Copyright ©1997-2004 
American Society of Exercise Physiologists
All Rights Reserved
ASEPNewsletter
Vol 8 No 3 March 2004
ISSN 1097-9743
 
 
Editors: Dr. Lonnie Lowery and Dr. Tommy Boone
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The 6th ASEP National Meeting:  Get the information you need about registration, hotel, (clicking here), and presentation topics, and presenters.

Editorial from ASEP's President

Dear Exercise Physiologists, 

In the fall of 1983, I completed my Master’s degree in Exercise Physiology. Not a day has gone by, in the last twenty years, where I have not wondered what I will do when I grow up! Over that same period of time, my passion for exercise and the profession of exercise physiology has never faded.

As ASEP’s sixth annual meeting draws near, I find myself reflecting on the past year and preparing for meetings and presentations in Indianapolis. There is much to talk about and yet there is even more to be done. On April 1-3, we are anticipating a great turnout for this conference. The anticipation stems from ASEP’s appeal to grassroots exercise physiologists. The grassroots exercise physiologists are those professionals working in the trenches of fitness centers, corporations, and healthcare. These are the exercise professionals who feel the daily pressure of performance without professional identity, without respect, and without financial reward. 

ASEP’s appeal to this group is significant because for the first time in history a national organization has demonstrated significant commitment to the professional needs and issues facing exercise physiologists. Following the first ever “Summit on the Licensure of Exercise Physiologists” several years ago, ASEP pledged support for professional exercise physiologists through a written proclamation outlining our position and course of action. At this year’s annual meeting, I will map out our current position and share a course of action for several years to come. 

During the past year, the ASEP Board of Directors have met regularly, prepared documents, planned the annual meeting, drafted a strategic plan, and lobbied state legislators. We have found friends in strange places, lost members from our board and gained members on our board. We have started new state associations and gained membership. You couldn’t ask for more but I am. We still need YOUR help. There are committees that need members to get work done. If we spread the tasks among many people the organization becomes stronger and exercise physiologists benefit from an hour of your time each week

At the national meeting we hope to have GREAT news! This news will drive many discussions among exercise physiologists for weeks, months and maybe years after this meeting is done. At the very least you will see what ASEP has done for you and what ASEP is planning to do for professional exercise physiologists. It is no small step.

ASEP has stayed the course and will demonstrate that it is an exciting time for professional exercise physiologists. Please join us in Indianapolis on April 1-3, 2004. 

Sincerely, 
Steve Jungbauer, MA, MBA, FASEP, FAACVPR 
Board Certified Exercise Physiologist,
President


Exercise Physiology News and Comments
From the Co-Editor: Dr. Tommy Boone 

Placing Blame and Consequences
Several days ago, two intelligent young men in a very highly recognized academic institution contacted me for a brief discussion about lifestyle factors, diseases, and the responsibilities each person shares in the overall healthcare picture in the United States if not worldwide.  The students’ objective was to identify a method to ensure that individuals exercised when they said they did.  While exercise is important for the obvious reasons, the idea of requiring members of any community to a predetermined exercise program is unsettling to me.  They wanted to know if there was a physiological measurement, such as heart rate, that could identify a specific person from another person.  The thinking goes something like this: “If exercise is so important, and if disease is decreased by exercise, then anyone who is not exercising is contributing to society’s problems (e.g., emotional and/or physical and, particularly, costs of healthcare insurance to others, and the costs of hospital treatment).  Non-exercisers then must be held accountable by paying higher insurance premiums.  They cannot be allowed to continue contributing to the healthcare problems of society.” 

Frankly, this kind of thinking scares me a lot.  It is everything that democracy is not.  However unfortunate it is that a certain percent of the 260+ million people in the United States may engage in unhealthy practices, it is their right.  As an exercise physiologist, the consequences of requiring every person to walk or run 5 miles a week is troubling to me.  Similarly, it would wrong to mandate that every person must dress a certain way on Tuesday, read only certain books, avoid certain movies, go to bed exactly at 9:00 pm every night, or weigh within two pounds of an identified weight for a person’s height.  This kind of thinking has no place in a democratic society.  Big brother is not always right and, as for as science goes, what we thought we knew at one time may be discarded a month or a year from now.  Just imagine how many helpless Type As must have suffered and worried themselves uselessly because it was so-called “proven” that their type caused heart disease and premature heart attacks.  We know that this is not true, and that the data from more than 30 years ago were incomplete.  Failure to take into account the multifaceted complexity of what we as human beings is always a problem. 

