Allied Health Faculty Members’ Perspective on Interprofessional Collaborative Practice: A Hermeneutic Phenomenological Study

A framework for interprofessional collaborative practice (IPCP) was developed by the World Health Organization (WHO) (WHO, 2010) in response to the need to address the complicated conditions that exist in today’s health systems. Much of the focus of today’s health service delivery is predicated on the social determinants of health (Barzansky et al., 2019), which refer to the environmental conditions associated with where people are born, live, go to school, work, play, age, and worship that have an impact on health, function, quality of life, and risks (Healthy People 2030, n.d.). IPCP is thought to be the only approach effective enough to address these complicated systems associated with health (Bosch & Mansell, 2015). This co-authored dissertation explores what may impact the development of IPCP skills in allied health professionals. This study focused on the lived experiences associated with IPCP of four allied health providers at three points along their professional paths. Those points were as students, clinicians, and faculty members. A hermeneutic phenomenological approach included the use of semi-structured interviews to gather information associated with IPCP at these three points. The overall results indicate that IPCP education, exposure, and application vary among the participants. Two of the four participants appear to have had more experience with IPCP, which has implications for patient and client interventions and professional education programs in allied health. Future research is indicated to further examine implications from this study

Comprehensive Analysis of Established Dyslipidemia-Associated Loci in the Diabetes Prevention Program

Background-We assessed whether 234 established dyslipidemia-associated loci modify the effects of metformin treatment and lifestyle intervention (versus placebo control) on lipid and lipid subfraction levels in the Diabetes Prevention Program randomized controlled trial. Methods and Results-We tested gene treatment interactions in relation to baseline-adjusted follow-up blood lipid concentrations (high-density lipoprotein [HDL] and low-density lipoprotein-cholesterol, total cholesterol, and triglycerides) and lipoprotein subfraction particle concentrations and size in 2993 participants with pre-diabetes. Of the previously reported single-nucleotide polymorphism associations, 32.5% replicated at PP>1.1×10-16) with their respective baseline traits for all but 2 traits. Lifestyle modified the effect of the genetic risk score for large HDL particle numbers, such that each risk allele of the genetic risk scores was associated with lower concentrations of large HDL particles at follow-up in the lifestyle arm (β=-0.11 μmol/L per genetic risk scores risk allele; 95% confidence interval,-0.188 to-0.033; P=5×10-3; Pinteraction=1×10-3 for lifestyle versus placebo), but not in the metformin or placebo arms (P>0.05). In the lifestyle arm, participants with high genetic risk had more favorable or similar trait levels at 1-year compared with participants at lower genetic risk at baseline for 17 of the 20 traits. Conclusions-Improvements in large HDL particle concentrations conferred by lifestyle may be diminished by genetic factors. Lifestyle intervention, however, was successful in offsetting unfavorable genetic loading for most lipid traits. Clinical Trial Registration-URL: https://www.clinicaltrials.gov. Unique Identifier: NCT00004992

Comprehensive Analysis of Established Dyslipidemia-Associated Loci in the Diabetes Prevention Program

Background-We assessed whether 234 established dyslipidemia-associated loci modify the effects of metformin treatment and lifestyle intervention (versus placebo control) on lipid and lipid subfraction levels in the Diabetes Prevention Program randomized controlled trial. Methods and Results-We tested gene treatment interactions in relation to baseline-adjusted follow-up blood lipid concentrations (high-density lipoprotein [HDL] and low-density lipoprotein-cholesterol, total cholesterol, and triglycerides) and lipoprotein subfraction particle concentrations and size in 2993 participants with pre-diabetes. Of the previously reported single-nucleotide polymorphism associations, 32.5% replicated at PP>1.1×10-16) with their respective baseline traits for all but 2 traits. Lifestyle modified the effect of the genetic risk score for large HDL particle numbers, such that each risk allele of the genetic risk scores was associated with lower concentrations of large HDL particles at follow-up in the lifestyle arm (β=-0.11 μmol/L per genetic risk scores risk allele; 95% confidence interval,-0.188 to-0.033; P=5×10-3; Pinteraction=1×10-3 for lifestyle versus placebo), but not in the metformin or placebo arms (P>0.05). In the lifestyle arm, participants with high genetic risk had more favorable or similar trait levels at 1-year compared with participants at lower genetic risk at baseline for 17 of the 20 traits. Conclusions-Improvements in large HDL particle concentrations conferred by lifestyle may be diminished by genetic factors. Lifestyle intervention, however, was successful in offsetting unfavorable genetic loading for most lipid traits. Clinical Trial Registration-URL: https://www.clinicaltrials.gov. Unique Identifier: NCT00004992