scholarly journals Preliminary Data on Trauma Knowledge, Confidence, and Stress During Navy Trauma Training

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 266-272
Author(s):  
Tony Torres ◽  
Jami A Stakley ◽  
Elizabeth Garcia ◽  
Sorana Raiciulescu ◽  
Travis M Polk ◽  
...  
Keyword(s):  
Preliminary Data ◽  
Repeated Measures ◽  
High Volume ◽  
Medical Personnel ◽  
Physician Assistants ◽  
Small Sample ◽  
Published Data ◽  
Clinical Role ◽  
Trauma Training ◽  
Over Time

ABSTRACT Introduction The Navy Trauma Training Center (NTTC) is a military–civilian partnership that provides advanced trauma training for application across the range of military operations while exposing military medical personnel to high-volume and high-acuity trauma. Few published data evaluate the outcomes of military–civilian partnerships, including NTTC. The purpose of this study is to evaluate the knowledge, confidence, and stress of NTTC participants before, at mid-point, and after completion of the program. Participants include corpsmen (HM), nurses (RNs), physician assistants (PAs), and physicians (MDs). Materials and Methods These are preliminary data from an ongoing prospective, observational study with repeated measures. Included are participants that complete NTTC training. Pre-training measures include a demographic questionnaire, trauma knowledge test, Confidence survey, and the Perceived Stress Scale. These same instruments are completed at mid-training and at the conclusion of the NTTC curriculum. Data were analyzed using paired t-tests and linear mixed models. Results The sample was composed of 83 participants (49 HM, 18 RNs, 4 PAs, and 12 MDs. Knowledge and confidence increased from baseline to post-NTTC for each clinical role (P < .05). Stress for all roles was low and stable over time (P > .05). Conclusions These preliminary data suggest that, as expected, trauma-related knowledge and confidence increase significantly with training at NTTC. Stress was low and stable over time. These data from a small sample of participants indicate NTTC training is increasing participants’ trauma knowledge and confidence to care for trauma casualties. Continued collection of data in the ongoing study will allow us to determine whether these early findings persist in the overall study sample and may help inform the optimal length of training needed.

Quality of life (QOL) of older adults with acute myeloid leukemia (AML): Effects of treatment and time

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6566-6566
Author(s):  
M. Leach ◽  
M. Kowgier ◽  
H. Kermalli ◽  
A. Schattner ◽  
V. Gupta ◽  
...  
Keyword(s):  
Older Adults ◽  
Global Health ◽  
Physical Function ◽  
Repeated Measures ◽  
Social Function ◽  
Small Sample ◽  
Intensive Chemotherapy ◽  
European Organization ◽  
Modest Improvement ◽  
Over Time

6566 Background: AML in older adults has a poor prognosis. Although intensive chemotherapy may be associated with a modest improvement in survival, this needs to be balanced against possible worsening of QOL. However, published research in this area is limited. Methods: English-speaking patients aged 60 or older presenting with newly diagnosed AML to our referral centre were enrolled. Patients were excluded if life expectancy was <1 month. QOL was measured at baseline and at 1, 4, and 6 months. Questionnaires included the European Organization for the Research and Treatment of Cancer QLQ-C30 (global health and 5 QOL domains) and the Functional Assessment of Cancer Therapy Fatigue subscale. Patients were stratified into intensive (IT) and non-intensive treatment (NIT) groups. Baseline scores between groups were compared using Student’s T-test. Repeated measures modeling was used to compare the groups over time. Results: From June 2003 to December 2005, 63 patients (mean age 72, 46 IT, 17 NIT) were enrolled. At baseline, physical function and social function were the most affected domains and most patients had moderate fatigue. IT patients had better physical function and slightly less fatigue at baseline than NIT patients but were similar in 4 QOL domains and global health scores. By 6 months, 44% of IT and 60% of NIT patients had died. Over time, global health, role function, and emotional function improved but physical function, social function, and cognitive function did not change. Improvements in QOL domains were similar for IT and NIT patients for all measures. Fatigue scores remained unchanged over time. Conclusion: Intensive chemotherapy is not associated with worse QOL than NIT in older patients with AML, although our small sample size and attrition bias may overestimate QOL among survivors. Concerns about worse QOL with IT appear to be unfounded and this should not deter clinicians from considering IT for older adults with AML. No significant financial relationships to disclose.

scholarly journals Quantifying Clinical Opportunities at the Navy Trauma Training Center

