Creating a Graduate Level Interprofessional Ethics Course for Health Science Students: A Systematic Approach

Interprofessional collaboration in practice is an important skill, but creating interprofessional courses is challenging. Healthcare ethics is ideal for interprofessional education because no one discipline has authority over the subject. Most ethics courses for health science students, however, are based on the expertise of the instructor. In an interprofessional course, it is difficult for an instructor from one discipline to divine the needs of students from another field. The purpose of this paper is to methodically develop a graduate level ethics course for health science students based on a systematic review of the literature. The results are clear recommendations for creating a meaningful interprofessional learning experience in healthcare ethics

Juveniles\u27 Attitudes toward the Police as Affected by Prior Victimization.

The purpose of this study was to analyze juveniles\u27 attitudes toward the police and how their attitudes were affected by prior victimization and delinquency, controlling for race, gender, and city of residence. All variables used in this study came from the Gang Resistance Education and Training (G.R.E.A.T.) data collected by Esbensen (1999). The analysis indicated that females held more favorable attitudes toward the police than males, Whites held more favorable attitudes toward the police than non-Whites, and juveniles living in small rural/suburban areas held more favorable attitudes than those living in large urban areas. The major finding of this study was that a spurious relationship existed between prior victimization and attitudes toward the police with delinquency being the true predictor of juveniles\u27 attitudes. A possible explanation for this finding is that those juveniles at the greatest risk of victimization are the same ones committing the majority of the delinquent acts

Information Encoding on a Pseudo Random Noise Radar Waveform

Navigation requires knowledge of current location and a planned destination. This is true with manned vehicles and unmanned vehicles. There are many ways to acquire the current location, including global positioning system (GPS), triangulation, radar, and dead reckoning. Today GPS is the most reliable and accurate navigation technique when there is a clear, unobstructed view of the satellite constellation. Various sensors can be used to perform indoor navigation; however, when the vehicle is autonomous the sensors need to provide the exact location to the system. This research determined if using a template replay strategy has the same RNR performance as using an analog noise source. Using the template replay approach, each RNR node has a priori knowledge about the transmitted waveforms of other nodes. The analysis here revealed that modifications do not significantly alter RNR functionality. The analysis revealed that even at SNIR equal to 0 dB, there are no parameters that can be reliably extracted other than transmitted signal bandwidth and transmitted template length; the transmitted message length was able to be extracted because the message was repeated over and over. If the message was not replayed the analysis showed that there would be no ability to extract parameters. Finally, by using the RNR to transmit digitally generated templates, digital communication is possible and the symbol error rate (SER) is traceable to simulated SER

Third Time’s a Charm: The Case of Tennessee’s Four Junior Football Players who Endured Three Different Head Coaches in Three Seasons

For college student-athletes enduring multiple head coaching changes during their careers, challenges include changes in the level of competition, lifestyle pressures, identity issues, loss of support system, and changes in training environment. Student-athletes are required to build relationships with a new head coach while facing issues with loneliness, frustration, discouragement, self-doubt, and feelings of decreased self-worth. This unique case study examined the transitions of junior student-athletes at the University of Tennessee who played for three different head coaches. Themes that were constructed from challenges the student-athletes faced were: Trust, Individual and Team Strength, and Future. A tremendous amount of effort and resources is poured into coaching searches but there seems to be little for the student-athletes during transitional periods of coaching changes. These findings demonstrate that transition is not something that easily happens and may not happen at all, which leads to student-athletes transferring after any coaching change. Resources and counseling services should be made available to assist student-athletes in this transition and not make the coach the focus of the transition

Office-based Air-Fluid Exchange for Diabetic Post-Operative Vitreous Cavity Hemorrhage

Post-operative vitreous cavity hemorrhage (POVCH) is observed in 6-75% of eyes undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). We describe our technique for office-based Air fluid exchange (AFX) in the treatment of POVCH. Sixteen eyes (15 patients) with PDR and POVCH undergoing office-based AFX between January 2006 and November 2016 were retrospectively identified. The pre- and post- procedure visual acuity (VA) and complications were compared between eyes with and without traction retinal detachment (TRD). Medicare charges for office-based AFX versus PPV were also analyzed. Mean age at the time of AFX was 55.31 (± 8.02) years. Nine eyes (56.25%) had TRD prior to PPV and 11 eyes (68.75%) were pseudophakic. The improvements in mean (± standard deviation [SD]) logMAR VA at the last postoperative visit (3 - 8 months) were 1.38 (± 0.99), 0.82 (± 0.91) and 2.09 (± 0.53) in all eyes, TRD eyes and non-TRD eyes, respectively. Complications included cataract progression, hypotony, and recurrence of TRD and ghost cell glaucoma. The total cost of outpatient AFX was $1,409.59 less than that of PPV. Office-based AFX is a cost-effective alternative treatment for non-clearing diabetic POVCH with an acceptable risk profile

Office-based Air-Fluid Exchange for Diabetic Post-Operative Vitreous Cavity Hemorrhage

