bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of Heart Disease using Biomedical Data through Machine Learning Techniques
Authors: Lutimath Nagaraj M. , Sharma Neha , B K Byregowda
Published: August 2021

INTRODUCTION: Random Forests are an important model in machine learning. They are simple and very effective classification approach. The random forest identifies the most important features of a given problem.OBJECTIVES: The heart disease is cardiovascular disease, with a set of conditions affecting the heart. During heart disease, there will be heartbeat problems with congenital heart disorders and coronary artery defects. A coronary heart defect is a heart disease, which decreases the flow of blood to the heart. When the flow of blood decreases heart attack occurs. It is necessary to analyse the prediction of heart attack based on the symptoms.METHODS: The available data set of patients with heart defects symptoms is taken and analysed in this paper using the random forest and decision tree regression models. The missing data is updated using mean value of the attribute. Python language is used to predict the accuracy.RESULTS: Three performance measures are taken for analysing the available UCI Cleveland data set for heart disease. The performance measures are the Mean Absolute Error, Mean Squared Error and Root Mean Squared Error. Vital attributes of the data set are taken for analyses using the random forest regression model and decision tree regression model. The analyses shows that the slope attribute provides the better prediction for the heart disease. The results are shows that the females are more prone to heart attack.CONCLUSION: Prediction of heart disease using the UCI machine learning data set at Cleveland repository is analysed using random forest regression model and decision tree regression models. We find random forest regression model provides better accuracy than decision tree regression model.
Case Report: First Report of Disseminated Trachipleistophora hominis Infection in an AIDS Patient from Thailand
Authors: Siripaitoon Pisud , Seatamanoch Nirin , Brownell Narisa , Kongdachalert Switt , Hortiwakul Thanaporn , Phumee Atchara , Siriyasatien Padet
Published: August 2021

Microsporidial myositis caused by Trachipleistophora hominis is a life-threatening and emerging microsporidiosis among immunocompromised hosts. This article reports a case of disseminated microsporidiosis caused by T. hominis in southern Thailand. The patient had HIV and presented at the clinic with incapacitating muscle pain. She was diagnosed with disseminated microsporidiosis. Molecular identification revealed the sequence of 18S ribosomal RNA gene involving sequences sharing 99% nucleotide identity with T. hominis from an Australian patient. To our knowledge, this is the first study to report the detection of T. hominis microsporidia in an HIV patient in Thailand.
A theological assessment of clergy leadership capabilities in the Ethiopian Episcopal Church in South Africa
Authors: Dweba Zandisile M , Rashe Reuben Z
Published: August 2021

That theological training, only, may not be in itself adequate to prepare priests for their
leadership roles, is a subject which many in the church circles, prefer to avoid. Using
Mumford’s Leadership Capabilities and Osmer’s Practical Theology theories, this study sought to assess the clergy’s leadership capabilities in the Ethiopian Episcopal Church in South Africa, and to suggest solutions that could be implemented to mitigate the leadership competency gaps, should such be identified. The authors opted for a mixed-methods approach to the study, intending to first expose the respondents to information about what capabilities leaders needed to possess, to be effective. Following self-assessment, they were requested to suggest what might be done to improve their leadership capabilities and their capacity to lead the church. The most compelling findings were that the clergy largely confirmed the inadequacy of clerical training as well as their incapacity and supported the idea of additional capacitation to augment their theological training. This includes a crossdisciplinary approach to clergy development, interdenominational collaboration, formalisation of clergy development programmes and open discussions on the church’s doctrine, vision and values. The study also found sizeable support for the regulation of admission to the priesthood
and the setting of minimum entry qualifications for such admission to be effected.
Kelimpahan dan Indeks Ekologis Perifiton di Sungai Bone Kabupaten Bone Bolango Gorontalo
Authors: Kono Segita , Tiopo Ayinda Kristi , Pasisingi Nuralim , Kadim Miftahul Khair
Published: August 2021

Perifiton merupakan organisme yang hidup menempel pada substrat alam iseperti batu. Tujuan dari penelitian ini yaitu untuk mengetahui kelimpahan perifiton di Sungai Bone Kabupaten Bone Bolango. Penelitian ini dilakukan di dua stasiun yakni di Desa Panggulo Kecamatan Suwawa Timur dan Desa Tolomato Kecamatan Suwawa Tengah Kabupaten Bone Bolango. Hasil penelitian menunjukkan bahwa di Sungai Bone ditemukan 23 genus yang terdiri dari 8 kelas. Kelimpahan relatif perifiton yang tertinggi yaitu dari kelas Bacillariophyceae sebesar 33%. Indeks keanekaragaman perifiton di Stasiun 1 berkisar 1,80-1,90 dan pada Stasiun 2 berkisar 1,81-1,99. Indeks keseragaman perifiton di Stasiun 1 berkisar 0,70-0,75 dan di Stasiun 2 berkisar 0,86-0,93. Indeks dominansi hampir tidak ada individu yang mendominasi.
Potensi Karbon pada Lamun Thalassia hemprichii dan Enhalus acoroides di Perairan Pantai Waai Pulau Ambon
Authors: Tupan Charlotha Irenny , Sangur Ferdinandus , Lailossa Grasiano W
Published: August 2021

