There are many occupational and professional careers that demand performance at the highest levels of function possible in hot environments. During heat exposure, the body undergoes a battery of physiological changes in response high heat stress. A problem arises when current physiological strain models are applied towards instantaneous monitoring of physiological strain in field settings. The Montana Center for Work Physiology and Exercise Metabolism has developed a novel equation to assess physiological strain, coined the Physiological Strain Scale (PSS), using the metrics of skin temperature (chest) and heart rate. This purpose of this study was to validate the new equations through previously collected data from 2 field studies (N=29, N=12), which varied in workload (Firefighting duties vs. Controlled Wattage Ride) , intensity, and environmental conditions (WLFF: 27.4 °C ± 3.61 °C and 6.5 mph ± 3.0 mph vs. Cycling: 12.5°C ± 7.1°C and 6.2 mph ± 5.7 mph). Core temperature, skin temperature (chest), and heart rate were continuously monitored in both studies. Accuracy was assessed between the gold standard PSI and the novel PSS equation by a 2 x 5 ANOVA between the number of overall minutes spent in the following groupings: No/Little= <2, Low=2.1-4, Moderate= 4.1-6, High= 6.1-8, Very high= >8. The novel equation of PSS demonstrated accuracy and reliability in the higher ambient temperature, lower wind speed environment when compared to PSI. However, PSS measured physiological strain to be significantly less in the lower temperature, higher wind speed environment when compared to PSI. This data suggests PSS is reliable in environments with a low Tcore-Tskin gradient, but may need adjustment in environments with a large Tcore-Tskin gradient.

ABSTRACT. Howard, Christine, M.S., December 2013 Health & Human Performance Descriptive Study on the Academic and Employment Expectations of Graduate Assistant Athletic Trainers Chairperson: Dr. Valerie Moody Introduction: It is common for newly certified athletic trainers to acquire a graduate assistantship as a certified athletic trainer. This graduate assistantship is a unique role in the profession where they juggle the demands of the job as a certified athletic trainer with the demands of attending graduate school full-time. There are few studies on this specific population of athletic trainers. Objective: To describe the academic and employment expectations of graduate assistant certified athletic trainers, Design: A descriptive study that used an electronic survey to explore the expectations of graduate assistant athletic trainers. Methods: National Athletic Trainers Association (NATA) sent a broadcast email to 302 certified-student members inviting them to participate in the study. Two reminder emails were also sent during the collection period. Eighty graduate assistant athletic trainers completed the survey in its entirety for a response rate of 26.5%. Intervention: Expectations of Graduate Assistant Certified Athletic Trainers Survey (EGAATCS) was developed using SurveyMonkey software. The survey consists of 7 demographic questions and 36 questions pertaining to specific job requirements (employment expectations) and academics (academic expectations), as well as two open-ended optional questions asking about the rewards and challenges of the position. Analysis: Quantitative data was analyzed using Microsoft Excel. Qualitative data analysis used a grounded theory approach that utilized open, axial, and selective coding procedures. Results: Graduate assistant certified athletic trainers focus more on their job and employment responsibilities than they do on their academic responsibilities. Conclusion: Graduate assistant certified athletic trainers are expected to attend graduate school full time while working (essentially) a full time job. Balance and time management pose to be the biggest challenges they face, while the most gratifying aspect was found in their socialization and clinical experiences. Keywords: clinical experience, education, athletic training, role strain

