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Introduction: In this study, we aim to determine the risk of bleeding or thrombosis with concurrent use of tyrosine kinase inhibitors (TKIs) used to treat CML, and serotonin reuptake inhibitors (SSRIs). Methods: We conducted a retrospective cohort study of patients with CP-CML cared for at Massachusetts General Hospital (MGH) between April 2016 to February 2021. Participants were included if diagnosed with CP-CML and began TKI treatment (imatinib, dasatinib, nilotinib, bosutinib, or ponatinib) after April 2016. Results: One hundred patients were evaluated, eighty of whom were taking TKIs only (median age 55, 40% female), and twenty were taking TKI and SSRI concomitantly (median age 53.5, 55% female). Baseline demographics between these groups were similar across all variables. Patients in the TKI only group had 9 bleeding events and 3 thrombotic events. Patients in the combination group had 6 bleeding events and 1 thrombotic event. There was no difference between overall rates of major bleeding (4% v. 10%, p = 0.26) or thrombotic events (4% v. 5%, p = 1). However, patients in the combination group were more likely to have major intracranial bleeding events (0% v. 10%, p = 0.04), and there was a trend to significance for minor bleeding events (7.5% v. 20%, p = 0.11). Conclusions: Concomitant use of TKIs and SSRIs does not appear to increase the total risk of bleeding or thrombotic events compared to patients on TKIs only. However, concomitant use of TKIs and SSRIs may increase risk of intracranial bleeding. Further work is needed to fully assess this risk. [ABSTRACT FROM AUTHOR]

Study Design.: Cross-sectional survey study. Objective.: The aim was to determine if health literacy level is associated with patient-reported outcomes and self-reported health status among patients presenting to an academic outpatient spine center. Summary of Background Data.: Patient reports are critical to assessing symptom severity and treatment success in orthopedic spine patients. Patient-reported outcome measures (PROMs) are important instruments commonly used for this purpose. However, the influence of patient health literacy on PROMs has not yet been given much consideration in spine literature. Materials and Methods.: Consecutive English-speaking patients over the age of 18 years and new to our clinic verbally completed the Newest Vital Sign health literacy assessment tool and a sociodemographic survey, including self-reported health status. In addition, seven Patient-Reported Outcomes Measurement Information System scores were extracted from patient records. Regression modeling was performed with PROMs considered as dependent variables, health literacy level as the primary predictor, and all other factors (age, sex, race, ethnicity, native English speaker, highest educational degree, grade-level reading, marital status, employment status, annual household income, and type of insurance) as covariates. Results.: Among the 318 included patients, 33% had limited health literacy. Adjusted regression analysis demonstrated that patients with limited health literacy had worse PROM scores across all seven domains (Physical Function: P =0.028; Depression: P =0.035; Global Health—Physical: P =0.001; Global Health—Mental: P =0.007; Pain Interference: P =0.036; Pain Intensity: P =0.002; Anxiety: P =0.047). In addition, patients with limited health literacy reported worse self-reported health status (P <0.001). Conclusions.: Spine patients with limited health literacy have worse baseline PROM scores confounders and report worse general health. Further investigations are necessary to elucidate if limited health literacy is a marker or the root cause of these disparities. Findings from this study urge the consideration of patient health literacy when interpreting PROMs as well as the implications for patient assessment and discussion of treatment options. [ABSTRACT FROM AUTHOR]

