Graduate Student Commentary

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Kinesio Taping and the Circulation and Endurance Ratio of the Gastrocnemius Muscle

Context Kinesio Tex tape is a therapeutic tape that is applied with the Kinesio-taping (KT) method and is theorized to increase circulation and subsequently improve muscle function. However, little research has been conducted to determine how KT affects performance. Objective To determine the effect of KT on muscular endurance ratio, blood flow, circumference, and volume of the gastrocnemius muscle. Design Randomized controlled clinical trial. Setting Research laboratory. Patients or Other Participants Sixty-one healthy, active people (23 men, 38 women; age = 19.99 ± 8.01 years, height = 169.42 ± 23.62 cm, mass = 71.53 ± 36.77 kg) volunteered to participate. They were assigned randomly to 1 of 3 groups: treatment KT, sham KT, and control. Intervention(s) Tape was applied based on group assignment. The treatment KT group received the ankle-tape technique as described in the KT manual. The sham KT group received 1 strip of Kinesio Tex tape around the circumference of the proximal gastrocnemius muscle. The control group did not receive tape application. Main Outcome Measure(s) The dependent variables were blood flow in blood perfusion units, volume of water displacement in milliliters, circumference of the gastrocnemius muscle in centimeters, and endurance ratio in joules measured before, 24 hours after, and 72 hours after the intervention. Separate repeated-measures analyses of variance were conducted for each dependent variable. Results We found no group-by-test day interaction for endurance ratios (F4,116 = 1.99, P = .10). Blood flow, circumference, and volume measurements also yielded no differences among groups (F2,58 range, 0.02–0.51; P \u3e .05) or test days (F2,116 range, 0.05–2.33; P \u3e .05). Conclusions We found KT does not enhance anaerobic muscle function measured by endurance ratio. The KT also did not affect circulation or volume of the gastrocnemius muscle in a healthy population

Calling in retirement: A mixed methods study

This mixed methods study aimed to examine the experiences of a calling in retirement with a sample of 196 retired adults. First, a qualitative analysis explored the types of activities participants experienced as a calling as well as the types of barriers that participants perceived as keeping them from living their calling. ‘Helping Others’ emerged as the largest category of calling that participants endorsed and ‘No Resources to Live Calling’ emerged as the most frequently endorsed barrier. Building on our qualitative findings, we conducted a quantitative analysis to examine the relation of perceiving a calling with well-being. Consistent with prior research with working adult populations and in support of our hypotheses, perceiving a calling related to life meaning and life satisfaction, and structural equation modeling demonstrated that life meaning and living a calling (via life meaning) fully mediated the perceiving calling–life satisfaction relation. Implications for research and practice are discussed

Strengthening nursing, midwifery and allied health professional leadership in the UK - a realist evaluation

