ABSTRACT
Students' perspective on generalized nursing education in Germany: Results of a nationwide online survey Abstract. Background: Generalized nursing education in Germany was introduced in 2020 as a reaction to changed care conditions. The reform's implementation is accompanied by a nationwide longitudinal survey with three surveys among students in generalized nursing education. Aims: We present results of the first survey round. The explorative approach provides data that allows insights into students' experiences and thus indicates adjustment opportunities. Method: The online survey used standardized questionnaires and was directed at students that had begun generalized nursing education in 2020. 1,267 students from 316 nursing schools in 15 German federal states participated in the first survey round. The survey recorded students' career choice motivations, learning experiences in nursing schools and practical placements, as well as contextual factors. Results: The students' career choice is mainly interest-driven (77.8%). The program is rated good to satisfactory (overall grade 2.45). Frequent and well-designed practical guidance and a transfer of information between nursing school and clinical placement appear important but insufficiently implemented. Data shows an increased need for support services. Conclusions: In addition to positive findings, the practical learning design and the dialogue between theory and practice appear challenging, while support services should be expanded.
Subject(s)
Education, Nursing, Baccalaureate , Education, Nursing , Students, Nursing , Humans , Education, Nursing, Baccalaureate/methods , Surveys and Questionnaires , LearningABSTRACT
German nursing study programs from the students' perspective: First results of a nationwide longitudinal study Abstract. Background: The Nursing Professions Act establishes a concrete framework for academic nursing education in Germany for the first time. The primary qualifying nursing courses started in 2020 and will be accompanied by a systematic reporting of students' experiences over a period of three years. Aims: The article presents the results of the initial survey period (2021) on the students' point of view. Challenges and the need for further regulation of the primary qualifying nursing studies are analyzed and approaches to solutions are developed. Methods: The online survey is designed as a longitudinal cohort study with three measurement periods (2021, 2022, 2023). A descriptive analysis considers data of N = 57 students in the initial survey period. Results: The primary qualifying nursing study program is rated good overall (overall grade 2.32). However, one third (35.85%) are more critical in their assessments. Every second student perceives a need for adjustment in the financing of students. Learning in clinical placement settings often does not meet students' expectations. 86% of respondents report that nursing practice sites are insufficiently informed about students' qualification. Conclusions: Students' financing, and in particular the payment of assignments in the nursing practice, represents a regulatory gap with need for short-term solutions. For learning in nursing practice, there is a need for an enhanced practical placement guidance that is better geared to academic nursing education. This is accompanied by the need for a more specific definition of later professional fields and job profiles.
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Education, Nursing, Baccalaureate , Education, Nursing , Students, Nursing , Humans , Longitudinal Studies , Education, Nursing/methods , Learning , Curriculum , Surveys and Questionnaires , Education, Nursing, Baccalaureate/methodsABSTRACT
Rapid rise of population migration is a defining feature of the 21st century due to the impact of climate change, political instability, and socioeconomic downturn. Over the last decade, an increasing number of migrant peoples travel across the Americas to reach the United States seeking asylum or cross the border undocumented in search of economic opportunities. In this journey, migrant people experience violations of their human rights, hunger, illness, violence and have limited access to medical care. In the 'Divine Comedy', the Italian poet Dante Alighieri depicts his allegorical pilgrimage across Hell and Purgatory to reach Paradise. More than 700 years after its publication, Dante's poem speaks to the present time and the perilious journey of migrant peoples to reach safehavens. By exploring the depths and heights of the human condition, Dante's struggles resonate with the multiple barriers and the unfathomable experiences faced by migrant peoples in transit across South, Central, and North America to reach the United States. Ensuring the safety of migrant peoples across the Americas and elsewhere, and attending to their health needs during their migratory paths represent modern priorities to reduce social injustices and achieving health equity.
