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Athletic Trainers\u27 Familiarity, Comfort, Knowledge, and Recognition of Social Determinants of Health
No full textContext: Social determinants of health (SDOH)-education, transportation, housing, employment, health systems and services, economic status, and physical and social environments-influence patient outcomes; therefore, athletic trainers (ATs) need to understand and address these factors. However, little is known about how ATs perceive SDOH or how knowledgeable they are about social factors that contribute to patient health and well-being. Objective: To evaluate ATs\u27 familiarity and comfort with SDOH and their perceived knowledge and recognition of SDOH. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: Our survey was distributed to 17 000 ATs; 1829 accessed it (access rate = 10.8%), and 1694 completed it (completion rate = 92.6%, AT experience = 15.2 ± 10.6 years, age = 36.6 ± 10.8 years). Main Outcome Measure(s): The survey included multipart questions that evaluated ATs\u27 perceptions of their familiarity, comfort, and knowledge about SDOH. Data were summarized using descriptive statistics. Results: Few respondents (4.1%, 70/1691) reported being extremely familiar with SDOH. Most indicated being moderately familiar (45.0%, 761/1691), minimally familiar (34.7%, 587/1691), or not familiar at all (16.1%, 273/1691). For questions about comfort, few described being extremely comfortable (3.5%, 59/1691) with SDOH, and most reported being moderately comfortable (35.4%, 598/1691), minimally comfortable (41.1%, 695/1691), or not comfortable at all (18.6%, 314/1691). For questions about knowledge, few indicated being extremely knowledgeable (2.7%, 46/1686) about SDOH, and the majority described being moderately (36.8%, 622/1686), minimally (41.8%, 704/1686), or not knowledgeable at all (18.6%, 314/1686). Over half of ATs accurately categorized 8 of the 9 SDOH listed in the survey, and 22% endorsed more correct than incorrect items. Conclusions: A majority of ATs perceived their familiarity, comfort, and knowledge about SDOH to be moderate to low, which may reflect the relatively recent emphasis on SDOH in athletic health care. Because SDOH can have a major effect on patient health and well-being, strategies should be developed for educating ATs about SDOH. Developing strategies to increase comfort with SDOH in patient care is critical to ensure that those factors that can be addressed at the patient level are identified and managed
Fragile Statistical Findings in Randomized Controlled Trials Evaluating Autograft Versus Allograft Use in Anterior Cruciate Ligament Reconstruction: A Systematic Review
No full textPurpose: To analyze the statistical stability of randomized controlled trials (RCTs) evaluating the surgical management of autografts versus allografts in the anterior cruciate ligament reconstruction (ACLR) literature and calculate the fragility index (FI) and fragility quotient and explore a subgroup analysis by calculating the proportion of outcome events where the FI was less than the number of patients lost to follow-up. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic search in the PubMed and Cochrane databases to identify RCTs published between 2000 and 2022 that investigated the use of autografts versus allografts in ACLR literature and reported dichotomous data. The fragility index of each dichotomous variable was calculated through the reversal of a single outcome event until significance was reversed. The fragility quotient was calculated by dividing each fragility index by the study sample size. The interquartile range also was calculated. Results: Of the 4407 articles screened, 23 met the search criteria, with 11 RCTs evaluating ALCR using autografts and allografts included for analysis. Two hundred and 18 outcome events with 32 significant (P \u3c .05) outcomes and 186 nonsignificant (P ≥ .05) outcomes were identified. The overall fragility index and fragility quotient for all 218 outcomes were 6 subjects (interquartile range 5-8) and 0.058 (interquartile range 0.039-0.077). Fragility analysis of statistically significant outcomes and nonsignificant outcomes had a fragility index of 3.5 (interquartile range 1-5.5) and 6 (interquartile range 5-8), respectively. All of the studies reported a loss to follow-up where 45.5% (5) reported a loss to follow-up greater or equal to 6. Conclusions: The RCTs in the ACLR peer-reviewed literature evaluating autograft versus allograft use are vulnerable to a small number of outcome event reversals and exemplify significant statistical fragility in statistically significant findings. Level of Evidence: Level I, systematic review of Level I studies
Sensory\u27s Role in the General Education Classroom
Get PDFBackground. Sensory processing significantly impacts students’ ability to learn successfully in educational environments (Little et al., 2017). Classroom sensory strategies have been shown as an effective method to regulate student’s sensory systems, promoting academic success through improved participation and attention (Dean et al., 2018). Academic faculty are the ideal candidates to provide sensory strategies to the general student population, yet these roles typically lack sensory education (Budd & Rehling, 2014). Occupational therapists are in a prime position to provide academic faculty with sensory education due to their expertise in sensory processing, their responsibility to provide professional development to educators, and their role in the general education classroom. (Budd & Rehling, 2014; AOTA, 2015).
Purpose. Measure the effects of an occupational therapist-led sensory training on understanding and confidence levels regarding sensory processing and classroom sensory strategies in academic faculty at five EdKey schools.