Under no circumstances should exercise physiologists get caught up in placing blame on the victims for their disease or dysfunction.  There are simply too many diseases and dysfunctions that have no identifiable cause or causes.  There are too many people every year in the United States who have heart attacks without having elevated low-density lipoprotein cholesterol.  Stress itself may not be the problem.  It may have something to do with the person’s genetic disposition to disease.  Life is more than research, although research is an excellent tool to understand some aspects of lifestyle factors.  So, when it comes to finding a physiological measurement or an ankle band with a personalized chip to determine a person’s exercise habits, the hairs on the back of my neck stand up.  This kind of thinking that holds the “person” accountable by raising his or her premiums for healthcare insurance to make the bottom line easier for big business is wrong.  It is uncritical, unethical, and un-American.  Yet, frankly, it is very likely to hit us square between the eyes at some point in the future?  That is also why we must be especially prepared with solid ethical thinking and science to not allow big business to intrude any farther into the American way of living. 

As a related story, did you read about the “teacher who was refused a job because her relatives have Huntington’s disease”?  Jane Burgermeister reported the case in the British Medical Journal [1].  To paraphrase what was reported, a young teacher in Germany was refused a permanent job because members of her family have Huntington’s disease.  Since she therefore has a risk of developing the disease, the employer rejected her for a job on the grounds of a prediction that places the burden of the risk on the young teacher.  This kind of thinking is totally unacceptable.  This is not the purpose of research.  Discrimination is wrong in any form.  Exercise physiologists should find time to reflect on this issue and related issues since they are involved in the healthcare field as practitioners and researchers. 

Reference
1. Burgermeister, J. (2003). Teacher was refused job because relatives have Huntington’s disease. British Medical Journal. 327 (October 11): 827. [Online]. http://bmj.bmjjournals.com/cgi/content/full/327/7419/827

Exercise Physiology Certification: What is it?
The personal training industry is not a profession.  Exercise physiology is a profession.  There are dozens of organizations that offer personal trainer certifications.  There is only one organization of exercise physiologists.  Accrediting an organization to certify personal trainers is not the same thing as an academic institution accreditation.  The ASEP Board of Accreditation has accredited six colleges and universities.  The academic program in each is a professional degree.  Again, a certification program that is accredited by an organization is not the same as the accreditation of an academic institution.  Individuals disinterested in these basic axioms are foolishly traveling down the wrong road.  It is also a huge waste of time and money. 

Personal trainers are not in position to call themselves healthcare professionals.  Exercise physiologists are healthcare professionals.  You might agree or disagree, but the ASEP organization and its professional infrastructure have established it as the professional organization of exercise physiologists.  It became clear a few years before the founding of ASEP that the American College of Sports Medicine, the Cooper Institute, the International Sports Science Association, and the National Strength and Coaching Association certifications are not “exercise physiology” certifications.  In fact, it does not matter whether different organizations, like the Aerobics and Fitness Association of America, have issued thousands, even 160,000 certifications as reported by AFAA, the certifications are essentially useless in terms of a stable, sustainable career in healthcare.  Actually, what it does, including certifications by the National Federation of Professional Trainers, is increase expectations as though those who are certified have a serious future in healthcare. 

Certification that fails to match up to traditional steps towards professionalism, like nursing or physical therapy, will not provide the career options and financial stability that is expected.  Even the writing of standards to try and demonstrate some assurance of accountability outside of the academic setting will not evolve with respect or acceptance by the public.  The ASEP leadership understands this thinking.  While there is no conflict between exercise physiologists and personal trainers, there is a serious difference between the two (particularly, in the areas of academic preparation and professional philosophy that separates the two).  Exercise physiologists can in their practice connect with their clients on a one-to-one basis (i.e., through personal advice, consultation, cardiovascular and other testing, and so forth).  This is not true with personal trainers.  In other words, the public will not accept personal trainers supervising cardiovascular testing. 

