Training hour requirements to provide acupuncture in the United States.

INTRODUCTION: The National Academy of Medicine recommends, and Joint Commission requires, offering non-pharmacologic approaches to pain management, including acupuncture, to reduce opioid overuse in the United States. This study describes 2019 state training requirements to evaluate how they represent opportunities and barriers to increasing access to acupuncture. METHODS: We searched publicly available databases to identify Acupuncture Practice Acts and additional statutes and regulations pertaining to acupuncture training requirements on state licensure board websites. We then extracted state-specific acupuncture training requirements for individuals with and without a healthcare-related professional license. RESULTS: Thirty-three states allow physicians to provide acupuncture without requiring any additional training requirements, 11 states and the District of Columbia (DC) require 200-300 training hours, and three require physicians to obtain a separate acupuncture license. Three states have no regulatory agency ruling. Forty states require non-healthcare professionals to complete an accredited program of more than 1900 h and pass an examination. Twenty-three states have an Acupuncture Detoxification Specialist designation allowing individuals without a clinical professional license to provide auricular acupuncture for substance use disorder treatment after a 70-h training course. DISCUSSION: State-level training requirements are intended to increase safe and effective care, but variations represent a potential barrier to increasing the number of acupuncture providers in the United States. Allowing non-physician medical professionals to complete reduced training requirements for specific indications could be a model to increase access to acupuncture. The influence of training requirements on acupuncture access and opioid overuse needs examination.

Intensivistas, perded toda esperanza / Intensivists, lose all hope

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Exploring the effectiveness of a school-based physical activity policy in British Columbia, Canada: a mixed-methods observational study.

The Daily Physical Activity (DPA) policy in British Columbia requires elementary schools to help students achieve 30 min of physical activity during instructional and noninstructional time on school days. The purpose of this study was to determine how elementary teachers implement the DPA policy, and examine differences in children's light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) at school, based on how the teacher implemented the DPA policy during the school day (provision of DPA during instructional time or only noninstructional time). In this observational mixed-methods study, 12 teachers were interviewed on their implementation approaches. Teachers provided DPA opportunities during instructional time (i.e., prescriptive implementers, n = 9) or relied on students to be active during noninstructional times (i.e., nonprescriptive, n = 3). Next, 10 students from each interviewed teacher's classroom were randomly selected to wear accelerometers for one school week. Hierarchical linear modeling was used to examine the contribution of teacher's implementation strategy on student's activity levels. t-Tests examined differences in students' activity levels between implementation groups. Teacher's DPA implementation strategy accounted for a significant proportion of variance in student's activity throughout the school day (p's < .05). The prescriptive group (n = 88) was more active (LPA and MVPA) and spent a greater proportion of their school days in MVPA during instructional time than the nonprescriptive group (n = 23). Heterogeneity in policy implementation creates variations in policy effectiveness. Students provided with opportunities to be active during instructional time may accumulate more MVPA compared with those who are not given these opportunities. Registration: Not applicable.

Psychoeducational assessment of students with intellectual disability: professional-action framework analysis.

BACKGROUND: The right to educational inclusion for students with intellectual disability (SWID) requires the development of good assessment and intervention practices from holistic perspectives not exclusively focused on the academic limitations that SWID may present. These practices are settled in Spain, via regulations drawn up by each Autonomous Community (AC). The variety of existing regulations demands a critical review of the decisions taken to promote the inclusion of those students. METHOD: current regulations-in-force in each AC that regulate attention to diversity (AD) have been were analyzed by using a checklist that includes the variables that defining each stage of the AD process and the ways of providing supports that favor the development, learning and participation of SWID. RESULTS: attention to diversity measures in each AC emphasize organizational and curricular issues, with no AC following holistic approaches in both assessment and intervention, but rather neglecting self-determination and the promotion of quality of life for SWID. CONCLUSIONS: guidelines for the development of new legal frameworks and professional practices based on the latest evidence-based models of attention to SWID and on the results are discussed.

