Note on paramoudra-like carbonate concretions in the Urenui Formation, North Taranaki: possible plumbing system for a Late Miocene methane seep field

A reconnaissance study of calcitic and dolomitic tubular concretions in upper slope mudstone of the Late Miocene Urenui Formation exposed along the north Taranaki coastline indicates that they have a complex diagenetic history involving different phases of carbonate cementation and likely hydrofracturing associated with build up of fluid/gas pressures. The concretions resemble classical paramoudra in the European chalk, but are not siliceous and do not have a trace fossil origin. Stable oxygen and carbon isotope data suggest that the micritic carbonate cements in the Urenui paramoudra were probably sourced primarily from ascending methane fluid/gases, and that they precipitated entirely within the host mudstone below the seafloor. We suggest the paramoudra may mark the subsurface plumbing networks of a Late Miocene cold seep system, in which case they have relevance to the evolution and migration of hydrocarbons in Taranaki Basin, at this site perhaps focussed along the Taranaki Fault. The presence of dislodged and mass-emplaced paramoudra in the axial conglomerate of channels within the Urenui mudstone suggests there could be a connection between the loci of seep field development and slope failure and canyon cutting on the Late Miocene Taranaki margin

Tubular carbonate concretions as hydrocarbon migration pathways? Examples from North Island, New Zealand

Cold seep carbonate deposits are associated with the development on the sea floor of distinctive chemosyn¬thetic animal communities and carbonate minerali¬sation as a consequence of microbially mediated anaerobic oxidation of methane. Several possible sources of the methane exist, identifiable from the carbon isotope values of the carbonate precipitates. In the modern, seep carbonates can occur on the sea floor above petroleum reservoirs where an important origin can be from ascending thermogenic hydrocar¬bons. The character of geological structures marking the ascent pathways from deep in the subsurface to shallow subsurface levels are poorly understood, but one such structure resulting from focused fluid flow may be tubular carbonate concretions. Several mudrock-dominated Cenozoic (especially Miocene) sedimentary formations in the North Island of New Zealand include carbonate concretions having a wide range of tubular morphologies. The concretions are typically oriented at high angles to bedding, and often have a central conduit that is either empty or filled with late stage cements. Stable isotope analyses (δ13C, δ18O) suggest that the carbonate cements in the concretions precipitated mainly from ascending methane, likely sourced from a mixture of deep thermogenic and shallow biogenic sources. A clear link between the tubular concretions and overlying paleo-sea floor seep-carbonate deposits exists at some sites. We suggest that the tubular carbonate concretions mark the subsurface plumbing network of cold seep systems. When exposed and accessible in outcrop, they afford an opportunity to investigate the geochemical evolution of cold seeps, and possibly also the nature of linkages between subsurface and surface portions of such a system. Seep field development has implications for the characterisation of fluid flow in sedimentary basins, for the global carbon cycle, for exerting a biogeochemical influence on the development of marine communities, and for the evaluation of future hydrocarbon resources, recovery, and drilling and production hazards. These matters remain to be fully assessed within a petroleum systems framework for New Zealand’s Cenozoic sedimentary basins

Gender Differences In Academic Ethics With Recommendations For Curricular Change

An extensive study has been performed on the importance of building ethical principles into secondary school and college curricula.  In published surveys, females are almost universally found to be more ethical, but experience tells us females lag behind males in their ability to maintain and act upon their convictions in the workplace.  We examined these issues by administering a survey on academic ethics to an undergraduate business school population, focusing heavily on gender differences. Careful analysis of survey results using one-way ANOVA, the Tukey-Kramer procedure, and two-way ANOVA procedures provided an understanding of differences in ethical beliefs and ethical behaviors based on gender and other demographic characterizations.  Predictive analysis was completed using logistic regression and discrete choice modeling to determine the likelihood of ethical behavior in the future and evolution of ethical beliefs.  The accumulated results of the analyses were used to guide the authors in the development of a strong and pervasive ethics-based curriculum for secondary schools and universities.  We have combined elements of classroom instruction, technology, active learning, games and extracurricular activities to embed ethical concepts and particularly encourage strength in convictions across the entire curricula. 