Lamun sebagai tanaman tingkat tinggi memanfaatkan karbondioksida untuk menghasilkan bahan organik dan menyimpannya dalam biomassa, sehingga tanaman ini berpotensi mengurangi pencemaran gas karbondioksida di lingkungan. Penelitian ini bertujuan untuk menganalisis cadangan dan serapan karbon dua spesies lamun di Perairan Pantai Waai, Pulau Ambon. Dua spesies lamun yang menjadi fokus penelitian adalah Thalassia hemprichii dan Enhalus acoroides yang merupakan spesies dominan pada perairan tersebut. Penelitian ini dilakukan pada bulan Juni 2019 pada dua stasiun penelitian berdasarkan perbedaan substrat yaitu Stasiun 1 mewakili substrat berlumpur, dan Stasiun 2 mewakili substrat berpasir. Analisis cadangan karbon dilakukan dengan menggunakan pendekatan analisis biomassa, yang dibedakan atas bagian di atas substrat dan bagian di bawah substrat. Analisis serapan karbon dilakukan dengan menggunakan pendekatan analisis laju produksi. Analisis kandungan karbon didasarkan pada metode Walkley and Black. Berdasarkan hasil penelitian diperoleh potensi cadangan karbon pada spesies E. acoroides berkisar antara 112,38 – 126,34 gC.m-2 dan lebih tinggi dari pada T. hemprichii yang berkisar antara 9,31 – 11,28 gC.m-2. Cadangan karbon ini lebih tinggi pada bagian bawah substrat khususnya pada bagian rhizoma yang mencapai 52% dari total cadangan karbon. Potensi penyerapan karbon juga lebih tinggi pada spesies E. acoroides yang berkisar antara 1,45 – 1,81 gC.m-2.h-1 dibandingkan T. hemprichii yang berkisar antara 0,43 – 0,54 gC.m-2.h-1. Kemampuan kedua spesies tersebut dalam menyerap dan menyimpan karbon lebih baik pada daerah substrat berlumpur didukung dengan kandungan nutrien yang cukup.
Pengaruh Penggunaan Substrat yang Berbeda Terhadap Pertumbuhan dan Kelangsungan Hidup Larva Rajungan (Portunus pelagicus)
Authors: AS Agus Putra , Mastuti Rini , Sinaga Sorbakti
Published: August 2021

Rajungan termasuk kedalam kelas Portunidae dan di beberapa negara kepiting ini terkenal sebagai komoditas ekspor.Penelitian ini dilakukan untuk menentukan substrat terbaik yang dapat meningkatkan kelangsungan hidup dan laju pertumbuhan Portunus pelagicus. Penelitian ini menggunakan rancangan acak lengkap dengan 4 perlakuan dan tiga ulangan.Perlakuan tersebut adalah: penggunaan substrat pasir (P1), lumpur (P2), kerikil (P3), dan kombinasi pasir dan kerikil (P4). Parameter yang diamati adalah tingkat kelangsungan hidup, berat dan panjang larva, rasio konversi pakan (FCR) dan kualitas air. Hasil penelitian menunjukkan bahwa tingkat kelangsungan hidup tertinggi terlihat pada P1 (33,67%), pertambahan berat dan panjang terbaik terdapat pada P1 (1,69 gr dan 0,39 cm) dan terendah pada P2 (1,54 gr dan 0,34 cm). Data menunjukkan bahwa FCR terbaik terdapat pada perlakuan P3 yaitu 3,92. Penelitian ini menunjukkan bahwa penggunaan substrat pasir memberikan pengaruh terbaik terhadap pertumbuhan dan kelangsungan hidup larva rajungan.
Pharmacy students’ experience of a novel government-funded experiential learning initiative: A mixed-method study (ACTp Study)
Authors: Jacob Sabrina Anne , Jebara Tesnime , Watson Margaret , Cunningham Scott , Power Ailsa , Boyter Anne C
Published: August 2021

Background: In 2018, the Scottish Government made the Pharmacy Additional Cost of Teaching (ACTp) funding available to support the development of Experiential Learning (EL) in undergraduate pharmacy education. To inform the further expansion of EL in the pharmacy degree evaluation of new EL sites was required.   
Aim and method: A mixed-methods study was undertaken to determine students’ perceptions of four new areas included in an EL pilot: primary care, out-of-hours, specialist sites, and remote and rural.    
Results: There were 43 survey respondents (response rate 72%). Majority agreed the pilot had developed their clinical (n=28, 74%) and communication skills (n=31, 82%), and prepared them for future practice (n=30, 79%). One third felt the EL did not permit them to interact with patients. Focus group and interview participants were positive about their experience and the opportunity to experience new pharmacy roles in non-traditional settings. Many highlighted the lack of hands-on experience and facilitator feedback. Facilitator training and quality assurance of sites are warranted.
Conclusions: Future work should focus on assessment of and feedback for students, and interprofessional opportunities within EL.
Introduction of an Emerging Technology Device Through PowerPoint® Training
Authors: Estes Rebecca , Ishee jimmy
Published: August 2021

