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Navigating the Myths and Truths Behind Pharmacological Drug and Herbal Supplement Use: A Guide for Pregnant Women
Get PDFThe author comments on current Federal Food and Drug Administration (FDA) guidelines on the regulation of herbal supplements and compares them to international guidelines. They elucidate on how gaps in these regulations can be detrimental to the health of patients and uses this as a platform to introduce an extensive guide denoting the major biochemical changes occurring antepartum and postpartum as an explanation for symptoms often experienced during pregnancy. They then use this as a background to detail the mechanism of the active ingredients in these supplements and comment on the effectiveness of the relating FDA regulations. The author hopes that this thesis will help raise awareness about common herbal supplements and serve as a resource grounded in scientific facts for women looking into alternative medicine during pregnancy
Enhancing Environmental Staff Cleaning Process and Adenosine Triphosphate (ATP)
Get PDFClostridium difficile (C. difficile) has become the most common microbial cause of healthcareassociated infections (HAI) in U.S. hospitals and costs billions of dollars each year in excess of health care costs for acute care facilities alone (Centers for Disease Control and Prevention [CDC], 2015, para. 2). Inadequate cleaning of contaminated surfaces in the hospital environment may lead to an HAI. Potential barriers related to environmental cleaning of C. difficile infected rooms were identified at a small safety net hospital. The investigator used a convenience sample of 12 environmental staff (EVS) and a quasi-experimental pre-posttest design, to explore whether or not an educational intervention with EVS on a new cleaning process and Adenosine triphosphate (ATP) testing would improve environmental staff understanding of the cleaning process, as well as decrease the incidence of C. difficile HAI. Overall, the study supported the use of an educational intervention to improve cleaning efficacy with statistically significant results from the EVS staff educational pre-posttest (t= -2.680, p=.021) and pre-post ATP tests (t=12.520, p=.000). The study site’s C. difficile incidence rates changed from 3.76 to 1.86. The major limitation of this study was the small sample size. The most significant implication of this study is the investigator plans to continue implementing the new cleaning process with follow-up ATP testing, as well as conduct future research to assess other possible risk factors for C. difficile HAI
A Commentary on Trauma’s Different Layers
Get PDFThis article highlights how trauma may be caused by factors aside from catastrophic events, physical violence or accidents resulting in physical injury. Examples of trauma beyond the more commonly known causes are detailed. This article also emphasizes how individuals engaging in psychotherapy may at times lack awareness that their self-reported dilemma, or symptoms, may stem from early relational trauma. The following commentary originated with first-hand clinical experience and was reinforced by literature. It is important to recognize that individuals reporting symptoms of depression and anxiety are most effectively treated in psychotherapy when past trauma is accurately identified as the root of their dilemma
The effects of an unanticipated side-cut on lower extremity kinematics and ground reaction forces during a drop landing
No full textUnanticipated direction to cut after landing may alter the lower extremity landing biomechanics when performing landing motions. These alterations may potentially increase the risk of ACL injury. The purpose of this study was to determine if an unanticipated side-cut affects lower extremity landing biomechanics in females. Eighteen recreational female athletes participated in two blocks of testing: the first block of testing consisted of three acceptable trials of anticipated dominant limb and non-dominant limb 45-degree diagonal cutting after landing, which were performed in a counterbalanced order. The second block of testing consisted of three acceptable trials of unanticipated dominant limb and non-dominant limb diagonal cutting after landing. Data analysis mainly focused on the dominant limb landing biomechanics. Unanticipated side-cut landing, compared (paired t-test, p \u3c 0.05) to the anticipated landings, resulted in less hip abduction and tibial internal rotation angle at initial contact (IC) and a lower maximum ankle inversion angle and a greater maximum knee abduction angle, and knee and hip displacement. Also, greater posterior GRF and a longer time to peak medial GRF were exhibited. These outcomes indicate that athletes may adapt their landing mechanics to land unsafely when encountering an unanticipated event
Widespread Pressure Pain Sensitivity and Referred Pain from Trigger Points in Patients with Upper Thoracic Spine Pain
No full textObjectives: The presence of trigger points (MTrPs) and pressure pain sensitivity has been well documented in subjects with neck and back pain; however, it has yet to be examined in people with upper thoracic spine pain. The purpose of this study was to investigate the presence of MTrPs and mechanical pain sensitivity in individuals with upper thoracic spine pain. Methods: Seventeen subjects with upper thoracic spine pain and 17 pain-free controls without spine pain participated. MTrPs were examined bilaterally in the upper trapezius, rhomboid, iliocostalis thoracic, levator scapulae, infraspinatus, and anterior and middle scalene muscles. Pressure pain thresholds (PPTs) were assessed over T2, the C5-C6 zygapophyseal joint, the second metacarpal, and the tibialis anterior. Results: The numbers of MTrPs between both groups were significantly different (P \u3c 0.001) between patients and controls. The number of MTrPs for each patient with upper thoracic spine pain was 12.4 ± 2.8 (5.7 ± 4.0 active TrPs, 6.7 ± 3.4 latent TrPs). The distribution of MTrPs was significantly different between groups, and active MTrPs within the rhomboid (75%), anterior scalene (65%), and middle scalene (47%) were the most prevalent in patients with upper thoracic spine pain. A higher number of active MTrPs was associated with greater pain intensity and longer duration of pain history. Conclusions: This study identified active MTrPs and widespread pain hypersensitivity in subjects with upper thoracic spine pain compared with asymptomatic people. Identifying proper treatment strategies might be able to reduce pain and improve function in individuals with upper thoracic spine pain. However, future studies are needed to examine this
