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An Educational Relationship Between an Athletic Training Program and an Elementary School

Dani M. Moffit, Jamie L. Mansell, and Anne C. Russ

Temple University Owls Athletic Training Society (OATS), committed to education and community involvement, formed a relationship with Lanning Square Elementary School (LSE). Located less than 10 miles from campus in Camden, NJ, a high incidence of poverty, violence, and one-parent families is the norm. Through a grant, OATS adopted the fifth-grade classes at LSE for 1 year, beginning with letter exchanges between OATS students and elementary students. OATS traveled to LSE for their holiday party, met their pen pals, and provided healthy snacks. In the spring, the LSE completed a health/wellness unit and visited Temple. Students shared several health activities including learning about bones/muscles in the anatomy laboratory, stretching properly, and exercising. They received lunch and Temple mementos. OATS raised money the following year to continue the project. This allowed OATS and administrators to participate positively in our community, promote diversity, and introduce healthy lifestyles to youngsters.

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Sexual Harassment and Internships: How Do We Protect Our Students and Program?

Anne C. Russ, Dani M. Moffit, and Jamie L. Mansell

Sexual harassment is a sensitive and pervasive topic in higher education. Programs and institutions have the responsibility to protect the students from sexual harassment under Title IX of the Education Amendments of 1972 (United States Department of Education Office of Civil Rights, 2011). While much attention has been focused toward on-campus interactions (i.e., professor/student, student/student), many students participate in off-campus fieldwork and internships associated with coursework, where the students are still protected under Title IX. The purpose of this discussion is to define sexual harassment, summarize research regarding sexual harassment in a fieldwork setting, consider how sexual harassment affects students, and identify resources to help programs identify and respond to sexual harassment.

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Workplace Bullying in Healthcare: A Critically Appraised Topic

Jonathan I. Hochstetler, Anne C. Russ, Ryan Tierney, and Jamie L. Mansell

Focused Clinical Question: In athletic training, what is the percentage of workplace bullying compared to the percentage in nursing? Clinical Bottom Line: There is evidence that workplace bullying is prevalent in the athletic training and nursing professions.

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The Impact of Concussion Education on Injury Disclosure in High School Athletes: A Critically Appraised Topic

Alyson Hansbarger, Ryan Thomson, Jamie L. Mansell, and Ryan T. Tierney

Clinical Scenario: Sport-related concussions are common injuries during sport-related activities. Evaluations of these injuries involve symptom reporting. Unfortunately, concussion symptoms are widely underreported by athletes, and can lead to longer recovery times. Concussion education programs were created to encourage reporting of symptoms by athletes. Clinical Question: Does concussion education impact injury disclosure in high school athletes? Summary of Key Findings: Three studies were included in this appraisal. Two studies utilized an educational lecture, and one study utilized an informational video providing the concussion education. All three studies found significant increases in injury history disclosure from pre-education to immediate post-education. Clinical Bottom Line: There is moderate evidence to support the idea that education has a positive impact on concussion reporting behaviors. These studies found positive results immediately following concussion education therefore it may be beneficial to provide concussion education several times a year. Strength of Recommendation: There is Level B evidence to support the idea that implementing concussion education will impact concussion reporting behaviors as it pertains to injury history disclosure.

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Genetic Variation and Individualized Medicine

Jamie L. Mansell, Ryan T. Tierney, Jeffrey B. Driban, Shannon M. Clegg, Michael J. Higgins, Anurag K. Mishra, and Evgeny Krynetskiy

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The Efficacy of Cryotherapy on Decreasing Swelling: A Critically Appraised Topic

Rachel A. Ziner, Jamie L. Mansell, Anne C. Russ, and Ryan T. Tierney

Context: Swelling is a major consequence of musculoskeletal conditions and can be a barrier to healing. Cryotherapy has been reported to decrease swelling. How effective is cryotherapy in reducing swelling during rehabilitation? Methods: PubMed was searched in June 2022 using the Boolean phrases: Swelling OR edema AND cryotherapy OR ice, Swelling AND injury AND cryotherapy. Included articles were published during or after 2017, consisted of one or more cryotherapy interventions, and listed swelling as an outcome measure. The PEDro scale was used to assess study validity. Swelling was measured by the figure-of-eight method (in centimeters). Means, SDs, and 95% confidence interval (CI) were calculated. Results: Three articles were screened. Stasinopoulos et al. received a score of 9/10; Sari et al. and Tittley et al. received a score of 10/10. Tittley et al. reported a decrease in swelling from 52.7 (SD = 0.8; 95% CI [52.35, 53.05]) to 52.0 (SD = 0.8; 95% CI [51.65, 52.35]). Stasinopoulos et al. reported decreases from 62.62 (SD = 0.34; 95% CI [62.51, 62.80]) to 61.10 (SD = 0.30; 95% CI [60.98, 61.24]). Sari et al. also found minimal change in swelling from pre- to posttreatment, 38.7 (SD = 2.6; 95% CI [37.83, 39.57]) to 38.2 (SD = 2.4; 95% CI [37.40, 39.00]). Conclusion: There is consistent evidence indicating that cryotherapy applied during rehabilitation does not decrease swelling in a patient with a musculoskeletal condition.