Purpose: This paper aims to share the findings of a realist evaluation study that set out to identify how to strengthen nursing, midwifery and allied health professions (NMAHP) leadership across all health-care contexts in the UK conducted between 2018 and 2019. The collaborative research team were from the Universities of Bangor, Ulster, the University of the West of Scotland and Canterbury Christ Church University. Design/methodology/approach: Realist evaluation and appreciative inquiry were used across three phases of the study. Phase 1 analysed the literature to generate tentative programme theories about what works, tested out in Phase 2 through a national social media Twitter chat and sense-making workshops to help refine the theories in Phase 3. Cross-cutting themes were synthesised into a leadership framework identifying the strategies that work for practitioners in a range of settings and professions based on the context, mechanism and output configuration of realist evaluation. Stakeholders contributed to the ongoing interrogation, analysis and synthesis of project outcomes. Findings: Five guiding lights of leadership, a metaphor for principles, were generated that enable and strengthen leadership across a range of contexts. – “The Light Between Us as interactions in our relationships”, “Seeing People’s Inner Light”, “Kindling the Spark of light and keeping it glowing”, “Lighting up the known and the yet to be known” and “Constellations of connected stars”. Research limitations/implications: This study has illuminated the a-theoretical nature of the relationships between contexts, mechanisms and outcomes in the existing leadership literature. There is more scope to develop the tentative programme theories developed in this study with NMAHP leaders in a variety of different contexts. The outcomes of leadership research mostly focussed on staff outcomes and intermediate outcomes that are then linked to ultimate outcomes in both staff and patients (supplemental). More consideration needs to be given to the impact of leadership on patients, carers and their families. Practical implications: The study has developed additional important resources to enable NMAHP leaders to demonstrate their leadership impact in a range of contexts through the leadership impact self-assessment framework which can be used for 360 feedback in the workplace using the appreciative assessment and reflection tool. Social implications: Whilst policymakers note the increasing importance of leadership in facilitating the culture change needed to support health and care systems to adopt sustainable change at pace, there is still a prevailing focus on traditional approaches to individual leadership development as opposed to collective leadership across teams, services and systems. If this paper fails to understand how to transform leadership policy and education, then it will be impossible to support the workforce to adapt and flex to the increasingly complex contexts they are working in. This will serve to undermine system integration for health and social care if the capacity and capability for transformation are not attended to. Whilst there are ambitious global plans (WHO, 2015) to enable integrated services to be driven by citizen needs, there is still a considerable void in understanding how to authentically engage with people to ensure the transformation is driven by their needs as opposed to what the authors think they need. There is, therefore, a need for systems leaders with the full skillset required to enable integrated services across place-based systems, particularly clinicians who are able to break down barriers and silo working across boundaries through the credibility, leadership and facilitation expertise they provide. Originality/value: The realist evaluation with additional synthesis from key stakeholders has provided new knowledge about the principles of effective NMAHP leadership in health and social care, presented in such a way that facilitates the use of the five guiding lights to inform further practice, education, research and policy development

Effect of Water Depth on Heart Rate and Core Temperature During Underwater Treadmill Walking

Exercising using an underwater treadmill (UTM) has become a popular modality; however, few studies have focused on the physiological demands of UTM walking at varying water depths. Thus, the objective of this study was to investigate changes in heart rate (HR) and core temperature (CT) values in college-aged males and females while exercising at different water immersion depths using an UTM. Twenty participants (age = 21.50 ± 2.19 years; height = 169.04 ± 10.85cm; weight = 75.56 ± 22.28kg) walked at water depths of 10cm below the xiphoid process and at the level of the superior iliac crest (I.C.). Each UTM session lasted 15 minutes, consisting of 5-minute bouts at 1, 2, and 3 mph. Polar HR monitors and ingestible thermoregulatory pills were used to measure HR and CT. Results indicated that HR at 1 (p = .305) and 2 mph (p = .864) were not significantly different between water depths. Heart rate was significantly higher at 3 mph (p = .003) at the I.C. water level. No significant differences were found in CT at 1 (p = .919), 2 (p = .392), or 3 mph (p = .310) during either immersion depth. As a result, higher immersion depths resulted in a lower average HR during higher intensity exercise due to the increased buoyancy effects and the reduced gravity environment of the water. Thus, exercising in higher immersion depths allows participants to exercise at a higher intensity with less overall stress placed on the lower extremities

Use of Calcium Hypochlorite as a Sanitizer for Seeds Used for Sprouting: Task #2; Impact: Improved Alfalfa Decontamination Technologies

