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To date, there has been very little research-based mathematics curriculum for talented elementary students. Yet the gifted education and mathematics literature suggest support for curriculum that is both enriched and accelerated with a focus on developing conceptual understanding and mathematical thinking. Project M[superscript 3]: Mentoring Mathematical Minds is a 5-year Javits research grant project designed to create curriculum units with these essential elements for talented elementary students. These units combine exemplary teaching practices of gifted education with the content and process standards promoted by the National Council of Teachers of Mathematics. The content at each level is at least one to two grade levels above the regular curriculum and includes number and operations, algebra, geometry and measurement, and data analysis and probability. The focus of the pedagogy encourages students to act as practicing professionals by emphasizing verbal and written communication. Research was conducted on the implementation of 12 units in 11 different schools, 9 in Connecticut and 2 in Kentucky. The sample consisted of approximately 200 mathematically talented students entering third grade, most of whom remained in the project through fifth grade. Students in this study demonstrated a significant increase in understanding across all mathematical concepts in each unit from pre- to posttesting. Thus, Project M[superscript 3] materials may help fill a curriculum void by providing appropriate accelerated and enriched units to meet the needs of mathematically talented elementary students. (Contains 3 tables and 1 footnote.)

This research responds to the call by early childhood educators advocating for more challenging mathematics curriculum at the primary level. The kindergarten Project M[superscript 2] units focus on challenging geometry and measurement concepts by positioning students as practicing mathematicians. The research reported herein highlights the features of the kindergarten units and reports on student achievement, including the differences between the intervention and comparison groups. Hierarchical linear modeling results indicate that students in the intervention group (n = 210) outperformed those in the comparison group (n = 196) on the Iowa Tests of Basic Skills Mathematics subscale (p < 0.01; d = 0.25), and an open-response assessment (p < 0.001; d = 2.68) encompassing performance-based, verbal, and written components. These results suggest that kindergarteners can achieve at high levels of mathematical understanding when given the opportunity to learn from more challenging curriculum.

The primary goal of Project M[superscript 2] was to develop and field-test challenging geometry and measurement units for all K-2 students. This article reports on the achievement results for students in Grade 2 at 12 urban and suburban sites in 4 states using the Iowa Tests of Basic Skills (ITBS) mathematics concepts subtest and an open-response assessment. The experimental group exhibited a deeper understanding of geometry and measurement concepts as measured by the open-response assessment while still performing as well on a traditional measure covering all mathematics content.

Context: As the first medical professionals on scene when emergency situations arise in sport, athletic trainers (ATs) need to be proficient in recognizing and managing these conditions. Recent evidence regarding exertional heatstroke indicates a lack of educational training as a factor preventing implementation of best practices, yet other causes of sudden death exist, and little is known about the educational training provided to the AT. Objective: To gain insight into the entry-level AT and athletic training students' (ATSs') perceptions of education received in the area of emergency care techniques. Design: Mixed methods study. Setting: Athletic training programs (ATPs) and practice settings. Patients or Other Participants: Thirteen first-year ATs (n = 7) or recent ATS graduates before employment (n = 6). Data Collection and Analysis: One-on-one phone interviews were conducted and transcribed verbatim. Data were analyzed inductively using a grounded theory approach and open coding. Close-ended questions were analyzed by calculating frequencies, means, and standard deviations. Multiple analyst triangulation and peer review were used to establish data credibility. Results: One main theme emerged: participants revealed they perceived their education to be compartmentalized. Compartmentalization comprised 3 subthemes: cognitive knowledge, skill implementation, and clinical integration. Participants received the cognitive knowledge through traditional teaching methods but had minimal hands-on laboratory practice in the area of basic emergent and immediate care skills. Instructors placed greater focus on situations or cases that educators had encountered versus on the broader scope of conditions. Contrived, discussion-based instructional methods rather than real-life integration were used to evaluate the ATSs' ability to apply the knowledge and skills. Conclusions: Beyond providing ATSs with the necessary didactic knowledge and hands-on practice through structured laboratory sessions, educators must also provide the opportunity for clinical application of knowledge and skills. Athletic training students must be provided opportunities to apply emergent care skills in order to demonstrate competency and critical thinking.