A variety of dietary choices are marketed to enhance glycogen recovery after physical activity. Past research provides recommendations regarding the timing, dose, and nutrient compositions to facilitate glycogen resynthesis. This study examined the effects of isocaloric sport supplements (SS) vs fast-food (FF) on glycogen resynthesis and exercise performance. Eleven male completed two experimental trials in a randomized, counterbalanced order. Each trial included a 90-minute glycogen depletion ride followed by a 4-hour recovery period. Absolute amounts of macronutrients (1.54±0.27 g.kg-1 carbohydrate, 0.24±0.04 g.kg-1 fat, and 0.18±0.03 g.kg-1 protein) as either SS or FF were provided at 0 and 2 hours. Muscle biopsies were collected from the vastus lateralis at 0 and 4 hours post exercise. Blood samples were obtained at 0, 30, 60, 120, 150, 180, and 240 minutes post exercise for insulin, glucose and blood lipids. A 20k time-trial (TT) was completed following the final muscle biopsy. There were no differences in the blood glucose and insulin responses. Similarly, rates of glycogen resynthesis were not different across the diets (6.9±1.7 and 7.9±2.4 mmol·kg-1·h-1 for SS and FF, respectively). There were also no differences across the diets for TT performance (34.1±1.8 and 34.3±1.7 minutes for SS and FF, respectively. These data indicate that short-term food options to initiate glycogen resynthesis can include a wide range of dietary options when total macronutrient composition is balanced.

Purpose: To determine if the effects of environmental conditions and their corresponding levels of heat strain during wildfire suppression influence behavior of wildland firefighters (WLFFs). Methods: Twenty-two WLFFs participated in regular activities on the fireline while under direct observation. Core (TC) and skin (TSK) temperatures, heart rate (HR), breathing rate (RR), physiological strain index (PSI), activity counts (ACT), ambient temperature (TEMP), relative humidity (HUM), and a detailed activity log were recorded in 10-minute averages across the entire work shift of subjects in the study. Wet-bulb globe temperature (WBGT) estimations were calculated using TEMP and HUM inputs recorded during the work shift. Results: Total time spent in temperature classifications defined by WBGT was 2,280 minutes or 16% of the total time (14,240 min). Average ACT in the white, green, yellow, red, and black flag conditions (384.0 ± 400.5 countsmin-1, 122.0 ± 125.8 countsmin-1, 106.8 ± 176.3 countsmin-1, 324.1 ± 353.6 countsmin-1, 249.7 ± 236.8 countsmin-1) were not less than ACT during WBGT conditions below 78.0°F (487.0 ± 704.4 countsmin-1). PSI values observed in the five flag conditions (3.1 ± 1.3, 2.2 ± 1.4, 2.1 ± 1.2, 2.7 ± 0.9, 2.9 ± 0.7) and outside of (2.2 ± 1.6) indicate adequate thermoregulation in this population across all weather conditions. Additionally, there was no difference in TC in response to changing environmental conditions. TSK and the gradient between TC and TSK were highly variable across all 22 subjects and environmental conditions. Conclusion: Increase in WBGT gradation did not reduce observed measurements of ACT and PSI. Situations of elevated body temperature were mitigated by individuals in response to body heat manifestation across all temperatures.

The purpose of this study was to explore current perceptions and attitudes of local food producers and hospital staff towards incorporating locally-sourced foods into hospital food service programs. Perceived opportunities and challenges to procuring and using local products in the hospital setting were identified. Additionally, perceived enablers and barriers of local producers were identified around working directly with institutions. The goal of this study was to integrate perceptions of producers and hospital staff to develop locally relevant suggestions for strengthening producer-hospital relationships and increase the amounts of local foods in hospital food service programs. Qualitative data was collected by conducting interviews with hospital staff involved with food procurement and management, as well as with local producers and food distributors. Demographic data was also collected from participants. Findings resulted in the identification of opportunities and challenges associated with direct working relationships between local food producers and hospitals and the increase of locally-sourced foods in food services. Barriers included price, product availability and quantity while opportunities included positive relationships, product quality, and champion leaders. The integration of results allowed for the development of capacity building suggestions. Such suggestions included the development of aggregated food systems, hospital staff wellness programs and collaborative problem solving processes. Most significantly, this study suggested that efforts to connect producers and hospitals in collaborative dialogue to identify and resolve misconceptions and misinformation may serve to most successfully strengthen Montanas farm-to-institution system and increase the amounts of locally-sourced foods being used in hospital food service programs.

