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Concept: World Wheelchair and Amputee Games

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Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games.

Concepts: Medicine, Olympic Games, Management, Philosophy of science, Leadership, Paralympic Games, World Wheelchair and Amputee Games, Special Olympics World Games

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SUMMARY Syndromic surveillance is vital for monitoring public health during mass gatherings. The London 2012 Olympic and Paralympic Games represents a major challenge to health protection services and community surveillance. In response to this challenge the Health Protection Agency has developed a new syndromic surveillance system that monitors daily general practitioner out-of-hours and unscheduled care attendances. This new national system will fill a gap identified in the existing general practice-based syndromic surveillance systems by providing surveillance capability of general practice activity during evenings/nights, over weekends and public holidays. The system will complement and supplement the existing tele-health phone line, general practitioner and emergency department syndromic surveillance systems. This new national system will contribute to improving public health reassurance, especially to meet the challenges of the London 2012 Olympic and Paralympic Games.

Concepts: Epidemiology, Olympic Games, London, Summer Olympic Games, Paralympic Games, World Wheelchair and Amputee Games, 2012 Summer Paralympics, Special Olympics World Games

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The laboratory anti-doping services during XXII Winter Olympic and XI Paralympic Games in Sochi in 2014 were provided by a satellite laboratory facility. In total, 2134 urine and 479 blood samples were analyzed during Olympic Games (OG), and 403 urine and 108 blood samples-during Paralympic Games (PG). The number of erythropoietin tests requested in urine was 946 and 166 at the OG and PG, respectively. Several adverse analytical findings have been reported including pseudoephedrine (1), methylhexaneamine (4), trimetazidine (1), dehydrochloromethyltestosterone (1), clostebol (1), and a designer stimulant N-ethyl-1-phenylbutan-2-amine (1.).

Concepts: Olympic Games, Russia, Winter Olympic Games, Summer Olympic Games, Paralympic Games, World Wheelchair and Amputee Games, Special Olympics, 2014 Winter Olympics

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London 2012 is the first Olympic and Paralympic Games to explicitly try and develop socioeconomic legacies for which success indicators are specified - the highest profile of which was to deliver a health legacy by getting two million more people more active by 2012. This editorial highlights how specialists in Sport and Exercise Medicine can contribute towards increasing physical activity participation in the UK, as well as how the National Centre for Sport and Exercise Medicine might be a useful vehicle for delivering an Olympic health legacy. Key challenges are also discussed such as acquisition of funding to support new physical activity initiatives, appropriate allocation of resources, and how to assess the impact of legacy initiatives.

Concepts: United Kingdom, Olympic Games, Weight loss, London, Summer Olympic Games, Paralympic Games, World Wheelchair and Amputee Games, Special Olympics World Games

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Mass gatherings are regarded as potential risks for transmission of infectious diseases, and might compromise the health system of countries in which they are hosted. The evidence for increased transmission of infectious diseases at international sporting mass gatherings that attract many visitors from all over the world is not clear, and the evidence base for public health surveillance, epidemiology, and response at events such as the Olympics is small. However, infectious diseases are a recognised risk, and public health planning is, and should remain, a crucial part of the overall planning of sporting events. In this Series paper, we set out the planning and the surveillance systems that were used to monitor public health risks during the London 2012 Olympic and Paralympic Games in the summer of 2012, and draw attention to the public health issues-infectious diseases and chemical, radiation, and environmental hazards-that arose. Although the absolute risk of health-protection problems, including infectious diseases, at sporting mass gatherings is small, the need for reassurance of the absence of problems is higher than has previously been considered; this could challenge conventional public health surveillance systems. Recognition of the limitations of health-surveillance systems needs to be part of the planning for future sporting events.

Concepts: Medicine, Epidemiology, Cancer, Infectious disease, Olympic Games, Summer Olympic Games, Paralympic Games, World Wheelchair and Amputee Games

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The Summer and Winter Olympic and Paralympic Games are the pinnacle of many athletes' careers, yet few have been fully reported on regarding injury occurrence (Athanasopoulos et al. BJSM 2007;41:603). We collated the evidence on sports injuries at Olympic and Paralympic Games into a complete review to inform medical provision, injury prevention and data collection planning for future multi-sport events. Eight electronic databases were systematically searched for articles fulfilling the following criteria: (i) title regarding any Olympic or Paralympic Games competition or training period, (ii) abstract documenting the frequency, characteristics or causes of sports related injuries that (iii) occurred in participating athletes. Twelve articles met the inclusion criteria. Four included all athletes and injuries at the event investigated. In the 2008 Summer Olympics, 1055 injuries were reported from 9572 athletes, highest proportions in football and commonest location the knee. In the 2010 Winter Olympics, 287 injuries were reported from 2567 athletes, highest proportions in snowboard cross and commonest location the knee. In the 2010 and 2002 Winter Paralympics, injuries were reported from 120 of 505 and 39 of 416 athletes respectively, highest proportions in sledge hockey. Current evidence suggests a similar proportion of injuries in Summer and Winter Olympics, an inconclusive proportion in Winter Paralympics, and a lack of research on Summer Paralympics. Severe injuries occur in training and competition, so adequate medical cover is needed during both. Preventative strategies should be sport-specific as injury causalities vary (Engebretsen et al. BJSM 2010;44:772). To better understand emerging sport specific injury patterns, International Federations could consider collaboration to establish a prospective surveillance system to produce longitudinal evidence from future sporting events (Webborn et al. CJSM 2012;22:3).

