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team management

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This interview was conducted by Dr Boris Gojanovic after the Lausanne 2020 Youth Olympic Games. Richard, can you please introduce yourself, as a medical doctor and an athlete. I am the medical and scientific director for the IOC and I started off in life as a rower. As an athlete, I had the privilege to compete in the 1984 Olympic Games in Los Angeles, and I won a gold medal there.
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Purpose: The Youth Olympic Games (YOG) are an elite sporting event for young athletes aged 15-18 years from all over the world. In the third Youth Olympic Winter Games, held in Lausanne in 2020, there were 16 disciplines and 81 events. In previous reports regarding YOG, injury risk was highest in the skiing events and alpine ski had a high rate, 14% in 2012 and 12.9% in 2016. The purpose of this report is to discuss the rescue organization, investigate the incidence of alpine ski injury during YOG 2020 and compare to previous reports.
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L’attribution des Jeux Olympiques de la Jeunesse (JOJ) à Lausanne a déclenché dans toute la Romandie un engouement extraordinaire pour la préparation des Jeux, avec la volonté affirmée de faire des Jeux pour les jeunes, avec les jeunes et par les jeunes. En tant qu’étudiant-e-s en médecine, nous avons eu le privilège de participer aux JOJ du 4 au 24 janvier 2020; un groupe de 20 étudiant-e-s en 6e année ont eu l'occasion d’effectuer un stage de médecine du sport, validé dans le catalogue de l’année à option, dans le cadre de la troisième édition hivernale des Jeux Olympiques de la Jeunesse à Lausanne, plus connus sous l’appellation Lausanne 2020.
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The Youth Olympic Games are an elite sporting event that include a series of educational activities and we built the whole concept of medical care at the village in the same spirit. We wanted not only to build a clinic with a lot of expertise, but to create a space for education for the young athletes, their medical teams and our volunteers.
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Since the first report from the 1968 Olympic Games, many studies have consistently reported poor oral health in elite athletes without any differences regarding socio-economic status or continental location. Poor oral health is an important issue as it has a clear impact on quality of life, confidence, appearance and socialisation. It also has an impact on sport performance and training with impaired preparation for competition. Many causes to impaired oral health can include nutritional diet and carbohydrate supplementation, oral dehydration, depression of various aspect of the immune function due to intense exercise, negative health behaviours, lack of awareness, time and prioritisation.
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Sudden death of an athlete is the most devastating medical event in sports. While accidents account for more than 50% of these cases, sudden cardiac deaths (SCD) are less frequent (approx. 15%), but the leading medical cause of deaths. The risk depends on age, sex, ethnicity, type of sport and sport level. There are large variations in the methods of registration of SCD in recreational and competitive sports. This must be taken into account when interpreting reported incidences and causes. High data quality in registries is a prerequisite for meaningful preventive strategies (e.g. ECG screening and safety at sports facilities).
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Through continuous improvement of diagnostic accuracy of ECG criteria for athletes sensitivity as well as specificity have grown so much that foregoing this screening tool is not feasible anymore. The most updated guidelines, the so-called “International (Seattle) Criteria” globally exhibit the most important reference publication, currently. The criteria were created with the purpose that particularly “non-cardiologists” should be able to use them before clearly pathological findings lead to further follow-up examinations at a specialist. On the other hand, physiologic ECG findings should not prompt expensive further evaluations, as it used to happen quite frequently.
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Traditionally, cardiovascular screening has been recommended mostly for competitive athletes younger than 35 years. The perception that only young competitive athletes at top level are at increased risk, has changed in the last years. Theoretically, we advocate a voluntary cardiovascular screening for all athletes who exercise vigorously, independent of their competitive status, and age. Although, this should be based on an individual estimation of the athlete’s risk. Physical examination, medical history and an ECG should be the baseline investigations for all athletes.
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As soon as he prescibes medicine to an athlete, any physician is confrounted if he wants or not, and if he is aware of it or not, with the numerous and often complex rules treating with the universal fight against doping. In case of an involountary mistakee or not, the doctor can be involved in very unpleasant situations over different regulations. As ignorance is no valid defense form, it seems obvious that it is very imporant that each practitionner is informed the better possible about these legal aspects. This is the objective of the following presentation.
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