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Christine C. Center, Samuel J. Wilkins, Ross Mathiasen and Adam B. Rosen

The purpose of this report is to present the case of a high school football player who sustained an injury during a game, resulting in an acute subdural hematoma (SDH). The patient underwent an emergent decompressive craniectomy. The uniqueness of the case is due to both rare pathology and treatment. The athlete had a positive outcome due to prompt on-field assessment and advanced surgical treatments. Athletic trainers should know how to recognize symptoms of emergent traumatic brain injuries and be prepared to implement an emergency action plan when necessary.

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Jose Lam and Jacqueline Walsh

This case illustrates the challenges entrepreneurs experience as they try to guide a new venture to the commercialization stage in the entrepreneurial process. Steve Wheeler, Mike Maddock, and Marcel Savidon are three young entrepreneurs and friends who founded Magine Snowboards, a company focused on the manufacturing of snowboards. This case is set in January of 2012 as Steve Wheeler debates the next strategic step for the company. Magine has developed an innovative product—a snowboard that uses environmentally friendly and sustainable materials. The entrepreneurs have been able to start the business through bootstrapping. However, they now need to develop a strategy that can guide the company forward.

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Lucas C. Bianco, James M. May, Smokey L. Fermin, Robert Oates and Scott W. Cheatham

In the current case series, three male patients aged 19–21 years, all participating in basketball activities during their competitive season, were evaluated and classified with patella tendinopathy. A combination of positional release therapy (PRT) treatment with therapeutic exercises was used to decrease pain and improve function. Over the course of the treatment, each patient improved outcomes at discharge and sustained the improvements at follow-up. The purpose of this paper is to compare the results of this case series with a study of the effects of eccentric exercises on physically active patients diagnosed with patella tendinopathy and participating in jumping sports.

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Brandon C. Platt, Sue Falsone and Kenneth C. Lam,

A 21-year-old male baseball catcher sustained an injury to the right testicle from a foul ball that ricocheted from the ground to his groin. The athlete was removed from competition when testicular pain began to increase. Ice was applied to the affected area and nonsteroidal anti-inflammatory drugs (NSAIDs) were utilized through the evening. Further diagnosis and treatment were warranted the following morning. Diagnostic ultrasound revealed a fracture to the right testicle, necessitating surgical repair. The athlete followed a return-to-play progression and returned to play 20 days postinjury. This case describes evaluation and treatment of a rare acute condition and the need for early recognition and diagnosis.

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Brigid Byrd, Tamara Hew-Butler and Jeffrey J. Martin

The purpose of the study was to assess changes in multidimensional physical self-concept (PSC) over time of novice obese female runners participating in a 10-week running intervention. Multidimensional Physical Self-Concept was assessed at pre- and postintervention times and 3 months postintervention. A repeated measures MANOVA was significant, F (2, 7) = 8.82, p < .05. Follow-up tests indicated that 4 of the 9 PSCs significantly changed from Time 1 to Time 2 (p < .05) in the expected directions for physical activity (t = -2.45; h2 = 1.0), body fat (t = Ò3.21; h2 = 0.78), endurance (t = -3.75; h2 = 0.90), and general physical (t = -2.36; h2 = 0.99) self-concepts and these positive changes were maintained 3 months later at Time 3. We found that a 10-week running program appeared to produce positive changes in physical self-concept. Importantly, these positive changes were sustained for 3 months past the end of the intervention. These findings suggest that women running programs may be a viable way to increase physical self-concept, and sustain such positive changes in months following.

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Xiaoya Ma, Kaitlyn J. Patterson, Kayla M. Gieschen and Peter F. Bodary

The prevalence of iron deficiency tends to be higher in athletic populations, especially among endurancetrained females. Recent studies have provided evidence that the iron-regulating hormone hepcidin is transiently increased with acute exercise and suggest that this may contribute to iron deficiency anemia in athletes. The purpose of this study was to determine whether resting serum hepcidin is significantly elevated in highly trained female distance runners compared with a low exercise control group. Due to the importance of the monocyte in the process of iron recycling, monocyte expression of hepcidin was also measured. A single fasted blood sample was collected midseason from twenty female distance runners averaging 81.9 ± 14.2 km of running per week. Ten age-, gender-, and BMI-matched low-exercise control subjects provided samples during the same period using identical collection procedures. There was no difference between the runners (RUN) and control subjects (CON) for serum hepcidin levels (p = .159). In addition, monocyte hepcidin gene expression was not different between the two groups (p = .635). Furthermore, no relationship between weekly training volume and serum hepcidin concentration was evident among the trained runners. The results suggest that hepcidin is not chronically elevated with sustained training in competitive collegiate runners. This is an important finding because the current clinical conditions that link hepcidin to anemia include a sustained elevation in serum hepcidin. Nevertheless, additional studies are needed to determine the clinical relevance of the well-documented, transient rise in hepcidin that follows acute sessions of exercise.

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Kevin R. Heinsimer, Nicolas G. Nelson, Kristin J. Roberts and Lara B. McKenzie

Background:

The objective was to describe the patterns and mechanisms of water tubing–related injuries treated in U.S. emergency departments.

