Football Practices in Hot Environments Impact Subsequent Days' Hydration.

Ashley, CD, Lopez, RM, and Tritsch, AJ. Football practices in hot environments impact subsequent days' hydration. J Strength Cond Res 38(1): 90-96, 2024-The impact of proper hydration to prevent exertional heat illness in American football has not been evaluated during high school preseason football practices in a hot environment (wet-bulb globe temperature = 31.

Distribution of upper limit of the prescriptive zone values for acclimatized and unacclimatized individuals.

Heat stress has an adverse impact on worker health and well-being, and the effects will increase with more frequent and severe heat events associated with global warming. Acclimatization to heat stress is widely considered to be a critical mitigation strategy and wet bulb globe temperature- (WBGT-) based occupational standards and guidelines contain adjustments for acclimatization. The purpose here was to ) compare the mean values for the upper limit of the prescriptive zone (ULPZ, below which the rise in core temperature is minimal) between unacclimatized and acclimatized men and women; ) demonstrate that the change in the occupational exposure limit (ΔOEL) due to acclimatization is independent of metabolic rate; ) examine the relation between ΔOEL and body surface area (BSA); and ) compare the exposure-response curves between unacclimatized and acclimatized populations.

Exertional Heat Illness: Adoption of Policies and Influencing Contextual Factors as Reported by Athletic Administrators.

Background: Little is known about the adoption by athletic administrators (AAs) of exertional heat illness (EHI) policies, and the corresponding facilitators and barriers of such policies within high school athletics. This study describes the adoption of comprehensive EHI policies by high school AAs and explores factors influencing EHI policy adoption.

Hypothesis: We hypothesized that <50% of AAs would report adoption of an EHI policy, and that the most common facilitator would be access to an athletic trainer (AT), whereas the most common barrier would be financial limitations.

The Role of the Athletic Trainer in Providing Care to Transgender and Gender-Diverse Patients: Foundational Knowledge and Disparities-Part I.

Transgender and gender-diverse (TGD) patients experience discrimination, harassment, marginalization, and minority stress at greater rates than their cisgender counterparts, leading to numerous health and health care disparities that negatively affect well-being and access to quality health care.1 Despite being in an opportune position to improve health equity for TGD patients under their care, many athletic trainers (ATs) report having little to no formal education on TGD patient care, leading to a reduction in self-reported competence. As such, to fill this knowledge gap, the purposes of the first part of this 2-part narrative literature review are to (1) provide readers with foundational information and terminology, (2) explore relevant health and health care disparities, and (3) identify the role of the AT within an interprofessional care team treating TGD patients.

The Role of the Athletic Trainer in Providing Care to Transgender and Gender-Diverse Patients: Considerations for Medical Affirmation-Part II.

Recently, with discriminatory legislation efforts and changing participation policies in organized sports, media attention surrounding transgender and gender-diverse (TGD) individuals has increased. These changes and the historical lack of competence and education regarding the transgender patient population have resulted in subpar patient care and a misunderstanding of the athletic trainer's (AT's) role within the health care and compliance systems. This literature review is the second part of a 2-paper series, and our objective was to educate ATs on the processes relevant to medical affirmation, including compliance considerations regarding medical eligibility, and to establish the AT's role.

Sports Medicine Physicians Comfort and Competence in Caring for Transgender and Gender Nonconforming Patients and Athletes.

Objective: The purpose of this study was to explore primary care sports medicine physicians' comfort, competence, education, and scope of training in caring for transgender and gender nonconforming (TGNC) patients/athletes.

Design: Mixed-methods, cross-sectional survey.

Setting: Online.

Proper Recognition and Management of Exertional Heat Stroke in a High School Cross-Country Runner: A Validation Clinical Case Report.

A 14-year-old female high school cross- country runner (height = 154 cm, mass = 48.1 kg) with no history of exertional heat stroke (EHS) collapsed at the end of a race. An athletic trainer assessed the patient, who presented with difficulty breathing and then other signs of EHS (eg, confusion and agitation).

Relationship Between Pre- and Post-exercise Body Mass Changes and Pre-exercise Urine Color in Female Athletes.

Although studies use body mass changes or urine color to measure hydration status, the purpose of this study was to examine the relationship between pre-practice urine color and exercise body mass changes in female tackle football players. Twenty-six female American football players (Age: 29.9 ± 7.

Sleep Dysfunction in Adolescents With Prolonged Postconcussion Symptoms: A Reciprocal Coupling of Traumatic Brain Injury and Sleep-Related Problems.

Clinical Scenario: Concussions are often neglected injuries that affect children and adolescents. Two physiological responses to a concussion are an ionic flux and an increased indiscriminate release of glutamate, which leads to an increase of intracellular calcium and extracellular potassium. This can ultimately result in sleep dysfunction, which often occurs after concussion and has long been thought of as simply another concussion symptom.

