Effect of a Cooling Kit on Physiology and Performance Following Exercise in the Heat.

CONTEXT: Exercising in the heat leads to an increase in body temperature that can increase the risk of heat illness or cause detriments in exercise performance. OBJECTIVE: To examine a phase change heat emergency kit (HEK) on thermoregulatory and perceptual responses and subsequent exercise performance following exercise in the heat. DESIGN: Two randomized crossover trials that consisted of 30 minutes of exercise, 15 minutes of treatment (T1), performance testing (5-10-5 pro-agility test and 1500-m run), and another 15 minutes of treatment (T2) identical to T1. SETTING: Outdoors in the heat (wet-bulb globe temperature: 31.5°C [1.8°C] and relative humidity: 59.0% [5.6%]). PARTICIPANTS: Twenty-six (13 men and 13 women) individuals (aged 20-27 y). INTERVENTIONS: Treatment was performed with HEK and without HEK (control, CON) modality. MAIN OUTCOME MEASURES: Gastrointestinal temperature, mean skin temperature, thirst sensation, and muscle pain. RESULTS: Maximum gastrointestinal temperature following exercise and performance was not different between trials (P > .05). Cooling rate was faster during T1 CON (0.053°C/min [0.049°C/min]) compared with HEK (0.043°C/min [0.032°C/min]; P = .01). Mean skin temperature was lower in HEK during T1 (P < .001) and T2 (P = .05). T2 thirst was lower in CON (P = .02). Muscle pain was lower in HEK in T2 (P = .03). Performance was not altered (P > .05). CONCLUSIONS: HEK improved perception but did not enhance cooling or performance following exercise in the heat. HEK is therefore not recommended to facilitate recovery, treat hyperthermia, or improve performance.

Effects of mild hypohydration on cooling during cold-water immersion following exertional hyperthermia.

PURPOSE: We investigated the effects of mild hypohydration compared to euhydration on the cooling efficacy of cold-water immersion (CWI). METHODS: Fourteen participants (eight male, six female; age 26 ± 5 years; ht 1.77 ± 0.08 m; wt 72.2 ± 8.8 kg; 20.6 ± 7.4 % body fat) completed one euhydrated (EU) trial followed by one hypohydrated trial (HY; via 24 h fluid restriction) in an environmental chamber (33.6 ± 0.9 °C, 55.8 ± 1.7 % RH). Volitional exercise was performed in a manner that matched end-exercise rectal temperature (T re) through repeating exercise mode and intensity. Participants were then immersed in ice water (2.0 ± 0.8 °C) until T re reached 38.1 °C or for a maximum of 15 min. T re, heart rate (HR), skin blood flux (SBF) and mean skin temperature (T sk) were monitored continuously during cooling. RESULTS: Pre-cooling body mass was decreased in the HY trial (-2.66 ± 1.23 % body mass) and maintained in the EU trial (-0.66 ± 0.44 %) compared to baseline mass (P < 0.001). Cooling rates were faster when EU (0.14 ± 0.05 °C/min) compared to HY (0.11 ± 0.05 °C/min, P = 0.046). HR, SBF, and T sk were not different between EU and HY trials (P > 0.05), however, all variables significantly decreased with immersion independent of hydration status (P < 0.001). CONCLUSION: The primary finding was that hypohydration modestly attenuates the rate of cooling in exertionally hyperthermic individuals. Regardless of hydration status, the cooling efficacy of CWI was preserved and should continue to be utilized in the treatment of exertional hyperthermia.

Exploring STEM Teaching Assistants' Self-Efficacy and Its Relation to Approaches to Teaching.