Balance in chronic traumatic brain injury: correlations between clinical measures and a self-report measure
No full textObjective: To assess associations among commonly used self-report and clinical measures of balance in chronic TBI. Design: Cross-sectional analysis of balance in a convenience sample of individuals at least one year post TBI. Main Outcome Measures: Activities-Specific Balance Confidence Scale (ABC) (self-reported balance impairment), Community Balance and Mobility Scale (CB&M) (clinical measure validated in TBI), and Balance Evaluation Systems Test (BESTest) (clinical measure not validated in TBI). Methods: Fifty-nine individuals (64% male, mean age 48.2 years) ambulating independently within the home participated in testing. Pearson correlation coefficients were used to quantify the direction and magnitude of the relationships among the three balance impairment measures. Results: A significant positive correlation was noted between the ABC and CB&M (r = 0.42, p = 0.0008), between the ABC and BESTest (r = 0.46, p = 0.0002), and between the CB&M and BESTest (r = 0.86, p \u3c 0.0001). Conclusions: This is the first study we are aware of in the chronic moderate to severe TBI population directly comparing patient’s self-reported balance impairment with clinical measures. Positive correlations were found between the self-report measure and both clinical measures. Overall, individuals with chronic TBI tend to self-report less impaired balance than clinical measures indicate. These results provide preliminary evidence to support the need for validation of the BESTest in this population. Abbreviations: ABC: Activities-specific balance confidence scale; BESTest: balance evaluation systems test; BOS: base of support; COM: center of mass; CB&M: community balance and mobility scale; CI: confidence interval; IQR: interquartile range; PTs: physical therapists; SD: standard deviation; SE: standard error; TBI: traumatic brain injury
Interprofessional education telephone simulation for campus-based pharmacy students and distance-learning family nurse practitioner students
No full textBackground: Interprofessional education (IPE) is an essential component of healthcare professions’ curriculum but is often difficult to provide due to scheduling issues, cost, different learning formats, and lack of access to other health care professions. To meet the school of pharmacy\u27s need to have IPE with prescribers and the school of nursing\u27s need to provide IPE to distance-learning students, a telephone-based IPE activity was created. The goals of the simulation activity were to provide students a forum to practice communication skills, work to maintain a climate of mutual respect, and forge interdependent relationships with another profession. Interprofessional activity: Each student in a team completed a survey rating the other professional students and qualitative data was collected. Individual care plans were evaluated for appropriateness of therapy, monitoring, and follow-up recommendations. Achievement of the effective communication outcome was evaluated through student survey data, qualitative comments, and concordance of care plans among team members. Concordance was determined based on whether the team was in complete agreement. Discussion: Qualitative data revealed the goals of mutual respect and interdependent relationships between professions were achieved. The majority of students agreed that effective communication was achieved; however, discordance of the patient care plans between team members suggested ineffective communication. Implications: The simulation activity met IPE accreditation needs of both pharmacy and nursing profession in a creative method to address barriers of location, cost, scheduling, and lack of access to other healthcare professions
Influence of sacroiliac bracing on muscle activation strategies during 2 functional tasks in standing-tolerant and standing-intolerant individuals
No full textPeople who develop low back pain during standing (standing-intolerant) are a subclinical group at risk for clinical low back pain. Standing-intolerant individuals respond favorably to stabilization exercise and may be similar to people with sacroiliac joint dysfunction that respond to stabilization approaches including sacroiliac joint (SIJ) bracing. The purpose was to characterize muscle activation and response to SIJ bracing in standing-tolerant and standing-intolerant individuals during forward flexion and unilateral stance. Trunk and hip electromyography data were collected from 31 participants (17 standing-tolerant and 14 standing-intolerant) while performing these tasks with and without SIJ bracing. Kinematics were captured concurrently and used for movement phase identification. Cross-correlation quantified trunk coactivation and extensor timing during return-to-stand from forward flexion; root mean square amplitude quantified gluteal activity during unilateral stance. The standing-intolerant group had elevated erector spinae–external oblique coactivation without bracing, and erector spinae–internal oblique coactivation with bracing during return-to-stand compared with standing-tolerant individuals. Both groups reversed extensor sequencing during return-to-stand with bracing. Standing-tolerant individuals had higher hip abductor activity in nondominant unilateral stance and increased hip extensor activity with bracing. SIJ bracing could be a useful adjunct to other interventions targeted toward facilitating appropriate muscle activation in standing-intolerant individuals
Challenges and Coping Mechanisms of Whites Committed to Antiracism
No full textScholars have cited an antiracist identity as an ideal development status for Whites seeking to change systemic racism (Helms, 1995). However, little is known regarding the lived complexities of antiracist work itself. This article examines the experiences of one group of Whites (N = 10) committed to antiracist action. Outcomes indicate challenges that include backlash and struggles to identify more effective antiracist tactics. Coping mechanisms are considered in relation to counseling and counselor training practices