Anticholinergics Influence Transition from Normal Cognition to Mild Cognitive Impairment in Older Adults in Primary Care

Study Objective To determine the influence of anticholinergic medications on transitions in cognitive diagnosis of older adults in primary care. Design This observational cohort study was conducted over a mean follow‐up of 3.2 years. Anticholinergic exposure was defined by pharmacy dispensing and claims records. Cognitive diagnosis was performed by an expert panel at baseline and annually up to 4 years. Data Source Medication exposure and other clinical data were extracted from the Indiana Network for Patient Care (INPC). The cognitive diagnosis was derived from a cognitive screening and diagnosis study. Participants A total of 350 adults 65 years and older without dementia and receiving primary care in a safety net health care system. Measurement and Main Results Cognitive diagnosis followed a two‐phase screening and consensus‐based neuropsychiatric examination to determine a baseline diagnosis as normal cognition, mild cognitive impairment (MCI), or dementia, with a follow‐up neuropsychiatric examination and consensus‐based diagnosis repeated annually. The Anticholinergic Cognitive Burden scale was used to identify anticholinergics dispensed up to 10 years before enrollment and annually throughout the study. A total standard daily dose of anticholinergics was calculated by using pharmacy dispensing data from the INPC. Among 350 participants, a total of 978 diagnostic assessments were completed over a mean follow‐up of 3.2 years. Compared with stable cognition, increasing use of strong anticholinergics calculated by total standard daily dose increased the odds of transition from normal cognition to MCI (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.01–1.31, p = 0.0342). Compared with stable MCI, strong anticholinergics did not influence the reversion of MCI to normal cognition (OR 0.95, 95% CI 0.86–1.05, p = 0.3266). Conclusion De‐prescribing interventions in older adults with normal cognition should test anticholinergics as potentially modifiable risk factors for cognitive impairment

Does ethnicity impact DPT students’ clinical readiness and performance? An exploratory study

The purpose of this study was to explore the influence of ethnicity on clinical readiness and performance among DPT students as determined by (1) clinical reasoning Physical Therapist Self-Efficacy (PTSE) score during clinical experiences(2) self-confidence rating treating patients, and (3) final APTA Clinical Performance Instrument (CPI) clinical reasoning and summative ratings by clinical instructors. A 28 question survey was administered to 211 second- and third-year students in a Doctor of Physical Therapy program at mid-term of their clinical experience. Survey scores, PTSE scores, and CPI scores were analyzed using a Kruskal-Wallis test for differences between groups. All ethnic groups demonstrated strong clinical readiness and performance during all clinical experience levels. Ethnic groups did not differ in clinical reasoning self-efficacy or confidence treating patients. Although the gap appears to be closing, there continues to be underrepresentation of ethnic groups in DPT academic programs

Fossil vesicomyid bivalves from Miocene hydrocarbon seep sites, North Island, New Zealand

Two fossil species of vesicomyids are described from Lower to Middle Miocene hydrocarbon seep carbonates in eastern North Island, New Zealand. One elongate species is proposed as a new genus and species: Notocalyptogena neozelandica. The other species probably belongs to the genus Pliocardia, but due to poor preservation is not identified further. The composition of this Miocene vesicomyid seep fauna differs from that found in modern New Zealand seeps located on the offshore Hikurangi convergent margin, which contain the genera Calyptogena, Archivesica, and Isorropodon. The fossil fauna went extinct locally after the Middle Miocene and has been since replaced by the modern vesicomyid taxa

Self-Efficacy with Telehealth Examination: the Doctor of Physical Therapy Student Perspective

Introduction: The shift to telehealth exposed gaps in our understanding of how physical therapy students perceive patient assessment in a remote situation using the examination component of the patient/client management (PCM) model. The purpose of the study was to compare Doctor of Physical Therapy (DPT) students’ self-efficacy performing patient assessment using the examination component of the PCM model using telehealth compared with conventional examination. To achieve the purpose of this study, the Physical Therapist Self-Efficacy (PTSE) scale was used. More specifically, self-efficacy in clinical reasoning was measured using the following items: (1) PTSE total score (2) performance of tests and measures, (3) determining when to refer to another practitioner, and (4) screening for primary medical disease. Methods: A survey-based descriptive and exploratory repeated measures design was used, with surveys distributed to entry-level DPT students during their clinical experiences in the United States during the Fall 2020 semester. A convenience sample of 35 second- and third-year entry-level DPT students who reported provided both telehealth and traditional examinations during clinical experiences was used. Descriptive and inferential statistics were used to evaluate within group differences comparing student self-efficacy using telehealth and conventional examination. Results: Wilcoxon sign ranks revealed statistically significant differences in self-efficacy scores of students conducting patient assessment using telehealth compared to conventional examination. More specifically, scores for telehealth were lower (P \u3c 0.001) compared to conventional examination in PTSE total score, performance of tests and measures, determining when to refer to another practitioner, and medical screening for primary disease. Discussion: Doctor of Physical Therapy students’ self-efficacy was lower when providing telehealth across all PTSE questions pertaining to the examination component of the PCM model. Exploring telehealth content and sequence in entry-level physical therapy curriculum may help students feel more prepared to perform telehealth examination. Key words: Examination, Physical therapy, Self-efficacy, Students, Telehealth

