Using Environmental Physiology to Teach Physiological Regulation

Environmental Physiology at Boise State University, Idaho, is a multidisciplinary course that expands students’ understanding of human regulatory physiology through acute and chronic responses to environmental extremes. Students explore the physics (pressure, fluid dynamics, gas laws, sound, and light) of the underwater environment, marine flora and fauna adaptations to this environment, and the human experience within this environment. Included is completion of the Professional Association of Dive Instructors (PADI) Open Water Scuba Certification. The course culminates in an international dive trip where course concepts are further demonstrated and explored, and conservation activities are undertaken.

Current Guidelines for Gender Affirming Care for Transgender Individuals

Background and goals: The guidelines for transgender care are evolving and incorporate a multidisciplinary team approach. These roadmaps entail an understanding of gender development, mental health, and sociocultural factors in individual and family lives, as well as the specific medical needs in the process of transitioning and ongoing treatment. New research is continuing to update the best evidence-based practice. Multiple professional health organizations have published guidelines. The World Professional Association of Transgender Health has pioneered the Standard of Care, currently version seven. Other leading organizations have their own publications with an emphasis on specific relevant medical needs. In this paper, The World Professional Association of Transgender Health Standard of Care and the recommendation of multiple psychiatric and pediatric organizations are reviewed to provide an overview. Discussion: Most current guidelines have similar recommendations in providing care for transgender individuals. The more recent data has shown the benefits of medical transitioning in youth and updated recommendations in this age group. Healthcare professionals are encouraged to stay up to date with these current guidelines. Further research is recommended.

Factors Affecting Audit Professional Ethics - Approach from the Perception of Auditors in Vietnam

Auditor independence is one of the most important attributes of audit professional ethics. This article delivers a full insight into the perception of auditors about independence in the auditing activities in Vietnam. The article approaches from the auditor's perception in the actual working environment. The article uses a mixed approach based on the experimental methodology. The article uses the archival research method and group discussions method to analyze and assess the research problems and verify by experimental data. The article takes the group discussions with experts and surveys 300 directors, auditors, auditor assistants who are working in 70 auditing firms. The results show that perception of independence is affected by moral awareness, working environment, and professional Association. Factors affecting auditors’ independence from moral awareness of auditor include perception of utilitarianism, perception of deontology; perception of egoism. Factors affecting auditor’s independence from working environment: business philosophy, management practices. Factors relating to the professional association as orientation, supervision, risk of audit practice. In particular, factors relating to the risk of audit practice do not promote the preservation of auditor independence due to the low litigation risks in the Vietnamese auditing environment while the remaining factors motivate auditors to increase their independence. The article implies that the auditors, the audit firms, and the Association of Certified Public Accountants should possess appropriate orientations and policies to raise the perception of auditor independence. Thereby, auditors will improve their attitude and behavior to ensure independence.

Enhancing Auditor Independence in Developing Countries in Context of Globalization – Evidence in Vietnam

Purpose: Globalization brings many opportunities and challenges for developing countries. So, does globalization create a motivation to improve the auditing profession's ethics? Independence is one of the most important components of auditing professional ethics, which must be maintained throughout the audit process. This article delivers a full insight into identifying factors that enhance the auditor independence promoted in the international integration process. Design/methodology/approach: This article approached from international integration process that affect auditor independence from auditors’ awareness, working environment and professional association. This article used a mixed approach based on the experimental methodology. This article used the archival research method and group discussions method to analyze and assess the research problems and verified by experimental data. The article took the group discussions with experts and survey 280 directors, auditors, auditor assistants who are working in 70 auditing firms. Findings: The results showed that globalization support auditors, audit firms, and professional Association to improve auditor independence. Especially, the factors that enhance the auditor independence driven by international integration: Knowledge, Technology, Competition, Management, Monitoring. Practical implications: The article implied to improve auditor independence in the context that Vietnam is strongly integrating internationally. Originality/value: The article has taken a new approach on auditor independence from globalization in Vietnam.

