bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, availability and utilization of growth monitoring facilities in urban and rural health facilities in Enugu State, South East Nigeria: A survey of nursing mothers
Authors: Ezeala-Adikaibe Ngozi Praise , Eze Joy , Ezeanosike Obumneme Benaiah , Ayuk Adaeze , Ezeala-Adikaibe Birinus
Published: September 2021

Sub Saharan Africa (SSA) has one of the highest rates of child mortality compared to the rest of the world’s regions. The usefulness of growth monitoring cuts across all areas of pediatric care and remains the pivot for prevention of childhood diseases and prevention untoward mortality. This study therefore aimed at determining the availability of growth monitoring facilities, and knowledge and utilization of such facilities among mothers attending rural and urban health facilities in Enugu state. This was a cross sectional descriptive survey of mothers done in selected urban and rural government health facilities using the multi-stage sampling method. Data obtained were analyzed using SPSS version 21.0. Conclusions were drawn at a level of significance, p<0.05 at 95% Confidence interval. A total of 440 mothers were recruited for the study; 330 (75%) were from urban and 110 (25%) from rural locations. Mothers in urban centers exhibited higher knowledge (84%, VHL) of growth monitoring facilities than those in rural areas, p=0.04. Growth monitoring facilities were more available in urban areas compared to rural areas, p<0.01. However, growth monitoring facilities were more utilized by mothers in rural areas than in urban locations. Although GM facilities were more available in urban health centers in Enugu state. These facilities were less utilized especially in the urban areas even though mothers demonstrated were very knowledge about these facilities.
GLUCOSE METABOLISM AND INSULIN RESPONSE TO ORAL GLUCOSE TOLERANCE TEST (OGTT) IN PREPUBERTAL PATIENTS WITH TRANSFUSION DEPENDENT Β-THALASSEMIA (TDT): A LONG-TERM RETROSPECTIVE ANALYSIS
Authors: De Sanctis Vincenzo , Soliman Ashraf , Tzoulis Ploutarchos , Daar Shahina , Di Maio Salvatore , Fiscina Bernadette , Kattamis Christos
Published: September 2021

Background: Glucose dysregulation (GD), including prediabetes and diabetes mellitus (DM), is a common complication of transfusion dependent β-thalassemia (TDT) patients. The prevalence increases with age and magnitude of iron overload, affecting a significant proportion of patients. The development of GD is frequently asymptomatic and therefore an early diagnosis, according to the international guidelines, requires an annual oral glucose tolerance test (OGTT) in all TDT patients aged ten years or older.

 

Purpose: This retrospective study aims to evaluate the prevalence of GD in a homogenous population of prepubertal TDT patients and to enhance understanding of the pathogenesis and progression of glucose homeostasis in this group of patients.

 

Methods: A selected group of 28 TDT patients was followed for at least 10.3 years (range: 10.3 - 28.10 years) from prepubertal age (mean 11.0 ± standard deviation 1.1 years) to adulthood (28.7 ± 3.7 years). Glucose tolerance and insulin response to OGTT were assessed, and indices of β-cell function, insulin sensitivity and insulin secretion were calculated.

 

Results: At baseline, 18 TDT patients had normal glucose tolerance (NGT) and 10 isolated impaired fasting glycaemia (IFG), according to the American Diabetes Association (ADA) criteria. Compared to 18 prepubertal healthy controls (mean ± SD age: 10.9 ± 1.1 years), the fasting plasma glucose (FPG), basal insulin level and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index were significantly higher in the group of TDT patients (p= 0.001, 0.01 and 0.012, respectively). At the last observation, 7/18 patients (38.8%) with NGT and 9/10 (90%) with IFG at baseline deteriorated; 3 female patients developed type 2 DM (1 from the NGT group and 2 from the IFG group). Compared to adult controls, TDT patients with NGT had a reduced oral disposition index (DI) (p= 0.006), but no significant difference in HOMA-IR and Matsuda index. Conversely, all insulin indices (HOMA-IR, MI and DI) but one [insulinogenic index (IGI)] were statistically different in TDT patients with GD compared to controls.

 

Conclusion: This study shows a spectrum of disturbances in glucose homeostasis among TDT patients and that prepubertal patients with IFG are at higher risk for developing a deterioration of glucose metabolism.
Case Report: Fatal Viscerotropic Disease in a Young Woman Following Yellow Fever Vaccination
Authors: Brunaldi Mariângela Ottoboni , Silva René Julias Costa , Fabro Alexandre Todorovic , de Almeida e Araujo Daniel Cardoso , Basile-Filho Anibal , Auxiliadora-Martins Maria , Menegueti Mayra Gonçalves , Beloddi Maria Isabel , Alves Esposito Danillo Lucas , Lopes da Fonseca Benedito Antônio
Published: September 2021

Yellow fever is a viral hemorrhagic disease, and vaccination is the most effective way to minimize the impact of the disease. Serious adverse events after yellow fever vaccination are rare. We report the case of a young woman with an unusual presentation of yellow fever 17DD vaccine-associated acute viscerotropic disease, with severe hepatic impairment following a long incubation period. She died more than a month after yellow fever vaccination.
Laktancij in spis O smrtih preganjalcev
Authors: Lovenjak Milan
Published: September 2021