Concepts: Olympic Games, Winter Olympic Games, Summer Olympic Games, Paralympic Games, World Wheelchair and Amputee Games, 2010 Winter Paralympics, 2010 Winter Olympics, Multi-sport events

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BACKGROUND: Little information exists on the illness and injury patterns of athletes preparing for the Olympic and Paralympic Games. Among the possible explanations for the current lack of knowledge are the methodological challenges faced in conducting prospective studies of large, heterogeneous groups of athletes, particularly when overuse injuries and illnesses are of concern. OBJECTIVE: To describe a new surveillance method that is capable of recording all types of health problems and to use it to study the illness and injury patterns of Norwegian athletes preparing for the 2012 Olympic and Paralympic Games. METHODS: A total of 142 athletes were monitored over a 40-week period using a weekly online questionnaire on health problems. Team medical personnel were used to classify and diagnose all reported complaints. RESULTS: A total of 617 health problems were registered during the project, including 329 illnesses and 288 injuries. At any given time, 36% of athletes had health problems (95% CI 34% to 38%) and 15% of athletes (95% CI 14% to 16%) had substantial problems, defined as those leading to moderate or severe reductions in sports performance or participation, or time loss. Overuse injuries represented 49% of the total burden of health problems, measured as the cumulative severity score, compared to illness (36%) and acute injuries (13%). CONCLUSIONS: The new method was sensitive and valid in documenting the pattern of acute injuries, overuse injuries and illnesses in a large, heterogeneous group of athletes preparing for the Olympic and Paralympic Games.

Concepts: Health care, Medicine, Epidemiology, Illness, Olympic Games, Paralympic Games, World Wheelchair and Amputee Games, Special Olympics World Games

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[Purpose] This study analyzes awareness and participation behavior in disabled sports and disability understanding after Tokyo’s bid for the 2020 Olympics and Paralympics. [Subjects and Methods] The study conducted a cross survey on 220 registrants of an Internet research firm. It analyzed: the awareness of citizens and their behavioral changes, in the aftermath of the allocation of Olympic and Paralympic Games; subject attributes and education level; recognition of disabled sports; and the awareness and behavior of participants, with regard to disabled sports. The analysis was conducted using SPSS Ver. 21 (IBM). [Results] The subjects were not interested in watching (72.2%), participating (76.8%), or volunteering (71.8%) in disabled sports. In addition, 76.8% of the subjects exhibited no behavioral changes-such as by watching, participating, or volunteering in disabled sports-after the Olympics and Paralympics bid decision. [Conclusion] This study’s subjects had no confidence in their disability knowledge and no opportunities to interact with disabled persons. Furthermore, the bids for mega-events such as the Olympic and Paralympic Games did not lead to behavioral changes concerning disabled sports. Therefore, disability understanding should promote and deepen participation behavior in disabled sports.

Concepts: Olympic Games, Summer Olympic Games, Ancient Olympic Games, Paralympic Games, World Wheelchair and Amputee Games, International Paralympic Committee, Special Olympics, Disabled sports

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In 2020, Japan will host the Tokyo Olympic and Paralympic Games in 2020 (Tokyo 2020) which will involve a large population influx from various countries to Tokyo, the most populated city in Japan. We summarize the potential health risks for visitors to Tokyo 2020, related to communicable disease risks and other health threats, based on recent national and local surveillance reports.

Concepts: Epidemiology, Demography, United Kingdom, Olympic Games, Paralympic Games, World Wheelchair and Amputee Games, Special Olympics World Games, Judo

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This paper summarizes the results obtained from the doping control analyses performed during the Summer XXXI Olympic Games (from 03 to 21 August 2016) and XV Paralympic Games (from 07 to 18 September 2016). The analyses of all doping control samples were performed at the Brazilian Doping Control Laboratory (LBCD), a World Anti-Doping Agency (WADA)-accredited laboratory located in Rio de Janeiro, Brazil. A new facility at Rio de Janeiro Federal University (UFRJ) was built and fully operated by over seven hundred professionals, including Brazilian and international scientists, administrative staff and volunteers. For the Olympic Games, 4,913 samples were analysed. In 29 specimens, the presence of a prohibited substance was confirmed, resulting in adverse analytical findings (AAFs). For the Paralympic Games, 1,687 samples were analysed, twelve of which were reported as AAFs. For both events, 82.8% of the samples were urine, and 17.2% were blood samples. In total, more than thirty-one thousand analytical procedures were conducted. New WADA technical documents were fully implemented; consequently, state-of-the-art analytical toxicology instrumentation and strategies were applied during the Games, including different types of mass spectrometry (MS) analysers, peptide and protein detection strategies, endogenous steroid profile measurements and blood analysis. This enormous investment yielded one of the largest Olympic legacies in Brazil and South America.

Concepts: United States, Olympic Games, Rio de Janeiro, Summer Olympic Games, 2016 Summer Olympics, Paralympic Games, World Wheelchair and Amputee Games, World Anti-Doping Agency