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 40-48
Author(s):  
Virginia Schmied Blackman ◽  
Tony Torres ◽  
Jami A Stakley ◽  
Sorana Raiciulescu ◽  
Elizabeth Garcia ◽  
...  
Keyword(s):  
Emergency Department ◽  
Preliminary Data ◽  
Demographic Data ◽  
Penetrating Trauma ◽  
Physician Assistants ◽  
Clinical Activity ◽  
Training Center ◽  
Care Providers ◽  
Trauma Training ◽  
Skill Performance

ABSTRACT Introduction Military-Civilian partnerships (MCPs), such as the Navy Trauma Training Center, are an essential tool for training military trauma care providers. Despite Congressional and military leadership support, sparse data exist to quantify participants’ clinical opportunities in MCPs. These preliminary data from an ongoing Navy Trauma Training Center outcomes study quantify clinical experiences and compare skill observation to skill performance. Materials and Methods Participants completed clinical logs after each patient encounter to quantify both patients and procedures they were involved with during clinical rotations; they self-reported demographic data. Data analyses included descriptive statistics and chi-square statistics to compare skills observed to skills performed between the first and second half of the 21-day course. Results A sample of 47 Navy personnel (30 corpsmen, 10 nurses, 3 physician assistants, 4 physicians) completed 551 clinical logs. Most logs (453/551) reflected experiences in the emergency department, where corpsmen and nurses each spent 102.0 hours, and physician assistants and physicians each spent 105.4 hours. Logs completed per participant ranged from 1 to 31, (mean = 8). No professional group was more likely than others to complete the clinical logs. Completion rates varied by cohort, both overall and by clinical role. Of emergency department logs, 39% reflected highest acuity patients, compared with 21% of intensive care unit logs, and 61% of operating room logs. Penetrating trauma was reported on 16.5% of logs. Primary and secondary trauma assessments were the most commonly reported clinical opportunities, followed by obtaining intravenous access and administration of analgesic medications. With few exceptions, logs reflected skill observation versus skill performance, a ratio that did not change over time. Conclusion Prospective real-time data of actual clinical activity is a crucial measure of the success of MCPs. These preliminary data provide a beginning perspective on how these experiences contribute to maintaining a skilled military medical force.

scholarly journals Clinical characterization of dysautonomia in long COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicolas Barizien ◽  
Morgan Le Guen ◽  
Stéphanie Russel ◽  
Pauline Touche ◽  
Florent Huang ◽  
...  
Keyword(s):  
Mixed Models ◽  
Repeated Measures ◽  
Physical Medicine ◽  
Persistent Symptoms ◽  
Index Changes ◽  
Changes Over Time ◽  
And Control ◽  
Testing Group ◽  
Over Time

AbstractIncreasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. 39 participants were included from December 2020 to January 2021 for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200 pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. A significant NOL index dissociation over time between long COVID-19 participants with fatigue and control participants was observed (p = 0.046). A trend towards significant NOL index dissociation over time was observed between long COVID-19 participants without fatigue and control participants (p = 0.109). No difference over time was observed between the two groups of long COVID-19 participants (p = 0.904). Long COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia. Trial registration: The study was approved by the Foch IRB: IRB00012437 (Approval Number: 20-12-02) on December 16, 2020.

Use of breathable silicone technology in an ostomy appliance flange

2021 ◽  
Vol 30 (Sup8) ◽  
pp. 25-35
Author(s):  
Peta Lager ◽  
Lisa Loxdale
Keyword(s):  
Preliminary Data ◽  
Transepidermal Water Loss ◽  
User Evaluation ◽  
Skin Damage ◽  
Healthcare Use ◽  
Skin Injury ◽  
Moisture Management ◽  
Peristomal Skin ◽  
Medical Adhesive ◽  
Over Time

Leaks and peristomal skin complications are highly prevalent among people with a stoma, reported by over 80% of ostomates within 2 years of surgery. This suggests that there is room for improvement in ostomy appliances, particularly in their hydrocolloid-based adhesive flanges. Hydrocolloid has an absorptive method of moisture management that, over time, risks maceration and skin stripping, potentially leading to moisture-associated skin damage (MASD) and medical adhesive-related skin injury (MARSI). The newly developed Genii ostomy appliances (Trio Healthcare) use novel Sil2 Breathable Silicone Technology to provide secure, effective adhesion and manage moisture levels by replicating natural transepidermal water loss (TEWL). This has the potential to increase appliance wear time, reduce incidence of MASD and permit atraumatic removal without adhesive remover, reducing the risks of MARSI, as well as time burdens on the user and economic burdens on the healthcare system. Meanwhile, the silicone flanges and water-resistant sports fabric pouches are lightweight, flexible and unobtrusive, and they are the first appliances to be available in colours to match different skin tones, all of which provides security, comfort, confidence and discretion. This article explores the features of Sil2 and Genii ostomy appliances, with reference to preliminary data from a user evaluation.