The bottom line is that it is up to the exercise physiologists, particularly the ASEP board certified exercise physiologists, to define what they do in the public sector and how their future is changing through ASEP, accreditation, and professionalism.  ASEP exercise physiologists have defined their standards of practice; a practice that is linked to certification that underpins exactly what they do in health, fitness, rehabilitation, and athletics.  Why settle for anything less when it comes to a career in healthcare as an exercise physiologist? 

Quick and Dirty Research
Research is an engaging and, often times, complex process that takes time and commitment to many different facets of data collection, statistical analyses, and manuscript preparation (not to mention hours spent thinking about submission, rejection, and/or acceptance).  It is not impossible to do good research, but it is a challenge.  Most published articles are well done.  Some are little more than a purchased product.  The authors are not going to tell you that is the case.  Why should they?  Their reputation and job may be adversely influenced by the truth.  So, in short, studies are done as though the authors have followed the rules of research.  The truth is that much of what is published is not always the best research.  To be specific, research facilitated by large companies that stand to benefit from the sell of their products may not be good research. 

Quick and dirty publishing is research to sell products or an idea.  Authors of these advertisements understand all to well what they are doing.  Most have rationalized their behavior to the point that they actually believe their lies.  It is unfortunate.  Everyone is cheapened by the ease at which big companies are more than glad to hand over money from their big budgets to get their products advertised with a research theme.  Why?  Simply because society has been educated to the obvious.  Straight thinking and ethical thinking goes beyond biased thinking and for-profit thinking.  Society has come to value evidence-based research.  The problem is that there is no quick and easy ride to know whether a supplement or a drug works as it is advertised to work.  Evidence-based ethical thinking is not about quotes to produce quick sells of products.  It is about whether the product works and, therefore, whether the drug, for example, is worth taking to deal with a particular disease or dysfunction.  It is about responsible thinking that results in responsible research. 

What Are Exercise Physiologists Thinking About?
The answer might surprise readers of the ASEPNewsletter (i.e., if we knew what they are thinking).  I do not know what they are thinking?  Do you?  If we knew, how might the information influence us?  Maybe it would not have an influence whatsoever.  Very likely, if exercise physiologists are thinking about anything, they are thinking about either research projects, money, or how to get athletes to run faster, jump higher, or lift more weight.  Those with the doctorate degree are more prone to think about research and publishing.  Non-doctorate exercise physiologists are probably thinking about making it, financially speaking.  I wish there was a designated exercise physiologist who would gather information about other exercise physiologists to know what they are thinking.  Such a person and the information would add to understanding whether professionalism is valued or not.  For certain, the leadership of the American Society of Exercises Physiologists should know what exercise physiologists are thinking about.  What do you think?  Are you thinking about exercise physiology professionalism, code of ethics, and standards of practice?  Research?  Financial issues?  Career opportunities?  I wish I knew what you are thinking about. 

Advertising Is All About Money!
Have you thought about advertisements lately?  When you see one or read one, do you believe the information?  Could the content be accurate?  What if the companies are dishonest when they advertise their products?  Wow…that would be a first, right!  Could people get hurt or even die?  What seems obvious is that no one is evaluating the accuracy of many advertisements.  For example, is the Xenadrine-EFX ‘s thermogenic formula really different from other diet supplements?  Does it really increase metabolism and caloric expenditures [1, 2] as stated in the Star Magazine [3]?  Is Xenadrine-EFX the #1 diet supplement in the world because it works or is it the money that Cytodyne Technologies has to market the product?  Are the citations credible?  Are the statements supported by solid scientific research? 

