Nevin Manimala

J Atten Disord. 2023 Jun 2:10870547231172763. doi: 10.1177/10870547231172763. Online ahead of print.

ABSTRACT

OBJECTIVE: We assessed the feasibility and validity of remote researcher-led administration and self-administration of modified versions of two cognitive tasks sensitive to ADHD, a four-choice reaction time task (Fast task) and a combined Continuous Performance Test/Go No-Go task (CPT/GNG), through a new remote measurement technology system.

METHOD: We compared the cognitive performance measures (mean and variability of reaction times (MRT, RTV), omission errors (OE) and commission errors (CE)) at a remote baseline researcher-led administration and three remote self-administration sessions between participants with and without ADHD (n = 40).

RESULTS: The most consistent group differences were found for RTV, MRT and CE at the baseline researcher-led administration and the first self-administration, with 8 of the 10 comparisons statistically significant and all comparisons indicating medium to large effect sizes.

CONCLUSION: Remote administration of cognitive tasks successfully captured the difficulties with response inhibition and regulation of attention, supporting the feasibility and validity of remote assessments.

PMID:37269091 | DOI:10.1177/10870547231172763

Cancer. 2023 Jun 2. doi: 10.1002/cncr.34843. Online ahead of print.

ABSTRACT

BACKGROUND: Allogeneic hematopoietic cell transplantation (allo-HCT) is the only cure for acute myeloid leukemia (AML) in second complete remission (CR2). Patients lacking a matched sibling donor (MSD) receive transplants from matched unrelated donors (MUDs), mismatched unrelated donors (MMUDs), haploidentical (haplo) donors, or cord blood.

METHODS: This is a retrospective, registry-based European Society for Blood and Marrow Transplantation study that investigates changes in patient- and transplant-related characteristics and posttransplant outcomes over time.

RESULTS: We identified 3955 adult patients (46.7% female; median age, 52 years [range, 18-78 years]) with AML in CR2 first transplanted between 2005 and 2019 from a MUD 10/10 (61.4%), MMUD 9/10 (21.9%), or haplo donor (16.7%) and followed for 3.7 years. A total of 725 patients were transplanted between 2005 and 2009, 1600 between 2010 and 2014, and 1630 between 2015 and 2019. Over the three time periods, there was a significant increase in patient age (from 48.7 to 53.5 years; p < .001), use of a haplo donor (from 4.6% to 26.4%; p < .001), and use of posttransplant cyclophosphamide (from 0.4% to 29%; p < .001). There was a significant decrease in total body irradiation and in vivo T-cell depletion. In multivariate analysis, transplants performed more recently had better outcomes. Leukemia-free survival (hazard ratio [HR], 0.79; p = .002) and overall survival (HR, 0.73; p < .001) increased over time. Similarly, nonrelapse mortality (HR, 0.64; p < .001) decreased over time. We also observed better graft-vs-host disease (GVHD) rates (acute GVHD II-IV: HR, 0.78; p = .03; GVHD-free, relapse-free survival: HR, 0.69; p < .001).

CONCLUSIONS: Even in the absence of an MSD, outcomes of allo-HCT in CR2 for AML have significantly improved over time, with most favorable outcomes achieved with a MUD.

PMID:37269074 | DOI:10.1002/cncr.34843

Int J Gynaecol Obstet. 2023 Jun 2. doi: 10.1002/ijgo.14909. Online ahead of print.

ABSTRACT

OBJECTIVE: Placenta accreta spectrum (PAS) has been linked to severe negative maternal-fetal pregnancy outcomes, including a high risk of maternal death. The goal of this study was to determine whether an abdominal aortic balloon block performed before fetal birth lowered intraoperative bleeding and the risk of severe bleeding, as opposed to a block performed after fetal birth.

METHODS: In this retrospective cohort study, patients who underwent pre-delivery or post-delivery inflation were compared for intraoperative hemorrhage, transfusion rate, hysterectomy rate, intensive care unit (ICU) hospitalization, and newborn indices. To ensure the robustness of our findings, we applied multivariate logistic regression, propensity score analysis, and an inverse probability-weighting model.

RESULTS: This study included 168 patients who underwent balloon occlusion (62 pre-delivery, 106 post-delivery). The overall probability of major bleeding was 56.5% (95/168), and the pre-delivery and post-delivery probabilities for major bleeding were 64.5% (40/62) and 51.9% (55/106) (P = 0.112), respectively. In the multivariable-adjusted model, post-delivery inflation was associated with a 33% numerically higher probability of massive bleeding (odds ratio 1.33, 95% confidence interval 0.54-3.25, P = 0.535). However, the difference was not statistically significant.

CONCLUSION: According to our findings, pre-delivery inflation did not significantly reduce the risk or amount of severe bleeding.