High Schools' Adoption of Evidence-Based Practices for the Management of Exertional Heat Stroke.

Context: Exertional heat stroke (EHS) deaths can be prevented by adhering to best practices.

Objective: To investigate high schools' adoption of policies and procedures for recognizing and treating patients with EHS and the factors influencing the adoption of a comprehensive policy.

Design: Cross-sectional study.

Heat Safety in the Workplace: Modified Delphi Consensus to Establish Strategies and Resources to Protect the US Workers.

The purpose of this consensus document was to develop feasible, evidence-based occupational heat safety recommendations to protect the US workers that experience heat stress. Heat safety recommendations were created to protect worker health and to avoid productivity losses associated with occupational heat stress. Recommendations were tailored to be utilized by safety managers, industrial hygienists, and the employers who bear responsibility for implementing heat safety plans.

Validation of a Machine Learning Brain Electrical Activity-Based Index to Aid in Diagnosing Concussion Among Athletes.

Importance: An objective, reliable indicator of the presence and severity of concussive brain injury and of the readiness for the return to activity has the potential to reduce concussion-related disability.

Objective: To validate the classification accuracy of a previously derived, machine learning, multimodal, brain electrical activity-based Concussion Index in an independent cohort of athletes with concussion.

Design, Setting, And Participants: This prospective diagnostic cohort study was conducted at 10 clinical sites (ie, US universities and high schools) between February 4, 2017, and March 20, 2019.

Roundtable on Preseason Heat Safety in Secondary School Athletics: Prehospital Care of Patients With Exertional Heat Stroke.

Objective: First, we will update recommendations for the prehospital management and care of patients with exertional heat stroke (EHS) in the secondary school setting. Second, we provide action items to aid clinicians in developing best-practice documents and policies for EHS. Third, we supply practical strategies clinicians can use to implement best practice for EHS in the secondary school setting.

Efficacy of an Educational Intervention for Improving the Hydration Status of Female Collegiate Indoor-Sport Athletes.

Context: Research focusing on improving hydration status and knowledge in female indoor-sport athletes is limited. Investigators have demonstrated that hydration education is an optimal tool for improving the hydration status of athletes.

Objective: To assess the hydration status and fluid intake of collegiate female indoor-sport athletes before and after a 1-time educational intervention.

Perceptions of Secondary School Athletic Trainers in the Diagnosis of Exertional Heat Stroke.

Context: Health care providers, including athletic trainers (ATs), may not be using the best practices for diagnosing exertional heat stroke (EHS), including rectal thermometry. Therefore, patients continue to be susceptible to death from EHS.

Objective: To examine the health belief model and its association with using rectal thermometry as the best practice for diagnosing EHS.

Early Aerobic Exercise for the Treatment of Acute Pediatric Concussions.

Sport-related concussion is a common injury that has garnered the attention of the media and general public because of the potential for prolonged acute symptoms and increased risk for long-term impairment. Currently, a growing body of evidence supports the use of various therapies to improve recovery after a concussion. A contemporary approach to managing concussion symptoms is to use aerobic exercise as treatment.

Do Alternative Cooling Methods Have Effective Cooling Rates for Hyperthermia Compared With Previously Established CWI Cooling Rates?

Clinical Scenario: In the last few years, there have been several studies examining alternative cooling strategies in the treatment of exertional heat stroke (EHS). Morbidity and mortality with EHS are associated with how long the patient's core body temperature remains above the critical threshold of 40.5°C.

Thermoregulation and Hydration in Female American Football Players During Practices.

Lopez, RM, Ashley, CD, Zinder, SM, and Tritsch, AJ. Thermoregulation and hydration in female American football players during practices. J Strength Cond Res 35(9): 2552-2557, 2021-Little is known about hydration practices and thermoregulation in female tackle football players.

A Functional Return-to-Play Progression After Exertional Heat Stroke in a High School Football Player.

Objective:   To present a functional return-to-play (RTP) progression after exertional heat stroke (EHS) in a 17-year-old high school football defensive end (height = 185 cm, mass = 145.5 kg).

Background:   The patient had no pertinent medical history but moved to a warm climate several days before the EHS occurred.

Examining the Influence of Exercise Intensity and Hydration on Gastrointestinal Temperature in Collegiate Football Players.

DeMartini-Nolan, JK, Martschinske, JL, Casa, DJ, Lopez, RM, Stearns, RL, Ganio, MS, and Coris, E. Examining the influence of exercise intensity and hydration on gastrointestinal temperature in collegiate football players. J Strength Cond Res 32(10): 2888-2896, 2018-Debate exists regarding the influence of intensity and hydration on body temperature during American football.