A Case Report of Acute Heart Failure Due to Infective Aortic Endocarditis Diagnosed by Point-of-care Ultrasound

Introduction: Infective endocarditis (IE) is a life-threatening condition with significant morbidity and mortality, and can require surgical repair.Case Report: A 36-year-old man presented to the emergency department for worsening dyspnea and chest pain. Point-of-care echocardiography demonstrated a mobile oscillating mass on the aortic valve with poor approximation of the valve leaflets, suggesting aortic valve insufficiency secondary to IE as the cause of acute heart failure. The patient underwent emergent aortic valve replacement within 24 hours.Discussion: While point-of-care echocardiography has been well documented in identifying tricuspid vegetations, aorticvalve involvement and subsequent heart failure is less well described. Earlier recognition of aortic valve vegetations and insufficiency can expedite surgical intervention, with decreased complication rates linked to earlier antimicrobial therapy.Conclusion: This case report highlights the ability of point-of-care ultrasound to identify aortic vegetations, allowing for the earlier diagnosis and therapy

Relationships Among Administrative Computerization, Hospital Size, and Administrative Expenses

The healthcare industry is computerizing administrative functions in an attempt to reduce expenses and remain competitive. This correlational study of 3,088 Medicare-certified, short-term, acute-care hospitals in the United States was based on a general systems theory framework; it sought to examine the relationships among the independent variables of hospital size and administrative computerization and the dependent variable of administrative expenses. Secondary data from Health Information Management Systems Society\u27s surveys and cost reports from the Centers for Medicare and Medicaid services were used. Correlation analyses with an alpha of .05 were used to test 3 of the 4 hypotheses; regression analysis was used to test the final hypothesis. Approximately 52% of the variance in administrative expenses was explained by the number of beds, a moderate-to-high relationship. Only 6.3% of the variance in administrative expenses was explained by the amount of administrative computerization, a significant but small relationship. Only 9% of the variance in administrative computerization was explained by the hospital size, a significant but small relationship. The results of this study can be used as a basis to determine whether investment in technology in administration will reduce health care expenses. Appropriate investment in technology can contribute to social change by reducing consumer health care costs

Student Perceptions and Grade Comparisons after Exposure to Instructor-Made Skills Videos in a Kinesiology Course

The purpose of this mixed method, descriptive case study was to determine whether the use of pre-recorded instructor-made videos (PRIMVs) in a kinesiology course, along with curricular design changes, facilitated increased conceptual and practical student learning. The study examined three student cohorts in one occupational therapy program. Two of the student cohorts had unrestricted access to the PRIMVs designed to support student learning of bone and muscle palpation and joint actions. Students from the two cohorts completed a survey about their experience of having access to the videos. Exam data from the student cohorts who had access to the videos was compared to exam data from an earlier cohort who had not been exposed to the videos. While no significant differences in the lab exam grades were noted, quantitative and qualitative data collected from the surveys revealed that students perceived that their overall course grade was higher and they were better prepared for clinical fieldwork as a result of having access to the videos. This study adds to the growing body of evidence that supports video technology as a supplemental learning tool in occupational therapy education

Children and young people’s experiences and perceptions of self-management of type 1 diabetes: A qualitative meta-synthesis

The aim of this review was to conduct a meta-synthesis of the experiences and perceptions of self-management of type 1 diabetes of children and young people living with type 1 diabetes (CYPDs). Six databases were systematically searched for studies with qualitative findings relevant to CYPDs’ (aged 8–18 years) experiences of self-management. A thematic synthesis approach was used to combine articles and identify analytical themes. Forty articles met the inclusion criteria. Two analytical themes important to CYPDs’ experiences and perceptions of self-management were identified: (1) negotiating independence and (2) feeling in control. The synthesis contributes to knowledge on contextual factors underpinning self-management and what facilitates or impedes transition towards autonomous self-management for CYPDs

Giving Children a Voice: Investigation of children's participation in consultation and decision making in Irish hospitals

