336 research outputs found

    Phase Zero

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    In October 2006 General Charles Wald, Deputy Commander U.S. European Com- mand, brought “Phase Zero” into the joint lexicon with the publication of an article, “The Phase Zero Campaign.”1 Over the last five years the concept of taking coordinated action in peacetime to affect the strategic environment has becomewidely accepted and is now integrated into theater campaign plans. These activi- ties focus on building capacity of partners and influencing potential adversaries to avoid war. In contrast, Chinese strategic culture has encouraged taking actions to defeat an enemy prior to the onset of hostilities for two and a half millennia

    Use of remote sensing techniques for inventorying and planning utilization of land resources in South Dakota

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    The basic procedures for interpreting remote sensing imagery to rapidly develop general soils and land use inventories were developed and utilized in Pennington County, South Dakota. These procedures and remote sensing data products were illustrated and explained to many user groups, some of whom are interested in obtaining similar data. The general soils data were integrated with land soils data supplied by the county director of equalization to prepare a land value map. A computer print-out of this map indicating a land value for each quarter section is being used in tax reappraisal of Pennington County. The land use data provided the land use planners with the present use of land in Pennington County. Additional uses of remote sensing applications are also discussed including tornado damage assessment, hail damage evaluation, and presentation of soil and land value information on base maps assembled from ERTS-1 imagery

    Heresies

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    Orthopaedic Physical Therapy Residency and Fellowship Program Mentoring Structure: A Survey of Program Directors

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    Purpose/Hypothesis: Mentoring is a required component of physical therapy residency and fellowship training, and a primary reason applicants pursue training in these programs. Resources outlining core competencies for effective mentoring, mentor and mentee characteristics, and recommendations for effective mentoring have been described. However, little is known about the timing, structure, and process of how mentoring and feedback is implemented across residency and fellowship programs. The purpose of this study was to better understand the structure, timing, and delivery of mentoring and the role mentors and program directors (PDs) play in orthopaedic physical therapy residency and fellowship programs. A secondary purpose was to identify the influence of the COVID-19 pandemic on mentoring delivery. Number of Subjects: A survey was sent to 135 accredited orthopaedic physical therapy residency and fellowship program directors Materials and Methods: A practice committee of the Academy of Orthopaedic Physical Therapy Orthopaedic Residency and Fellowship Special Interest Group developed survey questions. Forty-eight questions about program background, mentoring logistics, structure, delivery, transitions, training, selection, feedback, communication, mentor roles, and impacts of COVID-19 on mentoring were asked. Questions were entered into a secure Red Cap survey and a recruitment email with survey link was sent to PDs from accredited programs on three separate occasions over two months. Descriptive statistics and survey responses were analyzed. Results: PDs submitted 32 surveys (23.7% response rate), had 15.9 (8.5) years’ experience as a physical therapist and a mean program involvement of 6.3 (3.2) years. Programs most often schedule 1:1 mentoring weekly (63%) or several days/week (25.9%); most often in four hour blocks (44.4%) for a mean of 157.6 (60.3) hours. Mentee feedback was delivered before, during, or after the mentoring session verbally 92.3%, and feedback was shared with the resident in front of the patient often 26.9%, sometimes 61.5% and rarely 11.5%. Mentoring was delivered 100% in-person by programs and virtually by 42.3%. Mentor and mentee paired assignments varied with 65.4% assigning more than one mentor. Most programs (84.6%) do not have a career development ladder for mentors. The COVID-19 pandemic influenced mentoring delivery with 53.8% using increased virtual mentoring, 19.2% using increased asynchronous mentoring, and 42.3% decreasing mentoring hours during the pandemic. Conclusions: Orthopaedic physical therapy residency and fellowship mentoring is delivered using a variety of methods, and mentors and program directors cross-cover multiple positions in residency and fellowship programs. Identifying the structure and delivery of mentoring commonly used in residency and fellowship programs provides baseline data to better understand optimal mentoring approaches and influence of mentoring structure on resident and fellowship outcomes

    Pilot Study Assessment of Dynamic Vascular Changes in Breast Cancer with Near-Infrared Tomography from Prospectively Targeted Manipulations of Inspired End-Tidal Partial Pressure of Oxygen and Carbon Dioxide

