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1.
Nurse Educ Today ; 110: 105225, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35344840

RESUMO

BACKGROUND: Training helps maintain high-quality supervision and its associated benefits (e.g. reduced burnout, improved care). While studies have previously evaluated extended-duration supervision training programmes, none have treated these as complex interventions so have not employed realist approaches. OBJECTIVES: Building on a previous realist synthesis, this evaluation tests and develops programme theory for extended-duration supervision training to answer the question: to what extent does the supervision training programme work, for whom, under what circumstances and why? DESIGN: We conducted a realist evaluation of a novel state-wide Victorian 3-month supervision training programme including one or two 3.5-h workshops followed by weekly reflexive longitudinal audio diaries (LADs) for up to 12 weeks. METHODS: Realist evaluation data comprised 25 entrance interviews with nurses and allied health professionals, 176 LADs (and 29 written diaries), and 23 exit interviews. We employed team-based realist analysis to identify context-mechanism-outcome configurations (CMOCs) to test and develop programme theory. RESULTS: We refined four recurring CMOCs from the realist synthesis programme theory, found insufficient evidence for two, and established five new recurring CMOCs. We identified multiple positive outcomes from our extended-duration supervision training programme (e.g. improved supervisor practices) through various mechanisms relating to pedagogy (e.g. weekly reflexivity), supervisors (e.g. engagement), and workplaces (e.g. enabling supervision cultures). Some negative outcomes were reported (e.g. decreased engagement) through various mechanisms (e.g. suboptimal training design). Such mechanisms were thought to come about by diverse contexts including supervisors (e.g. inexperienced/experienced), professions (nursing/allied health), and organisations (supervision-enabled/non-enabled cultures). CONCLUSIONS: Our findings extend the realist synthesis programme theory by highlighting various contexts triggering outcome-generating mechanisms. Programme outcomes are maximised through ongoing supervisor reflexivity paying attention to facilitator-supervisor relationships, as well as protected time for supervisors to translate learning into practice.


Assuntos
Pessoal Técnico de Saúde , Local de Trabalho , Humanos , Aprendizagem
2.
J Genet Couns ; 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35502606

RESUMO

Motivational interviewing (MI) is a counseling approach that allows a provider to engage in a dialog with patients to evoke motivation for health behavior change or decision-making. MI is a relatively recent addition to the curricula of genetic counseling programs, and recent research has demonstrated its utility in genetic counseling practice. However, the perspectives of genetic counselors trained in MI have yet to be studied with the intent of illuminating how it is applied in practice or what should be emphasized in training. This qualitative study interviewed fifteen genetic counselors from various practice areas who have had training in MI. The interviews focused on how MI is being used in practice, and the strengths and weaknesses of their MI training. Five themes were identified through inductive qualitative analysis: (a) utility of MI in genetic counseling practice, (b) value of MI in genetic counseling training, (c) barriers to implementing MI in genetic counseling practice, (d) barriers to training genetic counselors in MI, and (e) timing of MI training. The perspectives discovered from this study can help inform genetic counseling educators who wish to include MI in their curriculum. In addition for those programs that already include MI, these results serve as a guide for the development of training role-plays and/or standardized patient encounter scenarios.

3.
Front Sports Act Living ; 4: 881054, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35498515

RESUMO

Introduction: To date, there exists no gold standard conservative treatment for lateral hip pain due to tendinopathy of the gluteus medius and/or minimus tendon (GT), a condition often complicated by pain and disability. Higher loads during everyday activities and exercise seems to be contraindicated with GT. The purpose of this study was to evaluate the feasibility of exercise with low-loads concurrent partial blood flow restriction (LL-BFR) and patient education for patients present GT. Methods: Recruitment took place at three hospitals in the Central Denmark Region. The intervention consisted of daily sessions for 8 weeks with one weekly supervised session. From week three patients exercised with applied partial blood flow restriction by means of a pneumatic cuff around the proximal thigh of the affected leg. Throughout the intervention patients received patient education on their hip condition. Sociodemographic and clinical variables were collected at baseline. The feasibility of LL-BFR was conducted by adherence to the exercise protocol and drop-out rate. Patient reported outcome measures (The Victorian Institute of Sport Assessment-Gluteal Questionnaire, EuroQol - 5 Dimensions-Visual Analogue Scale, Oxford Hip Score, Copenhagen Hip and Groin Outcome Score), maximal voluntary isometric hip abduction-, hip extension, and knee extension strength (Nm/kg) measured using a handheld dynamometer, and functional capacity tests (30 second chair-stand test and a stair-climb test) was conducted as secondary outcomes. Results: Sixteen women with a median (IQR) age of 51 (46-60) years were included. Median (IQR) Body Mass Index was 26.69 (23.59-30.46) kg/m2. Adherence to the total number of training sessions and the LL-BFR was 96.4 and 94.4%, respectively. Two patients dropped out due to (i) illness before initiation of LL-BFR and (ii) pain in the affected leg related to the LL-BFR-exercise. At follow-up both pain levels and patient-reported outcome measures improved. Isometric hip abduction-, hip extension-, and knee extension strength on both legs and functional performance increased. Conclusion: LL-BFR-exercise seems feasible for treatment of GT. At follow-up, a high adherence and low drop-out rate were observed. Further, patients reported clinically relevant reductions in pain, and showed significant increases in isometric hip and knee strength.

