Kinesiology Commons^™

Preceptor Development: Identifying The Best Modality For Building Clinical Educators, G W. Cohen, R M. Lopez, A J. Tritsch

Clinical Practice in Athletic Training

Introduction: Preceptor training and development are not standardized within the athletic training profession. The Commission on Accreditation of Athletic Training Education (CAATE) requires that Athletic Training Programs provide an ongoing education plan for preceptors to promote a constructive learning environment for students. However, with the rapid expansion of clinical education opportunities outside of institutions' immediate area, programs must identify how to reach all their preceptors and uphold their programmatic expectations for clinical educators. Methods: The investigators conducted a cohort pre-test-post-test design study. A preceptor development program (PDP) was created and grounded in the theory of gamified learning and adult learning …

The Financial Stresses That Affect Athletic Training Students: A Qualitative Investigation, C Kuehner-Boyer, E León Zaragoza

Clinical Practice in Athletic Training

Introduction: A recent survey examining barriers that affect athletic training students found that financial-related barriers created significant stress for students in professional athletic training programs. The need to work while attending a professional athletic training program was the highest reported barrier with 54.82% of respondents indicating that this was a barrier for them during their program. Beyond the overall reporting rate, the need to work while completing a professional athletic training program was indicated by athletic training students to be the barrier that they encountered the most frequently with respondents reporting that this was a stress for them between monthly …

Musculoskeletal Tumors Disguised As Orthopedic Injuries: A Case Report, A Summers

Clinical Practice in Athletic Training

Background: Musculoskeletal tumors are relatively rare, accounting for only 0.2 to 0.5% of all malignancies across all age groups. More specifically, Pigmented Villonodular Synovitis, a type of musculoskeletal tumor, has an incidence rate of 1.8 cases per one million people in a population. This benign, proliferative disease is a type of tenosynovial giant cell tumor that can affect the soft tissue lining of joints, bursae, and tendon sheaths. These joint-related tumors often present with an insidious onset and non-specific physical exam findings. Therefore, they are often mistaken for other, more common orthopedic injuries, making them difficult to diagnose. Patient Information: …

Enhancing Clinic Efficiency: A Quality Improvement Initiative For Postoperative Patient Care In An Outpatient Orthopedic Physician Practice Setting, D Stepan, T Jp Greffly, R M. Williams

Clinical Practice in Athletic Training

Introduction: Following orthopedic surgery, patient post-operative (post-op) visits are deemed global surgical observations where day 00 to day 90 are appointments that cannot be billed. Patients are typically seen 3 times during this global period. Thus, the outpatient clinic needs to have non-billable time slots each day for these patients. The current scheduling model double books patients every 15 minutes, with the physician being the primary provider seeing patients for post-op visits. Therefore, the clinic has demonstrated inefficiencies with scheduling these patients while having sufficient appointments available for billable patients. This quality improvement initiative aimed to decrease post-op patient visits …

Adolescent Femoral Neck Fractures: A Case Study On Initial Surgical Intervention, Avascular Necrosis Development, And Subsequent Total Hip Arthroplasty, K A. Fisher

Clinical Practice in Athletic Training

Background: The patient sustained a femoral neck fracture at the age of 13 after slipping and falling in his home. He was seen in the Emergency Department the same day and underwent a closed reduction and percutaneous pinning procedure the following morning. Ten weeks after returning to full weightbearing, and 13.5 weeks after his initial fracture, he developed stress fractures of the medial distal femoral and proximal tibial metaphyses. He experienced gradual worsening of hip pain and difficulty with ambulation between 11 to 13 months post-closed reduction and percutaneous pinning (CRPP). Avascular necrosis and collapse of the femoral head was …

Modification Of Ergonomics For A World-Class Brass Instrumentalist With A Congenital Limb Difference: Level 3 Case, O G. Newhouse

Clinical Practice in Athletic Training

Background: A drum and bugle corps is a musical marching organization that consists of approximately 160 brass, percussion, and color guard performers. There are currently twenty-one drum corps organizations at the world-class level that compete. Organizations learn their 8–10-minute show in the late spring and begin traveling the country performing and competing in the early summer until August. Rehearsal days can be up to 10 hours of practice including visual and music. It has been reported that the incidence of upper limb pain is higher in those who have longer practice times, in which is a symptom of overuse. These …

