Managing Allergic Rhinoconjunctivitis with Accelerated Subcutaneous Immunotherapy

Subcutaneous immunotherapy (SCIT) is a powerful treatmentoption for people with refractive allergic rhinoconjunctivitis.Immunotherapy is the only therapy that can modulate theimmune response and develop immune tolerance to commonaeroallergens such as pollen, dander, and dust mites for longerlasting results. Although the minimum treatment period forSCIT has been identified to be 3 years, there are still questionsregarding how long the beneficial effects of SCIT lasts afterdiscontinuation of therapy. There are also risks and benefits tovarious accelerated SCIT dosing schedules, including cluster and rushdosing. My presentation aims to be a comprehensive resource forproviders that need a better alternative to pharmacotherapy forrefractive allergic rhinitis and/or conjunctivitis

Cardiac Amyloidosis: An Underdiagnosed Cause of Heart Failure

Cardiac amyloidosis (CA) is thought of as a rare cause of heart failure, although underdiagnosis makes its true prevalence difficult to discern. Advances in diagnosis have revealed that CA is likely more prevalent than once previously believed. Despite the advances in treatment for cardiac amyloidosis, prognosis remains poor. Early recognition of “red flags” reduces delays in diagnosis and treatment. Additionally, as incidence of CA increases, clinicians must understand the treatment of CA and how it differs from other forms of heart failure. This CME emphasizes different epidemiological features and “red flags” that may alert a clinician to screen for cardiac amyloidosis. It will then discuss the diagnostic workup and treatment for CA and its comorbidities

BENEFITS OF EARLY INTERVENTION WITH A CERTIFIED LYMPHEDEMA THERAPIST FOR MANAGEMENT OF RADIATION FIBROSIS SYNDROME (RFS) AND AXILLARY WEB SYNDROME (AWS) IN BREAST CANCER PATIENTS

All breast cancer treatment leads to soft tissue changes in the treated quadrant. While these changes are chronic, they are also identifiable and manageable with care from an appropriate provider. Scarring, lymphedema, radiation fibrosis syndrome (RFS), and axillary web syndrome (AWS) may all be part of the post-treatment soft tissue changes for a breast cancer survivor. Familiarity with the likely presentation and lifelong management of a patient’s specific symptom burden is crucial. While any physical therapist can rehabilitate the neuropathies, shoulder pain, postural dysfunction, or other numerous orthopedic issues that may occur, there is an acknowledged deficit in the treatment of specific post treatment issues,1 in availability of appropriate clinicians with adequate knowledge and experience to manage these specific concerns, and in clinician willingness to treat this specialized population.2 Both providers and patients may be unaware of the lifelong functional and comfort improvements possible with early recognition of and intervention for post-treatment soft tissue and functional changes,2 as opposed to delaying referral

Breaking the Chains: An Exploration of the Effectiveness of CBT on Violent vs. Nonviolent Offenders

Cognitive-behavioral therapy (CBT) is a well known and common form of theory used to treat a variety of disorders. Our criminal justice system has tried and failed at rehabilitating offenders through a punishment-based approach. CBT opens the door to a treatment approach that actually reduces recidivism. Specifically, this research aims to look at the varying effects that CBT has on violent vs nonviolent offenders. Different types of CBT yield differing effects for violent and nonviolent offenders, with some benefitting one more than the other. Looking at the integrity of the CBT program is an important component to keep in mind when evaluating the effectiveness of these programs. Offenders who fully complete the programs have significantly lower recidivism when compared to drop-outs and control conditions. Community-based CBT programs are seen as the best type of program for offenders when compared to prison-based and court-ordered, Although, each has varying effects on recidivism depending on the offender. Adult offenders saw significantly lowered rates of recidivism, however, juveniles have more mixed results. It is also important that this research encompasses large follow-up periods to yield the best survival analysis. Overall, CBT does reduce recidivism in both violent and nonviolent offenders, but there are a lot of factors at play to keep in mind

Updated Guidelines for Screening and Prevention of Colorectal Cancer

Colorectal cancer (CRC) is one of the most common forms of cancer, typically manifesting in the later stages of life. Through ongoing technological advances and research, the medical field continues to make breakthroughs in CRC treatment.1 CRC rates are declining in people over age 65, while cases have increased by 2% in those aged 50-64 since 2011.2 Healthcare providers need to update their CRC screening guidelines to reflect changing patient demographics, environmental factors, and evolving lifestyle patterns. These updates are crucial as they directly impact early detection and treatment outcomes. Physician assistants (PAs) have emerged as key players in fighting CRC by developing and implementing comprehensive management practices. These practices emphasize patient education and adherence to screening guidelines, which are essential for improved detection rates. PAs serve as vital intermediaries, providing initial screenings and assessments while facilitating appropriate referrals for specialized treatment based on individual patient needs and conditions. This article conducts a thorough review of current, evidence-based CRC guidelines to demonstrate the pressing need for primary care PAs to integrate these updated protocols into their daily practice, ultimately enhancing patient care and outcomes

Deaf Culture Matters: The Perceived Implementation of Culturally Responsive Teaching Practices in Public Deaf Education