Consumption of raw or lightly cooked alfalfa sprouts has been a concern of the U.S. Food and Drug Administration (FDA) in recent years due to connections between sprouts and foodborne illnesses. Researchers have identified, contaminated seeds as the primary source of alfalfa sprouts contamination. Contamination of alfalfa seeds can originate in the field, harvesting, storing, or sprouting. Two pathogens of particular concern on alfalfa seeds are Escherichia coli 0157:H7 (E. coli) and Salmonella. These pathogens are capable of producing biofilms that provide protection for individual cells and allow for survival in otherwise hostile environments, including some disinfectant washes. Other factors that contribute to contamination are the crevices of the seed surface, which provide opportunities for the protection of organisms. Various disinfection options have been evaluated and the use of a 20,000 ppm calcium hypochlorite ( Ca( OCl)2)) solution is the most effective disinfectant for satisfying the requirements of Task 2. Continued outbreaks of food poisoning indicate current disinfecting procedures are inadequate. In an effort to improve disinfection procedures, three bench scale apparatuses were constructed and tested to provide options for the commercial range of seed sanitation rates (from about 75 to 600 lb/week). Experiments were conducted to determine the disinfecting effectiveness of the apparatuses, as well as the current sanitization practices in industry. Experiments included dye removal tests where non-uniform dye removal indicated ineffective contacting. Similar experiments were performed using E. coli inoculating and post-contacting culturing. One bench scale apparatus constructed was a model of the rotary drums widely used in industry. After a 30 minute treatment in the rotary drum, the seeds were found to be free of dye, indicating good contacting. The seeds were also sprouted showing sanitation did not damage the seeds. However, due to the capital expense of $14,000, the drum is not a viable option for small-scale sprout producers. For sprout growers who currently own rotary drums, drum use is recommended for seed sanitation. Another bench scale apparatus was designed to improve the current industry practice of hand dunking seed-filled mesh draw-string bags. Through experimentation, it was determined . the current hand dunking procedure, with little or no agitation, produces inadequate, non-uniform contact of the seeds and sanitizer. Therefore, the hand dunking procedure was modified to include agitation to effectively suspend the seeds throughout the bag to obtain good contact of the sanitizer solution with the seeds. The agitation-in-bag method is recommended for use in small volume sprout facilities, which currently employ the hand dunking procedure for sanitizing. A modest investment of$113 is needed to implement the agitation-in-bag sanitizing method. Since no additional operating costs are accrued in implementation, no incremental costs are required. Finally, an auger system was designed to sanitize one ton per hour of alfalfa seeds. The one ton per hour rate exceeds the demand of any individual sprout producer. Thus, the auger system is applicable to a partnership of sprout growers. Individual sprout growers within the mung bean industry, with much larger production volumes than the alfalfa industry, could economically use the auger system. However, the auger system can be scaled to sanitize any feed rate. A 1 3/8 diameter, 4\u27 long auger bench scale model was constructed and tested at 4.5 lbs/hr rate with a contact time of 15 minutes. Scale-up of this bench scale sanitizer to a 2000 lb/hr rate requires a 16 diameter by 20\u27 auger. The entire full-scale sanitizing system, which includes a vibrating screen washer, will handle 5,000,000 lb/yr of seeds, operating 8 \u27hr/day, with a capital investment of $227,000 and an incremental operating cost (primarily labor) of$214,000/yr

Evaluation of txt2MEDLINE and Development of Short Messaging Service–Optimized, Clinical Practice Guidelines in Botswana

Objective: Currently clinicians in sub-Saharan Africa have limited access to the Internet, whereas mobile phone access and use is extensive. The University of Pennsylvania in collaboration with the National Library of Medicine launched txt2MEDLINE, a short messaging service (SMS) query of PubMed/MEDLINE, and SMS-optimized clinical guidelines in Botswana. The objective of this project was to establish and evaluate the utility of these tools for clinicians in Botswana. Materials and Methods: A local server was established at the University of Botswana that allowed clinicians to send queries and receive results via local (in-country) SMS text messaging on any type of cellular phone. The queries sent via txt2MEDLINE were returned as abbreviated “the bottom line” summaries of abstracts. The 2007 Botswana Treatment Guide was converted into a format that can be queried by SMS. Various types of healthcare workers were recruited to use and evaluate these services. Results: Seventy-six healthcare workers attended training sessions for these services. In the preusage survey, most said they would use the services daily or weekly. During a 4-week trial period, use of these services dropped off dramatically. Participant feedback was collected and indicated that improvements in ease of use would increase the usage. Conclusions: This pilot project enables clinicians to query and receive PubMed abstract summaries and country-specific clinical guidelines using mobile phones. Feedback offers insight on how to improve this technology so that it can be adopted for long-term use. With further adjustments, these resources may provide an effective working model for other countries where limited Internet access impedes upon patient care