Title: Professional Socialization And Development Of Athletic Training Professional Program Directors, N A. Wilkins, K D. Pagnotta, L Kunkel, S David, A B. Thrasher

Clinical Practice in Athletic Training

Introduction: The role of Program Directors (PD) has vastly expanded over the last decade to meet the evolving demands of athletic training education and higher education. While specific responsibilities such as programmatic planning and accreditation maintenance are directly outlined in accreditation standards, PDs often assume additional institutional and programmatic responsibilities that now include recruitment and retention efforts, mentorship of faculty and students, curriculum design and mapping, and other administrative tasks. Previous research demonstrates athletic training faculty have little formalized training in administrative roles, and Coordinators of Clinical Education (CCEs) desired more support and development for that role. Little research exists …

Strength Assessment Protocol In Pre-Professional Ballet Dancers, Simona Di Nardo, Ivan Mascio

Clinical Practice in Athletic Training

Purpose: This research project aimed to investigate the effects, particularly regarding the ability to generate force, that could emerge following a ballet class. The purpose of the study was to support the thesis that low levels of fitness and performance in professional and amateur dancers, should be considered a significant gap that needs to be addressed. Larger will be the gap and bigger will be the demand of a dancer to be prepared athletically. While the shorter the gap and more efficient the artistic side of the dance performance will be. As a result, a stronger and healthier body will …

Characteristics Of Athletic Trainers That Are Satisfied And Dissatisfied With Their Compensation, K Ef Mair, J P. Young, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Job satisfaction among athletic trainers (ATs), particularly in relation to compensation, is a critical factor influencing retention and career fulfillment. Examining the factors linked to earnings satisfaction may offer insight into how workplace conditions can be improved to better support ATs. The purpose of our study was to investigate the attributes that distinguish ATs content with their compensation from those who are dissatisfied. Methods: We used a cross-sectional, web-based survey to gather AT compensation data, of which 1,887 participants responded to a question regarding their satisfaction with compensation. Respondents were divided into two groups based on their satisfaction with …

The Effects Of A Joint Reduction Trainer On Confidence Levels In Professional Athletic Training Students, T Franklin, S Hacherl

Clinical Practice in Athletic Training

Introduction: Dislocations are common injuries managed by athletic trainers, yet athletic training students are unlikely to practice reduction techniques during clinical experiences. Current standards set by the Commission on Accreditation of Athletic Training Education require accredited programs to prepare students to manage patients with dislocations, including joint reductions. Research indicates the use of simulation techniques, such as joint reduction simulators, in education can fill clinical experience gaps and improve student confidence and skills. Shoulder dislocations make up nearly 50% of dislocations with several reduction techniques identified in the current literature. The use of a joint reduction simulator may provide athletic …

An Investigation Of Travel Distance And Timeliness Of Breast Cancer Treatment Among A Diverse Cohort In The United States, Swann Arp Adams Ph.D., Ms, Face, Oluwole Adeyemi Babatunde, Whitney E. Zahnd, Peiyin Hung Ph.D., Karen E. Wickersham Phd, Rn, Nathaniel Bell Ph.D., Jan M. Eberth Ph.D.

Publications

Travel to and from distant cancer treatment facilities can place a significant burden on cancer patients, particularly rural and minority survivors. Thus, the purpose of our investigation was to examine the association between patient travel distance and delays in types of treatment for breast cancer (surgery, radiation, chemotherapy, and hormonal therapy) and treatment delays. Using a novel linkage between the state cancer registry and administrative data from Medicaid and a private insurance plan, 2155 BC patients were successfully linked to create the cohort. ArcGIS was used to geocode all case residences and treatment facility addresses and calculate network distance between …

International Society Of Sports Nutrition Position Stand: Nutritional Concerns Of The Female Athlete, Ralf Jäger, Jeffery L. Heileson, Sidney Abou Sawan, Broderick L. Dickerson, Megan Leonard, Richard B. Kreider, Chad M. Kerksick, Stephen M. Cornish, Darren G. Candow, Dean M. Cordingley, Scott C. Forbes, Grant M. Tinsley, Tindaro Bongiovanni, Roberto Cannataro, Bill I. Campbell, Shawn M. Arent Ph.D., Cscs*D, Fissn, Facsm, Fnak, Jeffrey R. Stout, Douglas S. Kalman, Jose Antonio