Utilización de cadáveres para la enseñanza de la intubación orotraqueal / Use of corpses for teaching orotracheal intubation

A propósito de una consulta realizada por un profesional, relacionada con la práctica de intubación orotraqueal de cadáveres con fines formativos, el Comité de Ética Asistencial (CAE) del Hospital Universitario Marqués de Valdecilla ha considerado de especial relevancia la contextualización del proceso, tanto a nivel temporal como de infraestructura (tipo de centro sanitario); y sus principales reflexiones y conclusiones, se pretenden dar a conocer. Primero, que existe un vacío legal a este respecto, que provoca interpretaciones legales sin base fundada. Segundo, se recomienda que atendiendo al principio de autonomía de las personas, así como a la dignidad de las mismas, se debiera obtener un consentimiento informado para la realización de dichas prácticas; y, en el caso de no poder obtenerse, se recomienda que el alumno se abstenga de realizar el procedimiento (AU)

With regard to a query raised by a professional, related to the practice of the orotracheal intubation of bodies for training purposes, the Healthcare Ethics Committee (HEC) of the Hospital Universitario Marqués de Valdecilla has considered the contextualisation of the process to be particularly relevant, both in terms of time and infrastructure (type of health centre); and it is intended to publicise its main reflections and conclusions. First, there is a legal loophole in this respect, leading to legal interpretations which are not well-founded. Second, it is recommended that by following the principle of individual autonomy and the dignity of individuals, it should be possible to obtain informed consent to carry out such practices. In the event that the informed consent cannot be obtained, it is recommended that students refrain from performing the procedure (AU)

Accepting, understanding, teaching, and learning (human) evolution: Obstacles and opportunities.

Questions about our origin as a species are universal and compelling. Evolution-and in particular human evolution-is a subject that generates intense interest across the world, evidenced by the fact that fossil and DNA discoveries grace the covers of major science journals and magazines as well as other popular print and online media. However, virtually all national polls indicate that the majority of Americans strongly reject biological evolution as a fact-based, well-tested, and robust understanding of the history of life. In the popular mind, no topic in all of science is more contentious or polarizing than evolution and media sources often only serve to magnify this polarization by covering challenges to the teaching of evolution. In the realm of teaching, debates about evolution have shaped textbooks, curricula, standards, and policy. Challenges to accepting and understanding evolution include mistrust and denial of science, cognitive obstacles and misconceptions, language and terminology, and a religious worldview, among others. Teachers, who are on the front lines of these challenges, must be armed with the tools and techniques to teach evolution in formal education settings across grades K-16 in a straightforward, thorough, and sensitive way. Despite the potentially controversial topic of human evolution, growing research is demonstrating that a pedagogical focus on human examples is an effective and engaging way to teach core concepts of evolutionary biology.

Evaluation of satisfaction in an extracurricular enrichment program for high-intellectual ability participants / Evaluación de la satisfacción de un programa de enriquecimiento extracurricular en participantes de alta capacidad intelectual

BACKGROUND: The objective of this study was to evaluate the satisfaction of an extracurricular enrichment program of the cognitive and personal management of participants with high intellectual ability. METHOD: At the first time point, the sample consisted of n= 38 participants, and n= 20 parents; n= 48 participants at the second time point; and n= 60 participants at the third time point. The Satisfaction Questionnaire (CSA in Spanish), both for students (CSA-S) and for parents (CSA-P), was constructed. RESULTS: The CSA-S scores showed adequate psychometric properties. Exploratory factor analysis yielded a unidimensional structure. Cronbach's alpha ranged between 85 and .86. Test-retest reliability was 0.45 (p<.05). The generalizability coefficient was .98. A high percentage of the sample was satisfied with the program, perceived improvements in cognitive and emotional management, motivation and interest in learning, and in the frequency and quality of their interpersonal relationships. CONCLUSIONS: The evaluation of educational programs is necessary in order to determine the efficacy and the effects of their implementation on the participants' personal and intellectual management