scholarly journals Identification of bone morphogenetic protein 4 in the saliva after the placement of fixed orthodontic appliance

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lovorka Grgurevic ◽  
Ruder Novak ◽  
Grgur Salai ◽  
Vladimir Trkulja ◽  
Lejla Ferhatovic Hamzic ◽  
...  
Keyword(s):  
Growth Factor ◽  
Bone Morphogenetic Protein ◽  
Bone Remodeling ◽  
Small Sample ◽  
Central Position ◽  
Published Data ◽  
Bone Morphogenetic Protein 4 ◽  
Orthodontic Appliance ◽  
Morphogenetic Protein ◽  
Fixed Orthodontic Appliance

Abstract Background This study was conducted in order to explore the effects of orthodontic tooth movement (OTM) on the changes of salivary proteome. This prospective observational pilot study recruited 12 healthy teenage boys with malocclusion treated with a fixed orthodontic appliance and 6 appropriate control participants. Saliva samples were collected a day before and at 0, 2, 7, and 30 days after initialization of treatment, corresponding to the initial, lag, and post-lag phases of OTM. Pooled samples were analyzed by liquid chromatography-mass spectrometry, ELISA, and Western blotting. To date, there is no published data on the presence of BMP molecules or their antagonists in the saliva or in the gingival cervical fluid related to orthodontic conditions. Results A total of 198 identified saliva proteins were classified based on their functional characteristics. Proteins involved in bone remodeling were observed exclusively 30 days post appliance placement, including bone morphogenetic protein 4 (BMP4), a BMP antagonist BMP-binding endothelial regulator, insulin-like growth factor-binding protein 3, cytoskeleton-associated protein 4, and fibroblast growth factor 5. Based on the analysis of protein interactions, BMP4 was found to have a central position in this OTM-related protein network. Conclusions The placement of a fixed orthodontic appliance induced occurrence of proteins involved in bone remodeling in the saliva at a time corresponding to the post-lag period of OTM. Limitations of this study include a relatively small sample size, limited time of monitoring patients, and the lack of interindividual variability assessment.

The underrepresentation of female participants in studies assessing the impact of high-dose exercise on cardiovascular outcomes: a scoping review

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
S Pallikadavath ◽  
R Patel ◽  
CL Kemp ◽  
M Hafejee ◽  
N Peckham ◽  
...  
Keyword(s):  
Scoping Review ◽  
High Volume ◽  
Cardiovascular Outcomes ◽  
High Dose ◽  
Funding Sources ◽  
Review Protocol ◽  
The Mean ◽  
The Impact ◽  
Over Time ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular adaptations as a result of exercise conducted at high-intensity and high-volume are often termed the ‘Athlete’s heart’. Studies have shown that these cardiovascular adaptations vary between sexes. It is important that both sexes are well represented in this literature. However, many studies assessing the impact of high-dose exercise on cardiovascular outcomes under-recruit female participants. Purpose This scoping review aimed to evaluate the representation of females in studies assessing the impact of high-dose exercise on cardiovascular outcomes and demonstrate how this has changed over time. Methods The scoping review protocol as outlined by Arksey and O’Malley was used. OVID and EMBASE databases were searched and studies independently reviewed by two reviewers. Studies must have investigated the effects of high-dose exercise on cardiovascular outcomes. To assess how the recruitment of females has changed over time, two methods were used. One, the median study date was used to categorise studies into two groups. Two, studies were divided into deciles to form ten equal groups over the study period. Mean percentage of female recruitment and percentage of studies that failed to include females were calculated. Results Overall, 250 studies were included. Over half the studies (50.8%, n = 127) did not include female participants. Only 3.2% (n = 8) did not include male participants. Overall, mean percentage recruitment was 18.2%. The mean percentage of recruitment was 14.5% before 2011 and 21.8% after 2011. The most recent decile of studies demonstrated the highest mean percentage of female recruitment (29.3%) and lowest number of studies that did not include female participants (26.9%). Conclusion Female participants are significantly underrepresented in studies assessing cardiovascular outcomes caused by high-dose exercise. The most recent studies show that female recruitment may be improving, however, this still falls significantly short for equal representation. Risk factors, progression and management of cardiovascular diseases vary between sexes, hence, translating findings from male dominated data is not appropriate. Future investigators should aim to establish barriers and strategies to optimise fair recruitment. Mean percentage females recruited per study (%) Percentage studies that do not include women (%) Overall (n = 250) 18.2 50.8 (n = 127) Studies before 2011 (n = 121) 14.5 59.5 (n = 72) Studies after 2011 (n = 129) 21.8 42.6 (n = 55) Table 1: Female recruitment characteristics. The year 2011 (median study year) was chosen as this divides all included studies into two equal groups.