Successful inclusion of assistive technology in intervention is limited by training and the level of comfort with technology of treating occupational therapists. Experienced and new therapists need exposure and training on high technology assistive devices newly introduced on the market. The purpose of the study was to identify the effect of a PowerPoint presentation to introduce an emerging high technology device on two groups: 30 licensed occupational therapists and 27 students in an entry level master of occupational therapy program. The PowerPoint developed introduced and educated participants on the Assistive Dining Device. Participants completed a demographic form, the Survey of Technology Use and the Quebec User Evaluation of Satisfaction with assistive Technology. Participants also to rated their satisfaction with the information presented. Results showed 98% of the participants were satisfied with the information presented and 95% of the participants were satisfied with their acquired knowledge base to recommend the device for client use. Master of occupational therapy students were similar in personal characteristics to occupational therapists but were both more satisfied with the Assistive Dining Device characteristics and had a more positive attitude toward technology. Participants who had a less positive attitude toward technology also had a slightly lower mean satisfaction with the Assistive Dining Device than those who had a more positive attitude toward technology. PowerPoint presentations appear to be one effective means of communicating information about new technologies. Further study needs to be done to evaluate the effectiveness of similar media included in packaging and marketing of assistive technology devices.
Framing a Vision for Physiotherapy Research: Synthesizing Educators' Viewpoints in Cape Town
Authors: louw Quinette , Grimmer-Somers Karen , Crous Lynette , Marais Margaret , Amosum Seyi
Published: August 2021

Purpose: The Cape Town region is the largest training locality for physiotherapy training in South Africa. The socio-political changes since the first democratic election in South Africa have impacted on physiotherapy training and clinical practice, although there currently is no evidence-based vision statement for physiotherapy practice in South Africa. This paper reports key findings from interviews held with three prominent physiotherapy educators / administrators in the three Cape Town universities' physiotherapy schools regarding their perspectives on research, clinical teaching and evidence-based practice in physiotherapy. The purpose of this research was to frame a vision for South African physiotherapy, which could underpin profession-wide discussions on equity, accessibility, safety, evidence-base and appropriate-resourced physiotherapy care for all South Africans. Method: A qualitative research design was employed and semi-structured interviews were conducted individually with 3 key participants who each have more than 10 years experience in education at the three physiotherapy tertiary training institutions in Cape Town. The questions sought perspectives on where physiotherapy research education had come from over recent times in South Africa, what contributed to its successes and failures, and what future there was for research and clinical practice in South Africa into the future. Results: The positive points about South African research were that research interest is perceived to be growing for academics and clinicians, postgraduate degrees have been introduced in all Cape Town universities. Negative points were reported included a lack of focus and direction for research and the overwhelming volume of research to be undertaken relative to the changing South African health care scene. Conclusion: The research findings highlight the need for the development of a vision that rises above individual organizations and institutions, and which takes a nation-wide view of future research and its relationship with clinical practice and community need.
Migraine and Risk of Stroke in Young Women
Authors: Nacey Theresa
Published: August 2021

Purpose: To explore the relationship between migraine and incidence of stroke in young women by analyzing variables of oral contraceptive use, hypercoagulability, cardiac abnormalities, and silent brain infarcts. Method:Variables were reviewed through computerized databases and current literature examining evidence-based medicine studies specific to analyzing the incidence of strokes in women with migraines. Results: Six recent studies, four case control and two cohort studies, were identified. Research outcomes indicate that the risk of stroke is greater in women less than 35 years of age who had migraine with aura and who used oral contraceptives. Other pathophysiologic variables, which may link migraine to stroke, include hypercoagulability, cardiac abnormalities, and silent brain infarcts. Conclusion: Young women with migraine appear to be at higher risk of ischemic stroke than women without migraine. This risk is further increased by the co-existence of other established risks including hypertension, smoking, and oral contraceptives. Patent foramen ovale, silent brain infarcts, and hypercoagulability are underlying mechanisms that appear to link migraine to stroke. Clinical studies and research into the pathophysiology of migraine is essential to explain why migraine patients are at higher risk of ischemic stroke.
The Prevalence of Incontinence Pre and Post-Lung Transplantation
Authors: White Dianne , Stiller Kathy
Published: August 2021

