2313 research outputs found
Sort by
Telehealth and Physical Therapy Clinical Decision Making in a Patient with a Falcine Meningioma
Full text linkTelehealth utilizes information technologies and communication networks to deliver healthcare and education with lower costs and improved access, quality, and efficiency of healthcare services. This report describes the application of telehealth for medical screening, clinical decision making, and medical referral in a physical therapy practice. The patient described was a 50-year old man who contacted his physical therapist via telephone for a chief complaint of worsening left sided numbness and tingling that began insidiously 2 days prior. Further questioning revealed that the patient also complained of left ankle weakness, and slight unsteadiness with walking. He had not been feeling well and had been experiencing increasing bouts of unexplained fatigue over the previous two months that were now interfering with his work and recreational activities. The patient was evaluated by his physician the next day. Magnetic resonance imaging of the brain revealed a large (4 cm) falcine meningioma in the right parietal region. The patient was immediately referred to a neurosurgeon and underwent a craniotomy and tumor resection ten days later and subsequent gamma knife radiosurgery of the residual tumor bed two months after craniotomy and tumor resection. Follow-up imaging one year later revealed no evidence of recurrence or residual tumor. This patient case underscores the importance of recognizing signs and symptoms of serious disease, and how referral following telehealth via telephone can inform diagnosis
A Heartbeat Away: Popular Culture’s Role in Teaching Presidential Succession
Full text linkThe role of popular culture in civic education is important. Many television viewers learn about the American political process through various dramatized depictions. The 25th Amendment has often received much attention from Hollywood, as it provides writers, directors, and producers a tool with which to further dramatize presidential succession. Through the television shows West Wing, Designated Survivor, Commander in Chief, Madam Secretary, and Political Animals, viewers are exposed to storylines revolving around the 25th Amendment. By viewing these dramatized versions of presidential succession, viewers are better able to understand the process and political science instructors are better able to elucidate the process in the classroom
The Role of Financial Strain in College Students’ Work Hours, Sleep, and Mental Health
Full text linkObjective: To examine poor sleep quality as a potential mediator between college students’ employment hours and depressive symptoms, and to examine if this mediation model might differ across students reporting different levels of financial strain.
Participants: The sample was collected through a multi-site study during the Spring of 2019 and included 792 undergraduates (M = 20.1, SD = 1.9) in Upstate New York.
Methods: Moderated mediation analyses based on cross-sectional self-report, online questionnaires.
Results: Increased work hours predicted greater sleep disturbance, which, in turn, predicted more depressive symptoms. Compared to students in more comfortable financial situations, this mediation model only emerged for students reporting more financial strain and lower family socio-economic status.
Conclusions: Student employment hours are a significant predictor of students’ mental well-being when considering their potential impact on their sleep. Furthermore, students reporting higher levels of financial stress are most at risk of being impacted by this process
Sedentary Behavior and the Use of Wearable Technology: An Editorial
Full text linkGlobally, we continue to face a mounting issue of obesity combined with inactivity; sedentary behaviour is independently associated with poor health outcomes including disease and mortality. As such, exploring ways to try to reduce sedentary behaviour and decrease the risk of diseases is an important area of consideration. The role of wearable technology, such as fitness trackers, to encourage and subsequently increase physical activity is relatively well documented. These devices have been successful at encouraging populations to increase daily activity levels. While time being sedentary is often correlated with physical activity participation, this is not always the case. Therefore, it may be just as important to consider the activity an individual is not doing when evaluating health and well-being. This Editorial will summarize the importance of distinguishing between physical activity and sedentary behaviour. It will also discuss how wearable technology, in the form of fitness trackers, may be used to encourage someone to break up sedentary bouts more often. Finally, we will consider important future research directions
A Curriculum/behavioral/assessment Framework for Promoting Highly Effective Instruction in Special Education
No full textIs It Time for New York State to Revise Its Village Incorporation Laws? A Background Report on Village Incorporation in New York State
Full text linkOver the past several years, New York State has taken considerable steps to eliminate or reduce the number of local governments — streamlining the law to make it easier for citizens to undertake the process as well as providing financial incentives for communities that undertake consolidations and shared services. Since 2010, the residents of 42 villages have voted on the question of whether to dissolve their village government. This average of 4.7 dissolution votes per year is an increase over the .79 a-year-average in the years 1972-2010. The growing number of villages considering dissolution is attributable to the combined influence of declining populations, growing property tax burdens, and the passage of the New N.Y. Government Reorganization and Citizen Empowerment Act (herein after the Empowerment Act), effective in March 2019, which revised procedures to make it easier for citizens to place dissolution and consolidation on the ballot. While the number of communities considering and voting on dissolution has increased, the rate at which dissolutions have been approved by the voters has declined. That is, 60 percent of proposed village dissolutions bought under the provisions of the Empowerment Act have been rejected at referendum (see Dissolving Village Government in New York State: A Symbol of a Community in Decline or Government Modernization?)
While the Empowerment Act revised the processes for citizen-initiated dissolutions and consolidations, it left the provisions for the incorporation of new villages unchanged. Thus, even as the state has created pressure on and increased incentives for residents to reduce the number of local governments, new villages continue to be created. Moreover, recent village incorporation efforts have been particularly contentious. This report highlights several recent village incorporation controversies, reviews the history of village incorporation patterns and procedures, and compares the incorporation provisions of New York relative to those of other states to ask whether the current state laws governing village incorporation are adequate to addressing the increasingly complex questions which surround local government formation and dissolution. The report concludes that it is time for New York’s legislature to look to other states for prospective models that would modernize the municipal incorporation process
Functional Performance and Discharge Setting Predict Outcomes 3 Months After Rehabilitation Hospitalization for Stroke
No full textBackground: Some clinical features of patients after stroke may be modifiable and used to predict outcomes. Identifying these features may allow for refining plans of care and informing estimates of posthospital service needs. The purpose of this study was to identify key factors that predict functional independence and living setting 3 months after rehabilitation hospital discharge by using a large comprehensive national data set of patients with stroke.
