Stephanie M. Mazerolle

Influence of Hydration on Physiological Function and Performance During Trail Running in the Heat

CONTEXT Authors of most field studies have not observed decrements in physiologic function and performance with increases in dehydration, although authors of well-controlled laboratory studies have consistently reported this relationship. Investigators in these field studies did not control exercise intensity, a known modulator of body core temperature. OBJECTIVE To directly examine the effect of moderate water deficit on the physiologic responses to various exercise intensities in a warm outdoor setting. DESIGN Semirandomized, crossover design. SETTING Field setting. PATIENTS OR OTHER PARTICIPANTS Seventeen distance runners (9 men, 8 women; age = 27 +/- 7 years, height = 171 +/- 9 cm, mass = 64.2 +/- 9.0 kg, body fat = 14.6% +/- 5.5%). INTERVENTION(S) Participants completed four 12-km runs (consisting of three 4-km loops) in the heat (average wet bulb globe temperature = 26.5 degrees C): (1) a hydrated, race trial (HYR), (2) a dehydrated, race trial (DYR), (3) a hydrated, submaximal trial (HYS), and (4) a dehydrated, submaximal trial (DYS). MAIN OUTCOME MEASURE(S) For DYR and DYS trials, dehydration was measured by body mass loss. In the submaximal trials, participants ran at a moderate pace that was matched by having them speed up or slow down based on pace feedback provided by researchers. Intestinal temperature was recorded using ingestible thermistors, and participants wore heart rate monitors to measure heart rate. RESULTS Body mass loss in relation to a 3-day baseline was greater for the DYR (-4.30% +/- 1.25%) and DYS trials (-4.59% +/- 1.32%) than for the HYR (-2.05% +/- 1.09%) and HYS (-2.0% +/- 1.24%) trials postrun (P < .001). Participants ran faster for the HYR (53.15 +/- 6.05 minutes) than for the DYR (55.7 +/- 7.45 minutes; P < .01), but speed was similar for HYS (59.57 +/- 5.31 minutes) and DYS (59.44 +/- 5.44 minutes; P > .05). Intestinal temperature immediately postrun was greater for DYR than for HYR (P < .05), the only significant difference. Intestinal temperature was greater for DYS than for HYS postloop 2, postrun, and at 10 and 20 minutes postrun (all: P < .001). Intestinal temperature and heart rate were 0.22 degrees C and 6 beats/min higher, respectively, for every additional 1% body mass loss during the DYS trial compared with the HYS trial. CONCLUSIONS A small decrement in hydration status impaired physiologic function and performance while trail running in the heat.

Work-Family Conflict, Part I: Antecedents of Work-Family Conflict in National Collegiate Athletic Association Division I-A Certified Athletic Trainers

CONTEXT Work-family conflict (WFC) involves discord that arises when the demands of work interfere with the demands of family or home life. Long work hours, minimal control over work schedules, and time spent away from home are antecedents to WFC. To date, few authors have examined work-family conflict within the athletic training profession. OBJECTIVE To investigate the occurrence of WFC in certified athletic trainers (ATs) and to identify roots and factors leading to quality-of-life issues for ATs working in the National Collegiate Athletic Association Division I-A setting. DESIGN Survey questionnaire and follow-up, in-depth, in-person interviews. SETTING Division I-A universities sponsoring football. PATIENTS OR OTHER PARTICIPANTS A total of 587 ATs (324 men, 263 women) responded to the questionnaire. Twelve ATs (6 men, 6 women) participated in the qualitative portion: 2 head ATs, 4 assistant ATs, 4 graduate assistant ATs, and 2 AT program directors. DATA COLLECTION AND ANALYSIS Multiple regression analysis was performed to determine whether workload and travel predicted levels of WFC. Analyses of variance were calculated to investigate differences among the factors of sex, marital status, and family status. Interviews were transcribed verbatim and then analyzed using computer software as well as member checks and peer debriefing. The triangulation of the data collection and multiple sources of qualitative analysis were utilized to limit potential researcher prejudices. RESULTS Regression analyses revealed that long work hours and travel directly contributed to WFC. In addition to long hours and travel, inflexible work schedules and staffing patterns were discussed by the interview participants as antecedents to WFC. Regardless of sex (P = .142), marital status (P = .687), family status (P = .055), or age of children (P = .633), WFC affected Division I-A ATs. CONCLUSIONS No matter their marital or family status, ATs employed at the Division I-A level experienced difficulties balancing their work and home lives. Sources of conflict primarily stemmed from the consuming nature of the profession, travel, inflexible work schedules, and lack of full-time staff members.