Chiropractic website claims related to non-musculoskeletal conditions: a cross-sectional study

Background Chiropractors frequently use spinal manipulation therapy as a treatment modality in the management of musculoskeletal (MSK) conditions such as spinal pain and sometimes in the treatment of non-MSK disorders. The latter is not supported by evidence. This study aimed to investigate the extent of non-MSK website claims from French chiropractors to assess if websites were aligned with current recommendations on evidence-based practice. Methods This was a cross-sectional study of a representative sample of French chiropractors. Information on non-MSK conditions was collected from chiropractic professional websites by two independent observers in June 2020. For each non-MSK condition, it was noted whether a clarifying explanation justifying the mentioning of the condition was available. In addition, data on professional association affiliation status, country of education, years since graduation, and special clinical focus (e.g., seniors, children) were collected. Results A total of 287 randomly selected websites were included in the study corresponding to 22% of all chiropractors registered in France. One or more of 42 different non-MSK conditions were identified on 231 websites, of which 5 (2.2%) provided a clarifying explanation. 226 (79%) websites mentioned a non-MSK condition without a clarifying explanation. The non-MSK conditions most often mentioned were sleep problems, constipation/digestive problems, unease/discontent in children and menstrual cramps/pains. A larger proportion of the websites advertising treatment for non-MSK disorders was found among those claiming a special clinical focus on infants/children, seniors, pregnant women or athletes compared to those that did not. Also, a larger proportion of chiropractors who were affiliated with a professional association were advertising treatment for non-MSK disorders compared to those who were not affiliated. Conclusions Eight out of ten chiropractic websites mentioned one or more non-MSK diagnoses or symptoms. It is unclear if this reflects inaccurate communication or if treatments for non-MSK conditions are provided by the chiropractors.

Current Practice for Transverse Mandibular and Maxillary Discrepancies in the Netherlands: A Web-Based Survey Among Orthodontists and Oral and Maxillofacial Surgeons

The main objective of this study was to provide an overview of the current practice for transverse mandibular and maxillary discrepancies in the Netherlands using a web-based survey. Orthodontists (ORTHO) and Oral and Maxillofacial Surgeons (OMFS) in the Netherlands were invited to the web-based survey via their professional association. Three cases were presented which could be treated non-surgically and surgically. Participants were asked what treatment they preferred: no treatment, orthodontic treatment with optional extractions or surgically assisted orthodontic treatment. The web-based survey ended with questions on various technical aspects and any experienced complication. Invitation was sent to all 303 members of professional association for ORTHO and to all 379 members of professional association for OMFS. Overall response number was 276 (response rate of 40.5%), including 127 incomplete responses. Generally, ORTHO prefer orthodontic treatment with optional extractions and OMFS lean towards surgically assisted orthodontic treatment. Mandibular Midline Distraction appears to be less preferred, possibly due to lack of clinical experience or knowledge by both professions despite being proven clinical stable surgical technique with stable long-term outcomes. There seems to be consensus on technical aspects by both professions, however, there are various thoughts on duration of consolidation period. Complications are mostly minor and manageable.

Chiropractic website claims related to non-musculoskeletal conditions: a cross-sectional study

Introduction: Chiropractors frequently use spinal manipulation therapy as a treatment modality in the management of musculoskeletal (MSK) conditions such as spinal pain and in some cases in the treatment of non-MSK disorders. The latter is not supported by evidence. This study aimed to investigate the extent of non-MSK website claims from French chiropractors to assess if websites were aligned with current recommendations on evidence-based practice.Method: This was a cross-sectional study of a representative sample of French chiropractors. Information on non-MSK conditions were collected from chiropractic professional websites by two independent observers. For each non-MSK condition, it was noted whether a clarifying explanation justifying the mentioning of the condition was available. In addition, data on professional association affiliation status, country of education, years since graduation, and special clinical focus (e.g., seniors, children) were collected. Results: A total of 287 randomly selected websites were included in the study corresponding to 22% of all chiropractors registered in France. One or more of 42 different non-MSK conditions were identified on 231 websites, of which 5 (2.2%) provided a clarifying explanation. 226 (79%) websites mentioned a non-MSK condition without a clarifying explanation. The non-MSK conditions most often mentioned were sleep problems, constipation/digestive problems, unease/discontent in children and menstrual cramps/pains. A larger proportion of the websites advertising treatment for non-MSK disorders were found among those claiming a special clinical focus on infants/children, seniors, pregnant women or athletes compared to those that did not. Also, a larger proportion of chiropractors who were affiliated with a professional association were advertising treatment for non-MSK disorders compared to those who were not affiliated.Conclusion: Eight out of ten chiropractic websites mentioned one or more non-MSK diagnoses or symptoms. It is unclear if this reflects inaccurate communication or if treatments for non-MSK conditions are provided by the chiropractors.