The primary aim of Project M[superscript 3]: Mentoring Mathematical Minds was to develop and field test advanced units for mathematically promising elementary students based on exemplary practices in gifted and mathematics education. This article describes the development of the units and reports on mathematics achievement results for students in Grades 3 to 5 from 11 urban and suburban schools after exposure to the curriculum. Data analyses indicate statistically significant differences favoring each of the experimental groups over the comparison group on the ITBS (Iowa Tests of Basic Skills) Concepts and Estimation Test and on Open-Response Assessments at all three grade levels. Furthermore, the effect sizes range from 0.29 to 0.59 on the ITBS Concepts and Estimation Scale and 0.69 to 0.97 on the Open-Response Assessments. These results indicate that these units, designed to address the needs of mathematically promising students, positively affected their achievement. (Contains 8 tables.)

Meeting the needs of mathematically talented elementary students has always been a real challenge due to the lack of appropriate curricular resources and training for teachers. Mathematics is not generally a strength area for elementary or gifted/talented teachers; rather, their talents and interests often lie in the language arts realm. This is coupled with the fact that, in general, elementary mathematics curriculum provides few to no advanced options for talented students. Materials labeled "enrichment worksheets" are often extra practice sheets that are neither interesting nor challenging for bright children. With that said, there are certainly some interesting creative problem solving books filled with logic puzzles, mind-benders, and non-routine problems, and these have a place in a challenging math program. What has been lacking and sorely needed is a curriculum that develops mathematical concepts in depth and with complexity, provides a cohesive structure in which students can explore these concepts, and requires youngsters to think and act at high levels akin to the process mathematicians use in discovering new theorems and advancements in the field. Project M[superscript 3] units provide such a challenge. Project M[superscript 3]: Mentoring Mathematical Minds was created under a United States Department of Education Javits curriculum and research grant and is currently in its fourth year of implementation. Project M[superscript 3] is a five-year collaborative research effort of faculty at the University of Connecticut, Northern Kentucky University, and Boston University. Included in the project are teachers, administrators, and students in 11 schools of varying socioeconomic levels. A team of national experts in the fields of mathematics, mathematics education, and gifted education created a total of 12 curriculum units (four units at three different levels) of advanced mathematics that are appropriate for talented elementary students in grades 2 through 6. (Contains 1 resource.)

Context: Evidence-based best practices for the recognition and treatment of exertional heat stroke (EHS) indicate that rectal thermometry and immediate, aggressive cooling via cold-water immersion ensure survival from this medical condition. However, little is known about the recovery, medical follow-up, and return to activity after an athlete has suffered EHS. Objective: To highlight the transfer of evidenced-based research into clinical practice by chronicling the treatment, recovery, and return to activity of a runner who suffered an EHS during a warm-weather road race. Design: Case study. Setting: Warm-weather road race. Participant: 53-y-old recreationally active man. Intervention: A runner's treatment, recovery, and return to activity from EHS and 2014 Falmouth Road Race performance. Main Outcomes: Runner's perceptions and experiences with EHS, body temperature, heart rate, hydration status, exercise intensity. Results: The runner successfully completed the 2014 Falmouth Road Race without incident of EHS. Four dominant themes emerged from the data: predisposing factors, ideal treatment, lack of medical follow-up, and patient education. The first theme identified 3 predisposing factors that contributed to the runner's EHS: hydration, sleep loss, and lack of heat acclimatization. The runner received ideal treatment using evidence-based best practices. A lack of long-term medical care following the EHS with no guidance on the runner's return to full activity was observed. The runner knew very little about EHS before the 2013 race, which drove him to seek knowledge as to why he suffered EHS. Using this newly learned information, he successfully completed the 2014 Falmouth Road Race without incident. Conclusions: This case supports prior literature examining the factors that predispose individuals to EHS. Although evidence-based best practices regarding prompt recognition and treatment of EHS ensure survival, this case highlights the lack of medical follow-up and physician-guided return to activity after EHS. [ABSTRACT FROM AUTHOR]