Methods. A quantitative pre/post-survey was developed to measure participants’ understanding and confidence levels regarding sensory processing in the classroom and classroom sensory strategies before and after receiving the training.
Results. Throughout all of the 46 survey responses, significant improvements occurred in post-survey scores.
Conclusion. The consistent improvement in pre- vs post-survey scores demonstrates that the training increased participants\u27 understanding and confidence in sensory processing and classroom sensory strategies. This improvement in scores contribute to the idea that occupational therapist-led sensory trainings are an effective method of improving academic faculty’s knowledge of sensory\u27s role in the educational environment
Mindfulness in Motherhood
Get PDFThe postpartum period is a vital healing window for new mothers who are undergoing serious physical, psychological, and hormonal changes. The current United States healthcare system fails to provide guidance and assistance for the role changes that occur in motherhood that impact daily habits, routines, and goals of women and their children. A substantial lack of education exists for healthcare professionals working with pregnant and postpartum women, by women themselves, and by society as a whole. Serious musculoskeletal, psychological, and social concerns commonly arise for many women after giving birth. The purpose of this capstone project was to attempt to fulfill the substantial gap of knowledge surrounding postpartum healing for a group of women within the capstone student’s local community YMCA. A three-phase three-part educational, mindfulness, and yoga-based class called “Mindfulness in Motherhood” was implemented in an attempt to increase education levels and awareness surrounding postpartum concerns. The student utilized pre- and post-surveys to collect data on women’s perceived levels of education before and after participating in the three-part class. The survey also inquired about their experiences as a woman giving birth and undergoing postpartum healing in the United States. The results of this capstone project confirmed what has been identified in the current literature and calls upon occupational therapists to advocate for, specialize in, and play a larger role in postpartum recovery
Orthodontic Treatments and Temporomandibular Joints: Dos and Don’ts
No full textABSTRACT For successful orthodontic treatment, it is necessary to understand what is possible and what is impossible. Since orthodontic treatment is a type of occlusal treatment, the treatment goals of aesthetics, function, and stability must be achieved based on good occlusion. Good occlusion does not mean simply the interlocking of the upper and lower teeth. For good function, a healthy condition of the temporomandibular joint must be premised. In this paper, we considered the following questions about the points to consider during orthodontic treatment to maintain a healthy temporomandibular joint. I. Is it possible to grow the mandible? II. Is it possible to put the displaced joint disc back in place? III. What can be done to create a healthy temporomandibular joint? And, we came to the following conclusion. 1. The use of the mandibular anterior positioning device (functional appliance) may temporarily promote mandibular bone formation, but in the long run, significant growth of the mandibular bone cannot be obtained, and TMD symptoms may occur in the process of positioning the mandibular forward, so care should be taken. 2. Attempts to re-position the displaced disc are generally unsuccessful due to morphological change of the disk, and can only be tried in acute lock within a week. 3. In patients with displacement of the joint disc, using stabilizing splint to form a pseudo-disc is the right treatment direction to follow to maintain a healthy temporomandibular joint. (Clin J Korean Assoc Orthod 2024;14(1):70-79
Production and comprehension of grammatical gender by Spanish heritage speakers: Evidence from accusative clitic pronouns
No full textObjectives: This study investigates (a) the accuracy of Heritage Speakers (HSs) in production and comprehension of Spanish clitic pronouns when compared to monolingual children, (b) the differences in error patterns between groups, and (c) the possible asymmetry in production and comprehension in gender clitics. Methodology: The participants included six groups, a group of Spanish-HS divided into three age groups, PreKinder, 3rd-Grade, and Adults, and a group of Spanish-monolinguals of the same ages. Agreement data were obtained using a cloze-format task for production and a picture selection task for comprehension. Data and Analysis: The results compared accuracy and response time scores between HSs and monolingual speakers, between age groups, and target gender using a 2 × 3 multivariable analysis of variance. Findings: Children in the HS-group scored lower in accuracy than the monolingual children, but Adult-HS performed at the same level as Adult-Monolinguals. HSs, but not monolinguals, overused the masculine form. Production and comprehension scores showed an asymmetrical development in which speakers are better at clitic production than comprehension. Gender clitic agreement is a difficult aspect at age 4, even in monolingual contexts. Originality: The potential contribution of this study is twofold. First, it contributes to the continuing debate on the development of HSs’ grammar by comparing comprehension and production data of monolinguals and HSs, matched for age. Second, it provides evidence of high rates of gender agreement in Adult-HSs. Significance: Grammatical gender is a vulnerable aspect of Spanish-HS grammar, but it is not an incompletely acquired representation. Results support a dissociation between production and comprehension of gender clitic
Donna Jackson-Maldonado. A life dedicated to joining theory and practice in language development research
