Encouraging Integrated Care for Dual Eligibles

Outlines examples and elements of integrated care models for those eligible for both Medicare and Medicaid, including multidisciplinary care teams, comprehensive provider networks, and data sharing, that would eliminate inefficiencies and reduce costs

Men with intellectual disabilities with a history of sexual offending: empathy for victims of sexual and non-sexual crimes

Background: The objectives were (a) to compare the general empathy abilities of men with intellectual disabilities (IDs) who had a history of sexual offending to men with IDs who had no known history of illegal behaviour, and (b) to determine whether men with IDs who had a history of sexual offending had different levels of specific victim empathy towards their own victim, in comparison to an unknown victim of sexual crime, and a victim of non-sexual crime, and make comparison to non-offenders. Methods: Men with mild IDs (N = 35) were asked to complete a measure of general empathy and a measure of specific victim empathy. All participants completed the victim empathy measure in relation to a hypothetical victim of a sexual offence, and a non-sexual crime, while additionally, men with a history of sexual offending were asked to complete this measure in relation to their own most recent victim. Results: Men with a history of sexual offending had significantly lower general empathy, and specific victim empathy towards an unknown sexual offence victim, than men with no known history of illegal behaviour. Men with a history of sexual offending had significantly lower victim empathy for their own victim than for an unknown sexual offence victim. Victim empathy towards an unknown victim of a non-sexual crime did not differ significantly between the two groups. Conclusions: The findings suggest that it is important include interventions within treatment programmes that attempt to improve empathy and perspective-taking

ACL RUPTURE IN COLLEGIATE WRESTLER

Objective: To educate others on unique Anterior Cruciate Ligament tears and percentage of usage of the ACL in normal daily function. Background: Patient is an eighteen year old male participating in wrestling and football at the time of the injury. Patient now only participates in wrestling. No previous knee or chronic injuries were reported prior to this injury. Patient was playing football during the time of injury. The patient stated that he planted his foot down and was tackled at the same time when the injury occurred. The patient felt his knee twist and buckle. Patient complained of clicking inside the knee and had minimal swelling. He also complained of it being difficult to bear weight at the time. The patient did not seek further treatment until two months after the injury occurred when he received an MRI. His MRI showed a positive finding for an Anterior Cruciate Ligament rupture. His previous Athletic Trainer could not find a positive diagnosis for the patient prior to the MRI. Differential Diagnosis: Possible meniscal or ACL injury. Treatment: Doctors officially diagnosed the injury as a complete rupture of the ACL. The patient did not receive surgery immediately. Doctors have stated that he only uses about 50% of his ACL on a daily basis compared to a normal person who uses about 95% of their ACL daily. Because of this, the patient played on his rupture for seven months before receiving surgery. He played a whole season of high school football and a whole season of wrestling his senior year with the ACL ruptured. The patient only used a brace for better comfort during the seven months. The patient then received reconstructive surgery to repair the rupture. A hamstring tendon graft was used to repair the ruptured ACL. Because a tendon was taken from the hamstring, patient experienced a tight ACL and hamstring of the left leg post-surgery. The patient participated in Physical Therapy for five months to strengthen and stretch the new ACL and hamstring. After completing five months of physical therapy, the patient joined a college wrestling team in August 2013. The athletic training staff at the university started him on a quadriceps and hamstring strengthening rehabilitation program for about one month. The staff also worked on continuous flexion and extension of the knee to where the patient could feel comfortable with doing activities with his knee. The patient continues to participate in daily stretching and strengthening protocols for his quadriceps and hamstring bilaterally. Deviation from the Expected/Uniqueness: The patient still participated on a fully ruptured ACL for seven months with just complaining of minimal pain and discomfort. The athlete chose to complete two seasons of activities instead of receiving surgery immediately. The ratio of people who rupture their ACL is about 5 in every 100,000 people. It is interesting that the high school clinician could not diagnose the injury until the patient received an MRI two months post-injury. The patient was also told by doctors that he only uses about 50% of his ACL on a daily basis compared to anyone else who uses their ACL about 95%. The patient felt comfortable with the ACL ruptured and changed any discomfort by just wearing a brace. Conclusions: Not many people can play on a ruptured ACL for seven months before receiving any surgical repairs. We need to keep this in mind as Athletic Trainers so we are not sending our athletes back on the field and possibly causing them more damage. The athlete continues stretching protocols daily. Key Words: rupture, ACL, Anterior Cruciate Ligamen

Students’ Perceptions of Course Syllabi: The Role of Syllabi in Motivating Students

In this mixed methods study, researchers explored students’ perceptions of different types of syllabi, the course, and the instructor articulated through the syllabi. Students were randomly assigned to read one of two US History syllabi: a content-focused syllabus (CFS), characterized as a traditional, content-focused, policy-laden syllabus; or a learning-focused syllabus (LFS), characterized by strong learning objectives, authentic assessments, and a positive, motivating tone. Results show that LFS participants (n=61) had significantly more positive perceptions of the document, the course, and the instructor described by the document than CFS participants (n=66). LFS participants found, for example, more of the syllabus components to be useful, anticipated more student involvement in class, expected to learn more useful concepts and skills, and anticipated that the instructor would help them be successful. Although additional research is needed to determine generalizability of these results, we conclude that instructors have little to lose and much to gain by creating a learning-focused syllabus

Child Exploitation and the FIFA World Cup: A review of risks and protective interventions

This review was commissioned by the Child Abuse Programme (CAP) of Oak Foundation, a large international philanthropic organisation. It forms part of CAP’s effort to win societal rejection of practices such as the sexual exploitation of children and adolescents around major sporting events (MSEs), and to embed prevention and protection from exploitation as a permanent concern for global sports-related bodies. This review is intended to inform action in countries that host MSEs and to provide some suggestions on how hosting countries can avoid past pitfalls and mistakes in relation to child exploitation, especially economic and sexual exploitation. Importantly, it also acts as a call to action by those responsible for commissioning and staging MSEs, such as FIFA and the IOC, to anticipate, prepare for and adopt risk mitigation strategies and interventions. Positive leadership from these culturally powerful bodies could prove decisive in shifting hearts, minds and actions in the direction of improved safety for children

Downtown Providence Farmers Market Design

This market essentially combines a marketplace with an existing or new industrial building. The hybrid created results in space that has daily retail sales and hours, as well as other goods available at other times. The industrial aspect typically acts as the anchor, as the market’s activities help attract a different group of consumers at other business times. An example of this would be a seafood supply warehouse that also provides dining and entertainment as a nightlife destination

Taijiquan the 'Taiji World' way: Towards a cosmopolitan vision of ecology.

In this article, we present a case study analysis of data gathered on the practice of the art of Taijiquan (Tai Chi Chuan) in one UK context. Our interest in looking at this physical culture was in exploring if/how physical cultures of shared embodied experience and practice may help “sow the seeds of environmental awareness”. In so doing, we illustrate certain affinities between this interpretation of the art and Beck’s idea of a “cosmopolitan vision of ecology”. We present an analysis of documentary and interview data of one English Taijiquan organisation and how it currently promotes the idea of interconnectedness, wellbeing and an alternative meta-narrative for living through the practice of Taijiquan. We conclude that, while further research is needed, there is evidence that a cosmopolitan vision for ecology is emerging in physical cultures such as Taijiquan

Biomechanical changes of the trunk and lower limb during walking in patients after total hip arthroplasty for osteoarthritis: A systematic review and meta-analysis

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