Financial conflicts of interest and the ethical obligations of medical school faculty and the profession

Despite their potential benefits, relationships linking medical school faculty and the pharmaceutical and device industries may also challenge the professional value of primacy of patient welfare, a point highlighted in a recent Institute of Medicine report. Academic medical centers and professors have the added professional obligation to ensure the unbiased, evidence-based education of future doctors. This essay argues that faculty financial conflicts of interest may threaten this obligation by propagating the bias introduced by these relationships to students. This could occur directly through the process of curriculum determination and delivery, and also indirectly through the "hidden curriculum," which deserves particular attention, as its lessons may conflict with those professed in the formal curriculum. The essay concludes with guiding principles to consider when developing a conflict of interest policy at academic medical centers.     

Trash-Talking and Trolling

Among the extra-physical aspects of team sports, the ways in which players talk to each other are among the more colorful but understudied dimensions of competition. To contribute an empirical basis for examining the nature of “trash talk,” we present the results of a study of 291 varsity athletes who compete in the top division among US universities. Based on a preliminary review of trash-talk topics among student-athletes, we asked participants to indicate the frequency with which they have communicated or heard others talk about opposing players’ athleticism, playing ability, physical appearance, boyfriends, girlfriends, sexual behavior, parents, and home institution during competitions. Our three main findings are: (1) Trash-talking is most commonly about the proximately important topic of playing ability while ultimately relevant topics such as physical appearance also appear to be common; (2) Men appear to trash-talk significantly more than women, and consistently across topics; and (3) contact sports such as football, hockey, lacrosse, and wrestling are associated with trash talk significantly more than other sports. We also examined whether the anonymity provided by face-masked helmets in “combat sports” was associated with more trash talk than contact sports played without a helmet (e.g., wrestling) and found no consistent association with face masks. Our findings highlight the ways in which competitors in physical sporting contests attempt to use language—often in ways that focus on players’ kin or reproductive interests—in pursuit of victory while establishing a baseline for future research into trash-talking.     

Phenotyping of genetically engineered mice: humane, ethical, environmental, and husbandry issues

The growing use of genetically engineered (GE) mice in scientific research has raised many concerns about the animal welfare of such mice. The types of welfare concerns may differ within the three stages that comprise the establishment of GE animal models: development, production, and research use. The role and impact of the members of the research team on these concerns may also vary with each stage. To make both scientific and animal welfare decisions at each stage, it is necessary to have a thorough knowledge of the animal model-in this case, the phenotypic expression of the GE animal. Phenotype screening is the analysis of visible or measurable characteristics of an animal that result from the genotype and its interaction with the environment. Phenotypes expressed that are relevant to the research program are usually carefully investigated; however, those that may have an impact on the animal's welfare but have little or no impact on the disease process under study are often less carefully studied. Thorough analysis and documentation of the animal welfare aspects of phenotype provide the research team with the information they need to control the environment to minimize negative animal welfare effects. Such information is also essential to allow members of the institutional animal care and use committee to perform necessary cost:benefit ethical review of proposed GE animal studies. Investigators who submit information about models for publication should document all aspects of a phenotype, including the area of scientific interest as well as those areas that affect animal welfare, for clarity and for subsequent research with the respective models.     

Validity and reliability of agility tests in junior Australian football players

Young, W, Farrow, D, Pyne, D, McGregor, W, and Handke, T. Validity and reliability of agility tests in junior Australian football players. J Strength Cond Res 25(12): 3399-3403, 2011-The importance of sport-specific stimuli in reactive agility tests (RATs) compared to other agility tests is not known. The purpose of this research was to determine the validity and reliability of agility tests. Fifty junior Australian football players aged 15-17 years, members of either an elite junior squad (n = 35) or a secondary school team (n = 15), were assessed on a new RAT that involved a change of direction sprint in response to the movements of an attacking player projected in life size on a screen. These players also underwent the planned Australian Football League agility test, and a subgroup (n = 13) underwent a test requiring a change of direction in response to a left or right arrow stimulus. The elite players were significantly better than the school group players on the RAT (2.81 ± 0.08 seconds, 3.07 ± 0.12 seconds; difference 8.5%) but not in the arrow stimulus test or planned agility test. The data were log transformed and the reliability of the new RAT estimated using typical error (TE) expressed as a coefficient of variation. The TE for the RAT was 2.7% (2.0-4.3, 90% confidence interval) or 0.07 seconds (0.5-1.0), with an intraclass correlation coefficient (ICC) of 0.33. For the test using the arrow stimulus, the TE was 3.4% (2.4-6.2), 0.09 (0.06-0.15) seconds, and ICC was 0.10. The sport-specific stimulus provided by the new RAT is a crucial component of an agility test; however, adoption of the new RAT for routine testing is likely to require more accessible equipment and several familiarization trials to improve its reliability.     