Cardiovascular disease is the leading cause of hospitalizations and deaths in the United States. Although cardiac rehabilitation is recognized as a standard element of continuum of cardiac care only 10-60% of eligible patients participate. Various barriers exist preventing cardiac patients to enroll in cardiac rehabilitation. These barriers are categorized into three different levels: 1) patient barriers, 2) physician barriers and 3) healthcare system barriers. Patient barriers can include lack of insurance, transportation, need to return to work, family issues and the perception cardiac rehabilitation is not needed but lack of physician referral is the leading deterrent for patients not enrolling in cardiac rehabilitation. Numerous reasons have been found to influence whether or not a physician processes a referral including age and gender of the patient, motivation of patient, type of physician (primary care versus cardiologist) and lack of knowledge on local cardiac rehabilitation facilities. One way researchers have found to overcome the obstacles related to issuing a referral is for the hospital and staff to utilize an automatic referral system along with trained liaisons to increase the enrollment rates of cardiac rehabilitation. While this strategy has proven to be effective in increasing referral and enrollment rates there is still a need for strategies that address other barriers for cardiac patients. Home-based cardiac rehabilitation programs can address the problems of transportation, family and work-related issues and the preference of not exercising in group settings. Home-based programs give the patients more freedom and therefore can help increase exercise adherence rates.

We investigated the role of intramuscular pressure on the blood volumes delivered to working muscle during contractions spanning the entire range of force output that could be elicited from our subjects. Our subjects included four male (age = 22 ± 14 yr, mass = 63 ± 1.5 kg) and four female (age = 23 ± 9 yr, mass = 81.4 ± 5.6 kg). Vascular occlusion is thought to occur at similar pressures between sexes, but these pressures are achieved at different fractions of the male vs female maximum voluntary contraction. We therefore used a triplex capable pulsed Doppler ultrasound to obtain non-invasive measures of blood velocity and femoral artery diameter during single leg knee extension exercise performed by male (n = 4) and female (n = 4) subjects on an instrumented custom ergometer. We observed that greater periods of muscle inactivity between subsequent analysis (i.e. lower duty cycles), provided enhanced opportunity for circulatory based clearance by as much as 60 % and 64 % in males and females respectively. The forces subjects applied to the ergometer were measured via single-element strain gauges as the subjects adhered to a constant investigator-imposed cadence. Subjects performed bouts of knee extension exercise ranging from no-external imposed force, up to the level that could be performed for only three consecutive contractions (male = 524.66 ± 71.24 N vs female = 326.90 ± 115.75 N) while matching the experimental cadence. Resistance is controlled by manual Monarch turns and cadence is controlled by dual column LED array. We measured peak oxygen uptake (male = 26.90 ± 5.17 ml O2 kg-1 min-1 vs female = 19.57 ± 2.47 ml O2 kg-1 min-1) and surface EMG to determine the forces necessary to elicit anaerobic metabolism and the onset of compensatory neuromuscular recruitment an indicator, respectively. These experiments determined whether short-duration performance decrements are an issue of oxygen availability or related to clearance of metabolic byproducts elicited by muscle contraction.

The transgender community has been identified as a group at high risk for HIV transmission and increased possibility for poor quality of life. This paper represents the results of a qualitative research study using interviews and Photovoice as methodologies to explore the contextual factors that define and shape the lives of people in Montana who identify as transgender, and specifically to explore factors that influence their risk of infection with HIV/AIDS. Ten major themes emerged from the interviews as well as the discussions surrounding the photographs. Sense of self was identified as a core category related to the overall health and risk behaviour of the transgender community in Montana. The other nine major categories, including 1) age of transition, 2) the importance of love, 3) availability of support, 4) passing as your identified gender, 5) normalization in society, 6) ignorance surrounding gender variance, 7) health care, 8) legal issues, and 9) life in Montana, were seen as contributing to the development of a stronger or weaker sense of self. The findings from this study will be used by the Montana Department of Public Health and Human Services to increase awareness of the lived experience and health needs of the transgender community in Montana.