Subject(s)
Transients and Migrants , Americas , Developing Countries , Humans , Italy , Population Dynamics , United StatesABSTRACT
BACKGROUND: Nosocomial infections represent a serious challenge for healthcare systems worldwide. Adherence to hand hygiene plays a major role in infection prevention and control. These adherence rates can be improved through behaviour tracking innovations. This requires the systems to be widely implemented and accepted. Therefore, both a systematic analysis of the normative issues related and the evaluation of technology acceptance are equally important. OBJECTIVES: To explore and describe relevant aspects regarding the acceptance of technology and ethical implications using a tracking device to measure and improve adherence to hand hygiene. RESEARCH DESIGN: A quantitative study with a descriptive design was performed. PARTICIPANTS AND RESEARCH CONTEXT: A total of 75 questionnaires were collected in three hospitals in Germany. Acceptance of technology was measured with n = 60 participants (n = 50 nurses; n = 9 physicians; n = 1 not disclosed) and ethical assessment with n = 15 participants (nurses only). ETHICAL CONSIDERATIONS: Ethical approval for this study was obtained from the institutional review board. FINDINGS: The acceptance of technologies improving hygiene in general was good (median = 80.5, interquartile range = 28, range: 0-100). The experience with technologies in general (median = 48.5, interquartile range = 57, range: 0-100) and the acceptance of the specific technology (mean = 82.23, standard deviation = 15.16 (range: 23-138)) was moderate. There was a significant positive correlation between the acceptance and experience of technology in general (r = 0.217, p = .025). Ethical concerns played a minor role. The need for practical support was a key topic. DISCUSSION: Study participants accepted technologies improving hygiene; however, the specific device implemented was only moderately accepted. This creates specific opportunities in the implementation process for higher later acceptance. More practical support and an increase in experience may create opportunities for device implementation with high acceptance and low ethical concerns. CONCLUSION: Study results indicate a vast potential for improving the implementation process of hand hygiene technologies. Ethical concerns in this study did not seem to be a relevant barrier for successful implementation of hand hygiene technologies.
Subject(s)
Cross Infection , Hand Hygiene , Physicians , Cross Infection/prevention & control , Germany , Hand Hygiene/methods , Humans , Surveys and QuestionnairesABSTRACT
OBJECTIVES: Simulation-based learning is widely used in nurse education, including virtual reality (VR) methods which have experienced a major growth lately. Virtual reality offers risk free and contactless learning. Currently, little is known about what topics of nursing are adopted for VR simulations and how their design meets various educational goals. This review aims to scope existing articles on educational VR nursing simulations, and to analyse approaches from didactic and technical perspectives. METHOD: A systematic mapping review following the PRISMA-ScR guideline and PICo search strategy was conducted. Peer reviewed articles in English and German were searched across Scopus, CINAHL, PsycINFO, PSYNDEX, PsycARTICLES, PubMed, ERIC and The Cochrane Library. Studies had to include at least one immersive head-mounted display VR simulation in the field of nursing education. Data extraction and analysis was performed in a narrative, graphical and tabular way. RESULTS: Twenty-two articles were identified. There is a large variety in the use and definition of VR simulation for educational purposes. Simulations were classified into four main educational objectives: procedural skills training to improve technical knowledge and proficiency; emergency response training that focusses on confidence; soft skills training that teaches empathy; and finally, psychomotor skills training. Various approaches and simulation designs were implemented to achieve these educational outcomes. A few of them were highly innovative in providing an immersive experience to learn complex tasks, e.g. auscultation, or foster empathy by mimicking life with dementia. CONCLUSIONS: Despite an increase in the use of state-of-the-art VR nursing simulations, there is still a paucity of studies on immersive HMD based VR scenarios. Researchers designing educational VR packages need to be clear on terminology. In order to make full use of VR, designers should consider including haptic devices to practise psychomotor skills and include social interaction to teach soft skills.
