Still Scholarworks (A.T. Still University)
Not a member yet
2228 research outputs found
Sort by
Maximizing Clinical Skills Training in Physician Assistant Education: Integrating Simulation-Based Learning to Enhance Clinical Proficiency, Confidence, and Team-Based Care
No full textNo abstract availabl
Mannosylated preactivated hyaluronic acid-based nanostructures for bacterial infection treatment
No full textSalmonella Typhi is an intracellular bacterium causing a variety of enteric diseases, being typhoid fever the most common. Current modalities for treating S. typhi infection are subjected to multi-drug resistance. Herein, a novel macrophage targeting approach was developed via coating bioinspired mannosylated preactivated hyaluronic acid (Man-PTHA) ligands on a self-nanoemulsifying drug delivery system (SNEDDS) loaded with the anti-bacterial drug ciprofloxacin (CIP). The shake flask method was used to determine the drug solubility in the different excipients (oil, surfactants and co-surfactants). Man-PTHA were characterized by physicochemical, in vitro, and in vivo parameters. The mean droplet size was 257 nm, with a PDI of 0.37 and zeta potential of −15 mV. In 72 h, 85 % of the drug was released in a sustained manner, and the entrapment efficiency was 95 %. Outstanding biocompatibility, mucoadhesion, muco-penetration, anti-bacterial action and hemocompatibility were observed. Intra-macrophage survival of S. typhi was minimal (1 %) with maximum nanoparticle uptake, as shown by their higher fluorescence intensity. Serum biochemistry evaluation showed no significant changes or toxicity, and histopathological evaluation confirmed the entero-protective nature of the bioinspired polymers. Overall, results confirm that Man-PTHA SNEDDS can be employed as novel and effective delivery systems for the therapeutic management of S. typhi infection
Athletic Trainers’ Perceptions of Their Scope of Practice
No full textAll athletic trainers (ATs) must meet regulatory standards as outlined in state practice acts. While state practice acts are similar, some variations can lead to misunderstanding or unfamiliarity with appropriate scopes of practice. We aimed to describe ATs’ perceptions regarding athletic training scope of practice. Only 29.7% of respondents correctly identified state government as the agency that defines athletic training scope of practice and 51.7% agreed their respective state practice act limits the skills they can perform. To advocate for the profession, ATs must have a primary understanding of the laws and regulations that promote ATs to work at their fullest ability
Utility of a Clinical Prediction Tool for Persisting Postconcussive Symptoms in a Multicenter Sample of Youth Athletes With Concussion: The Sport Concussion Outcomes in Pediatrics (SCOPE) Study
No full textBackground: A validated clinical risk tool has been developed to identify pediatric and adolescent patients at risk of developing persisting symptoms after concussion, but has not been prospectively investigated within a sample of athletes seen after concussion by primary care sports medicine physicians and/or athletic trainers. Purpose: To determine whether a validated clinical risk prediction tool for persistent postconcussive symptoms (PPCSs) predicted which patients would develop PPCSs when obtained within 14 days of concussion among a multicenter sample of adolescent athletes. Study Design: Cohort study; Level of evidence, 2. Methods: Pediatric and adolescent patients (8-18 years of age) from 7 pediatric medical centers and 6 secondary school athletic training facilities who were diagnosed with a concussion and presented ≤14 days after concussion were enrolled as part of the Sport Concussion Outcomes in Pediatrics (SCOPE) study during their initial visit and were followed until symptom resolution. Clinical risk scores (Predicting and Preventing Post-concussive Problems in Pediatrics [5P]) and total symptom severity were obtained using the Post-Concussion Symptom Inventory at the initial visit (mean, 4.9 ± 2.9 days after concussion). Participants were then compared based on symptom resolution time: PPCS group (≥28 days to symptom resolution) and no-PPCS group (\u3c28 days). The authors assessed the odds of developing PPCSs based on the 5P risk score using a binary logistic regression model and the utility of the clinical risk prediction tool to identify total time to symptom resolution using a Cox proportional hazards model. Results: A total of 184 participants enrolled, underwent initial evaluation, and were followed until symptom resolution (mean age, 15.2 ± 2.1 years; 35% female). The mean time to symptom resolution across the entire sample was 17.6 ± 3.7 days; 16% (n = 30) of participants developed PPCS. Those in the PPCS group had significantly greater mean initial total 5P risk scores than those in the no-PPCS group (7.9 ± 1.7 vs 5.9 ± 2.3, respectively; P \u3c.001). After adjustment for initial symptom severity, time to assessment, and assessment setting, a higher initial total 5P risk score was associated with a significantly greater odds of developing PPCSs (adjusted odds ratio, 1.49; 95% CI, 1.07-2.08; P =.019). Furthermore, a higher 5P risk score was significantly associated with longer total symptom resolution time (hazard ratio, 0.80; 95% CI, 0.74-0.88; P \u3c.001). Conclusion: In a multicenter sample of youth athletes seen in different outpatient health care settings, the 5P risk score accurately predicted which athletes may be at risk for developing PPCSs
Patient-Reported Outcomes at Return to Sport After Lateral Ankle Sprain Injuries: A Report From the Athletic Training Practice-Based Research Network