Background: Limited health literacy has been associated with adverse health outcomes. Undergoing orthopedic surgery often requires patients to make complex decisions and adhere to complicated instructions, suggesting that health literacy skills might have a profound impact on orthopedic surgery outcomes. Purpose: We sought to review the literature for studies investigating the level of health literacy in patients undergoing orthopedic surgery and also to assess how those studies report factors affecting health equity. Methods: We conducted a systematic search of PubMed, Embase, and Cochrane Library for all health literacy studies published in the orthopedic surgery literature up to February 8, 2022. Search terms included synonyms for health literacy and for all orthopedic surgery subspecialties. Two reviewers independently extracted study data in addition to indicators of equity reporting using the PROGRESS+ checklist (Place of Residence, Race/Ethnicity, Occupation, Gender/sex, Religion, Education, Social capital, Socioeconomic status, plus age, disability, and sexual orientation). Results: The search resulted in 616 studies; 9 studies remained after exclusion criteria were applied. Most studies were of arthroplasty (4/9; 44%) or trauma (3/9; 33%) patients. Validated health literacy assessments were used in 4 of the included studies, and only 3 studies reported the rate of limited health literacy in the patients studied, which ranged between 34% and 38.5%. At least one PROGRESS+ item was reported in 88% (8/9) of the studies. Conclusions: We found a paucity of appropriately designed studies that used validated measures of health literacy in the field of orthopedic surgery. The potential impact of health literacy on orthopedic patients and their outcomes has yet to be elucidated. Thoughtful, high-quality trials across diverse demographics and geographies are warranted. [ABSTRACT FROM AUTHOR]

Sport coaching policies in Europe lack a guiding framework, and there is limited knowledge about good practices within those policies. This lack of guidance stands in stark contrast to the growing role and importance, from both a practical and a policy perspective, that coaches play in Europe. It is against this background that the Policy, Evidence, and Knowledge in Coaching (PEAK) project was initiated to strengthen the policy foundations of sports coaching in Europe. To do so, the Policy, Evidence, and Knowledge in Coaching project aimed to develop coaching policy recommendations for national authorities and sport federations on the European continent. In the following, we present the main policy recommendations for national authorities as well as the extensive process that led to the formulation of those recommendations. Based on this work, nine recommendations featuring a total of 61 indicators were developed. Overall, we contend that the policy foundation for an effective coaching system includes clarity on who the policies are for, how the results of the policy will be measured, the education, regulation, and support of the workforce, and addressing the inclusion of underrepresented groups. [ABSTRACT FROM AUTHOR]

The contribution that sport coaches make to society has received growing recognition among policy-makers over the last decade. Sport coaching is no longer only associated with professional and Olympic sport, trophies, and medals, and it is regularly proposed as an activity that contributes to the development of individuals, communities, and societies. Unfortunately, sport coaching has also been associated with negative outcomes, such as institutionalized doping, abuse of athletes, and match fixing. The level of scrutiny and expectations on coaches are higher than ever, and, therefore, more and more countries and sport organizations are examining how coaches are currently recruited, educated, developed, supported, employed, represented, and recognized. In the current landscape, the need to review the existing International Council for Coaching Excellence position statement on "Sport Coaching as a Profession," written in 2011, is paramount. The 2021 position statement takes into account policy, practice, and research developments over the last decade to propose a way forward for sport coaching over the next 10 years. [ABSTRACT FROM AUTHOR]

Sport coaching is at a pivotal moment in its short history. The publication of the International Sport Coaching Framework by the International Council for Coaching Excellence (ICCE) in 2013 has drawn attention to coaching world-wide and fostered a step change in the way coaching systems are understood and built. Within this evolving context, higher education institutions are increasingly playing a greater role in the education and development of coaches in many countries. One way in which they are doing so is through the delivery of partial or full sport coaching degrees. ICCE recognises this emerging landscape. In this article we present an introduction to the newly developed International Sport Coaching Bachelor Degree Standards. The Standards are the culmination of a 12-month process of cooperation and consultation between an expert group and the coaching community at large. They aim to respond to the needs of higher education institutions and serve as an internationally accepted reference point to aid the development of bachelor coaching degrees that prepare coaches to effectively support athletes and participants. [ABSTRACT FROM AUTHOR]

The strategy of the International Council for Coach Education (ICCE) has placed the development of sport coaching as a profession at the core of the mission of the organisation. The authors examine the basis for this aspiration against criteria associated with established professions, taking into account the unique features of sport coaching. It is concluded that, at a global level, sport coaching does not meet a number of the traditional hallmarks of a profession, primarily due to its current position on key descriptors such as purpose, knowledge base, organisation and ethics. In addition, the lack of fit of traditional 'right to practice' provisions within the established professions is identified as problematic. Sport coaching status categories include volunteer coach, professional coach, and the preparatory category of pre-coach. It is suggested that sport coaching should define its future identity as a blended professional area, operating within the wider field [ABSTRACT FROM AUTHOR]