Spis z naslovom Knjiga Lucija Cecilija izpovedovalcu Donatu o smrtih preganjalcev (De mortibus persecutorum) je ohranjen v enem samem rokopisu iz 11. stoletja, odkritem leta 1778 v samostanski knjižnici v Moisacu. Ob prvi objavi (1779) ga je Etienne Baluze pripisal krščanskemu piscu in učitelju retorike Laktanciju (ok. 250–ok. 325), najbolj znanemu po prvi celoviti obravnavi krščanske vere, spisu Božji nauk (Divinae institutiones), a kmalu so se pojavili dvomi o njegovem avtorstvu. Tako po formi kot po obravnavani temi, strahotnih koncih cesarjev preganjalcev, ki jih je Bog strogo kaznoval za njihove zločine, spis v antični književnosti nima prave primere. Zato je bil deležen različnih opredelitev kot krščanski pamflet, Konstantinov panegirik, konstantinska propaganda ipd. Forma je izrazito retorična, vsebuje tudi elemente krščanskega in poganskega zgodovinopisja in hagiografije, zgleduje se po judovski in antični tradiciji, v njem so opazne sorodnosti z Drugo knjigo Makabejcev in Konstantinovim govorom Oratio ad sanctorum coetum. Po vrsti razprav in člankov za in proti Laktancijevemu avtorstvu, ko se je zdelo že, da dvomov ni več, je leta 2013 izšla knjiga Jeana Rougeja in Daniela de Deckerja z obnovljeno tezo, da je spis služil konstantinski propagandi in je nastal na pobudo cesarja, podkrepljeno s temeljito študijo drugih Laktancijevih del, in argumenti, oprtimi tudi na izsledke računalniško pripravljenih analiz. Zdi se, da vprašanje ostaja odprto.
Liutprand Kremonski, Antapodosis 6: Podoba Bizanca na latinskem Zahodu desetega stoletja
Authors: Liutprand Kremonski  , Škraban Kajetan
Published: September 2021

Liutprand Kremonski je bil škof, diplomat in zgodovinar langobardskega porekla, ki je deloval v sredini 10. stoletja. Njegova zgodovinopisna dela Antapodosis, Relatio de legatione Constantinopolitana in Historia Ottonis so nadvse pomembna za poznavanje politične zgodovine 10. stoletja, zlasti za dogajanje na Apeninskem polotoku. Hkrati pa velja tudi obratno: literarna vrednost njegovih del v veliki meri izhaja iz pogosto duhovite, mestoma pa tudi izrecno napadalne kritike političnih nasprotnikov in nekdanjih zaveznikov.
Canine Synovial Sarcoma of the Stifle Joint with Pulmonary and Liver Metastases
Authors: Samson R.J. , Mpagike F.H. , Felix A.K. , Matondo A.B. , Makungu M.
Published: September 2021

A seven-year-old female mongrel dog was presented at the Sokoine University of Agriculture Teaching Animal Hospital for second opinion regarding a progressive swelling of the right hind limb of two months duration. Clinical examination revealed a loss of body condition, tachypnea and tachycardia, a painful immobile solid mass of 20 cm x 14 cm x 10 cm located on the right stifle joint, leucocytosis, and anaemia. Radiographic examination of the joint revealed marked soft tissue swelling with amorphous areas of mineralization and complete destruction of the proximal tibia. Smooth and solid periosteal reaction was seen around the tibia and fibula with a Codman’s triangle. Multiple nodules and a mass with soft tissue opacity were seen in the lung fields. Post-mortem examination revealed separation of tibia and fibula, softening of the proximal parts of the tibia, and complete integration of the proximal region of the two bones and articular tissues into the surrounding muscular tissues. Multifocal nodular lesions of variable sizes were mostly found in the lungs and partly in the liver. Histologically, predominantly oval and round cells with variable nuclear sizes and moderate mitoses were observed in tissue samples from the joint, lungs and the liver although some parts of the lung metastases showed both round and spindle shaped tumor cells. Clinical profile is suggestive of aggressive biphasic (spindle and epithelial) type of synovial cell sarcoma with lung and liver metastasis. Early radiographic and biopsy examination of persistent musculoskeletal nodules is recommended for early diagnosis and interventions.
Aktivitas Pemijahan, Perkembangan Awal, dan Pertumbuhan Larva Ikan Pelangi Arfak dalam Kondisi Laboratorium: Studi Pendahuluan untuk Penangkarannya
Authors: Manangkalangi Emmanuel , Lapadi Ida , Lefaan Paskalina Theresia , Rahardjo M. Fadjar , Hadiaty Renny K. , Hariyadi Sigid , Simanjuntak Charles P. H.
Published: September 2021

