Sports Admin Chapter 7-10 Set

4 use valid and reliable methods

Must be able to provide and proof that a positive result is associated with a particular athletes samples through carefully documented chain of custody and the selected laboratory must come for all positive results with GC-MS or LC/MS/MS technology

false positive

Test says yes when it really is n

3. Nonmaleficence

commitment to avoid doing bad things to do no harm.

4. professional collaboration

cooperation with each other and deserved an imperative for those working within the healthcare delivery system

Breach of Confidentiality exceptions

* A professional should recognize the difference between a reason and an excuse and should accept a reason as an excuse only when it is both unavoidable and justifiable . These reasons would be considered excusable but any other reasons would be inexcusable 1. When the client is in clear and immediate Danger period 2. when other persons are in clear or immediate Danger . 3. when legal requirements demand the release of confidential information

When NOT to do the PPE

- Not ideal would be to perform the service on the day that the athletes return to their first team organized practice this coincides with reviewing compliance-related issues issue in sports equipment and holding the first practice all within the same day . the benefit of this timing is that all of the activities are managed within a well-organized compact time. But can later challenges for the sports medicine team . findings of concern will need to have additional review and possibly more scheduling and follow-up monitoring to Grant clearance for participation . deficiencies identified at this time would not benefit from a period of Rehabilitation before the start of actual practice as they would if the PPE was performed six to eight weeks in advance . - the greatest concern is that of the "carte blanche" attitude that a coaching staff may take towards the PPE if it is performed just prior to the first practice because the coaching staff is likely excited to see the athletes perform on their first day of practice after being away for a long time and any delay in this opportunity could lead to disappointment or rational bargaining and adverse behaviour towards the medical staff

Code of Ethics Organizations

- The national athletic trainers Association guides the action of every member of this Association in the practice of athletic training . there are four general principles with each sub statement; a breach of these principles could result in suspension or revocation of certification - athletic trainers with dual credentialing as physical therapist must also adhere to the American Physical Therapy Association code of ethics -Necessary to build public Trust which is based on altruism, respect, honesty, Integrity, Duty, honor, excellence, and accountability - the people who have challenges with these codes are people with dual certifications and credentials when in these circumstances they may find that organizations are at odds with each other - Professional organizations focus on supporting endorsing and protecting their professional members so they don't really like professionals who have dual memberships - various practice domains for athletic trainers to examine ethical codes of other disciplines to make sure they do not stray away from accepted practices in his discipline ... for example an AT provides counseling to a student would have to follow the American Counseling Association code of ethics

6 options for determining medical qualification to participate

1 Passed, the athlete is cleared for participation in all sports with no reservations or contradictions 2 Passed with conditions, the athlete has a medical condition that requires follow-up and they may participate in some activities but resume for activity pending satisfactory follow up 3 Passed with reservations, the athlete may not participate in contact or Collision Sports 4. Failed with reservations, the athlete is not cleared for his or her requested sport, but other sports may be considered however contact or Collision is not allowed 5 Failed with conditions, the athlete must be reevaluated for participation after the medical condition is addressed and resolved 6 Failed, may not participate in any sport at any level of competition

Proceeding with caution

1 develop written policies and procedures 2 clearly articulate the purpose of the program 3 make testing a sport specific as possible 4 use valid and reliable methods 5 incorporate and appeal mechanism 6 protect the athletes privacy 7 obtain consent 8 inform potential athletes 9 inform current athletes 10 train and retrain personnel

Where and How a PPE should be conducted (13 Steps)

1 what kind of information do we need to get from the PPEs 2 how many people will be able to recruit to help conduct the PPEs 3 how many people we recruit will be trained medical personnel with an interest and experience and sports Health Care 4 what options do we have in terms of physical facilities for the PPEs 5 do the facilities to which we have access have adequate Provisions for privacy 6 how much time do we have for conducting PPEs 7 What expenses will be incurred 8 will the people conducting the PPEs be volunteers or will they expect to be paid 9 will that individuals performing the physical exams require background checks according to state laws 10 how many athletes will need to be serviced 11 what are the characteristics of the athletes to be screened? adults children male or female ? 12 do the planned dates conflict with any holidays or major local school related or other events 13 do the facilities have ample parking as large numbers of participants are expected