Faculty Publications

Position Statement: The International Society of Sports Nutrition (ISSN) presents this position based on a critical examination of the literature surrounding the effects of long-chain omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation on exercise performance, recovery, and brain health. This position stand is intended to provide a scientific foundation for athletes, dietitians, trainers, and other practitioners regarding the effects of supplemental ω-3 PUFA in healthy and athletic populations. The following conclusions represent the official position of the ISSN: Athletes may be at a higher risk for ω-3 PUFA insufficiency. Diets rich in ω-3 PUFA, including supplements, are effective strategies for …

Common Questions And Misconceptions About Energy Drinks: What Does The Scientific Evidence Really Show?, Jose Antonio, Brandi Antonio, Shawn M. Arent Ph.D., Cscs*D, Fissn, Facsm, Fnak, Darren G. Candow, Guillermo Escalante, Cassandra Evans, Scott Forbes, David Fukuda, Maureen Gibbons, Patrick Harty, Andrew R. Jagim, Douglas S. Kalman, Chad M. Kerksick, Jennifer A. Kurtz, Joseph Lillis, Lonnie Lowery, Gianna F. Mastrofini, Scotty Mills, Michael Nelson, Flavia Pereira, Justin Roberts, Michael Sagner, Jeffrey Stout, Jaime Tartar, Adam Wells

Faculty Publications

Energy drinks are a commonly consumed beverage, and studies suggest a possible performance-enhancing effect. A Google Scholar search using the keywords “energy drinks” and “exercise” yields numerous results, underscoring the voluminous research on this topic. However, there are questions regarding the effectiveness and safety of energy drinks. These questions include, but are not limited to: (1) What are the main active ingredients in energy drinks? (2) Do energy drinks assist in weight management? (3) Do energy drinks enhance aerobic performance? (4) Do energy drinks enhance athletic speed? (5) Do energy drinks improve reaction time? (6) Do energy drinks enhance lean …

International Society Of Sports Nutrition Position Stand: Β-Hydroxy-Β-Methylbutyrate (Hmb), John A. Rathmacher, Lisa M. Pitchford, Jeffrey R. Stout, Jeremy R. Townsend, Ralf Jäger, Richard B. Kreider, Bill I. Campbell, Chad M. Kerksick, Patrick S. Harty, Darren G. Candow, Brandon M. Roberts, Shawn M. Arent Ph.D., Cscs*D, Fissn, Facsm, Fnak, Douglas S. Kalman, Jose Antonio

Faculty Publications

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on an analysis of the literature regarding the effects of β-Hydroxy-β-Methylbutyrate (HMB). The following 12 points have been approved by the Research Committee of the Society: 1. HMB is a metabolite of the amino acid leucine that is naturally produced in both humans and other animals. Two forms of HMB have been studied: Calcium HMB (HMB-Ca) and a free acid form of HMB (HMB-FA). HMB-FA appears to lead to increased appearance of HMB in the bloodstream when compared to HMB-Ca, though recent results are mixed. 2. …

Sculpting Success: The Importance Of Diet And Physical Activity To Support Skeletal Muscle Health During Weight Loss With New Generation Anti-Obesity Medications, Gregory J. Grosicki, Nikhil V. Dhurandhar, Jessica L. Unick, Shawn M. Arent Ph.D., Cscs*D, Fissn, Facsm, Fnak, J. Graham Thomas, Holly Lofton, Madelyn C. Shepherd, Jessica Kiel, Christopher Coleman, Satya S. Jonnalagadda

Faculty Publications

Obesity is a public health crisis, with prevalence rates tripling over the past 60 y. Although lifestyle modifications, such as diet and physical activity, remain the first-line treatments, recent anti-obesity medications (AOMs) have been shown to achieve greater reductions in body weight and fat mass. However, AOMs also reduce fat-free mass, including skeletal muscle, which has been demonstrated to account for 20% to 50% of total weight loss. This can equate to ∼6 kg or 10% of total lean mass after 12–18 mo, a loss comparable to a decade of human aging. Despite questions surrounding the clinical relevance of weight …