Subject(s)
Education, Nursing , Virtual Reality , Clinical Competence , Educational Status , Humans , LearningABSTRACT
This article addresses the question of whether the human parsing mechanism (HPM) derives sentence meaning always from representations that are computed algorithmically or whether the HPM sometimes resorts to non-algorithmic strategies that may result in misinterpretations. Misinterpretation effects for noncanonical sentences, such as passives, constitute important evidence in favour of models allowing for nonveridical representations. However, it is unclear whether these effects reflect errors in the mapping of form to meaning, or difficulties specific to the procedure used to test comprehension. We report two experiments combining two different comprehension tasks to address these alternative possibilities. In Experiment 1, participants first judged the plausibility of canonical and noncanonical sentences and then named the agent or patient of the sentence. In Experiment 2, the order of the two tasks was reversed. Both tasks require the correct identification of agent or patient/theme, but differ regarding the complexity of operations required to complete the task successfully. In both experiments, participants made a substantial number of errors with agent/patient naming, even when they had correctly assessed sentence plausibility. We conclude that misinterpretation effects do not indicate parsing errors and therefore cannot serve as evidence for non-algorithmic processing. Our results support models of the HPM that assume algorithmic processing only.
Subject(s)
Comprehension , Language , HumansABSTRACT
BACKGROUND: Refugees and migrants face an increased risk of developing posttraumatic stress disorder (PTSD). Adequate care can be insufficient due to language barriers, cultural differences, and knowledge deficits of health service providers. Therefore, professional associations requested that healthcare providers to be educated to provide culturally sensitive care. An evidence-based educational intervention in the form of a continuing interprofessional education (CIPE) for healthcare providers on the topic of PTSD in migrants and refugees was developed, pilot-implemented, and evaluated according to the first two levels of the Kirkpatrick evaluation model (reaction and learning). METHODS: The development of a curriculum for the CIPE intervention was based on a narrative literature review. Its content was validated by experts (N = 17) in an online survey and analyzed using both the Content Validity Index and a thematic analysis. The evaluation of the CIPE intervention was performed by conducting a pilot study with a quasi-experimental single group, using a pre-posttest design. In total, there were 39 participants distributed among three pilot courses. We collected and analyzed data on satisfaction, knowledge, and feasibility. RESULTS: The curriculum for a half-day course, consisting of 8 modules, showed almost excellent content validity (S-CVI = 0.92). In the pilot-implementation phase, participants were "very satisfied" with the pilot courses and a positive effect on their knowledge was detected. No correlation between satisfaction and knowledge gain was found. CONCLUSIONS: The CIPE intervention can be considered feasible and seems promising in its effects on satisfaction and knowledge. The insights gained in this study can be used to adapt and optimize the educational intervention, whereby the feedback from course attendees is particularly useful. Future studies need to further examine the effects in larger samples and more robust study designs.
Subject(s)
Refugees , Stress Disorders, Post-Traumatic , Transients and Migrants , Health Personnel/education , Humans , Interprofessional Education , Pilot Projects , Stress Disorders, Post-Traumatic/therapyABSTRACT
The stability of metal nanocatalysts for electrocatalytic CO2 reduction is of key importance for practical application. We report the use of two polymeric N-heterocyclic carbenes (NHC) (polydentate and monodentate) to stabilize metal nanocatalysts (Au and Pd) for efficient CO2 electroreduction. Compared with other conventional ligands including thiols and amines, metal-carbene bonds that are stable under reductive potentials prevent the nanoclustering of nanoparticles. Au nanocatalysts modified by polymeric NHC ligands show an activity retention of 86 % after CO2 reduction at -0.9â V for 11â h, while it is less than 10 % for unmodified Au. We demonstrate that the hydrophobicity of polymer ligands and the enriched surface electron density of metal NPs through σ-donation of NHCs substantially improve the selectivity for CO2 reduction over proton.
