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Interview with Dr. Miguel La Serna
No full textCENFAD community interview with Dr. Miguel La Serna, Professor of History at the University of North Carolina at Chapel Hill, concerning his book With Masses and Arms: Peru\u27s Tupac Amaru Revolutionary Movement (UNC Press, 2020
Pelvic Floor Therapy for Athletes with Urinary Incontinence: A Critically Appraised Topic
No full textExercise and sports put a strain on the pelvic floor muscles, causing many women to experience Urinary Incontinence (UI) or pain during activity. It has been reported that up to 75% of athletes experience urine loss while participating in sport and it is purported that pelvic floor therapy may decrease incidence of UI. Clinical questions: “In female athletes with UI, does pelvic floor therapy decrease incidence of urinary leakage?”Pubmed, Cochrane, and Google Scholar were searched in June of 2021 using the Boolean phrases: Pelvic floor therapy AND athletes, Pelvic Floor OR urinary incontinence AND athletes, stress incontinence AND athletes, Pelvic floor muscle training AND athletes, Pelvic floor AND physically active, Pelvic Floor therapy, Pelvic floor muscle training. Internal and external validity were assessed using the STROBE checklist for cohort studies and the Center for Evidence Based Management (CEBM) critical appraisal of randomized control trials and the CASP for case control studies.Study Titles were reviewed for relevance, then abstract, and full text. Articles were included based on their ability to answer the research question and matching clinical outcome measure. Only studies from the past 7 years were considered. The search initially resulted in 1,460 articles, all but 15 were excluded based on title and study type. Of the 15 screened, 2 were included for analysis. In both studies, UI was assessed using the Pad test to measure urinary leakage. In one study using the pad test (Ferreira et al), female athletes were randomly assigned to control or experimental (pelvic floor muscle rehabilitation program) group. UI decreased by 45.5% in the experimental group vs 4.9% in the control. In another study using the pad test (Pires et al), athletes were randomly assigned to an at-home pelvic floor muscle training group or control group. There was a significant reduction in the mean leakage for the experimental group between initial (1.83 ± 2.40) and funal phases (2.00 0 ± 1.67). The percentage of urine loss decreased in EG to 42.9% (n = 3) and increased in CG to 83.3% (n = 5). One study scored 9/10 on the CASP and one scored 3/3 on CEBM.There is consistent evidence that pelvic floor therapy is beneficial in decreasing urinary incontinence in athletes. This is reliant on the ability to target the correct muscles to build awareness of proper muscle contraction and adherence to the exercise protocol. UI is common in athletes, particularly females participating in high impact sports. Pelvic floor therapy protocols should be developed and available for high impact sport athletes to mitigate the occurrence of urinary incontinence during sport. SORT B
Anti-racism training for healthcare professionals: A critically appraised topic
No full textContext There is documented presence of racism in health care, resulting in negative health outcomes for minoritized people. While there is a focus on anti-racism and anti-bias training for providers, it is unknown whether these programs are beneficial. Therefore, the clinical question is “Does anti-racism training increase knowledge of racism in health care professionals? “ Methods PubMed was searched in July of 2021 using a specific Boolean phrase of (racism*[tiab] OR "anti racism"[tiab] OR "racism"[MeSH Terms]) AND (train*[tiab] OR educat*[tiab]) AND (("health personnel"[MeSH Terms] OR ("health*"[All Fields] AND "personnel"[All Fields]) OR "health personnel"[All Fields] OR ("healthcare"[All Fields] AND "professional"[All Fields]) OR "healthcare professional*"[tiab] OR "healthcare provider*"[tiab] OR physician*[tiab] OR "athletic trainer*"[tiab] OR "physical therapist*" OR dentist*[tiab] OR "dental hygienist*"[tiab] OR doctor*[tiab] OR "medical professional*"[tiab] OR "medical provider*"[tiab] OR nurs*[tiab] OR "physician assistant*"[tiab])). For inclusion, a study had healthcare professionals who completed anti-racism training and self-assessment surveys providing measurable outcomes. Only articles from the previous 5 years were considered. Titles were reviewed for relevance, followed by abstract and full text, when needed. The STROBE checklist for cross-sectional studies was used for appraisal. Results The search yielded 274 articles. Of those, 259 were eliminated based on title and 12 were eliminated based on reading the full text. 3 were selected for inclusion. The first study utilized a clinical workshop developed to decrease the likelihood of clinicians expressing bias and stereotypes in interactions with patients of color. The average Likert scale for survey items included 4.8/5 for “information relevance and delivery”, 4.8 for “introduction to culture”, and 4.7/5 for “introduction to communication”. In the second study, cultural awareness training was aimed at increasing clinicians’ ability to provide culturally safe care using authentic personal stories. The average percentage of improvement was 27% for “attitude toward minorities”, 23.8% for “Inclusion of other in self”, and 23.8% for “interaction closeness.” The third study deployed an 8-hour training adapted to an online setting. Results demonstrated scores of 4.5/5 for “found training valuable”, 4.3/5 for “training will improve clinical care”, and 3.9/5 for “ability to create inclusive environment post-training”. The STROBE scores for these articles were 18/22, 20/22, and 21/22. Conclusion There is consistent self-reported evidence that anti-racism training is beneficial to clinicians. It is important to note that these studies were only conducted on the provider side, there is a need for information collected from the patient’s experience post-training. Due to the consistent, limited quality of evidence, a SORT score of B is recommended