4.
Ethik Med ; : 1-15, 2022 Apr 26.
Artigo em Alemão | MEDLINE | ID: mdl-35498231

RESUMO

Background: Teaching ethical competencies is an essential component of professional and postgraduate curricula. Developing practical-ethical problem-solving competencies as well as appraising program-specific studies and related research ethics are topics typically addressed. However, assessment of these ethical competencies poses a challenge. Written or oral assessment formats addressing relevant learning objectives is mainly limited to knowledge testing alone, often not capturing relevant skills or attitudes pertinent to those competencies. Aim: During the reaccreditation of the masters of science (MSc) program in Nursing Science at Witten/Herdecke University, this challenge was addressed by implementation of an innovative examination format for postgraduate education. Procedure: For the module "Ethics in nursing practice and research" a format based on the Objective Structured Clinical Examination (OSCE) format was developed. This assessment method incorporates evaluation of acquired skills and attitudes of nursing students. Conclusion: The article demonstrates development and adaption of the OSCE format for this purpose.

5.
Rev. bras. med. esporte ; 28(3): 189-191, May-June 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1365702

RESUMO

ABSTRACT Introduction: The research of different training has always attracted the attention of people in sports circles all over the world. Training for strength testing is also an important part of athletes' physical training. Objective: To explore the effects of different training loads and training ratios on the cardiorespiratory endurance of track and field athletes. Methods: A total of 50 male students from a university were selected for the experiment, 30 from the university's track and field training team, and 20 ordinary students. Results: When the load is 75W, 125W, or 150W there is a significant difference in R between the first stage and the third stage (p<0.05); when the load of the middle and long distance running team is 25W and 125W, there is a significant difference between the VE of the third stage and the first stage; when the load is 100W, there is a significant difference in R between the first and second stages (P<0.05). Conclusions: In the exercise load test, the cardiorespiratory endurance and energy metabolism characteristics of the different training teams in the third stage were better than those in the first and second stages. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Introdução: Investigações buscando diferentes formas de treinamento sempre atraíram a atenção de pessoas nos círculos esportivos pelo mundo. O treino para testes de força também é uma parte importante do condicionamento físico de atletas. Objetivo: Explorar os efeitos de diferentes cargas e regimes de treino na resistência cardiorrespiratória de praticantes de atletismo. Métodos: Um total de 50 estudantes do sexo masculino de uma universidade foi selecionado para o experimento, sendo 30 da equipe de atletismo da universidade e 20 estudantes regulares. Resultados: Com cargas de 75W, 125W, ou 150W, houve diferença significativa no R entre o primeiro e o terceiro estágios (p<0,05); quando a carga aplicada ao time de corrida de média e longa distância foi de 25W e 125W, houve diferença significativa no VE dos mesmos estágios; quando a carga aplicada foi de 100W, houve diferença significativa no R entre o primeiro e segundo estágios (p<0,05). Conclusões: Nos testes de exercício com carga, a resistência cardiorrespiratória e a energia metabólica das diferentes equipes de treinamento foram melhores no terceiro estágio que no primeiro e segundo estágio. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.


