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Anatomy of spinal CSF loss in the American alligator (Alligator mississippiensis)
No full textA variety of anatomical techniques, imaging modalities, dyes and contrast agents, were used to document the mechanisms/routes whereby spinal cerebrospinal fluid (CSF) would move beyond the confines of the spinal dura in the American alligator, Alligator mississippiensis. Three pathways for CSF loss were identified: spinal arachnoid granulations, perineural flow along the spinal nerves, and lymphatic drainage (both along the surface of the dura and at the venous plexus surrounding the spinal ganglion). These same three pathways for spinal CSF loss have been documented in mammals, suggesting that they may be a common feature of (at least) amniotes. Crocodilians, including A. mississippiensis, have the largest epidural venous sinus system of any vertebrate, the present study suggests that, as in mammals, the venous complex of the alligator plays a direct role in regulating the absorption of CSF from the spinal compartment
Nerve Impingement
No full textThis chapter will address several nerve impingement diagnoses and related issues that the occupational therapy practitioner can address in primary care. The chapter will outline the basic role of the primary care physician, as well as the evaluation techniques and intervention strategies employed by the occupational therapy practitioner
Psychometric properties of the Arabic version of the meaningful use of speech scale (Arabic MUSS)
No full textPurpose: To examine the construct, discriminative, and predictive validity, and the test-retest reliability of the Arabic Meaningful Use of Speech Scale (MUSS). Methods: Parents of 102 children with cochlear implantation (CI) with a matching control group of 102 children with normal hearing completed the Arabic-MUSS scale. A random subsample of 30 parents was interviewed after two weeks to examine the test-retest reliability Results: the construct validity of the Arabic-MUSS was established by exploratory factor analysis that yielded a unidimensional scale and explained a total of 92.48% of the variance in the total score of the Arabic-MUSS. The internal consistency of the scale was excellent with Cronbach’s alpha = 0.975. The Arabic-MUSS discriminative validity was supported by the significant difference between the total score of children with CI and children with normal hearing (p \u3c 0.0001). The Arabic-MUSS has a moderate predictive validity as demonstrated by the moderate correlation between the total score and the time since cochlear implantation (p \u3c 0.001). The Arabic-MUSS has excellent test-retest reliability. Conclusion: The Arabic-MUSS is a valid and reliable measure that can be used to guide plans for auditory rehabilitation and monitor the progress of children with cochlear implantation over time.IMPLICATIONS FOR REHABILITATION The Arabic-Meaningful Use of Speech Scale is a valid and reliable parent-report assessment. The Arabic-Meaningful Use of Speech Scale evaluates functional speech in children with cochlear implantation. Clinicians can use the Arabic- Meaningful Use of Speech Scale to plan and monitor the progress of auditory rehabilitation programs
Student Perceptions of Learning Clinical Masking in Audiology: An Exploratory Survey Study
No full textPurpose: The audiology literature is rich with work in the area of clinical masking, yet there is a perception that learning how to mask is difficult. The purpose of this study was to explore the experiences of audiology doctoral students and recent graduates in learning clinical masking. Method: This exploratory study used a cross-sectional survey design, sampling doctor of audiology (AuD) students and recent graduates to probe the perceived effort required and challenges experienced in learning clinical masking. A total of 424 survey responses were included in the analysis. Results: A large majority of respondents rated learning clinical masking as being challenging and effortful. Responses suggested that it took more than 6 months for confidence to develop. Qualitative analysis of the open-ended question uncovered four themes: “negative experience in the classroom”; “lack of consensus or variation in teaching”; “focus on content/rules”; and “positives, internal and external.” Conclusions: Survey responses shed light on the perception that clinical masking is difficult to learn and highlight teaching and learning strategies that affect the development of this skill. Students reported a negative experience when significant emphasis was placed on formulas and theories and when encountering multiple masking methods in the clinic. On the other hand, students found clinic, simulations, lab-based classes, and some classroom instruction beneficial to learning. Students reported that their learning process included use of cheat sheets, practicing independently, and conceptualizing the process of masking to support their learning
Effect of a Wilderness Rafting Trip on Disability Identity with those who Have Physical Disabilities
Get PDFBackground: Disability identity is a concept that can occur when one focuses their identity and purpose on their disability. This can be positive or negative and have direct effects on one’s quality of life. Several studies have found that being in the wilderness has improved one’s self-perception, community, and goals for the future. This project aims to measure, after going on a 12-day rafting trip in the Grand Canyon, if there is any change on one’s disability identity, as well as to analyze accessibility for those with physical disabilities.