Bodychecking Rules and Concussion in Elite Hockey

Athletes participating in contact sports such as ice hockey are exposed to a high risk of suffering a concussion. We determined whether recent rule changes regulating contact to the head introduced in 2010–11 and 2011–12 have been effective in reducing the incidence of concussion in the National Hockey League (NHL). A league with a longstanding ban on hits contacting the head, the Ontario Hockey League (OHL), was also studied. A retrospective study of NHL and OHL games for the 2009–10 to 2011–12 seasons was performed using official game records and team injury reports in addition to other media sources. Concussion incidence over the 3 seasons analyzed was 5.23 per 100 NHL regular season games and 5.05 per 100 OHL regular season games (IRR 1.04; 95% CI 1.01, 1.50). When injuries described as concussion-like or suspicious of concussion were included, incidences rose to 8.8 and 7.1 per 100 games respectively (IRR 1.23; 95% CI 0.81, 1.32). The number of NHL concussions or suspected concussions was lower in 2009–10 than in 2010–11 (IRR 0.61; 95% CI 0.45, 0.83), but did not increase from 2010–11 to 2011–12 (IRR 1.05; 95% CI 0.80, 1.38). 64.2% of NHL concussions were caused by bodychecking, and only 28.4% of concussions and 36.8% of suspected concussions were caused by illegal incidents. We conclude that rules regulating bodychecking to the head did not reduce the number of players suffering concussions during NHL regular season play and that further changes or stricter enforcement of existing rules may be required to minimize the risk of players suffering these injuries.     

Injuries to primary school pupils and secondary school students during physical education classes and in their leisure time

The study aimed to establish the frequency of injuries in primary and secondary schools during leisure time and physical education classes in school as well as in group and individual sports. The sample included 2842 pupils from nine primary schools and 1235 students from five secondary schools in Slovenia. The data were processed with the SPSS statistical software package and the frequencies and Crosstabs were calculated. The results showed that substantially more pupils and students were injured in their leisure time than during physical education classes. Girls were more frequently injured in group and individual sports practiced during physical education classes and in individual sports practiced in their leisure time, whereas boys suffered more injuries in group sports practiced in their leisure time. As regards group sports, pupils and students were most frequently injured while playing football in their leisure time whereas, during physical education classes, they suffered most injuries in volleyball, followed closely by basketball and football; as regards individual sports, pupils and students were most frequently injured while cycling and rollerblading in their leisure time, whereas during physical education classes they suffered most injuries in athletics.     

Home and Away: The Grounding of New Football Teams in Perth,Western Australia

Metropolitan sporting, and particularly football, competitions were established in all of Australia's colonial state capital cities about a century ago. Typically, they were comprised of teams from and were supported by the inhabitants of working‐class, inner suburbs. These competitions were the primary foci of Australians' sporting interest and loyalty for almost a century. But, with the shift of public attention and private capital to national competitions, the former stadia of many local clubs have become redundant spaces in what are now gentrifying inner suburbs. Simultaneously new, and even old, national league teams have sought larger, more modern (near) city centre venues for their operations. In this context, two new national league teams in Perth—Fremantle Dockers and Perth Glory—have experienced considerable challenges in establishing both physical ‘homes’ and local identities. These have included both the supplanting of traditional local clubs and the placating of new kinds of inner suburban residents.     

Body size and composition of National Football League players

The purpose of this study was to present a profile of body size and composition of National Football League (NFL) players prior to the start of the regular season. Fifty-three members of the Indianapolis Colts professional football team were measured for height, body mass, and percentage body fat using the BOD POD air-displacement plethysmography system during summer camp of the 2003 football season. These data were categorized by position for comparison with previous studies of NFL football players. The relationships observed were as follows (= represents nonsignificant; > represents p < or = 0.05): Height: Offensive Line = Defensive Line = Quarterbacks/Kickers/Punters = Tight Ends > Linebackers > Running Backs = Wide Receivers = Defensive Backs. Body Mass: Offensive Line = Defensive Line > Tight Ends = Linebackers > Running Backs = Quarterbacks/ Kickers/Punters > Wide Receivers = Defensive Backs. Percentage Body Fat: Offensive Line > Defensive Line > Quarterbacks/ Kickers/Punters = Linebackers = Tight Ends > Running Backs = Wide Receivers = Defensive Backs. Comparisons to teams in the 1970s indicate that body mass has increased only for offensive and defensive linemen; however, height and body fat among player positions have not dramatically changed. Furthermore, the body mass index is not an accurate measure or representation of body fat or obesity in NFL players. These data provide a basic template for size profiles and differences among various positions and allow comparisons with other studies for changes in the NFL over the past 3 decades.     

