The Impact of Behavior Skills Training on Secondary Math Teachers’ Use of Evidence Based Classroom Management Strategies

School-Wide Positive Behavior Interventions and Supports (SW-PBIS) is a research-based approach that improves student engagement, behavior, and school culture, primarily in elementary schools, but is growing in secondary schools. Secondary teachers often resist SW-PBIS due to perceptions that it’s meant for younger students and the belief that high schoolers should already know socially appropriate behavior. One significant barrier to its implementation is the lack of time and space for effective teacher training at the secondary level (Estrapala et al., 2021; Swain-Bradway et al., 2015). Behavior skills training (BST), derived from applied behavior analysis, has proven effective in training educators to improve classroom management (Leaf et al., 2015). This study evaluated BST’s effectiveness in teaching secondary math teachers two strategies: review and implementation of classroom expectations and delivering behavior-specific praise. A single-subject A-B-C design was used with four participants. After baseline was collected, a training occurred with two post-training phases and the second phase included feedback. Results showed that three out of four teachers increased their implementation of classroom expectations and behavior-specific praise. These improvements were sustained after feedback was provided. A social validity measure indicated that all participants found the training effective and manageable. The study highlights the need for better training models for secondary teachers and suggests future research should explore the connection between classroom management and student math achievement. The findings emphasize the importance of extending evidence-based practices like SW-PBIS to secondary education, with a focus on training that includes feedback

Eccentric-Emphasis Exercise Program For Supraspinatus Partial Tear in Retired Police Officer an Intervention Case Report

Abstract Background and Purpose: Eccentric exercise has been shown to reduce pain in patients with multiple comorbidities, orthopedic surgeries, and neurologic conditions, while providing safety for greater loading during resistance training. The purpose of this case report is to describe changes in function and pain of a patient with a partial rotator cuff tear, following rehabilitation exercises focusing on eccentric action. Case Description: A 65 y/o retired police male officer who presented right shoulder pain secondary to a partial tear of the supraspinatus tendon. The case reported mild to severe pain under the visual analog scale (VAS) of 75mm that limited house activities, recreational pursuits like shooting, and disrupted sleep. Initial assessment using the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) scored 46 indicated moderate disability . The plan of care followed guidelines for rotator cuff tendinopathies with an emphasis on eccentric exercises. Outcomes: After 12 weeks of intervention, the subject’s pain improved by 30mm on VAS during activities, and 12 points on DASH, allowing him to contribute more to household activities and go to the shooting range once a week. Discussion: This case report intended to demonstrate the advantages of eccentric exercise in improving strength, tendon capacity, and reducing pain in rotator cuff tendinopathy. Although guidelines recommend exercise and manual therapy, limited evidence exists specifically for eccentric exercise in rotator cuff injuries. Further research, including images and outcome measures, is recommended to investigate the physiological effects of eccentric exercises on rotator cuff tendon healing

Evaluation of acute generalized rashes in travelers returning from Southeast Asia: A guide for clinicians in primary care settings

Americans are travelling internationally in record numbers, and Southeast Asia is among the regions seeing the largest increase in tourism. Travelers to Southeast Asia are exposed to a wide array of diseases and medical conditions that they might otherwise not encounter at home. As such, it is imperative that clinicians working in primary care have the knowledge to both advise travelers of their potential risks as well as recognize diseases in the patient returning from travel. However, many primary care providers may not be sufficiently knowledgeable in travel medicine to confidently evaluate travel-related complaints. Missed diagnoses or improperly treated conditions in this context can lead to unnecessary morbidity and even mortality. Dermatological complaints are among the most frequent reasons that patients returning from Southeast Asia seek professional medical care. This article intends to serve as a resource for clinicians working in primary care who encounter the generalized rash in a patient recently returned from travel to Southeast Asia. It specifically explores how to evaluate these patients to arrive at the correct diagnosis, while highlighting some of the unique, must-not-miss diagnoses endemic to Southeast Asia

CRISPR-Cas9 - The Future of Sickle Cell Disease Management

Sickle cell disease is a life-threatening, inherited blood disorder affecting millions globally. It results from a single point mutation in the β-globin gene, leading to abnormal hemoglobin S and distorted red blood cells that cause vaso-occlusion, anemia, pain crises, and organ damage. While traditional therapies such as pain control, hydroxyurea, and blood transfusions provide symptomatic relief, they are not curative and come with significant limitations. CRISPR-Cas9, a revolutionary gene-editing technology, offers a novel therapeutic approach. Utilizing a guide RNA and Cas9 endonuclease, the system precisely targets and edits DNA, either repairing the sickle mutation or enhancing fetal hemoglobin production. In December 2023, the FDA approved the first CRISPR-based therapy for sickle cell disease, known as, Casvegy, marking a significant milestone in genomic medicine. Despite its promise, CRISPR-Cas9 presents challenges including high cost, accessibility barriers, potential off-target genetic effects, and ethical concerns regarding germ-line transmission. However, early clinical results are encouraging, suggesting significant symptom relief and improved quality of life. This poster explores the mechanism, clinical application, and future implications of CRISPR-Cas9 in sickle cell disease. It highlights the need for ongoing research, ethical deliberation, and equitable access as gene editing becomes the cornerstone of modern medicine