Undergraduate and graduate teaching assistants (TAs) play large roles in introductory undergraduate education despite having little to no teaching experience or professional development (PD). Self-efficacy and teaching approach have each been studied as independent variables that impact teaching performance and student learning in the absence of practiced skill or developed knowledge. This study explored relationships between TAs' teaching approaches and teaching self-efficacy. Self-efficacy was measured using the Graduate Teaching Self-Efficacy Scale (GTA-TSES), and teaching approach was measured using the Approaches to Teaching Inventory (ATI). The following research questions guided the study: What is the relationship between TAs' approaches to teaching and their self-efficacy? How do approaches to teaching and self-efficacy interact to impact the model of TA self-efficacy? Both ATI subscales correlated strongly with the GTA-TSES learning environment subscale and weakly with the instructional strategy subscale. High self-efficacy TAs demonstrated more concern with impacting student learning, which may contribute to a more student-centered teaching approach. Results indicate that TAs with more confidence in their teaching ability may have a more student-centered approach than teacher-centered approach to teaching. Implications include enhancing TA PD with peer mentoring, constructive feedback, and reflection and incorporating learning concerns in the model of TA teacher efficacy.

Developing a Model of Graduate Teaching Assistant Teacher Efficacy: How Do High and Low Teacher Efficacy Teaching Assistants Compare?

Graduate teaching assistants (TAs) are often responsible for teaching introductory courses to undergraduate science, technology, engineering, and mathematics students. The TAs are usually novices at teaching, and an important factor in their resilience and persistence in the face of inevitable challenges is self-efficacy. Little is known about what affects TA teacher efficacy or whether and how high- and low-efficacy TAs differ in their development as teachers. Bridging these gaps in the literature will inform best practices in developing and implementing professional development (PD) for TAs. Using a mixed-methods sequential exploratory research design, this study found differences in high- and low-efficacy TAs in both TAs' self-reflection and their students' perceptions. These differences concerned the focus of TAs' attention: inward at their own practices and emotions (salient in low-efficacy TAs) versus outward at the impact of their instructional guidance on their learners (prevalent in high-efficacy TAs). A proposed model of teacher efficacy based on TAs but generally applicable is presented to inform future research and provide suggestions for TA PD opportunities.

Renal stress and kidney injury biomarkers in response to endurance cycling in the heat with and without ibuprofen.

Exercise, especially in the heat, can contribute to acute kidney injury, which can expedite chronic kidney disease onset. The additional stress of ibuprofen use is hypothesized to increase renal stress. OBJECTIVES: To observe the effects of endurance cycling in the heat on renal function. Secondarily, we investigated the effect of ibuprofen ingestion on kidney stress. DESIGN: Randomized, placebo controlled and observational methods were utilized. METHODS: Forty cyclists (52±9y, 21.7±6.5% body fat) volunteered and completed an endurance cycling event (5.7±1.2h) in the heat (33.2±5.0°C, 38.4±10.7% RH). Thirty-five participants were randomized to ingest a placebo (n=17) or 600mg ibuprofen (n=18) pre-event. A blood sample was drawn before and following the event. Serum creatinine was assessed by colorimetric assay. An ELISA was used to measure serum neutrophil gelatinase-associated lipocalin. Fractional excretion of sodium was calculated after urinary and serum electrolyte analyses. RESULTS: Placebo versus ibuprofen groups contributed no significant difference in any variable (p>0.05). Serum creatinine significantly increased from pre- (0.52±0.14mg/dL) to post-event (0.88±0.21mg/dL; p<0.001). Serum neutrophil gelatinase-associated lipocalin significantly increased (pre: 68.51±17.54ng/mL; post: 139.12±36.52ng/mL; p<0.001) and fractional excretion of sodium was significantly reduced from pre- (0.52±0.24%) to post-event (0.27±0.18%; p<0.001). CONCLUSIONS: Changes in renal biomarkers suggest mild acute kidney injury and reduced kidney function during a single bout of endurance cycling in the heat, without influence from moderate ibuprofen ingestion.

Physiological and perceptual effects of a cooling garment during simulated industrial work in the heat.