Informasi yang lengkap mengenai reproduksi, perkembangan awal, dan pertumbuhan larva menjadi sangat penting dalam upaya penangkaran dan reintroduksi spesies ikan yang terancam punah. Salah satu di antara spesies yang mulai terancam adalah ikan elangi Arfak, Melanotaenia arfakensis yang sudah berada dalam kategori rentan dan informasinya masih sangat terbatas. Oleh karena itu, penelitian ini dilakukan dengan tujuan untuk mendeskripsikan aktivitas pemijahan, perkembangan awal, dan pertumbuhan larva spesies ikan elangi ini dalam kondisi laboratorium. Percobaan dalam skala laboratorium dilaksanakan pada bulan Maret-September 2017. Ikan yang digunakan berasal dari Sungai Nimbai. Sebanyak tiga pasang individu jantan dan betina dengan kisaran ukuran 46,5 sampai 60,1 mm dipilih untuk perlakuan. Namun, hanya satu pasangan yang berhasil diamati aktivitas pemijahannya secara lengkap. Pemijahan berlangsung di antara waktu pagi hari sampai siang hari dalam tiga periode pemijahan. Dalam setiap periode, pemijahan berlangsung di antara 8 dan 11 hari. Antarperiode pemijahan membutuhkan waktu 14 sampai 22 hari. Setelah dibuahi, telur dilekatkan dengan filamen pada substrat pemijahan dan diletakkan pada kedalaman 7,3-24,3 cm dari permukaan air. Satu kelompok telur yang dipijahkan terdiri atas 78-116 butir dengan kisaran diameter di antara 1,05 dan 136 mm. Telur menetas dalam periode 4 sampai 10 hari. Panjang tubuh larva yang baru menetas berkisar 4,13-4,40 mm dan akan mencapai ukuran 7,85 mm dengan tingkat sintasan 48,1% setelah 41 hari. Hasil penelitian ini menemukan beberapa kuntungan dari karakteristik pemijahan dan pertumbuhan tahap awal yang bermanfaat untuk upaya penangkaran dan pelepasliaran ikan ini ke habitat aslinya. Dengan demikian, populasinya di sistem Sungai Prafi dapat tetap dilestarikan.
Profil Kawasan Reboisasi Mangrove Kepulauan Seribu Berdasarkan Karakteristik Lingkungan dan Fauna Makrobentik Terkait
Authors: Lestari Febrianti , Syahrial Syahrial , Anggraini Rika , Andika Yudho , 'Akla Cut Meurah Nurul , Samad Agus Putra Abdul
Published: September 2021

Fauna makrobentik sering digunakan sebagai bioindikator kualitas lingkungan dan informasi tentang karakteristik lingkungan maupun keberadaan fauna makrobentik di kawasan reboisasi mangrove masih sangat terbatas. Kajian profil kawasan reboisasi mangrove Kepulauan Seribu berdasarkan karakteristik lingkungan dan fauna makrobentiknya telah dilakukan pada bulan Maret 2014. Kajian ini bertujuan untuk mengetahui kondisi ekologi perairan di sekitar kawasan reboisasi mangrove Kepulauan Seribu. Untuk mengetahui keterkaitan karakteristik lingkungan dan fauna makrobentik dengan stasiun pengamatan dilakukan dengan statistik Correspondence Analysis (CA), sedangkan karakteristik lingkungan penentu fauna makrobentik serta hubungannya dilakukan dengan statistik Principal Component Analysis (PCA) dan regresi linier sederhana. Hasil kajian memperlihatkan bahwa konsentrasi karakteristik lingkungan yang diukur tidak begitu berbeda antar stasiun dan tidak melebihi ambang baku mutu untuk kehidupan biota laut. Selanjutnya fauna makrobentik yang ditemukan terdiri dari 6 spesies dengan kepadatan tertingginya berada di Stasiun 3 (05.00 ind/m2) dan terendahnya di Stasiun 1 (02.00 ind/m2). Pada Stasiun 1 konsentrasi pH dan suhunya sangat tinggi, sedangkan Stasiun 2 dan 3 konsentrasi salinitasnya yang tinggi. Fauna makrobentik Atilia (Columbella) scripta, Metopograpsus latifrons, Littoraria scabra, Saccostrea cucculata dan Cardisoma carnifex dapat berasosiasi dengan mangrove di semua stasiun. Selain itu, karakteristik lingkungan yang menentukan keberadaan fauna makrobentik C. carnifex adalah parameter pH, dimana semakin tinggi konsentrasi pH, maka kepadatan C. carnifex semakin menurun. Selain itu, karakteristik lingkungan yang menentukan keberadaan fauna makrobentik S. cucculata, M. latifrons dan A. scripta ditentukan oleh parameter DO dan salinitas yakni semakin rendah konsentrasi DO dan salinitas, maka kepadatan S. cucculata, M. latifrons maupun A. scripta akan semakin tinggi.
Osmanlı İmparatorluğu’ndan Türkiye Cumhuriyeti’ne Şapkanın Değişim Serüveni
Authors: ARABACI Hülya , SAATÇİOĞLU Kenan
Published: September 2021

Osmanlı İmparatorluğunun son yüzyılında yaşanan olumsuzluklar nedeniyle kurumların ve toplumun yeniden yapılanması gerekmiştir. Bu bağlamda imparatorluğun eski gücünü yeniden kazanması için siyasal ve kültürel bazı reformlar yapılmıştır. Batılılaşma hareketi olarak adlandırılan bu reformlar imparatorluk içerisinde yaşayan halkın sahip olduğu giyim-kuşam kültürü üzerinde oldukça etkili olmuştur. Özellikle belirtilen döneme kadar var olan süreçte geleneksel giyim-kuşam öğelerini tercih eden halk, zaman içerisinde gerçekleşen bu Batılılaşma hareketleri ile kendileri için farklı olarak nitelendirilebilecek olan dönemin Avrupa modasına ait giysi ve aksesuar parçaları ile tanışma fırsatı yakalamışlardır. Mevcut dönemde özellikle dönemin yayın organları ile erkek, kadın ve çocuk giyimine şapka adapte edilmeye çalışılmıştır. Osmanlı İmparatorluğu’nun devamında kurulan Türkiye Cumhuriyeti’nde ise şapka; 1925 yılında gerçekleşen şapka inkılabı ile Avrupa modasına ait bir aksesuar olarak hayatımızın içerisinde tamamıyla yer almaya başlamıştır. Şapka hem toplumsal hayatı düzenlemede hem de siyasi ve sanatsal hayatın içerisinde tarih sahnesine çıktığı günden bu yana farklı şekiller ve misyonlarda karşımıza çıkmıştır. Bu çalışmada, Osmanlı imparatorluğunun son döneminden erken Cumhuriyet dönemine ve günümüze kadar uzanan sürecin içerisinde şapkanın ve şapka kültürünün seyri ortaya çıkarılmak istenmiştir. Mevcut amaç doğrultusunda, lisansüstü tezler, makaleler, kitaplar, dergiler ve görsel veriler incelenmiş ve şapkanın belirtilen tarihsel süreç içerisindeki değişimi örneklerle incelenmiştir.
Resim Sanatına Yansıyan İstanbul Sokak Satıcılarının Osmanlı-Türk Sosyal Yaşamındaki Yeri ve Önemi
Authors: KALYONCU Hülya
Published: September 2021