Increased aggression during human group contests when competitive ability is more similar

Theoretical analyses and empirical studies have revealed that conflict escalation is more likely when individuals are more similar in resource-holding potential (RHP). Conflicts can also occur between groups, but it is unknown whether conflicts also escalate more when groups are more similar in RHP. We tested this hypothesis in humans, using data from two professional sports competitions: football (the Bundesliga, the German first division of football) and basketball (the NBA, the North American National Basketball Association). We defined RHP based on the league ranks of the teams involved in the competition (i.e. their competitive ability) and measured conflict escalation by the number of fouls committed. We found that in both sports the number of fouls committed increased when the difference in RHP was smaller. Thus, we provide what is to our best knowledge the first evidence that, as in conflicts between individuals, conflicts escalate more when groups are more similar in RHP.     

The NFL combine: does it predict performance in the National Football League?

The authors investigate the correlation between National Football League (NFL) combine test results and NFL success for players drafted at three different offensive positions (quarterback, running back, and wide receiver) during a recent 6-year period, 1999-2004. The combine consists of series of drills, exercises, interviews, aptitude tests, and physical exams designed to assess the skills of promising college football players and to predict their performance in the NFL. Combine measures examined in this study include 10-, 20-, and 40-yard dashes, bench press, vertical jump, broad jump, 20- and 60-yard shuttles, three-cone drill, and the Wonderlic Personnel Test. Performance criteria include 10 variables: draft order; 3 years each of salary received and games played; and position-specific data. Using correlation analysis, we find no consistent statistical relationship between combine tests and professional football performance, with the notable exception of sprint tests for running backs. We put forth possible explanations for the general lack of statistical relations detected, and, consequently, we question the overall usefulness of the combine. We also offer suggestions for improving the prediction of success in the NFL, primarily the use of more rigorous psychological tests and the examination of collegiate performance as a job sample test. Finally, from a practical standpoint, the results of the study should encourage NFL team personnel to reevaluate the usefulness of the combine's physical tests and exercises as predictors of player performance. This study should encourage team personnel to consider the weighting and importance of various combine measures and the potential benefits of overhauling the combine process, with the goal of creating a more valid system for predicting player success.     

Horse Husbandry and Preventive Health Practices in Australia: An Online Survey of Horse Guardians

Little is known about the horse health management practices of Australian horse caregivers (owners). This article presents findings from a convenience sample of 505 horse owners who participated in an online survey. No large-scale welfare issues were identified, but there were some areas of potential concern, including owners who did not regularly deworm their horses (4%), a lack of strategic parasite control (3.1%), and a lack of regular dental care (11%). Several participants did not have their horse’s hooves regularly shod or trimmed (2%), and 14% had an unqualified person maintain their horse’s hooves. One in five owners (19%) did not vaccinate their horses against tetanus. The findings are discussed in relation to current Australian horse health guidelines and traditional sources of horse health information, together with recommendations for providing horse owners with relevant information in relevant forms.     

Drinkers,non‐drinkers and deferrers: Reconsidering the beer/footy couplet amongst Australian Rules football fans1

There is a common perception that football and alcohol go hand in hand and that players and fans routinely engage in excessive and irresponsible drinking. In Australia, this is manifest in the stereotypical ‘Pissed Aussie Rules fan’. Following research with Australian Rules football fans in South Australia, we identified three categories of fans according to their (non)engagement with alcohol: Drinkers, Non‐Drinkers and Deferrers. Deferrers were self‐identified drinkers who separated alcohol consumption from spectating, for fear of ‘contamination’. Our identification of counter‐stereotypic ways in which fans engage with alcohol (or not) challenges the assumptive worlds in which popular commentary on football and drinking operates. This was, to our knowledge, the first ethnography of drinking behaviour amongst Australian Rules football fans. It demonstrates the advantage of using ethnographic research techniques to understand the relationship between identity and consumption.     

The relationship between internal and external loads as a tool to monitor physical fitness status of team sport athletes: a systematic review

The efficiency index (Eff_index) combines internal and external loads, and it has been considered a promising tool to evaluate physical fitness status. However, its real applicability and limitations have not been elucidated yet. To examine and discuss the findings from studies that used Eff_index as a tool for the evaluation of physical fitness status in team sports. A systematic search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases conferred were PubMed, Scopus, Web of Science, SPORTDiscus, MEDLINE and CINAHL. The articles selected were published up to March 2021. Fourteen articles were included after meeting the inclusion criteria. A wide variety of combinations of external and internal loading parameters to calculate Eff_index were found. The pooled sample included 349 male participants (23 ± 3 years). Fifty-nine percent of the sample were soccer players, 20% rugby players, 10% Australian football players, 7% hurling players, and 4% basketball players. Most Eff_index calculations used total distance (TD) divided by heart rate derived parameters. However, recent studies have suggested the use of accelerations as the external load parameter. Eff_index is a simple and powerful tool for the evaluation of physical fitness status in team sports athletes. The disparity of external and internal loading parameters used to calculate Eff_index may affect its sensitivity to detect changes in fitness status in different team sport settings. More studies with indoor team sports and female athletes are warranted.     

