Celina de Borja’s research while affiliated with UCSF University of California, San Francisco and other places

Background The COVID-19 pandemic limited in-person recruitment opportunities for many training programs at academic medical centers. This study aimed to determine the prevalence of social media use among Primary Care Sports Medicine (PCSM) fellowship programs and to investigate the impact of social media on recruitment. Additionally, potential barriers to social media interaction between programs and applicants were examined. Methods A cross-sectional study was conducted using publicly available online sources to identify PCSM fellowship programs and corresponding social media accounts. PCSM Fellowship directors were surveyed regarding their program's use of social media. Prospective PCSM Fellowship Applicants and current fellows were surveyed to determine their interaction with PCSM fellowship social media accounts and how social media influenced their perception of the programs. Results A total of 211 PCSM fellowship programs were identified on the American Medical Society for Sports Medicine (AMSSM) website, of which 83% had a social media presence. The most commonly used platforms were Instagram (43%), Facebook (30%) and Twitter (24%). Among the surveyed fellows and applicants, 95% reported using social media, with 35% reported following PCSM accounts. Of those who did not follow, the most common reason was lack of awareness of these accounts. 22% of respondents indicated that social media positively influenced their perception of a program and its rank list position, while the remainder reported a neutral effect. 47% of the fellowship directors reported their program did not have official guidelines for appropriate social media use. Lack of time, resources, and oversight were identified as the most common barriers to social media use. Conclusions A majority of PCSM fellowship programs, fellows, and applicants are present on social media. Social media presence can positively impact an applicant’s view of a program. However, applicants’ lack of awareness of these accounts may serve as a barrier for interaction. The development of universal guidelines for appropriate social media use may help increase adoption and utilization of social media platforms for PCSM fellowship recruitment, particularly during times when in-person recruitment opportunities are limited.

Purpose of Review To discuss the use of ultrasound for diagnosis and management of common pediatric musculoskeletal conditions through a case-based approach. Recent Findings Ultrasound is an essential diagnostic modality in the early detection of developmental dysplasia of the hips and can be used as early as 6 weeks of age when the ossific nucleus has not developed yet. Ultrasound is helpful in diagnosing traumatic injuries such as fractures and intramuscular hematomas, can visualize fracture healing at early stages, and can also be used to guide aspiration of hematomas that can help with decreasing pain and faster recovery. Ultrasound is superior to radiographs in evaluating joint effusions and soft tissue infections or masses and is better tolerated by children compared to other imaging modalities such as magnetic resonance imaging (MRI). Summary Ultrasound is an easily accessible, affordable, non-invasive, and radiation-free imaging modality that is well tolerated by children and their families. It can aid in the diagnosis and management of a wide variety of musculoskeletal conditions including developmental, traumatic, and infectious etiologies, as well as in the evaluation of superficial soft tissue masses.

Purpose of Review The aim of this study is to review the most recent literature on common upper extremity injuries in pediatric athletes and discuss their diagnosis, management, and outcomes. We also highlight ultrasound as a tool in their evaluation. Recent Findings Shoulder conditions presented include little league shoulder, glenohumeral rotation deficit, acute traumatic shoulder dislocation, and multidirectional shoulder instability. Elbow conditions include capitellar OCD, medial epicondyle avulsion fracture, and medial epicondylitis. We also review scaphoid fractures and gymnast wrist. Not all physeal injuries lead to long-term growth disruption. Ultrasound has been shown to be useful in the diagnosis of scaphoid fracture, medial epicondyle avulsion fractures, and capitellar OCD. It can also be helpful in assessing risk for shoulder and elbow injuries in overhead athletes. Summary There is a rising burden of upper extremity injuries among pediatric athletes. Knowledge of their sport specific mechanics can be helpful in diagnosis. As long-term outcome data become available for these conditions, it is clear, proper diagnosis and management are critical to preventing adverse outcomes. We highlight many of these injuries, best practice in care, and controversies in care in hopes of improving outcomes and preventing injury for pediatric athletes.

Purpose of Review The exponential growth of women participating in competitive sports throughout the years was made possible through several initiatives by the International Olympic Committee and the passage and implementation of Title IX as a federal law in the United States. However, this positive trend towards gender equity in sports has not transpired for women in medicine, especially in fields that care for elite athletes. This current review will discuss specific areas that can be tailored to help female athletes prevent injuries and optimize their athletic performance. We will also highlight how increased female team physician representation in sports may help optimize care for female athletes. Recent Findings Female athletes are considered high risk for certain conditions such as ACL tears, patellofemoral pain syndrome, bone stress injuries, sport-related concussions, and sexual violence in sport. Addressing factors specific to female athletes has been found to be valuable in preventing injuries. Strength and conditioning can optimize athletic performance but remains underutilized among female athletes. Although diversity in healthcare workforce has been found to be beneficial for multiple reasons, women remain underrepresented in sports medicine. Increasing female team physician representation may positively impact care for female athletes. Summary Team physicians must understand the physiologic, biomechanical, and anatomic factors that are unique to female athletes in order to tailor injury prevention programs and optimize their athletic performance. Advocating for gender equity in sports medicine to advance representation of women in the field will increase workforce diversity and promote excellence in sports medicine care.