Context: Recent case reports on malignant hyperthermia (MH)-like syndrome in physically active populations indicate potential associations among MH, exertional heat stroke (EHS), and exertional rhabdomyolysis (ER). However, an expert consensus for clinicians working with these populations is lacking. Objective: To provide current expert consensus on the (1) definition of MH; (2) history, etiology, and pathophysiology of MH; (3) epidemiology of MH; (4) association of MH with EHS and ER; (5) identification of an MH-like syndrome; (6) recommendations for acute management of an MH-like syndrome; (7) special considerations for physically active populations; and (8) future directions for research. Setting: An interassociation task force was formed by experts in athletic training, exercise science, anesthesiology, and emergency medicine. The "Round Table on Malignant Hyperthermia in Physically Active Populations" was convened at the University of Connecticut, Storrs, September 17-18, 2015. Conclusions: Clinicians should consider an MH-like syndrome when a diagnosis of EHS or ER cannot be fully explained by clinical signs and symptoms presented by a patient or when recurrent episodes of EHS or ER (or both) are unexplained. Further research is required to elucidate the genetic and pathophysiological links among MH, EHS, and ER. [ABSTRACT FROM AUTHOR]

This study investigated the effects of environmental temperature on repetitive box lifting (RBL) performance, associated stress hormone and creatine kinase (CK) responses. Ten healthy males performed two experimental trials in a random crossover design. The trials consisted of three 40 min (10 min sitting, 20 min standing, and 10 min RBL) circuits performed in either 23°C or 38°C followed by a 180 min seated recovery period in 23°C. RBL performance (i.e., number of boxes lifted) was reduced (p ≤ 0.05) in 38°C compared to the 23°C trial. Physiological Strain Index was significantly different between trials (38°C: 8.5 ± 1.1 versus 23°C: 7.2 ± 0.7; p ≤ 0.01). Plasma testosterone was elevated (p ≤ 0.05) across both trials and then decreased at 60 min recovery, compared to pre-exercise (PRE) measures, but was higher (p ≤ 0.05) during the 38°C trial. Plasma cortisol increased (p ≤ 0.05) at 60 min during both trials and remained elevated until 120 min in 23°C, and until 60 min recovery in 38°C. Serum CK was greater through 48 hr post compared to PRE values in both trials. Thus, 10 min RBL performance was reduced in 38°C despite the 30-min rest periods between RBL intervals. Plasma testosterone and cortisol were generally higher during the 38°C trial, suggesting a greater stress response. Additional research is needed to determine optimal work:rest cycles for maximizing work performance in thermally oppressive environments. [ABSTRACT FROM AUTHOR]

Context: Athletic trainers recommend and use a multitude of rehydration (REHY) methods with their patients. The REHY modality that most effectively facilitates recovery is unknown. Objective: To compare 5 common REHY methods for thermoregulatory and stress hormone recovery after exercise dehydration (EXDE) in trained participants. Design: Randomized, cross-over, controlled study. Patients or Other Participants: Twelve physically active, non-heat-acclimatized men (age = 23 ± 4 years, height = 180 ± 6 cm, mass = 81.3 ± 3.7 kg, Vo2max = 56.9 ± 4.4 mL⋅min-1⋅kg-1, body fat = 7.9% 6 3%) participated. Intervention(s): Participants completed 20-hour fluid restriction and 2-hour EXDE; they then received no fluid (NF) or REHY (half-normal saline) via ad libitum (AL), oral (OR), intravenous (IV), or combination IV and OR (IV + OR) routes for 30 minutes; and then were observed for another 30 minutes. Main Outcome Measure(s): Body mass, rectal temperature, 4-site mean weighted skin temperature, plasma stress hormone concentrations, and environmental symptoms questionnaire (ESQ) score. Results: Participants were hypohydrated (body mass -4.23% ± 0.22%) post-EXDE. Rectal temperature for the NF group was significantly greater than for the IV group {P= .023) at 30 minutes after beginning REHY (REHY30) and greater than OR, IV, and IV + OR (P ≤ .009) but not AL (P = .068) at REHY60. Mean weighted skin temperature during AL was less than during IV + OR at REHY5 (P= .019). The AL participants demonstrated increased plasma cortisol concentrations compared with IV + OR, independent of time (P = .015). No differences existed between catecholamine concentrations across treatments (P > .05). The ESQ score was increased at REHY60 for NF, AL, OR, and IV (P< .05) but not for IV + OR (P = .217). The NF ESQ score was greater than that of IV + OR at REHY60 (P=.012). Conclusions: Combination IV + OR REHY reduced body temperature to a greater degree than OR and AL REHY when compared with NF. Future studies addressing clinical implications are needed. [ABSTRACT FROM AUTHOR]

The author discusses a study "Interleukin-6 responses to water immersion therapy after acute exercise heat stress: A Pilot Investigation," by Melinda Williams and colleagues. The results revealed that Whole-body cooling rates were greater in the cold water-bath condition as compared to warm and cold water-bath conditions. It concluded that cold water immersion related to IL-6 increased from post exercise values compared to warmer water-bath temperature, which hampered this increase.