Male Infertility: From Root Causes to Modern Interventions

Male infertility impacts up to 15% of men and contributes significantly to worldwide infertility.1 A multifaceted issue with etiologies from before, after or during spermatogenesis. It includes hypothalamic-pituitary-gonadal axis dysfunction, genetic abnormalities, congenital malformations, systemic illnesses and environmental factors.2 The evaluation of male infertility considers contributing factors and interconnections with broader health issues. Pre-testicular factors discussed include Klinefelter syndrome, Y-chromosome microdeletions, hyperprolactinemia, thyroid dysfunction, obesity, diabetes mellitus, nutrition, pharmaceuticals and lifestyle. Problems within the testicles are cryptorchidism, varicoceles, infections, neoplasms, trauma and anti-sperm antibodies. Common post-testicular reasons are cystic fibrosis, erectile dysfunction, premature ejaculation, hypoactive sexual desire, vasectomies and retrograde ejaculations. Narrowing down causes includes semen analysis, history-taking, examination, hormonal and genetic testing. Treatments vary as patients may benefit from assisted reproductive technologies, surgical interventions, behavior modifications, medication adjustments and hormone therapies.1 Correcting male infertility requires a personalized approach and is unattainable in 30% of cases

Magnesium Sulfate as an Adjunctive Treatment to Therapeutic Hypothermia in Neonatal Hypoxic-ischemic Encephalopathy (HIE)

Neonatal hypoxic-ischemic encephalopathy (HIE) is a critical condition characterized by impaired oxygen and blood supply to the newborn brain, resulting in potential long-term neurological deficits.1,2 HIE remains a significant cause of morbidity and mortality in newborns, necessitating the exploration of therapeutic strategies. Magnesium sulfate (MgSO4), used in conjunction with therapeutic hypothermia, has emerged as a promising neuroprotective agent in the context of HIE. This research delves into current literature and clinical trials examining the efficacy of MgSO4 in mitigating HIE\u27s consequences, emphasizing its neuroprotective mechanisms involving modulation of excitotoxicity, inflammation, and oxidative stress.2,3 Notably, the American College of Obstetricians and Gynecologists (ACOG) recommends MgSO4 administration in cases of anticipated preterm birth before 32 weeks of gestation to prevent cerebral palsy (CP).16 However, the specific use of MgSO4 in the treatment of neonatal HIE remains an evolving area of research. The timing of administration and the severity of the hypoxic-ischemic insult are crucial factors influencing the effectiveness of MgSO4. While promising, further studies are needed to establish standardized protocols for MgSO4 use in neonatal HIE, ensuring optimal neuroprotective outcomes and minimizing potential adverse effects. Healthcare professionals should consider individual patient factors and adhere to the latest guidelines when making treatment decisions

Treatment Strategies to Improve Fertility Outcomes in Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a disorder affecting women of reproductive age, with prevalent characteristics including oligomenorrhea or amenorrhea, infertility, hyperandrogenism, obesity, and polycystic ovaries. This disease can be owed to the imbalance of FSH and LH, increasing androgen production by the ovaries, and preventing follicular maturation and ovulation. A large concern for most patients when diagnosed with PCOS is infertility and their ability to conceive a child. Approaches to management for PCOS include lifestyle modifications versus different types of pharmacological management to induce ovulation, including clomiphene citrate and letrozole. Most patients today prefer holistic approaches to manage their health, and want to avoid any unnatural materials administered into their bodies. Lifestyle modification strategies, including dietary changes with calorie restriction and exercise, have been shown to be as effective as pharmacological management for treating ovulation and improving infertility. Research also shows letrozole to be a superior drug to clomiphene, as it has higher success rates with ovulation and pregnancy rates. It is vital for patients who prefer natural approaches to have autonomy over their health, and understand that holistic approaches will provide them similar results, and tend to be the preferred treatment. However, it is important to understand lifestyle management requires strict discipline with their health in order to get the desired outcomes

Management and Prevention of Recurrent, Uncomplicated Urinary Tract Infections in Premenopausal Women

Urinary tract infections (UTIs) are a common complaint encountered by healthcare providers in a multitude of clinical settings and primarily affect non-pregnant women of reproductive age. Many of these individuals experience chronically recurring UTIs either due to a relapsing infection or reinfection following resolution of the initial infection. The current cornerstone and most effective form of prophylaxis utilizes long term, low dose antibiotics. However, the emergence of worldwide antimicrobial resistance highlights the need for further exploration of alternatives to antibiotics in the management of recurrent UTIs. This article reviews the pathophysiology of recurrent UTIs and presents both antibiotic and non-antibiotic approaches to care

Early Recognition of Ehlers-Danlos Syndrome for the Prevention of Musculoskeletal Injuries and Chronic Pain

Ehlers-Danlos syndrome (EDS) is a connective tissue disorder impacting collagen synthesis that can increase a patient’s risk for more frequent musculoskeletal injuries. Oftentimes, these injuries become chronic and affect an individual\u27s quality of life. This study demonstrates the impact of EDS on the musculoskeletal (MSK) system and the importance of early intervention to prevent chronic injury. Within this CME, information on clinical presentation, diagnosis, and treatment options for EDS are provided. Exercise based physical therapy training programs are the most effective intervention method for EDS. The Involvement of a professional physical therapist is essential within these exercise based programs for safety and efficacy. Medical Devices are most helpful during activities which involve end of range movements and help patients feel supported during activity. Overall, patients reported improved activities of daily living, less pain, and decreased fear of movement after interventions were implemented. Early identification, validation, and intervention for individuals with EDS improves patient’s long-term outcomes and overall quality of life