An increased prevalence of urinary incontinence (UI) is reported in patients with chronic lung disease because of the stress that repeated coughing places on the pelvic floor. To date, it is not known if lung transplantation (LTx) affects the prevalence of UI. Purpose: to compare the prevalence, severity and impact of urinary / faecal incontinence in adult patients pre- and post-LTx. Method: patients registered with the Royal Adelaide Hospital Lung Transplant Unit were eligible for participation. The prevalence, severity, and impact of incontinence was measured using a questionnaire administered in a private interview. Results: Ninety-four patients (44 males, 50 females; 42 pre-LTx, 52 post-LTx; mean age 46.3 years [SD 13.0]) completed the questionnaire. The prevalence of UI was significantly higher in patients pre-LTx (69.0%) than patients post-LTx (30.8%), whereas the prevalence of faecal incontinence was similar in the two groups (16.7% pre-LTx, 13.5% post-LTx). In most patients with UI, it was episodic, the amount leaked was small, it was most often associated with coughing and sneezing, and it was perceived as causing few problems. Conclusion: LTx appears to be associated with a significant decrease in the prevalence of UI.
Emotional-Social Intelligence in Health Science Students and its Relation to Leadership, Caring and Moral Judgment
Authors: Wessel Jean , Larin Helene , Benson Gerry , Brown Barbara , Ploeg Jenny , Williams Renee
Published: August 2021

The purposes of this study were to describe and compare the emotional-social intelligence (ESI) of students in nursing, physical therapy and health science programs, and to determine the relationship between ESI and each of leadership, caring and moral judgment. Subjects were 154 students from nursing, physical therapy and bachelor of health science (BHSc) programs in a Canadian university and a physical therapy program in an American college. Data were collected by means of self-report measures of ESI, leadership, caring, and moral judgment. The measures included the Bar-On Emotional Quotient Inventory Short (EQ-i:S), the Self-Assessment Leadership Inventory (SALI), the Caring Ability Inventory (CAI), the Caring Dimensions Inventory - 35 (CDI-35) [for nursing only] and the Defining Issues Test (DIT-2) [for physical therapy and BHSc only]. One-way analyses of variance (ANOVA ) revealed no differences between groups for the EQ-i:S, SALI, or DIT-2. There were significant differences for the Courage subscale of the CAI between students in the American physical therapy program and in the Canadian nursing program (p=.025). Pearson correlation coefficients were significant for EQ-i:S and each of SALI (r=.53), CAI-Knowledge (r=.59) and CAI-Courage (r=.60). The EQ-i:S scores were not related to the CDI (r=.15) or the DIT-2 (r=-.06). The results of this study confirmed the positive relationship between ESI and leadership and suggested that ESI may be an important construct in caring. There were no major differences between students in different health science programs, and ESI was not related to moral judgment.
The Language of Dyspnoea: A Systematic Review
Authors: Garrard Ashleigh , Williams Marie
Published: August 2021

Dyspnoea is an uncomfortable conscious awareness of breathing. Since the late 1980s, studies on the language used to describe the sensation of breathlessness have emerged in order to understand mechanisms and differences between chronic diseases. This systematic review aimed to consider primary studies of the language of breathlessness in order to describe the evolution of this field, methodological approaches, key findings and, identify areas which require further investigation. A systematic search process was used to identify thirty-five primary studies. This field of study has evolved rapidly over the past eighteen years. Descriptions of the sensation of breathlessness have been acquired by subjects either selecting a descriptor statement from a pre-existing list (endorsed) or describing the sensation in their own words (volunteered). Three common inventories have been used by the majority of studies to obtain qualitative descriptors of breathlessness. Studies have generally focused upon on physical descriptors of the sensation, though the need for similar studies in the affective domain has been acknowledged. Clear associations between descriptions of breathlessness and medical conditions have been reported, though consistency between studies is equivocal. Further investigations are required to confirm the consistency of the language of breathlessness within people with the same medical conditions, reliability between occasions of assessment (subject in the same state of breathlessness), consistency between recalled descriptions and reality of the experience, changes in the qualitative sensation of breathless over the natural history of chronic diseases, impact of interventions of the sensation of breathlessness, and differences between adults and children.
An Exploration of Athletic Trainers’ Perceptions of the Continuing Education Process
Authors: Walker Stacy , Pitney William , Lauber Christine , Berry David
Published: August 2021

Purpose: Many health care professionals, including athletic trainers, utilize continuing education to maintain their certification or licensure status. Little is known about the perceptions of athletic trainers toward this educational process. The purpose of this study was to explore the perceptions of athletic trainers toward the continuing education process.Method: Data were collected from 2 sources: field notes from 6 focus groups with 43 individuals, and 6 hours of transcribed audiotape recordings from focus groups. Trustworthiness was established through member checks and multiple analyst triangulations. Results: Continuing education is valued and it is believed to advance the profession of athletic training and maintain competence. Engagement in continuing education was generally based on individual learning interest and applicability of the content to their individual work setting. Lastly, athletic trainers feel they are ultimately accountable for honestly engaging in learning activities and reporting continuing education activity. Conclusion:Continuing education is valued by credential holders and is an integral part of what it means to be a professional. It can be effective as long as athletic trainers appropriately select continuing education programs and responsibly engage in learning. Knowledge that is applicable and pertains to individual work duties is perceived as more meaningful. The benefits of effective continuing education are the maintenance of competency, improved self-efficacy, and enhanced professional respect, all of which can have a positive impact on and advance the profession.
Phamacists’ Inter-Gender Differences in Behavior and Opinions: Is work Input an Important Mediator?
Authors: Carvajal Manuel , Hardigan Patrick
Published: August 2021