Osmanlı Devleti’nde sabit bir dükkâna sahip olmaksızın mal veya hizmet satışı yapan ve “sokak satıcıları” ya da “seyyar satıcılar” adını alan satıcıların, yansıdıkları resim sanatı üzerinden alt başlıklar dâhilinde sınıflandırılmasının yapılarak, Osmanlı sosyal yaşamı içerisinde yerlerinin ve önemlerinin tespit edilmesinin amaçlandığı bu çalışmada, yöntem olarak Osmanlı’ya dair kaynaklarda yer alan sokak satıcıları ile ilgili yazılı ve görsel kaynak taramaları yapılmış, ilgili görsel kaynaklardan satıcı tipolojileri saptanarak fiziksel tanımlamalarının tespitine çalışılmış, yazılı kaynaklardan ise satıcıların toplum içerisindeki yerleri ve önemleri irdelenmeye çalışılmıştır. Yapılan araştırma ile geçim zorlukları nedeni ile Anadolu’nun farklı kentlerinden İstanbul’a gelen, Osmanlı toplumunun vazgeçilmezi olan bu kişilerin sosyo-kültürel ve sosyo-ekonomik yaşama da doğrudan etki etmiş oldukları ve bu etkinin günümüz Türkiye’sinde de halen devam ettiği sonucuna varılmıştır. Bu bağlamda sokak satıcılığının Osmanlı’dan da gelen kültür birikimi sürekliliğinin sağlanması ve aynı zamanda ekonomik ve sosyal yaşama katkı sağlanması için, sektörün tamamen ortadan kaldırılması yerine, gelişmiş ülke örneklerinde görüldüğü şekliyle belediyeler tarafından modernize edilmiş çağdaş ekipmanlar ve kaliteli hizmet eğitimleri verilmek sureti ile organize edilerek, sektöre kazandırılmaları önerimizdir.
SPWM Fed Induction Motor Drive Performance Using SIMULINK
Authors: Hema Singampalli , Hema Singampalli , Hema Singampalli , Hema Singampalli
Published: September 2021

In the former times, IC engines were used for transportation by most of the vehicles. But due to the depletion of fossil fuels day to day, the world is moving towards the Electric Vehicles (EVs) to overcome this problem. Electric Vehicles have higher efficiency and weight/power ratio. In general, DC motors were used in electric vehicles. The DC motors could not meet the requirements of customer needs because of its low speed range. In the recent studies, an AC Induction motor has several advantages over DC motors because of its robustness, high speed range, and efficiency and weight/power ratio. This paper presents the performance analysis of AC Induction motor when fed with the Single-Phase Inverter. The gate pulses are given by using Sinusoidal Pulse Width Modulation (SPWM) technique. The results are then compared with the performance of DC motor using MATLAB/SIMULINK.
Hydrogeology of Al-Hamdaniya, Northern Iraq
Authors: Najeeb Fadi Raed
Published: September 2021

The current study evaluated the hydrogeological conditions and hydraulic properties of the groundwater aquifers in Qaraqosh, Karamless and Bartella areas within Al-Hamdaniya district east Mosul. The depths and water tables of groundwater for 48 well were measured in October 2019, were ranged between 5 - 45 meters and 234 - 278.5 meters, respectively. The highest water table reaches in the center of the studied area north Qaraqosh and decreases gradually in all directions. A map of the flow net was drawn, and it was found that the general direction of water movement is from north to south, with local directions resulting by pumping from the aquifer, or due to the heterogeneity of the porous media. The results of the pumping test in Karamless area shows that the transmissivity was 107.671 m2/day and 100.682 m2/day according to Theis and Cooper-Jacob methods, respectively. The hydraulic conductivity of 157.65 m saturated thickness was found to be 0.683 m/day and 0.639 m/day using Theis and Cooper-Jacob methods, respectively. While the storage coefficient using Theis and Cooper-Jacob methods was 0.0023 and 0.0020، respectively. In Qaraqosh, the transmissivity was 87.1685 m2/day and 88.1004 m2/day according to the mentioned methods, respectively. While the hydraulic conductivity of saturated thickness of 71.07 m was found to be 1.24 m/day and 1.23 m/day using Theis and Cooper-Jacob methods, respectively. The values of storage coefficient using these methods was 0.00135 and 0.00115 respectively. The total dissolved solids (TDS) measured to conclude the hydrogeological system according to the quality of the groundwater aquifers, it was found that the concentrations of total dissolved solids are more than 3500 ppm in the mid of the study area and decreased towards all directions to the limits of 250 ppm. This wide variation in salinity may be because the wells in the central area penetrate the groundwater aquifers, represented by the layers of gypsum in Al-Fat'ha formation, which is hydraulically connected with the main aquifer of the Injana formation.
Sequence Stratigraphy and Depositional Environment of the Zubair Formation in Rumaila Oilfields, Southern Iraq: Microfacies and Geochemistry
Authors: Alsultan Hamid A. A.
Published: September 2021

