Comparative Effectiveness of Online Training in Assistive Technology and its Use for Development of Rehabilitation Professionals’ Interprofessionality and Reflectiveness

Assistive technology (AT) is used by individuals with disabilities in order to perform functions that might otherwise be difficult or impossible, and a professional designation common to the application of AT is the AT Professional (ATP) held by thousands of health professionals and suppliers. A novel hybrid continuing education certificate program was developed at the University of Pittsburgh to prepare practitioners for the ATP exam through a focus of interprofessional learning and reflective practice. In addition to an expected increase in content knowledge, I hypothesized that both interprofessional learning, defined as interactive and group-based education aimed at improving collaborative practice (Parsell & Bligh, 1999), and reflective practice (Schon, 1983), or the capacity to reflect on action so as to engage in a process of continuous learning, would increase after trainees’ participation in the hybrid program as a result of the program’s design. I conducted a mixed methods assessment consisting of validated questionnaires and a unique qualitative coding scheme on the certificate program. Twenty-eight trainees completed the program. A convenience sample of twenty-eight matched control subjects who completed a similar individual online certificate program was also included to draw marginal inferences between the two groups. Based on pre/post assessments analyzed through STATA and Dedoose data analysis software, trainee gains were made in areas of content knowledge, interprofessionality, and reflectiveness. Predictors of learning outcomes included a trainee’s background knowledge, job, and expertise level. The hybrid training group had greater increases in content knowledge, interprofessionality, and reflectiveness compared to the online group. Study limitations include selection bias, insufficient pre/post data from the control group, the author’s role in the program, and the particular treatment level. This study may be of interest to higher education administrators, faculty in education, health sciences, and those interested in the implications of online vs. hybrid continuing education programs. As the findings are concretely related to AT, continuing education, and online programs, my recommendations will assist those developing AT programs and the trainees that are taking them, as a result of more comprehensive and effective pedagogy and content. Subsequently, these findings may also assist the beneficiaries of the trainees, the clients who are seeking AT, due to the optimal prescription of devices and recommended solutions

Management Repercussions Of The Increased Tax On Americans Working Overseas

The Tax Increase Prevention and Reconciliation Act of 2005 extended expiring tax-reduction provisions, and created new ones.  However, not all of TIPRA’s provisions reduce taxes.  Many Americans working abroad ended up paying higher income taxes, retroactive to the beginning of 2006.  This created new managerial challenges for companies that have hired Americans in overseas positions, companies that have previously attempted to accommodate the additional costs these workers incur, and raises serious tax policy questions

Needs Assessment of Suicide Prevention in Vermont Middle and High Schools

Introduction. Adolescent suicide is epidemic. 17% of high school students con- sidered suicide and 8% attempting to take their lives in 2015 nationwide. Vermont has seen a 2% increase within the last two years according to the VT Youth Risk Behavior Survey. School is one of several settings where effective suicide interventions could take place. Previous studies have identified means prevention as an effective way to combat adolescent suicide. This study aims to identify training levels and comfort of school staff in dealing with suicidality. Methods. A survey was emailed to all schools in Vermont covering grades 6-12. The survey addressed employee demographics, training, perception of suicide in their school, and concern regarding lethal means. Questions were multiple choice, scaled and free responses. Data was analyzed using SPSS and free responses were organized using thematic content analysis. Results. 126 responses represented 46% of Vermont middle and high schools. 77% agreed or strongly agreed that they felt confident in recognizing a student with suicidality. Respondents were not comfortable implementing lethal means prevention. Respondents identified early intervention and trusting communicative relationships as key to prevention, and identified lack of time, protocols, and resources as obstacles. Discussion. Respondents identified suicidality in 2.2% of their students, com- pared to the YRBS that recognized 12% of adolescents. Survey technique may con- tribute to this discrepancy, but it is also likely that schools are failing to identify students at risk. A lack of comfort recognizing suicidality and implementing prevention techniques warrants standardized training, screening and response protocols.https://scholarworks.uvm.edu/comphp_gallery/1265/thumbnail.jp