ABSTRACT
Janus nanoparticles (NPs) containing two chemically distinct materials in one system are of great significance for catalysis in terms of harnessing catalytic synergies that do not exist in either component. We herein present a novel synthetic method of two Janus-type MnOx-Ag and MnOx-AgI NPs. The synthesis of Janus-type MnOx-AgI NPs is based on the oxidative nucleation and growth of Ag domains on MnO first and the subsequent iodization of Ag. A mild and non-disruptive iodization strategy is developed to yield Janus MnOx-AgI NPs, in which converting Ag to AgI domains with iodomethane (CH3I) is achieved through partial iodization. Simultaneously, Mn2+ species in the primary MnO octahedra are oxidized during the growth of Ag NPs, leading to the formation of amorphous p-type MnOx domains. Therefore, the as-resultant Janus-type MnOx-AgI NPs combining two semiconductors into an integrated nanostructure can be used as an efficient photocatalyst for visible-light-driven water oxidation. Janus MnOx-AgI NPs show an expected photocatalytic activity even in the absence of Ru(bpy)3Cl2 as an electron mediator. This intriguing synthesis may offer a new opportunity to develop asymmetric nanostructures of two semiconductors that will potentially be efficient photocatalysts for solar-driven water splitting.
ABSTRACT
BACKGROUND: Hand hygiene is crucial for preventing nosocomial infections; however, adherence rates need further attention. Prevention of nosocomial infections through regular hand hygiene monitoring and feedback is recommended by the World Health Organization. Technology holds the potential for achieving this goal. The aim of this study was to assess the influence of technological behavior monitoring innovations on hand hygiene adherence and their acceptance by healthcare professionals. METHODS: A rapid review of the literature was conducted. A literature search was performed in electronic databases (Cochrane Library, Scopus, PubMed, CINAHL, PsycINFO, PsycARTICLES, PSYNDEX) and via citation tracking in November 2017. Records were screened for eligibility. Included studies were analyzed and synthesized in a narrative, tabular way. RESULTS: Overall, 2,426 studies were identified, and 12 were included. Findings indicated that behavior monitoring technology improves hand hygiene adherence, resulting in adherence increases between 6.40%-54.97%. The majority of systems provided real-time feedback. Factors influencing acceptance of technology by healthcare professionals include transparency and confidentiality, user attitude and environment, device function, and device usability. CONCLUSIONS: Recognizing the importance of hand hygiene adherence, active communication between behavior monitoring technology and healthcare workers seems to mediate improvement in sustainable hand hygiene adherence behavior.
Subject(s)
Behavior Observation Techniques/methods , Behavior Therapy/methods , Hand Hygiene/statistics & numerical data , Infection Control/methods , Inventions/trends , Attitude of Health Personnel , Behavior Observation Techniques/instrumentation , Behavior Therapy/instrumentation , Cross Infection/prevention & control , Guideline Adherence/statistics & numerical data , Humans , Infection Control/instrumentation , Patient Acceptance of Health CareABSTRACT
Satisfaction with continuing education can be defined as positive attitudes towards educational programs, which has potential to strengthen learning outcomes. A multi-dimensional construct may enhance continuing education program evaluation processes. The objective is to describe the development and psychometric testing of the 'affective - behavioral - cognitive - satisfaction questionnaire' (ABC-SAT) for assessing participants' satisfaction with a continuing education program for nurses in infection control. The multi-staged development of a satisfaction questionnaire comprised of three subscales. The pilot tool was administered to a nationwide sample of 126 infection control nurses to assess satisfaction after participating in a continuing education program. Satisfaction scores were calculated and psychometric testing was performed to determine reliability, using Cronbach's alpha, face validity, objectivity, and economy. A principle component analysis using varimax rotation and Kaiser normalization was performed. The analysis led to a three-factor solution of the questionnaire with 11 items, explaining 61.4% of the variance. Internal consistency of three scales using Cronbach's alpha was 0.83, 0.60, and 0.66, respectively. Selectivity coefficients varied between 0.39 and 0.70. Participants needed approximately three minutes to complete the questionnaire. Initial findings refer to a satisfying scale structure and internal consistency of the 3-dimensional ABC-SAT questionnaire. Further research is required to confirm the questionnaires' psychometric properties.