Comparison of Flex vs. residential clinical education program outcomes: physical therapy students’ self-efficacy, confidence, and clinical competence

Purpose: Alternative flexible (Flex) path Doctor of Physical Therapy (DPT) programs may have an emerging footprint. The differences between Flex and traditional residential DPT program clinical experience outcomes remain unknown. The purpose of this study was to evaluate Flex and residential DPT students’ clinical reasoning self-efficacy, confidence with treating, and Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences. Methods: A descriptive and exploratory cross-sectional survey was used with a voluntary convenience sample of 211 university DPT students during Fall 2020 full-time clinical experiences. Descriptive and inferential statistics evaluated differences in Flex and residential DPT program students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final CPI clinical reasoning and summative scores during clinical experiences. Results: Mean PTSE scores were significantly lower for Flex (x̄ = 14.2) compared to residential DPT students (x̄ = 15.2) (P \u3c 0.05). No significant student differences were found in (1) Flex (x̄ = 2.1) and residential (x̄ = 2.2) confidence with treating at the initial visit (P = 0.59), (2) Flex (x̄ = 2.8) and residential (x̄ = 3.0) confidence with treating subsequent same-patient visits (P = 0.15), and (3) Flex (x̄ = 15.8) and residential (x̄ = 16.5) CPI clinical reasoning (P = 0.17), and (4) Flex (x̄ = 16.1) and residential (x̄ = 16.7) CPI summative scores (P = 0.21). Conclusion: Clinical reasoning self-efficacy among Flex DPT students was lower, but there was no difference in CPI clinical reasoning or summative results between Flex and residential DPT students. In the university investigated, the Flex distance learning DPT program curriculum appeared effective in preparing students’ clinical reasoning readiness for the available full-time clinical experiences. We recommend academic institutions consider expanding Flex entry-level DPT program availability options because the outcomes were comparable. Additional flex entry programs may help address the underrepresentation of nontraditional students in entry-level DPT programs and societal demands for physical therapy services

Clinical Reasoning Readiness and Confidence of DPT Students with PT Interventions Using Telehealth

Telehealth service-delivery content has an emerging footprint on entry-level physical therapy programs. This study evaluated clinical reasoning readiness and confidence in third-year DPT students during clinical experiences with and without telehealth. Students’ clinical reasoning readiness and confidence were determined using the Physical Therapist Self-Efficacy (PTSE) score, self-confidence rating treating patients, and final APTA Clinical Performance Instrument (CPI) clinical reasoning and summative ratings. DPT students providing PT interventions using telehealth reported lower clinical reasoning self-efficacy (PTSE) when compared to traditional service-delivery. Confidence treating using telehealth was greater at the initial visit compared to subsequent visits, suggesting a lack of student readiness for providing subsequent telehealth visits. Final CPI ratings did not differ between DPT students with and without telehealth

Doctor of Physical Therapy students’ clinical reasoning readiness and confidence treating with telehealth: a United States survey

Purpose: Telehealth has an emerging footprint on entry-level physical therapy programs. Students’ readiness for clinical reasoning with virtual versus traditional face-to-face treatment remains unknown. The purpose of this study was to evaluate Doctor of Physical Therapy (DPT) students’ preparedness for clinical experiences with and without telehealth. Methods: A descriptive and exploratory cross-sectional survey was employed, with a voluntary convenience sample of 211 second- and third-year university DPT students during Fall 2020 clinical experiences. Descriptive and inferential statistics evaluated differences in DPT students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences with and without telehealth. Results: Telehealth availability was 40.3%, with 16.6% of DPT students reporting participation. Most students reported being comfortable (39.3%) or neutral (32.2%) using telehealth. DPT students’ confidence level using telehealth to treat was 74% on initial and 97% on subsequent same-patient visits. Mean PTSE scores were significantly lower during clinical experiences with telehealth (13.1) compared to traditional experiences (15.1) (PP Conclusion: While entry-level DPT programs continue to establish best practice for telehealth education, current trends in academic curriculum seem to prepare students’ clinical reasoning readiness for clinical experiences. The PTSE could be used to identify outlier students requiring additional mentoring during traditional and telehealth clinical experiences