RESUMEN Introducción: Investigaciones buscando diferentes formas de entrenamiento siempre atrajeron la atención de las personas en los círculos deportivos por el mundo. El entrenamiento para pruebas de fuerza también es una parte importante de la preparación física de atletas. Objetivo: Explorar los efectos de diferentes cargas y regímenes de entrenamiento en la resistencia cardiorrespiratoria de practicantes de atletismo. Métodos: Fue seleccionado un total de 50 estudiantes del sexo masculino de una universidad para el experimento, siendo 30 del equipo de atletismo de la universidad y 20 estudiantes regulares. Resultados: Con cargas de 75W, 125W o 150W, hubo diferencia significativa en el R entre la primera y la tercera etapa (p<0,05); cuando la carga aplicada al equipo de corrida de media y larga distancia fue de 25W y 125W, hubo diferencia significativa en el VE de las mismas etapas; cuando la carga aplicada fue de 100W, hubo diferencia significativa en el R entre la primera y la segunda etapa (p<0,05). Conclusiones: En las pruebas de ejercicio con carga, la resistencia cardiorrespiratoria y la energía metabólica de los diferentes equipos de entrenamiento fueron mejores en la tercera etapa que en la primera y la segunda. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

6.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-22274659

RESUMO

TOPLINE SUMMARYO_ST_ABSWhat is a Rapid Review?C_ST_ABSOur rapid reviews use a variation of the systematic review approach, abbreviating or omitting some components to generate the evidence to inform stakeholders promptly whilst maintaining attention to bias. They follow the methodological recommendations and minimum standards for conducting and reporting rapid reviews, including a structured protocol, systematic search, screening, data extraction, critical appraisal and evidence synthesis to answer a specific question and identify key research gaps. They take one to two months, depending on the breadth and complexity of the research topic/question(s), the extent of the evidence base and type of analysis required for synthesis. Background / Aim of Rapid ReviewThe COVID-19 pandemic has led to differential economic, health and social impacts illuminating prevailing gender inequalities (WEN Wales, 2020). This rapid review investigated evidence for effectiveness of interventions to address gender inequalities across the domains of work, health, living standards, personal security, participation, and education. Key FindingsO_ST_ABSExtent of the evidence baseC_ST_ABSO_LI21 studies were identified: 7 reviews, 6 commentaries and 8 primary studies C_LIO_LILimited evidence for the effectiveness of identified innovations in minority groups C_LIO_LIA lack of evaluation data for educational interventions C_LIO_LIA lack of evidence for cost-effectiveness of the identified interventions C_LIO_LI14 additional articles were identified in the grey literature but not used to inform findings (apart from the Education domain, where there was a lack of peer-reviewed evidence). C_LI Recency of the evidence baseO_LIAll studies were published in 2020-2021 C_LI Summary of findingsSome evidence supported interventions/innovations related to work: O_LIPermanent contracts, full-time hours, and national childcare programmes to increase income for women and thereby decrease the existing gender wage gap. C_LIO_LIMore frequent use of online platforms in the presentation of professional work can reduce gender disparities due to time saved in travel away from home. C_LI Some evidence supported interventions/innovations related to health: O_LILeadership in digital health companies could benefit from women developing gender-friendly technology that meets the health needs of women. C_LIO_LICreate authentic partnerships with black women and female-led organisations to reduce maternal morbidity and mortality (Bray & McLemore, 2021). C_LI Some evidence supported interventions/innovations related to living standards including: O_LIMulti-dimensional care provided to women and their children experiencing homelessness. C_LI Limited evidence supported interventions/innovations related to personal security including: O_LISpecific training of social workers, psychologists and therapists to empower women to use coping strategies and utilise services to gain protection from abusive partners. C_LIO_LIHelplines, virtual safe spaces smart phone applications and online counselling to address issues of violence and abuse for women and girls. C_LI Very limited evidence supported interventions/innovations related to participation including: O_LIUse of online platforms to reduce gender disparities in the presentation of academic/professional work. C_LIO_LIEnsuring equal representation, including women and marginalised persons, in pandemic response and recovery planning and decision-making. C_LI Limited evidence from the grey literature described interventions/innovations related to education including: O_LITeacher training curricula development to empower teachers to understand and challenge gender stereotypes in learning environments. C_LIO_LIEducation for girls to enable participation in STEM. C_LI Policy ImplicationsThis evidence can be used to map against existing policies to identify which are supported by the evidence, which are not in current policy and could be implemented and where further research/evaluation is needed. Further research is needed to evaluate the effectiveness of educational innovations, the effectiveness of the innovations in minority groups and the social value gained from interventions to address gender inequalities. Strength of EvidenceOne systematic review on mobile interventions targeting common mental disorders among pregnant and postpartum women was rated as high quality (Saad et al., 2021). The overall confidence in the strength of evidence was rated as low due to study designs. Searches did not include COVID specific resources or pre-prints. There may be additional interventions/innovations that have been implemented to reduce inequalities experienced by women and girls due to the COVID-19 pandemic but have not been evaluated or published in the literature and are therefore not included here.