The purpose of this study was to investigate sick children’s experiences of participation in consultation and decision-making within the healthcare setting. The specific objectives were: to describe children’s experiences of consultation in the healthcare setting; to identify the factors that enhance children’s involvement in consultation and the decisionmaking process; to identify the factors that hinder children from involvement in consultation and the decisionmaking process; to explore strategies that will empower children to participate in their own healthcare decisions

Committed to burnout: An investigation into the relationship between sport commitment and athlete burnout in Gaelic games players

This study examined the relationship between sports commitment, outlined in the hierarchical Sport Commitment Model, and athlete burnout in men and women playing Gaelic games, for the first time. These athletes experience a number of unique challenges, including playing with numerous teams simultaneously, significant personal commitment despite their amateur status, and the societal and cultural importance of their sports. This study also involved piloting a novel commitment measure of ‘team importance’ for team-sport athletes. Two-hundred-and-one male and female Gaelic games players completed the Sports Commitment Questionnaire, team importance measure and Athlete Burnout Questionnaire. Hierarchical Multiple Regression analyses revealed a negative relationship between sport enjoyment, social support (emotional) and desire to excel and particular burnout components; a positive relationship between other priorities and personal investments and particular burnout components; and enthusiastic commitment was associated with lower burnout, while constrained commitment was linked to higher burnout. The team importance measure was also found to be a reliable and valid measure of sports commitment. These findings provide important insight into how sports commitment can contribute to, or guard against, burnout in male and female athletes

Optimisation and validation of a PCR for Antigen Receptor Rearrangement (PARR) assay to detect clonality in canine lymphoid malignancies

PCR for antigen receptor gene rearrangements (PARR) analysis is being increasingly used to assist diagnosis of canine lymphoma. In this study, PARR was carried out on consecutive samples received as part of routine diagnostic practice from 271 patients: 195 with lymphoid malignancies, 53 with reactive conditions and 23 with other neoplasms. Initially, published primer sets were used but later minor primer modifications were introduced and primers were rationalised to give a PARR panel that provides a good compromise between sensitivity and cost. Results were compared to diagnoses made by histology or cytology, coupled with immunophenotyping by flow cytometry or immunohistochemistry where possible. After exclusion of 11 poor quality samples, 230/260 (88%) gave a clear result with 162/163 (99%) of samples classified as clonal and 56/67 (84%) classified as polyclonal giving results concordant with the cytological/histological diagnosis. Among 30 samples with equivocal results, 21 had clonal peaks in a polyclonal background and nine showed little amplification. These were from patients with a range of neoplastic and non-neoplastic conditions emphasising the need to interpret such results carefully in concert with other diagnostic tests. The combination of primer sets used in this study resulted in a robust, highly specific and sensitive assay for detecting clonality

The Role of Political Skill in the Stressor–Outcome Relationship: Differential Predictions for Self- and Other-Reports of Political Skill

The beneficial role of political skill in stress reactions and performance evaluations has been demonstrated in a substantial amount of empirical research. Most of the research, however, has focused on self-perceptions of political skill. This study examines the differential moderating effects of self- vs. other-rated political skill in the conflict – emotional burnout and performance relationships, using two samples including non-academic staff employees of a large university (N = 839) and a variety of office and retail employees from an automotive organization (N = 142). We argue that self-reported political skill moderates the relationship between conflict and a self-reported strain-related outcome that is important to the individual (i.e., emotional burnout), but that supervisor-rated political skill does not moderate this relationship. Further, we argue that supervisor-rated political skill moderates the relationship between conflict and an outcome important to the supervisor and the organization (i.e., job performance), but that self-reported political skill does not moderate this relationship. Findings partially support our hypotheses as both self and supervisor-rated political skill neutralized the negative effects of conflict on burnout, but only supervisor-rated political skill neutralized the negative effects of conflict on performance. Limitations and directions for future research are discussed