Objective: Identify and assess inter-gender differences in pharmacists’ behavior and perceptions while controlling for number of hours worked. Design: Every respondent is classified into two independent categories: gender and work input. Behavior and opinion variables are studied. Behavior variables measure who the pharmacist is and what he/she does; opinion variables measure perceptions related to satisfaction with his/her professional life. Setting: Survey questionnaire mailed to 5,000 registered pharmacists throughout the U.S. in 2004. Results: Compared to their male counterparts, female pharmacists are younger, possess less experience and job longevity, and earn lower levels of income and wage rates. These patterns are observed in every work-input category. Systematic variation in behavior variables by work-input category is more common within men than within women. Practitioners respond more positively toward job-specific than toward career-specific opinion variables, and this trend occurs more often for men than for women. In their general perception of pharmacy as a profession, women respond more positively than do men, but with respect to their own job situation, fewer gender disparities and more differences by work-input category are detected. As the level of work effort increases, male practitioners report less satisfaction, more appreciation, greater workload, more stress, less autonomy, and fewer advancement opportunities about their jobs, whereas women’s response is limited to heavier workloads and more stress. Conclusion: Male and female pharmacists exhibit different behavior characteristics, and these differences appear consistently in the three work-input categories. The conclusions derived from the analysis of opinion variables are less definitive, but provide a meaningful contribution towards understanding the forces shaping practitioners’ perceptions.
Measurement Error Between a Goniometer and the NIH ImageJ Program for Measuring Quadriceps Angle
Authors: Roush James , Bustillo Karen , Low Ellen
Published: August 2021

Purpose: Measurement error when determining the size of an angle is always an issue for clinicians. Computer assistance may help to decrease that error. The purpose of this study is to determine the amount of error when measuring Q-angles using a goniometer and the IMAGEJ program, a public domain program developed at the U.S. National Institutes of Health. Methods: Two investigators participated in data collection; one who is a licensed physical therapist who has over 25 years of clinical practice in orthopedic physical therapy and a second who is familiar and experienced with analyzing data using the National Institute of Health (NIH) IMAGEJ computer program. Quadriceps angles measured bilaterally for 30 subjects between the ages of 21 and 50 years were recorded. Interrater and intrarater reliability with standard error of the measurements were calculated. Results: The ICC (2,1) for measuring Q-angle with a goniometer was .96 (SEM =1.02°), while the ICC (2,1) for measuring Q-angle with the IMAGEJ program was .98 (SEM = 1.05°). The ICC (3,2) between measures obtained with a goniometer versus the IMAGEJ program was .89 (SEM = 2.06°). Conclusions: There is a high association between measures of Q-angle obtained with a goniometer compared to those obtained with computer-assistance using the IMAGEJ program. There may be a bias on the part of raters when measuring higher values of Q-angle. Further investigations should be conducted to examine the feasibility of increased use of IMAGEJ in measuring angles.
Undergoing Venipuncture in Healthcare Education: The Psycho-Biological Effect on Students
Authors: Sarid Orly , Anson Ofra , Schwartz Dagan , Yaari Arich
Published: August 2021

Venipuncture training is an integral part of healthcare educational programs. Despite its extensive use, no previous studies have evaluated the psychobiological impact of this procedure among health-care students. Participants were 26 healthy students, practicing venipuncture on each other as part of their curricular activity. Self reported pencil and paper questionnaires aimed at assessing depression, anxiety and mood states were administered before and after venipuncture and saliva sample collection. Anti heat shock protein (Hsp) 70 and cortisol levels in blood and saliva were collected from the participants. A reduction in anxiety, anger and confusion mood states took place after venipuncture. All participants had high levels of cortisol and anti-Hsp 70 in the serum and saliva. Anti-Hsp 70 and cortisol evaluated in the serum were correlated with some of the mood variables. Routine educational practices such as venipuncture elicit significant psychological stress. If confirmed by additional studies it will have a significant implication on health-care educational practices.
A Systematic Review on the Effectiveness of Mental Practice with Motor Imagery in the Neurologic Rehabilitation of Stroke Patients
Authors: Svetlana Ludmina , Dizon Janine
Published: August 2021

Background: Mental practice with motor imagery entails an individual to symbolically rehearse a physical activity within working memory in the absence of overt body movement. It has been proven to be useful in sports training and other skills training. However, much is yet to be determined if the same promising results may be gained when this training method is used with persons with brain lesions, like stroke patients. Objectives: The aim of the study is to investigate evidence for the effectiveness of mental practice with motor imagery in the neurological rehabilitation of stroke patients in improving their impairments and functional limitations, and to identify variations in mental practice protocols (duration, type of imagery employed, etc) and characteristics of participants, (age of subjects, duration of stroke prior to intervention) that may have affected the results gathered. Methods: Literature search was accomplished with electronic databases such as Science Direct, Pub Med, Proquest, MEDLINE, CINAHL, Cochrane Library for Systematic Reviews and OVID. Criteria used in selecting articles included (1) Clinical controlled trials or RCTs, (2) adult stroke patients, except with cerebellar or basal ganglia pathology, (3) intervention given was mental practice with motor imagery without external aids. Two peer reviewers individually rated the quality of each study using checklists used by JBI. Results:. A total of 7 articles were included for this systematic review after quality appraisal. This included 5 randomized controlled trials and 2 CCTs. All studies reported improvement of UE function after the intervention. Conclusion Although researches done with this intervention have yielded equivocal results, a relatively small body of evidence for mental practice with motor imagery in rehabilitation of UE of stroke patients still exists. Future studies employing quality research endeavors with research designs at the upper levels of the hierarchy of evidence are recommended to strengthen the present evidence.
Which Assessments and Interventions do Physiotherapists Value in the Management of Adults with Cystic Fibrosis in Australia?
Authors: Stiller Kathy , White Dianne , Williams Marie
Published: August 2021