7.
Occup Ther Int ; 2022: 4590154, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35521629

RESUMO

Persons with post-COVID-19 conditions have prolonged symptoms and longer-term consequences which can prevent them from returning to previous everyday functioning. Fatigue is the most frequent symptom reported in literature. Occupational therapists (OTs) are specialized in client-centered problem analysis, counseling, and education to recover occupational engagement and performance in everyday life. Since the beginning of the COVID-19 pandemic, OTs have been challenged to respond with services adequate to the needs of this patient group. Energy management education (EME) was initially developed for persons with multiple sclerosis-related fatigue and then made independent of diagnosis suitable to persons living with chronic disease-related fatigue. EME, a structured self-management education, is becoming a part of the new services. This study was aimed at exploring the initial experiences of OTs using the EME protocol and materials with persons with postacute COVID-19 and/or post-COVID-19 condition-related fatigue and gathering their recommendations for improvements and adaptions. One online focus group discussion took place in May 2021 with OTs experienced in using the EME protocol. The topics addressed were the institutional context of the OTs and their experiences during the treatment. A thematic analysis was performed. According to nine OTs working in different settings in Switzerland, the EME protocol is exploitable in both in- and outpatient settings and was judged appropriate by them, even if the EME materials can be improved. The main challenges for the OTs were the short period their patients had lived with fatigue; the discrepancy between self-concept, self-perception, and performance; and the insecurity, fear, and anxiety related to recovery. Further research is needed to include the perspective of EME participants and to measure quantitative outcomes such as fatigue impact, self-efficacy, occupational performance, and quality of life. Until the existing EME protocol is improved, it is applicable to persons with post-COVID-19 condition-related fatigue.


Assuntos
COVID-19 , Terapia Ocupacional , Fadiga/etiologia , Fadiga/terapia , Grupos Focais , Humanos , Terapia Ocupacional/métodos , Pandemias , Qualidade de Vida
8.
J Commun Disord ; 97: 106196, 2022 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-35526293

RESUMO

INTRODUCTION: Language and communication disruptions in schizophrenia are at the center of a large body of investigation. Yet, the remediation of such disruptions is still in its infancy. Here we targeted what is known to be one of the most damaged language domains in schizophrenia, namely pragmatics, by conducting a pragmatics-centered intervention with a randomized controlled trial design and assessing also durability and generalization. To the best of our knowledge, this is the first study with these characteristics. METHODS: Inspired by the Gricean account of natural language use, we tailored a novel treatment addressing the pragmatics of communication (PragmaCom) and we tested its efficacy in a sample of individuals with schizophrenia randomized to the experimental group or to an active control group. The primary outcome with respect to the efficacy of the PragmaCom was measured by changes in pragmatic abilities (as evaluated with the global score of the Assessment of Pragmatic Abilities and Cognitive Substrates test) from baseline to 12 weeks and at 3-month follow-up. The secondary outcome was measured by changes in metaphor comprehension, abstract thinking, and global functioning from baseline to 12 weeks and at 3-month follow-up. RESULTS: Relative to the control group, at post-test the PragmaCom group showed greater and enduring improvement in global pragmatic skills and in metaphor comprehension. At follow-up, these improvements persisted and the PragmaCom exerted beneficial effects also on functioning. CONCLUSIONS: Despite the limited sample size, we believe that these findings offer initial yet encouraging evidence of the possibility to improve pragmatic skills with a theoretically grounded approach and to obtain durable and clinically relevant benefits. We argue that it is time that therapeutic efforts embrace communicative dysfunctions in order to improve illness outcome.

9.
Artigo em Inglês | MEDLINE | ID: mdl-35527585

RESUMO

BACKGROUND: Balance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation (ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition. OBJECTIVE: To test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis. METHODS: 16 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded. RESULTS: Walking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time-treatment (F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS. CONCLUSIONS: Task-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.

