Athletic Training Assessment of Knowledge Inconsistent with Perceptions of Knowledge Needs: Part II

Purpose: Continuing education (CE) is intended to promote continued competence beyond the level required for entry-level practice. Previous research suggests that athletic trainers are unable to identify their knowledge gaps regarding their clinical practice. The purpose of this research study was to determine if athletic trainers’ perceived need for CE aligns with their performance on an actual knowledge assessment. Method: We used a correlational design conducted on Qualtrics, a web-based platform. Four hundred, forty-four (444) athletic trainers completed all the CE Needs Assessment and over 60% of the athletic training assessment of knowledge. The CE Needs Assessment determined participant’s perceived need for CE using a 5-point Likert scale on the 8 content areas within the National Athletic Trainers’ Association’s educational competencies. The athletic training assessment of knowledge included 71 multiple-choice questions across the 5 domains of athletic training. Actual knowledge for each domain was determined by calculating the percent of correct answers within the domain. We used a Pearson’s correlation analysis to determine the relationship between perceived need for CE and actual knowledge for each domain. Results: We identified a poor, negative, significant correlation between orthopedic clinical assessment and diagnosis (r=-0.10, P=0.034) and domain 2 (clinical evaluation and diagnosis) total score. We also identified a poor, negative significant correlation between therapeutic interventions (r=-0.10, P=0.04) and domain 4 (treatment and rehabilitation). We identified non-significant correlations between perceived need for CE in evidence-based practice, prevention and health promotion, acute care of injury and illness, psychosocial strategies and referral, healthcare administration, and professional development and responsibility and their respective domain total scores. Conclusions: Athletic trainers are unable to consistently identify their need for CE in relation to their actual knowledge performance. This suggests that perceived need is not an effective means to identify areas of weakness in athletic training clinical practice and should not be used to guide CE choices

KNOWLEDGE OF ATHLETIC TRAINERS REGARDING AIRWAY ADJUNCTS

Context: Research shows that knowledge gaps occur among various professions and practitioners, which may harm patients. Little research has been done in Athletic Training to determine if knowledge gaps exist. Objective: To determine the relationship between perceived and actual knowledge of airway adjunct use and determine the difference in perceived knowledge. Design: Knowledge assessment Setting: Web-based survey Participants: 2000 Certified Athletic Trainers received the survey via email, 152 responded. Our response rate was 7.6%. Interventions: The perceived knowledge questionnaire was modified from Flynn and Goldsmith 5-item subject knowledge assessment. Flynn and Goldsmith examined the assessment tool to ensure validity and reliability. The 5 original items were applied to airway adjunct use to assess pre and post test perceived knowledge. We performed a factor analysis, which revealed that, 68.7% of the variance was assumed within 3 factors defined as knowledge retrieval, comprehension, and knowledge utilization. Main Outcome Measures: We measured pre and post-test perceived knowledge using the perceived knowledge questionnaire. Actual knowledge was measured using an assessment consisting of 9 questions related to common airway adjunct uses. We asked each participant to rate their likelihood to pursue continuing education during the pre and post-test perceived knowledge questionnaire. We also asked participants how often lifesaving skills were used in their job. We used dependent t-tests to determine the pre and post-test differences in perceived knowledge and likelihood to pursue continuing education. A correlation analysis was used to determine the relationship between perceived and actual knowledge. We used an analysis of variance to determine if differences in actual knowledge existed between genders, employment settings, and how frequently they used life saving skills. Results: We identified no significant change (t150 = -0.91, p = 0.37, 95% CI = -0.17 to 0.06) in likelihood to pursue continuing education from before (pre = 4.35 ± 1.30) and after testing (post = 4.40 ± 1.35). A poor relationship (r = 0.36, p < 0.001) was identified between perceived knowledge and actual knowledge. We found a significant difference (F1,145 = 4.63, p = 0.03, 1-β = 0.57) between the frequency of use of life saving skills and actual knowledge. Conclusion: We identified a knowledge gap amongst athletic trainers in the use of airway adjuncts. Although the likelihood to pursue continuing education score was high, the score did not significantly increase after completing the assessment, which is inconsistent with previous literature. Participants who use life saving skills more frequently scored higher on the actual knowledge assessment, suggesting that the more frequently athletic trainers utilize a skill, the more knowledge they demonstrate

