[The Luxembourg Society for Sports Medicine (SLM) after 60 years]

This review will mainly focus the last 10 years of the society's history because several important changes occurred during this relatively short period. The most important was the creation of the first clinical sports medicine department in Luxembourg in 2004. This modern new infrastructure was made possible by the recruitment of 2 highly competent sports physicians, the excellent collaboration of the governing board of the Centre Hospitalier de Luxembourg (CHL) and the support of the sports minister. In 2008 the new department received the label "Medical Olympic Centre of Luxembourg". One year later a Research Lab of Sports Medicine (CRP-Santé) completed the new concept. Thus within 4 years the structure of Luxembourgish sports medicine was completely rearranged and includes today orthopaedic surgery and traumatology, functional rehabilitation, sports cardiology, exercise physiology, physiotherapy and specific sports medicine research. An important new challenge of the SLMS will be to integrate the external sports physicians into this new infrastructure. Another ongoing mission of the SLMS will be the education and training of new young sports medicine specialists. Here the new department could play an outstanding role and the SLMS is in close negotiations with the University of Luxembourg, in charge of academic education in Luxembourg. A recruitment of new young sports physicians is necessary to perpetuate the routine sports medicine exams in the 15 regional centres in Luxembourg, where such an exam is mandatory in order to get an official sports licence. Since 2010 an ECG exam has been added for all new licence candidates, according to the recent recommendations of the scientific societies. New young sports physicians will also be needed to assure the medical attendance of the different national teams of Luxembourg. Until 1985 these activities were confined only to the Olympic teams every 4 years, but since the implementation of the Games of the Small European Countries in 1985, where rather big teams represent Luxembourg every two years, this mission has become more important. The history of the SLMS reflects the development both of sports and sports medicine during the last 60 years. At the beginning of the 21.century sports medicine is well settled in the Grand-duchy of Luxembourg.

Professional relations in sport healthcare: workplace responses to organisational change

This article examines the impact of organisational changes in UK elite sport on the professional relations among and between different healthcare providers. The article describes the processes by which demand for elite sport healthcare has increased in the UK. It further charts the subsequent response within medicine and physiotherapy and, in particular, the institutionalisation of sport-specific sub-disciplines through the introduction of specialist qualifications. Drawing on semi-structured interviews with 14 doctors and 14 physiotherapists, the article argues that organisational changes have led to intra-professional tensions within both professional groups but in qualitatively different forms reflecting the organisational traditions and professional identities of the respective disciplines. Organisational changes promoting multi-disciplinary healthcare teams have also fostered an environment conducive to high levels of inter-professional cooperation though significant elements of inter-professional conflict remain. This study illustrates how intra-professional relations are affected by specialisation, how legitimation discourses are used by different professions, and how intra- and inter-professional conflict and cooperation should be seen as highly interdependent processes.

Key factors for providing appropriate medical care in secondary school athletics: athletic training services and budget

CONTEXT

Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care.

OBJECTIVE

To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care.

DESIGN

Cross-sectional study.

SETTING

Mailed and e-mailed survey.

PATIENTS OR OTHER PARTICIPANTS

One hundred sixty-six South Carolina high schools.

INTERVENTION(S)

The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r = 0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables.

MAIN OUTCOME MEASURE(S)

The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines.

RESULTS

Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P < .001) when controlling for the setting, region, and rate of free or reduced lunch qualifiers. These 2 variables accounted for 30% of the variance in ACI score (R(2) = 0.302). Post hoc analysis showed differences between ACI score based on the source of the athletic trainer and the size of the sports medicine supply budget.

CONCLUSIONS

The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for interscholastic athletes.

[Awareness of doctors in sportmedicine and sportsmen concerning stomatological health]

The questioning was carried out among 182 sportsmen of the age of 12--45 years living in Samara region and among the medical personnel serving the given group. Questioning had shown low awareness of sportsmen and sports doctors on questions of stomatologic diseases preventive measures.

Understanding organization structures of the college, university, high school, clinical, and professional settings

Athletes participate at many different levels of competition--from amateur to professional, from backyard sandlot to Yankee Stadium. There are as many different organized structures involved in providing medical care to athletes as there are types of athletes themselves. Although the organizational structures involved in providing medical care for a little league team in a small town are different from those involved in providing care for a professional baseball team, the mission is the same-caring for athletes. This is the central theme of this article. Though there are different organizational structures, there are more common threads than differences in the mission of those who provide medical care for athletes at any level.

Creating and promoting a sports performance service offering

Many private hospitals and physician groups are exploring the possibility of expanding their facilities to include advanced ancillary services. Services such as a sports performance center provide additional opportunities for quality patient care and at the same time augment the bottom line. By offering additional ancillary services, healthcare organizations such as an orthopaedics practice can become a full-service center enabling clinicians to more fully provide care to their patients. Marketing and promotion play a crucial role in this type of service. These activities must be designed and carried out in a way that encourages productive results and collaboration as the organization strives to position itself as a full-service center and as a sports specialist in its community.

Marathon Race Medical Administration

Marathon race medical coverage involves coordinating many organisations, personnel and government agencies. An infrastructure of aid stations, finish-line medical tents, ambulance services, communication networks and transport vehicles support the medical professionals covering the event. Knowledge of the volume and type of medical problems that arise during a marathon allow the medical director to assemble the necessary components for a safe event. Published data and/or historical race information will assist in planning for anticipated medical utilisation. Organisers must prepare for uncommon but possible catastrophic medical events such as cardiac arrest and exertional heat stroke. Advances in point-of-care medical devices and significant increases in training and education of medical professionals providing care at these events have greatly improved the quality of on-site medical care at marathon races.

Professional and collegiate team assistance programs: services and utilization patterns

Elite professional and collegiate athletes underuse stress control, mental health, and substance abuse treatment services. Behavioral health services use can be increased by establishing on-site, sports-specific services. Like Employee Assistance Programs of industry and government, Team Assistance Programs (TAPs) address critical issues such as substance abuse prevention, tobacco cessation, stress recognition, mental illness management, injury rehabilitation, performance enhancement, and cultural support. Strong links with the team's medical and conditioning staff can ensure a steady stream of TAP referrals and build trust with players and team staff. This article describes nine years of operation for two professional TAPs and three years for one college TAP. Use patterns and linkage strategies with team physicians, trainers, strength staff, chiropractors, and nutritionists are discussed.

Developmental Overview of Child and Youth Sports for the Twenty-first Century

This article presents an overview of sporting participation for children and adolescents from psychological, physical, social, developmental, and historical perspectives. The following areas are reviewed: (1) normal developmental readiness and sporting participation; (2) benefits and risks of athletic participation for the child and adolescent; (3) self concept and sporting participation; (4) adverse psychophysiological and somatoform effects of sports; (5) interactional and systemic contributions to adverse physical and psychological effects; (6) a historical/social perspective of sport in the United States; (7) the current and future role of psychiatrists in conjunction with sports medicine physicians; (8) the sports psychiatry interview of the child, family, and coach; and (9) summary and future challenges.