scholarly journals Acute Comparative Effect of Foam Rolling and Static Stretching on Range of Motion in Rowers

2021 ◽  
Vol 13 (7) ◽  
pp. 3631
Author(s):  
Alfonso Penichet-Tomas ◽  
Basilio Pueo ◽  
Marta Abad-Lopez ◽  
Jose M. Jimenez-Olmedo
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Static Stretching ◽  
Foam Rolling ◽  
Significant Difference ◽  
Post Test ◽  
Alternating Treatment Design ◽  
Stroke Amplitude ◽  
Treatment Design ◽  
Over Time

Rowers’ anthropometric characteristics and flexibility are fundamental to increase stroke amplitude and optimize power transfer. The aim of the present study was to analyze the effect of foam rolling and static stretching on the range of motion over time. Eight university rowers (24.8 ± 3.4 yrs., height 182.3 ± 6.5 cm, body mass 79.3 ± 4.6 kg) participated in an alternating treatment design study with two-way repeated measures ANOVA. The sit and reach test was used to measure the range of motion. Both in the foam rolling and in the static stretching method, a pre-test (T0), a post-test (T1), and a post-15-min test (T2) were performed. A significant effect was observed on the range of motion over time (p < 0.001), but not for time x method interaction (p = 0.680). Significant differences were found between T0 and T1 with foam rolling and static stretching (p < 0.001, d = 0.4); p < 0.001, d = 0.6). The differences between T0 and T2 were also significant with both methods (p = 0.001, d = 0.4; p < 0.001, d = 0.4). However, no significant difference was observed between T1 and T2 (p = 1.000, d = 0.1; p = 0.089, d = 0.2). Foam roller and static stretching seem to be effective methods to improve the range of motion but there seems to be no differences between them.

scholarly journals PSVIII-17 Assessment of conformational changes across three parities in sows

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 221-222
Author(s):  
Melanie D Trenhaile-Grannemann ◽  
Ronald M Lewis ◽  
Stephen D Kachman ◽  
Kenneth J Stalder ◽  
Benny E Mote
Keyword(s):  
Body Size ◽  
Body Length ◽  
Conformational Changes ◽  
Repeated Measures ◽  
Fixed Effects ◽  
Random Effect ◽  
Joint Angles ◽  
Body Depth ◽  
Conformation Changes ◽  
Over Time

Abstract Conformation-based sow selection is performed prior to reaching mature size, yet little is known about how conformation changes as growth continues. To assess conformation changes, 9 conformational traits were objectively measured at 12 discrete time points between 112 d of age and parity 3 weaning on 622 sows in 5 cohorts. The 9 traits included 5 body size traits (body length, body depth at the shoulder and flank, and height at the shoulder and flank) and 4 joint angles (knee, hock, and front and rear pastern). Data were analyzed with a repeated measures model (SAS V 9.4) including cohort and time point as fixed effects, sire as a random effect, and heterogeneous compound symmetry as the covariance structure. Sire variance ranged from 0.16 (body depth shoulder) to 2.00 (body length) cm2 for body size traits and 2.28 (rear pastern) to 4.22 (front pastern) degrees2 for joint angles. Cohort had an effect on all traits (P &lt; 0.05). All traits displayed changes over time (P &lt; 0.001). Size traits increased between 112 d of age and parity 3 weaning (64.16 vs. 107.57 cm, 26.62 vs. 44.14 cm, 23.32 vs. 36.92 cm, 46.10 vs. 73.55 cm, 49.36 vs. 77.47 cm for body length, body depth shoulder and flank, and height shoulder and flank, respectively); however, they fluctuated within parity by increasing during gestation and decreasing at weaning. Knee angle decreased (164.12 vs. 150.72 degrees) while fluctuating within parity by decreasing in the second half of gestation and increasing after weaning. Front and rear pastern angles decreased over time (60.89 vs. 53.74 degrees and 64.64 vs. 55.50 degrees for front and rear pastern, respectively), while biologically negligible change was observed in hock angle (148.63 vs. 147.48 degrees). Sow conformation changes throughout life, and these changes may require consideration when making selection decisions.