Principles for Forming Guidelines

1. Autonomy 2. Beneficence 3. Nonmaleficence 4. Fidelity 5. Veracity 6. Justice

Community based characteristics of a professional

1. Be a community of practitioners who simultaneously work for themselves customers and peers . 2. help patients and clients who are individuals making their own personal choices 3. serve private and personal needs of customers seeking wholeness . 4. work as agents on behalf of customers instead of transacting services 5. function in a relationship of trust

WHY Drug testing should be performed

1. means of promoting order and discipline on an athletic team 2 a way to prevent or discourage potentially illegal activity 3 employment programs as a deterrent to unfair competitive performance 4 a means of helping those with chemical addictions come to grips with their problems

The Time for PPEs

6-8 weeks before athletes intend to begin vigorous training for their sport . This allows time for remediation of most problems that the people are likely to detect . Most colleges conduct he peed one season before athletes intend to participate and their sport

Tavistock group

A group of interdisciplinary Health Care Providers consisting of Physicians nurses Healthcare administrators academics ethists lawyers economists and philosophers met to develop ethical principles that might be useful for all individuals involved in the healthcare deliveries .

Predictability of Tests

A majority of the screen activities normally undertaken during the PPE are relatively weak and insensitive predictors of athletic injury . The orthopedic exam is a poor predictor of future athletic injury if they are testing someone with no previous history . Someone with a previous Orthopedic condition should continue to have screenings and test for their musculoskeletal status . Only about 14% of findings associated with a physical exam will require follow-up prior to clearance of the athlete for participation . The athletic trainer should ask How likely is this test uncover a problem? For each element of the PPE example: an echocardiography and a 12-lead electrocardiogram will not detect many problems and is expensive to use

Medical Ethics

A moral philosophy that helps practitioners and others discern if and under what circumstances various Health Care practices are right or wrong period for doctors the foundation for ethical practice has been established by the Hippocratic Oath - This goes beyond the relationship between a single practitioner and a patient. All Healthcare professionals must work together .

Physician's examination

A physician should examine every athlete during the course of the PPE and in Most states the athlete is not considered to have undergone a PPE unless a physician examine them and verified in writing that they are fit to participate . The major components of this exam include General review of systems including examination of the head Eyes Ears Nose Throat chest and abdomen and genitalia it should also include a general cardiac screening including standing and supine precordial auscultation, brachial blood pressure in the sitting position, palpation of the femoral artery pulses, and screening for the physical Stigmata of Marfan syndrome . this helps in prevention of sudden cardiac death . Some physicans recommend maturational assessment including Tanner staging for Junior and senior high school athletes

2. Compliance with Association Rules

All School in college based athletic programs are subject to the rules of the athletic associations to which they voluntarily choose to be members . High School it is the national Federation of State High School Athletic Association which differs PPE to State associations and the states very. the national Collegiate Athletic Association also publishes guidelines for the PPE and instruct its member colleges to provide every student with a comprehensive PPE with cardiovascular screening upon entry to the program as well as histories and blood pressure screening

10 train and retrain personnel

All athletes with the potential to be tested should be informed in writing of the purposes of the program the procedures for selection and testing and the sanctions associated with positive test and the appeal procedures and of the risk that information regarding positive tests may be accessible to third parties through legal means

9 inform current athletes

All athletes with the potential to be tested should be informed in writing of the purposes of the program the procedures for selection and testing and the sanctions associated with positive test and the appeal procedures and of the risk that information regarding positive tests may be accessible to third parties through legal means

Reasonable Suspicion

Also known as reasonable cause or probable cause is based on specific signs of drug use in an individual . these signs are associated with observed Behavior abnormalities that may or may not be related to the athletes participation in sport. For example it's an athlete has serious games in muscle mass or other signs of anabolic steroid use this is related to an athlete's participation in a sport and they can be asked to submit a drug testing after being involved in a traffic accident in which they are under the influence of drugs an incident on related to the athletes involvement . you should be cautious about this because what is reasonable to one person isn't to another and suspicious behaviour should be documented with more than one person observing on more than one occasion period behaviors or qualities that are measurable with an increase in size and strength or a drop in grade point average are useful in defending the reasonableness of Suspicion . individuals can be tested without notice based on reasonable suspicion but it should be based on factual information ***A policy should allow for reasonable suspicion testing within an organization and should clearly identify how information is gathered how old is act upon and he will be made aware of the testing prior to its Administration