No full textContext: Limited evidence exists regarding the assessment of single-item patient-reported outcomes when patients are medically cleared to return to sport after a lateral ankle sprain (LAS) injury. Objective: To evaluate self-reports of improvement in health status, pain, function, and disability at return to sport after an LAS. Design: Descriptive study. Setting: Sixty-nine athletic training facilities across 24 states. Patients or Other Participants: A total of 637 patients (males ¼ 53.2%) who were diagnosed with an LAS, restricted from sport after injury, and subsequently medically cleared to return to sport within 60 days were included. Main Outcome Measure(s): Descriptive statistics were used to summarize scores for health status (Global Rating of Change), pain (Numeric Pain Rating Scale), function (Global Rating of Function), and disability (Global Rating of Disability). Mann-Whitney U tests were used to compare score differences between sexes. A Kaplan-Meier analysis was performed to provide a visual depiction of sex differences in the time to return to sport. Results: Most patients sustained an LAS injury while participating in basketball, football, or soccer and were cleared to return to sport 8 days after injury. More than two-thirds of patients reported a meaningful improvement in health status between the time of injury and return to sport. However, many noted deficits related to pain (65.1%), function (86.2%), or disability (35.8%) at return to sport. No differences were seen between males and females for pain (P ¼ .90), function (P ¼ .68), change in health status (P ¼ .45), or disability (P ¼ .21) at return to sport, although males returned to sport slightly sooner than females (P ¼ .025). Conclusions: Despite self-perceived improvements in health status since the time of injury, patients typically returned to sport with deficits in pain, function, and disability after an LAS. Patients may be returning to unrestricted sport participation before they feel their bodies have fully recovered from the injury
Tendinopathies
No full textThis chapter will address various tendinopathies and the 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
The Trainee Perspective on Getting Started With Scholarship in Graduate Medical Education
No full textThe use of artificial intelligence and game-based learning in removable partial denture design: a comparative study
No full textPurpose
The purpose of this study was to compare student performance in removable partial denture (RPD) design during a pre-clinical RPD course with and without using a recently developed computer software named AiDental. Additionally, student perceptions associated with the use of this software were assessed. Methods
The AiDental software consists of a learning environment containing an RPD design system that automatically designs RPDs based on the user\u27s input. The software also contains an RPD game component that compares the user\u27s RPD Design to an automatically generated RPD ideal design. The study was conducted in two phases. In phase one, pre-clinical second-year dental students who participated in the study were randomly divided into two groups: The AiDental group with AiDental software access (n = 36), and the conventional group without software access (n = 37). Both groups received conventional RPD instruction and practice, however, the AiDental group had additional access to the AiDental software. After 2 weeks, both groups took a mock practical test, which was collected and graded by the principal investigator (PI). The PI was blinded from group assignment and no identifying information was used in the mock practical. In phase two, all students were granted access to the AiDental software for the remainder of the pre-clinical course duration. At the conclusion of the course, all students were given a survey to evaluate their perceptions of the AiDental software. Descriptive statistics were calculated and analyzed. Variables related to perceptions of both the AiDental designer and game were assessed using Spearman\u27s rank correlation test, the chi-square test, Fisher\u27s exact test, and the non-parametric Wilcoxon rank-sum test as appropriate. In addition, a thematic analysis of the responses to the optional comments section was conducted using the Braun and Clarke method. Results
Phase one results showed that subjects in the AiDental group were more likely than subjects in the conventional group to receive a final grade of A or B. Phase two results showed generally favorable student perceptions towards the software, and additionally, the results showed that age was significantly negatively correlated with ease of use of the software, improving decision-making, and critical thinking relative to RPD design choices. However, no correlation between age and using the software as a reference were noted. Conclusions
The use of AiDental\u27s automated feedback and gamification techniques in RPD education had a positive effect on student grades and it was well-liked by students. Thus, the results suggest that AiDental has the potential to be a useful adjunct to pre-clinical teaching
Effect of the COVID-19 pandemic on racial disparities in neuraxial labor analgesia at a Texas level IV maternal care center
No full textWe hypothesized that racial disparities in labor epidural analgesia at our hospital that existed prior to the COVID-19 pandemic would be exacerbated during the COVID-19 pandemic. We examined patients who delivered vaginally at our hospital for the last 6 months of 2019 and the last 6 months of 2020. We performed joint testing of coefficient P values, and the interaction term between race and year of delivery was not significant (0.364). A multivariate logistic regression model found that Hispanic patients (odds ratio 0.555 [0.408, 0.756], P \u3c 0.001) and Black or African American patients (odds ratio 0.613 [0.408, 0.921], P = 0.018) were less likely to receive labor epidural analgesia compared to White or Caucasian patients. Odds ratios of receiving labor epidural analgesia were higher with increasing gestational age (1.116 [1.067, 1.168], P \u3c 0.001) and lower with increasing parity (0.789 [0.719, 0.867], P \u3c 0.001). The year of birth that corresponded to before or during the COVID-19 pandemic did not predict whether a patient received labor epidural analgesia (1.247 [0.941, 1.652], P = 0.124). Because the interaction between race and year of birth was not statistically significant, we conclude that the COVID-19 pandemic did not exacerbate racial disparities in labor epidural analgesia at our hospital