No full textPrecedents and objectives: Dr Donna Jackson-Maldonado, researcher and professor at the Centro de Estudios Lingüísticos y Literarios of the Universidad Autónoma de Querétaro in Mexico, left us on November 30, 2021. In this article, we review her main scientific contributions related to the three fundamental axes on which she worked: language acquisition, language disorders and language assessment. Methods and results: Dr Jackson-Maldonado\u27s studies on language acquisition included groups of premature babies, late talkers, and typical development children in bilingual and diverse socioeconomic conditions. Moreover, she studied atypical language development in children with hearing loss, children with developmental language disorders and children with Down syndrome and other syndromes. Finally, regarding language assessment, it should be noted that she led the Mexican Spanish version of the Communicative Development Inventories (CDI) that was used as a model for later adaptations in other Romance languages. Discussion and conclusion: Dr Jackson-Maldonado\u27s methodological approach combined rigour with a creative and innovative scientific spirit, yet she integrated theory and clinical practice from its very beginning. She left us an immense research and personal legacy that we want to honour in this paper
GFsa (GF “Scientific Age”) Index Application for Assessment of 1020 Highly Cited Researchers in Dentistry: A Pilot Study Comparing GFsa Index and H-Index
No full textObjective: The goal of this pilot study was to present a new index system (GFsa©) based on two variables, the total citations and “scientific age”, to evaluate the best-ranked researchers in dentistry. Methods: All researchers included were cited in the AD Scientific Index (2024, dentistry field) and had their Google Scholar page accessible for a manual consultation. Two authors retrieved this information. A dataset was prepared (name, H-index, i10 index, and publications). The formula applied was GFsa = (total number of citations)/(“scientific age”)2. The Pearson correlation statistically evaluated the data obtained; the confidence interval was 95%. Results: A total of 1020 were included. The mean “scientific age” was 34.18 ± 13.34. The GFsa© index was calculated, presenting a minimum value of 0.2186 and a maximum of 154.8. The data were organized and sorted following the ranking obtained. The Pearson correlation showed that the H-index had a weakly positive association with the researcher’s “scientific age”; thus, the H-index increased according to the increase in “scientific age”. By contrast, a moderately negative correlation between GFsa and “scientific age” was demonstrated. Moreover, a positive correlation was observed between both indexes. Conclusions: The variable reported (“Scientific age”) provided a better evaluation among the researchers in dentistry
Interdisciplinary treatment of mutilated dentition and transverse maxillary deficiency with microimplant-assisted rapid palatal expansion, microimplants, and dental implants
No full textObjective: This case report demonstrates an interdisciplinary approach to treat a 26-year-old male patient with hyperdivergent Class II skeletal pattern, maxillary transverse deficiency, slight anterior open bite, and multiple hopeless teeth with root rests. Clinical Considerations: An interdisciplinary treatment was required for oral hygiene improvement, caries treatment, extraction of residual roots and hopeless teeth, maxillary expansion using microimplant-assisted rapid palatal expansion, improvement of skeletal and dental relationship using orthodontic microimplants, and prosthetic restorations with the aid of dental implants. Conclusion: Consequently, esthetic and functional occlusal rehabilitation was achieved. Clinical Significance: Hyperdivergent Class II facial and skeletal patterns with multiple missing teeth can be effectively treated using orthodontic skeletal anchorage. In young adults, the transverse discrepancy can be resolved using MARPE, which is also useful for improving the sagittal and vertical relationships. In the case of multiple missing teeth, orthodontic treatment can provide the proper space to facilitate dental implants to achieve optimal esthetics and function
Defective pgsA contributes to increased membrane fluidity and cell wall thickening in S. aureus with high-level daptomycin resistance
No full textAbstract
Daptomycin is a membrane-targeting last-resort antimicrobial therapeutic for the treatment of infections caused by methicillin- and/or vancomycin-resistant Staphylococcus aureus. In the rare event of failed daptomycin therapy, the source of resistance is often attributable to mutations directly within the membrane phospholipid biosynthetic pathway of S. aureus or in the regulatory systems that control cell envelope response and membrane homeostasis. Here we describe the structural changes to the cell envelope in a daptomycin-resistant isolate of S. aureus strain N315 that has acquired mutations in the genes most commonly reported associated with daptomycin-resistance: mprF, yycG, and pgsA. In addition to the decreased phosphatidylglycerol (PG) levels that are the hallmark of daptomycin-resistance, the mutant with high-level daptomycin resistance had increased branched-chain fatty acids (BCFAs) in its membrane lipids, increased membrane fluidity, and increased cell wall thickness. However, the successful utilization of isotope-labeled straight-chain fatty acids (SCFAs) in lipid synthesis suggested that the aberrant BCFA:SCFA ratio arose from upstream alteration in fatty acid synthesis rather than a structural preference in PgsA. RT-qPCR studies revealed that expression of pyruvate dehydrogenase (pdhB) was suppressed in the daptomycin-resistant isolate, which is known to increase BCFA levels. While complementation with an additional copy of pdhB had no effect, complementation of the pgsA mutation resulted in increased PG formation, reduction in cell wall thickness, restoration of normal BCFA levels, and increased daptomycin susceptibility. Collectively, these results demonstrate that pgsA contributes to daptomycin resistance through its influence on membrane fluidity and cell wall thickness, in addition to phosphatidylglycerol levels