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Objective: To provide certified athletic trainers, physicians, and other health care professionals with recommendations on best practices for the prevention of overuse sports injuries in pediatric athletes (aged 6-18 years).Background: Participation in sports by the pediatric population has grown tremendously over the years. Although the health benefits of participation in competitive and recreational athletic events are numerous, one adverse consequence is sport-related injury. Overuse or repetitive trauma injuries represent approximately 50% of all pediatric sport-related injuries. It is speculated that more than half of these injuries may be preventable with simple approaches.Recommendations: Recommendations are provided based on current evidence regarding pediatric injury surveillance, identification of risk factors for injury, preparticipation physical examinations, proper supervision and education (coaching and medical), sport alterations, training and conditioning programs, and delayed specialization.

BackgroundScreening, Brief Intervention and Referral to Treatment (SBIRT) is a public health framework approach used to identify and deliver services to those at risk for substance-use disorders, depression, and other mental health conditions. Primary care is the first entry to the healthcare system for many patients, and SBIRT offers potential to identify these patients early and assist in their treatment. There is a need for pragmatic “best practices” for implementing SBIRT in primary care offices geared toward frontline providers and office staff.MethodsTen primary care practices were awarded small community grants to implement an SBIRT program in their location. Each practice chose the conditions for which they would screen, the screening tools, and how they would provide brief intervention and referral to treatment within their setting. An evaluation team communicated with each practice throughout the process, collecting quantitative and qualitative data regarding facilitators and barriers to SBIRT success. Using the editing method, the qualitative data were analyzed and key strategies for success are detailed for implementing SBIRT in primary care.ResultsThe SBIRT program practices included primary care offices, federally qualified health centers, school-based health centers, and a safety-net emergency department. Conditions screened for included alcohol abuse, drug abuse, depression, anxiety, child safety, and tobacco use. Across practices, 49,964 patients were eligible for screening and 36,394 pre-screens and 21,635 full screens were completed. From the qualitative data, eight best practices for primary care SBIRT are described: Have a practice champion; Utilize an interprofessional team; Define and communicate the details of each SBIRT step; Develop relationships with referral partners; Institute ongoing SBIRT training; Align SBIRT with the primary care office flow; Consider using a pre-screening instrument, when available; and Integrate SBIRT into the electronic health record.Conclusions and implicationsSBIRT is an effective tool that can empower primary care providers to identify and treat patients with substance use and mental health problems before costly symptoms emerge. Using the pragmatic best practices we describe, primary care providers may improve their ability to successfully create, implement, and sustain SBIRT in their practices.

Abstract-More than 1.2 million percutaneous coronary interventions are performed annually in the United States, with only an estimated 33% performed in women, despite the established benefits of percutaneous coronary intervention and adjunctive pharmacotherapy in reducing fatal and nonfatal ischemic complications in acute myocardial infarction and high-risk acute coronary syndromes. This statement reviews sex-specific data on the safety and efficacy of contemporary interventional therapies in women. 1 Despite the fact that more women than men die from cardiovascular disease in the United States, and despite the established benefits of PCI in reducing fatal and nonfatal ischemic complications in patients with acute myocardial infarction and high-risk acute coronary syndromes, only an estimated 33% of annual PCIs are performed in women. [1][2][3][4] In addition, women experience greater delays 5 to intervention and are referred for diagnostic catheterization less frequently than are men. 6 -8 Although suggested reasons for referral differences have included women's older age at presentation, greater risk profile, and increased risk for an adverse procedural outcome, as well as differences in symptoms and pain perception between men and women and lower predictive accuracy of noninvasive testing in women, some evidence suggests a potential sex and race bias. 9 In contrast, once women are referred for cardiac catheterization, revascularization rates and practices are similar to those in men. 10 -12 Recent advances in angioplasty equipment and technique have improved options for patients with smaller coronary and peripheral (access) arteries. In addition, the increased use of stents and adjunctive pharmacotherapy has improved outcomes in both women and men. Nevertheless, women continue to represent 15% to 38% of the population in studies of PCI, and still relatively few sex-or race-specific data exist.The purpose of this statement is to review what is known and not known about PCI in women and to put published data in context with contemporary coronary intervention. It is not the intention of the writing group to give specific treatment recommendations but rather to compile and collate the available sex-specific data on the safety and efficacy of interventional therapies in women. Tables 1 and 3 provide summaries of the findings in women drawn from this literature review, as well as recommendations from previously published American College of Cardiology/American Heart Association (ACC/AHA) guidelines. MethodsThe information in this statement was compiled by systematic literature review. By searching MEDLINE from JanuaryThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perc...

The NCDR provides a unique opportunity to understand the characteristics of large populations of patients with CVD, the centers that provide their care, quality of care provided, and important patient outcomes.