Comprehensive Knowledge Assessment for Athletic Trainers: Part I

Purpose: Continuing education (CE) is intended to help clinicians maintain competence, develop and advance knowledge and skills, and enhance knowledge, skills, and abilities beyond the levels required for entry-level practice. Based on previous literature, the current mode of CE in athletic training does not appear to be helping clinicians maintain competence. The purpose of this research was to validate a comprehensive assessment based on the Role Delineation Study/Practice Analysis (6th ed.) through item analysis and estimates of reliability to be used to assess athletic trainers’ actual knowledge. Method: We conducted an instrumentation validation study using Qualtrics® web-based platform. Athletic trainers (n=191; age=31.5±8.1yrs; years of experience=8.9±11.1yrs) in good standing with the NATA and BOC completed both administrations of the assessment. Six experts developed 220 multiple-choice items for inclusion with broad application across the five domains of clinical practice (Injury/Illness and Wellness Protection [49 items], Clinical Evaluation and Diagnosis [63 items], Immediate and Emergency Care [29 items], Treatment and Rehabilitation [29 items], and Organizational and Professional Health and Wellbeing [50 items]). A random sample of NATA members were recruited via email, received weekly reminders, and then after four weeks, they completed a second administration of the assessment. We evaluated the assessment tool for item difficulty, item discrimination, internal consistency, item total statistics, and test-retest reliability. Results: We eliminated 42 items from the tool created by the experts that were too difficult (0.90). We eliminated 50 additional items due to point-biserial correlations between item performance and total domain score performance below 0.20. We identified additional weaknesses in 57 items through intraclass correlation coefficients (ICCConclusions: We developed a valid and reliable assessment tool to measure athletic trainers’ actual knowledge. Future research should utilize a validated assessment of actual knowledge to guide continuing education activities

Adolescent Perceptions of Injury and Pressures of Returning to Sport: A Retrospective Qualitative Analysis

The increase in sport participation among adolescents has led to the rise in sport-related injuries, many of which have unique characteristics based on the patient, their perceptions, and the pressures faced when returning to sport. The purpose of this study was to identify the underlying factors that contributed to adolescents’ perceptions of injury and the various pressures they experienced when returning to sport. Two themes emerged from the study: support and fear. Support was provided to participants through development, care, and the environment. Fear was the factor that affected the participant in their return to sport, which came in the form of worry and doubt

Contamination of personal protective equipment during COVID-19 autopsies

Confronted with an emerging infectious disease at the beginning of the COVID-19 pandemic, the medical community faced concerns regarding the safety of autopsies on those who died of the disease. This attitude has changed, and autopsies are now recognized as indispensable tools for understanding COVID-19, but the true risk of infection to autopsy staff is nevertheless still debated. To clarify the rate of SARS-CoV-2 contamination in personal protective equipment (PPE), swabs were taken at nine points in the PPE of one physician and one assistant after each of 11 full autopsies performed at four centers. Swabs were also obtained from three minimally invasive autopsies (MIAs) conducted at a fifth center. Lung/bronchus swabs of the deceased served as positive controls, and SARS-CoV-2 RNA was detected by real-time RT-PCR. In 9 of 11 full autopsies, PPE samples tested RNA positive through PCR, accounting for 41 of the 198 PPE samples taken (21%). The main contaminated items of the PPE were gloves (64% positive), aprons (50% positive), and the tops of shoes (36% positive) while the fronts of safety goggles, for example, were positive in only 4.5% of the samples, and all the face masks were negative. In MIAs, viral RNA was observed in one sample from a glove but not in other swabs. Infectious virus isolation in cell culture was performed on RNA-positive swabs from the full autopsies. Of all the RNA-positive PPE samples, 21% of the glove samples, taken in 3 of 11 full autopsies, tested positive for infectious virus. In conclusion, PPE was contaminated with viral RNA in 82% of autopsies. In 27% of autopsies, PPE was found to be contaminated even with infectious virus, representing a potential risk of infection to autopsy staff. Adequate PPE and hygiene measures, including appropriate waste deposition, are therefore essential to ensure a safe work environment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00428-021-03263-7

Docosahexaenoic acid normalizes QT interval in long QT type 2 transgenic rabbit models in a genotype-specific fashion