10.
Work ; 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35527587

RESUMO

BACKGROUND: Vocational rehabilitation (VR) aims to help people with disabilities to return to the labour market. Though, there is not much evidence on its effectiveness. OBJECTIVES: We explore the effect of vocational training programmes in VR and the VR status itself on employment outcomes. METHODS: Using two samples from administrative data by the German Federal Employment Agency, we applied propensity score matching. We followed rehabilitants commencing VR in 2009/2010 (N = 7,905) for four years (comparison I) and general training participants with and without VR status completing training in 2012/2013 (N = 21,020) for one year (comparison II). For harmonisation purposes, we only considered individuals aged between 25 and 40 and excluded those in employment at the beginning of VR or training. RESULTS: Concerning the effect of training in VR (comparison I), we observe a lock-in effect during training (p <  0.001) due to an involvement in VR; after training, participants are more likely to obtain unsubsidised employment (0.05, p <  0.05) than non-participants, but there is no statistically significant income difference after four years. Regarding the effect of the VR status (comparison II), rehabilitants are more likely to take up (un-)subsidised employment (0.04, p <  0.01; 0.02, p <  0.001) after training, exhibit longer employment durations (19 days, p <  0.001) and achieve higher average incomes (2,414 euro/year, p <  0.001) compared to non-rehabilitants. CONCLUSIONS: Training participation helps to improve employment participation of rehabilitants. However, a longer observation period is recommended. Furthermore, the VR status itself leads to more sustainable and better-paid employment. This is due to more comprehensive support and longer-term subsidised employment opportunities.

11.
Transl Behav Med ; 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35532323

RESUMO

Maternal smoking is associated with a host of negative health outcomes, including an increased risk of children developing attention-deficit/hyperactivity disorder (ADHD). This study evaluated the efficacy of health messages disseminated through Facebook Ads focused on reducing tobacco smoke exposure during pregnancy. Two message versions were promoted via post advertisements on Facebook-a static infographic and a video containing an animated version of the infographic. The reach of and engagement with each message version was evaluated. Comments made to the posts were assessed using content analysis. The infographic reached approximately 60,000 people and the video reached about 16,000 people. The average costs were $10.00 and $40.00 per 1,000 people reached for the infographic- and video-based posts, respectively. While there was no engagement with the video, the infographic was liked (n = 157), given alternative likes (n = 59), shared (n = 171 to 341), and commented on (n = 221). About one-quarter of comments contained a personal narrative and mentions of health history related to ADHD and/or smoking. Comments were more often negative (than positive) (16.6% vs 3.9%) and expressed skepticism more often than message acceptance (21.5% vs 12.2%). Facebook users were more responsive to the infographic (compared to the video) and static posts were a preferred channel (i.e., higher engagement at a lower cost) to disseminate messages when using the boost post feature on Facebook for health education. Our review of the comments provided insights into message acceptance and guidance for future social media-based health message campaigns. However, it is not known whether and if so, how, these findings on message exposure would correlate with behavioral intentions or changes in behavior, such as intentions to quit smoking or smoking cessation.

12.
Transl Behav Med ; 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35532326

RESUMO

Physical activity (PA) is recommended for cancer survivors and their romantic partners yet cancer couples may be unaware of the benefits of PA specific to them. Exercise interventions targeting survivors and partners simultaneously may prove effective at increasing exercise knowledge, intentions, and outcomes. To examine the effects of a remotely-delivered cancer-specific exercise education video on cancer survivors' and their partners' exercise knowledge, beliefs, and intentions. Cancer survivors (N = 209) and their romantic partners (N = 155) completed an online survey with an embedded education video randomized to half the sample. Group differences (education vs. control) on study constructs among the whole sample and on a subset of the sample not meeting exercise guidelines [i.e., less than 150 min of moderate to vigorous physical activity (MVPA) per week; 50.5% survivors, 45.1% partners] were examined. Group differences on study constructs were also tested between survivors and partners meeting exercise guidelines or not. Survivors and partners in the education condition were more likely to correctly report the MVPA guidelines. The education increased survivors' personal exercise importance, outcome expectations, and likelihood of joining an individual exercise program. Participants meeting guidelines were significantly different on multiple exercise beliefs compared to those who were not. Among those not meeting guidelines, the education increased survivors' belief in the importance of exercising with their partner. A remotely-delivered exercise education video increased exercise knowledge and beliefs, which represents an important step in the development of couples' exercise interventions for cancer survivors and their romantic partners.


Exercise, defined as intentional physical activity, is recommended for cancer survivors and their romantic partners. However, few know the specific benefits of exercise following a cancer diagnosis. Theories of health behavior change suggest that access to information may influence individuals' valued importance of and intentions for a health practice. This work tested if an online video about cancer-specific exercise benefits could modify cancer survivors' and their romantic partners' exercise knowledge and beliefs. Cancer survivors and their romantic partners individually completed an online survey. The educational video was randomly embedded into the survey for half of participants. Survivors and partners who received the educational video were more likely to correctly report established exercise guidelines compared to those who did not get the video. The educational video also increased survivors' personal exercise importance, outcome expectations for exercise, and likelihood of joining an individual exercise program. Among survivors who were less active than the recommended guidelines, the educational video increased their importance of exercising with their partner. This research shows that an online video about exercise after cancer increased both survivors' and their partners' exercise knowledge as well as survivors' exercise beliefs and intentions to take part in an exercise program.

