bluuebunny/crossref_metadata_2025 huggingface dataset:
High School Athletes' Parents' Perceptions and Knowledge of the Skills and Job Requirements of the Certified Athletic Trainer
Authors: Weitzel Rachel L. , Miller Michael G. , Giannotta Erin R. , Newman Catherine J.
Published: September 2016

Context

Parents play a crucial role in determining medical services for their children, and it is important they understand the scope of practice and skills of the athletic trainer (AT).

Objective

To understand parents' perceptions and knowledge of the skills and job requirements of the secondary school AT.

Design

Cross-sectional study.

Setting

Sport meetings and banquets at 5 high schools in southwest Michigan during the fall, winter, and spring seasons.

Patients or Other Participants

A total of 539 parents whose children competed in at least 1 high school sport participated.

Data Collection and Analysis

A Parents' Perceptions and Knowledge of Certified Athletic Trainers Survey consisting of 32 questions, divided into 3 sections (demographics, perceptions, and knowledge), was developed and given to parents of high school athletes. One-way analyses of variance were used to determine significance among 3 categories of experience and perception and knowledge of ATs.

Results

Of the 539 parents who responded, 28% responded yes, and 72% responded no to having experience with an AT for their own injuries. When asked if they had experience with an AT due to their child's injuries, 60% responded yes. We found a difference among the 3 categories of experience for perception scores (P = .002) and knowledge scores (P < .001).

Conclusions

In the absence of past experience with an AT, parents' perceptions and knowledge of the skills and job requirements of the secondary school AT are limited. Athletic trainers should educate parents on their professional roles, which may enhance their ability to provide better health care.
Policies, Procedures, and Practices Regarding Sport-Related Concussion in Community College Athletes
Authors: Paddack Michael , DeWolf Ryan , Covassin Tracey , Kontos Anthony
Published: September 2016

Context

College sport organizations and associations endorse concussion-management protocols and policies. To date, little information is available on concussion policies and practices at community college institutions.

Objective

To assess and describe current practices and policies regarding the assessment, management, and return-to-play criteria for sport-related concussion (SRC) among member institutions of the California Community College Athletic Association (CCCAA).

Design

Cross-sectional study.

Setting

Web-based survey.

Patients or Other Participants

A total of 55 head athletic trainers (ATs) at CCCAA institutions.

Main Outcome Measure(s)

Data about policies, procedures, and practices regarding SRC were collected over a 3-week period in March 2012 and analyzed using descriptive statistics, the Fisher exact test, and the Spearman test.

Results

Almost half (47%) of ATs stated they had a policy for SRC assessment, management, and return to play at their institution. They reported being in compliance with baseline testing guidelines (25%), management guidelines (34.5%), and return-to-play guidelines (30%). Nearly 31% of ATs described having an SRC policy in place for academic accommodations. Conference attendance was positively correlated with institutional use of academic accommodations after SRC (r = 0.44, P = .01). The number of meetings ATs attended and their use of baseline testing were also positively correlated (r = 0.38, P = .01).

Conclusions

At the time of this study, nearly half of CCCAA institutions had concussion policies and 31% had academic-accommodation policies. However, only 18% of ATs at CCCAA institutions were in compliance with all of their concussion policies. Our findings demonstrate improvements in the management of SRCs by ATs at California community colleges compared with previous research but a need for better compliance with SRC policies.
Work-Based Social Interactions, Perceived Stress, and Workload Incongruence as Antecedents of Athletic Trainer Burnout
Authors: DeFreese J. D. , Mihalik Jason P.
Published: September 2016

Context

Burnout is an important psychological health concern for working professionals. Understanding how psychological stress and markers of workload contribute to athletic trainers' (ATs') perceptions of burnout is highly valuable. Both positive (social support) and negative social interactions should be considered when examining relationships among markers of ATs' health and wellbeing.

Objective

To examine the potential effects of social interactions on the relationships between (1) burnout and perceived stress and (2) burnout and workload incongruence in ATs.

Design

Cross-sectional study.

Setting

Participating ATs completed a computer-based survey during the fall sports season.

Patients or Other Participants

Responding participants were ATs randomly sampled from the National Athletic Trainers' Association membership (N = 154; men = 78, women = 76; age = 36.8 ± 9.5 years).

Main Outcome Measure(s)

Participants completed self-report assessments (Perceived Stress Scale, Social Support Questionnaire, Positive and Negative Social Exchanges, Maslach Burnout Inventory–Human Services Survey) via a secure e-mail link. Workload incongruence was calculated by subtracting anticipated work hours from actual current work hours (6.0 ± 9.6 hours). We used hierarchical multiple regression analyses to examine hypothesized relationships among study variables.

Results

Social interactions did not affect the relationships between burnout and perceived stress or workload incongruence at the global or dimensional level. However, perceived stress (β = .47, P < .001), workload incongruence (β = .12, P < .05), and social support (β = −.25, P < .001) predicted global AT burnout. Negative social interactions trended toward significance (β = .12, P = .055). Our findings suggest that stress perceptions and social support drive the dimensional AT burnout experience, whereas workload incongruence (emotional exhaustion) and negative social interactions (depersonalization) were linked to specific burnout dimensions.