What Should be evaluated during the PPE

Athlete's age and level of competition, sport, follow up, predictability of test

7 obtain consent

Athletes cannot be tested for drugs against their will . the document or consent that the sign should include a detailed description of the drug testing process and sanctions associated with positive test

Random selection of subjects by sport

Athletes might be able to entirely avoid being tested during their college careers if their teens are never chosen never participate in NCAA postseason championships

4. Compliance with Standards of Practice

Athletic in medical communities understand and accept the requirement to provide PPE that at least meet minimum standards even though this is not in federal or state statues and failure to provide these is a gross violation of the standards of practice for anyone charged with safeguarding the health of athletes . no fewer than six national standards not including State associations have been published and some organizations endorse or provide standards for the administration of pee pees such as

In house testing

Catabolic and anabolic universities in Lawrence athletic programs engage in year-round testing as a way to discourage offseason drug use. In high school these may be state-mandated programs design to stop performance enhancing and street drug use however these are expensive programs and require a lot of organization and bookkeeping . It's even more of a problem if my nerves are being tested because the parent could not be consented to allow the child to be tested

Professionalism

Change according to age experience level educational Rank and gender. 1. clinician patient relationship involving trust and confidence . 2. Collegial relationships involving other Healthcare professionals including professional growth 3. attire and hygiene including personal intangibles such as punctuality, adhering to commitments, understanding role limitations - one of the 6 core competencies for the Accreditation Council for graduate medical education and the American Board of Medical Specialties - For PTs: self-presentation, accountability, integrity, values

1 develop written policies and procedures

Codify the process in a written document that describes every step the program this is described in the NCAA drug testing Program 2009 210 booklet and as a useful template for institutions that wish to implement their own programs

6. Justice

Concept that all patients should be treated fairly without regard to race religion or so on

Legal Considerations

Consent & waiver of liability

HOW Drug testing should be conducted

Consent, Selection of subjects, reasonable suspicion, Drug testing methods, specimen handling and chain of custody, testing the sample, reporting the results

Post Championship testing

Drug testing is performed after an NCAA championship event . the athletes are randomly selected to be tested or be selected based on position of finish airplane position or playing time period for testing at non Championship events like postseason football bowl games financial aid status can be the basis for athlete selection

EMIT

Enzyme multiplied immunoassay technique is a method that uses light absorption to establish the level of the drug and a subject steering. The amount of light absorption is compared to Norms for a variety of drugs commonly tested for an athletic settings . It's inexpensive but can produce a high percentage of false positive test This test is not sensitive to the presence of anabolic steroids.

Random selection of subjects by financial aid status

Especially with NCAA division 1 Sports these subjects are drawn from the pool of athletes on athletic scholarship . Non-scholarship athletes are often eliminated from the pool

law

Ethical considerations overlap with some issues of the law and an athletic trainer must recognize that some situations that are ethical might not be a legal and what is legal might not be ethical . - difficult for those consider issues confidentiality and protection of individual rights to privacy - professional codes of Ethics usually dictate that it is unethical to engage in any practice activity that is illegal

ethics

Ethics is the study of the standards and principles that dictate right conduct among members of a society - based on moral values . - In business ethics it provides a perspective from which to judge the rightness or wrongness of a professional action and they are a reflection of the conscience

2 clearly articulate the purpose of the program

Everyone associated with a drug testing program must understand their purpose if not it can be easily manipulated and turned into something that its creators never intended it to be

GC-MS

Gas chromatography-mass spectrometry is more expensive but is regarded as the gold standard in urinalysis . It is a method of choice for determining the presence of anabolic steroids in urine . It works by separating the compounds found in the urine and developing fingerprints for each compound then they can be compared to those of known drugs . This is a sensitive method butt athletes can beat the system by using designer drugs for which no reference fingerprints are available

Common Elements of PPE

Health history, Physicians examination, Orthopedic examination, special medical test, physical fitness testing

1. a human right

Healthcare is a human right .