Answers to these questions are critical to understanding products like Xenadrine-EFX and all other advertising material and marketing brochures sent out by companies with a lot of money.  What if the Xenadrine-EFX advertising material is nothing more than what the company wants the reader to know?  After all, advertising is about moving a product and making money.  Even drug companies are caught up in making money over integrity.  A recent study of advertising materials and marketing brochures sent out by drug companies that make medicines concluded that 94% of the information in them had no basis in scientific evidence [4].  Who would have imagined major medical drug companies pushing products with false advertisements?  Right!  If only 6% of the medical brochures in the study contained statements that were scientifically supported by relevant research articles, what do the sports and dietary supplement companies have to do lose? 

Athletes should not take supplements or drugs to enhance their performance even if either does not work.  It is an ethical problem, but who cares about ethics?  Should we care about the quality of drug advertising material?  You bet we should.  Should we care about the advertising material of most sports supplements and the distorted images that speaks to athletics?  Without question, we should care.  Exercise physiologists, in particular, must be concerned with the misrepresentation of the assumed benefits, the decreased discussion about side effects, and especially the suppressed literature that fails to support the advertisements.  We should care about putting athletes’ health at risk.  We should care that big drug companies are paying for medical brochures that bear little to know direct relationship to the actual truth of the drugs they market.  We should care. 

References
1. Kalman, D. (2002). Efficacy of a commercial green tea extract/caffeine-based product to increase basal metabolism in healthy adults. Interaction of Physical Activity & Nutrition.  Poster Abstract, p. 45. 
2. Journal of the American College of Nutrition. (2002). The metabolic effects of commercial green tea extract/caffeine-based dietary supplement in healthy normal volunteers. Vol. 21, No. 5, p. 488. 
3. Star Magazine. (March 8, 2004). I lost an incredible 52 lbs and kept it off with Xenadrine-EFX! p. 57. 
4. Tuffs, A. (2004). Only 6% of drug advertising material is supported by evidence. British Medical Journal. 328:485:7438-7485. 

Taking Vitamin Supplements: Get Serious!
Can you believe that the person standing or sitting next to you is taking vitamins and combinations of dietary and/or sports supplements?  Do you think that the person has read the ingredients in the hundreds of containers?  Are there substances in the thousands of products that should not be in the products, and could the products be dangerous to the human body?  The short answer is “yes” to both questions.  Then, why does a person with an interest in health and fitness start supplementing his or her exercise with unregulated products?  There are no doubt dozens of reasons.  Unfortunately, at the top of the list is the suggestion to take a multi-vitamin/mineral supplement by personal trainers.  Personally, I do not believe that trainers have any business pushing vitamins and/or supplements on to their clients.  They have no idea what substances are in the supplement.  They have no idea whether the substances are safe or what side effects may be produced.  Trainers need to recognize their limitations.  They need to stay with what they know.  This is a serious issue that has legal implications, particularly if the supplement makes an existing health problem worse.  Personal trainers should stay with the basics.  That’s right.  Encourage clients to run, jump, and lift weights in a safe environment.  Stop pushing supplements!  This is the most important 21st century message personal trainers should take to heart.  It is time to be faithful to doing what is right for the client not for the trainer’s pocket book. 

Imagine you are looking across a gym from one end to the next and all you can see are gym rats mining their business of flattering their clients while peaking the conversation towards building their personal supplement business (such as the Sports Supplements and Winners Club).  Look at the clients working out, thinking they are getting the right message and not realizing the graveyard of unethical practices used on them.  Here is a picture of something less than professional.  Rather than push supplements and drugs and suck up to those who think it is right to do so, walk away from it.  Do not participate in the sweet music of fraud and misinformation.  It is not a self-portrait that you will want to look back on years from now.  Get serious and run the intruders from the gyms.  Do so after reading this piece.  Rubbish!  Did I hear you say, Rubbish!  Well, I say to you: “You are a crooked thinker; you, the gym rat who is money first above everything else. Where is your concern for the client?  There is choice to be made.  It has to be made.  Or Mr. Personal Trainer you will lose everything when the public wakes up to your motives, which leaves me to say:  Get Serious.  Take the advice of one of your own, David P. Hoyt [1]. 

Reference
1. Hoyt, D.P. (2004). Are there stimulants in my vitamins?  Personal Fitness Professional.  Vol. 6, No. 3, 30-33. 