Conclusions

Social interactions and markers of stress and workload should be considered when seeking to understand ATs' experiences with burnout and to design workplace interventions.
Comparative Effects of Different Balance-Training–Progression Styles on Postural Control and Ankle Force Production: A Randomized Controlled Trial
Authors: Cuğ Mutlu , Duncan Ashley , Wikstrom Erik
Published: September 2016

Despite the effectiveness of balance training, the exact parameters needed to maximize the benefits of such programs remain unknown. One such factor is how individuals should progress to higher levels of task difficulty within a balance-training program. Yet no investigators have directly compared different balance-training–progression styles.Context:

 To compare an error-based progression (ie, advance when proficient at a task) with a repetition-based progression (ie, advance after a set amount of repetitions) style during a balance-training program in healthy individuals.Objective:

 Randomized controlled trial.Design:

 Research laboratory.Setting:

 A total of 28 (16 women, 12 men) physically healthy young adults (age = 21.57 ± 3.95 years, height = 171.60 ± 11.03 cm, weight = 72.96 ± 16.18 kg, body mass index = 24.53 ± 3.7).Patients or Other Participants:

 All participants completed 12 supervised balance-training sessions over 4 weeks. Each session consisted of a combination of dynamic unstable-surface tasks that incorporated a BOSU ball and lasted about 30 minutes.Intervention(s):

 Static balance from an instrumented force plate, dynamic balance as measured via the Star Excursion Balance Test, and ankle force production in all 4 cardinal planes of motion as measured with a handheld dynamometer before and after the intervention.Main Outcome Measure(s):

 Selected static postural-control outcomes, dynamic postural control, and ankle force production in all planes of motion improved (P < .05). However, no differences between the progression styles were observed (P > .05) for any of the outcome measures.Results:

 A 4-week balance-training program consisting of dynamic unstable-surface exercises on a BOSU ball improved dynamic postural control and ankle force production in healthy young adults. These results suggest that an error-based balance-training program is comparable with but not superior to a repetition-based balance-training program in improving postural control and ankle force production in healthy young adults.Conclusions:
Altered Kinematics and Time to Stabilization During Drop-Jump Landings in Individuals With or Without Functional Ankle Instability
Authors: Wright Cynthia J. , Arnold Brent L. , Ross Scott E.
Published: September 2016

Context

It has been proposed that altered dynamic-control strategies during functional activity such as jump landings may partially explain recurrent instability in individuals with functional ankle instability (FAI).

Objective

To capture jump-landing time to stabilization (TTS) and ankle motion using a multisegment foot model among FAI, coper, and healthy control individuals.

Design

Cross-sectional study.

Setting

Laboratory.

Patients or Other Participants

Participants were 23 individuals with a history of at least 1 ankle sprain and at least 2 episodes of giving way in the past year (FAI), 23 individuals with a history of a single ankle sprain and no subsequent episodes of instability (copers), and 23 individuals with no history of ankle sprain or instability in their lifetime (controls). Participants were matched for age, height, and weight (age = 23.3 ± 3.8 years, height = 1.71 ± 0.09 m, weight = 69.0 ± 13.7 kg).

Intervention(s)

Ten single-legged drop jumps were recorded using a 12-camera Vicon MX motion-capture system and a strain-gauge force plate.

Main Outcome Measures

Mediolateral (ML) and anteroposterior (AP) TTS in seconds, as well as forefoot and hindfoot sagittal- and frontal-plane angles at jump-landing initial contact and at the point of maximum vertical ground reaction force were calculated.

Results

For the forefoot and hindfoot in the sagittal plane, group differences were present at initial contact (forefoot: P = .043, hindfoot: P = .004). At the hindfoot, individuals with FAI displayed more dorsiflexion than the control and coper groups. Time to stabilization differed among groups (AP TTS: P < .001; ML TTS: P = .040). Anteroposterior TTS was longer in the coper group than in the FAI or control groups, and ML TTS was longer in the FAI group than in the control group.

Conclusions

During jump landings, copers showed differences in sagittal-plane control, including less plantar flexion at initial contact and increased AP sway during stabilization, which may contribute to increased dynamic stability.
Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding
Authors: Hanlon Shawn , Caccese Jaclyn , Knight Christopher A. , Swanik Charles “Buz” , Kaminski Thomas W.
Published: September 2016

Several factors affect the reliability of the anterior drawer and talar tilt tests, including the individual clinician's experience and skill, ankle and knee positioning, and muscle guarding.Context:

 To compare gastrocnemius activity during the measurement of ankle-complex motion at different knee positions, and secondarily, to compare ankle-complex motion during a simulated trial of muscle guarding.Objectives:

 Cross-sectional study.Design:

 Research laboratory.Setting:

 Thirty-three participants aged 20.2 ± 1.7 years were tested.Patients or Other Participants:

 The ankle was loaded under 2 test conditions (relaxed, simulated muscle guarding) at 2 knee positions (0°, 90° of flexion) while gastrocnemius electromyography (EMG) activity was recorded.Intervention(s):

 Anterior displacement (mm), inversion-eversion motion (°), and peak EMG amplitude values of the gastrocnemius (μV).Main Outcome Measure(s):

