Gender Bias in Medicine — the CJSM podcast with Dr. Esther Choo

@choo_ek (a.k.a. Dr. Esther Choo) — a definite follow on Twitter!

We are excited to share the first CJSM podcast of 2019 with you.  Special guest Esther Choo M.D., M.P.H. joins us to discuss issues of gender bias in medicine:  “From Mansplaining to Bromotion — How We Can Move the Needle on Gender Bias in Sports Medicine.” 

For those not familiar with Dr. Choo’s work, I would direct you to a CJSM blog post from December 2018 where I shared with you some of my thoughts about one of her more recent commentaries published in the British Medical Journal (BMJ): “A Lexcion for Gender Bias in Academic Medicine.”

I would also direct you to her Twitter feed and heartily encourage you to follow her @choo_ek to continually learn from her, as I do on a nearly daily basis.  She argues strongly that issues of equality inform all our attempts to deliver high quality medicine; that issues of bias should be of interest to us all, because they affect not only our fellow professionals, but the patients we serve.

She also does this typically with a sense of humor, which has often put me in mind of Mark Twain’s quotation, “Against the assault of laughter nothing can stand.”  This work and this tone can be hard to achieve, because many of the issues Dr. Choo and others are tilting against can be dark.  In thinking of our own word of sports medicine, the complicated and horrific story of Larry Nassar and USA Gymnastics comes to mind.  I’m also mindful of stories like that of Eva Carneiro, former team physician of an English Premiership Club, whose summary dismissal was entwined with these issues of sexism.  Or the exceedingly common phenomenon of attending a sports medicine conference only to find that all the keynote speakers are male

The world we serve is rife with issues of gender bias.  On his recent retirement, Andy Murray was lauded as an all too rare light in men’s sport — a man who would publicly stand up for women’s issues, a #HeForShe.  Or what to make of the arena of NCAA Division I coaching, where the sight of a man coaching a women’s team is common (think Gino Auriemma of UConn Women’s Bball), but the reverse is an exceedingly uncommon phenomenon.

There is light in this darkness.  Dr. Choo and groups like Feminem.org are doing great work.  I am also mindful of the lead that the IOC 2020 Prevention Conference has taken on this — the organizers publicly stated their intention to assemble a gender balanced planning committee, and they got it right, I think, including many luminaries in our field including Margo Mountjoy, Kate Ackerman, Caroline Finch, and Christa Janse van Rensburg, among others. Bravo!

I hope you go to our podcast page on our main website, or subscribe to the podcast on iTunes, to listen to our conversation with Dr. Choo and sample all of our podcasts.  Please let us know what you think. Take the time if you can on our iTunes feed to give us your opinion on the podcast in general, as we always take feedback seriously and use it to ‘tweak’ our media to make it ever better for you.

 

It’s a New Year — CSJM Blog Journal Club 2019 Starts Now

Japan (and its iconic Mt. Fuji) will be one of the places on the globe that will be enjoying an exciting 2019 in the world of sport.

We here at CJSM hope all of our readers have enjoyed a festive and relaxing holiday season.  I am sure for most of us reading this post, ‘things’ have picked back up, because the global sports world never sleeps.  From Australian Open tennis to the NFL playoffs to the English Premiership, and beyond, the sports (and sports medicine) scenes have been ushered in with a bang.

2019 promises to be an exciting year in sports all over, but perhaps in no place quite like Japan, as it hosts the Rugby World Cup at year’s end and busily prepares for the 2020 Summer Olympic Games in Tokyo.  I just spent my holidays there and fell in love with the country.  I am looking forward to posting more about the upcoming global events Japan is hosting this year and next.

CJSM has entered the new year with a bang as well, as we begin our 29th year with an issue that is full of interesting offerings.

Among the pieces of original research we have just published in this January 2019 issue is this one: Head Impact Exposure in Youth Soccer and Variation by Age and Sex. This piece has already received a good deal of attention. The accompanying editorial arguing (relatively speaking) against a ban on heading in youth soccer has realized a comparable buzz.

Jason Zaremski MD, Junior Associate Editor CJSM

We thought this would be a particularly good study to ‘de-construct’ in the Journal Club, and so we contacted our regular correspondent Jason Zaremski MD to pen one of his ever popular, recurring posts.  Thanks Dr. Zaremski, as always.