The article discusses a study aimed at gaining a better understanding between emergency medical services (EMS) personnel and athletic trainers. Qualitative methods were used to document the comments of emergency medical technicians (EMTs) related to their understanding of athletic training profession and their perspective on emergency management of exertional heat stroke (EHS). It suggests for athletic trainers and EMS personnel to work together during stressful circumstances.

Context: Current evidence suggests rectal temperature(Tre) and cold-water immersion (CWI) are the most effective means to diagnose and treat exertional heat stroke (EHS), respectively. Educators, clinicians, and students should be apprised of this evidence to guide their practice. Objective: Investigate what athletic training students (ATS) are learning regarding EHS, both in the classroom and clinical settings that may one day influence their practices as athletic trainers (AT). Design: Qualitative design using in-person focus groups. Setting: National meeting in San Antonio, Texas, 2009. Patients or Other Participants: Thirteen rising senior ATS in a Commission on Accreditation of Athletic Training Education (CAATE)-accredited athletic training education program. Data Collection and Analysis: Interviews were transcribed verbatim and analyzed using open coding techniques. Peer debriefing and multiple-analyst triangulation were used to ensure trustworthiness of the data. Results: Two higher order themes emerged from the data analysis: Lack of Experience and Educators' Influence. Lack of Experience summarizes the ATS lack of exposure, both in the classroom and in the clinical setting regarding the skills associated with EHS. It was apparent that the participant's lack of understanding of EHS was a direct result of a lack of time spent with the topic. The higher order theme of Educators' Influence highlights the role that educators play in influencing and shaping ATS retention of materials, competence, and future practice beliefs regarding EHS. Conclusion: A cyclic reaction occurs with regards to EBP that directly influences ATS. Until the cycle is broken, ATs will continue to struggle implementing best practices identified from research into clinical practice. [ABSTRACT FROM AUTHOR]

Context: Athletic trainers (ATs) know to diagnose exertional heat stroke (EHS) via rectal thermometry (TJ and to treat EHS via cold-water immersion (CWI) but do not implement these recommendations in clinical practice. Objective: To gain an understanding of educational techniques used to deliver content regarding EHS. Design: Qualitative study. Setting: In-person focus groups at the National Athletic Trainers' Association (NATA) Annual Meeting in June 2009 and 2 follow-up telephone interviews to confirm emergent themes. Patients or Other Participants: Thirteen AT educators (11 men, 2 women) from programs accredited by the Commission on Accreditation of Athletic Training Education, with an average of 22 + 9 years of clinical experience and 16±10 years of experience as educators. Five NATA districts were represented. Data Collection and Analysis: Data were analyzed using inductive content analysis. Peer review and data source triangulation also were conducted to establish trustworthiness. Results: Four themes emerged from the analysis: educational techniques, educational competencies, previous educational training, and privacy/public opinion. Educational techniques highlighted the lack of hands-on training for Tre and CWI. Educational competencies referred to the omission of Tre and CWI as psychomotor skills. Previous educational training addressed educators not having the skills or comfort with the skills necessary to properly educate students. Privacy/public opinion comprised external inputs from various groups (parents and coaches), legal considerations, and social bias. Conclusions: Educators supplied students with the appropriate didactic knowledge about EHS, but their lack of training and misgivings about Tre prevented them from allowing students to gain competence with this skill. Until the NATA competencies state the need to teach Tre and CWI and until educators are provided with their own learning opportunities, evidence-based practice regarding EHS will be lacking. [ABSTRACT FROM AUTHOR]