 Anterior displacement did not differ between the positions of 0° and 90° of knee flexion (P = .193). Inversion-eversion motion was greater at 0° of knee flexion compared with 90° (P < .001). Additionally, peak EMG amplitude of the gastrocnemius was not different between 0° and 90° of knee flexion during anterior displacement (P = .101). As expected, the simulated muscle-guarding trial reduced anterior displacement compared with the relaxed condition (0° of knee flexion, P = .008; 90° of knee flexion, P = .016) and reduced inversion-eversion motion (0° of knee flexion, P = .03; 90° of knee flexion, P < .001).Results:

 In a relaxed state, the gastrocnemius muscle did not appear to affect anterior ankle laxity at the 2 most common knee positions for anterior drawer testing; however, talar tilt testing may be best performed with the knee in 0° of knee flexion. Finally, our outcomes from the simulated muscle-guarding condition suggest that clinicians should use caution and be aware of reduced perceived laxity when performing these clinical examination techniques immediately postinjury.Conclusions:
Using Pre-Exercise Photobiomodulation Therapy Combining Super-Pulsed Lasers and Light-Emitting Diodes to Improve Performance in Progressive Cardiopulmonary Exercise Tests
Authors: Miranda Eduardo Foschini , Vanin Adriane Aver , Tomazoni Shaiane Silva , Grandinetti Vanessa dos Santos , de Paiva Paulo Roberto Vicente , Machado Caroline dos Santos Monteiro , Monteiro Kadma Karênina Damasceno Soares , Casalechi Heliodora Leão , de Tarso Paulo , de Carvalho Camillo , Leal-Junior Ernesto Cesar Pinto
Published: September 2016

Skeletal muscle fatigue and exercise performance are novel areas of research and clinical application in the photobiomodulation field, and positive outcomes have been reported in several studies; however, the optimal measures have not been fully established.Context:

 To assess the acute effect of photobiomodulation therapy (PBMT) combining superpulsed lasers (low-level laser therapy) and light-emitting diodes (LEDs) on muscle performance during a progressive cardiopulmonary treadmill exercise test.Objective:

 Crossover study.Design:

 Laboratory.Setting:

 Twenty untrained male volunteers (age = 26.0 ± 6.0 years, height = 175.0 ± 10.0 cm, mass = 74.8 ± 10.9 kg).Patients or Other Participants:

 Participants received PBMT with either combined superpulsed lasers and LED (active PBMT) or placebo at session 1 and the other treatment at session 2. All participants completed a cardiopulmonary test on a treadmill after each treatment. For active PBMT, we performed the irradiation at 17 sites on each lower limb (9 on the quadriceps, 6 on the hamstrings, and 2 on the gastrocnemius muscles), using a cluster with 12 diodes (four 905-nm superpulsed laser diodes with an average power of 0.3125 mW, peak power of 12.5 W for each diode, and frequency of 250 Hz; four 875-nm infrared LED diodes with an average power of 17.5 mW; and four 640-nm red LED diodes with an average power of 15 mW) and delivering a dose of 30 J per site.Intervention(s):

 Distance covered, time until exhaustion, pulmonary ventilation, and dyspnea score.Main Outcome Measure(s):

 The distance covered (1.96 ± 0.30 versus 1.84 ± 0.40 km, t19 = 2.119, P < .001) and time until exhaustion on the cardiopulmonary test (780.2 ± 91.0 versus 742.1 ± 94.0 seconds, t19 = 3.028, P < .001) was greater after active PBMT than after placebo. Pulmonary ventilation was greater (76.4 ± 21.9 versus 74.3 ± 19.8 L/min, t19 = 0.180, P = .004) and the score for dyspnea was lower (3.0 [interquartile range = 0.5–9.0] versus 4.0 [0.0–9.0], U = 184.000, P < .001) after active PBMT than after placebo.Results:

 The combination of lasers and LEDs increased the time, distance, and pulmonary ventilation and decreased the score of dyspnea during a cardiopulmonary test.Conclusions:
Electromyographic Activity of Scapular Muscle Control in Free-Motion Exercise
Authors: Nakamura Yukiko , Tsuruike Masaaki , Ellenbecker Todd S.
Published: September 2016

The appropriate resistance intensity to prescribe for shoulder rehabilitative exercise is not completely known. Excessive activation of the deltoid and upper trapezius muscles could be counterproductive for scapulohumeral rhythm during humeral elevation.Context:

To identify the effects of different exercise intensities on the scapular muscles during a free-motion “robbery” exercise performed in different degrees of shoulder abduction in seated and standing positions.Objective:

Descriptive laboratory study.Design:

Kinesiology Adapted Physical Education Laboratory.Setting:

A total of 15 healthy male college students (age = 20.5 ± 2.2 years, height = 174.5 ± 5.3 cm, mass = 63.8 ± 6.0 kg).Patients or Other Participants:

Participants performed 5 repetitions of a randomized exercise sequence of the robbery exercise in 2 body positions (seated, standing), 2 shoulder-abducted positions (W [20°], 90/90 [90°]) at 3 intensities (0%, 3%, and 7% body weight).Intervention(s):