Over the last five decades, the number of Deaf and hard-of-hearing (DHH) students enrolled in public schools has significantly increased, while fewer attend traditional residential schools for the Deaf. Although public schools may provide academic advantages, concerns remain about their capacity to meet the cultural, linguistic, and social-emotional needs of DHH students. Access to Deaf culture is essential for students to develop a healthy Deaf identity, feel a sense of belonging, and participate meaningfully in their education. While the Culturally Responsive Teaching (CRT) framework has been widely researched, there is limited work examining Deaf culture explicitly through the lens of CRT. This mixed-methods study explored how Teachers of the Deaf (TODs) in a large urban public school district conceptualize Deaf culture and implement CRT practices in DHH classrooms. An explanatory sequential design guided the research. In Phase One, a modified version of the Culturally Responsive Teaching Self-Efficacy Survey (CRTSE) was administered to four TODs. Two participants with high CRTSE scores were selected for follow-up interviews. Findings indicate that TODs possess a solid understanding of Deaf culture and report moderate to high confidence in applying CRT practices. They shared examples of integrating culturally responsive strategies. The results also revealed areas for growth, particularly in collecting student-specific data to inform instruction. This study highlights the need for targeted professional development and underscores the importance of utilizing CRT practices in public schools. Additional implications for practice and recommendations for future research are discussed. Keywords: Deaf culture, culturally responsive teaching, DHH students, public schools, teacher self-efficac

Ultrabaroque Grandeur: Examining the Churrigueresque in Spanish Architecture from the Seventeenth and Eighteenth Centuries

Following the Protestant Reformation, Spain was in a unique position compared to the rest of Europe. The importance of Catholicism was intrinsic to Spanish society by this point, as it was under King Ferdinand and Queen Isabella, aptly dubbed the Catholic Monarchs, that the Christians reconquered the Iberian peninsula in 1492, after an eight century rule by Arab-Muslims. In the centuries that followed, Spanish architecture reached new levels of grandeur in the wake of reformed Catholic doctrine. Following the motto “docere, delectare, movere”(to teach, to delight, to move), architects were urged to convey the Church’s power and garner new supporters. The ultrabaroque, or “Churrigueresque” as it was known in Spain, emerged in the late-seventeenth century as an architectural style characterized by exuberant ornamentation and stucco along the facades of primarily ecclesiastical buildings. But what makes this so unique? Through the reinvigorated spirit of the Plateresque, a principally Spanish style, combined with the integral Solomonic and estípite columns and elaborate retablos, or altarpieces, the Spanish developed an architectural style uniquely their own. This style would go on to expand further to their colonies in the Americas, dominating the principal design for missionary architecture and cementing the Baroque and subsequently the “Churrigueresque” as a global art movement. Through my studies and experiences in Granada this past fall semester, I will demonstrate how the Spanish ultrabaroque was a truly unique style that emerged from the seventeenth and eighteenth centuries, through a series of case studies on the Granada Charterhouse and the Basilica of San Juan de Dios, along with secondary examples in the Convento de San Esteban in Salamanca and the Granada Cathedral. These locations exemplify the ultrabaroque style found in religious interiors and reflect the key characteristics of this Spanish style and identity

Evaluating Treatment Modalities in Concussion Management

At least 3 million Americans get a mild traumatic brain injury (mTBI) each year, and 1 in 5 have symptoms which last more than 1 month.10 Concussions can heavily impact the lives of patients causing symptoms of confusion, memory loss, headache, nausea and vomiting, balance issues, photophobia, phonophobia, and general feeling of being unwell. Some patients may even be affected by post concussion syndrome with long lasting effects. Without proper management to efficiently maximize recovery, symptoms can be prolonged and lead to long term consequences in health and decrease in quality of life for patients. An evaluation of prolonged cognitive rest versus active rehabilitation in the recovery of concussions can help shift the guidelines in place on the management of concussions. This article will display an evidence based guideline of concussion management to lead to faster concussion recovery with less long term negative outcomes for patients by utilizing early active rehabilitation

Non-invasive Modalities to Diagnosing Endometriosis

Endometriosis is a common gynecologic disease that affects a multitude of women of childbearing age. The symptoms of endometriosis can significantly impact a woman\u27s quality of life and include things like chronic pelvic pain, indigestion, fatigue, heavy menstrual bleeding, constipation, diarrhea and even infertility. These symptoms are similar to those of irritable bowel syndrome (IBS), pelvic inflammatory disease(PID), uterine fibroids, polycystic ovary syndrome (PCOS) and more. Because of its resemblance to other conditions and detrimental effects, it is crucial to have quick, easy, efficient diagnostic tools to differentiate endometriosis from other diseases. Currently, the gold standard modality to confirm endometriosis is an exploratory laparoscopy. Though endometriosis is commonly found to be in the lower abdomen or pelvis, it has potential to spread all over the body. Given its ability to spread, similarity to other syndromes, and invasive diagnostic methods, it is important to discover precise, non-invasive ways to confirm endometriosis anywhere in the body. This article aims to provide evidence-based research for non-invasive diagnostic tools to improve early detection and treatment for endometriosis and better patient outcomes