______________________________________________________________________________

Title:

Chrisman SPD, Ebel BE, Stein E, Sarah J. Lowry SJ, Rivara FP. Head Impact Exposure in Youth Soccer and Variation by Age and Sex. Clin J Sport Med 2019;29:3–10. http://dx.doi.org/10.1097/JSM.0000000000000497

Introduction:  

The newest edition of the Journal Club commentary for the Clinical Journal of Sports Medicine (CJSM) will be a review of an original research manuscript highlighting a very interesting topic, heading in “soccer” (referred to as “football” outside the United States) and its effects on our youth athletes. As the authors note, there are more than ¼ of a billion soccer players worldwide. In the USA, there are approximately 24 million soccer players and more than 37% are youth players. In the past few years there have been growing concerns about heading in youth soccer and possible associations with concussions and sub-concussive head impact exposures (HIE). Due to these concerns, individuals and some leagues (from local levels to national) have suggested a ban of heading to limit body contact and potential HIE. However, prior research has suggested that the actual number of youth players heading a soccer ball as well as intentional impacts with head to ball are low and heading restrictions may not be indicated. (Comstock et al JAMA Ped 2015, Lynall et al MSSE 2016, Press and Rowson CJSM 2016). Therefore, in order to obtain more objective data, the authors of this study wanted to objectively measure HIE in males and females at the youth level.

Purpose/Specific Aim(s):

The purpose of this study was to measure HIE using adhesive-mounted accelerometers during 1 month of soccer. Read more of this post

What’s in a word?

The year is coming to a close, and we’re continuing the end-of-year reflections we began with our most recent blog post.

2018 began with ‘mansplaining’ and ended with ‘he-ja-vu’.

What is that you say?

At the risk of mansplaining myself, let me explain.

In January 2018, the English language grew, according to the Oxford English Dictionary (OED)– among the words added to the OED was the verb ‘mansplaining’: seen when a man explains something to someone, typically a woman, in a manner that is condescending or patronizing.

We’ve all seen examples of this in various venues of our lives, including that of academic or clinical sports medicine.  I know I’ve been guilty of it.

Later in the year, I joined a group of esteemed colleagues in writing an editorial that appeared in BJSM that looked at gender bias in our profession while looking at the phenomenon of ‘manels.’ Now, I don’t believe the OED has given its official blessing to this term, but a quick search on Twitter using the hashtag #manel will alert you to its widespread use in the working lexicon of social media.

[‘manel’ — an all- or predominantly-male panel of experts seen at conferences]

And now, as 2018 ends, we have a new offering of words looking at related phenomena of gender inequities in academic medicine.  This is commentary just published in the British Medical Journal (BMJ) for Christmas:  A Lexicon for Gender Bias in Academia and Medicine. It is authored by three social media physicians (one woman, two men) who do great work on Twitter (definitely worth a follow): @choo_ek @DGlaucomfleken @rfdemayo

The commentary (subtitled “Mansplaining is the tip of the iceberg”) is a wickedly funny satire on so many different aspects of the problem of gender inequities in academic medicine.  It is laugh out loud funny  while also delivering a punch to the gut, as the authors propose various new terms for different regressive phenomena. To wit: Read more of this post

Concussions: The “Injury of 2018”

Concussions remain a dominant subject in the sport medicine literature and media at large — Photo: PET Scan Brain, Wikimedia

As 2018 winds down, the Clinical Journal of Sport Medicine, like so many of its sister media, finds itself in a reflective mood.

Time magazine, for instance, has just named its “Person of the Year”: a group of journalists the magazine notes has been ‘targeted’ for the work they do pursuing the truth.  Time calls them The Guardians. It is an interesting selection:  a media outlet honoring other professionals in its own line of work.

I thought it time that CJSM do its own version of “Person of the Year,” but with a sport medicine twist — Injury of the Year.

I’m naming “Concussion” the Injury of the Year.  In 2019, I’ll have my ‘act together’ and put out a Twitter poll in late November for reader contributions; but in 2018, I’ll have to play judge and jury, given that it’s nearly mid-December. Thanks for indulging me!

Like LeBron James of the NBA, who could probably be named MVP in any year he has played in the league, concussion is a sports injury which could probably earn this distinction in any year over the last decade or more.

In truth, 2018 was a red banner year for the injury, so to speak.  As an example, nearly our entire March 2018 issue was devoted to original research on various aspects of the subject, including a systematic review on the long-term consequences of traumatic brain injury in professional football players.  Continuing this line of reasoning, I would draw your attention to another noteworthy systematic review just published in our last issue of 2018 (November).   This one looks at the utility of blood biomarkers in the assessment of sports-related concussions (spoiler alert:  we have a long way to go in developing these for ‘prime time’).

The dominant theme of our 2018 podcasts was, again, concussion.  Read more of this post

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