Electromyographic (EMG) activity of the upper trapezius, lower trapezius, serratus anterior, anterior deltoid, and infraspinatus muscles of the upper extremity was collected. All EMG activities were normalized by the maximal voluntary isometric contraction of each corresponding muscle (%).Main Outcome Measure(s):

The serratus anterior, anterior deltoid, and infraspinatus EMG activities were greater at 7% body weight in the seated position compared with the standing position (P < .05). The EMG activities in all 5 muscles were greater in the 90/90 position than in the W position (P < .05).Results:

Scapular muscle activity modulated relative to changes in body posture and resistance intensity. These findings will enable clinicians to prescribe the appropriate level of exercise intensity and positioning during shoulder rehabilitation.Conclusions:
Safe-Play Knowledge, Aggression, and Head-Impact Biomechanics in Adolescent Ice Hockey Players
Authors: Schmidt Julianne D. , Pierce Alice F. , Guskiewicz Kevin M. , Register-Mihalik Johna K. , Pamukoff Derek N. , Mihalik Jason P.
Published: September 2016

Context: Addressing safe-play knowledge and player aggression could potentially improve ice hockey sport safety.

Objectives: To compare (1) safe-play knowledge and aggression between male and female adolescent ice hockey players and (2) head-impact frequency and severity between players with high and low levels of safe-play knowledge and aggression during practices and games.

Design: Cohort study.

Setting: On field.

Patients or Other Participants: Forty-one male (n = 29) and female (n = 12) adolescent ice hockey players.

Intervention(s): Players completed the Safe Play Questionnaire (0 = less knowledge, 7 = most knowledge) and Competitive Aggressiveness and Anger Scale (12 = less aggressive, 60 = most aggressive) at midseason. Aggressive penalty minutes were recorded throughout the season. The Head Impact Telemetry System was used to capture head-impact frequency and severity (linear acceleration [g], rotational acceleration [rad/s2], Head Impact Technology severity profile) at practices and games.

Main Outcome Measure(s): One-way analyses of variance were used to compare safe play knowledge and aggression between sexes. Players were categorized as having high or low safe-play knowledge and aggression using a median split. A 2 × 2 mixed-model analysis of variance was used to compare head-impact frequency, and random-intercept general linear models were used to compare head-impact severity between groups (high, low) and event types (practice, game).

Results: Boys (5.8 of 7 total; 95% confidence interval [CI] = 5.3, 6.3) had a trend toward better safe-play knowledge compared with girls (4.9 of 7 total; 95% CI = 3.9, 5.9; F1,36 = 3.40, P = .073). Less aggressive male players sustained significantly lower head rotational accelerations during practices (1512.8 rad/s2, 95% CI = 1397.3, 1637.6 rad/s2) versus games (1754.8 rad/s2, 95% CI = 1623.9, 1896.2 rad/s2) and versus high-aggression players during practices (1773.5 rad/s2, 95% CI = 1607.9, 1956.3 rad/s2; F1,26 = 6.04, P = .021).

Conclusions: Coaches and sports medicine professionals should ensure that athletes of all levels, ages, and sexes have full knowledge of safe play and should consider aggression interventions for reducing head-impact severity among aggressive players during practice.
Variability in Institutional Screening Practices Related to Collegiate Student-Athlete Mental Health
Authors: Kroshus Emily
Published: September 2016

Context: Universal screening for mental health concerns, as part of the preparticipation examination in collegiate sports medicine settings, can be an important and feasible strategy for facilitating early detection of mental health disorders.

Objective: To assess whether sports medicine departments at National Collegiate Athletic Association (NCAA) member colleges have policies related to identifying student-athlete mental health problems, the nature of preparticipation examination screening related to mental health, and whether other departmental or institutional screening initiatives are in place. I also aimed to characterize the variability in screening by institutional characteristics.

Design: Cross-sectional study.

Setting: College sports medicine departments.

Patients or Other Participants: Team physicians and head athletic trainers at NCAA member colleges (n = 365, 30.3% response rate).

Main Outcome Measure(s): Electronic survey of departmental mental health screening activities.

Results: A total of 39% of respondents indicated that their institution had a written plan related to identifying student-athletes with mental health concerns. Fewer than half reported that their sports medicine department administers a written or verbal screening instrument for symptoms of disordered eating (44.5%), depression (32.3%), or anxiety (30.7%). The strongest predictors of mental health screening were the presence of a written plan related to identifying student-athlete mental health concerns and the employment of a clinical psychologist. Additionally, Division I institutions and institutions with a greater ratio of athletic trainers to student-athletes tended to engage in more screening.

Conclusions: The substantial among-institutions variability in mental health screening suggests that opportunities exist to make these practices more widespread. To address this variability, recent NCAA mental health best-practice guidelines suggested that institutions should screen for a range of mental health disorders and risk behaviors. However, at some institutions, staffing deficits may need to be addressed to allow for implementation of screening-related activities.
Health-Related Quality of Life in Athletes: A Systematic Review With Meta-Analysis
Authors: Houston Megan N. , Hoch Matthew C. , Hoch Johanna M.
Published: September 2016

Context: Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized.

Objective: To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury?

Data Sources: We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted.

