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Medical and Disaster Preparedness of US Marathons
- Joshua Glick, Jeffrey Rixe, Nancy Spurkeland, Jodi Brady, Matthew Silvis, Robert P. Olympia
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- Journal:
- Prehospital and Disaster Medicine / Volume 30 / Issue 4 / August 2015
- Published online by Cambridge University Press:
- 23 June 2015, pp. 344-350
- Print publication:
- August 2015
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- Article
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Background
Despite the events that occurred at the 2013 Boston Marathon (Boston, Massachusetts USA), there are currently no evidence-based guidelines or published data regarding medical and disaster preparedness of marathon races in the United States.
PurposeTo determine the current state of medical disaster preparedness of marathons in the US and to identify potential areas for improvement.
MethodsA cross-sectional, questionnaire-based study was conducted from January through May of 2014. The questionnaire was distributed to race directors of US road and trail marathons, as identified by a comprehensive internet database.
ResultsOne hundred twenty-three questionnaires were available for analysis (19% usable response rate). Marathon races from all major regions of the US were represented. Runner medical information was not listed on race bibs in 53% of races. Only 45% of races held group training and planning sessions prior to race day. Automated external defibrillators (AEDs) were immediately available on 50% of courses, and medications such as albuterol (30%), oxygen (33%), and IV fluids (34%) were available less frequently. Regarding medical emergencies, 55% of races did not have protocols for the assessment of dehydration, asthma, chest pain, syncope, or exercise-induced cramping. With regard to disaster preparedness, 50% of races did not have protocols for the management of disasters, and 21% did not provide security personnel at start/finish lines, aid stations, road crossings, and drop bag locations.
ConclusionsAreas for improvement in the preparedness of US marathons were identified, such as including printed medical information on race bibs, increasing pre-race training and planning sessions for volunteers, ensuring the immediate availability of certain emergency equipment and medications, and developing written protocols for specific emergencies and disasters.
Glick J Rixe JA Spurkeland N Brady J Silvis M .Olympia RP Medical and Disaster Preparedness of US Marathons . Prehosp Disaster Med.2015 ;30 (4 ):1 –7 .
Contributors
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- By Avishek Adhikari, Susanne E. Ahmari, Anne Marie Albano, Carlos Blanco, Desiree K. Caban, Jonathan S. Comer, Jeremy D. Coplan, Ana Alicia De La Cruz, Emily R. Doherty, Bruce Dohrenwend, Amit Etkin, Brian A. Fallon, Michael B. First, Abby J. Fyer, Angela Ghesquiere, Jay A. Gingrich, Robert A. Glick, Joshua A. Gordon, Ethan E. Gorenstein, Marco A. Grados, James P. Hambrick, James Hanks, Kelli Jane K. Harding, Richard G. Heimberg, Rene Hen, Devon E. Hinton, Myron A. Hofer, Matthew J. Kaplowitz, Sharaf S. Khan, Donald F. Klein, Karestan C. Koenen, E. David Leonardo, Roberto Lewis-Fernández, Jeffrey A. Lieberman, Michael R. Liebowitz, Sarah H. Lisanby, Antonio Mantovani, John C. Markowitz, Patrick J. McGrath, Caitlin McOmish, Jeffrey M. Miller, Jan Mohlman, Elizabeth Sagurton Mulhare, Philip R. Muskin, Navin Arun Natarajan, Yuval Neria, Nicole R. Nugent, Mayumi Okuda, Mark Olfson, Laszlo A. Papp, Sapana R. Patel, Anthony Pinto, Kristin Pontoski, Jesse W. Richardson-Jones, Carolyn I. Rodriguez, Steven P. Roose, Moira A. Rynn, Franklin Schneier, M. Katherine Shear, Ranjeeb Shrestha, Helen Blair Simpson, Smit S. Sinha, Natalia Skritskaya, Jami Socha, Eun Jung Suh, Gregory M. Sullivan, Anthony J. Tranguch, Hilary B. Vidair, Tor D. Wager, Myrna M Weissman, Noelia V. Weisstaub
- Edited by Helen Blair Simpson, Columbia University, New York, Yuval Neria, Columbia University, New York, Roberto Lewis-Fernández, Columbia University, New York, Franklin Schneier, Columbia University, New York
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- Book:
- Anxiety Disorders
- Published online:
- 10 November 2010
- Print publication:
- 26 August 2010, pp vii-xii
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Neuroimaging and the functional neuroanatomy of psychotherapy
- JOSHUA L. ROFFMAN, CARL D. MARCI, DEBRA M. GLICK, DARIN D. DOUGHERTY, SCOTT L. RAUCH
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- Journal:
- Psychological Medicine / Volume 35 / Issue 10 / October 2005
- Published online by Cambridge University Press:
- 31 May 2005, pp. 1385-1398
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- Article
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Background. Studies measuring the effects of psychotherapy on brain function are under-represented relative to analogous studies of medications, possibly reflecting historical biases. However, psychological constructs relevant to several modalities of psychotherapy have demonstrable neurobiological correlates, as indicated by functional neuroimaging studies in healthy subjects. This review examines initial attempts to measure directly the effects of psychotherapy on brain function in patients with depression or anxiety disorders.
Method. Fourteen published, peer-reviewed functional neuroimaging investigations of psychotherapy were identified through a MEDLINE search and critically reviewed. Studies were compared for consistency of findings both within specific diagnostic categories, and between specific modalities of psychotherapy. Results were also compared to predicted neural models of psychotherapeutic interventions.
Results. Behavioral therapy for anxiety disorders was consistently associated with attenuation of brain-imaging abnormalities in regions linked to the pathophysiology of anxiety, and with activation in regions related to positive reappraisal of anxiogenic stimuli. In studies of major depressive disorder, cognitive behavioral therapy and interpersonal therapy were associated with markedly similar changes in cortical–subcortical circuitry, but in unexpected directions. For any given psychiatric disorder, there was only partial overlap between the brain-imaging changes associated with pharmacotherapy and those associated with psychotherapy.
Conclusions. Despite methodological limitations, initial neuroimaging studies have revealed convergent and mechanistically sensible effects of psychotherapy on brain function across a range of psychiatric disorders. Further research in this area may take advantage of emerging neuroimaging techniques to explore a broader range of psychotherapies, with the ultimate goal of improving clinical decision-making and treatment.