In Situ and Satellite Measured Temperature Comparability

Following the International Geophysical Year in the late 1950's, small meteorological rockets caught the interest of scientists as a potentially inexpensive method to obtain meteorological information (density, temperature, wind) above balloon-borne radiosonde altitudes. These small rocketsondes have served many important observational roles in terms of studies conducted of atmospheric structure and processes, enabling many new ideas about the atmosphere to emerge. Although no longer manufactured a small residual inventory of meteorological rocketsondes exist for specific research projects. The value of data from meteorological rocketsondes is without question but with their disappearance data from many different satellites are filling the need, some able to resolve high-altitude temperatures quite well. However, the rocketsonde vertical profile is more localized to the launch site whereas satellites move several kilometers per second. The objective of this presentation is to compare in situ temperature data with remotely measured/retrieved temperature data. There have been a number of U.S. conducted missions utilizing the passive falling sphere data that we use to verify the comparability of retrieved temperatures from these satellites. Missions, some as early as 1991, were conducted in polar, equatorial, and mid-latitude locations. An important aspect is that a single satellite profile compared to a falling sphere profile often does not agree while high density satellite measurements when averaged over an area near the rocketsonde data area seems to be in better agreement. Radiosonde temperature data are used in the analysis when appropriat

Sentinel Lymph Node Biopsy Does Not Improve Disease-Specific Survival in Elderly Patients with Intermediate Thickness Melanoma

Objective: To determine whether sentinel lymph node biopsy (SLNB) is associated with improved disease-specific survival among elderly patients with intermediate-thickness melanoma Design: Retrospective cohort study of prospectively-maintained tumor registry Setting: Single institution tertiary care center. P atients: Adults ≥ 70 years of age, who underwent surgical intervention for melanoma from 2000-2013. Main Outcome Measures: The primary outcomes were overall survival (OS) and disease-free survival (DFS). Other clinicopathologic variables measured included age, gender, anatomic site, histologic type, tumor thickness, presence of adverse features, receipt and result of SLNB, and receipt of completion lymph node dissection (CLND). Results: Ninety-one patients (mean age 80 years, 54% male) underwent wide excision of an intermediate-thickness melanoma. Forty-nine patients (54%) received a SLNB. Seven of these biopsies (14%) were positive, and five patients (71%) went on to receive CLND. Five-year OS was 41% in patients who did not receive SLNB and 52% in patients who did receive SLNB (Fig. 1A). However, 5-year DFS was 79% in patients who did not receive SLNB and 77% in patients who did receive SLNB (Fig. 1B). Conclusions: Among elderly patients with intermediate-thickness melanoma, patients who received SLNB had higher 5-year OS than those who did not receive SLNB. However, the 5-year DFS is similar between the two groups, which suggests that the OS differences are related to non-melanoma factors. Routine SLNB for intermediate-thickness melanoma patients may not significantly change the outcome for this age group, and clinical decision-making should consider individual patient comorbidities and goals of care

Fold Lens Flux Anomalies: A Geometric Approach

We develop a new approach for studying flux anomalies in quadruply-imaged fold lens systems. We show that in the absence of substructure, microlensing, or differential absorption, the expected flux ratios of a fold pair can be tightly constrained using only geometric arguments. We apply this technique to 11 known quadruple lens systems in the radio and infrared, and compare our estimates to the Monte Carlo based results of Keeton, Gaudi, and Petters. We show that a robust estimate for a flux ratio from a smoothly varying potential can be found, and at long wavelengths those lenses deviating from from this ratio almost certainly contain significant substructure.Comment: 16 pages, including 8 figure

Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System

Our understanding of pressure injury etiology and development has grown in recent years through research, clinical expertise, and global interdisciplinary expert collaboration. Therefore, the National Pressure Ulcer Advisory Panel (NPUAP) has revised the definition and stages of pressure injury. The revision was undertaken to incorporate the current understanding of the etiology of pressure injuries, as well as to clarify the anatomical features present or absent in each stage of injury. An NPUAP-appointed Task Force reviewed the literature and created drafts of definitions, which were then reviewed by stakeholders and the public, including clinicians, educators, and researchers around the world. Using a consensus-building methodology, these revised definitions were the focus of a multidisciplinary consensus conference held in April 2016. As a result of stakeholder and public input, along with the consensus conference, important changes were made and incorporated into the new staging definitions. The revised staging system uses the term injury instead of ulcer and denotes stages using Arabic numerals rather than Roman numerals. The revised definition of a pressure injury now describes the injuries as usually occurring over a bony prominence or under a medical or other device. The revised definition of a Stage 2 pressure injury seeks to clarify the difference between moisture-associated skin damage and injury caused by pressure and/or shear. The term suspected has been removed from the Deep Tissue Pressure Injury diagnostic label. Each definition now describes the extent of tissue loss present and the anatomical features that may or may not be present in the stage of injury. These important revisions reflect the methodical and collaborative approach used to examine the available evidence and incorporate current interdisciplinary clinical expertise into better defining the important phenomenon of pressure injury etiology and development