Outcomes from an interprofessional curriculum on trauma-informed care among pediatric service providers.

The effects of trauma on the health of individuals have been well established as a major public health concern. However, the integration of trauma-informed practices within the multidisciplinary pediatric health care system still faces significant challenges and barriers. This study sought to understand the changes in knowledge, behaviors, and attitudes related to trauma-informed care following administration of a trauma-informed educational intervention. Eighteen pediatric professionals participated in this interprofessional study design. The intervention included several components of self-study, face-to-face active learning experiences, presentations, and case discussions. Six weeks following the intervention, participants engaged in a follow-up focus group dialogue. To crystallize the transformative impact of education in practice, the study used both quantitative and qualitative data. Quantitative data was measured using the Attitudes Related to Trauma Informed Care (ARTIC) scale, while a focus group was used to understand the subjective experiences of participants and the effects of participation on practice. Results showed statistically significant pre- to post-programming improvements across all ARTIC domains. Qualitative themes aligned with the quantitative findings, indicating a sense of empowerment through knowledge, as well as an enhanced awareness of systematic challenges to implementation of trauma-informed care approaches.

Pelvic Floor Muscle Resting Tone in Children With Dysfunctional Voiding Symptomology Following Simple Gross Motor Exercises.

PURPOSE: The study aimed to understand the effects of a set of simple gross motor exercises on pelvic floor muscle (PFM) resting tone (RT) in children with dysfunctional voiding symptomology. METHODS: The study compared PFM RT for a single-sample before and after 2 protocols: exercise versus relaxation (metric standard). RESULTS: Participants included 27 children ages 5.00 to 10.92 years. Preintervention PFM RT was similar between the interventions: 63% (exercise) and 78% (relaxation) of children decreased PFM RT following intervention. Between-intervention post-minus-prechanges in PFM RT were compared. Between-intervention differences were similar. CONCLUSIONS: Exercise and relaxation protocols were comparable in lowering PFM RT in children with voiding dysfunction. Findings are clinically worthy in that either exercises or relaxation prior to toileting may assist with more complete emptying in children with symptoms.

Changes in knowledge, beliefs, self-efficacy, and affective commitment to change following trauma-informed care education for pediatric service providers.

OBJECTIVE: As organizations strive to build trauma-informed care (TIC) systems, further understanding of individual and organizational characteristics that may impact implementation is needed. The objective of this study was to assess changes in affective commitment, beliefs, foundational knowledge, and self-efficacy following completion of a TIC curriculum for a group of interprofessional pediatric service providers. Understanding effects of training on the perceptions of organizational support held by participants was also central to our inquiry. METHOD: A quasi-experimental pre/post design was used to assess the effectiveness of a curriculum comprising a required prereading component and a 4-hour interactive educational experience. The in-person session was designed to prompt a full appreciation of the impact of traumatic events on brain development and the long-term consequences of traumatic stress and historical trauma. Professionals recruited from several Midwestern pediatric service organizations completed pre- and posteducation surveys, answering questions on the Affective Commitment to TIC scale, Beliefs about Trauma subscale, Foundational Knowledge subscale, Principal Support for TIC, and TIC Self-Efficacy subscale. RESULTS: Findings suggest that the proposed TIC curriculum effectively increased participants' TIC beliefs, knowledge, and self-efficacy as well as their perceptions of organizational support. CONCLUSIONS: We propose that TIC trainings tailored to the specific needs of the target audience hold potential toward promoting systemic organizational change among pediatric agencies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cortical and Cerebellar Oscillatory Responses to Postural Instability in Parkinson's Disease.

Introduction: Posture and balance dysfunctions critically impair activities of daily living of patients with progressing Parkinson's disease (PD). However, the neural mechanisms underlying postural instability in PD are poorly understood, and specific therapies are lacking. Previous electrophysiological studies have shown distinct cortical oscillations with a significant contribution of the cerebellum during postural control tasks in healthy individuals. Methods: We investigated cortical and mid-cerebellar oscillatory activity via electroencephalography (EEG) during a postural control task in 10 PD patients with postural instability (PDPI+), 11 PD patients without postural instability (PDPI-), and 15 age-matched healthy control participants. Relative spectral power was analyzed in the theta (4-7 Hz) and beta (13-30 Hz) frequency bands. Results: Time-dependent postural measurements computed by accelerometer signals showed poor performance in PDPI+ participants. EEG results revealed that theta power was profoundly lower in mid-frontal and mid-cerebellar regions during the postural control task in PDPI+, compared to PDPI- and control participants. In addition, theta power was correlated with postural control performance in PD subjects. No significant changes in beta power were observed. Additionally, oscillatory changes during the postural control task differed from the resting state. Conclusion: This study underlines the involvement of mid-frontal and mid-cerebellar regions in postural stability during a balance task and emphasizes the important role of theta oscillations therein for postural control in PD.

Relationships between Freezing of Gait Severity and Cognitive Deficits in Parkinson's Disease.