Hippocratic Oath

I swear to fulfill, to the best of my ability and judgment, this covenant: I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

5 incorporate and appeal mechanism

If Athletes have a property interest in retaining their athletic scholarship eligibility or position on a professional team then they must have access to Due Process before they can be sanctioned . All athletes to test positive should be allowed to appeal the results

Testing the Sample

Immunoassay kits that athletic trainers could use to test urine should actually not be used because of the potential loss of athletic eligibility and its Associated social and financial consequences a reliable disinterested third party should test the samples. Organizations should contract with a lab experience and drug testing for every part of their drug-testing program including subject selection specimen collection sample testing and results reporting . The NCAA recommends that the contract only the labs that can provide information on false positives and false-negative rates for the specific test . Also federally certified labs are recommended

6. Safety

Initially there's anxiety over "Do no harm" because it is associated with doctors, but this principle seems important to include because there is increasing recognition of just how much harm Healthcare Systems produce and of how policies with benign intentions can create harm

2. Beneficence

Limit to do good to try to do the best for each patient

LC/MS/MS

Liquid chromatography-mass spectrometry mass spectrometry is more sensitive because a test at lower thresholds and can capture designer drugs

breach of confidentiality

One of the most frequently occurring ethical situations . 1. an athletic trainer often needs to share information with the team coaches and other colleagues who are responsible for some aspect of the athletes care - those needs conflict with what is the best interest of the athlete and the responsibilities that the athletic trainer has for their health care 2. Many people are often in the care of an athlete or other Physically Active patient . student and intern practitioners might not be fully aware of concerns for confidentiality . Athletic trainers responsible for the supervision of students and interns will also be held responsible for a student or interactions and they will become the primary party in a breach of confidentiality even if they weren't the immediate perpetrator 3. High profile of athletes and of the athletic industry and our society . The press and public desire pressures the athletic trainer . the athletic trainer should take proactive and diligent measures to protect information and communication

Why Establish Professional Standards

One of the most important of these characteristics is a commitment to high standards of ethical Behavior by the members of the profession

Health History

One portion of the PPE that seems to have the best predicted value is medical history . Most athletic injuries are the injuries . A medical history is recorded on a detailed questionnaire and is the most important part of the PPE . the answers of this questionnaire should guide the medical team when designing specific tests for each athlete to address their problems . This should be confidential because if the athlete thinks that their information will be shared they may not answer the questions truthfully and completely so they need to be reassured that the information will be confidential and not shared with anyone outside the medical staff unless they are authorized to . All the questions should have relevance to the evaluation with a plan for addressing them if the athletes response is not favorable for clearance to participate

Random selection of subjects by position

Only selected based on the position that they play on the team . The defensive players of one team could only be tested during the season while the offensive players don't get tested until another testing period

Random selection of subjects by playing time or finish position

Only test within a group of athletes who contributed to the outcome of a particular contest by virtue of their playing time or selected subjects who placed high in that individual sport championship

Consent (Drug Testing)

Oshc sign a consent form agreed to submit to drug testing . The language of good sense says that the activity is voluntary but normally when people don't sign it they are given athletic and eligibility . universities who have their own drug testing programs besides the one required by the NCAA should also use consent forms of the NCAA as well as their own . Policies and procedures should outline the consent to testing

1. Injury and Illness Prevention

PPEs can provide information that allows an athlete to participate in sports activities with reduced risk of injury or illness . This is only valid if the medical team conducting the PPE uses the data generated by the exam . Even if they are minor findings they must be followed up with and appropriate treatment otherwise the PPE is a waste of time and becomes potential liability for the medical staff One of the functions of the PPE is to determine and athletes Readiness for participation in her chosen sport . This may involve using information generated by the PPA to disqualify an athlete from participation however this should only be taken when participation in the sport would foresee lead to and exacerbation of an athlete's medical condition or cause harm to other participants . The team physician has the final say in the participation

Reporting the results

Positive drug test results should be reported only to those people with a legitimate need to have the information . there should be procedures regarding the dissemination of information regarding athletes who are put on the bench because of their drug testing . people who actually need to know this information are the athletes the doctors the athletic trainer and the athletic director and the head coach but this list can vary from Institution . Strength and conditioning coaches could possibly also know and academic advisors I also want to know because it could relate to their social behaviors . People on this list should be warned of the potential negative consequences of releasing the information . The athletic reputation and potential loss of income for the athlete make this area

WHEN drug testing should be performed

Post Championship testing, pre-season testing, and year-round testing, in house testing

Physican's Office PPE

Privacy of Physician's office is probably the best place for a PPE . This setting allows the physician to examine and Council the athlete with a minimum of interruption and to focus on the athlete and their problems . Also position to conduct PPE stand their office have the advantage to be able to use more medical equipment and services to provide comprehensive care to the athlete which could be difficult and a mass screening in somewhere like a gymnasium .