Subject(s)
Education, Continuing , Infection Control/standards , Nurse Clinicians/education , Personal Satisfaction , Psychometrics/methods , Adult , Female , Humans , Male , Middle Aged , Pilot Projects , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
Most current models of sentence comprehension assume that the human parsing mechanism (HPM) algorithmically computes detailed syntactic representations as basis for extracting sentence meaning. These models share the assumption that the representations computed by the HPM accurately reflect the linguistic input. This assumption has been challenged by Ferreira (2003), who showed that comprehenders sometimes misinterpret unambiguous sentences in which subject and object appear in noncanonical order, such as passives or object-clefts. According to Ferreira, these misinterpretations show that parallel to an algorithmic analysis, the HPM performs a heuristic analysis sometimes resulting in interpretations not licensed by the grammar. Our study investigated whether misinterpretation effects indeed reflect an erroneous mapping of form to meaning due to heuristic processing strategies. Using an experimental design closely following Ferreira (2003), Experiment 1 demonstrates that errors with noncanonical sentences show up in German as well, despite the fact that German provides morphological case, which a heuristic strategy should use. Experiment 2 required participants to judge the plausibility of the same sentences. With this task, no evidence for misinterpretation of noncanonical sentences was found. Taken together, our results suggest that misinterpretation errors do not reflect errors in the mapping of form to meaning, but task-specific difficulties that arise when participants retrieve information from the memory representation of a sentence. Consequently, misinterpretation errors do not provide evidence for the claim that the HPM pursues a heuristic analysis in addition to an algorithmic analysis. Our results instead lend support to models of the HPM that assume algorithmic processing only. (PsycINFO Database Record
Subject(s)
Comprehension , Linguistics , Adult , Heuristics , Humans , Middle Aged , Young AdultABSTRACT
BACKGROUND: Infection control link nurses (ICLNs) are important backup personnel for the prevention and control of infections in hospitals. To identify facilitators and barriers for the implementation of and long-term collaboration with ICLNs. METHODS: We conducted a systematic literature review, following the preferred reporting items for systematic reviews and meta-analyses guidelines. Inclusion criteria were defined as description of de novo implementation of an ICLN system, strengthening of an existing ICLN system, or analysis of an ICLN system. RESULTS: In 10 publications, facilitators and barriers were identified for mode of selection of ICLN candidates, characteristics and responsibilities of ICLNs, composition of a training curriculum, educational strategies, and external influencing factors. Experienced nurses with an interest in infection control seemed appropriate candidates. The importance of psychological skills in addition to technical knowledge was emphasized. A clear definition of responsibilities was important. Viable tasks for ICLNs included surveillance and teaching activities and the implementation of prevention measures. Ongoing teaching was superior to a single course. Management support was pivotal for success. CONCLUSION: Research on ICLNs is scarce. The potential to decrease health care-associated infections with the help of ICLNs has been demonstrated. The training in psychological skills in addition to technical knowledge deserves more attention.