Methods:

The National Electronic Injury Surveillance System was used to examine cases of water tubing–related injuries. Sample weights were used to calculate national estimates of water tubing–related injuries. Analyses were conducted in 2010.

Results:

From 1991−2009 an estimated 69,471 injuries were treated in US emergency departments for water tubing–related injuries. The annual number of cases increased 250% over the 19-year study period (P < .001). Sprains and strains accounted for the largest portion of injuries (27.2%). The head was the most frequently injured body part (27.5%). Children and adolescents ≤ 19 years were more likely to be injured by contact with another person (OR: 2.47; 95% CI = 1.61−3.80) and were more likely to sustain injuries to the head (OR: 2.61; 95% CI = 2.01−3.38) compared with adults. Adults ≥ 20 years, were more likely than individuals ≤ 19 years to sustain sprains and strains (OR: 2.11; 95% CI = 1.64−2.71) and were most commonly injured by impact with the water (54.6%).

Conclusions:

Patterns of water tubing–related injuries differ for children and adults. Research is needed to determine how best to reduce these injuries.

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Marcus A. Badgeley, Natalie M. McIlvain, Ellen E. Yard, Sarah K. Fields and R. Dawn Comstock

Background:

With more than 1.1 million high school athletes playing annually during the 2005−06 to 2009−10 academic years, football is the most popular boys’ sport in the United States.

Methods:

Using an internet-based data collection tool, RIO, certified athletic trainers (ATs) from 100 nationally representative US high schools reported athletic exposure and football injury data during the 2005−06 to 2009−10 academic years.

Results:

Participating ATs reported 10,100 football injuries corresponding to an estimated 2,739,187 football-related injuries nationally. The injury rate was 4.08 per 1000 athlete-exposures (AEs) overall. Offensive lineman collectively (center, offensive guard, offensive tackle) sustained 18.3% of all injuries. Running backs (16.3%) sustained more injuries than any other position followed by linebackers (14.9%) and wide receivers (11.9%). The leading mechanism of injury was player-player contact (64.0%) followed by player-surface contact (13.4%). More specifically, injury occurred most commonly when players were being tackled (24.4%) and tackling (21.8%).

Conclusions:

Patterns of football injuries vary by position. Identifying such differences is important to drive development of evidence-based, targeted injury prevention efforts.

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Ellen Yard and Dawn Comstock

Background:

There are over 7 million US high school athletes and one-third are overweight or obese. Our objective was to examine injury patterns by body mass index (BMI) in high school athletes.

Methods:

Certified athletic trainers (ATCs) at 100 nationally representative US high schools submitted exposure and injury information during the 2005 to 08 school years via High School RIO (Reporting Information Online). We retrospectively categorized injured athletes as underweight (≤15th percentile), normal weight (15th−85th percentile), overweight (85th−95th percentile), or obese (≥95th percentile).

Results:

ATCs reported 13,881 injuries during 5,627,921 athlete-exposures (2.47 injuries per 1000 athlete-exposures). Nearly two-thirds (61.4%) of injured high school athletes were normal weight. The prevalence of overweight and obesity was highest among injured football athletes (54.4%). Compared with normal weight athletes, obese athletes sustained a larger proportion of knee injuries (Injury Proportion Ratio [IPR] = 1.27, 95% CI: 1.14 to 1.42) and their injuries were more likely to have resulted from contact with another person (IPR = 1.31, 95% CI: 1.26 to 1.37). Compared with normal weight athletes, underweight athletes sustained a larger proportion of fractures (IPR = 1.45, 95% CI: 1.10 to 1.92) and a larger proportion of injuries resulting from illegal activity (IPR = 1.59, 95% CI: 1.03 to 2.46).

Conclusions:

Injury patterns differ by BMI. BMI-targeted preventive interventions should be developed to help decrease sports injury rates.

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Brandon M. Ness, Kory Zimney and William E. Schweinle

Context:

Injury risk factors and relevant assessments have been identified in women’s soccer athletes. Other tests assess fitness (eg, the Gauntlet Test [GT]). However, little empirical support exists for the utility of the GT to predict time loss injury.

Objectives:

To examine the GT as a predictor of injury in intercollegiate Division I female soccer athletes.

Design:

Retrospective, nonexperimental descriptive cohort study.

Setting:

College athletic facilities.

Participants:

71 female Division I soccer athletes (age 19.6 ± 1.24 y, BMI 23.0 ± 2.19).

Main Outcome Measures:

GT, demographic, and injury data were collected over 3 consecutive seasons. GT trials were administered by coaching staff each preseason. Participation in team-based activities (practices, matches) was restricted until a successful GT trial. Soccer-related injuries that resulted in time loss from participation were recorded.

Results:

71 subjects met the inclusion criteria, with 12 lower body time loss injuries sustained. Logistic regression models indicated that with each unsuccessful GT attempt, the odds of sustaining an injury increased by a factor of 3.5 (P < .02). The Youden index was 2 GT trials for success, at which sensitivity = .92 and specificity = .46. For successive GT trials before success (1, 2, or 3), the predicted probabilities for injury were .063, .194, and .463, respectively.

Conclusions:

The GT appears to be a convenient and predictive screen for potential lowerbody injuries among female soccer athletes in this cohort. Further investigation into the appropriate application of the GT for injury prediction is warranted given the scope of this study.