Study Selection: Studies were included if they used generic instruments to compare HRQOL outcomes between athletes and nonathletes and between uninjured and injured athletes. Studies were excluded if they did not use a generic instrument, pertained to instrument development, or included retired athletes or athletes with a chronic disease.

Data Extraction: We assessed study quality using the modified Downs and Black Index Tool. Bias-corrected Hedges g effect sizes and 95% confidence intervals (CIs) were calculated. The Strength of Recommendation Taxonomy (SORT) was used to determine the overall strength of the recommendation. A random-effects meta-analysis was performed for all studies using the composite or total score.

Data Synthesis: Eight studies with modified Downs and Black scores ranging from 70.6% to 88.4% were included. For question 1, the overall random-effects meta-analysis was weak (effect size = 0.27, 95% confidence interval = 0.14, 0.40; P < .001). For question 2, the overall random-effects meta-analysis was moderate (effect size = 0.68, 95% confidence interval = 0.42, 0.95; P < .001).

Conclusions: Grade A evidence indicates that athletes reported better HRQOL than nonathletes and that uninjured athletes reported better HRQOL than injured athletes. However, the overall effect for question 1 was weak, suggesting that the differences between athletes and nonathletes may not be clinically meaningful. Clinicians should monitor HRQOL after injury to ensure that all dimensions of health are appropriately treated.
Personality Traits and Burnout Among Athletic Trainers Employed in the Collegiate Setting
Authors: Barrett Jessica , Eason Christianne M. , Lazar Rhyan , Mazerolle Stephanie M.
Published: September 2016

Context: Burnout, a psychological state of mental weariness that occurs when work stresses become overwhelming, has frequently been documented in athletic trainers and has been hypothesized to affect professional retention. Experiences of burnout may be influenced by individual-level factors such as gender or personality, though few researchers have investigated such interactions in athletic trainers.

Objective: To investigate the relationship between personalities, as measured by the Big Five Personality Inventory, and burnout.

Design: Cross-sectional study.

Setting: Online Web-based survey.

Patients or Other Participants: A total of 189 athletic trainers working in the collegiate setting, 65 men (34.4%) and 124 women (65.6%), with an average of 5 ± 3 years certified and 2.5 ± 2 years working in their current position.

Main Outcome Measure(s): Data were collected using a Web-based survey instrument consisting of 3 sections: (1) demographics, (2) burnout survey, and (3) Big Five Personality Inventory. Likert responses for the burnout score were summed. Independent t tests, Pearson correlations, and multiple regressions were calculated to evaluate the relationships between demographics and burnout and between burnout and personality.

Results: This group of athletic trainers experienced moderate burnout, regardless of gender. A weak negative correlation was present between burnout score and both agreeableness and extraversion. A weak positive correlation existed between burnout and neuroticism. These variables did not predict burnout scores; only neuroticism added significantly to the weak predictive value. Personality explained only 17.3% of the variability in burnout scores.

Conclusions: Our study confirms the findings of previous researchers highlighting moderate burnout in athletic trainers employed in the collegiate setting. We did not find that personality significantly predicted burnout, though it did account for a small amount of the variance in burnout scores. Thus, organizational-level factors may play a greater role in determining burnout in athletic trainers than individual-level factors such as personality.
Athletic Training Services During Daily Patient Encounters: A Report From the Athletic Training Practice-Based Research Network
Authors: Lam Kenneth C. , Valier Alison R. Snyder , Anderson Barton E. , McLeod Tamara C. Valovich
Published: September 2016

Context: Athletic training services such as taping, wrapping, and stretching are common during routine care but rarely captured in traditional patient documentation. These clinical data are vital when determining appropriate medical coverage and demonstrating the value and worth of athletic trainers (ATs).

Objective: To analyze clinical data from daily encounter forms within the Athletic Training Practice-Based Research Network (AT-PBRN).

Design: Descriptive study.

Setting: Secondary school athletic training clinics.

Patients or Other Participants: Adolescent patients (n = 4888; age = 16.3 ± 1.4 years) seeking care from ATs.

Main Outcome Measure(s): We used Web-based electronic medical records from December 1, 2009, to July 1, 2015, to obtain patient characteristics via deidentified data. Descriptive data regarding practice characteristics from patient encounter forms were analyzed and reported as percentages and frequencies.

Results: A total of 36 245 patient encounters (mean = 7.5 ± 11.6 encounters per patient) were recorded. Football, basketball, soccer, track, and volleyball accounted for 85.1% of all encounters. Most encounters were for preventive services (48.8%, n = 22 329), followed by care for a current injury (37.2%, n = 17 027) and care for a new injury (13.9%, n = 6368). Of the preventive encounters, taping (52.7%) was the most common service provided, followed by ice- or hot-pack application (25.4%) and treatment (9.6%). Taping (28.7%) was also the most common service for current injuries, followed by treatment (26.7%) and ice- or hot-pack application (26.2%).

