Clinical Instructor Perceptions of the Collaborative Clinical Education Model: Providing Solutions for Success in Physical Therapy Education

Purpose: The most common approach to physical therapy clinical education is the one-to-one (1:1) model. The collaborative clinical education model (CCEM) offers an alternative and beneficial approach to education but is not widely utilized within physical therapy. The primary aim of this study was to explore the experiences and perceptions of clinical instructors (CIs) teaching within the CCEM while also receiving structured support from an academic program. Methods: This study used semi-structured interviews before and after the CCEM experience to explore CI perceptions. CIs received formalized support that included pre-experience meetings, a CCEM Toolkit resource, scheduled follow-ups during the experience, and a post-clinical debriefing. Interview transcripts were analyzed using a qualitative data analysis program and collaborative coding process. Results: CIs’ perceptions of the CCEM shifted following participation. Participants noted a need to be prepared with appropriate teaching strategies, have frequent communication with the academic program, and have a supportive clinical environment. Conclusion: CI participation in the CCEM is challenged by negative perceptions and lack of experience with collaborative learning. CI perceptions of the CCEM can become more positive after actually teaching in the CCEM; therefore, perceived challenges need to be addressed to increase CI participation. The CCEM may be more widely accepted if CIs’ perceived challenges are addressed in partnership with an academic program with intentional CCEM training and support strategies

A study of the preschool child's concept of race based upon an analysis of the child's picture interpretation

Call number: LD2668 .T4 1949 B4

Holographic second laws of black hole thermodynamics

Recently, it has been shown that for out-of-equilibrium systems, there are additional constraints on thermodynamical evolution besides the ordinary second law. These form a new family of second laws of thermodynamics, which are equivalent to the monotonicity of quantum R\'enyi divergences. In black hole thermodynamics, the usual second law is manifest as the area increase theorem. Hence one may ask if these additional laws imply new restrictions for gravitational dynamics, such as for out-of-equilibrium black holes? Inspired by this question, we study these constraints within the AdS/CFT correspondence. First, we show that the R\'enyi divergence can be computed via a Euclidean path integral for a certain class of excited CFT states. Applying this construction to the boundary CFT, the R\'enyi divergence is evaluated as the renormalized action for a particular bulk solution of a minimally coupled gravity-scalar system. Further, within this framework, we show that there exist transitions which are allowed by the traditional second law, but forbidden by the additional thermodynamical constraints. We speculate on the implications of our findings.Comment: 81 pages, 19 figures; v2: clarifications and reference added, minor typos corrected, published versio

First law of holographic complexity

We investigate the variation of holographic complexity for two nearby target states. Based on Nielsen's geometric approach, we find the variation only depends on the end point of the optimal trajectory, a result which we designate the first law of complexity. As an example, we examine the complexity=action conjecture when the AdS vacuum is perturbed by a scalar field excitation, which corresponds to a coherent state. Remarkably, the gravitational contributions completely cancel and the final variation reduces to a boundary term coming entirely from the scalar field action. Hence the null boundary of Wheeler-DeWitt patch appears to act like the "end of the quantum circuit".Comment: 7 pages + supplemental material, 2 figures; v2: clarifications and reference added, published versio

Aspects of The First Law of Complexity

We investigate the first law of complexity proposed in arXiv:1903.04511, i.e., the variation of complexity when the target state is perturbed, in more detail. Based on Nielsen's geometric approach to quantum circuit complexity, we find the variation only depends on the end of the optimal circuit. We apply the first law to gain new insights into the quantum circuits and complexity models underlying holographic complexity. In particular, we examine the variation of the holographic complexity for both the complexity=action and complexity=volume conjectures in perturbing the AdS vacuum with coherent state excitations of a free scalar field. We also examine the variations of circuit complexity produced by the same excitations for the free scalar field theory in a fixed AdS background. In this case, our work extends the existing treatment of Gaussian coherent states to properly include the time dependence of the complexity variation. We comment on the similarities and differences of the holographic and QFT results.Comment: 108 pages, 15 figures; v2: references adde

Effects of fetal position on the loading of the fetal brain during the onset of the second stage of labour

During vaginal labour, the delivery requires the fetal head to mould to accommodate the geometric constraints of the birth canal. Excessive moulding can produce brain injuries and long-term sequelae. Understanding the loading of the fetal brain during the second stage of labour (fully dilated cervix, active pushing, and expulsion of fetus) could thus help predict the safety of the newborn during vaginal delivery. To this end, this study proposes a finite element model of the fetal head and maternal canal environment that is capable of predicting the stresses experienced by the fetal brain at the onset of the second phase of labour. Both fetal and maternal models were adapted from existing studies to represent the geometry of full-term pregnancy. Two fetal positions were compared: left-occiput-anterior and left-occiput-posterior. The results demonstrate that left-occiput-anterior position reduces the maternal tissue deformation, at the cost of higher stress in the fetal brain. In both cases, stress is concentrated underneath the sutures, though the location varies depending on the presentation. In summary, this study provides a patient-specific simulation platform for the study of vaginal labour and its effect on both the fetal brain and maternal anatomy. Finally, it is suggested that such an approach has the potential to be used by obstetricians to support their decision-making processes through the simulation of various delivery scenarios

Patient characteristics of the Accident and Emergency Department of Kenyatta National Hospital, Nairobi, Kenya: a cross-sectional, prospective analysis

Background Resource-limited settings are increasingly experiencing a ‘triple burden’ of disease, composed of trauma, non-communicable diseases (NCDs) and known communicable disease patterns. However, the epidemiology of acute and emergency care is not well characterised and this limits efforts to further develop emergency care capacity. Objective To define the burden of disease by describing the patient population presenting to the Accident and Emergency Department (A&E) at Kenyatta National Hospital (KNH) in Kenya. Methods We completed a prospective descriptive assessment of patients in KNH’s A&E obtained via systematic sampling over 3 months. Research assistants collected data directly from patients and their charts. Chief complaint and diagnosis codes were grouped for analysis. Patient demographic characteristics were described using the mean and SD for age and n and percentages for categorical variables. International Classification of Disease 10 codes were categorised by 2013 Global Burden of Disease Study methods. Results Data were collected prospectively on 402 patients with an average age of 36 years (SD 19), and of whom, 50% were female. Patients were most likely to arrive by taxi or bus (39%), walking (28%) or ambulance (17%). Thirty-five per cent of patients were diagnosed with NCDs, 24% with injuries and 16% with communicable diseases, maternal and neonatal conditions. Overall, head injury was the single most common final diagnosis and occurred in 32 (8%) patients. The most common patient-reported mechanism for head injury was road traffic accident (39%). Conclusion This study estimates the characteristics of the A&E population at a tertiary centre in Kenya and highlights the triple burden of disease. Our findings emphasise the need for further development of emergency care resources and training to better address patient needs in resource-limited settings, such as KNH