Prosthetic device and service satisfaction, quality of life, and functional performance in lower limb prosthesis clients.

OBJECTIVE: The aim of this study was to characterize the relationship between prosthetic device and service satisfaction, health-related quality of life (HRQOL), and functional movement in a diverse population of lower limb prosthesis users. METHODS: An online survey was conducted on individuals with lower limb amputation between September and October 2021. Sample validated questionnaires assessing demographic and clinical features, satisfaction, functional outcomes, and quality of life were analyzed using path analysis. RESULTS: Participants were 1736 individuals with lower limb amputation. Overall, 44% of participants reported dissatisfaction with prosthetic device, whereas 37% were dissatisfied with prosthetic service. Low functional mobility was reported by 58% of participants and 61% reported low HRQOL. Lower extremity functional status (ß = 0.55), HRQOL (ß = 0.08), Activities-specific Balance Scale (ß = 0.22), and modified fall efficacy scale (ß = -0.07) are significantly associated with prosthetic device satisfaction (P < 0.0005, R2 = 0.47). Satisfaction with provider service was significantly associated with lower extremity functional status (ß = 0.44) and balance confidence (ß = 0.18) (P < 0.0005, R2 = 0.34). CONCLUSION AND CLINICAL RELEVANCE: Civilians, veterans, and service members reported low functional mobility, low quality of life, and moderate levels of dissatisfaction with their lower extremity prosthetic device and provider service. Improvements in mobility, balance, quality of life, and fall efficacy may enhance device satisfaction. Functional mobility and balance improvements may increase ratings of provider service. This study provides feedback that may improve clinical decisions on lower limb prosthesis patient care.

Single-Leg Squat and Reported Pain in Collegiate Softball Pitchers.

Background: Single-leg squat (SLS) performance is related to altered mechanics related to injury during the windmill softball pitch; however, it is unknown if SLS kinematics differ between softball pitchers with and without upper extremity pain. Purpose/Hypothesis: The purpose of this study was to compare knee valgus, trunk rotation, trunk lateral flexion, and trunk flexion during an SLS in collegiate softball pitchers with and without self-reported upper extremity pain. It was hypothesized that those who reported upper extremity pain would show increased compensatory trunk and knee kinematics compared with those without pain. Study Design: Controlled laboratory study. Methods: A total of 75 collegiate softball players (mean age, 20.4 ± 1.7 years; mean height, 173.3 ± 7.7 cm; mean weight, 79.1 ± 11.6 kg) participated and were placed in pain (n = 20) or no-pain (n = 55) groups. Participants performed an SLS once per side. Kinematic data were collected at 100 Hz using an electromagnetic tracking system. A 2 (pain vs no pain) × 2 (descent vs ascent) × 2 (drive leg vs stride leg) mixed-design multivariate analysis of variance with Wilks lambda distribution was used to determine differences in drive-leg and stride-leg lower body mechanics between the descent and ascent phases of the SLS between the pitchers in the current study with and without pain. Results: There was no significant effect in the 3-way interaction between upper extremity pain, side, and phase (Λ = 0.960; F[4, 70] = 0.726; P = .577; η2 = 0.04). However, there were large effects for the phase × side interaction (Λ = 0.850; P = .021; η2 = 0.150). There was a main effect of phase (Λ = 0.283; P < .001; η2 = 0.717). Conclusion: Study findings indicated that SLS mechanics do not differ between collegiate softball pitchers with and without reported upper extremity pain. Drive-leg mechanics showed more stability in the SLS than stride-leg mechanics. Clinical Relevance: Softball pitchers are at risk of upper extremity injury. It is important to identify mechanisms that may lead to pain in order to mitigate the risk of injury.

Impact on social capital and learning engagement due to social media usage among the international students in the U.S.

International students who pursue their academic goals in United States are prone to difficulties when attempting to build social resources and adjust to the new culture. Social media is a practical means of connection due to its ease of use and accessibility. Previous research has indicated contradictory effects of social media use on academic engagement. In addition to the direct effect, this research examined social media use influences on international students' learning engagement by mediating social capital and cultural adjustment. A total of 209 international students completed a web-based survey distributed via e-mail and social media between November 2021 and May 2022. Data were analyzed using Structural Equation Model. Results showed that only purposely using social media to collaborate with learning counterparts or materials directly improves international students' learning engagement. Other uses of social media (e.g., expanding new resources, solidifying close relationships) have no significant direct effects. Nonetheless, they are essential to improving levels of learning engagement via the mediation of bridging capital (social resources attributed to expanding relationships) and students' cultural adjustment in the U.S. International students' bonding capital (social resources available through trustworthy relationships) and home cultural retention showed little direct or indirect effects on learning engagement. This study recognizes the importance of social resources and cultural adjustment for international students. Also, this study provides valuable information to educators and administrators, as there is a need to identify the underlying mechanisms to contribute feasible learning intervention approaches and alleviate negative effects for international students.

