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Screening for Post-Stroke Visual Impairment: Implications for Occupational Therapy Practice
Get PDFThe prevalence of post-stroke visual impairment is alarmingly high, with estimates of up to two-thirds of stroke survivors experiencing deficits (Rowe, Hepworth, Howard et al., 2019). However, research indicates that greater than 60% of visual acuity deficits and visual-spatial neglect in patients with stroke are undetected by standard clinical practice (Edwards et al., 2006). Thus, many patients with stroke have clinically significant visual impairments that are not being detected, and therefore, are not being adequately addressed. Visual impairments can substantially influence an individual\u27s everyday functioning, safety, social interaction, and quality of life. Without skilled intervention and support, individuals experiencing these deficits may develop reduced self-efficacy, social isolation, and occupational deprivation (Perea et al., 2018).
The aim of this thesis is to spread awareness of the high prevalence and underdiagnosis of post-stroke visual impairment, educate current and future occupational therapy practitioners on recommendations to reduce heterogeneity in assessment practices, and advocate for the role of occupational therapy in improving detection of post-stroke visual impairment to optimize the functional recovery and quality of life of stroke survivors. This knowledge was disseminated in three ways. The first method was to educate occupational therapy practitioners and students via a Minnesota Occupational Therapy Association virtual continuing education session. The second method was to inform readers of the American Occupational Therapy Association’s Rehabilitation and Disability Special Interest Section Quarterly Practice Connection through an article submitted for publication. The final method was to raise awareness and educate occupational therapy practitioners, students, and educators attending the 2021 Iowa Occupational Therapy Association annual conference by presenting a poster.
Completion of these three knowledge translation projects generated awareness and greater understanding of the factors resulting in the underdiagnosis of post-stroke visual impairment and affirmed occupational therapy’s role in screening for visual impairments poststroke. However, there is need for continued education aimed at improving knowledge and awareness of the visual problems that can occur after stroke amongst occupational therapists, other members of the stroke care team, and the general public. Furthermore, now that core outcome sets for vision screening and full vision assessment have been developed to assist in reducing the heterogeneity in assessment practices, efforts to disseminate this information to clinicians and researchers involved in screening and assessment of post-stroke visual impairment should be prioritized. Future research should evaluate the use of these outcome sets and attempt to achieve consensus on how the outcomes should be measured
The Impact of Writing Strategies on Student Proficiency and Confidence Levels in an Advanced Placement Human Geography Course
Get PDFThis action research project investigated the impacts of writing strategy instruction on proficiency and confidence levels of students in an Advanced Placement (AP) Human Geography course. Participants included forty-eight 10th to 12th-grade AP Human Geography students in a rural, midwestern high school. Students utilized collaboration, peer feedback, and organizational tools. In the midst of teaching during various learning models (online, hybrid, and face-to-face) due to the COVID-19 pandemic, data was collected using a pre- and post-assessment, and questionnaires to gauge student confidence levels and writing proficiency. In addition, the researcher gathered observations, student feedback, and sample student responses. The data collected showed inconclusive results with regard to improving student writing proficiency. However, 60% of the students reported an increase in their overall confidence level. The data collected suggests that further research is needed and would benefit from being collected during a traditional school year when the education system is not responding to a global health crisis
The Effects of Reading Strategies on EL Students while Transitioning into a Middle School Mainstream ELA Setting
Get PDFThe purpose of this action research was to determine if specific reading strategies would successfully support English Language Learners (ELLs) as they transitioned from an English Learning classroom setting into a mainstream English-Language Arts classroom. The research took place over an approximately six-month period in a public middle school in central Minnesota during a mix of hybrid and distance learning as a result of the COVID-19 pandemic. The focus population included six seventh-grade ELLs. Data collection took place through quantitative and qualitative measures, including Google Form surveys, formative and summative assessments, writing diagnostics and final essays. The changes to the learning environment led to inconsistent data collection and student participation. Continued research is needed to determine the overall effectiveness of the learning strategies on the ELL student population
Improving Ultrasound-Guided Vascular Access in the Emergency Department
Get PDFBackground: Intravenous access is commonly needed in the emergency department for lab testing, medication administration, imaging, and hospital admission. Complications may arise in patients who are critically or chronically ill, dehydrated, IV drug users, have large body mass, or poor vascularity. Ultrasound can allow the medical professional to visualize the vessel beneath the skin and confirm the placement of an intravenous catheter. The use of ultrasound requires education and hands-on training so the user becomes proficient and comfortable with use. Restrictions placed during the Covid-19 pandemic required the implementation of electronic education modules (vs. in-person delivery) to train staff on the proper use of ultrasound for IV placement.