Conclusions: Our findings highlight the unique role of ATs as health care providers who provide substantial preventive services to their patients. Further, these results represent one of the first attempts to describe athletic training services related to nontime-loss injuries, emphasizing the significant role that ATs play in the health care of secondary school athletes. These findings should help clinicians and administrators make more informed decisions regarding appropriate medical coverage.
Hip-Extensor Strength, Trunk Posture, and Use of the Knee-Extensor Muscles During Running
Authors: Teng Hsiang-Ling , Powers Christopher M.
Published: September 2016

Context: Diminished hip-muscle performance has been proposed to contribute to various knee injuries.

Objective: To determine the association between hip-extensor muscle strength and sagittal-plane trunk posture and the relationships among hip-extensor muscle strength and hip- and knee-extensor work during running.

Design: Descriptive laboratory study.

Setting: Musculoskeletal biomechanical laboratory.

Patients or Other Participants: A total of 40 asymptomatic recreational runners, 20 men (age = 27.1 ± 7.0 years, height = 1.74 ± 0.69 m, mass = 71.1 ± 8.2 kg) and 20 women (age = 26.2 ± 5.8 years, height = 1.65 ± 0.74 m, mass = 60.6 ± 6.6 kg), participated.

Main Outcome Measure(s): Maximum isometric strength of the hip extensors was assessed using a dynamometer. Sagittal-plane trunk posture (calculated relative to the global vertical axis) and hip- and knee-extensor work (sum of energy absorption and generation) during the stance phase of running were quantified while participants ran over ground at a controlled speed of 3.4 m/s. We used Pearson product moment correlations to examine the relationships among hip-extensor strength, mean sagittal-plane trunk-flexion angle, hip-extensor work, and knee-extensor work.

Results: Hip-extensor strength was correlated positively with trunk-flexion angle (r = 0.55, P < .001) and hip-extensor work (r = 0.46, P = .003). It was correlated inversely with knee-extensor work (r = −0.39, P = .01). All the correlations remained after adjusting for sex.

Conclusions: Our findings suggest that runners with hip-extensor weakness used a more upright trunk posture. This strategy led to an overreliance on the knee extensors and may contribute to overuse running injuries at the knee.
Exertional Heat Illness in American Football Players: When Is the Risk Greatest?
Authors: Cooper Earl R. , Ferrara Michael S. , Casa Douglas J. , Powell John W. , Broglio Steven P. , Resch Jacob E. , Courson Ronald W.
Published: September 2016

Context:

Knowledge about the specific environmental and practice risks to participants in American intercollegiate football during preseason practices is limited. Identifying risks may mitigate occurrences of exertional heat illness (EHI).

Objective:

To evaluate the associations among preseason practice day, session number, and wet bulb globe temperature (WBGT) and the incidence of EHI.

Design:

Descriptive epidemiology study.

Setting:

Sixty colleges and universities representing 5 geographic regions of the United States.

Patients or Other Participants:

National Collegiate Athletic Association football players.

Main Outcome Measure(s):

Data related to preseason practice day, session number, and WBGT. We measured WBGT every 15 minutes during the practice sessions and used the mean WBGT from each session in the analysis. We recorded the incidence of EHIs and calculated the athlete-exposures (AEs).

Results:

A total of 553 EHI cases and 365 810 AEs were reported for an overall EHI rate of 1.52/1000 AEs (95% confidence interval [CI] = 1.42, 1.68). Approximately 74% (n = 407) of the reported EHI cases were exertional heat cramps (incidence rate = 1.14/1000 AEs; 95% CI = 1.03, 1.25), and about 26% (n = 146) were a combination of exertional heat syncope and heat exhaustion (incidence rate = 0.40/1000 AEs; 95% CI = 0.35, 0.48). The highest rate of EHI occurred during the first 14 days of the preseason period, and the greatest risk was during the first 7 days. The risk of EHI increased substantially when the WBGT was 82.0°F (27.8°C) or greater.

Conclusions:

We found an increased rate of EHI during the first 14 days of practice, especially during the first 7 days. When the WBGT was greater than 82.0°F (27.8°C), the rate of EHI increased. Sports medicine personnel should take all necessary preventive measures to reduce the EHI risk during the first 14 days of practice and when the environmental conditions are greater than 82.0°F (27.8°C) WBGT.
Phasic Electrodermal Activity During the Standardized Assessment of Concussion (SAC)
Authors: Raikes Adam C. , Schaefer Sydney Y.
Published: September 2016

Context: The long-term effects of concussion on brain function during cognitive tasks are not fully understood and neuroimaging findings are equivocal. Some images show hyperactivation of prefrontal brain regions in previously concussed individuals relative to controls, suggesting increased cognitive resource allocation. Others show prefrontal hypoactivation and hyperactivation in other regions as a presumed compensatory mechanism. Given the relationship between sympathetic arousal and neural activation, physiologic measures of arousal, such as electrodermal activity, may provide additional insight into the brain's functional changes in those with a history of concussion.

Objective: To quantify differences in electrodermal activity during a commonly used standardized neurocognitive assessment between individuals with or without a history of concussion.

Design: Descriptive laboratory study.

Setting: Research laboratory.

Patients or Other Participants: Seven asymptomatic individuals with a self-reported history of physician-diagnosed, sport-related concussion (number of previous concussions = 1.43 ± 0.53; time since most recent concussion = 0.75 to 6 years, median = 3 years) and 10 individuals without a history of concussion participated in this study.