In the Rumaila oilfields in southern Iraq, the Zubair Formation was deposited in a shallow environment as three main facies, delta plain, backshore, and delta front depositional conditions indicating a transition from delta front and delta plain to a highstand level due to the finning upward mode. The facies of the Zubair clasts show well-sorted quartz arenite sandstone, poorly sorted quartz arenite sandstone, clayey sandstone that has not been properly sorted, sandy shale, and shale lithofacies. The minor lithofacies were identified using well-logging methods (gamma ray, spontaneous potential and sonic logs) and petrography. The Zubair clasts are of transition environment that appears to be transported from freshwater and deposited in a marine environment forming many fourth-order cycles reflect sea level rise fluctuations and still-stand under tectonics developed the sequence stratigraphy. A misalignment between relative sea-level and sediment supply caused asymmetry sedimentary cycles. A shallower environment of shale-dominated rocks rich in organic matter and pyrite were exposed. The basinal shale of Ratawi at the Zubair bottom and the shallow carbonate of Shuaiba emplace on the Zubair represent the beginning of the delta build up (delta front and delta plain) to a highstand stage.
A Description of Current Curricular Design Models Used In Physical Therapy Clinical Education and Their Relationship to Pass Rates on the National Physical Therapy Examination
Authors: Engelhard Chalee , McCallum Christine
Published: September 2021

Purpose. The purpose of this study was to develop descriptions and identify commonalities of current clinical education models used in physical therapy programs; then, using this information, to examine differences in first-time and ultimate pass rates among the derived formula from Commission on Accreditation in Physical Therapy Education (CAPTE) accredited programs in 2011-2013. Methods. This mixed methods study captured qualitative and quantitative data from the 204 PT programs located in the United States and Puerto Rico from 2011 to 2013. The data were coded into 11 different clinical education models which represented all programs. The models were then linked to first time and ultimate pass rates. Results. Twenty out of 204 (9.8%) PT programs reported first-time pass rates and 201/204 (98.5%) reported ultimate pass rates in the cited three-year cycle period stated in this study. The three most commonly occurring models make up 84% of all current existing models. All three frequently occurring models include both full time and clinical internship clinical experiences. Additionally, these models outperformed the national pass rate average by at least 3%. Conclusions. Our results are the first to provide an analysis of the various models in use in physical therapist education, as well as a preliminary outlook on how clinical education design is matched against a program’s pass rate on the national exam. Since pass rate is one of the few standardized, modifiable outcomes for CAPTE approved programs, it was selected as the outcome to allow comparison of clinical education models. One of the driving forces behind this study was to illustrate clearly the tremendous variety of clinical education models and a better understanding of the scope of the variances that is occurring.
Training Hospital Readiness in Speech-Language Pathology Students through Simulation
Authors: Miles Anna , Donaldson Selena , Friary Philippa
Published: September 2021

Simulated learning environments allow students to develop technical and clinical decision-making skills in a safe and realistic setting. The aim of this study was to evaluate speech-language pathology students’ perception of hospital readiness following a one-day simulation-based training day on swallowing management. Nineteen students attended the training day. Training included part-task skill learning and immersive simulated scenarios. Students were asked to complete course evaluation forms and participated in focus groups immediately after the day. Seven students participated in a further focus group after a five-week hospital placement within a month of the training day. Four students participated in a focus group after a five-week hospital placement three months after the training day. The training day was positively accepted by all students. Analyses revealed three global themes: (1) preparation for hospital environment, (2) speech-language pathology skills, and (3) impact of simulated learning environments. Students directly attributed increased confidence in working in the hospital environment and increased clinical competency to the training day. These themes continued up to three months post training. Simulated learning environments may have long lasting benefits in developing hospital readiness in speech-language pathology students.
Analysis of Speech-Language Pathology Graduate Students' Experience with Thickened Liquids
Authors: Gorham-Rowan Mary , Coston Jade
Published: September 2021

Purpose: Thickened liquids are frequently recommended for patients with dysphagia to minimize aspiration. When discussing the use of thickened liquids with graduate students in Communication Sciences & Disorders (CSD), it is beneficial to discuss the potential effect(s) of this dietary recommendation. Graduate level preparation involving first-hand experience with thickened liquids may help future speech-language pathologists (SLPs) develop a more complete understanding of the effects of diet modification. The purpose of the current study was to examine the reactions of graduate students in CSD to a brief period of thickened liquid use as an experiential learning activity. Methods: Sixty-eight graduate students enrolled in an accredited CSD program completed the study. As part of a class assignment, students were instructed to consume only thickened liquids for 24 hours. No further restrictions on food intake were made. Each student wrote a brief summary detailing his/her experience at the conclusion of the thickened liquid intake session. The narratives were examined for key terms that seemed to define the participants’ experiences. Results: Experiential terms were divided into physical symptoms, emotional responses, and behavioral changes. Common symptoms included persistent thirst, dryness, fatigue, perception of the experience as being unpleasant, irritability, and difficulty concentrating. Conclusion: Many of the symptoms were associated with dehydration secondary to reduced fluid intake, per the students’ reports. Specific symptoms included craving water, fatigue, and headache. All participants reported a greater understanding of thickened liquid use upon completion.
Factors Influencing the Use of Evidence-Based Practice among Physiotherapists and Occupational Therapists in Their Clinical Work
Authors: Fristedt Sofi , Areskoug Josefsson Kristina , Kammerlind Ann-Sofi
Published: September 2021