Purpose: This project aimed to pilot a sustainable electronic educational training system, developed by an interprofessional team, to increase knowledge and skill in ultrasound-guided intravenous access for employees in the emergency department.
Methods: Pre and post-education surveys were used to determine if online education modules could improve knowledge, comfort, and confidence in ultrasound-guided IV access (USGIVA). A convenience sample was used consisting of nurses and paramedics in the emergency department at a Midwestern urban level 1 trauma center. Online modules were created for instruction on using ultrasound equipment and placement technique for peripheral IV access. Each module contained a test that required a success rate of 80% to move to the next module. Pre-education questionnaires were collected before the module completion. Post-education questionnaires were collected after the completion of learning modules. Likert scale questionnaires were used, and answers were input into an Excel spreadsheet for data examination.
Results: All participants successfully completed the online education modules and post-tests. In post-education questionnaires, participants reported that online USGIVA training was helpful and appropriate for increasing understanding and knowledge related to machine use, placement procedure, technique, and supply use. Staff also reported high levels of confidence related to ultrasound machine use and the ability to place ultrasound-guided IVs successfully.
Conclusions and Implications: Online USGIVA education improves knowledge, confidence, and comfort while aiding employees in the emergency department to learn a highly valuable skill leading to improved patient care, decreased costs, and improved flow. Online USGIVA education can be an inexpensive, convenient, and sustainable resource for employees to utilize in patient care
Functional load, token frequency, and contact-induced change in Toronto Heritage Cantonese vowels
No full textUnlike many previous studies of heritage speakers showing phonological maintenance, this presentation will show evidence for a vowel merger among second-generation Toronto Cantonese speakers. Two pairs of vowels are tested for merger. Both pairs are hypothesized to merge due to the lack of similar contrasts in Toronto English: /y/~/u/ and /a/~/ɔ/. Results show merger for only /y/~/u/. This is argued to be due to the lower functional load of /y/~/u/ (three minimal pairs with /y/~/u/, but 105 minimal pairs for /a/~/ɔ/) and due to lower token frequency of /y/ and /u/ compared to /a/ and /ɔ/ in conversational speech
Using an interprofessional clinical scholars approach to address sleep disturbances in veterans in a long-term care facility
No full textCommunity and Collaboration: The Effects of Participation in an Online Leadership Cohort on the Self-Efficacy of School Leaders
Get PDFThis action research project was conducted to see if participation in an online leadership cohort would affect the self-efficacy of school leaders. Using an online platform, seven Montessori heads of schools from the United States gathered to discuss topics of greatest importance to them. The schools represented were public, private, non-profit, proprietary and charter. The heads of schools ranged in experience from 3 to 33 years. They met once a week, for four weeks, for an hour each session to discuss four topics most relevant to the group, as determined by their suggestions. Data was collected using pre and post intervention self-assessments and surveys, as well as field notes, observation records, and tally sheets taken during the four leadership cohort sessions. The researcher facilitated the group and guided the conversations with prompts and continued questions. The heads of school asked questions of each other, offered answers, and shared resources. The intervention was shown to increase the self-efficacy of some participants, decrease the self-efficacy of some participants, and not affect the self-efficacy of others. However, the participants all reported feelings of gratitude for the opportunity to come together, citing community and collaboration as the most positive rewards
The Impact of Identifying Problem-Solving Strategies within Collaborative Work in 5th and 6th Grade Classrooms
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