13.
Endosc Ultrasound ; 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35532570

RESUMO

Bckground and Objectives: EUS-guided cystogastrostomy is a well-established advanced endoscopic technique with a steep-learning curve which necessitates an ex-vivo simulator that would allow for adequate training. The aim of this study is to evaluate the feasibility of the model in allowing training for EUS-guided cystogastrostomy using lumen-apposing metal stent (LAMS). Subjects and Methods: The model was created by ROEYA Training Center, Egypt, using native porcine tissue to create fluid collections simulating both cystic and solid lesions. It was designed and tested in advance while the hydrogel was added on-site. The simulator was evaluated prospectively in five training sessions involving 17 international experts. The task was to successfully deploy the LAMS to drain the created cyst. After using the simulator, the experts were asked to fill a questionnaire to assess their experience. The primary endpoint was overall satisfaction with the model as a training tool. Results: All of the experts were satisfied with the model as a tool to train endoscopists for the technique. 76.5% (n = 11) of the experts thought the model to be moderately realistic. Proper visualization was reported by 94.1% of the experts. All experts believed the lesions to be either slightly like or very similar to real lesions. The model was graded "easy" in difficulty by 11 of the experts. Conclusions: In all parameters assessed, the experts thought the model to be a useful tool for future training. This preliminary study suggests that the aforementioned simulator can be used to train endoscopists on using LAMS in a risk-free environment.

14.
J Dent Educ ; 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35533070

RESUMO

PURPOSE: Dental students learn to prescribe pain management medications in dental school, including opioids. Given the current state of opioid-related morbidity and mortality in the US, dental schools should evaluate the context and implementation of opioid prescribing in their dental school clinics (DSCs). METHODS: A nationwide survey of deans of clinical operations at all US dental schools was conducted in 2020 related to pain management in their DSC. The Michigan Medicine Institutional Review Board deemed this study unregulated (HUM00151607). RESULTS: Of the 68 accredited dental schools in the United States, 26 deans of DSCs responded to the survey, yielding a 40% response rate. The survey results showed differences in the levels of education for dental students on opioid prescribing and patient education requirements. A comprehensive curriculum regarding safe opioid prescribing and patient education training was reported by 12 schools. Four dental programs did not have a single guideline or policy in relation to opioids for their dental students. CONCLUSION: The implementation of opioid prescribing guidelines and the surrounding context are different among DSCs, which could result in knowledge gaps and confusion for novice providers. Although many dental programs provide extensive opioid safety training, there is room for improvement and standardization to further advance patient care.

15.
BMC Geriatr ; 22(1): 398, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524188

RESUMO

BACKGROUND: The elderly population worldwide is increasing exponentially which will be associated with more people suffering from cognition and fitness declines. The well-established benefits of exercise training for the elderly's cognitive and physical functioning have been observed. However, the amalgamated effect of combining cognitive and physical exercises on the older adults' cognitive functions, physical fitness, or psycho-related health remains unclear. Thus, this study protocol was planned to conduct different combinations of cognitive and/or physical training interventions to community-dwelling older adults and expected to see the multifaceted effects of the varied combination of training on their health. METHODS: This study is a cluster randomized controlled trial (CRCT). A total of 285 older adults (age ≥ 60) from twenty elderly centres as clusters will be randomly selected and assigned to intervention groups (IGs, n = 16) or control groups (CGs, n = 4). Each IG will be randomly assigned to one of the four combinations of three training modes that include cognitive (A), physical (B), and combined cognitive and physical training (CCPT, i.e. C), namely Mixed ABC, A + B, C + A, B + C. The intervention will last for 4 months in which the training is conducted for 16 sessions, 2 sessions per week, and 60 min per session. Four repeated assessments (pre-test, two post-training tests after 2 months and 4 months, and a follow-up test) will be conducted. The CG will only receive the four repeated assessments but no intervention. The outcome measures include cognitive tests (tests of execution, memory, and psych-social status), physical fitness, and dynamic balance tests. DISCUSSION: This study will provide substantial evidence that the integrated format of cognitive and physical exercises training will have higher cognition and fitness impact than the single training modes, and all these mixed modalities will have greater positive outcomes than the control condition. If the effectiveness is proven, the intervention can be further explored and extended to the nation so that many more elderly would be benefited. TRIAL REGISTRATION: The trial has been registered in the ClinicalTrials.gov in U.S. NIH (ID: NCT04727450 , date: January 27, 2021).