Background: Evidence-based practice (EBP) is a process through which research is applied in daily clinical practice. Occupational therapists (OTs) and physiotherapists (PTs) are expected to work in line with EBP in order to optimise health care resources. This expectation is too seldom fulfilled. Consequently, research findings may not be implemented in clinical practice in a timely manner, or at all. To remedy this situation, additional knowledge is needed regarding what factors influence the process of EBP among practitioners. The purpose of the present study was to identify factors that influence the use of EBP and the experienced effects of the use of EBP among PTs and OTs in their clinical work. Method: This was a qualitative interview study that consisted of six group interviews involving either OTs or PTs employed by the Jönköping County Council in the South of Sweden. Resulting data were analysed using content analysis. Results: The analysis resulted in the following categories: “definition of evidence and EBP”, “sources of evidence”, “barriers to acquiring evidence and to using evidence in clinical work”, “factors that facilitate the acquisition of evidence and the use of evidence in clinical work”, and “personal experiences of using EBP”. Basing clinical practice on scientific evidence evoked positive experiences, although an ambivalent view towards acting on clinical experience was evident. Participants reported that time for and increased knowledge about searching for, evaluating, and implementing EBP were needed. Conclusion: Because OTs are more oriented towards professional theories and models, and PTs are more focused on randomised controlled trials of interventions, different strategies appear to be needed to increase EBP in these two professions. Management support was considered vital to the implementation of EBP. However, the personal obligation to work in line with EBP must also be emphasised; the participants apparently underestimate its importance.
Lessons Learned from a Major Near Miss: A Case Report Including Recommendations to Improve Future Patient Safety in Rehabilitation
Authors: Van Zytveld Chelsea , Rodriguez Jennifer , Struessel Tamara
Published: September 2021

Background: Most medical errors can be traced to system failure, but often individual providers are blamed. Few articles in the allied health literature address the topic of error or the analysis of error using a system approach. Purpose: This case report analysis illustrates how both individual and system factors contribute to error in rehabilitation settings and how identification of these factors allows development of methods to improve future patient safety. Case Description: A young male was admitted to a rehabilitation hospital with residual impairments following recent surgical resection of a benign meningioma. He was treated daily by a physical therapist intern as part of a large interdisciplinary team. On separate occasions over a three week span, the patient presented with isolated calf tightness, right-sided and central chest pain, and fever with increased heart rate. Although the intern considered possible deep vein thrombosis (DVT), each symptom was attributed to other causes by the intern, supervising physical therapist, physician assistant, and/or physician (i.e. muscle fatigue, heartburn, infection). On day 22, the patient was diagnosed with DVT and pulmonary embolism (PE). This event represents a major near miss due to the potential deadly outcomes of a missed DVT/PE diagnosis. The intern retrospectively completed an analysis of the event to identify contributing system factors. Outcome of Analysis: Active failures and latent system conditions on multiple levels of the healthcare system were identified as contributors to the major near miss. Discussion: The contributing factors identified in this paper are not unique to this case, intern, or facility, and may be widespread across rehabilitation settings and practitioners. Team members can and should consider how system-wide factors contribute to their own clinical actions and decisions. Once factors are identified, strategies for reducing risk can be implemented; ultimately creating a culture of safety.
Non-Medical Use of Cognitive Enhancing Prescription Medications Among Occupational Therapy and Speech Language Pathology Health Care Students: A Pilot Study
Authors: McCombie Randy , Slanina Hannah
Published: September 2021

Purpose: This research was designed to serve as a pilot study to generate baseline data on non-medical use of prescription drugs (NMUPD) for cognitive/academic enhancement purposes among students representing two healthcare professions, Occupational Therapy (OT) and Speech Language Pathology (SLP) and to assess students’ opinions regarding whether use of these medications constitutes academic “cheating.” Introduction: NMUPD, such as Adderall ® or Ritalin ®, to reduce fatigue, improve memory, and increase concentration to ultimately improve grades has increased among college students in recent years, with estimated use put as high as 35% on some campuses. These drugs appear to be readily available to those not prescribed them, with primary sources including family, friends, and classmates. Aside from health concerns stemming from ingesting non-prescribed medications is the ethical concern whether use of such cognitive enhancers is “cheating.” Methods: Following IRB approval, 150 OT and 150 SLP students, randomly selected from membership in their respective national associations, were mailed survey packets containing a cover letter, questionnaire, and return envelope. Results: A total of 51 completed surveys, including 25 OT and 26 SLP students, were returned and included in analyses. Of these, five (9.8%) reported using cognitive enhancing prescription medications. Four of these reported having a legal prescription, including one who admitted faking symptoms of ADHD to access the prescription. The fifth student had no prescription. Motives included recreational enjoyment, to improve attention/concentration, reduce hyperactivity/impulsivity, and to obtain higher grades. Four out of ten students indicated abuse of prescription medications was a problem at their institutions, with three out of ten believing it was easy to obtain such drugs. Students were visibly divided as to whether use of these medications was academic cheating. Conclusions: The percent of these healthcare profession students reporting to have used non-prescribed medications for academic enhancement purposes mirrors that of studies on the general college student population and reflects the division as to whether use constitutes cheating. As the survey is a self-report, the numbers using the prescription medications may be higher. Results indicate future research on NMUPD among healthcare students is warranted, along with a need to educate students on the risks of use of these medications for non-prescribed purposes.
Stress Among Bachelor Physical Therapy Students in Israel during Clinical Practice and Its Association with Academic Achievements– Results of a Longitudinal Study
Authors: Jacob Tamar , Einstein Ofira
Published: September 2021

