CyberAbuse in sport: beware and be aware!

As a mechanism for enabling abuse, online environments augment harm(s) that can occur in physical spaces and have created new forms of violence unique to these spaces. Currently, the literature in the sporting domain concerning abuse in online environments is sparse and has focused primarily on abuse targeting athletes via social networking sites

Lines in the sand: pre-interview rank and probability of receiving admission to medical school

Background: We provide an examination of one medical school’s attempt to determine whether their cut-off point for number of interviews offered is congruent with the probability these applicants’ have for admission post-interview. Methods: Offer probability was determined by organizing pre-interview rankings from 2013-2017 (n = 2,659) applicant cohorts into bins of 50 applicants and finding the quotient of successful and total applicants in each bin.A linear-by-linear association Chi-square test and adjusted standardized residuals with an applied Bonferroni correction were used to determine if the observed frequencies in each bin were different than expected by chance. A Spearman Correlation analysis between pre- and post-interview ranks was conducted. Results: All applicants have between a 50.0% and 76.4% chance of admission. Observed frequencies are different than chance (χ(1)=50.835, p<.001), with a significantly greater number of offers seen in the bins between 1 and 100 (p<.001 for both bins). There is a weak positive relationship between pre- and post-rank, rs(2657)= 0.258, p<.001. Conclusion: The results indicate the number of interviews conducted does not exceed a threshold wherein individuals with a relatively low chance of admission are interviewed. Findings are interpreted with respect to ethical resource allocation for both programs and applicants

Examining the relationship between exercise dependence, disordered eating, and low energy availability

Both dietary and exercise behaviors need to be considered when examining underlying causes of low energy availability (LEA). The study assessed if exercise dependence is independently related to the risk of LEA with consideration of disordered eating and athlete calibre. Via survey response, female (n = 642) and male (n = 257) athletes were categorized by risk of: disordered eating, exercise dependence, disordered eating and exercise dependence, or if not presenting with disordered eating or exercise dependence as controls. Compared to female controls, the likelihood of being at risk of LEA was 2.5 times for female athletes with disordered eating and >5.5 times with combined disordered eating and exercise dependence. Male athletes with disordered eating, with or without exercise dependence, were more likely to report signs and symptoms compared to male controls-including suppression of morning erections (OR = 3.4; p < 0.0001), increased gas and bloating (OR = 4.0–5.2; p < 0.002) and were more likely to report a previous bone stress fracture (OR = 2.4; p = 0.01) and ≥22 missed training days due to overload injuries (OR = 5.7; p = 0.02). For both males and females, in the absence of disordered eating, athletes with exercise dependence were not at an increased risk of LEA or associated health outcomes. Compared to recreational athletes, female and male international caliber and male national calibre athletes were less likely to be classified with disordered eating

Embracing change : The evolving science of relative energy deficiency in sport [Letter]

[Extract] Firstly, we would like to thank Dr. Strock, Koltun, and Ricker for their interest in our article (Kuikman et al., 2021) and for expressing their opinion on our review of treatment approaches to Relative Energy Deficiency in Sport (RED-S). We also appreciate the opportunity to address their [Econcerns and expand on the global direction of research in this area. Building upon the foundational research on the Female Athlete Triad (TRIAD), scientific knowledge of RED-S is rapidly expanding and evolving as the understanding of contributing and interacting factors increases. As the evidence base grows, researchers and members of the athlete support team must adapt their theories and frameworks. While this review was intended to highlight the state-of-the-art treatment approaches currently available, Strock et al. (2021) instead deemed this paper inaccurate and misleading for encapsulating the terminology of the TRIAD within the RED-S model..

Development of an Anthropometric Prediction Model for Fat-Free Mass and Muscle Mass in Elite Athletes

The monitoring of body composition is common in sports given the association with performance. Surface anthropometry is often preferred when monitoring changes for its convenience, practicality, and portability. However, anthropometry does not provide valid estimates of absolute lean tissue in elite athletes. The aim of this investigation was to develop anthropometric models for estimating fat-free mass (FFM) and skeletal muscle mass (SMM) using an accepted reference physique assessment technique. Sixty-four athletes across 18 sports underwent surface anthropometry and dual-energy X-ray absorptiometry (DXA) assessment. Anthropometric models for estimating FFM and SMM were developed using forward selection multiple linear regression analysis and contrasted against previously developed equations. Most anthropometric models under review performed poorly compared with DXA. However, models derived from athletic populations such as the Withers equation demonstrated a stronger correlation with DXA estimates of FFM (r = .98). Equations that incorporated skinfolds with limb girths were more effective at explaining the variance in DXA estimates of lean tissue (Sesbreno FFM [R2 = .94] and Lee SMM [R2 = .94] models). The Sesbreno equation could be useful for estimating absolute indices of lean tissue across a range of physiques if an accepted option like DXA is inaccessible. Future work should explore the validity of the Sesbreno model across a broader range of physiques common to athletic populations

The relationship between regional medical campus enrollment and rates of matching to family medicine residency

