Making space: Integrating meaningful interprofessional experiences into an existing curriculum

Many health professional education programs have instituted, or are in the process of developing, structures for implementing interprofessional education (IPE). Professional organizations are also adopting IP competencies for their respective memberships and accreditations. Our IPE design and educational framework was informed by evidence gathered from professional organizations; the students' lived experience with traditional approaches and evolving IPE designs and data from our school's longitudinal curriculum evaluation study. This paper briefly describes the evolution and design of an embedded IPE program within an existing master's level curriculum – which meets not only curriculum competencies but also nationally recognizes IPE competencies. In addition, the embedded program articulates with a mandatory faculty-wide IPE initiative. The creation of embedded IPE within existing courses allowed for enriched learning opportunities for both discipline-specific and IPE knowledge without changing the overall curriculum structure.     

Neonatal alcohol impairs the context preexposure facilitation effect in juvenile rats: Dose-response and post-training consolidation effects

Alcohol exposure on postnatal days (PND) 4-9 in the rat adversely affects hippocampal anatomy and function and impairs performance on a variety of hippocampus-dependent tasks. Exposure during this developmental window reveals a linear relationship between alcohol dose and spatial learning impairment in the context preexposure facilitation effect (CPFE), a hippocampus-dependent variant of contextual fear conditioning. The purpose of the current report was to examine the effect of a range of alcohol doses administered during a narrower window, PND7-9, than previously reported (Experiment 1) and to begin to determine which memory processes involved in this task are impaired by developmental alcohol exposure (Experiment 2). In Experiment 1, rats pups received a single day binge alcohol dose of either 2.75, 4.00, 5.25 g/kg/day or were sham-intubated (SI) from PND7-9. Conditioned freezing during the test day was evident in all dosing groups, except for Group 5.25 g, indicating no graded dose-related behavioral deficits with alcohol exposure limited to PND7-9. In Experiment 2, rat pups were exposed to the highest effective dose from Experiment 1 (5.25 g/kg/day) or were sham intubated over PND7-9. During training, rats remained in the conditioning context for 5-min following immediate shock delivery. During this test of post-shock freezing, both SI and alcohol-exposed rats given prior exposure to the conditioning context showed comparable freezing levels. Since alcohol-exposed rats showed normal post-shock freezing, deficits by these rats on the test day likely reflect a failure to consolidate or retrieve a context-shock association, rather than a deficit in hippocampal conjunctive processes (consolidation, pattern completion) that occur prior to shock on the training day. These findings illustrate the value of the CPFE for characterizing the separable memory processes that are impaired by neonatal alcohol exposure in this task.     

Is it possible to stabilize the trunk using rhythmic stabilization in the upper limb? A cross-sectional study of asymptomatic individuals

Objective: The study aim was to evaluate the immediate effect of rhythmic stabilization on local and distant muscles involved in a functional reach. Method: Prospective, observational cross-sectional study. Eight right-handed and non-impaired individuals (4 females and 4 males) aged 18–24 years (21.5 ± 1.58 years) were evaluated. Bilateral electromyographic recording of the biceps brachii, triceps brachii, multifidus lumbar, and rectus abdominis muscles was performed during three different tasks. Task 1 involved functional reach, while Task 2 involved rhythmic stabilization followed by a functional reach. Task 3 was similar to Task 2, but with 3 repetitions before a functional reach. Results: The results showed no difference between the tasks or sides. However, an interaction was observed between each side and muscles, with greater activation of the right multifidus lumbar muscle. Conclusion: Rhythmic stabilization during the task of reaching promotes an increase of multifidus activity ipsilateral to its application. Thus, this particular technique of proprioceptive neuromuscular facilitation can be useful for improving stability of the trunk and can be used in clinical practice for this purpose. Level of Evidence: 5.     

Best practice in clinical facilitation of undergraduate nursing students

Clinical facilitation is critical to successful student clinical experience. The research reported in this paper used an interpretive case study to explore perspectives of clinical facilitators on what constitutes best practice in clinical facilitation of undergraduate nursing students.Eleven clinical facilitators from South East Queensland, Australia, participated in focus groups, interviews and a concept mapping exercise to gather their perspectives on best practice. The data gathered information regarding their prior and current experiences as registered nurses and facilitators, considering reasons they became clinical facilitators, their educational background and self-perceived adequacy of their knowledge for clinical facilitation. Analysis was through constant comparison.Findings of the study provided in-depth insight into the role of clinical facilitators, with best practice conceptualised via three main themes; ‘assessing’, ‘learning to facilitate’ and ‘facilitating effectively’. While they felt there was some autonomy in the role, the clinical facilitators sought a closer liaison with academic staff and feedback about their performance, in particular their assessment of the students. Key strategies identified for improving best practice included educational support for the clinical facilitators, networking, and mentoring from more experienced clinical facilitators. When implemented, these strategies will help develop the clinical facilitators' skills and ensure quality clinical experiences for undergraduate nursing students.     