scholarly journals Mood and Global Symptom Changes among Psychotherapy Clients with Depressive Personality

2012 ◽  
Vol 2012 ◽  
pp. 1-12
Author(s):  
Rachel E. Maddux ◽  
Lars-Gunnar Lundh
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Psychological Symptoms ◽  
Self Report ◽  
Treatment Results ◽  
Repeated Measures Analysis ◽  
Depressive Personality ◽  
Symptom Changes ◽  
Psychotherapy Clients ◽  
Over Time

The present study assessed the rate of depressive personality (DP), as measured by the self-report instrument depressive personality disorder inventory (DPDI), among 159 clients entering psychotherapy at an outpatient university clinic. The presenting clinical profile was evaluated for those with and without DP, including levels of depressed mood, other psychological symptoms, and global severity of psychopathology. Clients were followed naturalistically over the course of therapy, up to 40 weeks, and reassessed on these variables again after treatment. Results indicated that 44 percent of the sample qualified for DP prior to treatment, and these individuals had a comparatively more severe and complex presenting disposition than those without DP. Mixed-model repeated-measures analysis of variance was used to examine between-groups changes on mood and global severity over time, with those with DP demonstrating larger reductions on both outcome variables, although still showing more symptoms after treatment, than those without DP. Only eleven percent of the sample continued to endorse DP following treatment. These findings suggest that in routine clinical situations, psychotherapy may benefit individuals with DP.

Sustainability-oriented strategy and Sustainable Development Goals

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Priscila Borin de Oliveira Claro ◽  
Nathalia Ramajo Esteves
Keyword(s):  
Sustainable Development ◽  
Sustainable Development Goals ◽  
Small Sample ◽  
Theoretical Argument ◽  
Negative Externalities ◽  
Global Compact ◽  
Content Type ◽  
For Profit ◽  
Development Goals ◽  
Over Time

PurposeSustainability-oriented strategies involve considering all possible environmental, social and economic factors that impact stakeholders and sustainable development. They could be a crucial contribution of the private sector to Sustainable Development Goals (SDGs). The study’s objective is twofolded. First, the authors want to discover if enterprises doing business in Brazil are contemplating the SDGs in their strategies. Second, the authors want to identify the external and internal factors that motivate them.Design/methodology/approachThe authors collected data through an online survey with employees from Global Compact signatories in Brazil. From a list of 335 for-profit enterprises, the authors got back 132 answers. The sample comprises Brazilian enterprises that only operate in the Brazilian market, Brazilian multinational enterprises (MNEs) and foreign multinationals operating in Brazilian and international markets. For this study, the MNEs’ group comprises Brazilian multinationals and foreign multinationals (MNEs). To characterize the sample and identify the motivating factors, the authors conducted a descriptive analysis. To compare the domestic and MNEs’ mean differences regarding the factors that influenced their strategies and the SDGs, the authors performed Mann–Whitney's U-test.FindingsThe results of the study show that enterprises are addressing the SDGs in their strategies. All internal and external driving factors are similar for domestic and MNEs, except for the value chain's negative externalities. MNEs are more prone to consider their negative externalities, which is a positive trend. Finally, results suggest that both groups of enterprises consider the 17 goals in their strategies, contrary to the theoretical argument that multinationals suffer more pressure because of their broad geographic scope.Research limitations/implicationsThe database of the study involves data collected through a self-response survey. Thus, the authors cannot discuss the effectiveness of real SDGs' strategies once enterprises' discourse on sustainability does not always correspond with practices. Therefore, the authors suggest that researchers address the results of implemented strategies on the SDGs over time to check for improvements and new developments.Practical implicationsThe authors suggest frequent materiality assessment of domestic enterprises' supply chain and articulation of explicit purposes around the selected SDGs, including setting key performance indicators (KPIs) and monitoring progress.Social implicationsThe authors believe that enterprises and decision makers should recognize their essential role to bend the curve on SDGs and shift their behavior toward strategic choices that could contribute to their positive performance over time, without contributing to environmental degradation and socioeconomic chaos.Originality/valuePublication on how enterprises address the SDGs in Brazil is relatively scarce. This study provides some answers to that by focusing on the factors influencing sustainability-oriented strategies on the SDGs. Besides, most previous studies consider a small sample of enterprises and are industry specific or focus on the effects of the SDGs in public policy. The sample of this study is diverse and represents 42% of the for-profit signatories of the Global Compact in Brazil.

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