to theme emergence.ResultsSixteen coaches of recreational, competitive and scholastic athletic teams participated. Coaches were primarily white (94%) males (81%) with an average age of 47. Ten were volunteer coaches. Analytic themes related to decision making include: 1) personal experience drives decisions more than concussion training, 2) coaches fear the legal liability of missing a concussive event on the field, and 3) discomfort with the ambiguity of making decisions on the field. Coach perceived factors for improving comfort with decision making were: 1) availability of checklists or tools for use on the sidelines, 2) improve shared decision making with all stakeholders, and 3) access to medical professionals on the sidelines.ConclusionsThere is a possible misalignment between coaches’ actual practices on the field and best practice guidelines. Coaches report behaviors on the sidelines that are distinct from practice guidelines and public health initiatives related to removal from play and return to play when events on the field present the potential for concussion.

Transforming a global order in New Zealand to reduce health inequities in service provision

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Rawson
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Indigenous Knowledge ◽  
Best Practice ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Health Inequities ◽  
Medical Emergency ◽  
Major Work ◽  
Health Initiatives

Abstract St John has been providing service in New Zealand for nearly 140 years since its arrival. It has now close to 4000 staff and nearly 20000 Members and over 8500 volunteers. In New Zealand the major work of St John is its Ambulance service providing front line first responders to crash, medical emergency and other life-threatening situations. St John New Zealand also provides a number of 'Community Health' initiatives focused on strengthening communities and prevention. In recent years St John has recognised that they have not engaged well with Indigenous communities and that their organisation in New Zealand must become skilled and relevant in addressing the needs of the Indigenous people of New Zealand, as they suffer the greater burden of disease and illness than any other population in the country. St John NZ Community and Health Services are embarking on a process of transformation through re-orienting its culture and practice by adopting Public Health approaches and an equity lens over all its programmes. They also have committed to understanding and using Indigenous knowledge to support this re-orientation to most effectively engage and implement programmes that will reduce Indigenous health inequities. This presentation will describe the process by which they will be implementing their strategy for change and highlight best practice for working with Indigenous communities. Key messages Indigenous Knowledge is key to addressing Indigenous Health inequities. Mainstream Public Health can learn from Indigenous Public Health approaches.

EXPRESS: Cruel optimism as organizing strategy in USA Gymnastics: The threat of high stakes organizations in precarious times

2021 ◽  
pp. 001872672110546
Author(s):  
Amy Way
Keyword(s):  
Decision Making ◽  
Sexual Abuse ◽  
Organizational Commitment ◽  
Young People ◽  
Medical Care ◽  
Youth Sports ◽  
Organizational Practices ◽  
High Stakes ◽  
Sports Organizations

In January of 2018, after decades of sexual abuse of hundreds of athletes under his medical care, Larry Nassar faced 156 of the women he victimized when they testified at his sentencing hearing and detailed the abuse. In the wake of the Nassar verdict, gymnastics and other youth sports organizations have come under fire for abusive practices that victimize young people. Scholars have recently argued for an approach to understanding sexual violence as an organizational, rather than individual phenomenon. The power organizations have to inflict violence on their members requires an understanding of the increased role of organizations in our decision-making and the shaping of our values and desires. Through an analysis of testimonies submitted by the women who were victimized by Nassar as children, I argue that violence was intentionally deployed as an organizational strategy by USA Gymnastics. Abusive organizational practices traumatized girls, leading them to recalibrate their expectations for what was normal and acceptable, ultimately facilitating their abuse. I propose ‘high stakes organizations’ as contexts particularly vulnerable to violent organizational practices. I argue that in these high stakes organizations, trauma is likely to be deployed as a strategy for organizational commitment, further fostering precarity in modern organizations.

scholarly journals Best practice guidelines for management of spinal disorders in skeletal dysplasia

2020 ◽  
Author(s):  
Klane White ◽  
Michael B Bober ◽  
Tae-Joon Cho ◽  
Michael J Goldberg ◽  
Julie Hoover-Fong ◽  
...  
Keyword(s):  
Decision Making ◽  
Practice Guidelines ◽  
Skeletal Dysplasia ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Case Series ◽  
Clinical Decision ◽  
Spinal Disorders ◽  
Best Practice Guidelines ◽  
Group A

Abstract Background: Disorders of the spine present a common and difficult management concern in patients with skeletal dysplasia. Due to the rarity of these conditions however, the literature, largely consisting of small, single institution case series, is sparse in regard to well-designed studies to support clinical decision making in these situations. Methods: Using the Delphi method, an international, multi-disciplinary group of individuals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, “best practice” guidelines in the care of spinal disorders in patients with skeletal dysplasia. Results: Starting with 33 statements, the group a developed a list of 31 “best practice” guidelines. Conclusions: The guidelines are presented and discussed to provide context for clinicians in their decision making in this often-challenging realm of care.