Background: The Michael G. DeGroote School of Medicine expanded its medical education across three campus sites (Hamilton, Niagara Regional and Waterloo Regional) in 2007. Ensuring the efficacy and equivalency of the quality of training are important accreditation considerations in distributed medical education.&nbsp; In addition, given the social accountability mission implicit to distributed medical education, the proportion of learners at each campus that match to family medicine residency programs upon graduation is of particular interest. Methods: By way of between campus comparisons of Canadian Residency Matching Service (CaRMS) match rates, this study investigates the family medicine match proportion of medical students from McMaster’s three medical education campuses. These analyses are further supported by between campus comparisons of Personal Progress Index (PPI), Objective Structured Clinical Examination (OSCE), Medical Council of Canada Qualifying Examination-Part 1 (MCCQE1) performances that offer insight into the equivalency and efficacy of the educational outcomes at each campus. Results: The Niagara Regional Campus (NRC) demonstrated a significantly greater proportion of students matched to family medicine. With respect to education equivalency, the proportion of students’ PPI scores that were more than two SD below the mean was comparable across campuses.&nbsp; OSCE analysis yielded less than 2% differences across campuses with no differences in the last year of training.&nbsp; The MCCQE1 pass rates were not statistically significant between campuses and there were no differences in CaRMS match rates. With respect to education efficacy, there were no differences among the three campuses’ pass rates on the MCCQE1 and CaRMS match rates with the national rates. Conclusions: Students in all campuses received equivalent educational experiences and were efficacious when compared to national metrics, while residency matches to family medicine were greater in the NRC. The reasons for this difference may be a factor of resident and leadership role-models as well as the local hospital and community environment

The IOC consensus statement: Beyond the female athlete triad-Relative Energy Deficiency in Sport (RED-S)

Protecting the health of the athlete is a goal of the International Olympic Committee (IOC). The IOC convened an expert panel to update the 2005 IOC Consensus Statement on the Female Athlete Triad. This Consensus Statement replaces the previous and provides guidelines to guide risk assessment, treatment and return-to-play decisions. The IOC expert working group introduces a broader, more comprehensive term for the condition previously known as ‘Female Athlete Triad’. The term ‘Relative Energy Deficiency in Sport’ (RED-S), points to the complexity involved and the fact that male athletes are also affected. The syndrome of RED-S refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency. The cause of this syndrome is energy deficiency relative to the balance between dietary energy intake and energy expenditure required for health and activities of daily living, growth and sporting activities. Psychological consequences can either precede RED-S or be the result of RED-S. The clinical phenomenon is not a ‘triad’ of the three entities of energy availability, menstrual function and bone health, but rather a syndrome that affects many aspects of physiological function, health and athletic performance. This Consensus Statement also recommends practical clinical models for the management of affected athletes. The ‘Sport Risk Assessment and Return to Play Model’ categorises the syndrome into three groups and translates these classifications into clinical recommendations

Le Certificat de compétence additionnelle en médecine familiale : une enquête descriptive sur le point de vue des médecins de famille sur les pratiques d'amélioration des compétences au Canada

Introduction: The College of Family Physicians of Canada (CFPC) offers the Certificate of Added Competence (CAC) program to designate a family physician with enhanced skills. In 2015, the College expanded its program to introduce enhanced certification in four new domains: Palliative Care, Care of the Elderly, Sports and Exercise Medicine, and Family Practice Anesthesia. In this study, we elicited perceptions from Canadian family physicians with and without the CAC on practice impacts associated with the program. Methods: Active family physicians in Canada with and without CACs were surveyed between November 2019 to January 2020. Descriptive statistics were generated to describe the perceptions of family physicians regarding the CAC program and its impacts on practice. Results: Respondents agreed with several benefits of the program including enhancing the capacity to deliver comprehensive care, alleviating the burden of patient travel by increasing the availability of care in rural and remote communities, and providing opportunities to engage in various collaborative care models and new leadership roles. All respondents perceived CAC holders to pursue the certificate to meet both professional interests and community needs. Conclusions: There is a need for strong and continued investment in systemic practice improvements that incentivize the delivery of comprehensive family medicine practice.Introduction : Le certificat de compétence additionnelle (CCA) accordé par le Collège des médecins de famille du Canada (CMFC) vise à reconnaître un haut niveau de compétences chez un médecin de famille. En 2015, le Collège a élargi le titre de compétences additionnelles à quatre nouveaux domaines : soins palliatifs, soins aux personnes âgées, médecine du sport et de l'exercice, et anesthésie en médecine familiale. Dans cette étude, nous avons recueilli les perceptions de médecins de famille titulaires et non titulaires d’un CCA sur l’influence de pratiques associées au programme de certification. Méthodes : Des médecins de famille actifs au Canada, titulaires et non titulaires du CCA, ont été interrogés entre novembre 2019 et janvier 2020. Des statistiques descriptives ont été générées pour décrire leurs perceptions concernant le Certificat et ses impacts sur la pratique. Résultats : Les répondants s’entendaient pour reconnaître au CCA plusieurs avantages, notamment le fait d'améliorer la capacité des médecins à fournir des soins complets, de leur offrir la possibilité de s'engager dans divers modèles de soins collaboratifs et de nouveaux rôles de leadership, et d'alléger le fardeau des déplacements des patients en augmentant la disponibilité des soins dans les populations rurales et éloignées. Tous les répondants estiment que les médecins recherchent l’obtention de ce titre de compétence pour répondre à la fois à leurs intérêts professionnels et aux besoins de la collectivité. Conclusions : Il faut investir de manière importante et continue dans des améliorations systémiques qui favoriseront une pratique holistique de la médecine familiale