Characterization Of Health And Safety Resources For Athletes With Sickle Cell Trait At Ncaa Institutions, Susan W. Yeargin Ph.D., Atc, Lat, Courtney M. Meyer Ph.D., Rebecca M. Hirschhorn, Abbi D. Lane, Shawn M. Arent Ph.D., Cscs*D, Fissn, Facsm, Fnak, Clint R. Haggard

Faculty Publications

Yeargin, SW, Meyer, CM, Hirschhorn, RM, Lane, AD, Arent, SM, and Haggard, CR. Characterization of health and safety resources for athletes with sickle cell trait at NCAA institutions. J Strength Cond Res 38(11): 1967-1973, 2024 - The purpose of this study was to report the prevalence of student-athletes with sickle cell trait (SCT), determine which screening practices are most commonly used, describe the health and human performance services provided to athletes, and ascertain if differences between National Collegiate Athletic Association (NCAA) designations or divisions exist. A cross-sectional survey design was used to query healthcare administrators regarding SCT resources at their …

Standardized Patient Evaluation Tool: A Valid Measure Of The Core Competencies, Lindsey E. Eberman, Jessica Edler Nye

Clinical Practice in Athletic Training

No abstract provided.

The Value Of Using Validated Competency-Based Assessments Across The Career Span Of An Athletic Trainer, Matthew Drescher, Lindsey Eberman

Clinical Practice in Athletic Training

No abstract provided.

The Development, Implementation, And Value Of The Athletic Training Milestones For Assessing Progressive Clinical Behaviors, Hollie Walusz, Eric Sauers, Mark Laursen, Forrest Pecha

Clinical Practice in Athletic Training

No abstract provided.

Perceptions And Use Of The Athletic Training Milestones In Education: A Report From The Aate Research Network, Cailee E. Welch Bacon, Barton E. Anderson, Julie M. Cavallario, Bonnie L. Van Lunen, Lindsey E. Eberman

Clinical Practice in Athletic Training

The Athletic Training Milestones (AT Milestones) were developed as an evaluation tool to capture the breadth and depth of athletic training knowledge, skills, and behavior. However, it is unclear whether athletic training programs are implementing this tool or how they are implementing it to gauge the clinical progression of students or residents in athletic training. We aimed to explore the perceptions and use of the AT Milestones among educators in athletic training programs. We used a cross-sectional, web- based survey with open-ended questions to collect data from athletic training programs on if and how they implement the AT Milestones at …

Interface Between Sensorimotor Dynamics And Trunk-Hip Movement Control: Implications For Movement Assessment In Low Back Pain, John Ryan Gilliam

Theses and Dissertations

Low back pain is the leading cause of activity limitation and work absence and results in billions of dollars in healthcare expenditures. Impaired trunk-hip movement control is associated with the development of back pain and the persistence of symptoms. Theories suggest a causal relationship between altered sensorimotor dynamics, including altered afferent somatosensory information from the periphery and neuroplastic central nervous system adaptations, and impaired trunk-hip movement patterns. We characterized trunk-hip movement patterns and their associated sensorimotor brain dynamics in people with and without chronic low back pain (cLBP). Supine, atop an instrumented system, 48 individuals with cLBP and 37 healthy …

Collegiate Student-Athlete Responses To The Covid-19 Pandemic, Alexa Jenny Chandler

Theses and Dissertations

Introduction: Exercise imposes a physiological stressor on the body which is amplified as training intensifies. Collegiate fall-sport student-athletes return after summer break (off-season) and have approximately two weeks of training (preseason) with coaching staff before competition begins. The 2020 fall season was preceded by a five-month period away from campus due to the timing of the coronavirus 2019 (COVID-19) pandemic. This also meant all commercial gyms and training facilities were closed, and student-athletes were forced to train with the resources they had at home. Upon return to campus, significant changes were made to practice and competition structures in attempt to …

Advancing Objective Mobile Device Use Measurement Inchildren Ages 6–11 Through Built-In Device Sensors: A Proof-Of-Concept Study, Olivia L. Finnegan, Robert Glenn Weaver Med, Phd, Hongpeng Yang, James W. White, Srihari Nelakuditi, Zifei Zhong, Rahul Ghosal Ph.D., Yan Tong, Aliye B. Cepni, Elizabeth L. Adams, Sarah Burkart Mph, Ph.D., Michael W. Beets Med, Mph, Phd, Bridget Armstrong Ph.D.