Context: Exertional heat stroke (EHS) is one of the leading causes of death in athletes. Certified athletic trainers (ATs) demonstrate strong knowledge of recommended practices with EHS but are apprehensive in implementing 2 basic procedures: rectal temperature assessment and cold water immersion. This apprehension might lead to deaths from EHS that could have been prevented. Objective: To investigate why collegiate and high school ATs do not implement best practices for the recognition and treatment of EHS. Design: Qualitative study. Setting: In-person focus groups consisting of 3 to 6 collegiate or high school ATs. Patients or Other Participants: A total of 19 ATs (9 men, 10 women; age = 36±10 years, length of certification = 12±9 years) employed at either the collegiate (n = 10) or high school (n = 9) level participated in the study. Data Collection and Analysis: Interviews were transcribed Verbatim, and data were analyzed using deductive data analysis. Peer review and multiple-analyst data triangulation were conducted to establish trustworthiness of the data. Results: Five emergent themes explained the lack of evidence-based practice (EBP) regarding recognition and treatment of EHS. Three themes (lack of knowledge, comfort level, lack of initiative) were common in both the collegiate and high school settings, and 2 separate themes (liability concerns, lack of resources) were present in the high school setting. Conclusions: Our findings are consistent with those in the literature on EBP and EHS. Regardless of clinical setting, ATs have basic information on recognition and treatment of EHS, but 5 themes act as barriers to implementing proper management in the clinical setting. Workshops or hands-on training sessions need to be made available to improve students' comfort levels so ATs will implement EBP into everyday settings. [ABSTRACT FROM AUTHOR]

Context: Certified athletic trainers (ATs) working at the National Collegiate Athletic Association Division I level experience challenges balancing their professional and personal lives. However, an understanding of the strategies ATs use to promote a balance between their professional and personal lives is lacking. Objective: To identify the strategies ATs employed in the Division I setting use to establish a balance between their professional and personal lives. Design: Qualitative investigation using inductive content analysis. Setting: Athletic trainers employed at Division I schools from 5 National Athletic Trainers' Association districts. Patients or Other Participants: A total of 28 (15 women, 13 men) ATs aged 35 ± 9 years volunteered for the study. Data Collection and Analysis: Asynchronous electronic interviews with follow-up phone interviews. Data were analyzed using inductive content analysis. Peer review, member checking, and data-source triangulation were conducted to establish trustworthiness. Results: Three higher-order themes emerged from the analysis. The initial theme, antecedents of work-family conflict, focused on the demands of the profession, flexibility of work schedules, and staffing patterns as contributing to work-life conflict for this group of ATs. The other 2 emergent higher-order themes, professional factors and personal factors, describe the components of a balanced lifestyle. The second-order theme of constructing the professional factors included both organizational policies and individual strategies, whereas the second-order theme of personal factors was separation of work and life and a supportive personal network. Conclusions: Long work hours, lack of control over work schedules, and unbalanced athlete-to-AT ratios can facilitate conflicts. However, as demonstrated by our results, several organizational and personal strategies can be helpful in creating a balanced lifestyle. [ABSTRACT FROM AUTHOR]

Abstract: Normative values and confidence intervals for the hydration indices of women do not exist. Also, few publications have precisely described the fluid types and volumes that women consume. This investigation computed seven numerical reference categories for widely used hydration biomarkers (eg, serum and urine osmolality) and the dietary fluid preferences of self-reported healthy, active women. Participants (n=32; age 20±1 years; body mass 59.6±8.5 kg; body mass index [calculated as kg/m2] 21.1±2.4) were counseled in the methods to record daily food and fluid intake on 2 consecutive days. To reduce day-to-day body water fluctuations, participants were tested only during the placebo phase of the oral contraceptive pill pack. Euhydration was represented by the following ranges: serum osmolality=293 to 294 mOsm/kg; mean 24-hour total fluid intake=2,109 to 2,506 mL/24 hours; mean 24-hour total beverage intake=1,300 to 1,831 mL/24 hours; urine volume=951 to 1,239 mL/24 hours; urine specific gravity=1.016 to 1.020; urine osmolality=549 to 705 mOsm/kg; and urine color=5. However, only 3% of women experienced a urine specific gravity <1.005, and only 6% exhibited a urine color of 1 or 2. Water (representing 45.3% and 47.9% of 24-hour total fluid intake), tea, milk, coffee, and fruit juice were consumed in largest volumes. In conclusion, these data provide objective normative values for hyperhydration, euhydration, and dehydration that can be used by registered dietitians and clinicians to counsel women about their hydration status. [Copyright &y& Elsevier]