Random timing - some notice

Provide subjects with some notice that they will be tested the farther in advance they have to know about this test the greater the chances that they will be able to manipulate the results and can dilute their samples over hydrating an effort to mask the test results

4. Fidelity

Subordination of one's needs to those of the patient.

pre-season testing

Tested before their first season of competition. This is usually part of the PPE and it's considered a pre employment test . In the NFL all rookies are tested for anabolic steroids and drugs of abuse at the combine . even rookies who do not attend the combine are tested if they sign a contract . Their contract will be void if their drug test is positive

Specimen Handling and Chain of Custody

The Collection labeling and packaging of a urine sample must be observed by a reliable witness otherwise the sample is of no value . Athletes should be observed while they deliver their urine samples and this requires that the toilet facilities should be in the immediate vicinity of the drug testing area . If an athlete has trouble producing a specimen water can be provided from sealed containers . The drink should be caffeine free and alcohol free. That they should be allowed to observe the handling of the sample until it has been transferred to the appropriate bottle provided by The Testing Lab and should be allowed to observe as a bottle is being sealed and labeled after the assessment has been sealed and label the athlete to sign a form indicating that the specimen they provided was indeed their own and that they did not tamper with its the specimen or any other containers used to collect or store it and that they observed the transfer of the specimen to the storage bottle and the ceiling thereof and that the name of the storage bottle is theirs

NCAA Drug Testing Mission

The NCAA has made two calls for a drug testing program which is the standard for college sports in the United States . 1 to promote fair and Equitable competition all athletes should compete on a Level Playing Field and only the sum of their training and talent determines the outcome of a contest. 2 to safeguard the health and safety of athletes by discouraging drug use through drug testing . No athlete should feel pressure to take drugs to have a chance to win . hopefully athletes who use drugs will be caught and be counseled and received treatment for any problems their drug use may have engendered . many athletes are willing to sacrifice their health for short-term Glory

year-round testing

The NCAA requires all Division 1 and 2 football and baseball and Division 1 indoor and outdoor track and field to submit to drug testing on a year-round basis . NFL and Olympic sport National governing bodies require year-round testing of athletes

Consent

The athlete has to provide informed consent and must be told what will happen to them during the PPE and must understand what they are being told and to have the opportunity to ask questions and must sign a document indicating that they agree to submit to the procedure . Parents or guardians of minor children have to provide informed consent on their behalf

primary party

The athletic trainer is directly involved in the situation as a person who has behaved in an ethically questionable manner or was the victim of an unethical acts committed by another person

3 make testing a sport specific as possible

The drug testing program must be designed to prevent or detect problems clearly associated with a particular sport

Athlete age and level of competition

The emphasis of the elements of the PPE are different for people of different ages although the elements maybe the same . a PPE for a 12 year old should have a greater emphasis on developmental problems common to the age group. an adult in a National Football League would need an extensive Orthopedic examination maybe even an MRI and other Imaging

Sport

The exam should be sport-specific. Especially when it comes to an athlete's physical fitness .

Participation Physical Exams (PPEs)

The first step in injury prevention in school college and professional sports. athletic trainers play an important role in helping to organize this aspect of the injury prevention program. For this program to be effective it must identify disease or processes that will affect the athlete, be sensitive and accurate, and be practical and affordable They can be expensive to administer even though providers who participate serve in the volunteer room they require significant effort on the part of many people who could be doing other things like practicing or coaching they are important because: they serve in injury and illness prevention, compliance with Association rules, education and counseling of athletes, and compliance of standards of practice

Follow Up

The information collected during the PPE is valuable only if the problems discovered are acted upon . Vision Strength and Fitness training are only useful if they have a follow-up evaluation with a specialist . the athletic trainer should ask the question what will we do if ....? for each component of the exam . effective follow-up would be a single or group educational counseling for athletes identified as having a sickle cell trait, asthma, diabetes, or other medical conditions that could affect their performances and their overall health status