Vestibular and Balance Dysfunction Following Sport-Related Concussion

2019 ◽  
Vol 4 (6) ◽  
pp. 1349-1363
Author(s):  
Jamie M. Bogle
Keyword(s):  
Public Health ◽  
Multidisciplinary Team ◽  
Return To Sport ◽  
Return To Play ◽  
Health Concern ◽  
Balance Function ◽  
Public Health Concern ◽  
Gaze Stability ◽  
Significant Public Health Concern ◽  
Significant Public Health

Purpose Sport-related concussion is a significant public health concern that requires a multidisciplinary team to appropriately manage. Athletes often report dizziness and imbalance following concussion, and these symptoms can predict increased time to recover. Vestibular diagnostic evaluations provide important information regarding the athlete's oculomotor, gaze stability, and balance function in order to identify deficits for rehabilitation. These measures also describe objective function helpful for determining when an athlete is ready to return to play. The purpose of this clinical focus article is to provide background on the current understanding of the effects of concussion on the peripheral and central vestibular system, as well as information on a protocol that can be used for acute concussion assessment. Case studies describing 3 common postconcussion presentations will highlight the usefulness of this protocol. Conclusion Sport-related concussion is a highly visible disorder with many symptoms that may be evaluated in the vestibular clinic. A thoughtful protocol evaluating the typical presentation of these patients may help guide the multidisciplinary team in determining appropriate management and clearance for return to sport.

scholarly journals Best Practice Guidelines in Managing the Craniofacial Aspects of Skeletal Dysplasia

2020 ◽  
Author(s):  
Ravi Savarirayan ◽  
David E. Tunkel ◽  
Laura M. Sterni ◽  
Michael B. Bober ◽  
Tae-Joon Cho ◽  
...  
Keyword(s):  
Decision Making ◽  
Practice Guidelines ◽  
Delphi Method ◽  
Skeletal Dysplasia ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Subsequent Development ◽  
Clinical Decision ◽  
Best Practice Guidelines ◽  
Disciplinary Group

Abstract Background Recognition and appropriate management of the craniofacial manifestations of patients with skeletal dysplasia are challenging, due to the rarity of these conditions, and dearth of literature to support evidence-based clinical decision making. Methods Using the Delphi method, an international, multi-disciplinary group of individuals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, best practice guidelines in the management of craniofacial aspects of these patients. Results After a comprehensive literature review, 23 initial statements were generated and critically discussed, with subsequent development of a list of 22 best practice guidelines after a second round voting. Conclusions The guidelines are presented and discussed to provide context and assistance for clinicians in their decision making in this important and challenging component of care for patients with skeletal dysplasia, in order standardize care and improve outcomes.

scholarly journals Best practice guidelines in managing the craniofacial aspects of skeletal dysplasia

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ravi Savarirayan ◽  
◽  
David E. Tunkel ◽  
Laura M. Sterni ◽  
Michael B. Bober ◽  
...  
Keyword(s):  
Decision Making ◽  
Practice Guidelines ◽  
Delphi Method ◽  
Skeletal Dysplasia ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Subsequent Development ◽  
Clinical Decision ◽  
Best Practice Guidelines ◽  
Disciplinary Group

Abstract Background Recognition and appropriate management of the craniofacial manifestations of patients with skeletal dysplasia are challenging, due to the rarity of these conditions, and dearth of literature to support evidence-based clinical decision making. Methods Using the Delphi method, an international, multi-disciplinary group of individuals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, best practice guidelines in the management of craniofacial aspects of these patients. Results After a comprehensive literature review, 23 initial statements were generated and critically discussed, with subsequent development of a list of 22 best practice guidelines after a second round voting. Conclusions The guidelines are presented and discussed to provide context and assistance for clinicians in their decision making in this important and challenging component of care for patients with skeletal dysplasia, in order standardize care and improve outcomes.

General practitioners' patterns of treatment of febrile travellers in north Queensland: an exploratory study

2012 ◽  
Vol 18 (2) ◽  
pp. 166 ◽  
Author(s):  
Kajsa L. Engström ◽  
Jane Mills ◽  
William J. H. McBride ◽  
Caroline M. Johansson
Keyword(s):  
Public Health ◽  
Health Services ◽  
Dengue Fever ◽  
General Practitioners ◽  
Best Practice ◽  
Index Case ◽  
Health Concern ◽  
Public Health Services ◽  
Structured Interviews ◽  
The Cost

In north Queensland, recurring epidemics of dengue fever are a public health concern. Each epidemic is initiated by an index case: an infected person arriving from an endemic country or region with dengue activity who then transmits the disease to local mosquitoes. A timely diagnosis of dengue in an index case and notification to public health services is essential to prevent epidemics. This qualitative study explores north Queensland general practitioners’ experiences and patterns of treatment of febrile travellers. Individual, semi-structured interviews with 50 general practitioners working in north Queensland were conducted. Analysis of the data resulted in four themes for discussion: characteristics of febrile travellers presenting to local general practitioners, the cost of pathology tests as a barrier to diagnosis, appropriate pathology testing, and notifying tropical public health services. Recommendations from this study point to a need for ongoing education and training for general practitioners in best practice with regards pathology testing for suspected dengue fever cases. As well, there is a need to provide clearer guidelines to general practitioners on when to notify tropical public health services of suspicious diagnoses of dengue.

Crisis management and human factors

2020 ◽  
pp. 1-8
Author(s):  
Simon Mercer
Keyword(s):  
Decision Making ◽  
Human Factors ◽  
Mental Models ◽  
Crisis Management ◽  
Psychological Stress ◽  
Practice Guidelines ◽  
Best Practice ◽  
Situational Awareness ◽  
Best Practice Guidelines ◽  
National Quality

This first chapter explains how human factors affect the management of crises. The roles human factors play in the management of emergencies and crisis situations are becoming increasingly recognized in healthcare, having gained political momentum following a concordat from the National Quality Board in 2013. A framework is presented for emergency preparation, including standard operating procedures, checklists, allocation of roles, preparing equipment and drugs, sharing mental models, and communicating with support specialists. During the incident the focus is on situational awareness, leadership and teamwork, communication, and decision-making. Post-event debriefing is discussed with the joint goals of addressing psychological stress and learning for the future. Also provided are links to available up-to-date best-practice guidelines and useful resources for further reading.

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