Single-Leg Squat Compensations Are Associated With Softball Pitching Pathomechanics in Adolescent Softball Pitchers.

BACKGROUND: A lack of lumbopelvic-hip complex (LPHC) stability is often associated with altered pitching mechanics, thus increasing pain and injury susceptibility. The single-leg squat (SLS) is a simple diagnostic tool used to examine LPHC stability. PURPOSE: To examine the relationship between trunk compensatory kinematics during the SLS and kinematics at foot contact during the windmill pitch. STUDY DESIGN: Descriptive laboratory study. METHODS: Participants included 55 youth and high school softball pitchers (mean age, 12.6 ± 2.2 years; height, 160.0 ± 11.0 cm; weight, 60.8 ± 15.5 kg). Kinematic data were collected at 100 Hz using an electromagnetic tracking device. Participants were asked to complete an SLS on each leg, then throw 3 fastballs at maximal effort. Values of trunk flexion, trunk lateral flexion, and trunk rotation at peak depth of the SLS were used as the dependent variables in 3 separate backward-elimination regression analyses. Independent variables examined at foot contact of the pitch were as follows: trunk flexion, trunk lateral flexion, trunk rotation, center of mass, stride length, and stride knee valgus. RESULTS: The SLS trunk rotation regression (F(1,56) = 4.980, P = .030) revealed that trunk flexion predicted SLS trunk rotation (SE = 0.068, t = 2.232, P = .030) and explained approximately 7% of the variance in SLS trunk rotation (R 2 = 0.083, adjusted R 2 = 0.066). The SLS trunk flexion regression (F(1,56) = 5.755, P = 0.020) revealed that stride knee valgus significantly predicted SLS trunk flexion (SE = 0.256, t = 2.399, P = .020) and explained approximately 8% of variance in SLS trunk flexion (R 2 = 0.095, adjusted R 2 = 0.078). CONCLUSION: Additional trunk rotation and trunk flexion at peak depth of the SLS showed increased knee valgus and trunk flexion at foot contact of the pitch, both of which indicate poor LPHC stability during the softball pitch and may increase the potential for injury. CLINICAL RELEVANCE: Players and coaches should implement SLS analyses to determine their players' risk for injury and compensation due to poor core stability.

Kinematic Differences Exist Between the Fastball, Changeup, Curveball, and Dropball Pitch Types in Collegiate Softball Pitchers.

BACKGROUND: A majority of softball literature focuses on the mechanics associated with pain and injury within a single pitch type per study; however, the generalizability of these findings is unknown since a kinematic comparison has yet to be performed between pitch types. Understanding kinematic differences between pitch types can be used to identify risk factors for injury, improve safety guidelines, and improve performance by linking specific mechanics with desired pitch outcomes. HYPOTHESIS/PURPOSE: The purpose of this study was to compare kinematics between the fastball, changeup, curveball, and dropball pitch types in collegiate softball pitchers. It was hypothesized that there would be significant kinematic differences between pitch types. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 28 female collegiate softball pitchers pitched 3 trials of each pitch type to a catcher at regulation distance. Pitch speed, stride length, trunk extension, trunk rotation, trunk lateral flexion, elbow flexion, and center of mass for each trial were calculated using an electromagnetic motion capture system and were averaged for analysis. A 1-way analysis of variance (ANOVA) was used to investigate pitch speed differences between the 4 pitch types. A 4 (pitch type) × 5 (event) within-athlete multivariate ANOVA was also used to determine kinematic differences. RESULTS: The results revealed a significant difference in pitch speed between pitch types; a pitch type main effect for trunk extension, trunk rotation, trunk lateral flexion, and center of mass; and an event main effect for all variables except stride length. The results also revealed a pitch type by event interaction for trunk flexion, trunk lateral flexion, and center of mass. Specifically, the dropball type had less trunk extension than the fastball at all pitching events. Similarly, the curveball type had a more posteriorly shifted center of mass than the dropball at the last 3 pitching events of foot contact, ball release and follow-through. CONCLUSION: Significant kinematic differences exist between pitch types, but these differences may be necessary to execute desired pitch outcomes. CLINICAL RELEVANCE: This is the first study to analyze kinematic differences between pitch types in softball pitchers. Understanding the effects of different pitch types on kinematic parameters may enhance injury prevention and performance strategies for softball pitchers.

Pharmacist self-reported antidepressant medication counseling.