OBJECTIVE: Evaluate physiological and perceptual responses using a phase change cooling (PCC) garment during simulated work in the heat. METHODS: Twenty males wearing compression undergarments, coverall suit, gloves, and hard-hat, completed two randomly assigned trials (with PCC inserts or control, CON) of simulated industrial tasks in the heat (34.2 ± 0.05 °C, 54.7 ± 0.3%RH). Trials consisted of two 20 min work bouts, a maximum performance bout, and 10 min of recovery. RESULTS: Physiological strain index (PSI) was lower during PCC after the second work bout and during recovery (all P < 0.05). PCC reduced heat storage (27.0 ± 7.6 W m-2) compared to CON (42.7 ± 9.9 W m-2, P < 0.001). Perceptual strain index (PeSI) was reduced with PCC compared to CON (P < 0.001), however performance outcomes were not different between trials (P = 0.10). CONCLUSIONS: PCC during work in the heat attenuated thermal, physiological, and perceptual strain. This PCC garment could increase safety and reduce occupational heat illness risk.

Effects of a phase change cooling garment during exercise in the heat.

The purpose of our study was to examine the physiological, perceptual, and performance effects of wearing a phase change cooling garment (CG) during an interval exercise routine in the heat. Sixteen male participants (age 23 ± 3 years, ht 1.76 ± 0.11 m; wt 78.5 ± 11.2 kg; body fat 15.2 ± 5.8%) completed two trials (one with phase change inserts, CG, and one control without inserts) consisting of two submaximal exercise portions separated by 5-minute seated rest, and a final maximal effort performance bout. Each submaximal bout involved 30 seconds or 1 minute of muscular endurance and agility exercises and 5 minutes of treadmill jogging and step-ups. The performance bout included 30 seconds or 1 minute of muscular endurance and agility exercises, with participants completing as many repetitions as possible, followed by a 15-minute recovery (active and passive). Rectal temperature (Tre) and heart rate were not different between trials, however change in Tre from baseline was improved during 10 and 15 minutes of recovery with the CG (P < .05). Mean skin temperature was lower using the CG vs control throughout the trial (P < .05). Thermal sensation was lower when using the CG compared to control (P < .001). There were no differences in any outcomes of the performance exercises (P > .05). These findings indicate that the continuous use of a CG during an interval style workout in the heat provides improvements in thermal sensation, however, only minimal thermophysiological benefits, and no performance augmentation.

Effectiveness of Ice-Sheet Cooling Following Exertional Hyperthermia.

BACKGROUND: The procedure of wrapping a heat casualty in ice-water soaked bed sheets to reduce core temperature has received little investigation, despite the practice and recommendation for its use in some military settings. Thus, the purpose of this study was to investigate the cooling efficacy of ice-sheet cooling (ISC) following exertional hyperthermia. METHODS: 13 (11 males, 2 females) participants (age = 23 ± 3 years, height = 176.5 ± 10.3 cm, mass = 78.6 ± 15.3 kg, body fat = 19.6 ± 8.6%, and body surface area = 1.95 ± 0.22 m2) volunteered to complete 2 randomized, crossover design trials on an outdoor recreation field (34.4 ± 1.4°C, 54.4 ± 4.1% relative humidity). Each trial consisted of exercise (self-paced 400-m warm-up, 1,609-m run, and 100-m sprints) followed by 15 minutes of either lying supine in the shade with no treatment (control [CON]) or being treated with ice-water soaked sheets wrapped around their body (ISC). Physiological (rectal temperature [Tre], heart rate, mean-weighted skin temperature) and perceptual measures (thermal sensation, rating of perceived exertion) were assessed after each exercise protocol, every 3 minutes during treatment, and every 5 minutes during recovery. FINDINGS: By design, there were no differences during exercise between ISC and CON for Tre (p = 0.16), skin temperature (p = 0.52), heart rate (p = 0.62), thermal sensation (p = 0.89), or rating of perceived exertion (p = 0.99). There were greater decreases in Tre at 3 (ISC 0.33 ± 0.26°C vs. CON 0.03 ± 0.30°C, p = 0.01) and 6 minutes (ISC 0.47 ± 0.27°C vs. CON 0.30 ± 0.19°C, p = 0.05) of treatment; however, the overall rate of cooling was not different between trials (CON 0.05 ± 0.02°C/min vs. ISC 0.06 ± 0.02°C/min, p = 0.72). Skin temperature (Tsk) was significantly reduced from 3 minutes (ISC 34.4 ± 1.7°C vs. CON 36.6 ± 0.5°C, p = 0.007) through 15 minutes (ISC 32.4 ± 1.5 vs. CON 36.1 ± 0.4°C, p < 0.001) of treatment. There was a trend for lower heart rate with ISC (p = 0.051). Thermal sensation was reduced from 3 minutes of treatment (ISC 3.5 ± 0.9 vs. CON 4.5 ± 0.6, p = 0.002) through 15 minutes (ISC 2.8 ± 1.0 vs. CON 3.9 ± 0.4, p = 0.005). DISCUSSION: ISC does not provide effective reduction in Tre following exertional hyperthermia compared to no treatment. However, perceptual benefits may warrant the use of ISC in settings where rapid reductions in core temperature are not a concern (i.e., recovery from exercise). Thus, clinicians should continue to utilize validated techniques (i.e., cold-water immersion) for the treatment of exertional heat illnesses.