Freezing of gait (FOG) is one of the most debilitating motor symptoms experienced by patients with Parkinson's disease (PD), as it can lead to falls and a reduced quality of life. Evidence supports an association between FOG severity and cognitive functioning; however, results remain debatable. PD patients with (PDFOG+, n = 41) and without FOG (PDFOG-, n = 39) and control healthy subjects (n = 41) participated in this study. The NIH toolbox cognition battery, the Montreal Cognitive Assessment (MoCA), and the interval timing task were used to test cognitive domains. Measurements were compared between groups using multivariable models and adjusting for covariates. Correlation analyses, linear regression, and mediation models were applied to examine relationships among disease duration and severity, FOG severity, and cognitive functioning. Significant differences were observed between controls and PD patients for all cognitive domains. PDFOG+ and PDFOG- exhibited differences in Dimensional Change Card Sort (DCCS) test, interval timing task, and MoCA scores. After adjusting for covariates in two different models, PDFOG+ and PDFOG- differed in both MoCA and DCCS scores. In addition, significant relationships between FOG severity and cognitive function (MoCA, DCCS, and interval timing) were also found. Regression models suggest that FOG severity may be a predictor of cognitive impairment, and mediation models show the effects of cognitive impairment on the relationship between disease severity and FOG severity. Overall, this study provides insight into the relationship between cognitive and FOG severity in patients with PD, which could aid in the development of therapeutic interventions to manage both.

Resilience and First-Year Pharmacy Students' Academic Performance in a Pharmacy Math Course.

Objective. The purpose of this study was to examine the relationship between academic resilience and academic success in Doctor of Pharmacy (PharmD) students.Methods. A cross-sectional survey using the Academic Pharmacy Resilience Scale (APRS-16) was conducted in two cohorts of first year pharmacy (P1) students (n = 374) during fall orientation in 2019 and 2020. The following data were also collected from student records: demographics, pre-pharmacy grade point average (GPA), Pharmacy Math outcome (passing or failing the course), and Pharmacy Math final numerical grade. Academic success was defined as achieving a passing grade in a Pharmacy Math course. Correlational, multiple logistic regression, and multiple linear regression analysis were conducted.Results. The survey response rate was 98.1%, and approximately 95% of participants passed Pharmacy Math. No significant correlations were found between Pharmacy Math final pass/fail outcome or Pharmacy Math final numerical grade and APRS-16 overall and subscale scores. In multiple logistic regression, neither pre-pharmacy GPA nor APRS overall scale or subscale scores were significantly associated with final Pharmacy Math outcome (passing/failing). In multiple linear regression, pre-pharmacy GPA was significantly associated with Pharmacy Math final numerical grade, but APRS-16 overall score and subscale scores were not.Conclusion. First-year pharmacy students' performance in Pharmacy Math was not influenced by academic resilience. Studies like this one examining the relationship between pharmacy students' resilience and academic performance are lacking. Future studies should assess whether academic resilience may affect performance in other courses as well as performance in the PharmD curriculum.

Values that influence employment acceptance among physical therapists practicing in primary care shortage and non-urban designation areas.

INTRODUCTION: Physical therapists (PTs) in all United States, DC, and the US Virgin Islands have first-contact direct access privileges to examine and treat patients. Evidence supports the value of PT services in reducing annual healthcare costs, decreasing the need for prescription pain medication, and decreasing the need for outpatient physician care. PTs can play an essential role in managing patient health needs in primary care health professional shortage areas (pcHPSAs), especially in rural areas, which are disproportionately affected by shortage-related health disparities. The current study examined values that differentiated PTs who accept and maintain employment in pcHPSAs and non-urban areas, as a means of advising health agencies within these designation areas. METHODS: A survey invitation was emailed to PTs in six states. The Determinants of Employment Acceptance Survey was used to survey the importance of six factors (attachment to place, community assets, practice environment, professional advancement, relationships, and remuneration) when considering employment. RESULTS: Respondents included 373 PTs (36% pcHPSA; 33% non-urban). Professional advancement was significantly more important to PTs intending to continue their employment in a pcHPSA. Community assets were more important to PTs in non-urban areas who planned to leave their employment within 5 years. The most valued factors for PTs, regardless of practice location, were practice environment and attachment to place. CONCLUSION: Employers in rural areas or pcHPSAs who are interested in recruiting and retaining PTs should consider the importance of professional advancement, practice environment, and workplace relationships, and should use strategic measures to fortify these assets within the workplace.

Developing a Framework of Relationships Among Noncognitive Factors in Doctor of Pharmacy Students' Academic Performance.