Main Outcome Measure(s): All participants wore bilateral wrist electrodermal activity sensors during the Standardized Assessment of Concussion. We measured normalized phasic (reactive) electrodermal activity during each test element (orientation, immediate recall, concentration, delayed recall).

Results: A significant group-by-test element interaction was present (P = .003). Individuals with a history of concussion had greater phasic activity during delayed recall (P < .001). Delayed-recall phasic activity was greater in both groups relative to the other elements.

Conclusions: Delayed recall resulted in greater physiologic arousal in previously concussed individuals relative to healthy control participants, supporting previous neuroimaging findings of increased prefrontal cortex activity during memory tasks after concussion. Given similar task performance and arousal patterns across the test, our results suggest that previously concussed individuals incur additional cognitive demands in a short-delay recall task.
Program Directors' Perceptions of Professional Bachelor's Athletic Training Student Decisions to Persist and Depart
Authors: Bowman Thomas G. , Hertel Jay , Mazerolle Stephanie M. , Dodge Thomas M. , Wathington Heather D.
Published: September 2016

Context: Recent literature has focused on reasons for athletic training student persistence and departure. However, accredited professional bachelor's athletic training program (ATP) directors' opinions regarding student retention have yet to be studied, to our knowledge.

Objective: To determine reasons for athletic training student persistence and departure from professional bachelor's ATPs across the United States from the program directors' (PDs') perspective.

Design: Two-part qualitative study.

Setting: Commission on Accreditation of Athletic Training Education professional bachelor's ATPs.

Patients or Other Participants: For Part 1 of this study, we asked PDs of all 343 ATPs to complete an online survey, gathering responses from 177 (51.6%). Using data saturation as a guide, Part 2 included performing follow-up telephone interviews to gain further understanding, clarity, and triangulation with 16 randomly selected PDs.

Main Outcome Measure(s): During Part 1, participants chronicled responses to open-ended questions as part of the online survey. For the second part of the study, the telephone interviews followed a semistructured format and were recorded to facilitate transcription. We analyzed data using grounded theory and secured trustworthiness by using multiple-analyst triangulation, member checks, and a peer review.

Results: Program directors reported athletic training students persist due to their career goals, the personal relationships they create, and because they enjoy and are dedicated to athletic training. The respondents stated that athletic training students leave ATPs because of the academic rigor, the program not meeting expectations, a loss of interest, career considerations, and financial reasons.

Conclusions: Program directors should educate prospective athletic training students about athletic training by providing a realistic explanation of the roles and responsibilities of the profession. Selecting clinical education sites with preceptors who enjoy their career choice and good working conditions may help solidify athletic training student commitment to the ATP and the athletic training profession.
Canadian Athletic Therapists' Association Education Task Force Consensus Statements
Authors: Lafave Mark R. , Bergeron Glen , Klassen Connie , Parr Kelly , Valdez Dennis , Elliott Jacqueline , Peeler Jason , Orecchio Elsa , McKenzie Kirsty , Streed Kristin , DeMont Richard
Published: September 2016

Context: A published commentary from 2 of the current authors acted as a catalyst for raising some key issues that have arisen in athletic therapy education in Canada over the years.

Objective: The purpose of this article is to report on the process followed to establish a number of consensus statements related to postsecondary athletic therapy education in Canada. The consensus statements should act as a future plan for entry-level athletic therapy education.

Design: Content validation for consensus statements.

Setting: Video-conference meetings at 7 Canadian postsecondary colleges/universities.

Patients or Other Participants: Canadian Athletic Therapists' Association (CATA) program directors and CATA leaders from education, certification, and program accreditation committees.

Main Outcome Measure(s): A Delphi method and modified Ebel procedure were used to gather opinions from participants about athletic therapy education.

Results: We created 10 consensus statements, with a series of caveats that are presented in this article. All components received at least 80% consensus from the expert validation group.

Conclusions: The final Education Task Force Report was created and content was validated by a group of experts in the topics associated with every consensus statement. The final report was presented to the CATA Board of Directors for adoption and implementation.
The notion of the Holy Spirit as Paraclete from a Pentecostal perspective
Authors: Nel Marius
Published: September 2016

Pentecostals share an interest in the work and person of the Holy Spirit although not at the cost of a well-developed Christology. The term Paraclete (παράκλητος) appears four times in the Gospel according to John in reference to the Holy Spirit (Jn 14:16, 26; 15:26; 16:7), and once in 1 John 2:1 in reference to Jesus. The question the article asks is: What is meant by the notion of the Spirit as Paraclete from a primarily Pentecostal perspective? To answer the question it is necessary to ask where John’s Paraclete fits into the pneumatology of the early Christian Church before investigating the different contexts in the Johannine literature and what they suggest about the Spirit (and Jesus) as Paraclete. Lastly the meaning of the term in the Graeco-Roman world of the 1st century CE is observed before some suggestions are made for interpreting Paraclete, specifically in forensic terms.
Radio-anatomical Study of the Greater Palatine Canal and the Pterygopalatine Fossa in a Lebanese Population: A Consideration for Maxillary Nerve Block
Authors: Aoun Georges , Nasseh Ibrahim , Sokhn Sayde
Published: September 2016

Aim:

The aim of this study was to describe the morphology of the component, greater palatine canal-pterygopalatine fossa (GPC-PPF), in a Lebanese population using cone-beam computed tomography (CBCT) technology.