Cooling Effectiveness of a Modified Cold-Water Immersion Method After Exercise-Induced Hyperthermia.

CONTEXT: Recommended treatment for exertional heat stroke includes whole-body cold-water immersion (CWI). However, remote locations or monetary or spatial restrictions can challenge the feasibility of CWI. Thus, the development of a modified, portable CWI method would allow for optimal treatment of exertional heat stroke in the presence of these challenges. OBJECTIVE: To determine the cooling rate of modified CWI (tarp-assisted cooling with oscillation [TACO]) after exertional hyperthermia. DESIGN: Randomized, crossover controlled trial. SETTING: Environmental chamber (temperature = 33.4°C ± 0.8°C, relative humidity = 55.7% ± 1.9%). PATIENTS OR OTHER PARTICIPANTS: Sixteen volunteers (9 men, 7 women; age = 26 ± 4.7 years, height = 1.76 ± 0.09 m, mass = 72.5 ± 9.0 kg, body fat = 20.7% ± 7.1%) with no history of compromised thermoregulation. INTERVENTION(S): Participants completed volitional exercise (cycling or treadmill) until they demonstrated a rectal temperature (Tre) ≥39.0°C. After exercise, participants transitioned to a semirecumbent position on a tarp until either Tre reached 38.1°C or 15 minutes had elapsed during the control (no immersion [CON]) or TACO (immersion in 151 L of 2.1°C ± 0.8°C water) treatment. MAIN OUTCOME MEASURE(S): The Tre, heart rate, and blood pressure (reported as mean arterial pressure) were assessed precooling and postcooling. Statistical analyses included repeated-measures analysis of variance with appropriate post hoc t tests and Bonferroni correction. RESULTS: Before cooling, the Tre was not different between conditions (CON: 39.27°C ± 0.26°C, TACO: 39.30°C ± 0.39°C; P = .62; effect size = -0.09; 95% confidence interval [CI] = -0.2, 0.1). At postcooling, the Tre was decreased in the TACO (38.10°C ± 0.16°C) compared with the CON condition (38.74°C ± 0.38°C; P < .001; effect size = 2.27; 95% CI = 0.4, 0.9). The rate of cooling was greater during the TACO (0.14 ± 0.06°C/min) than the CON treatment (0.04°C/min ± 0.02°C/min; t15 = -8.84; P < .001; effect size = 2.21; 95% CI = -0.13, -0.08). These differences occurred despite an insignificant increase in fluid consumption during exercise preceding CON (0.26 ± 0.29 L) versus TACO (0.19 ± 0.26 L; t12 = 1.73; P = .11; effect size = 0.48; 95% CI = -0.02, 0.14) treatment. Decreases in heart rate did not differ between the TACO and CON conditions (t15 = -1.81; P = .09; effect size = 0.45; 95% CI = -22, 2). Mean arterial pressure was greater at postcooling with TACO (84.2 ± 6.6 mm Hg) than with CON (67.0 ± 9.0 mm Hg; P < .001; effect size = 2.25; 95% CI = 13, 21). CONCLUSIONS: The TACO treatment provided faster cooling than did the CON treatment. When location, monetary, or spatial restrictions are present, TACO represents an effective alternative to traditional CWI in the emergency treatment of patients with exertional hyperthermia.