Estimation of Blood Alcohol Concentrations in Young Male Drinkers

This research examined individual differences in the ability to self-monitor the effects of alcohol. Thirty-nine male subjects consumed 0.75 ml/kg alcohol and estimated their blood alcohol concentrations (BACs) at peak BAC and on the ascending and descending limbs of the blood alcohol curve. Family history of alcohol dependence did not affect the accuracy of estimation of BACs. Subjects who reported lower levels of subjective intoxication underestimated their BACs more than did subjects who reported higher levels of subjective intoxication. Subjects with less behavioral impairment underestimated their BACs more than subjects with greater behavioral impairment on the ascending limb of the blood alcohol curve. Accuracy was better on the ascending limb compared with peak BAC and the descending limb, and accuracy became worse over time on the descending limb. It appears that cues to the effects of alcohol rapidly become unavailable on the descending limb, which may contribute to decisions concerning further alcohol consumption and driving after drinking.     

DeBakey Ⅲ型夹层动脉瘤的治疗

目的：分析与总结我院收治的ＤｅＢａｋｅｙⅢ型夹层动脉瘤患者３５例的治疗经验与效果。方法：本组男性３２例，女性３例，男女比例为１０∶１，年龄２１～６４岁，平均５２．０±３．２岁。全部患者均经Ｘ线胸片，数子减影血管造影术，计算机断层摄影术，磁共振成像检查证实诊断，动脉瘤的直径４．６～９．０ｃｍ，平均５．１±２．２ｃｍ。全组患者中２１例进行了手术治疗（手术组），其中１７例行人造血管部分降主动脉替换术，２例行升主动脉及腹主动脉转流手术，２例行主动脉折叠手术。１４例未行手术（非手术组）。结果：手术组死亡３例（术中出血１例，住院死亡２例）。非手术组８例在住院期间动脉瘤破裂（６例死亡，２例包裹后出院，半年后因动脉瘤再次破裂死亡）；２例随访３年存活；１例失访；３例自动出院。结论：目前对ＤｅＢａｋｅｙⅢ型夹层动脉瘤的治疗尚存在不同意见，本组患者结果表明手术治疗优于非手术治疗（Ｐ＜０．０５）。     

Descending Perineum Syndrome: Are Abdominal Hysterectomy and Bowel Habits Linked?

PURPOSE This retrospective study evaluates the effect of abdominal hysterectomy on patients affected by descending perineum syndrome. METHODS Eighty-nine female patients affected by descending perineum syndrome and one group of 10 healthy women with normal bowel habits were studied retrospectively. Thirty-two descending perineum syndrome patients (Group 1) had received an abdominal hysterectomy for benign diseases, while 57 descending perineum syndrome patients (Group 2) had not undergone this surgery. All 99 subjects underwent clinical evaluation, computerized anorectal manometry, and defecography. RESULTS Dyschezia was found predominantly in Group 2 subjects (P < 0.05). Fecal incontinence was significantly higher in Group 1 than in Group 2 (P < 0.05). The worst anal resting pressure was found in the incontinent Group 1 patients (P < 0.01). Rectoanal intussusception was a significant defecographic sign in Group 1 subjects (P < 0.05). CONCLUSIONS Clinical evaluation and instrumental data suggested a possible link between fecal incontinence and abdominal hysterectomy in patients affected by descending perineum syndrome.     

The effect of the Kinesio Tape on the muscle power performance of elite weightlifters

IntroductionTo investigate the effect of the Kinesio Tape on the muscle power of the elite weightlifters.MethodsA randomized controlled trial, single blind. Forty-two male weightlifters were randomly assigned to the experimental Kinesio Tape and sham Kinesio Tape groups of the study. The participants then performed a single leg vertical jump and a single leg horizontal jump with three attempts of each to obtain the measurement of muscle power. Outcome measures were included single-leg vertical countermovement jump, estimated peak power, and single-leg horizontal countermovement jump.ResultSignificant effect of Kinesio Tape on horizontal jumps distance among the weightlifters in the experimental group (p = 0.002). The study showed that the vertical jump height (p = 0.433), estimated peak power (p = 0.542) and horizontal jump distance (p = 0.841) measurements did not improve significantly between the groups at level p = 0.05.ConclusionThere is a small and better improvement noticed on the outcome measurements after Kinesio Tape application, which may be considered clinical importance for the sport. However, there was no statistically significant effect of Kinesio Tape between the groups.