Why is Statistical Significance Important?
Do you have any idea why the scientific method is important?  This is one of many questions posed in courses about exercise physiology research and statistics.  Students are taught to understand the probability of a treatment effect.  For example, does a sports massage prior to submaximal exercise increase running efficiency?  They know that if one or more of the dependent variables (especially oxygen consumption) meet statistical significance (P<0.05), then the treatment is directly related to the findings.  If the findings do not reach statistical significance, then, in the case of the sports massage, it would be inappropriate to concluded that a sports massage prior to exercise increases running economy. 

Of course, there are a considerable number of concerns and issues that surround good research.  At times, there may be no significance (no difference) between the control and the treatment data, and still uncertainty exists.  In simple terms if there is no statistically significant difference between treatment and control data, then it is wrong to describe the data as if there is a significant difference (P>0.05).  As an example, the following statements were taken from an article published in the Journal of Physical Therapy Science: (1) “The larger cardiac output and stroke volume in the supine posture indicated the relative importance of cardiac pump, compared to muscle pump, during mild exercise.”  The naïve reader may not appreciate that cardiac output and stroke volume were only increased at 150W (P<0.05), not at 50W (P>0.05).  (2) “The lower a-vO2 diff in the supine posture indicates a relative ineffectiveness of oxygen supply by the blood flow in the exercising muscles.”  Yet, according to Table 1, page 23, a-vO2 diff was not statistically significant between sitting and supine at rest, 50W, or 150W.  (3) “The blood pressure in the present supine position was, however, lower than in the sitting posture despite a lower perfusion pressure in the exercising muscles.”  Here again, there were no statistically significant changes in blood pressure.  (4) “The lower TPR in the supine position agrees with this explanation, since the TPR is largely influenced by sympathetic nervous activity.”  Still, there were no statistically significant changes in TPR.  Therefore,  TPR is not lower!  (5) “The higher HR in the supine posture…..”  Heart rate was unchanged across the three conditions. 

The reporting of the data as if statistical significance had been found is unsettling.  College professors should make a concerted effort to incorporate and report on such information in class.  They should place emphasis on its potential effect of serious misinformation when no existing effect of treatment is evident.  In other words, to demonstrate whether there are physiological differences between exercising in the supine position versus the upright position is to find statistical significance.  Investigators who describe the data as if to argue on behalf a treatment without the findings having met significance are doing an injustice to the scientific method.  This is particularly important because not all students understand the need for responsible accounting of research data. 

References
1. Miyashita, S., Haruna, Y., Suzuki, Y., and Gunji, A. (1995). Effects of posture on cardiorespiratory responses during mild exercise. Journal of Physical Therapy Science. 7:21-25. pp. 23-24. 

Online Publishing
The leadership of ASEP has worked hard at publishing important and relevant articles in the Journal of Exercise Physiologyonline and the Professionalization of Exercise Physiologyonline.  Understandably, exercise physiologists know more about research and athletics than they do about professionalism and what it takes to build a profession of exercise physiology.  This is the consensus at least several of my students have shared with me.  Hence, they expect the academic exercise physiologists to continue publishing in JEPonline more so than in PEPonline.  From their point of view, it is a matter of time before more exercise physiologists will seek out PEPonline to publish their ideas, issues, and concerns.  Clearly, the JEPonline electronic journal is a success, and Dr. Robert Robergs, the Editor-in-Chief, deserves a lot of praise and positive comments for his hard work. JEPonline has become so popular that recently the ASEP leadership discussed a small budget for handling the peer review and online publishing process. 

The PEPonline journal is not so popular.  There are no academic exercise physiologists, except for a few, interested in publishing online manuscripts about professionalism.  This is likely to change in a big way in the future.  The need to talk about ethics, standards of practice, teaching strategies, credible certifications, professional development guidelines, and hundreds of other important topics exists.  The hope is that academic exercise physiologists will get the message that research and professional development have always gone hand in hand together.  Trust in this understanding is also why I started the Journal of Professional Exercise Physiology (JPEP).  The Editor-in-Chief is soon-to-be Dr. Jesse Pittsley. 

