Perceived Confidence of DPT Students with Telehealth to Examine Neurologic Patients during COVID 19 Pandemic

Purpose/Hypothesis: Within the neuromuscular courses (NM1, NM2) in the DPT program at the University of St. Augustine for Health Sciences (USAHS), some form of patient integration is offered to prepare students for different aspects of patientcare, including examination and treatment. The utilization of telehealth provided an opportunity to continue patient integration experiences while maintaining a safe and socially distant environment. Patients with neurological conditions were integrated into both courses as a form of patient integration. The purpose was to investigate student perceived confidence in using telehealth to examine and treat neurological patients. For this study, the data was based on the primary questions: (1) is there a difference in confidence in the examination, assessment and treatment of patients with a neurological condition as a result of using telehealth? and (2) if so, what specific components differentiate confidence as a result of the telehealth experience? Number of Subjects: Ninety students were included in the final analysis (48.7% male). Materials and Methods: This cross-sectional IRB approved study enrolled DPT students from the Miami Campus in theNM1and NM2course. Students answered the Physiotherapy Self-Efficacy (PSE) survey and a focused questionnaire at baseline and after the second experience to assess their confidence in utilizing telehealth as a form of patient integration. Analysis included descriptive statistics, averages, and trends. Paired T-test and Cohen’s d estimated effect size was used to compare student perceived confidence. Results: Two telehealth sessions were completed (one in each course). The mean total score of the PSE increased 59% (28.2 + 10.6 to 44.9 + 9.0). Significantly higher total means cores in the PSE at the end of telehealth experience were noted. Conclusions: The results suggest that student’s level of confidence was significantly lower before the first-time participation in telehealth. However, they showed significantly greater perceived confidence in their ability to complete a neurological examination and treatment using telehealth as a result of the two experiences. Clinical Relevance: The use of telehealth is novel within DPT programs and may provide educators with additional opportunities to facilitate patient integration. In addition, telehealth may increase students’ self-confidence in completing a neurological examination and treatment which is linked to a positive effect on student’s success

Heterogeneous Reaction of NO2 on Soot Surfaces and the Effect of Soot Aging on its Reactivity Leading to HONO Formation

Soot aerosols are known to be an important atmospheric constituent. The physical and chemical properties of soot allows it to act as a precursor of gas-surface heterogeneous reactions, providing active sites for the reduction and oxidation of trace species in the atmosphere, potentially affecting atmospheric composition. In this work the heterogeneous reaction of NO2 on soot leading to nitrous acid (HONO) formation was studied through a series of kinetic uptake experiments and HONO yield measurements. The soot was collected from a diffusion flame using propane and kerosene fuels using two different methods. A low pressure fast-flow reactor coupled to a Chemical Ionization Mass Spectrometer (CIMS) was used to monitor NO2 and HONO signals evolution using atmospheric-level NO2 concentration. HONO yields up to 100 percent were measured and NO2 uptake coefficients varying from 5.6x10-6 to 1.6x10-4 were obtained. Heating soot samples before exposure to NO2 increased HONO yield and the NO2 uptake coefficient on soot due to the removal of the organic fraction from the soot backbone unblocking active sites, which become accessible for the heterogeneous reaction. From the kinetic uptake curves and the effect observed in the HONO yield and NO2 uptake coefficient measurements by heating the soot samples, our results support a complex oxidation-reduction mechanism of reaction. This heterogeneous reaction mechanism involves a combination of competitive adsorptive and reductive centers on soot surface where NO2 is converted into HONO, and the presence of processes on soot where HONO can be decomposed producing other products. Atmospheric soot "aging" effect on the reactivity of soot toward NO2 and HONO yield was studied by coating the soot surface with glutaric acid, succinic acid, sulfuric acid, and pyrene. Glutaric and succinic acid increased both HONO yield and the NO2 uptake coefficients, while sulfuric acid decreased both. However, pyrene did not show any particular trend

Research skills for university students’ thesis in E-learning: Scale development and validation in Peru

