Telemedicine Perception: An Identification and Evaluation of Factors Contributing To The Use of Telemedicine Services

A morbidity and mortality report made by the Centers for Disease Control (CDC) on the impact of telehealth services during the COVID-19 pandemic throughout 2020 noted several instances in which telemedicine tools had contributed to improved patient outcomes, including: increasing the availability of care to patients otherwise left with little access to health care, decreasing unnecessary patient visits, and reduced disease exposure to patients and staff directly at risk (CDC, 2020). As the utilization of telemedicine becomes more important and prevalent in U.S. health care systems, it is important to recognize factors that inhibit patient usage. Factors such as inadequate access to electronic tools, the internet, education on telemedicine program use, and personal preference in health care management can affect how patients participate in telemedicine. The purpose of this DNP project was to identify and analyze the different factors that affect telemedicine use among adult participants utilizing a questionnaire created by the researcher. The questionnaire was made available to two locations for convenience sampling: The University of Southern Mississippi (USM) Nursing College student email list via direct online hyperlink, and a specialty clinic in Hattiesburg, Mississippi via paper copies and QR code signage linked to the questionnaire online. Improving health care systems such as patient telemedicine use can positively impact patient health outcomes through improved health care access. Providers, health care organizations, and other interested parties can improve patient participation through individualized promotion and education on the use and benefits of telemedicine by recognizing factors that impact telemedicine use. Providing a self-completed questionnaire for patients evaluating telemedicine perception, access, and use can provide adequate data to improve patient-centered approaches to telemedicine participation

Berceuse

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A Comparison of Adaptations via Either a Linear Periodization or an Undulating Periodization Model of Weight Training

BACKGROUND: Resistance training has been proven to have a positive impact on parameters such as muscular strength, hypertrophy and endurance. Periodization is a progressive mode of training that has been shown to illicit greater results than programs that stay consistent throughout. The two prime modes of periodization are linear (LP), which progresses from high volume/low intensity to low volume/high intensity, and undulating (UP) which follows an oscillating volume/intensity design. The purpose of this study was to compare the effects of a 12 week linear program to those from an undulating program on strength and body composition when both programs reflect the entire NSCA repetition continuum. METHODS: 10 resistance trained men were matched according to weight-relative strength and randomly assigned to either a linear (N=4, 21 ± 2.5 yrs, 69.08 ± 0.69in, 1178.13 ± 19.5 lbs, 16.9 ± 5.2 %BF) or undulating (N=6, 20 ± 1.7 yrs, 70.27 ± 2.13 in, 180.17 ± 23.98 lbs, 13.67 ± 2.94 %BF) periodization program. Subjects participated in 3 days per week of supervised total body resistance training with repetitions and intensities reflecting the entire NSCA repetition continuum. At 0, 4, 8 and 12-weeks, subjects were tested on body composition via dual energy x-ray absorptiometry, 1RM strength, muscular endurance, vertical jump and anaerobic capacity. Statistical analyses utilized a two-way ANOVA with repeated measures for all criterion variables (p ≤ 0.05). Data are presented as mean ± SD changes from baseline values. RESULTS: Significant main effects for time (p \u3c 0.05) were observed on bench press (LP: 15.03 ± 8.02 lb; UP: 26.10 ± 5.05 lb), leg press (LP:161.07 ± 14.10 lb ; UP: 164.03 ± 55.20 lb), and Wingate peak power (LP: 148.21 ± 78.05 W; UP: 143.22 ± 137.04 W). However, no significant interactions were observed between groups on any of these parameters. Also, no significant group or time effects for time or differences between groups were observed in the measures of percent body fat, lean muscle mass, or vertical jump. CONCLUSION: Both undulating and linear periodization models of resistance training that reflect the entire repetition continuum can bring forth highly significant changes in strength and peak anaerobic power. However, despite the fact that the undulating method resulted in a 43% greater increase in upper body strength, there is no significant difference in the magnitude of the training adaptations that stem from the two methods over 12 weeks

Das Schulbuch im fächerübergreifenden naturwissenschaftlichen Unterricht

In der Diskussion um integrierten naturwissenschaftlichen Unterricht wird häufig anhand der inhaltlichen Struktur sowohl pro fächerübergreifenden, also auch pro fachsystematischen Unterricht argumentiert. Inwiefern sich die Sachstrukturen der beiden Varianten unterscheiden, ist derzeit noch nicht hinreichend geklärt. In diesem Beitrag wird untersucht, ob eine automatisierte Extraktion von Sachstrukturen aus Schulbüchern möglich ist, und ob ein Unterschied zwischen den zentralen Konzepten in Physikschulbüchern und Schulbüchern für das integrierte Fach feststellbar ist. Anhand der Schulbuchreihen Universum Physik für das Fach Physik und PRISMA Naturwissenschaften für das integrierte Fach wird exemplarisch gezeigt, dass eine automatisierte Extraktion der Sachstruktur gelingt, anhand derer die zentralen Konzepte verglichen werden können. Erste Ergebnisse zeigen Unterschiede zwischen den beiden Schulbüchern

Villars-les-Dombes – Rue Carnot

Identifiant de l'opération archéologique : 9889 Date de l'opération : 2008 (EX) Un diagnostic a été réalisé dans l’emprise (1 500 m2 ) d’un futur immeuble d’habitation, situé à une cinquantaine de mètres au sud d’une butte remarquable, monument médiéval dénommé la Poype, (classé au titre des Monuments Historiques en 1905), épicentre du bourg castral médiéval. La Poype étant siège de pouvoir militaire et/ou religieux entre la fin du haut Moyen Age et le bas Moyen Age, il s’agissait d’identifi..