Subject(s)
Cross Infection/prevention & control , Hospital Administration , Hospitals , Infection Control/organization & administration , Nurses , HumansABSTRACT
OBJECTIVES: Prolonged support with a left ventricular assist device (LVAD) has evolved as an alternative treatment strategy for patients with end-stage heart disease. This requires a shift in focus on sexual activity and psychosocial outcomes in patients with an LVAD and their partners. METHODS: This cross-sectional study was designed to capture Sexual Activities in Left Ventricular Assist Device Patients Or PaRtners (SALVADOR) perceptions on illness-related changes in the quality of sexual activity and its impact on quality of life, anxiety and depression using standardized patient-reported outcome scales (Sexual Adjustment Scale, 36-Item Short Form Health Survey, Hospital Anxiety and Depression Scale). A total of 72 patients with LVADs (50% response rate) along with 48 partners participated. RESULTS: For patients with an LVAD (median age 60 years; 84.7% male), median time on the device was 650 days; 69.5% stayed in long-term partnerships (median 23 years). Prevalence rates for illness-related changes in the quality of sexual activity were 58.3% for patients and 52.1% for partners. Device-related disturbances in sexual activities occurred due to battery pockets (patients/partners: 59.2%/37.6%; P = 0.006) and the driveline (46.3%/37.5%; P = 0.033) and led to significantly increased distress in patients/partners (battery pockets: 53.5%/41.3%; P = 0.006; driveline 54.9%/37.5%; P = 0.004). Disturbances in sexual activity were independently associated with higher rates of depression (odds ratio 1.33, 95% confidence interval 1.14-1.55; P = 0.001) in patients and lower mental quality of life (odds ratio 6.18, 95% confidence interval 1.13-33.98; P = 0.036) in partners. CONCLUSIONS: Disturbances in sexual activity are common in patients with an LVAD and their partners while the patients are on durable long-term support. Counselling on long-term adjustment should provide a platform for information seeking on illness-related changes in the quality of sexual activity.
Subject(s)
Anxiety/etiology , Depression/etiology , Heart-Assist Devices/adverse effects , Quality of Life , Sexual Behavior , Spouses/psychology , Aged , Cross-Sectional Studies , Employment , Female , Heart-Assist Devices/psychology , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Quality of Life/psychology , Sexual Behavior/psychologyABSTRACT
Background: In the guidelines issued by the Robert Koch Institute, the training and establishing of infection control link nurses (HYG-PFLEGs) as multipliers is stipulated in order to propagate the acceptance and implementation of recommended hygiene measures. To date, there is no standardized format for the further education of these nurses in Germany. Aim: To develop a modular curriculum for HYG-PFLEGs to be trained by infection control nurses. Method: Ward managers (n = 15) and infection control nurses (n = 14) from different hospitals in North Rhine-Westphalia were interviewed about the specific requirements for curricula for infection control link nurses. Four focus group interviews were carried out between October 2012 and January 2013. The tape recordings were transcribed and analysed according to Mayring's content analysis. Results: HYG-PFLEGs were regarded as an indispensable entity for controlling the flow of information between the wards and hygiene teams in hospitals. A core curriculum adjustable for differing institutions should contain a high share of hygiene-related contents, pedagogical-didactical, and psychological competencies as well as practical forms of education. Conclusions: Within the context of the implementation of complex interventions these results provide a basis for the development and implementation of a modular curriculum for infection control link nurses.
Subject(s)
Cross Infection/nursing , Curriculum , Education, Nursing/organization & administration , Hygiene/education , Specialties, Nursing/education , Clinical Competence , Cross Infection/prevention & control , Focus Groups , Germany , HumansABSTRACT
Dupuytren contracture is a debilitating disease that characteristically presents as a firm nodularity on the palmar surface of the hand with coalescing cords of soft tissue on the webs and digits. With few nonsurgical modalities providing clinical benefits, open surgical procedures are the standard of care for patients with this condition. However, recent studies have associated surgical intervention with many complications, necessitating further exploration of nonsurgical treatment options. We describe the case of a 64-year-old woman who presented with decreased extension of the fourth and fifth digits on the upper extremities bilaterally; previous conservative treatment regimens had been unsuccessful. After a diagnostic ultrasound, the patient was diagnosed as having Dupuytren contracture and underwent 5 treatments consisting of ultrasound-guided dry-needle aponeurotomy, lidocaine injections, and osteopathic manipulative treatment. During the fifth treatment session, the patient experienced dramatic relief of her symptoms after a palpable release during the manual manipulation portion of her therapeutic regimen. At 2-week follow-up, the patient was symptom-free. Based on this desirable outcome, the authors suggest future research be directed at minimally invasive therapeutic options in the management of Dupuytren contracture.