Work-Family Conflict, Part II: Job and Life Satisfaction in National Collegiate Athletic Association Division I-A Certified Athletic Trainers

CONTEXT Previous researchers have shown that work-family conflict (WFC) affects the level of a persons job satisfaction, life satisfaction, and job burnout and intentions to leave the profession. However, WFC and its consequences have not yet been fully investigated among certified athletic trainers. OBJECTIVE To investigate the relationship between WFC and various outcome variables among certified athletic trainers working in National Collegiate Athletic Association Division I-A settings. DESIGN A mixed-methods design using a 53-item survey questionnaire and follow-up in-depth interviews was used to examine the prevalence of WFC. SETTING Division I-A universities sponsoring football. PATIENTS OR OTHER PARTICIPANTS A total of 587 athletic trainers (324 men, 263 women) responded to the questionnaire, and 12 (6 men, 6 women) participated in the qualitative portion of the mixed-methods study. DATA COLLECTION AND ANALYSIS We calculated Pearson correlations to determine the relationship between WFC and job satisfaction, life satisfaction, and job burnout. Regression analyses were run to determine whether WFC was a predictor of job satisfaction, job burnout, or intention to leave the profession. Interviews were transcribed verbatim and then analyzed using the computer program N6 as well as member checks and peer debriefing. RESULTS Negative relationships were found between WFC and job satisfaction (r = -.52, P < .001). Positive were noted between WFC and job burnout (r = .63, P < .001) and intention to leave the profession (r = .46, P < .001). Regression analyses revealed that WFC directly contributed to job satisfaction (P < .001), job burnout (P < .001), and intention to leave the profession (P < .001). CONCLUSIONS Overall, our findings concur with those of previous researchers on WFC and its negative relationships to job satisfaction and life satisfaction and positive relationship to job burnout and intention to leave an organization. Sources of WFC, such as time, inflexible work schedules, and inadequate staffing, were also related to job burnout and job dissatisfaction in this population.

Undergraduate athletic training students' influences on career decisions after graduation.

CONTEXT Career opportunities for athletic training students (ATSs) have increased substantially over the past few years. However, ATSs commonly appear to be opting for a more diversified professional experience after graduation. With the diversity in available options, an understanding of career decision is imperative. OBJECTIVE To use the theoretical framework of socialization to investigate the influential factors behind the postgraduation decisions of senior ATSs. DESIGN Qualitative study. SETTING Web-based management system and telephone interviews. PATIENTS OR OTHER PARTICIPANTS Twenty-two ATSs (16 females, 6 males; age = 22 ± 2 years) who graduated in May 2010 from 13 different programs accredited by the Commission on Accreditation of Athletic Training Education. DATA COLLECTION AND ANALYSIS All interviews were transcribed verbatim, and the data were analyzed inductively. Data analysis required independent coding by 2 athletic trainers for specific themes. Credibility of the results was confirmed via peer review, methodologic triangulation, and multiple analyst triangulation. RESULTS Two higher-order themes emerged from the data analysis: persistence in athletic training (AT) and decision to leave AT. Faculty and clinical instructor support, marketability, and professional growth were supporting themes describing persistence in AT. Shift of interest away from AT, lack of respect for the AT profession, compensation, time commitment, and AT as a stepping stone were themes sustaining the reasons that ATSs leave AT. The aforementioned reasons to leave often were discussed collectively, generating a collective undesirable outlook on the AT profession. CONCLUSIONS Our results highlight the importance of faculty support, professional growth, and early socialization into AT. Socialization of pre-AT students could alter retention rates by providing in-depth information about the profession before students commit in their undergraduate education and by helping reduce attrition before entrance into the workforce.