Method: Six participants with physical disabilities were included. All participants were Caucasian and had a college degree. Participants went on a 12-day rafting trip through the Grand Canyon. They completed a pre-trip survey one week prior to the trip, a post-trip survey one week after, a three month follow up survey, and a six month follow up survey to measure their disability identity using the Gibson Disability Identity Development Scale. Daily informal interviews were also completed to assess accessibility with this trip and wilderness.
Results: While there were trends found, the data was not statistically significant. There was a slight decrease in their scores, showing a negative shift in their disability identity immediately following the trip. However, at the three month follow up survey, all participants who completed the baseline and three-month survey showed a slight increase in their disability identity score, representing a positive shift in their disability identity. Accessibility issues included the restroom (groover), boat access, campsite mobility, and the safari chairs used on this trip.
Conclusion: Further research is warranted for individuals who are newly diagnosed or have a more negative disability identity, offering more room for progress. Combining the wilderness and occupational therapy offers the potential to improve not only functional skills but their identity and self-perception, which could contribute to a greater quality of life
Concussion History and the Emotional and Behavioral Dyscontrol Domains of Health-Related Quality of Life in College Students
No full textContext: Injury or illness can affect individual perceptions of health status and health-related quality of life (HRQOL). Concussion can result in different symptoms, impairments, and functional limitations that have been found to lower HRQOL. Furthermore, concussion is known to influence the emotional and behavioral dyscontrol domains of HRQOL in pediatric populations; however, this has yet to be explored in other populations. Objective: To compare individuals with and those without a concussion history and (1) HRQOL and (2) the emotional and behavioral dyscontrol domains of HRQOL in college students. Design: Cross-sectional study. Setting: University laboratory setting. Patients or Other Participants: Of a total of 252 participants (155 women; age = 19.95 6 1.53 years), 76 (30.2%) had a history of concussion and 176 (69.8%) did not. For participants with a history of concussion, the mean time since injury was 5.29 6 2.77 years. Main Outcome Measure(s): The Patient-Reported Outcome Measures Information System (PROMIS) Global Health, version 1.1, and Quality of Life in Neurological Disorders Emotional and Behavioral Dyscontrol Short Form (Neuro-QOL). Results: No differences were seen between median scores in individuals with and those without a history of concussion in the PROMIS Physical Health (13.0 versus 14.0; P = .24), PROMIS Mental Health (12.0 versus 12.0; P = .99), and Neuro-QOL (16.0 versus 16.0; P = .47) scores. Additionally, when gender was controlled, the associations between a history of concussion and PROMIS Physical Health score (odds ratio [OR] = 1.04; 95% CI = 0.43, 2.52), PROMIS Mental Health score (OR = 0.66; 95% CI = 0.13, 3.25), and Neuro-QOL score (OR = 1.16; 95% CI = 0.66, 2.04) were not significant. Conclusions: Preliminary findings suggested that the emotional and behavioral dyscontrol domains were not influenced by a concussion history of \u3e 1 year in college-aged participants. Future researchers should continue to explore specific HRQOL domains affected by concussion as well as the influences of prior mental health conditions and behavioral dysfunction after a subsequent injury
Concussion education perceptions among secondary school athletic trainers
No full textPurpose: Describe concussion education perceptions among secondary school athletic trainers and determine the relationship between education program characteristics and perceived effectiveness. Methods: Two hundred and three participants completed at least one survey item (age = 35.2 ± 9.4 years; male = 27.6%). We used descriptive statistics to describe concussion education characteristics and point out biserial correlations to determine if relationships existed between concussion education characteristics and perceived effectiveness. Results: The most frequently used mandated concussion education programs were informational handouts created by the state interscholastic association, the Centers for Disease Control and Prevention’s (CDC) Heads Up materials, and the National Federation of State High School Athletic Association’s materials. The CDC’s Heads Up