Subject(s)
Dupuytren Contracture/drug therapy , Lidocaine/therapeutic use , Manipulation, Osteopathic , Needles , Ultrasonography, Interventional , Dupuytren Contracture/diagnostic imaging , Dupuytren Contracture/surgery , Fascia/ultrastructure , Fasciotomy , Female , Humans , Injections, Intramuscular , Lidocaine/administration & dosage , Middle Aged , Minimally Invasive Surgical Procedures , Tendons/diagnostic imaging , Tendons/surgery , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the clinical effects of intraarticular platelet-rich plasma (PRP) injections in a small group of patients with primary and secondary osteoarthritis. Most of the current treatments for osteoarthritis are palliative and attack the symptoms rather than influencing the biochemical environment of the joint. Autologous platelet-rich plasma has emerged as a treatment option for tendinopathies and chronic wounds. In addition to release of growth factors, platelet-rich plasma also promotes concentrated anti-inflammatory signals including interleukin-1ra, which has been a focus of emerging treatments for osteoarthritis. DESIGN: In this single-center, uncontrolled, prospective preliminary study, 14 patients with primary and secondary knee osteoarthritis who met the study criteria received three platelet-rich plasma injections in the affected knee at â¼4-wk intervals. Outcome measures included the Brittberg-Peterson Visual Pain (Visual Analog Scale [VAS]), Activities, and Expectations score and the Knee Injury and Osteoarthritis Outcome Scores at preinjection visit at 2-, 5-, 11-, 18-, and 52-wk follow-up visits. Musculoskeletal ultrasound was used to measure cartilage thickness. RESULTS: There were no adverse events reported. The study demonstrated significant and almost linear improvements in Knee Injury and Osteoarthritis Outcome Scores, including pain and symptom relief. Brittberg-Peterson VAS showed many improvements including reduced pain after knee movement and at rest. Cartilage assessment was limited because of the small sample size. The majority of the patients expressed a favorable outcome at 12 mos after treatment. CONCLUSIONS: The positive trends and safety profile demonstrated could potentially be used to inspire a larger, blinded, and randomized clinical trial to determine whether platelet-rich plasma is safe and effective for the treatment of knee osteoarthritis.
Subject(s)
Osteoarthritis, Knee/therapy , Platelet-Rich Plasma , Adolescent , Adult , Aged , Aged, 80 and over , Cartilage, Articular/diagnostic imaging , Follow-Up Studies , Humans , Injections, Intra-Articular , Middle Aged , Pain Measurement , Patient Satisfaction , Pilot Projects , Prospective Studies , Ultrasonography , Young AdultABSTRACT
In this ERP study we investigate the processes that occur in syntactically ambiguous German sentences at the point of disambiguation. Whereas most psycholinguistic theories agree on the view that processing difficulties arise when parsing preferences are disconfirmed (so-called garden-path effects), important differences exist with respect to theoretical assumptions about the parser's recovery from a misparse. A key distinction can be made between parsers that compute all alternative syntactic structures in parallel (parallel parsers) and parsers that compute only a single preferred analysis (serial parsers). To distinguish empirically between parallel and serial parsing models, we compare ERP responses to garden-path sentences with ERP responses to truly ungrammatical sentences. Garden-path sentences contain a temporary and ultimately curable ungrammaticality, whereas truly ungrammatical sentences remain so permanently--a difference which gives rise to different predictions in the two classes of parsing architectures. At the disambiguating word, ERPs in both sentence types show negative shifts of similar onset latency, amplitude, and scalp distribution in an initial time window between 300 and 500 ms. In a following time window (500-700 ms), the negative shift to garden-path sentences disappears at right central parietal sites, while it continues in permanently ungrammatical sentences. These data are taken as evidence for a strictly serial parser. The absence of a difference in the early time window indicates that temporary and permanent ungrammaticalities trigger the same kind of parsing responses. Later differences can be related to successful reanalysis in garden-path but not in ungrammatical sentences.