Apparently the “establishment” simply fails to get it.  They fail to understand that the old paradigm (i.e., exercise physiology defined as the study of acute and chronic changes with regular exercise) is the old way of thinking about exercise physiology.  And, in many respects, this is probably why they still hold tightly to the notion that the print copy forum is the only road to credible scientific publications.  What a mistake?  The concept of free online journals has been at the forefront of ASEP since 1997.  There are no hidden agendas.  There is no cost to the authors for the publication of their work.  There are no industry sponsors of any type or kind that may influence what is published or how data are interpreted.  Advertisements do not drive the ASEP Web site or its journals, and yet the ASEP online journals have survived and gained in popularity and credibility.  The objective is simple to understand:  ASEP promotes intellectual growth and opportunity and, therefore, ultimately enriches the ASEP society of exercise physiologists in many ways. 

Open Peer Review 
Given the relatively few authors who have submitted articles to PEPonline, as Editor-in-Chief, and founder of the electronic journal, I decided several months ago to go public with the review process.  Since my articles represent the bulk of the publications on a monthly basis, since I have an invested interest in the professionalization of exercise physiology, and since I believe there must be a “professionalism” journal that is valued as highly as a “research” journal within the context of any profession, I have stopped asking for help with the PEPonline journal.  This means that I publish what I believe is critical to an increased understanding of what is exercise physiology and who is an exercise physiologist along with dozens of topics that are important to any emerging profession. 

The current online publishing model makes it easy to publish in PEPonline.  As Editor-in-Chief, I will publish any manuscript submitted to PEPonline without changing the content per se.  All any editor asks of those who submit their work is that the manuscript must be professional.  If it is and even should the content disagree with the ASEP perspective, it will be published.  If the manuscript is not professional, it will not be published.  This is still consistent with an open peer review process.  I have no intention of suppressing dissemination of thoughts and/or ideas that disagree with the steps taken to professionalize exercise physiology through the ASEP perspective.  If professionally written, the question of accountability falls completely upon the author(s). 

This move to open peer review does not suggest at all that integrity of the editorial process was (or ever has been) a problem.  This is not a case of failing to accept a manuscript to have it surface in a comparable journal.  Point in fact; there is no comparable journals to PEPonline.  Rather, as Editor-in-Chief, I’m doing what seems reasonable to increase the number of manuscripts published on PEPonline other than just my manuscripts.  I believe this is important in hopes of publishing more diverse ideas and to increase public access to the online forum.  There is no way that exercise physiology is going to get better without more input from other professionals in the field. 

There is no charge to the author(s) for publishing his or her work.  I am optimistic that new thoughts will emerge to guide us out of the 20th century thinking about exercise physiology into the 21st century thinking of exercise physiologists as healthcare professionals.  There is a growing momentum among many non-doctorate exercise physiologists in support for the ASEP vision, perspective, and 21st century thinking.  Much has been done in just 6 years, and yet there is still much more to be done. 

Second Hand Smoke:  Bad Stuff, Right? Maybe Not!
Exercise physiologists are interested in finding ways to live a healthier and disease-free life.  Professors lecture on the benefits of exercise to their students.  They act as role models for the healthcare community.  Their research confirms the benefits of regular exercise.  At times, they also unintentionally embrace ideas prematurely.  For example, it was just several decades ago that exercise at high intensity was encouraged more so than low to moderate intensity [1].  This was true for post-myocardial infarction patients, too.  It made no sense then, and it certainly does not make sense today.  Then, there was the shared belief that elevated low-density cholesterol “caused” coronary artery disease [2].  Of course, many exercise physiologists talked bad about second hand smoke without evaluating the literature [3]. 

Regarding second hand smoke (also called environmental tobacco smoke and passive smoking), have you heard exercise physiologists talk hard and dirty about the long-term mortality from tobacco related disease?  Have you thought about whether they arguments are sound?  Are exercise physiologists objective in their dissemination of the information about lifestyle matters?  Answers to these questions might surprise you.  As an example, consider “summary statement” the 2003 publication of a scientific manuscript by Enstrom and Kabat [4] in the British Medical Journal:  “The results do not support a causal relation between environmental tobacco smoke and tobacco related mortality….the association between exposure to environmental tobacco smoke and coronary heart disease and lung cancer may be considerably weaker than generally believed.” [4, p. 2]. 