Materials and Methods:

CBCT images of 79 Lebanese adult patients (38 females and 41 males) were included in this study, and a total of 158 cases were evaluated bilaterally. The length and path of the GPCs-PPFs were determined, and the data obtained analyzed statistically.

Results:

In the sagittal plane, of all the GPCs-PPFs assessed, the average length was 35.02 mm on the right and 35.01 mm on the left. The most common anatomic path consisted in the presence of a curvature resulting in an internal narrowing whose average diameter was 2.4 mm on the right and 2.45 mm on the left. The mean diameter of the upper opening was 5.85 mm on the right and 5.82 mm on the left. As for the lower opening corresponding to the greater palatine foramen, the right and left average diameters were 6.39 mm and 6.42 mm, respectively.

Conclusion:

Within the limits of this study, we concluded that throughout the Lebanese population, the GPC-PPF path is variable with a predominance of curved one (77.21% [122/158] in both the right and left sides); however, the GPC-PPF length does not significantly vary according to gender and side.
Creating a Novel Cardiac Limited Ultrasound Exam Curriculum for Internal Medical Residency: Four Unanticipated Tasks
Authors: Nardi Melissa , Shaw David J. , Amundson Stanley A. , Phan James N. , Kimura Bruce J.
Published: September 2016

Over the past two decades, our internal medicine residency has created a unique postgraduate education in internal medicine by incorporating a formal curriculum in point-of-care cardiac ultrasound as a mandatory component. The details regarding content and implementation were critical to the initial and subsequent success of this novel program. In this paper, we discuss the evidence-based advances, considerations, and pitfalls that we have encountered in the program's development through the discussion of four unanticipated tasks unique to a point-of-care ultrasound curriculum. The formatted discussion of these tasks will hopefully assist development of ultrasound programs at other institutions.
Overconvergent subanalytic subsets in the framework of Berkovich spaces
Authors: Martin Florent
Published: September 2016

We study the class of overconvergent subanalytic subsets of a

k

-affinoid space

X

when

k

is a non-archimedean field. These are the images along the projection

X \times \mathbb B^n \to X

of subsets defined with inequalities between functions of

X \times \mathbb B^n

which are overconvergent in the variables of

\mathbb B^n

. In particular, we study the local nature, with respect to

X

, of overconvergent subanalytic subsets. We show that they behave well with respect to the Berkovich topology, but not to the

G

-topology. This gives counter-examples to previous results on the subject, and a way to correct them. Moreover, we study the case dim

(X)=2

, for which a simpler characterisation of overconvergent subanalytic subsets is proven.
Two-Level Defect-Correction Method for Steady Navier-Stokes Problem with Friction Boundary Conditions
Authors: Liu An , Li Yuan , An Rong
Published: September 2016

In this paper, we present two-level defect-correction finite element method for steady Navier-Stokes equations at high Reynolds number with the friction boundary conditions, which results in a variational inequality problem of the second kind. Based on Taylor-Hood element, we solve a variational inequality problem of Navier-Stokes type on the coarse mesh and solve a variational inequality problem of Navier-Stokes type corresponding to Newton linearization on the fine mesh. The error estimates for the velocity in the H1 norm and the pressure in the L2 norm are derived. Finally, the numerical results are provided to confirm our theoretical analysis.
Morphometric evaluation of dural venous sinuses: anatomical study with its implications in surgical interventions
Authors: Thamke S. , Kalra S. , Khandelwal A.
Published: September 2016

Introduction: Knowledge of the normal anatomical variations of venous sinuses is important for clinicians and radiologist for investigations and diagnosing various pathologies of dural venous sinuses like thrombosis, embolism and fistula etc. The detailed morphometric study of dural venous sinuses is missing in academic literature. Although few radiological studies have been done in the past but direct anatomical proof in the form of cadaveric study of dural venous sinuses is not available in the literature. Methods: The present study involved the examination of superior sagittal sinus, sigmoid sinus, transverse sinus, straight sinus and occipital sinus in 12 dura maters of formaldehyde fixed cadavers. The length and width (at midpoint and near confluences) of these sinuses and width of confluences were measured with venire callipers. Results: Some remarkable findings were observed in this study. It was established that the width of torcular herophilus is directly proportional to length of superior sagittal sinus and is also directly proportional to length of right sigmoid sinus. Torcular herophilus is situated away from right sigmoid sinus with intervening right transverse sinus and still its width is directly proportional to length of right sigmoid sinus. Also it was observed that the length of straight sinus was directly proportional to length of right transverse sinus. Right sigmoid sinus is a continuation of right transverse sinus but its width increases with increase in width of left transverse sinus. Length of left sigmoid sinus was directly proportional to length of right but width of left sigmoid sinus and vice a versa. Width of left sigmoid sinus is directly proportional to the length of right and left sigmoid sinus. Conclusion: It is extrapolated that this study will be valuable to neurosurgeons for preoperative planning and clinicians and radiologist to prevent misdiagnosis.