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The Effect of the Closed-Loop Control System on Blood Glucose Control With Exercise: A Critically Appraised Topic

Melanie A. Mason, Anne C. Russ, Ryan T. Tierney, and Jamie L. Mansell

Context: Exercise can cause fluctuations in blood glucose control in type 1 diabetics. For athletes with type 1 diabetes, maintenance of blood glucose within an ideal range may be difficult. Objective: To determine, in individuals with type 1 diabetes, the effectiveness of the closed loop control system versus the open loop control system in keeping blood glucose levels in the ideal range with exercise. Data Sources: A search of PubMed was conducted in June of 2020 using the Boolean phrases: (closed loop control system OR artificial pancreas) AND type 1 diabetes AND exercise AND ideal range AND adolescents, artificial pancreas AND glucose prediction AND exercise. Study Selection : Titles were reviewed for relevance, the abstract was then assessed for applicability, and finally the full text was examined. Articles were included that examined the percent of time in the ideal blood glucose range when exercise occurred during that day. Articles were excluded that didn’t compare the closed loop and open loop control systems and articles that did not involve exercise. Data Extraction : The PEDro scale was used to determine the methodological quality of the included studies. The measure addressed was the percent of time in the ideal blood glucose range of 70-180 mg/dL. 95% Confidence Intervals and Cohen’s D were calculated for each article. Data Synthesis : The search yielded 268 articles and 3 were selected for inclusion. The two randomized controlled trials scored 9/10 on the PEDro scale and the randomized two-arm crossover clinical trial scored 9/10 on the PEDro scale. Percent time spent in the ideal blood glucose range when exercise was performed was significantly higher in the closed loop group versus the open loop group in each of the three studies. In one randomized control trial, mean time in the ideal range was 71.3% (SD = 17.6, 95% CI = 62.5, 80.10) in the closed loop group versus 64.7% (SD = 13.3, 95% CI = 58.1–71.4) in the open loop group. Cohen’s D was 0.4. In the second randomized control trial, mean time in the ideal range was 73.5% (SD = 8.4, 95% CI = 70.1, 76.9) for the closed loop group versus 50% (SD = 26.8, 95% CI = 39.1, 60.9). Cohen’s D was 1.2. The two-arm crossover clinical trial resulted in a mean time in target range of 84.1% (SD = 11.5, 95% CI = 79.0, 89.2) in the closed loop group versus 68.7% (SD = 13.9, 95% CI = 62.5, 74.9) in the open loop group. Cohen’s D was 1.2. Conclusions : For adolescents with type 1 diabetes who exercise, the closed loop control system maintains blood glucose levels in the ideal range for a longer percent of time versus an open loop system. Each patient should be evaluated on a case-by-case basis with his/her healthcare team. Future research should examine the closed loop control system on specific energy systems.

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In Physicians and Athletic Trainers, Is Burnout Associated With Self-Reported Medical Errors: A Critically Appraised Topic

Mark S. Myers, Jamie L. Mansell, Ryan T. Tierney, and Anne C. Russ

Clinical Question: In physicians and athletic trainers, is burnout associated with self-reported medical errors (MEs)? Clinical Bottom Line: Burnout directly increased the odds of self-reported ME. Physicians and surgeons with burnout had a higher risk of an self-reported ME than athletic trainers with burnout. This disparity may reflect the different definitions, oversight, and opportunities to commit MEs in the respective fields. Emotional exhaustion and personnel accomplishment appear to drive MEs within clinically practicing athletic trainers, whereas emotional exhaustion and depersonalization are indicative of MEs within practicing physicians. Understanding the mechanism behind burnout within practice settings may provide insights into mitigation strategies to reduce MEs and improve patient outcomes. Strength of Recommendation Taxonomy B.