Post-operative vitreous cavity hemorrhage (POVCH) is observed in 6-75% of eyes undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). We describe our technique for office-based Air fluid exchange (AFX) in the treatment of POVCH. Sixteen eyes (15 patients) with PDR and POVCH undergoing office-based AFX between January 2006 and November 2016 were retrospectively identified. The pre- and post- procedure visual acuity (VA) and complications were compared between eyes with and without traction retinal detachment (TRD). Medicare charges for office-based AFX versus PPV were also analyzed. Mean age at the time of AFX was 55.31 (± 8.02) years. Nine eyes (56.25%) had TRD prior to PPV and 11 eyes (68.75%) were pseudophakic. The improvements in mean (± standard deviation [SD]) logMAR VA at the last postoperative visit (3 - 8 months) were 1.38 (± 0.99), 0.82 (± 0.91) and 2.09 (± 0.53) in all eyes, TRD eyes and non-TRD eyes, respectively. Complications included cataract progression, hypotony, and recurrence of TRD and ghost cell glaucoma. The total cost of outpatient AFX was $1,409.59 less than that of PPV. Office-based AFX is a cost-effective alternative treatment for non-clearing diabetic POVCH with an acceptable risk profile

European Vitreoretinal Society Macular Hole Study, Prognostic Factors for Anatomical and Functional Success

Background: To identify prognostic preoperative and intraoperative factors for anatomical and visual success of idiopathic macular hole (MH) surgery. Methods: We conducted a non-randomized, collaborative multicenter study using data of 4207 MH surgery from 140 surgeons. Main study outcomes were anatomical closure and best corrected visual acuity (BCVA) improvement postoperative at 6-12 months. Results: Information on anatomical success was available for 4138 eyes of 4207 operations. Anatomical closure of MH was achieved in 85.7% (3546 eyes). Closure was higher in smaller MH (stages 1-2 versus stage 3: OR=0.35; stage 2 versus stage 4: OR=0.16, and in MH with shorter duration before the operation (OR=0.94). Macular Holes were more likely to close when dyes were used to facilitate internal limiting membrane (ILM) peeling (odds ratio=1.73 to 3.58). The most important predictors of postoperative BCVA were the preoperative BCVA (estimate=0.39, p<0.001) and closure of the macular hole (estimate=0.34, p<0.001). We observed Larger improvement in BCVA in combined vitrectomy and phacoemulsification (estimate = 0.10) and post cataract surgery in phakic eyes (estimate=0.05). Retinal tears occurred in 5.1% of eyes, and were less with use of trocars (OR= -1.246) and in combined vitrectomy/ phacoemulsification surgery (OR= -0.688). Conclusion: This international survey confirmed that staining with dyes improves anatomical results but not visual outcomes. After surgery, visual acuity improved during the first year, and final visual acuity was better in both pseudophakic eyes and eyes that underwent cataract surgery during the first year following MH repair

Modality-Independent Effects of Phonological Neighborhood Structure on Initial L2 Sign Language Learning

The goal of the present study was to characterize how neighborhood structure in sign language influences lexical sign acquisition in order to extend our understanding of how the lexicon influences lexical acquisition in both sign and spoken languages. A referent-matching lexical sign learning paradigm was administered to a group of 29 hearing sign language learners in order to create a sign lexicon. The lexicon was constructed based on exposures to signs that resided in either sparse or dense handshape and location neighborhoods. The results of the current study indicated that during the creation of the lexicon signs that resided in sparse neighborhoods were learned better than signs that resided in dense neighborhoods. This pattern of results is similar to what is seen in child first language acquisition of spoken language. Therefore, despite differences in child first language and adult second language acquisition, these results contribute to a growing body of literature that implicates the phonological features that structure of the lexicon is influential in initial stages of lexical acquisition for both spoken and sign languages. This is the first study that uses an innovated lexicon-construction methodology to explore interactions between phonology and the lexicon in L2 acquisition of sign language

A Database Study of Visual Outcomes and Intraoperative Complications of Postvitrectomy Cataract Surgery

PURPOSE: To analyze the visual outcomes and rate of intraoperative complications of phacoemulsification surgery after prior pars plana vitrectomy (PPV). DESIGN: Retrospective, multicenter database study. PARTICIPANTS: Eyes that underwent phacoemulsification between June 2005 and March 2015 at 8 sites in the United Kingdom. METHODS: Study eyes were classified as vitrectomized (prior PPV group) or nonvitrectomized (reference group) depending on the vitreous state at the time of cataract surgery. Eyes with multiple intraocular surgeries or history of ocular diseases known to cause cataract progression or increased risk of intraoperative complications during phacoemulsification were excluded. MAIN OUTCOME MEASURES: Logarithm of the minimum angle of resolution (logMAR) visual acuity (VA), rate of intraoperative complications, and time interval to cataract surgery. RESULTS: Eyes in the prior PPV group (n = 2221) had worse preoperative logMAR VA (0.96±0.60 vs. 0.62±0.52, P \u3c 0.0001), were from younger patients, and had longer axial lengths than the nonvitrectomized group (n = 136 533). At all postoperative time points measured up to 24 weeks, mean vision was poorer in the prior PPV group (0.41±0.47 vs. 0.17±0.29 at 4-12 weeks, P \u3c 0.0001) and a smaller proportion of eyes achieved postoperative VA ≤0.30 logMAR (Snellen, ≥20/40) (60.8% vs. 86.5% at 4-12 weeks, P \u3c 0.0001). The rate of posterior capsular rupture was not different between the prior PPV (1.5%) and the nonvitrectomized (1.7%) groups, but the incidences of zonular dialysis (1.3% vs. 0.6%) and dropped nuclear fragments (0.6% vs. 0.2%) were higher in the prior PPV group (P \u3c 0.0001). The mean time interval between PPV and cataract surgery was 399 days. CONCLUSIONS: We found a significant improvement in VA with postvitrectomy cataract surgery. However, compared with eyes without prior PPV, there was a worse mean postoperative vision of 0.2 logMAR units, a higher rate of zonular dialysis and dropped nuclear fragments, and a similar rate of posterior capsule rupture