Assuntos
Cognição , Terapia por Exercício , Idoso , Terapia por Exercício/métodos , Humanos , Testes Neuropsicológicos , Aptidão Física , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego
16.
BMC Nurs ; 21(1): 105, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524262

RESUMO

BACKGROUND: Iran's nursing education has undergone significant modifications in the last decades, especially following the Islamic revolution and the Iran-Iraq war. This review outlined changing trends in Iran's nursing education and evaluate its status compared to other developing and developed countries. METHODS: Six international and two national electronic data sources were searched up to May 2021, using relevant keywords and terms. The studies were included if they addressed history, development, or evolutionary aspects of Iran's nursing education or evaluated its status by comparing it with developing or developed countries, using Bereday's model. To obtain more relevant information, the organizational documents of the Iranian Ministry of Health and Medical Education and the Iranian Ministry of Culture and Higher Education were searched. Of 753 evidence found in the initial search, 73 were considered eligible for this review. A systematic and unbiased data synthesis was performed and a narrative and tabulated summary was presented. RESULTS: The evolution in Iran's nursing education has resulted in the establishment of Bachelor, Master, and Ph.D. PROGRAMS: Iran's nursing education system plays an important role in fulfilling the healthcare system's mission, and it does not hold a dissatisfactory position in comparison with other developed and developing countries. However, this system is expected to be more versatile for the upcoming changes and advancements. CONCLUSION: Iran's nursing education has a moderate rating despite recent changes. Hence, this system has to be modified in some aspects by adopting experiences of other countries, with an appropriate and successful education system, to prepare future highly competent nurses.

17.
BMC Med Educ ; 22(1): 345, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524331

RESUMO

BACKGROUND: Deaf and hard of hearing (DHH) people are an underserved population and underrepresented among healthcare professionals. A major barrier to success for DHH healthcare professionals is obtaining effective accommodations during education and employment. Our objective: describe DHH individuals' experiences with accommodations in healthcare education. METHODS: We used an online survey and multipronged snowball sampling to recruit participants who identify as DHH and who had applied to a U.S. health professional school (regardless of acceptance status). One hundred forty-eight individuals representing multiple professions responded; 51 had completed their training. Over 80% had been accepted to, were currently enrolled, or had completed health professions schools or residency programs, and/or were employed. The survey included questions addressing experiences applying to health professions programs and employment; satisfaction with accommodations in school and training; having worked with a disability resource professional (DRP); and depression screening. RESULTS: Use and type of accommodation varied widely. While in school, respondents reported spending a mean of 2.1 h weekly managing their accommodations. Only 50% were highly satisfied with the accommodations provided by their programs. Use of disability resource providers (DRPs) for accommodations was highest during school (56%) and less frequent during post-graduate training (20%) and employment (14%). Respondents who transitioned directly from school to employment (versus via additional training) were more satisfied with their accommodations during school and were more likely to find employment (p = 0.02). Seventeen respondents screened positive for risk of depression; a positive screen was statistically associated with lower school accommodation satisfaction. CONCLUSIONS: DHH people study and practice across many health professions. While respondents were mostly successful in entering health professions programs, accommodation experiences and satisfaction varied. Satisfaction with accommodations was related to successful employment and wellness. Low satisfaction was associated with higher likelihood of depression symptoms. To increase representation in the workforce, healthcare professional schools, training programs, and employers should enhance support for the learning and working climates for people with disabilities.


Assuntos
Pessoas com Deficiência , Pessoas com Deficiência Auditiva , Atenção à Saúde , Escolaridade , Emprego , Humanos
18.
Artigo em Inglês | MEDLINE | ID: mdl-35524927

