Creating Significant Learning Experiences for Clinical Reasoning by Physical Therapist Students

Background: Clinical reasoning skills are embedded in all aspects of practice. There is a lack of consensus and standards for curriculum design and teaching methods of clinical reasoning in entry-level education of health professionals. Purpose: The purpose was to describe a process of designing one comprehensive, planned sequence of four courses to create significant learning experiences for clinical reasoning for Doctor of Physical Therapy students. Method: Fink’s design process was used to develop four clinical decision-making courses to ensure a close alignment of learning goals, feedback and assessment, and learning activities to engage students in practicing components of clinical reasoning. Student outcomes were measured by self-efficacy ratings for clinical reasoning in a practical exam for first-year students and by ratings of performance by clinical instructors for third-year students. Results: 41 first-year students ranked their confidence in making clinical decisions both before and after a midterm practical. A paired t-test found a significant difference (.05t40 = -6.66, ρ=0.00) in the mean ratings of students from the pre-practical assessment to the post-practical assessment about confidence in making clinical decisions. Third-year students received ratings that met or exceeded expectations on five audited skills from the Physical Therapist manual for the Assessment of Clinical Skills (PT MACS), both at midterm and at the final assessment. No significant differences between midterm and final ratings on any of the selected skills were found using a Chi-Square Test of Independence (α=.05). Conclusion: The four-course sequence was designed using four themes: patient-centered care, models of practice, and evidence-based practice, and ethics/legal issues. This paper offers specific details about how one method of teaching clinical reasoning meets the current trends in education and health care for accountability and meaningful outcomes. Students gained practical knowledge and skills in the components of clinical reasoning and decision-making by participating in active and engaging significant learning experiences

Survey of Mississippi Catfish Farmers on Means, Effort, and Costs to Repel Fish-Eating Birds from Ponds

Eighty-seven percent of 281 Mississippi catfish farmers felt that fish-eating birds were enough of a problem to warrant harassment. Farmers estimated that they spent an average of 2.6 man-hours per day harassing birds at an average annual cost of $7400. Sixty percent of the farmers who harassed birds did so by driving around the ponds and firing at birds to repel them. Propane exploders and pyrotechnics were also used. Pyrotechnics were judged the most effective repellent technique. The cost of bird harassment according to these farmers is$2.1 million. The value of fish loss to cormorants alone is roughly estimated at $3.3 million. The total annual loss to birds is estimated at$5.4 million

Gain, impedance measurements and dielectric loading of ground penetrating radar (GPR) antennas using a watertank testing facility

The design and testing of suitable GPR antennas to be used in the field is both an arduous and challenging task. Presented here is a watertank testing facility incorporating a method of measuring gain and impedance of scaled-down models of prospective GPR antennas. A vertical ground plane is placed in a watertank measuring 1200mm×600mm×600mm. A monopole version of the test antenna is connected to a 150mm square plate which fits exactly into the ground plane. Underwater and air probes are placed in a semi-circular fashion on the vertical conducting ground plane around the square plate at radii of 150mm and 300mm respectively. Results are presented as gain and impedance plots for a monopole test antenna with two different water levels; Omm and 5mm below the base of the test antenna. Results for a salty solution and Isopropylalcohol dielectrically loaded, cavity backed, slot bowtie antenna are also given. The results show the sudden change in electrical length that occurs near a half-space surface, lateral wave phenomena as an air gap appears between the antenna's base and the water's surface as well as improved fractional bandwidth through dielectric loading

Loneliness and health risk behaviours among Russian and U.S. adolescents: a cross-sectional study

BACKGROUND: For some adolescents feeling lonely can be a protracted and painful experience. It has been suggested that engaging in health risk behaviours such as substance use and sexual behaviour may be a way of coping with the distress arising from loneliness during adolescence. However, the association between loneliness and health risk behaviour has been little studied to date. To address this research gap, the current study examined this relation among Russian and U.S. adolescents. METHODS: Data were used from the Social and Health Assessment (SAHA), a school-based survey conducted in 2003. A total of 1995 Russian and 2050 U.S. students aged 13–15 years old were included in the analysis. Logistic regression was used to examine the association between loneliness and substance use, sexual risk behaviour, and violence. RESULTS: After adjusting for demographic characteristics and depressive symptoms, loneliness was associated with a significantly increased risk of adolescent substance use in both Russia and the United States. Lonely Russian girls were significantly more likely to have used marijuana (odds ratio [OR]: 2.28; confidence interval [CI]: 1.17–4.45), while lonely Russian boys had higher odds for past 30-day smoking (OR, 1.87; CI, 1.08–3.24). In the U.S. loneliness was associated with the lifetime use of illicit drugs (excepting marijuana) among boys (OR, 3.09; CI, 1.41–6.77) and with lifetime marijuana use (OR, 1.79; CI, 1.26–2.55), past 30-day alcohol consumption (OR, 1.80; CI, 1.18–2.75) and past 30-day binge drinking (OR, 2.40; CI, 1.56–3.70) among girls. The only relation between loneliness and sexual risk behaviour was among Russian girls, where loneliness was associated with significantly higher odds for ever having been pregnant (OR, 1.69; CI: 1.12–2.54). Loneliness was not associated with violent behaviour among boys or girls in either country. CONCLUSION: Loneliness is associated with adolescent health risk behaviour among boys and girls in both Russia and the United States. Further research is now needed in both settings using quantitative and qualitative methods to better understand the association between loneliness and health risk behaviours so that effective interventions can be designed and implemented to mitigate loneliness and its effects on adolescent well-being