Purposes: This study aimed 1) to evaluate perceived stress of a cohort of bachelor physical therapy (PT) students from Ariel University in Israel across three clinical practice periods; 2) to evaluate the relationship between perceived stress and academic achievements; 3) to evaluate the relationship between students' perceived stress and clinical practice periods' order and content; and 4) to identify clinical and socio-demographic variables related to perceived stress. Methods: A longitudinal study was conducted among a cohort of undergraduate PT students during their first, second, and third clinical practice assignments. Data were collected using an online questionnaire. The Perceived Stress Scale 10 (PSS) and the Scale for Assessing Academic Stress (SAAS) were used to evaluate perceived stress. A ten-degree Visual Analogue Scale (VAS) was used to evaluate perceived difficulty. Students' grade point averages from the first three years of study were considered academic achievements. An ANOVA was used to evaluate the relationship between perceived stress and academic achievements, and between clinical practice order and area and the socio-demographic characteristics. Results: A total of 39 undergraduate physical therapy students participated in the study. The degrees of PSS and SAAS were higher than those reported previously in undergraduate PT students. Perceived stress was not related to academic achievement, clinical practice order or area, or to socio-demographic characteristics. Conclusions: Participation in clinical practice in general might be a stressful situation, but no specific clinical or socio-demographic factors that might be a source of higher levels of perceived stress were identified. As undergraduate students are away from the campus during clinical practice periods, it is suggested that clinical instructors, who are in daily contact with the students, should receive guidance regarding the ways to identify individuals who present signs of increased stress and the types of strategies that can help students cope with stress in real time.
Athletic Training Students' Perceptions of Electronic Textbooks and Computer use in the Classroom
Authors: Brown Christopher , David Shannon , Monaco Michele
Published: September 2021

Purpose: Academia is currently seeing a surge in technology integration in the classroom. Electronic textbooks (e-textbooks) is expected to grow exponentially in the future. Although there is a rush in use of technology in academia, few studies have evaluated perceptions of electronic textbooks especially among athletic training students. The purpose of this study is to identify athletic training student computer use, if athletic students are using electronic textbooks, and to help understand their perceptions of those electronic texts. Method: A cross sectional survey design was utilized. Participants completed a self-reported online survey. A survey link was emailed to athletic training faculty in 360 undergraduate programs to be forwarded to their students. The survey contained an informed consent item followed by 37 items (6 demographic) related to perceptions of electronic textbooks. Data analysis used descriptive statistics. Results: A total of 861 athletic training students completed the survey. When students were asked about their preference for e-textbooks or traditional textbooks, 69% prefer a traditional textbook while 22% state they had never had the opportunity to work with an e-textbook. A majority of students (96.4%) feel comfortable with computers. A large number of students (43.1%) respond they are not aware e-textbooks exist for athletic training courses. The primary reasons students prefer traditional textbooks over e-textbooks are ease of reading, followed by ease of note taking. Conclusions: The majority of athletic training students, who fall in the age range of the Millennial Generation, prefer traditional textbooks over e-textbooks. Educators should continue to utilize traditional textbooks as a primary method of learning while incorporating technology such as e-textbooks as secondary methods.
Effect of two semesters of small group problem-based learning (PBL) on expectations of physician assistant students regarding self, others, and facilitator using the PBL Readiness Questionnaire
Authors: Hawkins Susan , Hertweck Mark , Goreczny Anthony , Laird John
Published: September 2021

Purpose: The purpose of this study was to assess changes in expectations and perceptions among physician assistant (PA) program matriculants regarding small group problem-based learning (PBL) from the beginning to the end of the first didactic year. Some of the stress experienced by students entering health science professional programs using PBL may be due to lack of awareness of the goals and norms of PBL which differ from those of traditional lecture-based curricula. A change in student expectations as a result of participation in PBL would indicate that these goals and norms can be learned through participation. Methods: The authors developed the PBL Readiness Questionnaire, a 71-item 10-point Likert scale regarding student expectations of the PBL experience regarding self, others and the facilitator. Questionnaire items were developed using data from a student survey as well as literature on characteristics associated with successful performance in a PBL setting. The questionnaire was administered to 60 PA students at the beginning of the first year fall semester and again at the end of the first year spring semester. Results: Analysis revealed a significant change from pre to posttest on total score as well as on the subscales of Expectations of Self and Expectations of Facilitators. The subscale of Expectations of Others approached significance. Conclusions: The change in Expectations of Facilitator may reflect the different role of facilitator vs. lecturer. Facilitators challenge physician assistant students with questions rather than providing information. The change in Expectations of Self could indicate that physician assistant students do not have accurate expectations of their own role in this type of group setting, and the experience of participating in PBL may positively affect their expectations. An area for future study would be a psychometric analysis of the questionnaire items in order to refine the tool and ascertain the reliability and validity of items and subscales.
The Effectiveness of Equine-Based Therapy in the Treatment of Social and Behavioural Aspects of Children with Autism Spectrum Disorder: A Systematic Review
Authors: Wiese Courtney , Simpson Rebecca , Kumar Saravana
Published: September 2021