Purpose: Evidence based practice involves the integration of three main components: best available research evidence, practitioner’s clinical expertise, and patient’s preferences. While the effectiveness of physiotherapy interventions for patients with cystic fibrosis (CF) has been extensively studied, no studies have explored physiotherapists’ perceptions and values concerning their management of patients with CF. The aim of this study was to document the opinions and values that CF physiotherapists in Australia have regarding their management of patients with CF. Method: A purpose-designed questionnaire addressing these issues was mailed to all 38 physiotherapists working with adults with CF on a regular/frequent basis in major Australian healthcare units. Results: Thirty-three questionnaires were returned completed (87%). Subjective history was considered by respondents as the most valuable component of assessment, with personal experience being the primary factor influencing this response. Coughing/huffing was deemed one of the most valuable airway clearance techniques across five different clinical scenarios; non-invasive ventilation, postural drainage, percussion and vibrations were perceived as valuable techniques for unwell, hospitalised patients; and exercise, positive expiratory pressure and flutter therapy/Acapella were considered valuable for out-patients. Personal experience was the factor most often influencing respondents’ opinions about treatment techniques. Conclusions: CF physiotherapists in Australia appear to mainly base their opinions about the value/usefulness of physiotherapy management of adults with CF on their past clinical experience. These data provide an initial insight into CF physiotherapists’ clinical expertise and will give CF clinicians around the world the opportunity to compare their own clinical practice with that of their Australian peers.
The Relationship between Staff Compliance with Implementing Discharge Planning Guidelines, and Stroke Patients’ Experiences Post-Discharge
Authors: Luker Julie , Grimmer-Somers Karen
Published: August 2021

Purpose: To investigate staff compliance with discharge planning clinical guideline recommendations in an acute stroke unit, and its relationship with post-discharge experiences of stroke patients and their carers. Subjects: Fifty acute stroke patients were systematically recruited for a retrospective patient record audit of staff compliance with clinical guideline recommendations related to discharge planning. Methods: Semi-structured interviews were conducted over six months post-discharge on patients’ actual community support needs and experiences. Audit and patient experience data were integrated to seek evidence of 1) characteristics of patients receiving guideline-compliant care, 2) relationships between staff compliance with discharge planning recommendations and patient’s post-discharge experiences, and 3) whether patient’s post-discharge experiences of shortfalls in support related to hospital discharge planning. Results: Not all patients received guideline-based care. There was a trend that patients with more complex strokes received guideline-compliant care than other patients. Compliance with providing an occupational therapy (OT) home assessment was significantly related to discharge directly home from hospital. There was a shortfall with 40% of patients between community supports predicted by hospital staff and actual post-discharge support requirements. Community support requirements increased over time for 32% of patients, whose six-month post-discharge needs were actually greater than their needs at six weeks. Conclusions: Staff compliance with discharge planning recommendations was variable and did not always relate to improved post-discharge patient experiences. The post-discharge experiences of many stroke patients could not have been predicted whilst they were in hospital. Discharge planning and support systems thus need to be flexible and responsive to short and long-term needs.
International Students’ Perspectives of an Introductory Course as Preparation for Entry into a Postgraduate Physiotherapy Program
Authors: Roberts Jennifer , Das Rebekah , Kumar Saravana
Published: August 2021

Purpose: Introductory or preparatory courses are often provided to international students in Australia as means to help them adjust to a new cultural and communication environment and a foreign educational setting. However, there is very little evaluation research on these introductory courses, especially from students’ perspectives, on their merits and demerits. Methods: This research utilised primary and secondary research methods. Firstly, a systematic review of the literature was undertaken to identify international students’ perspectives of education in Australia. Secondly, using qualitative and quantitative research methods, international postgraduate physiotherapy students’ perspectives of an introductory course at an Australian educational institution was identified. Results: Literature evidence from the systematic review of the literature identified that international students in Australia are confronted by a range of issues. These multidimensional issues reflect a range of concerns including those intrinsic to education itself (such as learning style, educators) as well several extrinsic issues ranging across a wide spectrum (such as cultural and social). Primary research evidence on the evaluation of an introductory course point to mixed findings. While students valued the introductory course, they also identified numerous areas for improvement. Key themes identified included repetition, workload, altering expectations, lack of learning support, and value for money. Conclusion: Findings from this research indicate that international students are confronted with numerous concerns when embarking on education in Australia. While introductory courses address some of these concerns, there are opportunities for improvement. As education moves towards a student-centred model, it is important to recognise and respond to students’ perspectives.
Measuring the Quality of Rural-Based, Government Health Care Workers in Nepal
Authors: Knoble Stephen , Pandit Anil , Koirala Bibek , Ghimire Laxmi
Published: August 2021