Access to water in the countries of the former Soviet Union.

BACKGROUND: During the Soviet period, authorities in the USSR invested heavily in collective farming and modernization of living conditions in rural areas. However, many problems remained, including poor access to many basic amenities such as water. Since then, the situation is likely to have changed; economic decline has coincided with migration and widening social inequalities, potentially increasing disparities within and between countries. AIM: To examine access to water and sanitation and its determinants in urban and rural areas of eight former Soviet countries. METHODS: A series of nationally representative surveys in Armenia, Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russia and Ukraine was undertaken in 2001, covering 18,428 individuals (aged 18+ years). RESULTS: The percentage of respondents living in rural areas varied between 27 and 59% among countries. There are wide urban-rural differences in access to amenities. Even in urban areas, only about 90% of respondents had access to cold running water in their home (60% in Kyrgyzstan). In rural areas, less than one-third had cold running water in their homes (44% in Russia, under 10% in Kyrgyzstan and Moldova). Between one-third and one-half of rural respondents in some countries (such as Belarus, Kazakhstan and Moldova) obtained their water from wells and similar sources. Access to hot running water inside the homes was an exception in rural households, reflecting the lack of modern heating methods in villages. Similarly, indoor access to toilets is common in urban areas but rare in rural areas. Access to all amenities was better in Russia compared with elsewhere in the region. Indoor access to cold water was significantly more common among rural residents living in apartments, and in settlements served by asphalt roads rather than dirt roads. People with more assets or income and living with other people were significantly more likely to have water on tap. In addition, people who had moved in more recently were more likely to have an indoor water supply. CONCLUSIONS: This was the largest single study of its kind undertaken in this region, and demonstrates that a significant number of people living in rural parts of the former Soviet Union do not have indoor access to running water and sanitation. There are significant variations among countries, with the worse situation in central Asia and the Caucasus, and the best situation in Russia. Access to water strongly correlates with socio-economic characteristics. These findings suggest a need for sustained investment in rebuilding basic infrastructure in the region, and monitoring the impact of living conditions on health

The value of qualitative methods to public health research, policy and practice.

This article reviews the role and use of qualitative methods in public health research.'Signs of quality' are introduced to help guide potential authors to publish their qualitative research in public health journals. We conclude that high-quality qualitative research offers insights that quantitative research cannot. It is time for all public health journals to recognise the value of qualitative research and increase the amount that they publish

Decontamination of a \u3cem\u3eHistoplasma capsulatum\u3c/em\u3e-Infested Blackbird Roost: Use of a Sprinkler System to Apply Formalin

When disturbed, blackbird/starling roost sites can be sources of locally severe outbreaks of histoplasmosis; therefore decontamination with formalin is sometimes prudent. We describe the use of a $5000 sprinkler system for spraying formalin on a Histoplasma capsulatum-infested roost site. This system precludes direct worker involvement in the application of this hazardous chemical to the area. Analysis of soil samples collected and cultured both before and after formalin treatment confirmed the eradication of H. capsulatum from the 1.3 ha site. Cost was approximately$17,000 with sprinkler system provided at no charge

Arts on Prescription in Scandinavia: a review of current practice and future possibilities

Aims: This article reviews current practice relating to arts and culture on prescription in Sweden, Norway, Denmark and in the UK. It considers future possibilities and considers each of the Scandinavian countries from a culture and health policy and research perspective. The UK perhaps leads the field of Arts on Prescription practice and subsequent research is described in order to help identify what the Scandinavian countries might learn from the UK research. Method: The method adopted for the literature search, was a rapid review which included peer-reviewed and grey literature in English and the respective languages of Scandinavia. Results: The discussion considers the evidence to support social prescription and the obstacles of the implementation of Arts on Prescription in Scandinavian countries. Conclusion: The article concludes that of the Scandinavian countries, Sweden is ahead in terms of Arts on Prescription and has embraced the use of culture for health benefits on a different scale compared to Norway and Denmark. Denmark, in particular is behind in recognising ways in which art and culture can benefit patients and for wider public health promotion. All three countries may benefit from the evidence provided by UK researchers