Faculty Publications

Mobile devices (e.g., tablets and smartphones) have been rapidly integrated into the lives of children and have impacted howchildren engage with digital media. The portability of these devices allows for sporadic, on-demand interaction, reducing theaccuracy of self-report estimates of mobile device use. Passive sensing applications objectively monitor time spent on a givendevice but are unable to identify who is using the device, a significant limitation in child screen time research. Behavioralbiometric authentication, using embedded mobile device sensors to continuously authenticate users, could be applied toaddress this limitation. This study examined the preliminary accuracy of machine learning models trained on iPad …

Comparison Of Raw Accelerometry Data From Actigraph, Apple Watch, Garmin, And Fitbit Using A Mechanical Shaker Table, James W. White Iii, Olivia L. Finnegan, Nick Tindall, Srihari Nelakuditi, David E. Brown Iii, Russell R. Pate Ph.D., Gregory J. Welk, Massimiliano De Zambotti, Rahul Ghosal, Yuan Wang, Sarah Burkart, Elizabeth L. Adams, Mvs Chandrashekhar, Bridget Armstrong, Michael W. Beets, Robert Weaver Med, Phd

Faculty Publications

The purpose of this study was to evaluate the reliability and validity of the raw accelerometry output from research-grade and consumer wearable devices compared to accelerations produced by a mechanical shaker table. Raw accelerometry data from a total of 40 devices (i.e., n = 10 ActiGraph wGT3X-BT, n = 10 Apple Watch Series 7, n = 10 Garmin Vivoactive 4S, and n = 10 Fitbit Sense) were compared to reference accelerations produced by an orbital shaker table at speeds ranging from 0.6 Hz (4.4 milligravity-mg) to 3.2 Hz (124.7mg). Two-way random effects absolute intraclass correlation coefficients (ICC) tested inter-device reliability. …

Balancing Best Practice And Reality In Behavioral Intervention Development: A Survey Of Principal Investigators Funded By The National Institutes Of Health, Lauren Von Klinggraeff, Sarah Burkart, Christopher D. Pfledderer, Alexander Mclain, Bridget Armstrong Ph.D., Robert Glenn Weaver Med, Phd, Michael Beets Med, Mph, Phd

Faculty Publications

Preliminary studies play a prominent role in the development of large-scale behavioral interventions. Though recommendations exist to guide the execution and interpretation of preliminary studies, these assume optimal scenarios which may clash with realities faced by researchers. The purpose of this study was to explore how principal investigators (PIs) balance expectations when conducting preliminary studies. We surveyed PIs funded by the National Institutes of Health to conduct preliminary behavioral interventions between 2000 and 2020. Four hundred thirty-one PIs (19% response rate) completed the survey (November 2021 to January 2022, 72% female, mean 21 years post-terminal degree). Most PIs were aware …

Whole-Of-School Physical Activity Implementation In The Context Of The Dubai Fitness Challenge, Chris Mcmahon, Collin A. Webster, Robert Weaver, Christophe El Haber, Gönül Tekkurşun Demir, Zainab Mohamed Ismail, Syeda Zoha Fatima Naqvi, Mehnaz Ghani, Şevval Kepenek, Manel Kherraf, Thrisha Krishnakumar, Pranati Prakash, Yeowon Seo

Faculty Publications

Introduction

Physical activity (PA) promotion among school-aged youth is a global health priority. Recommendations for such promotion include implementing whole-of-school approaches that maximize resources across the school environment. This study examined schools’ participation in an annual, government-led, and emirate-wide initiative in Dubai, called the Dubai Fitness Challenge, in which the goal is to accrue 30 minutes of PA every day for 30 days (as such, the initiative is colloquially referred to as “Dubai 30x30”).

Methods

A mixed-methods design was employed for this study. Three schools were recruited using convenience sampling. Participants were 18 physical education teachers, 20 classroom teachers, 2 …

Left Ventricle Function And Post-Transcriptional Events With Exercise Training In Pigs, Stephanie L. Samani, Shayne C. Barlow, Lisa A. Freeburg, Traci L. Jones, Marlee Poole, Mark A. Sarzynski Ph.D., Faha, Facsm, Michael R. Zile, Tarek Shazly, Francis G. Spinale

Faculty Publications

Background

Standardized exercise protocols have been shown to improve overall cardiovascular fitness, but direct effects on left ventricular (LV) function, particularly diastolic function and relation to post-transcriptional molecular pathways (microRNAs (miRs)) are poorly understood. This project tested the central hypothesis that adaptive LV remodeling resulting from a large animal exercise training protocol, would be directly associated with specific miRs responsible for regulating pathways relevant to LV myocardial stiffness and geometry.