Objectives: To characterize Primary Care Sports Medicine (PCSM) fellowship opportunities for Pediatrics-trained physicians across all programs in the United States. Methods: Cross-sectional study using data from publicly-available online sources. Data were collected from the Association of American Medical Colleges (AAMC) and American Medical Society for Sports Medicine (AMSSM) online listings of PCSM programs and cross-referenced with individual program websites. Variables such as program location, departmental sponsor, and eligibility criteria specific to pediatricians were collected. Results: 202 programs were identified. 196 (97.0%) were ACGME-accredited, of which 75.0% were sponsored by Family Medicine (FM), 9.7% by Physical Medicine and Rehabilitation (PMR), 9.2% by Pediatrics, and 5.1% by Emergency Medicine (EM) departments. Pediatrics-trained physicians were eligible for 133 of 196 (67.9%) programs and 241 of 350 (68.9%) total positions. Eligibility for pediatricians was highest in Pediatrics-sponsored programs (18/18, 100.0%), followed by EM (7/10, 70.0%), FM (98/147, 66.7%), and PMR (9/19, 47.4%). 49 of 133 (36.8%) programs accepting pediatricians had discrepancies regarding eligibility criteria (e.g. did not confirm eligibility criteria on their website, listed conflicting eligibility criteria within or between their website and AMSSM listing, or did not have a website available to cross-reference). Conclusions: Pediatricians are eligible for more than two-thirds of PCSM fellowship programs across the United States, including programs that are not sponsored by Pediatrics departments. Applicants may not be aware of these opportunities given discrepancies regarding eligibility in over one-third of programs. In a field underrepresented by Pediatrics-trained physicians, accurate online information and transparency of eligibility criteria are critical to raise awareness about fellowship opportunities and foster equity with regards to career opportunities for pediatricians in PCSM.

Background To determine if following specific diets was associated with reporting behaviors that are consistent with disordered eating compared to non-diet-adherent athletes. We hypothesized that athletes adhering to specific diets were more likely to report disordered eating than those not following a diet. Methods One thousand female athletes (15–30 years) completed a comprehensive survey about athletic health and wellness. Athletes were asked to specify their diet and completed 3 eating disorder screening tools: the Brief Eating Disorder in Athletes Questionnaire, the Eating Disorder Screen for Primary Care, and self-reported current or past history of eating disorder or disordered eating. Descriptive statistics were calculated for all study measures and chi-squared tests assessed relationships between athletes’ dietary practices and their responses to eating disorder screening tools. Statistical significance was defined as p < 0.05. Results Two hundred thirty-four of 1000 female athletes reported adherence to specific diets. 69 of the 234 diet-adhering athletes (29.5%) were excluded due to medically-indicated dietary practices or vague dietary descriptions. Of the 165 diet-adherent athletes, 113 (68.5%) screened positively to ≥1 of the 3 eating disorder screening tools. Specifically, athletes practicing a low-carbohydrate diet were more likely to report disordered eating vs. athletes without dietary restrictions (80% vs. 41.8%; p < 0.0001). Conclusion Specific diet adherence in female athletes may be associated with reporting behaviors that are consistent with disordered eating. Health practitioners should consider further questioning of athletes reporting specific diet adherence in order to enhance nutritional knowledge and help treat and prevent eating disorders or disordered eating.

BACKGROUND: To determine if following specific diets was associated with responding positively to eating disorder/disordered eating (ED/DE) screening tools compared to non-diet-adherent athletes. We hypothesized that athletes adhering to specific diets were more likely to respond positively on ED/DE screening tools than those not following a diet. METHODS: 1000 female athletes (15-30 y) completed a comprehensive survey about athletic health and wellness. Athletes were asked to specify their diet and completed 3 ED/DE screening tools: the Brief Eating Disorder in Athletes Questionnaire, the Eating Disorder Screen for Primary Care, and self-reported current or past history of ED/DE. Descriptive statistics were calculated for all study measures and chi-squared tests assessed relationships between athletes’ dietary practices and their responses to ED/DE screening tools. Statistical significance was defined as p<0.05. RESULTS: 234 of 1000 female athletes reported adherence to specific diets. 69 of the 234 diet-adhering athletes (29.5%) were excluded due to medically-indicated dietary practices or vague dietary descriptions. Of the 165 diet-adherent athletes, 122 (67.9%) responded positively to ≥1 of the 3 ED/DE screening tools. Athletes practicing vegetarian, vegan, low-carbohydrate, low-dairy, or ≥2 diets were more likely to respond positively to ≥1 ED/DE screening tool vs. athletes without dietary restrictions (70.0%, 77.8%, 79.5%, 60.0%, and 65.6%, respectively vs. 41.8%; p≤0.048). CONCLUSION: Specific diet adherence in female athletes is associated with positive responses to ED/DE screening tools. Health practitioners should consider further ED/DE questioning of athletes reporting specific diet adherence in order to enhance nutritional knowledge and help treat and prevent ED/DE.