Long QT syndrome (LQTS) is a cardiac channelopathy predisposing to ventricular arrhythmias and sudden cardiac death. Since current therapies often fail to prevent arrhythmic events in certain LQTS subtypes, new therapeutic strategies are needed. Docosahexaenoic acid (DHA) is a polyunsaturated fatty acid, which enhances the repolarizing IKs current.We investigated the effects of DHA in wild type (WT) and transgenic long QT Type 1 (LQT1; loss of IKs), LQT2 (loss of IKr), LQT5 (reduction of IKs), and LQT2-5 (loss of IKr and reduction of IKs) rabbits. In vivo ECGs were recorded at baseline and after 10 µM/kg DHA to assess changes in heart-rate corrected QT (QTc) and short-term variability of QT (STVQT). Ex vivo monophasic action potentials were recorded in Langendorff-perfused rabbit hearts, and action potential duration (APD75) and triangulation were assessed. Docosahexaenoic acid significantly shortened QTc in vivo only in WT and LQT2 rabbits, in which both α- and β-subunits of IKs-conducting channels are functionally intact. In LQT2, this led to a normalization of QTc and of its short-term variability. Docosahexaenoic acid had no effect on QTc in LQT1, LQT5, and LQT2-5. Similarly, ex vivo, DHA shortened APD75 in WT and normalized it in LQT2, and additionally decreased AP triangulation in LQT2.Docosahexaenoic acid exerts a genotype-specific beneficial shortening/normalizing effect on QTc and APD75 and reduces pro-arrhythmia markers STVQT and AP triangulation through activation of IKs in LQT2 rabbits but has no effects if either α- or β-subunits to IKs are functionally impaired. Docosahexaenoic acid could represent a new genotype-specific therapy in LQT2

Evaluating a peer-to-peer health education program in Australian public housing communities during the COVID-19 pandemic

Abstract Background The cohealth Health Concierge program operated in Melbourne, Australia from July 2020 to 30 June 2022. It provided peer-to-peer support to culturally and linguistically diverse residents of high-rise public housing. During this time, the COVID-19 public health response changed frequently and included movement restriction, testing and vaccination. We conducted a mixed-methods evaluation to determine the Health Concierge program’s impact on residents’ engagement with health services and public health activities. Methods The evaluation, informed by a Project Reference Group, used the RE-AIM framework. We analysed data from 20,901 routinely collected forms describing interactions between Concierges and residents from August 2021 to May 2022. Additional evaluation-specific data were collected between March and May 2022 in four housing estates; we surveyed 301 residents and conducted 32 interviews with residents, Concierges and program stakeholders. Results Concierges promoted COVID-safe behaviours; linked residents with support, testing and vaccination services; and disseminated up-to-date information. Of the 20,901 recorded interactions, 8,872 (42%) included Concierges providing support around COVID-19 vaccination. Most surveyed residents (191/301, 63%) reported speaking with a Concierge in the previous six months. The self-reported two-dose COVID-19 vaccine uptake was 94% (283/301). Some residents described having meaningful, appreciated conversations with Concierges, and some described superficial interactions. While residents initially welcomed the program, many felt it failed to evolve. Poorly defined management and hiring criteria led to variable program implementation. A need for bicultural workers to continue linking residents with services was discussed. Conclusions Concierges’ impact on residents may have contributed to high community uptake of COVID-19 testing and vaccination, and had benefits beyond the COVID-19 remit. We recommend the program be revised and continued to inform further preparedness planning and support service access generally. Program models such as this have potential to inform and reassure high-risk communities during a pandemic. In addition, such programs can help overcome vaccine hesitancy and promote protective health behaviours, regardless of whether a pandemic is currently occurring. Ensuring these programs remain responsive to the changing needs of end-users needs over time is imperative

Additional file 1 of Evaluating a peer-to-peer health education program in Australian public housing communities during the COVID-19 pandemic

Supplementary Material 1: Appendix 1: Health Concierge Form 2.

Humans and Great Apes Share Increased Neocortical Neuropeptide Y Innervation Compared to Other Haplorhine Primates

Neuropeptide Y (NPY) plays a role in a variety of basic physiological functions and has also been implicated in regulating cognition, including learning and memory. A decrease in neocortical NPY has been reported for Alzheimer\u27s disease, schizophrenia, bipolar disorder, and depression, potentially contributing to associated cognitive deficits. The goal of the present analysis was to examine variation in neocortical NPY-immunoreactive axon and varicosity density among haplorhine primates (monkeys, apes, and humans). Stereologic methods were used to measure the ratios of NPY-expressing axon length density to total neuron density (ALv/Nv) and NPY-immunoreactive varicosity density to neuron density (Vv/Nv), as well as the mean varicosity spacing in neocortical areas 10, 24, 44, and 22 (Tpt) of humans, African great apes, New World monkeys, and Old World monkeys. Humans and great apes showed increased cortical NPY innervation relative to monkey species for ALv/Nv and Vv/Nv. Furthermore, humans and great apes displayed a conserved pattern of varicosity spacing across cortical areas and layers, with no differences between cortical layers or among cortical areas. These phylogenetic differences may be related to shared life history variables and may reflect specific cognitive abilities.</p