As contributing editor to the ASEPNewsletter, I am not for smoking or necessarily against smoking.  Life is rather short to live exactly as science would dictate.  Maybe the best we can do is live life to the best we can.  Life is complex and poorly understood on many fronts.  As Richard Smith commented in the August 30 issue of the British Medical Journal [5, p. 1], “Scientific truths are all provisional.  Most of science falls away as new paradigms emerge.” 

References
1. Boone, T. (1986). Exercise prescription for cardiac patients: reasons for concerns. Sports Medicine. 3:157-164. 
2. Boone, T. (1992). Coronary artery disease predictions from epidemiological research: Some critical reflections. The MAHPER Journal. 12:20-24. 
3. Boone, T. (2001). Using criticial thinking to better understand the health concerns of passive smoking. Professionalization of Exercise Physiologyonline. Vol. 3, No. 2 [Online]. http://faculty.css.edu/tboone2/asep/CriticalThinkingPassiveSmoking.html
4. Enstrom, J.E. and Kabat, G.C. (2003). Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98. British Medical Journal. Vol. 326 (May 17): 7398: 1057.  [Online]. http://bmj.bmjjournals.com/cgi/content/full/326/7398/105
5. Smith, R. (2003). Passive smoking: comment from the editor. British Medical Journal. Vol. 327 (August 30): 7413: 505. [Online]. http://bmj.bmjjournals.com/cgi/content/full/327/7413/505

The Power of Titles
As I sat with my son at Barnes and Nobles a few days ago, I overheard a person close to us talking about titles.  What’s in a title, and why it is important.  It caught my attention because I, too, have talked about titles in my professional development course at The College of St. Scholastica.  I’ve written about titles, too [1].  Understanding the importance of using the right title and having a professional title is essential to a share vision.  The cost of the title is hard work and dedication.  To know that an exercise physiologist does not understand the power of a title is a poignant example of failure to embrace change. 

Nurses have a title.  Physical therapists have a title.  Lawyers have a title.  It should be obvious that a title is linked to a profession.  The reasoning behind this thinking is based on decades of work towards professionalism by each of the three professions mentioned.  In the case of exercise physiology, the academic community has not kept up with the overall assessment of the mess their students find themselves.  It is easy to think that everything is fine, but I rejected that idea a decade ago.  Unsound reasoning that states a title is not important is a fallacy.  Exercise physiologists, as a community of healthcare professionals, must read about professionalism wherever they can find information about values, commitments, convictions, and demonstrate the passion to express, explain, and expand exercise physiology from the fitness “gym rat” personal training point of view to the healthcare perspective. 

Reference
1. Boone, T. (1999). What's In a Title? Professionalization of Exercise Physiologyonline. Vol. 2, No. 1 [Online]. http://faculty.css.edu/tboone2/asep/fldr/terms6.htm



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Abington, PA

Job Title: Exercise Physiologist - Part-time 
Job Type: (Full-Time, Part-Time, Internship, or Contract):  Part-time 
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Job Description: (Duties and Responsibilities) Part-time position available in Rehab Medicine. Individual will prepare patients and equipment for treatment and assist therapists in administering treatment to patients of varying ages ranging from infancy through late adulthood. 

Job Qualifications: (Experience and education required) Bachelor's degree in Exercise Science or related field required. Must have flexible schedule to work morning or afternoon shifts. Experience preferred, along with ACLS and ACSM. 

Response Information: Please write this in paragraph form. Include any or all of the following information: Company Name, Address, Contact Name, Phone, Fax, E-Mail, and Beeper. Abington Memorial Hospital is a 508-bed community teaching hospital and comprehensive regional health center located in the Philadelphia suburbs. AMH offers a highly competitive salary and benefits package. On-site child care facility now open! 

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or send resume to:

ATO, Personnel Department 
Abington Memorial Hospital 
1200 Old York Road 
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