A representative, cross-sectional clinical skills assessment of 163 mid-level, rural-based, government health care workers was conducted in four districts of Nepal in June 2007. All Health Assistants and Auxiliary Healthcare Workers within the target districts were scored using checklists of standardized key skills in clinical encounters with model patients or clinical models. Participant scores were reported as a mean percentage in adult medicine 28(%), pediatric medicine 56(%), maternity medicine 35(%), orthopedic medicine 45(%), clinical procedures 59(%), and management 46(%). This was measured against the government’s 60(%) standard on clinical skills. There was little significant difference between categories of health workers by district of posting or years of experience. There was a minor difference in skills by level of facility - workers in higher level facilities scored better across the domains. Reasons for poor performance in clinical skills were attributed to a lack of clinical in-service training programs, training only focusing on prevention and public health, and poor on-sight supervision. Poor pre-service schooling factors included heavy theory concentration in pathophysiology and inadequate clinical exposure opportunities. Recommendations for the improvement of clinical skills and decision-making include the institution of in-service competency-based training with a high emphasis on real patient exposure. Pre-service recommendations include implementation of a national certification program and an expansion of the current government clinical training sites and clinical teacher development programs.
The Interrater Reliability of the Load and Shift Test for Anterior Shoulder Instability: A Technical Report
Authors: Kolber Morey , Carrao Melissa
Published: August 2021

Background: Shoulder disorders affect up to 67% of the adult population at some point in their lifetime. The shoulder complex ranks third, trailing low back and neck pain, in musculoskeletal disorders for which individuals seek physical rehabilitation. The assessment of shoulder stability is an integral component of the patient examination, as it may assist the clinician in making a diagnosis, measuring improvement or deterioration, and determining functional impairments. Reliable tests and measurements are therefore essential to both the clinician and researcher desiring to objectively monitor disease progression, outcomes, and mobility impairments. Many of the currently used clinical tests for anterior instability are documented based on a dichotomous outcome, thus do not provide a means of quantifying or ranking the degree of anterior translation associated with the instability. The load and shift test has been described in textbooks and research investigations as a method to quantify (rank) anterior shoulder instability and/or translation at the glenohumeral joint. This test is attractive clinically, as it requires no special equipment or space, thus may be utilized in multiple settings and without cost; however, few studies have investigated the interrater reliability of this test. Purpose: The purpose of this investigation was to determine the interrater reliability of the seated load and shift test using a 4-level grading criteria. Method: Two investigators performed the load and shift test on the non-dominant shoulder of 29 asymptomatic female participants in a repeated measures intrasession design. Each investigator was blinded to the results and the order of testing was counterbalanced to minimize potential bias. Results: Results indicated good interrater reliability with an Intraclass Correlation Coefficient (2, 1) (95% CI) = 0.80 (0.61, 0.90). Conclusion: The load and shift test appears to be a reliable clinical test for detecting and quantifying anterior translation of the glenohumeral joint when using the grading criteria outlined in this investigation. Shoulder translation when excessive is associated with shoulder instability, thus this test may prove valuable as a measurement of anterior instability. Recommendations: Future investigations are needed to determine the reliability and validity of this test among a symptomatic population and including a male cohort.
Building Pedagogical Intelligence in Allied Health: A Primer
Authors: Dewald Lori
Published: August 2021

Allied health education has changed dramatically over the last ten years with many new educational program faculty drawn to the academy. This recent academic evolution is driving the need for allied health educators to become well versed in content-specific applied pedagogy. This article will briefly explore contemporary teaching techniques relevant to today’s allied health educators and it is hoped that they will further explore these pedagogical concepts in their own classrooms and through applicable research.
O potencial do vírus da varíola como arma biológica no cenário mundial atual
Authors: CRUZ Nádia Vaez Gonçalves da , DAMASO Clarissa R
Published: August 2021

A erradicação da varíola é considerada uma das maiores conquistas da humanidade, alcançada em 1980 graças ao uso de uma das mais potentes vacinas já desenvolvidas. Porém, no cenário mundial atual,o vírus da varíolaé considerado uma ameaçaem potencial que pode ser usado comoarma biológica para fins de bioterrorismo. Avanços da biotecnologia, ausência de imunidade em grande parte da população mundial, estoques de vacinas restritos e o risco de ainda existiremestoques clandestinos do vírus são os principais motivos que possibilitariam o retorno da doença. Este éum trabalhoderevisãoque abrange vários aspectos históricos, epidemiológicose clínicosda varíola e sua erradicação, mas, principalmente, trata das medidas de contenção e prevenção contra varíolausadas no passado e disponíveis na atualidade, bem como, dos esforços a nível mundial para evitar que a varíola voltea aterrorizar novamente a humanidade.
CALENDÁRIO VACINAL DOS MILITARES DO EXÉRCITO BRASILEIRO NO BRASIL: UMA PROPOSTA DE ATUALIZAÇÃO
Authors: ALMEIDA Julianna Medeiros de , COSTA Vanessa Santos
Published: August 2021