Physical and performance characteristics of Japanese division 1 collegiate football players

Iguchi, J, Yamada, Y, Ando, S, Fujisawa, Y, Hojo, T, Nishimura, K, Kuzuhara, K, Yuasa, Y, and Ichihashi, N. Physical and performance characteristics of Japanese division 1 collegiate football players. J Strength Cond Res 25(12): 3368-3377, 2011-This study aimed to establish the physical and performance characteristics of football players in the Japanese Division 1 collegiate football program and perform a comparison of these characteristics between Japanese (n = 208) and US Division 1 football players (n = 797). The following comparisons were made: (a) between a higher-ranked university team vs. a lower-ranked university team in Japan, (b) between different playing positions in Japan, (c) between starters and nonstarters in Japan, and (d) between playing positions in Japan vs. those in the United States. The results of this study suggest that players in the higher-ranked university team were heavier, stronger in back squat, jumped higher, and had greater power than those on the lower-ranked team. Furthermore, linemen were generally characterized by larger size, greater strength, and more fat as compared with backs. On the other hand, backs tended to be faster, smaller in physical size, have higher vertical jump height, and show greater relative strength than linemen did. Starters were taller, heavier, stronger, had more powerful, and more fat-free mass than nonstarters. Finally, our results revealed that players in the United States were superior to players in Japan in all body status comparisons (p < 0.01). This study revealed that performance and superior body composition are essential for the success of a football player. Power and strength seem to be key factors in defining good football performance.     

THE HIGH SCHOOL FOOTBALL TEAM PHYSICIAN

Mutual confidence is necessary between the football coach and the team physician. The physician''s decision in the matter of a boy''s condition must always be final. The coach should also consider the physician''s advice in shaping his psychological appeals to the players in before-game and between-halves talks. The physician should be on his way to a man injured on the field as soon as the play is ended. It is up to him and not the trainer or coach to make the diagnosis. The physician must have the ability to make an immediate evaluation of the extent of injury and use appropriate measures to get the player off the field. To see a semi-conscious man with dangling head being half dragged off the field is far worse from the patient''s standpoint and from the spectator''s standpoint than removal by stretcher.     

Shifting public values and what they mean for increasing democracy in wildlife management decisions

Over the last century, changing public attitudes about the value of wildlife have triggered substantial changes in species management that have both benefited and hindered conservation efforts. Understanding and integrating contemporary public values is therefore critical for effective conservation outcomes. Using historic and contemporary examples, we highlight how public attitudes—expressed through the media and campaigns—are shaping the management of introduced and native species, as values shift towards animal welfare and mutualism. We focus on the issue of deliberate human-caused killing of wildlife, because protests against such management have disrupted traditional political and management structures that favoured eradication of wildlife across many jurisdictions and ecological contexts. In doing so, we show that it is essential to work with multiple stakeholder interest groups to ensure that wildlife management is informed by science, while also supported by public values. Achieving this hinges on appropriate science communication to build a better-informed public because management decisions are becoming increasingly democratised.     

Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest

ABSTRACT: Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this first paper we discuss: the target audience(s) for guidelines and their use of guidelines; identifying topics for guidelines; guideline group composition (including consumer involvement) and the processes by which guideline groups function and the important procedural issue of managing conflicts of interest in guideline development.     

Social Workers and General Practice

Weekly case conferences have been found valuable in the management of problem families in a general practice in a new town. These are attended by health visitors, mental welfare and child care officers, welfare officers, and psychiatric social workers, as well as by the family doctors. The conferences are a quick and easy way of exchanging important information and leading to rapid decisions.     

Financial Relationships between Organizations That Produce Clinical Practice Guidelines and the Biomedical Industry: A Cross-Sectional Study

BackgroundFinancial relationships between organizations that produce clinical practice guidelines and biomedical companies are vulnerable to conflicts of interest. We sought to determine whether organizations that produce clinical practice guidelines have financial relationships with biomedical companies and whether there are associations between organizations’ conflict of interest policies and recommendations and disclosures provided in guidelines.ConclusionsFinancial relationships between organizations that produce clinical practice guidelines and biomedical companies are common and infrequently disclosed in guidelines. Our study highlights the need for an effective policy to manage organizational conflicts of interest and disclosure of financial relationships.