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AbstractIndividuals post-stroke commonly demonstrate alterations in motor behavior with regard to both task performance and the motor strategies used in pursuit of task goals. We evaluated whether constraining postural sway (motor strategy) during practice would affect upper-limb precision aiming performance (task performance) and postural control adaptations. Adults with stroke stood on a force plate while immersed in a virtual scene displaying an anterior target. Participants aimed to position a virtual laser pointer (via handheld device) in the target. Participants then completed practice trials involving aiming at a lateral target. For this practice session, participants were randomized to either (a) a “constraint” group wherein they received physical constraint to limit postural sway, or (b) a “no-constraint” group. Task performance and postural control were assessed before and after practice, and transfer to another upper-limb task was evaluated. After practice, both groups improved paretic upper-limb performance. For the target task, the no-constraint group showed task-sensitive changes in postural control. The constraint group showed no changes in postural control. At transfer, the constraint group increased postural sway. Constraining postural sway after stroke should be carefully considered with the recognition that postural sway arises from exploratory movements involved in the discovery of adaptable motor solutions. [ABSTRACT FROM AUTHOR]

This case study discusses the deconstructions and synergies of problem-based learning (PBL) and community-based project-organized education. The growing literature on these methods lacks in coverage of their synergies and their applicability to meaningful projects with communities as partners. Community-based learning is inherently problem based and provides a natural environment to introduce problem-based learning, but problem-based learning is not inherently community-based. A project-organized curriculum is not necessarily community based or problem oriented. Its application in community problem-based models therefore requires clear articulation. Scholars wishing to use both approaches are faced with the challenge of revisiting the connections from time to time, given the evolving and changing contextual nature of community issues, problems, and needs. This article discusses theoretical underpinnings, context, applications, and experiences in using these methods at the Department of Nursing Sciences at the University of Venda in South Africa.

Interprofessional collaboration among speech-language pathology, physical therapy, and occupational therapy is considered to promote best practice in rehabilitation as it can enhance efficiency, patient outcomes, and clinician and patient satisfaction. Although clinician experiences with interprofessional collaboration have been studied in each of the rehabilitation professions separately, limited research has been conducted on the shared attitudes or experiences across speech-language pathology, physical therapy, and occupational therapy. The purpose of this study was to understand speech-language pathologist, physical therapist, and occupational therapist experiences of interprofessional collaborations. We conducted an exploratory cross-sectional online survey study. The survey included Likert-scale questions and open-ended questions that probed clinicians' general experiences with interprofessional practice and views and beliefs regarding barriers and facilitators to interprofessional collaboration. Responses from 213 clinician respondents were analyzed using descriptive quantitative methods and a qualitative content analysis. The results revealed overlap in attitudes and experiences across speech-language pathology, physical therapy, and occupational therapy about barriers and benefits to interprofessional collaboration. Perceived respect differed among the professions, with speech-language pathologists more frequently reporting that their role is often misunderstood or undervalued by other rehabilitation professionals. These results may guide future research focused upon the predictors of successful interprofessional collaborations and interactions. [ABSTRACT FROM AUTHOR]

Better understanding of breathlessness perception addresses an unmet clinical need for more effective treatments for intractable dyspnoea, a prevalent symptom of multiple medical conditions. The insular-cortex is predominantly activated in brain-imaging studies of dyspnoea, but its precise role remains unclear. We measured experimentally-induced hypercapnic air-hunger in three insular-glioma patients before and after surgical resection. Tests involved one- minute increments in inspired CO2, raising end-tidal PCO2 to 7.5 mmHg above baseline (38.5 ± 5.7 mmHg), whilst ventilation was constrained (10.7 ± 2.3 L/min). Patients rated air-hunger on a visual analogue scale (VAS). Patients had lower stimulus--response (2.8 ± 2 vs. 11 ± 4 %VAS/mmHg; p = 0.004), but similar threshold (40.5 ± 3.9 vs. 43.2 ± 5.1 mmHg), compared to healthy individuals. Volunteered comments implicated diminished affective valence. After surgical resection; sensitivity increased in one patient, decreased in another, and other was unable to tolerate the ventilatory limit before any increase in inspired CO2. We suggest that functional insular-cortex is essential to register breathlessness unpleasantness and could be targeted with neuromodulation in chronically- breathless patients. Neurological patients with insula involvement should be monitored for blunted breathlessness to inform clinical management. [ABSTRACT FROM AUTHOR]

Background: Our previous research found very high levels of burnout and mental health problems among medical students across Indonesia, in line with rates in many other countries. This study further analyses the data by comparing six different regions of Indonesia to determine any differences between them on such measures and to look for possible explanations. Results: Our sample of 1,729 students reported high levels of burnout and 'mild' psychiatric illness across all six regions. There were however significant differences between some regions. Sumatran students reported the lowest scores for both the Oldenburg Burnout Inventory (OLBI) and General Health Questionnaire 12 (GHQ12) scales. Sources of stress also varied among regions, with relationships and study the most reported. Further exploration of possible cultural differences is needed as well as prompt mental health support for medical students. [ABSTRACT FROM AUTHOR]

Background: Medical students face high pressures to perform academically, which may lead to poor psychological wellbeing, burnout, and even mental illness. Aims: This study aims to evaluate the mental health, degree of burnout and substance misuse among medical students in Indonesia in order to to build a system that supports the prosperity of future doctors. Methods: In February to March 2020, we conducted an online survey of Indonesian medical students to assess burnout (using Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12), and alcohol abuse (CAGE questionnaire). Results/Conclusion: A total of 1,729 students from 29 universities participated in the study; 93% felt disengaged, 95% felt exhausted, and 74% were identified to have mild psychiatric illness. We discuss potential factors that need to be explored in further research, including further concerns related to developments since the pandemic, and the need for potential interventions at both local and national levels to enhance the wellbeing of medical students. [ABSTRACT FROM AUTHOR]