Ao longo do tempo, os militares foram vetores e portadores de patógenos infecciosos, o que levou a muitas mortes de militares em combate por doenças infecciosas até a Segunda Guerra Mundial. Neste contexto, as vacinas começaram a ser criadas, a fim de reduzir os impactos causados por epidemias avassaladoras, como uma solução econômica para garantir que os militares permaneçam saudáveis e sempre prontos para o combate. A profissão militar é considerada de risco quando atuam em missões em regiões com riscos epidemiológicos e com possibilidades de surtos causados por doenças imunopreveníveis. Este estudo tem por objetivo apresentar uma proposta de atualização do calendário vacinal dos oficiais e praças do Exército Brasileiro, necessária para a sua atividade laboral habitual e nas missões realizadas no Brasil, identificando quais seriam as vacinas necessárias para os militares e quais não estão sendo contempladas atualmente no calendário vacinal. Realizou-se um estudo qualitativo, observacional, sobre o calendário vacinal dos militares, oficiais e praças, do Exército Brasileiro, de ambos os sexos, de 20 a 59 anos, em 2019, no Brasil. Foram utilizadas as bases de dados: US National Library of Medicine (PubMed), Scientific Eletronic Library Online (SciELO) e Google Acadêmico. Utilizou-se as palavras-chaves “Vacinas”, “Imunização”, “Militares” e “Programas de Imunização”, de forma isolada ou combinada. Utilizou-se também como base teórica os manuais, boletins e livros. Concluiu-se com este estudo que além das vacinas presentes atualmente no calendário de vacinação do militar no território nacional, outras vacinas como de Hepatite A, Varicela, Dengue e VIP deveriam ser acrescentadaspara as atividades laborais habituais. E, para as missões realizadas no Brasil, deveriam ser acrescentadas as vacinas de Raiva, Febre Tifoide, Meningocócicas B e ACWY.
SÍNDROMES DISENTÉRICAS EM OPERAÇÕES
Authors: JESUS João Gilberto de Sá de , COSTA Cláudia de Almeida Guaranha
Published: August 2021

A disenteria decorre da evolução de uma síndrome diarreica, que possui etiologia multifatorial, porém, há casos, que decorredo diagnóstico precoce falho, que geralmente é bem simples, ocasionando umtratamento tardio, propiciando que o militar tenha um quadro clínico muito mais exuberantee até mesmo grave, fazendo com queocorram várias baixas, comprometendo toda a operação. Objetivos: Estimular a realização de protocolos que propiciem umdiagnóstico eficaz, rápido, simples e precoce de militares com queixas de diarreia ou já iniciando quadro clínico de síndrome disentérica, promovendo uma triagem dos mesmos, de forma que possamos estabelecer quais poderão se manter na Linha de Contato(zona de combate) e os que deverão ser removidos/evacuados para a zona de interior(Hospitais de Campanha e Hospitais Gerais), permitindo que desta forma, um controle dos gastos médicos pela força combatente empregada. Desenvolvimento: Compreender quais são as alterações iniciais em um militar com uma queixa de diarréia, que venha procurar atendimento tanto pré, mas principalmente per teatro operacional, para que haja um tratamento precoce e eficiente para o mesmo, evitando que militaradoeça que forma que tenha deser evacuadopara escalões superioresassim como evitar que haja infecção de outros militares na área de operação, levando a importantes baixas, antes mesmo daação no objetivo. Conclusão: Promoção de palestras educativas pré operacionais sobre os sintomas para o efetivo que será empregado, ensinando para o militar na Zona de Combate medidas de autotratamento inicial sintomático, inteligência médica acerca da epidemiologia local e da higiene e ração operacional que será adotada, determinação da severidade dos sintomas, com análise simples das fezes como de sinais vitais, poderão evitar danos importantes ao erário com a saúde da força, conseguindo manter a plenitude da operacionalidade da tropa.
Live Longer, but How? Nutrition and Aging
Authors: BARCIN GÜZELDERE Hatice Kübra , AKSOY Meral
Published: August 2021

The elderly population increases and more prolonged life expectancy and increased worldwide, and with this increase, healthy aging gained importance. The increased expectancy of a longer and healthier life has created curiosity about how nutrition can be. Nutrition is one of the critical factors for healthy aging. Some diet models and diet applications (for example, calorie restriction) extend the quality and span of life. Life expectancy is longer in some places globally (Blue Zones, Hunza, Abkhazia, Vilcabamba), which is mainly linked to nutrition. Peoples who live longer eat natural foods, primarily vegetables and fruits, fish, yogurt, and drink pure water. In addition to nutritional behavior, lifestyle is essential. In the world's healthy elderly's have social, mental, and physically active life.