Office Based PPEs

The issue is to identify the appropriate position to conduct the examination . the question is if all athletes should be examined and the team Physician's office or in their personal Physicians offices . the team physician would be more versed in sports Health Care issues and may be better able to make judgments regarding participation status and follow-up treatment for the conditions discovered during the PPE . This person is also the medical director of the school's Athletic program so they would be responsible legally for judging an athlete participation status . The Athlete's family physician may be more familiar with the personal and family history which can be important when it established in the confidence that the athlete will need to confide in and be receptive to the physician. Sometimes the athletic setting plays a role in the decision such as the team physician having the ultimate say in the athletes participation . and secondary school it's common for athletes to use their own position this makes it hard on the athletic trainer he would have to have relationships with multiple doctors. However he is pretty easy to do so most Physicians should be able to do it . the nature of the patient is probably what we'll finally make the decision . Young people would probably use personal Physicians and for most college and high school or professional athletes the team physician would provide medical care

Frequency of PPEs

The least rigorous standard requires a complete and comprehensive PPE when an athlete enters an athletic program with annual health history updates thereafter . High school programs require a PPE every year but few states require only one PPE every three years. - The frequency of the ppe it relates closely to its content the more comprehensive and detailed the PPE the less frequent and needs to be repeated and when it's less comprehensive and detailed then it DOES need to be repeated . - the nature of the sport is another Factor especially with contact and collision sports with high and dreary that may be more frequent of repetition for the PPE that sports with less frequent or serious injuries

Orthopedic examination

The orthopedic examination may not be a strong predictor of injury for athletes with no previous history of injury but it is an important part of the PPE for athletes who have suffered injury. This exam should focus on problems that the athlete identified in the health history questionnaire using evaluation techniques specific to those body parts . range of motion flexibility accessory joint motion and muscle strength should be considered part of this exam Orthopedic special tests should be included as they pertain to the more commonly involved anatomical structures for each person and their sport . The general Orthopedic exam doesn't need to be done by association rules what athletic trainers and physical therapist and physician's assistant will assume this responsibility

Wavier of Liability

The purpose of the PPE used to prevent athletes from participating when they have a medical condition that endangers their health or the health of their teammates or opponents . The athletes sometimes take the second third or even fourth opinion to justify I desire to participate when a physician decides that they should not participate in a given sport. The medical team can take action and require athletes to sign waivers when they wish to participate against the advice of the physician and needs waivers must be tailored to each specific case and include a full description of the medical condition the findings of the PPE and other Associated examinations connected to the condition and a complete list of all the possible medical complications that would arise from participation including permanent disability and death . it can include financial implications of temporary or permanent disability . If the athlete is married the spouses sign a similar document waiting their right to sue for loss of Consortium . - should be written in a simple language explain medical terms . -Athletes parents and spouses should be given an opportunity to ask questions regarding the contents of the waiver . - The waiver states that in signing it the athlete admits to having read the waiver understanding it and agreed to hold the institution and its medical staff harmless for any future injuries associated with the condition question . *Waivers are viewed as a violation of public interest and are not frequently a pound no matter how detailed or explicit .

What to Test for

The two most common list of banned drugs are those published by the NCAA and the list of drugs tested for an athlete to compete in the Olympic Games the Olympic list is longer and more restrictive than the NCAA list. Drugs band include stimulants Like Cocaine anabolic agents like testosterone, diuretics like acetazolamide, street drugs like heroin and marijuana, and peptide hormones and analogues like human growth hormone or erythropoietin . Some drugs are allowed in sports but not others . Drug testing programs do not test for alcohol although it has the greatest abuse among high school and college age students

Group PPEs and Station method

This involves screaming many athletes at a common site using a variety of stations to collect information about their health . obtaining the Privacy for one-on-one counseling between a physician and athlete and this setting is hard however this method is successful in helping detect the more serious and common conditions that will compare an athlete's ability to participate in sports with a relative degree of safety .

Special Medical tests

This will vary greatly depending on the financial resources available and the philosophy of the physician common special tests like simple urinalysis to detect protein or sugar are normally done X-rays and cardiovascular or other assessments are not recommended unless warranted by the health history questionnaire or the physician's exam

3. Education and Counseling of Athletes

This'll be sometimes the only time that an athlete talks to a physician so the position can counsel and educate The Athlete on health-related issues such as home Life Education activities drugs sex and suicide to prevent health problems that day are most likely to experience . It is also a chance to educate athletes on the benefits of hepatitis B vaccination or nutrition Alcohol Tobacco and drug use and sexually transmitted diseases . a mass screening in a gym locker room is a poor setting for this kind of activity . The Examiner should be highly trained and comfortable because an athlete will be more likely to open up to those that they know and trust

5. Veracity

Truth-telling and honesty.