ANTECEDENTES: el objetivo de este estudio fue evaluar la satisfacción de un programa de enriquecimiento extracurricular para el desarrollo cognitivo y la gestión de recursos de los participantes de alta capacidad intelectual. MÉTODO: en el primer punto del tiempo la muestra fue de n= 38 participantes y n= 20 padres; n= 48 participantes en el segundo punto de tiempo; y n= 60 participantes en el tercer momento temporal. Se construyó el Cuestionario de Satisfacción (CSA), con una versión para el alumno (CSA-A) y otra para los padres (CSA-P). RESULTADOS: las puntuaciones CSA-A mostraron propiedades psicométricas adecuadas. Una estructura esencialmente dimensional fue encontrada cuando se llevó a cabo el análisis factorial exploratorio. El alfa de Cronbach osciló entre 0,85 y 0,86. La fiabilidad test-retest fue 0,45 (p < 0,05). El coeficiente de generalizabilidad fue de 0,98. Un alto porcentaje de la muestra se mostró satisfecho con el programa y percibió mejoras en gestión cognitiva y emocional, en la motivación y el interés hacia el aprendizaje, y en la frecuencia y calidad de sus relaciones interpersonales. CONCLUSIONES: la evaluación de los programas extracurriculares es necesaria con el fin de determinar la eficacia y los efectos de su aplicación en la gestión personal e intelectual de los participantes

Comparative morality judgments about lesbians and gay men teaching and adopting children.

The purpose of this study was to compare morality judgments of American Catholics and the general public about lesbians and gay men adopting and teaching children. The general sample endorsed higher agreement that lesbians and gay men should be allowed to adopt and to teach children compared to the Catholic only sample. Older participants were less accepting than all other age groups, and there was an interaction effect between education and political ideology such that those with less education and with more politically conservative beliefs were generally less accepting of lesbians and gay men adopting and teaching children.

The teaching/research trade-off in law: data from the right tail.

BACKGROUND: There is a long scholarly debate on the trade-off between research and teaching in various fields, but relatively little study of the phenomenon in law. This analysis examines the relationship between the two core academic activities at one particular school, the University of Chicago Law School, which is considered one of the most productive in legal academia. METHOD: We measure of scholarly productivity with the total number of publications by each professor for each year, and we approximate performance in teaching with course loads and average scores in student evaluations for each course. In OLS regressions, we estimate scholarly output as a function of teaching loads, faculty characteristics, and other controls. We also estimate teaching evaluation scores as a function of scholarly productivity, fixed effects for years and course subject, and faculty characteristics. RESULT: Net of other factors, we find that, under some specifications, research and teaching are positively correlated. In particular, we find that students' perceptions of teaching quality rises, but at a decreasing rate, with the total amount of scholarship. We also find that certain personal characteristics correlate with productivity. CONCLUSION: The recent debate on the mission of American law schools has hinged on the assumption that a trade-off exists between teaching and research, and this article's analysis, although limited in various ways, casts some doubt on that assumption.

DEGAM criteria catalogue for training practices in primary care--a proposal for the assessment of the structural quality of training practices.

BACKGROUND: Whilst the structure of primary care vocational training in Germany is being increasingly formalized there remains an abundance of disparate locally defined criteria for the training practices. Advanced medical training in the ambulatory setting has also been identified as an area of need by other specialties. GOAL: In contrast to the current practice of a unregulated authorization by regional medical associations this catalogue provide transparent, clearly defined criteria for the assignment of training practice status. METHODS: The first draft of the criteria catalogue integrates feedback from 30 academic general practitioners. The feasibility of the catalogue was tested by a further 30 surgeries. Analysis included an assessment of the sociodemographic characteristics of the trainers and their practices as well as satisfaction of the participants with the approved authorization period. RESULTS: The criteria catalogue comprises 19 items within the domains of trainer qualification, practice infrastructure and patient specific factors as well as mandatory criteria. The points scored through this system confer a variable period of authorization. Of the 30 participants 17 were satisfied with the period of authorization they received, 10 were dissatisfied, and one was indifferent. Satisfaction showed no correlation with sex, experience as a trainer, or with the score achieved through the criteria catalogue. It correlated little with the length of time practicing as a doctor. CONCLUSION: The criteria catalogue reflects both the breadth of general practice as well as the skills of the trainers. Satisfaction of participants in the test group was good, and infers a basis for applying the catalogue through regional medical associations to assign teaching practice status. It may also be used as a blue-print for other medical specialties.

