Search

This study was conducted to evaluate the impact of formal and informal messages transmitted to urban and rural communities in Ecuador, on the knowledge of prevention and control of the SARS-CoV-2 pandemic. Six focus groups were carried out with six to eight people per group through Zoom platform, from August 2020 to April 2021; NVivo 12 software was used for the thematic analysis of the data. Thirty-nine people, including male and female, participated in the study with mean age 39 years. Main outcomes included: use of alternative medicine for prevention and control of COVID-19; religious acceptance; impact of COVID-19 on mental health; lack of understanding and knowledge of the disease; and the mixed messages shared through official and unofficial channels about virus prevention and control. The study demonstrates the importance of using formal channels of communication to transmit accurate information, to reach people regardless of their geographical location.

Context: Deficits in ankle and hip strength and lower-extremity postural control are associated with chronic ankle instability (CAI). Following strength training, muscle groups demonstrate increased strength. This change is partially credited to improved neuromuscular control, and many studies have investigated ankle protocols for subjects with CAI. The effects of isolating hip musculature in strength training protocols in this population are not well understood. Objective: To examine the effects of hip strengthening on clinical and self-reported outcomes in patients with CAI. Design: Prospective randomized controlled clinical trial. Setting: Athletic training facility. Participants: Twenty-six participants with CAI (12 males and 14 females; age = 20.9 [1.5] y, height = 170.0 [12.7] cm, and mass = 77.5 [17.5] kg) were randomly assigned to training or control groups. Intervention: Participants completed either 4 weeks of supervised hip strengthening (resistance bands 3 times a week) or no intervention. Main Outcome Measures: Participants were assessed on 4 clinical measures (Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions; Balance Error Scoring System; hip external rotation strength; and hip abduction strength) and a patient-reported measure (the Foot and Ankle Ability Measure activities of daily living and sports subscales) before and after the 4-week training period. Results: The training group displayed significantly improved posttest measures compared with the control group for hip abduction strength (training: 446.3 [77.4] N, control: 314.7 [49.6] N, P P P P P P P Conclusion: Improved clinical and patient-reported outcomes in the training group suggest hip strengthening is beneficial in the management and prevention of recurrent symptoms associated with CAI.

While large clinical trials have shown rare adverse side effects in post-menopausal women taking uninterrupted oral bisphosphonates (BPs), there is mounting evidence that longer-term treatment may be associated with osteonecrosis of the jaw (ONJ). There is a paucity of information regarding the causal relationship between extended oral BP treatment and ONJ, and the safety of non-surgical therapy of apical lesions and length of treatment in women on long-term BPs. We describe a post-menopausal woman on long-term oral BPs who developed ONJ without any contributory risk factors. Quantitative data was gathered through review of the patient's medical record. Qualitative data was gathered from face-to-face interviews with patient and clinician. Analysis of the data revealed the patient did not feel it was important to report her use of BPs. Given the wide usage of antiresorptives dental clinicians should manage all post-menopausal women with the assumption they currently or have recently been treated with BPs. There is a need for a collaborative effort by medical and dental practitioners to reduce risk of ONJ, ensure proper BP dosing and length of treatment, identify contributory risk factors, and explore alternate modalities, such as Ca(OH)2 multi-visit palliative pulpectomy, to avert ONJ and improve treatment outcomes.

PURPOSE Some physician assistant (PA) program directors believe paying clinicians and administrators for clinical sites is fair and necessary, while others regard such practices as undermining traditional altruistic motivations for precepting. The purpose of this study was to assess PA program directors' attitudes on this topic and describe current practices and future plans regarding compensation to clinical sites. METHODS A cross-sectional descriptive survey was sent to directors of PA programs with continuing and provisional accreditation status in 2012. RESULTS Seventy-eight (48%) of the 163 program directors surveyed participated in the study. Although most respondents indicated that paying for clinical sites was not an acceptable practice, almost half believed it would. be acceptable if there were standards and definitions for equitable and fair payments. Despite the finding that most respondents' programs do not pay for clinical sites, nearly half anticipate their programs will be paying for clinical sites in three years, and the cost of such payments will be passed on to students in the form of increased tuition or separate fees. Many indicated a concern that paying for clinical sites may result in monopolies and bidding wars. CONCLUSION While paying clinical sites may be effective for recruitment and retention of clinical sites, most program directors are concerned about the expanded role economics will have for their program. Agreed-upon standards and definitions for fair and equitable payment practices may alleviate some of these concerns. However, the potential effects on students and programs identified in this study necessitate additional research to fully assess what implications this may have on PA education and the profession.

Patient falls in hospitals continue to exist as a serious societal problem. The purpose of this study was to analyze nurses' perceptions of patient fall risk factors that may be used to develop an electronic patient decision support system to prevent patient falls. A survey was distributed to 150 nurses in a moderate-size hospital system in Central Florida (200+ beds). Survey questions were developed to identify 3 fall risk factor categories: patient-centered, operational, and critical. Sixty-five surveys (43.3%) were returned. Descriptive statistics such as frequencies and percentages were calculated on all study variables. All participants indicated they were familiar with the circumstances that have contributed to falls or near-falls of patients. Findings included the majority of nurses perceived both patient-centered and operational factors increased the risks for patient falls, with pertinent results indicating a lack of appropriate ambulatory device (90.8%), low to very low nurse staffing levels (87.7%), and a history of a fall within the past year (73.8%) increased the risk for falls. The nurses' perceptions define a standard medical terminology that can be recorded in electronic progress notes and programmed to quickly link to additional sources of fall risk data (eg, laboratory work, medications) housed within the hospital's electronic health record. Further research is needed to assess the feasibility of an electronic health record-based system to prevent hospital falls using risk factors identified in this and other studies.

Christian divorce support groups offer a community-based approach to help divorcees heal from their divorce. Yet, their effectiveness in ethnically diverse populations has not been fully elucidated. The purpose of this qualitative study was to investigate if Christian divorce support groups influence the forgiveness process and lead to improved self-reported health outcomes in Black Christian divorcees. Surveys and focus groups were used to evaluate key variables in 43 participants. Findings demonstrate participation in Christian divorce support groups positively influences forgiveness levels and health outcomes in Black Christians. These findings have religious, mental health, and clinical implications.

Stress fractures are a common overuse problem among military trainees resulting in preventable morbidity, prolonged training, and long-term disability following military service. Femoral neck stress fractures (FNSFs) account for 2% of all stress fractures but result in disproportionate burden in terms of cost and convalescence. The purpose of this study was to describe and investigate FNSF in U.S. Air Force basic trainees and to present new data on risks factors for developing FNSF. We examined 47 cases of FNSF occurring in Air Force basic trainees between 2008 and 2011 and 94 controls using a matched case-control model. Analysis with t tests and conditional logistic regression found the risk of FNSF was not associated with body mass index or abdominal circumference. Female gender (p < 0.001) and slower run time significantly increased risk of FNSF (1.49 OR, p < 0.001; 95% CI 1.19-1.86). A greater number of push-up and sit-up repetitions significantly reduced risk of FNSF (0.55 OR, p = 0.03; 95% CI 0.32-0.93; 0.62 OR, p = 0.04; 95% CI 0.4-0.98) for females. In this study body mass index was not correlated with FNSF risk; however, physical fitness level on arrival to training and female gender were significantly associated with risk of FNSF.