The Effects of Pre- and Post-Exercise Whey vs. Casein Protein Consumption on Body Composition and Performance Measures in Collegiate Female Athletes

Two of the most popular forms of protein on the market are whey and casein. Both proteins are derived from milk however the two differ concerning their absorption in the body. This difference between whey and casein proteins could affect the response seen in conjunction with training. PURPOSE: To investigate the potential effects of two types of protein ingestion in conjunction with a controlled resistance training program utilizing college female basketball players. METHODS: 16 NCAA Division III female basketball players were matched according to weight and double-blind randomly assigned to consume 24 grams whey protein (WP) (N = 8, 20 ± 1.9 years, 158 ± 27.3 cm, 66 ± 4.9 kg, 27 ± 4.9 %BF) or 24 grams casein protein (CP) (N = 8, 21 ± 2.8 years, 153 ± 2.9 cm, 68 ± 2.9 kg, 25 ± 5.7 %BF) pre- and post-exercise for eight weeks. Subjects participated in a supervised 4-day per week undulating periodized training program. At 0, 4, and 8 weeks, subjects underwent DEXA body composition analysis. At 0 and 8 weeks subjects underwent 1RM strength, muscle endurance, vertical jump, 5-10-5 and broad jump testing sessions. Data analysis using repeated measures ANOVA are presented as mean ± SD changes from baseline after 60 days. RESULTS: No significant group x time interaction effects were observed among groups in changes in any variable (p \u3e 0.05). A significant time effect was observed for body fat (WP: -2 ± 1.1 %BF; CP: -1 ± 1.6 %BF, p \u3c 0.001), lean mass (WP: 1.5 ± 1 kg; CP: 1.4 ± 1 kg, p \u3c 0.001), fat mass (WP: -1.3 ± 1.2 kg; CP: -0.6 ± 1.4 kg, p \u3c 0.001), leg press 1RM (WP: 88.7 ± 43.9 kg; CP: 90 ± 48.5 kg, p \u3c 0.001), bench press 1RM (WP: 7.5 ± 4.6 kg; CP: 4.3 ±4.5 kg, p = 0.01), vertical jump (WP: 1.6 ± 0.74 in; CP: 1.4 ± 3 in, p \u3c 0.001), 5-10-5 (WP: -0.3 ± 0.2 sec; CP: -0.09 ± 0.42 sec, p \u3c 0.001), and broad jump (WP: 4.1 ± 2.6 in; CP: 5.1 ± 2.8 in, p \u3c 0.001). CONCLUSION: The combination of a controlled undulating resistance training program with pre- and post-exercise protein supplementation is capable of inducing significant changes in performance and body composition. There does not appear to be a difference in the performance enhancing effects of whey versus casein proteins

The association between preoperative spinal cord rotation and postoperative C5 nerve palsy

BACKGROUND: C5 nerve palsy is a known complication of cervical spine surgery. The development and etiology of this complication are not completely understood. The purpose of the present study was to determine whether rotation of the cervical spinal cord predicts the development of a C5 palsy. METHODS: We performed a retrospective review of prospectively collected spine registry data as well as magnetic resonance images. We reviewed the records for 176 patients with degenerative disorders of the cervical spine who underwent anterior cervical decompression or corpectomy within the C4 to C6 levels. Our measurements included area for the spinal cord, space available for the cord, and rotation of the cord with respect to the vertebral body. RESULTS: There was a 6.8% prevalence of postoperative C5 nerve palsy as defined by deltoid motor strength of /= 11 degrees ) and palsy (point-biserial correlation = 0.94; p \u3c 0.001). A diagnostic criterion of 6 degrees of rotation could identify patients who had a C5 palsy (sensitivity = 1.00 [95% confidence interval, 0.70 to 1.00], specificity = 0.97 [95% confidence interval, 0.93 to 0.99], positive predictive value = 0.71 [95% confidence interval, 0.44 to 0.89], negative predictive value = 1.00 [95% confidence interval, 0.97 to 1.00]). CONCLUSIONS: Our evidence suggests that spinal cord rotation is a strong and significant predictor of C5 palsy postoperatively. Patients can be classified into three types, with Type 1 representing mild rotation (0 degrees to 5 degrees ), Type 2 representing moderate rotation (6 degrees to 10 degrees ), and Type 3 representing severe rotation (\u3e/= 11 degrees ). The rate of C5 palsy was zero of 159 in the Type-1 group, eight of thirteen in the Type-2 group, and four of four in the Type-3 group. This information may be valuable for surgeons and patients considering anterior surgery in the C4 to C6 levels