Introduction: Individuals with Autism spectrum disorder (ASD) present with impairments in social interactions, communication, restricted, repetitive and stereotyped patterns of behaviour, interests or activities. Equine-based therapy is used as a treatment with children with disabilities. There have been no systematic reviews conducted on the effectiveness of equine-based therapy in children with ASD. Purpose: To examine the effectiveness of equine-based therapy on behavioural and social interactions in the treatment of children with ASD. Methods: A systematic search of Cochrane, OT Seeker, MEDLINE, Embase, CINAHL, PsychINFO, Informit health databases and Proquest central were conducted. Studies of participants, aged 4-16 years, with professional diagnosed ASDs were included if they utilised outcome measures assessing behaviours and social interactions through questionnaire or observation. A critical appraisal, using the McMaster Critical Review Form for Quantitative Studies, was performed to assess methodological quality. NHMRC body of evidence framework was used to provide the study with an overall grade of recommendation in assessing quality of evidence. Results: Eight studies of varying research designs and methodological quality met the inclusion criteria. The participants in these studies were aged between 4-16 years of age. The duration of the inventions ranged from 6-12 weeks, and each study used varied measures of outcome. Overall, studies showed some improvements in behaviours and social interactions following an equine-based therapy intervention. Conclusions: Few studies have investigated the effect of equine therapy on behaviour and social interactions of children with ASD. The current body of evidence is constrained by small sample size, lack of comparator, crude sampling methods, and the lack of standardised outcome measures. Equine-based therapy shows potential as a treatment method for behaviours and social interactions in children with ASD.
Effectiveness of an Interprofessional Education Event for Graduate Health Professional Students
Authors: Knecht-Sabres Lisa , Gunn James , Conroy Christine , Getch Sarah , Cahill Susan , Lee Michelle , Ciancio Mae , Jaskolski Jayne , Palmisano Lisa , Kristjansdottir Kolbrun
Published: September 2021

Purpose: The purpose of this study was to investigate the impact of a single, optional, half-day, interprofessional education (IPE) event for a myriad of graduate-level health professional students (n=44) at a university in Illinois, USA. Methods: The researchers in this study examined students’ performance on two out of six of the domains on the Interprofessiomnal Collaborator Assessment Rubric (ICAR): Roles and Responsibilities and Communication Strategies. This study also investigated quantitative and qualitative findings related to student perceptions regarding this IPE opportunity. Results: Results indicated that students met or exceeded the minimum competency for the ranking of “developing” for all 6 of the behaviors evaluated. Results also revealed that this half-day extracurricuricular IPE event was viewed favorably by health-professional students and created a venue whereby students belonging to different health professional programs can enter into discussions and learn about each others’ respective roles and responsibilities in patient care. Conclusion: The creation and implementation of short term extracurricular IPE events may be a valuable alternative for healthcare programs that are unable to implement IPE activities due to some of the common barriers impacting the development, implementation, or continuation of IPE opportunities.
The Use of an Online Module to Increase Occupational Therapy Practitioners’ Evidence-based Practice Knowledge and Skills
Authors: Egan Brad , Cahill Susan , Huber-Lee Cheryl , Wallingford Minetta
Published: September 2021

Purpose: To evaluate the effectiveness of an optional, self-paced, online module to increase occupational therapy practitioners’ knowledge and skills related to evidence-based practice (EBP). Method: Participants’ EBP knowledge and skills were evaluated using the Adapted Fresno Test (AFT) after they completed the online module. Results: Twenty-nine occupational therapy practitioners (25 OTR/L, 4 COTA/L) completed the entire 17-month initiative. Nineteen practitioners (65.5%) used the supplemental online module and 10 (34.5%) did not. Analyses of AFT scores revealed a mean test score of 83.00 (n = 19, SD + 31.11) for participants who utilized the online EBP module and a mean test score of 56.20 (n = 10, SD + 36.67) for participants who did not use the module. An independent sample t test (equal variances assumed) revealed that participants who used the online module achieved statistically significantly higher scores ( p = 0.048, < 0.05) on the AFT. Discussion: The findings from this study suggest that the online EBP module was a useful support in significantly improving occupational therapy practitioners’ knowledge and skills related to evidence-based practice. Conclusions: Online modules may be an effective tool to teach practitioners about EBP. More research is needed to identify particular features of online learning modules that are the most effective in increasing practitioners’’ EBP knowledge and skills.
The Role of Rehabilitation in Cancer Treatment
Authors: Smith Jennifer
Published: September 2021

In the past, persons diagnosed with cancer were thought to need to prepare for death. Currently, the five-year survival rate for all cancers has increased to 66.2% from 2005 to 2011 as compared to 49% from 1975 to 1977. This increased survival rate can be attributed to earlier diagnosis, improved treatments, and the supportive care provided today. Cancer has become one of the most disabling and costly conditions affecting Americans today. A prevalent cause of disability and emotional distress in cancer survivors is physical dysfunction, and cancer survivors frequently report many unmet needs. This information suggests potential opportunities for rehabilitation professionals to help meet the needs of cancer patients. Rehabilitation for cancer patients may occur along the continuum of care including acute care services, inpatient rehabilitation facilities, skilled nursing facilities, home- health and outpatient therapy services. This editorial describes how rehabilitation professionals could become involved in the care of patients dealing with a diagnosis of cancer.