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    The dynamic vascular changes in the breast resulting from manipulation of both inspired end-tidal partial pressure of oxygen and carbon dioxide were imaged using a 30 s per frame frequency-domain near-infrared spectral (NIRS) tomography system. By analyzing the images from five subjects with asymptomatic mammography under different inspired gas stimulation sequences, the mixture that maximized tissue vascular and oxygenation changes was established. These results indicate maximum changes in deoxy-hemoglobin, oxygen saturation, and total hemoglobin of 21, 9, and 3%, respectively. Using this inspired gas manipulation sequence, an individual case study of a subject with locally advanced breast cancer undergoing neoadjuvant chemotherapy (NAC) was analyzed. Dynamic NIRS imaging was performed at different time points during treatment. The maximum tumor dynamic changes in deoxy-hemoglobin increased from less than 7% at cycle 1, day 5 (C1, D5) to 17% at (C1, D28), which indicated a complete response to NAC early during treatment and was subsequently confirmed pathologically at the time of surgery

    Characterizing Community-Based Mental Health Services for Children with Autism Spectrum Disorders and Disruptive Behavior Problems

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    This study describes the characteristics of children with autism spectrum disorders (ASD) with disruptive behavior problems served in community-based mental health clinics, characterizes psychotherapy process and outcome, and examines differences between children with ASD and a non-ASD comparison group. Results indicate that children with ASD served in this setting are high functioning and diagnostically complex. Certain research-based behavioral and cognitive behavioral psychotherapeutic strategies were observed frequently, while parent training strategies and active teaching strategies were observed less frequently. The intensity or thoroughness with which strategies were pursued was relatively low. Outcome analyses indicate improvement in child symptoms and family functioning. Treatment delivery and outcome were similar for children with and without ASD. These findings represent the first detailed observational data characterizing community-based mental health services for children with ASD

    A skin abscess model for teaching incision and drainage procedures

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    <p>Abstract</p> <p>Background</p> <p>Skin and soft tissue infections are increasingly prevalent clinical problems, and it is important for health care practitioners to be well trained in how to treat skin abscesses. A realistic model of abscess incision and drainage will allow trainees to learn and practice this basic physician procedure.</p> <p>Methods</p> <p>We developed a realistic model of skin abscess formation to demonstrate the technique of incision and drainage for educational purposes. The creation of this model is described in detail in this report.</p> <p>Results</p> <p>This model has been successfully used to develop and disseminate a multimedia video production for teaching this medical procedure. Clinical faculty and resident physicians find this model to be a realistic method for demonstrating abscess incision and drainage.</p> <p>Conclusion</p> <p>This manuscript provides a detailed description of our model of abscess incision and drainage for medical education. Clinical educators can incorporate this model into skills labs or demonstrations for teaching this basic procedure.</p

    Prevalence and demographics of methicillin resistant Staphylococcus aureus in culturable skin and soft tissue infections in an urban emergency department

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    <p>Abstract</p> <p>Background</p> <p>The rising incidence of methicillin resistant <it>Staph. aureus </it>(MRSA) infections is a concern for emergency practitioners. While studies have examined MRSA in inpatients, few have focused on emergency department populations. We sought to describe predictors of MRSA skin infections in an emergency department population.</p> <p>Methods</p> <p>This was a prospective observational cohort study conducted over three months in 2005. A convenience sample of patients with culturable skin infections presenting to a busy, urban emergency department was enrolled. Demographic and risk factor information was collected by structured interview. The predictive value of each risk factor for MRSA, as identified by culture, was tested using univariable logistic regression, and a multivariable predictive model was developed.</p> <p>Results</p> <p>Patients were 43% black, 40% female and mean age was 39 years (SD 14 years). Of the 182 patients with cultures, prevalence of MRSA was 58% (95%CI 50% to 65%). Significant predictors of MRSA were youth, lower body mass index, sexual contact in the past month, presence of an abscess cavity, spontaneous infection, and incarceration. The multivariable model had a C-statistic of 0.73 (95%CI 0.67 to 0.79) with four significant variables: age, group living, abscess cavity, and sexual contact within one month.</p> <p>Conclusion</p> <p>In this population of emergency department patients, MRSA skin infection was related to youth, recent sexual contact, presence of abscess, low body mass index, spontaneity of infection, incarceration or contact with an inmate, and group home living.</p
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