"Background: The aims of the study was to evaluate the psychometric properties and to characteristics of a scale on research skills as well as to characterize the experience of university thesis students using information databases (i.e., Scopus or Web of Science) and bibliographic reference managers. Methods: A sample of 1598 university students from five departments, acroos the different campuses of one Peruvian university. The psychometric properties of the instrument were evaluated using factor analysis and measurement invariance according to sex and age groups. In addition, an internal consistency analysis was conducted for scale reliability using Cronbach’s alpha, ordinal alpha, and the omega index. Results: Our study identified that the unidimensional model with correlated errors showed adequate indicators of reliability and goodness of fit, with the exception of the RMSEA, which shows values higher than 0.08. Measurement invariance by sex and age group was present. The majority of university students in E-learning showed use of the bibliographic manager Mendeley (52.13%), low ability to use information databases such as Scopus (22.24%) or Web of Science (17.26%), and the least skilled research skills were in formulating the problem, objectives, and hypotheses (51.63%) and carrying out data analysis and processing using statistical techniques (49.37%). Conclusions: The conclusions of the study were that the 8-item research skills instrument presents acceptable psychometric indicators in Peruvian university students in thesis courses. Likewise, a scarce use of global databases, the approach to the research topic, and carrying out its statistical processing.

Research skills for university students’ thesis in E-learning: Scale development and validation in Peru

"Background: The aims of the study was to evaluate the psychometric properties and to characteristics of a scale on research skills as well as to characterize the experience of university thesis students using information databases (i.e., Scopus or Web of Science) and bibliographic reference managers. Methods: A sample of 1598 university students from five departments, acroos the different campuses of one Peruvian university. The psychometric properties of the instrument were evaluated using factor analysis and measurement invariance according to sex and age groups. In addition, an internal consistency analysis was conducted for scale reliability using Cronbach’s alpha, ordinal alpha, and the omega index. Results: Our study identified that the unidimensional model with correlated errors showed adequate indicators of reliability and goodness of fit, with the exception of the RMSEA, which shows values higher than 0.08. Measurement invariance by sex and age group was present. The majority of university students in E-learning showed use of the bibliographic manager Mendeley (52.13%), low ability to use information databases such as Scopus (22.24%) or Web of Science (17.26%), and the least skilled research skills were in formulating the problem, objectives, and hypotheses (51.63%) and carrying out data analysis and processing using statistical techniques (49.37%). Conclusions: The conclusions of the study were that the 8-item research skills instrument presents acceptable psychometric indicators in Peruvian university students in thesis courses. Likewise, a scarce use of global databases, the approach to the research topic, and carrying out its statistical processing.

Comparative neurohormonal responses in patients with preserved and impaired left ventricular ejection fraction: Results of the studies of left ventricular dysfunctions (SOLVD) registry

AbstractObjectives. The aim of this study was to determine the differences in neurohumoral responses between patients with pulmonary congestion with and without impaired left ventricular ejection fraction.Background. Previous studies have established the presence of neurohumoral activation in patients with congestive heart failure. It is not known whether the activation of these neurohumoral mechanisms is related to the impairment in systolic contractility.Methods. The 898 patients recruited into the Studies of Left Ventricular Dysfunction (SOLVD) Registry substudy were examined to identify those patients with pulmonary congestion on chest X-ray film who had either unpaired (<- 45%, group I) or preserved (> 45%, group II) left ventricular ejection fraction. Plasma norepinephrine, plasma renin activity, arginine vasopressin and atrial natriuretic peptide levels were measured in these two groups of patients and compared with values in matched control subjects,Results. Distribution of the New York Heart Association symptom classification was the same in the two groups of patients. Compared with control subjects, patients in group II with pulmonary congestion and preserved ejection fraction had no activation of the neurohumoral mechanisms, except for a small but statistically significant increase in arginine vasopressin and plasma renin activity. Compared with patients in group II, those in group I with pulmonary congestion and unpaired ejection fraction had significant increases in plasma norepinephrine (p < 0.002), plasma renin activity (p < 0.02) and atrial natriuretic peptide levels (p < 0.0007). When we controlled for baseline differences between groups I and II, the between-group differences in plasma norepinephrine (p < 0.02) and atrial natriuretic peptide (p < 0.002) remained significant. However, plasma renin activity was not significantly different between groups I and II. When the effects of diuretic agents and angiotensinconverting enzyme inhibitors were adjusted, patients with lower ejection fraction were found to have significantly higher plasma norepinephrine and atrial natriuretic peptide levels.Conclusions. The results point to the importance of the decrease in left ventricular ejection fraction as one of the mechanisms for activation of neurohormones in patients with heart failure