Random timing - no notice

Unannounced spot checks at random intervals period this often involves taking an athlete off the field to administer a drug test with no warning . This is a way to discourage cheating the system because I need to know when they will be tested can often mask their drug use by abstaining for as little as a few days before the test

Random Selection

Unprofessional an Olympic sport use random selection . Random selection means that the testing is random with regard to the subject selected and in other cases it means that the timing of testing Is Random

false negative

When a screening gives a negative result despite the presence of the disease.

1. Autonomy

a patient's right to be fully informed and to make his her own health care decisions and to have his inherent dignity respected

6 protect the athletes privacy

White person with a legitimate need to know should be informed about the positive drug test and this list should be codified and written policies and procedures . No one else should have access to this information without written permission from the athlete

Tavistock principles (7)

a set of principles derived from their discussions that are all-encompassing designed to benefit those who are responsible for the Healthcare System those who work in it and those who use it 1. A human right 2. balance patient centered with population sensitive 3. comprehensively manage disease burden and promote prevention 4. professional collaboration 5. quality improvement 6. Safety 7. openness

5. quality improvement

all individuals and groups involved in health care, whether they're providing access or services, have the continuing responsibility to help improve its quality .

Physical fitness testing

an opportunity to establish a baseline for athlete's physical fitness this is a medically necessary to clear an athlete for participation but this information can be useful to athletes and staff members and provided an assessment of the obvious conditioning status . The strength and conditioning staff can also benefit from these tests and strengthens the purpose of the exam overall the information gathered in this testing by the strength and conditioning staff will be acted upon and incorporated into the athletes ongoing conditioning program and goals . 1. all physical fitness test should be designed to provide data that are important to normal physiological function for specific sport. 2. If it is testing is to be included as part of the PPE it should always be the last element completed because the athletes always be subjected to the health history positions exam and Orthopedic exam before engaging in strenuous exercise so that any problems can be identified first

8 inform potential athletes

athlete that have been recruited to participate in an athletic program should be informed that the institution has drug testing to which that they may be subjected and this information should be reiterated when the student and rolls

Randomization

athletic trainer must develop a system that equalizes the probability that one athlete has much of a chance of being tested as any other athlete randomization can occur by: 1 the athlete is unusually assigned a number 2 one can select their number either by Consulting a table of random numbers or by generating a list of number from a computer statistics program . The AT must document the method used so that they can withstand any challenge to the validity of the selection procedure

perpetrator

behaved in an ethically questionable manner

Volunteers in the Mass PPE

non-medical volunteers play an important role in helping conduct this mass PPE . the athletic trainer identifies the number of stations recruit an adequate number of volunteers for each station and provides the training that the volunteers will need to perform their duties . Volunteers include parents coaches and students and their duties include checking height and weight controlling flow through the various stations collecting money in checking to make sure that the required forms have been completed before the athlete the examination area period for Fitness testing coaches who have training and techniques are a good choice to operate the stations

Another approach when not wanting to go to with a waiver

stick to their decision to deny medical clearance for participation and allow the athlete to bring suit - this forces the courts make a decision as to the reasonableness of the physician's decision any orders of the Court should be included in the athletes medical file as a record of facts of the case if an injury results from participation at a later date

Code of Ethics

the Professional Organization of each profession that provides Healthcare Services to athletes or other Physically Active patients writes a code of ethics to establish its ethical standards. - Purpose of these codes are to provide guidance of appropriate conduct for members and to provide a reference by which to judge when their conduct comes into question and to provide assurance and protection to the public who are served by members of the profession - documents provide guidelines for ethical conduct within the respective professions and are applied to the entire range of practice patterns and settings applicable to those professions . - these standards are enforceable for the members of each organization but should also be considered applicable for non-members within the profession .

2. balance patient centered with population sensitive

the care of individual is at the center of Health Care delivery but must be viewed and practiced within the overall context of continuing work to generate the greatest possible Health gains for groups and populations .

Urinalysis

the examination of urine to determine the presence of abnormal elements

3. comprehensively manage disease burden and promote prevention

the responsibilities of the health care delivery system include the prevention of illness and the alleviation of disability .

7. openness

this is the most banal in the most profound. nobody could argue against being open honest and trustworthy, yet every day people fail to do this on all three count

3 barriers to professionalism

time constraints, high workloads, having to work with challenging or difficult parties