Methods: The Uniform Data System for Medical Rehabilitation was queried for the records of patients with a diagnosis of stroke who were hospitalized for inpatient rehabilitation from 2005 through 2007. The system includes demographic, administrative, and clinical variables collected at rehabilitation admission, discharge, and 3-month follow-up. Primary outcome measures were the Functional Independence Measure score and living setting 3 months after rehabilitation hospital discharge.
Results: The sample included 16,346 patients (80% white; 50% women; mean [SD] age, 70.3 [13.1] years; 97% ischemic stroke). The strongest predictors of Functional Independence Measure score and living setting at 3 months were those same factors at rehabilitation discharge, despite considering multiple other predictor variables including age, lesion laterality, initial neurologic impairment, and stroke-related comorbid conditions.
Conclusions: These data can inform clinicians, patients with stroke, and their families about what to expect in the months after hospital discharge. The predictive power of these factors, however, was modest, indicating that other factors may influence postacute outcomes. Future predictive modeling may benefit from the inclusion of educational status, socioeconomic factors, and brain imaging to improve predictive power
Association of Functional Screening Tests and Noncontact Injuries in Division I Women Student-Athletes
No full textTo determine the association between functional screening tests and lower-body, noncontact injuries in Division I women basketball, soccer, and volleyball student-athletes (SA). Sixty-eight injury-free women SA (age: 19.1 ± 1.1 years, height: 171.3 ± 8.7 cm, and mass: 68.4 ± 9.5 kg) were tested preseason with single hop (SH), triple hop (TH), and crossover hop (XH) for distance, and isometric hip strength (abduction, extension, and external rotation) in randomized order. The first lower-body (spine and lower extremity), noncontact injury requiring intervention by the athletic trainer was abstracted from the electronic medical record. Receiver operating characteristic and area under the curve (AUC) were calculated to determine cut-points for each hopping test from the absolute value of between-limb difference. Body mass–adjusted strength was categorized into tertiles. Logistic regression determined the odds of injury with each functional screening test using the hopping tests cut-points and strength categories, adjusting for previous injury. Fifty-two SA were injured during the sport season. The cut-point for SH was 4 cm (sensitivity = 0.77, specificity = 0.43, and AUC = 0.53), and for TH and XH was 12 cm (sensitivity = 0.75 and 0.67, specificity = 0.71 and 0.57, AUC = 0.59 and 0.41, respectively). A statistically significant association with TH and injuries (adjusted odds ratio = 6.50 [95% confidence interval: 1.69–25.04]) was found. No significant overall association was found with SH or XH, nor with the strength tests. Using a clinically relevant injury definition, the TH showed the strongest predictive ability for noncontact injuries. This hopping test may be a clinically useful tool to help identify increased risk of injury in women SA participating in high-risk sports
Psychological Flexibility and Inflexibility as Sources of Resiliency and Risk During a Pandemic: Modeling the Cascade of COVID-19 Stress on Family Systems with a Contextual Behavioral Science Lens
No full textBackground The coronavirus disease (COVID-19) pandemic and the historic economic shutdown and stay-at-home efforts to slow its spread have radically impacted the lives of families across the world, completely disrupting routines and challenging them to adjust to new health risks as well as to new work and family demands. The current study applied a contextual behavioral science lens to the spillover hypothesis of Family Systems Theory to develop a multi-stage mechanistic model for how COVID-19 stress could impact family and child functioning and how parents’ psychological flexibility could shape those processes. Methods A total of 742 coparents (71% female; 84% Caucasian, 85% married, M = 41 years old) of children (ages 5–18, M = 9.4 years old, 50% male) completed an online survey from March 27th to the end of April 2020. Results Path analyses highlighted robust links from parent inflexibility to all components of the model, predicting: greater COVID-19 stress, greater coparenting discord and family discord, greater caustic parenting, and greater parent and child distress. Parent flexibility was associated with greater family cohesion, lower family discord and greater use of constructive parenting strategies (inductive, democratic/autonomy supportive, positive). Results further suggested that COVID-19 stressors predicted greater family and coparent discord, which in turn predicted greater use of caustic parenting (reactive, inconsistent, aggressive), which in turn predicted greater child and parent distress. Conclusions The current results highlight parental flexibility and inflexibility as key points of intervention for helping families navigate the current global health crisis, highlighting the crucial role they play in the lives of families
Barriers and Facilitators of the Medication Reconciliation Process Among Nurse Practitioners
No full textMedication reconciliations are utilized during most healthcare encounters. The process of the medication reconciliation in regards to safety must begin with an accurate understanding of the medications that patients are taking. Completing the medication reconciliation can be timely and extremely complicated. There are a multitude of factors that can inhibit the reconciliation from being accurately completed in its entirety. Design: The purpose of this phase 1 action research study was to identify perceived barriers and facilitators of completing the medication reconciliation process among nurse practitioners. A review of the literature related to the medication reconciliation process was conducted to identify current knowledge. Purposive samples of three nurse practitioners who complete the medication reconciliation process were interviewed at a primary care community health center located in Western New York. Participation was voluntary and confidential. Conclusions: Barriers found included lack of time, lack of patient knowledge regarding medication regime, and lack of universal medical record access. Facilitators found included patient compliance, and the use of electronic medical records. A phase 1 action plan was established utilizing the literature, facilitators and recommendations provided by the participants. Lastly, implications and recommendations for further research were discussed