[Towards a pedagogical e-learning approach to improve preparation for medical school curriculum in Grenoble: results over the 10 last years]. / Réforme pédagogique et « e-learning ¼ pour le concours de première année à la faculté de médecine de Grenoble : satisfaction des étudiants et des enseignants.

INTRODUCTION: Before 2005, at Grenoble, the teaching of the first year of medicine satisfied neither the students, nor the teachers anxious to exempt a correctly targeted effective teaching. METHODS: By 2006, the Grenoble-native teaching method was reformed in-depth with the introduction of information and communication technology (ICT) in education. Each sequence was over 4 weeks connecting: self- learning using multi-media resources, questions submitted online, meetings with teaching staff for interactive question-answer sessions in the presence of the teacher,) tutorials animated by older students for Multiple Choice Question (MCQ) training in preparation for the exams. The whole health formation was structured in 12 cycles of this same structured sequence. Since 2010, this method was extended from the faculty of medicine to the faculty of pharmacy and maieutic. Each year, more than 1600 students, 40 teachers and 140 tutors are concerned. The ICT laboratory was responsible for the production of the multi-media support, of the management of the questions online, the collection and the treatment of the evaluations of the lesson by the students. It also took part in the preparation of the MCQ trainings and after each sequence, delivered to students their personal ranking. RESULTS: Staffs between teachers and students are organized for the 12 cycles. The teachers' and students' opinions were analyzed to evaluate the reforms and allow teaching methods to be adapted accordingly. The expressed satisfaction' rate vary from 85% with more than 91% by students and teachers. The intensive use of new information and communication technologies is well accepted, by both sides: teachers and students. After each tutorial, students had their results and their rank, which are linked with the contest result. The mean of the 12 notes obtained during the tutorials is correlated with the note with the contest (R of Spearman=0.75). Student profiles at registration and success in the exams following the reform are described. The keys to success (e.g. social background, high school specialization) seem to be modified by the reform providing greater equality of opportunity between students. CONCLUSION: Since 2006, the teachers have adopted this teaching reform. All the returns from the students but also the staff and the teachers, allowed us to improve teachings quality. This teaching reform modified the profiles and the characteristics of the students received with the contest as well as the nature of the factors of this success.

Female sexual offenders in the educational system: a brief overview.

Female sexual offenders comprise the minority of sexual offenders in the criminal justice system. However, empirical research reveals that sexual offenses against adolescents by females are a bigger problem than previously thought, particularly in the educational system. The authors review some of the data in the criminal justice system as well as in empirical research studies about female sexual offenders, with a specific focus on females who commit sexual crimes against students who are minors.

Darning, doylies and dancing: the work of the Leeds Association of Girls' Clubs (1904-1913).

The Leeds Association of Girls' Clubs (LAGC) was set up by a group of women, including Hilda Hargrove, Dr Lucy Buckley and Mary and Margaret Harvey, to promote collaboration between the city's girls' clubs. The organisation epitomised women working in partnership whilst reflecting their differing philanthropic and political interests. However LAGC's collaborative approach resulted in liberal consensus which downplayed the significance of girls' working conditions. Throughout the decade LAGC's focus was its annual competitions. These featured utilitarian and decorative handicrafts (darning and doylies) enshrining both frugality and aspiration, alongside dance and drill which channelled girls' vigour. Nevertheless, LAGC's resilience resulted in an organisation which is still in existence.