OBJECTIVES: To identify the extent of pharmacists' self-reported antidepressant counseling (SRAC) and to identify factors that may affect pharmacists' decisions to provide antidepressant counseling. DESIGN: Cross-sectional study. SETTING: Alabama community pharmacies in 2011. PARTICIPANTS: Full-time pharmacists from 600 community pharmacies. INTERVENTION: Self-administered survey; three mail contacts with alternate electronic surveys were used. MAIN OUTCOME MEASURES: Pharmacists' SRAC behavior and its relationship with pharmacists' illness perceptions of depression, self-efficacy, and organizational and environmental influences. RESULTS: 600 surveys were sent; 22 were undeliverable, 1 was partially completed (<80% questions answered), and 118 were completed (20.6% overall response rate). Pharmacists reported low rates of involvement in antidepressant counseling; 61% reported assessing patient knowledge and understanding of depression, and 36% discussed options for managing adverse effects with no more than a few patients. More than one-quarter (28.6%) never asked patients whether they had barriers to taking antidepressants. Pharmacists' perceptions regarding consequences, control/cure, and the episodic nature of depression, as well as their self-efficacy, had significant relationships ( P < 0.05) with pharmacists' involvement in antidepressant counseling. CONCLUSION: Low rates of pharmacists' involvement in antidepressant counseling were reported. Pharmacists must become more involved in counseling patients about their antidepressant medications and overcoming barriers preventing greater involvement.

Psychometric Analysis of the JSPE Nursing Student Version R: Comparison of Senior BSN Students and Medical Students Attitudes toward Empathy in Patient Care.

Background. Empathic communication skills are critical to providing high-quality nursing care to holistically understand the patient's perspective. A survey research design was used to address the research questions discussed in this study. Data consisted of responses from nursing students attending accredited programs in the southeastern United Sates using the Jefferson Scale of Physician Empathy Nursing Student Version R (JSPE-R). Findings. Comparisons of the total scores from JSPE Versions S and R yielded similar means and standard deviations with 115 and 114.57, respectively, and standard deviations of 10 and 10.94, respectively. The results of a one-sample t-test failed to render statistical significance (t = -1.22, P = .224), indicating that the overall attitudes of nursing students and medical students are similar. The 25th, 50th, and 75th percentiles and overall instrument reliability were also comparable. Conclusions. This paper supports the emergence of alternative factor analysis structures as applied to nursing students through statistical progression from exploratory factor analysis to confirmatory structures. Implications for practice explore the utility of empathy instruments in nurse education, such as empathy progression through curriculum. As nursing educators, the utility of development of instruments to measure effectiveness of teaching strategies and pedagogy for empathy enhancement in practice is important.

The influence of habitual exercise training and meal form on diet-induced thermogenesis in college-age men.

This study compared type of habitual exercise and meal form on diet-induced thermogenesis (DIT) in 29 men age 19-28 yr. Resting metabolic rate (RMR) and DIT response to solid-meal (bar) vs. liquid-meal (shake) ingestion were measured via indirect calorimetry; classifications were sedentary (n = 9), endurance trained (n = 11), or resistance trained (n = 9). Height, weight, and body composition (using bioelectrical impedance) were measured for each subject. Energy expenditure was determined before and every 30 min after meal consumption for 210 min. RMR was significantly (p = .045) higher in the endurance- and resistance-trained groups. However, when expressed per kilogram fat-free mass (FFM; relative RMR), differences were not significant. Both DIT (kcal/min) and relative DIT (kcal · min-1 · kg FFM-1) significantly increased with time (p < .0001) from RMR for each meal form. There was no significant exercise-group effect on DIT or relative DIT. There was a significant (p = .012) effect of meal form on DIT; shakes elicited a higher DIT. This significant difference was not found for relative DIT. There was a significant interaction between group and meal form for DIT (p = .008) and relative DIT (p < .0001). Shakes elicited a significantly greater DIT (p = .0002) and relative DIT (p = .0001) in the resistance-trained group. In the sedentary group, relative DIT from shakes was significantly lower than from bars (p = .019). In conclusion, habitual exercise appears to increase RMR, and meal form may impart changes in relative DIT depending on exercise status.

Physicians' expectations of pharmacists.

Physicians' current and future expectations of and current experiences with pharmacists were studied. A three-part questionnaire was mailed to 2600 practicing physicians in California, including office-based practitioners, hospital-employed (nonhouse staff) physicians, and medical residents. A 5-point Likert scale was used to measure respondents' level of agreement with statements in each part; part 1 dealt with current expectations, part 2 with current experiences, and part 3 with future expectations. Respondents were asked to confirm their practice setting (office-based, hospital-based, medical resident, or other) and to indicate the number of years since graduation from medical school. The mean values of physician agreement with each statement were reported. There was neither strong agreement nor strong disagreement with any statement regarding physicians' current and future expectations of and current experiences with pharmacists. There was no correlation between practice setting and level of agreement with statements in any part of the questionnaire. There was a correlation between the number of years since graduation from medical school and the level of agreement with statements about current and future expectations; in both cases, those physicians who graduated from medical school less than 10 years ago had higher expectations of pharmacists than those who graduated 10 or more years ago. Overall, physicians do not know what to expect of pharmacists. Physicians' expectations of pharmacists were most strongly correlated with the number of years since graduation from medical school and least strongly correlated with physicians' practice setting.