Is oral temperature an accurate measurement of deep body temperature? A systematic review.

CONTEXT Oral temperature might not be a valid method to assess core body temperature. However, many clinicians, including athletic trainers, use it rather than criterion standard methods, such as rectal thermometry. OBJECTIVE To critically evaluate original research addressing the validity of using oral temperature as a measurement of core body temperature during periods of rest and changing core temperature. DATA SOURCES In July 2010, we searched the electronic databases PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTDiscus, Academic Search Premier, and the Cochrane Library for the following concepts: core body temperature, oral, and thermometers. Controlled vocabulary was used, when available, as well as key words and variations of those key words. The search was limited to articles focusing on temperature readings and studies involving human participants. DATA SYNTHESIS Original research was reviewed using the Physiotherapy Evidence Database (PEDro). Sixteen studies met the inclusion criteria and subsequently were evaluated by 2 independent reviewers. All 16 were included in the review because they met the minimal PEDro score of 4 points (of 10 possible points), with all but 2 scoring 5 points. A critical review of these studies indicated a disparity between oral and criterion standard temperature methods (eg, rectal and esophageal) specifically as the temperature increased. The difference was -0.50°C ± 0.31°C at rest and -0.58°C ± 0.75°C during a nonsteady state. CONCLUSIONS Evidence suggests that, regardless of whether the assessment is recorded at rest or during periods of changing core temperature, oral temperature is an unsuitable diagnostic tool for determining body temperature because many measures demonstrated differences greater than the predetermined validity threshold of 0.27°C (0.5°F). In addition, the differences were greatest at the highest rectal temperatures. Oral temperature cannot accurately reflect core body temperature, probably because it is influenced by factors such as ambient air temperature, probe placement, and ingestion of fluids. Any reliance on oral temperature in an emergency, such as exertional heat stroke, might grossly underestimate temperature and delay proper diagnosis and treatment.

Fulfillment of work-life balance from the organizational perspective: a case study.

CONTEXT Researchers studying work-life balance have examined policy development and implementation to create a family-friendly work environment from an individualistic perspective rather than from a cohort of employees working under the same supervisor. OBJECTIVE To investigate what factors influence work-life balance within the National Collegiate Athletic Association (NCAA) Division I clinical setting from the perspective of an athletic training staff. DESIGN Qualitative study. SETTING Web-based management system. PATIENTS OR OTHER PARTICIPANTS Eight athletic trainers (5 men, 3 women; age = 38 ± 7 years) in the NCAA Division I setting. DATA COLLECTION AND ANALYSIS Participants responded to a series of questions by journaling their thoughts and experiences. We included data-source triangulation, multiple-analyst triangulation, and peer review to establish data credibility. We analyzed the data via a grounded theory approach. RESULTS Three themes emerged from the data. Family-oriented and supportive work environment was described as a workplace that fosters and encourages work-life balance through professionally and personally shared goals. Nonwork outlets included activities, such as exercise and personal hobbies, that provide time away from the role of the athletic trainer. Individualistic strategies reflected that although the athletic training staff must work together and support one another, each staff member must have his or her own personal strategies to manage personal and professional responsibilities. CONCLUSIONS The foundation for a successful work environment in the NCAA Division I clinical setting potentially can center on the management style of the supervisor, especially one who promotes teamwork among his or her staff members. Although a family-friendly work environment is necessary for work-life balance, each member of the athletic training staff must have personal strategies in place to fully achieve a balance.

