18 research outputs found
Fostering clinical reasoning in physiotherapy: Comparing the effects of concept map study and concept map completion after example study in novice and advanced learners
Background: Health profession learners can foster clinical reasoning by studying worked examples presenting fully worked out solutions to a clinical problem. It is possible to improve the learning effect of these worked examples by combining them with other learning activities based on con
Folliculin interacts with p0071 (plakophilin-4) and deficiency is associated with disordered rhoa signalling, epithelial polarization and cytokinesis
Inherited mutations in the folliculin (FLCN) gene cause the Birt-Hogg-Dubé syndrome of familial hair follicle tumours (fibrofolliculomas), lung cysts and kidney tumours. Though folliculin has features of a tumour suppressor, the precise function of the FLCN gene product is not well characterized. We identified plakophilin-4 (p0071) as a potential novel folliculin interacting protein by yeast two-hybrid analysis. We confirmed the interaction of folliculin with p0071 by co-immunoprecipitation studies and, in view of previous studies linking p0071 to the regulation of rho-signalling, cytokinesis and intercellular junction formation, we investigated the effect of cell folliculin status on p0071-related functions. Folliculin and p0071 partially co-localized at cell junctions and in mitotic cells, at the midbody during cytokinesis. Previously, p0071 has been reported to regulate RhoA signalling during cytokinesis and we found that folliculin deficiency was associated with increased expression and activity of RhoA and evidence of disordered cytokinesis. Treatment of folliculin-deficient cells with a downstream inhibitor of RhoA signalling (the ROCK inhibitor Y-27632) reversed the increased cell migration phenotype observed in folliculin-deficient cells. Deficiency of folliculin and of p0071 resulted in tight junction defects and mislocalization of E-cadherin in mouse inner medullary collecting duct-3 renal tubular cells. These findings suggest that aspects of folliculin tumour suppressor function are linked to interaction with p0071 and the regulation of RhoA signalling
Development of a National Pain Management Competency Profile to Guide Entry-Level Physiotherapy Education in Canada
Background
National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada. Aims
This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context. Methods
A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators. Results
Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being âvery satisfiedâ with the process. Conclusions
This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions
âNone of us are lyingâ: an interpretive description of the search for legitimacy and the journey to access quality health services by individuals living with Long COVID
Abstract
Background
Understanding of Long COVID has advanced through patient-led initiatives. However, research about barriers to accessing Long COVID services is limited. This study aimed to better understand the need for, access to, and quality of, Long COVID services. We explored health needs and experiences of services, including ability of services to address needs.
Methods
Our study was informed by the Levesque et al.âs (2013) âconceptual framework of access to health care.â We used Interpretive Description, a qualitative approach partly aimed at informing clinical decisions. We recruited participants across five settings. Participants engaged in one-time, semi-structured, virtual interviews. Interviews were transcribed verbatim. We used reflexive thematic analysis. Best practice to ensure methodological rigour was employed.
Results
Three key themes were generated from 56 interviews. The first theme illustrated the rollercoaster-like nature of participantsâ Long COVID symptoms and the resulting impact on function and health. The second theme highlighted participantsâ attempts to access Long COVID services. Guidance received from healthcare professionals and self-advocacy impacted initial access. When navigating Long COVID services within the broader system, participants encountered barriers to access around stigma; appointment logistics; testing and ânormalâ results; and financial precarity and affordability of services. The third theme illuminated common factors participants liked and disliked about Long COVID services. We framed each sub-theme as the key lesson (stemming from all likes and dislikes) that, if acted upon, the health system can use to improve the quality of Long COVID services. This provides tangible ways to improve the system based directly on what we heard from participants.
Conclusion
With Long COVID services continuously evolving, our findings can inform decision makers within the health system to better understand the lived experiences of Long COVID and tailor services and policies appropriately
Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada
Background
National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada.
Aims
This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context.
Methods
A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators.
Results
Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being âvery satisfiedâ with the process.
Conclusions
This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions.
RĂSUMĂ
Contexte: Contexte: Les stratĂ©gies nationales nord-amĂ©ricaines prĂ©conisent des amĂ©liorations sensibles Ă la formation de base en matiĂ©re de prise en charge de la douleur afin de contribuer Ă la rĂ©duction du fardeau de la douleur chronique. Des travaux antĂ©rieurs ont gĂ©nĂ©rĂ© un ensemble de compĂ©tences interprofessionnelles utile en matiĂ©re de prise en charge de la douleur afin de guider la formation des futurs professionnels de la santĂ©. Cependant, trĂ©s peu de travaux ont portĂ© sur l'acquisition de telles compĂ©tences pour des professions individuelles dans diffĂ©rentes rĂ©gions. Lâuisition de compĂ©tences spĂ©cifiques Ă une profession adaptĂ©es au contexte local est une premiĂšre Ă©tape nĂ©cessaire pour leur intĂ©gration dans les systĂšmes rĂ©glementaires locaux. Notre groupe travaille Ă cet objectif dans le cadre de programmes de formation de base en physiothĂšrapie partout au Canada.
Objectifs: Cette étude visait à créer un profil de compétences consensuel pour la prise en charge de la douleur, propre au contexte canadien de la physiothérapie.
Méthodes: Un devis Delphi modifié a étÚ utilisé pour parvenir à un consensus parmi des formateurs en milieu universitaire et clinique en matiÚre de douleur en milieu universitaire et clinique.
RĂ©sultats: Des reprĂ©sentants de 14 programmes de formation de base en physiothĂ©rapie (93 % des programmes canadiens) et de six formateurs en milieu clinique ont Ă©tĂ© recrutĂ©s. AprĂšs deux tours, 15 compĂ©tences ont atteint le seuil dâapprobation prĂ©dĂ©terminĂ© (75 %). La plupart des participants (85 %) ont dĂ©clarĂ© ĂȘtre « trĂšs satisfaits »du processus.
Conclusions: Ce processus a permis de dĂ©gager un consensus sur un nouveau profil de compĂ©tences en matiĂ©re de prise en charge de la douleur propre au contexte canadien de la physiothĂ©rapie. Ce profil dĂ©limite les habiletĂ©s requises des physiothĂ©rapeutes pour prendre en charge la douleur en dĂ©but de pratique. Les participants ont Ă©tĂ© trĂšs satisfaits du processus. Cette Ă©tude contribue Ă©galement Ă la littĂ©rature Ă©mergente sur la recherche intĂ©grĂ©e en matiĂšre de prise en charge de la douleur en dĂ©finissant une mĂ©thodologie de recherche qui peut ĂȘtre utilisĂ©e pour Ă©clairer des travaux similaires dans dâautres professions de la santĂ© et dans dâautres rĂ©gions
Additional file 1 of âNone of us are lyingâ: an interpretive description of the search for legitimacy and the journey to access quality health services by individuals living with Long COVID
Additional file 1: Appendix A. Participant self-identified cultural or ethic background