materials, handouts created by the state interscholastic association, and in-person presentations created by respondents were the most frequent concussion educational programs utilized by respondents who indicated no specific program mandated. Educational programs that were engaging increased perceived effectiveness (n = 131, rpb = 0.31,p \u3c 0.001). Conclusions: Our results highlight that materials created by state interscholastic association and the CDC’s Heads Up program among others are utilized to satisfy mandates and are perceived to be moderately effective, especially when perceived to be engaging. These results can help guide future studies to examine specific educational tools and administration strategies to determine effectiveness on concussion disclosure
The Role of Title 1 Secondary School Athletic Trainers in the Primary and Patient-Centered Care of Low Socioeconomic Adolescents
No full textAthletic trainers (ATs) provide regular encounters with a healthcare provider for many Title 1 student–athletes with healthcare access and quality barriers. Thus, they are uniquely positioned to serve as a student–athletes’ first point of contact for general medical concerns. This study aimed to describe ATs’ experiences providing primary care for Title 1 student–athletes. This qualitative design employing an interpretative phenomenological analysis (IPA) approach used in-depth, virtual focus groups to examine the experiences of ATs practicing at Title 1 secondary schools. The findings reveal that ATs were called upon to evaluate, treat, and, when necessary, refer student–athletes with general medical conditions. However, Title 1 ATs encountered numerous complex social determinants of health (SDoH) preventing efficient and effective referral to specialty healthcare providers. Thus, ATs ultimately felt their most important roles in the primary care of low socioeconomic adolescents were as caregivers who mitigated avoidable healthcare barriers in addition to coordinators of integrated care that assisted student–athletes and their families with navigating the healthcare system. Title I ATs need to be aware of the SDoH affecting their student–athletes and the ability of those SDoH to affect health outcomes as well as overall student–athlete health and well-being
Letter to the Editor: Does Medical Students\u27 Sense of Belonging Affect Their Interest in Orthopaedic Surgery Careers? A Qualitative Investigation
No full textThe Statistical Fragility of Orbital Fractures: A Systematic Review of Randomized Controlled Trials
No full textBackground: The P value has often been used as a tool to determine the statistical significance and evaluate the statistical robustness of study findings in orthopedic literature. The purpose of this study is to apply both the fragility index (FI) and the fragility quotient (FQ) to evaluate the degree of statistical fragility in orbital fracture literature. We hypothesized that the dichotomous outcomes within the orbital fracture literature will be vulnerable to a small number of outcome event reversals and will be statistically fragile. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), the authors identified all dichotomous data for randomized controlled trials (RCTs) in orbital fracture literature and performed a PubMed search from 2000 to 2022. The FI of each outcome was calculated through the reversal of a single outcome event until significance was reversed. The FQ was calculated by dividing each FI by study sample size. The interquartile range (IQR) was also calculated for the FI and FQ. Results: Of the 3,329 studies screened, 28 met the criteria with 10 RCTs evaluating orbital fractures included for analysis. A total of 58 outcome events with 22 significant (P \u3c .05) outcomes and 36 nonsignificant (P ≥ .05) outcomes were identified. The overall FI and FQ for all 58 outcomes was 5 (IQR: 4 to 5) and 0.140 (IQR: 0.075 to 0.250), respectively. Fragility analysis of statistical significant outcomes and nonsignificant outcomes had an FI of 3.5 with no IQR and 5 (IQR 4-5), respectively. All of the studies reported a loss to follow-up data, where 20% (2) was greater than the overall FI of 5. Conclusion: The orbital fracture literature provides treatment guidance by relying on statistical significant results from RCTs. However, the RCTs in the orbital fracture peer-reviewed literature may not be statistically stable as previously thought. The sole reliance of the P value may depict misleading results. Thus, we recommend standardizing the reporting of the P value, FI, and FQ in the orbital fracture literature to aid readers in reliably drawing conclusions based on fragility outcome measures impacting clinical decision-making