Objective. To develop a framework of the effects of select noncognitive factors (grit, perceived stress, internal locus of control, and select Big Five personality traits) on pharmacy students' academic performance.Methods. A survey measuring select noncognitive factors was administered to two cohorts of first professional year (P1) pharmacy students (entering classes of 2019 and 2020, n=374) during fall orientation. Demographics, pre-pharmacy GPA, and P1 fall semester GPA were collected from student records. Structural equation modeling was conducted to assess the proposed framework.Results. Academic performance was directly influenced by students' (n=367; 98.1%) perceived stress and neuroticism and indirectly influenced by internal locus of control and neuroticism (via perceived stress as mediator). Neuroticism has a complex relationship in the models as it was directly and positively associated with academic performance, and indirectly contributed to decreased academic performance via a positive association with perceived stress. Squared multiple correlations indicated 13% and 9% of the variance in academic performance in the first final model (academic performance measured by pre-pharmacy GPA and P1 fall GPA) and second final model (academic performance measured by P1 fall GPA), respectively, were explained by the predictor variables.Conclusion. Evidence provided by structural equation modeling supports the conclusion that select noncognitive factors, namely perceived stress, neuroticism, and internal locus of control, have direct and indirect effects on the academic success of P1 students. The model variances of 9% and 13% represent 36% to 52% of the predictive value of the most accepted cognitive measures used to determine students' potential for academic success.

Systematic review of noncognitive factors influence on health professions students' academic performance.

Increased importance has been placed on noncognitive skills in professional development and by accrediting bodies of health professions programs in recent years. Therefore, the purpose of this study was to conduct a comprehensive systematic review of evidence examining effects of academic resilience, grit, perceived stress, locus of control, and Big Five Personality Traits on academic performance of health professions students. A literature search of peer-reviewed, English-language articles describing select noncognitive factors was performed using seven databases. Searches were performed from the earliest index date through May 2020. The following data from included studies were extracted and summarized: research design hierarchy, hierarchy of study outcomes (modified from Kirkpatrick), association between noncognitive factors and academic outcomes, and quality assessment criteria. 149 articles met inclusion criteria. Almost 80% of studies were Level III (observational). Medical students were the most frequently studied population (n = 73 articles). The most studied academic outcome was grade point average (n = 61). Perceived stress and Big Five Personality Traits accounted for greater than 50% of studies. Most studies were rated as fair to good quality. Associations between noncognitive factors and academic outcomes were largely inconsistent, although greater perceived stress was generally associated with poorer academic performance outcomes, while higher conscientiousness, academic resilience, and grit were generally associated with better outcomes. This systematic review represents a large body of evidence concerning select noncognitive factors and their association with academic performance of health professions students. Support services addressing noncognitive factors should be deliberated and tailored for specific health professions education programs and student populations.

RHIA CERTIFICATION EXAM SUCCESS FACTORS.

This study explored possible success factors for passing the Registered Health Information Administration (RHIA) certification exam. According to the American Health Information Management Association (AHIMA), only 70 percent of first-time test-takers passed the RHIA exam in 2019. A literature review offered insight into factors related to passing certification exams. Sources included existing, relevant peer-reviewed and published literature since 1990 within 87 educational and health/medicine databases and 62 other articles and journal databases available at the University of South Dakota library. A correlational design was used in the study. Data was retrieved from AHIMA, cleaned, and binary logistic regression analysis was completed. A significant relationship was identified between having a prior credential, such as the Registered Health Information Technician (RHIT) credential and passing the RHIA exam. This new information will help improve pass rates, advance the HIM field research base, and help students improve their odds of passing the RHIA exam.

FACTORS FOR SUCCESSFULLY PASSING CERTIFICATION EXAMS: A SYSTEMATIC REVIEW.

This study explored possible success factors for health information management certification exams. Based on the American Health Information Management Association (AHIMA) website, in 2018 and 2019, only 70 percent of first-time test takers passed the Registered Health Information Administrator (RHIA) exam; 26 percent passed the Certified Health Data Analyst (CHDA) exam in 2018; and only 10 percent passed the Certified Health Data Analyst exam in 2019. A quantitative systematic review and meta-analysis offered insight into factors related to passing certification exams. Sources included existing, relevant peer-reviewed and published literature since 1990 within 87 educational and health/medicine databases and 62 other articles and journal databases available at the University of South Dakota library. Outcomes from the systematic review include illumination of factors for passing health information management, healthcare, and education certification exams. Ultimately, this new information will help improve pass rates on certification exams.

The impact of an evolving profession on the frequency and perceived difficulty of ethical encounters among physical therapists in the clinic.

Background: Ethical decision making is situated within dynamic contexts specific to practice standards and environments, contemporary policy, and responsive educational systems. Reflecting on an evolving profession lends insight into the role of ethical codes of conduct. Objective: The purpose of this study was to gather information about the frequency and perceived difficulty physical therapists (PTs) experience with common ethical situations within contemporary clinical practice. Methods: PTs within the United States were invited to participate in an online questionnaire replicating a 1980 study. Subjects were 336 PTs from a variety of practice environments. Results: Just 1 item was reported as moderately/extremely difficult by contemporary respondents, compared to 16 items in the 1980 study. The number of items meeting moderate/high encounter frequency was similar between the two groups (2015 = 16/19; 1980 = 15/19). Conclusions: While today's PTs report that they encounter ethical situations at a frequency similar to PTs in 1980, these same PTs report these ethical challenges as minimally difficult when compared to PTs responding to the 1980 survey. It is proposed that a move toward autonomous practice, the elevation of the entry level professional degree, and changing health care policy and environments have been influential in shaping these changes over time.