An assessment of burnout in graduate assistant certified athletic trainers.

CONTEXT Graduate assistant athletic trainers (GAATs) must balance the demands of clinical care and the academic load of graduate-level students. OBJECTIVE To examine burnout among GAATs with clinical assistantships at National Collegiate Athletic Association (NCAA) Division I institutions and to identify the personal and situational variables that are related to burnout. DESIGN Cross-sectional study. SETTING Division I universities offering graduate assistantship programs. PATIENTS OR OTHER PARTICIPANTS Two hundred one GAATs enrolled at NCAA Division I universities with graduate assistantship positions. MAIN OUTCOME MEASURES(S) The Athletic Training Burnout Inventory, which assesses stress and burnout among ATs through 4 constructs: emotional exhaustion and depersonalization, administrative responsibility, time commitment, and organizational support. The 6-point Likert scale is anchored by 1 (never true) and 6 (always true). RESULTS The GAATs who traveled with athletic teams (4.051 ± 0.895) and those who provided classroom instruction (4.333 ± 1.16) reported higher levels of stress due to time commitment than those who did not travel (3.713 ± 1.22) or teach (3.923 ± 0.929). We also found a difference in administrative responsibility across clinical settings (F(6,194) = 3.507, P = .003). The results showed that GAATs in NCAA Division I clinical settings (44.55 ± 13.17 hours) worked more hours than those in NCAA Division III clinical settings (33.69 ± 12.07 hours) and those in high school settings (30.51 ± 9.934 hours). CONCLUSIONS Graduate assistant ATs are at risk for burnout because of the time necessary to complete their clinical and academic responsibilities and their additional administrative responsibilities. Graduate assistants who work in the Division I clinical setting are at greater risk for burnout than those in the secondary school setting because of the large number of hours required.

The professional socialization of collegiate female athletic trainers: navigating experiences of gender bias.

CONTEXT Female athletic trainers (ATs) experience gender discrimination in the workplace due to stereotypical gender roles, but limited information is available regarding the topic. OBJECTIVE To understand the challenges and obstacles faced by young female ATs working in National Collegiate Athletic Association Division I athletics. DESIGN Exploratory study using semistructured interviews. SETTING Division I clinical setting. PATIENTS OR OTHER PARTICIPANTS A total of 14 female ATs were included in the study, using both criterion and snowball-sampling techniques. Their mean age was 27 ± 2 years, with 5 ± 2 years of overall clinical experience. Criteria included employment at the Division I clinical setting, being a full-time assistant AT, and at least 3 years of working experience but no more than 9 years to avoid role continuance. DATA COLLECTION AND ANALYSIS Analysis of the interview data followed inductive procedures as outlined by a grounded theory approach. Credibility was established by member checks, multiple-analyst triangulation, and peer review. RESULTS Clear communication with both coaches and players about expectations and philosophies regarding medical care, a supportive head AT in terms of clinical competence, and having and serving as a role model were cited as critical tools to alleviate gender bias in the workplace. CONCLUSIONS The female ATs in this study stressed the importance of being assertive with coaches early in the season with regard to the ATs role on the team. They reasoned that these actions brought forth a greater perception of congruity between their roles as ATs and their gender and age. We suggest that female athletic training students seek mentors in their field while they complete their coursework and practicums. The ATs in the current study indicated that a mentor, regardless of sex, helped them feel empowered to navigate the male-centric terrain of athletic departments by encouraging them to be assertive and not second-guess their decisions.

Role of Clinical Education Experiences on Athletic Training Students' Development of Professional Commitment

Context: Limited evidence exists on the role clinical education can play in the development of athletic training student commitment for the profession. Objective: Investigating the role clinical ed...

Athletic Training Student Socialization Part I: Socializing Students in Undergraduate Athletic Training Programs

Context: Professional socialization is a key process in the professional development of athletic training students. The published athletic training education research has focused on many perspectiv...