RESUMO

INTRODUCTION: In light of persistent health inequities, this commentary describes the critical role of maternal and child health (MCH) graduate training in schools and programs of public health (SPPH) and illustrates linkages between key components of MCH pedagogy and practice to 2021 CEPH competencies. METHODS: In 2018, a small working group of faculty from the HRSA/MCHB-funded Centers of Excellence (COEs) was convened to define the unique contributions of MCH to SPPH and to develop a framework using an iterative and consensus-driven process. The working group met 5 times and feedback was integrated from the broader faculty across the 13 COEs. The framework was further revised based on input from the MCHB/HRSA-funded MCH Public Health Catalyst Programs and was presented to senior MCHB leaders in October 2019. RESULTS: We developed a framework that underscores the critical value of MCH to graduate training in public health and the alignment of core MCH training components with CEPH competencies, which are required of all SPPH for accreditation. This framework illustrates MCH contributions in education, research and evaluation, and practice, and underscores their collective foundation in the life course approach. CONCLUSIONS: This new framework aims to enhance training for the next generation of public health leaders. It is intended to guide new, emerging, and expanding SPPH that may currently offer little or no MCH content. The framework invites further iteration, adaptation and customization to the range of diverse and emerging public health programs across the nation.

19.
BMC Sports Sci Med Rehabil ; 14(1): 84, 2022 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-35526065

RESUMO

BACKGROUND: Performing multiple high-intensity interval training (HIIT) sessions in a compressed period of time (approximately 7-14 days) is called a HIIT shock microcycle (SM) and promises a rapid increase in endurance performance. However, the efficacy of HIIT-SM, as well as knowledge about optimal training volumes during a SM in the endurance-trained population have not been adequately investigated. This study aims to examine the effects of two different types of HIIT-SM (with or without additional low-intensity training (LIT)) compared to a control group (CG) on key endurance performance variables. Moreover, participants are closely monitored for stress, fatigue, recovery, and sleep before, during and after the intervention using innovative biomarkers, questionnaires, and wearable devices. METHODS: This is a study protocol of a randomized controlled trial that includes the results of a pilot participant. Thirty-six endurance trained athletes will be recruited and randomly assigned to either a HIIT-SM (HSM) group, HIIT-SM with additional LIT (HSM + LIT) group or a CG. All participants will be monitored before (9 days), during (7 days), and after (14 days) a 7-day intervention, for a total of 30 days. Participants in both intervention groups will complete 10 HIIT sessions over 7 consecutive days, with an additional 30 min of LIT in the HSM + LIT group. HIIT sessions consist of aerobic HIIT, i.e., 5 × 4 min at 90-95% of maximal heart rate interspersed by recovery periods of 2.5 min. To determine the effects of the intervention, physiological exercise testing, and a 5 km time trial will be conducted before and after the intervention. RESULTS: The feasibility study indicates good adherence and performance improvement of the pilot participant. Load monitoring tools, i.e., biomarkers and questionnaires showed increased values during the intervention period, indicating sensitive variables. CONCLUSION: This study will be the first to examine the effects of different total training volumes of HIIT-SM, especially the combination of LIT and HIIT in the HSM + LIT group. In addition, different assessments to monitor the athletes' load during such an exhaustive training period will allow the identification of load monitoring tools such as innovative biomarkers, questionnaires, and wearable technology. TRIAL REGISTRATION: clinicaltrials.gov, NCT05067426. Registered 05 October 2021-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05067426 . Protocol Version Issue date: 1 Dec 2021. Original protocol. Authors: TLS, NH.

20.
Saudi Pharm J ; 30(4): 478-483, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35527824

RESUMO

Introduction: The Accreditation Council for Pharmacy Education (ACPE) offers certification for interested pharmacy programs outside the United States. This study aimed to explore the reported impact of this certification on the quality of pharmacy education among ACPE-certified pharmacy programs outside the US. Methods: This cross-sectional study was based on highly structured, standardized interviews. A predetermined questionnaire was designed to include both quantitative and qualitative items, which assessed participants' thoughts on the impact of ACPE certification on the quality of pharmacy education as well as programmatic and student learning outcomes. A total of 15 pharmacy colleges and schools outside the US have received the ACPE certification as of July 2020. After IRB approval, these programs were invited to participate in online live interviews, which were scheduled from May to July 2020 via Zoom®, and lasted approximately 45 min each. Results: Administrators from 13 programs participated in this study (87% respondent rate). The majority of these international pharmacy programs reported that the ACPE certification had promoted the quality of pharmacy education at their institutions. However, there were different views on how the ACPE certification has affected the operation of these international pharmacy programs. There was little or no impact of the certification on financial resources, such as salaries and development funds. Conclusion: Despite being confined to little or no change in certain areas of their programs, all the interviewees believed the ACPE certification had an overall positive impact on the quality of their programs, particularly in the area of assessment, preceptor quality and development, improving teaching and learning methods in both didactic and experiential curricula, and developing an inclusive feedback system to receive input from various stakeholders.

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