Methods and results

Pigs (n = 9; 25 Kg) underwent a 4 week exercise training protocol (10 degrees elevation, 2.5 mph, 10 min, 5 days/week) whereby LV chamber stiffness (KC) …

Physical Activity, Anxiety, Depression, And Coping In Turkish Men And Women During The First Wave Of Covid-19, Bijen Filiz, Funda Coşkun Özyol, Bengü Güven, Ezel Nur Korur, Yılmaz Yüksel, Cavit Işık Yavuz, Kele Ding, Jingzhen Yang, J. Larry Durstine Phd, Facsm, Faacvpr, Fnak, Ming-Kai Chin, Gıyasettin Demirhan

Faculty Publications

A need exists to better understand the relationships between COVID-19, coping behaviors, physical activity and stress, and COVID-19’s impact on way of life. A cross-sectional study design was used to examine adult physical activity, hope, depression, anxiety, and coping status by gender during the COVID-19 pandemic, and to determine the impact of these variables on the coping process. The study also examined the effect of gender on the relation between physical activity and dependent variables. A global survey instrument was used in this study, including 1,400 Turkish adults. This study identified significant gender-based differences regarding physical activity, hope, depression, anxiety, …

The Effects Of A Brand-Specific, Hemp-Derived Cannabidiol Product On Physiological, Biochemical, And Psychometric Outcomes In Healthy Adults: A Double-Blind, Randomized Clinical Trial, Gianna F. Mastrofini, Bridget A. Mcfadden, Alexa J. Chandler Ph.D., Blaine S. Lints, Harry P. Cintineo, Nathaniel D. Rhoades, Caroline S. Vincenty, Sten O. Stray-Gundersen Ph.D., Abbi D. Lane, Shawn M. Arent Ph.D., Cscs*D, Fissn, Facsm, Fnak

Faculty Publications

Background: Cannabidiol (CBD) is a non-psychoactive phyto-cannabinoid derived from the Cannabis sativa plant. CBD exhibits various interactions at receptor sites, prompting the research of its potential anti-inflammatory, immunomodulatory, psychological, and pain-relieving effects. This study aimed to investigate the physiological, biochemical, and psychometric effects of a brand-specific, hemp-derived CBD product in healthy adults over a 12-week observation period. Methods: 54 healthy males and females (age = 25 ± 7y; BMI = 24.82 ± 3.25 kg/m2) recruited from a large Southeastern University completed the study. Participants arrived at the laboratory after > 8 h of fasting, and > 48 h without alcohol consumption and …

Common Questions And Misconceptions About Caffeine Supplementation: What Does The Scientific Evidence Really Show?, Jose Antonio, Daniel E. Newmire, Jeffrey R. Stout, Brandi Antonio, Maureen Gibbons, Lonnie M. Lowery, Joseph Harper, Darryn Willoughby, Cassandra Evans, Dawn Anderson, Erica Goldstein, Jose Rojas, Matías Monsalves-Álvarez, Scott C. Forbes, Jose Gomez Lopez, Tim Ziegenfuss, Blake D. Moulding, Darren Candow, Michael Sagner, Shawn M. Arent Ph.D., Cscs*D, Fissn, Facsm, Fnak

Faculty Publications

Caffeine is a popular ergogenic aid that has a plethora of evidence highlighting its positive effects. A Google Scholar search using the keywords “caffeine” and “exercise” yields over 200,000 results, emphasizing the extensive research on this topic. However, despite the vast amount of available data, it is intriguing that uncertainties persist regarding the effectiveness and safety of caffeine. These include but are not limited to: 1. Does caffeine dehydrate you at rest? 2. Does caffeine dehydrate you during exercise? 3. Does caffeine promote the loss of body fat? 4. Does habitual caffeine consumption influence the performance response to acute caffeine …