PMID:37269053 | DOI:10.1002/ijgo.14909

J Allied Health. 2023 Summer;52(2):e79-e82.

ABSTRACT

Medical Assistant (MA) is one of the fastest growing healthcare professions, with the U.S Bureau of Labor Statistics predicting MA positions will grow by 18% between 2020 and 2030. The experience and knowledge MAs gain during their education and training provide a foundation for advancement into other healthcare occupations that could be leveraged to support efforts to diversify the healthcare workforce. However, the lack of federal investment in medical assistant education and training, as well as the lack of established education and career pathways that build on medical assisting, is a missed opportunity to better meet the workforce development needs of our primary care delivery system.

PMID:37269041

J Allied Health. 2023 Summer;52(2):e63-e71.

ABSTRACT

As costs of higher education continue to rise, textbook pur¬chase is an area in which students have control over spending. The purposes of this project were to: 1) describe textbook use among current students and recent graduates in one physical therapist program, and 2) determine how this information might be utilized in addressing faculty textbook decisions in entry-level education. Electronic surveys were sent to 83 students and 229 graduates of a Doctor of Physical Therapy program in Texas. Ten faculty completed an 8-question paper survey about factors considered in requiring a textbook. Data analyses included descriptive statistics, ANOVA, and chi-square test for independence. Thirty-two students, 28 graduates, and 7 faculty responded. A total of 23 textbooks were required during the curriculum. Only 6 of 23 required texts were reported as “useful” by students. Graduates identified 3 texts as “useful” during early clinical practice. Six faculty required textbooks for classes; 4 indicated texts were “necessary” for student success. Students purchased a small percentage of required textbooks and maintained a high level of success. Results indicate that faculty are providing the required content. Faculty should carefully consider their instructional delivery when making decisions about if required textbooks are truly required for success.

PMID:37269039

J Allied Health. 2023 Summer;52(2):e31-e37.

ABSTRACT

Entrance testing has been found to predict passing on professional licensure examinations in various allied health fields. Physical therapy (PT) programs do not consistently use an entrance test for assessment of an applicant’s prerequisite competence. The purpose of this study was to assess whether a correlation existed between a prerequisite entrance test and academic success measured by grade point average (GPA) in first-semester PT students. A 140-question entrance test assessing prerequisite knowledge was administered prior to matriculation to two consecutive cohorts at a medium-sized PT program in the southwestern United States. GPA was collected following completion of the first didactic semester. Inferential statistics were used including the Pearson product moment correlational coefficient (r) and a regression model. 108 students completed the entrance test and one semester of coursework. The entrance test scores ranged from 58.33-100, with a mean score of 79.71. There was a significant medium correlation between the two variables (r=0.423, p<0.001), and the exam and age contributed to the regression model. Entrance tests may provide programs with a more content-specific evaluation of graduate school readiness while providing administrators and faculty information regarding didactic areas of concern with which students may struggle.

PMID:37269035

J Allied Health. 2023 Summer;52(2):141-148.

ABSTRACT

AIMS: This study examined how the qualities of grit and resilience correlated with career achievements in physical therapists. The purpose of this study was to determine if select career achievements were correlated with 1) Original Grit Scale (Grit-O) scores, 2) Short Grit Scale (Grit-S) scores, or 3) Connor-Davidson Resilience Scale (CD-RISC) scores among Mayo Clinic School of Health Sciences Physical Therapy Program graduates from 2000-2018.

METHODS: Cross-sectional research design. Participants were 212 graduates between 2000 and 2018, inclusive. Participants completed the Grit-O, Grit-S, and CD-RISC scales and reported career achievements. Descriptive statistics were used to summarize the demographics, career achievements, grit, and resilience of the subjects. Point biserial and partial correlations were used to examine associations between Grit-O and Grit-S subscales, CD-RISC scores, and career achievements.

RESULTS: When controlled for gender and time since graduation, there were significant positive relationships between Grit-O Perseverance of Effort and 1) publication in a peer-reviewed journal and 2) attainment of an additional degree. Biological males were significantly more likely to have reported certain career achievements.

CONCLUSION: Few of the expected relationships were found, possibly due to a lack of true relationships, a homogeneous population, ceiling effect, or inaccurate self-reports.

PMID:37269033

J Allied Health. 2023 Summer;52(2):127-135.

ABSTRACT

AIMS: The purpose of this mixed-methods study was to investigate the effect of a first clinical experience on student perception of the importance of obtaining and assessing blood pressure (BP).

METHODS: Fifty-eight students preparing for their first clinical experiences were recruited from three New York State physical therapy programs. Student experience obtaining BP during a first clinical experience was investigated using online anonymous surveys and focus groups. The pre survey was administered at 2 weeks before the first clinical experience, and a post survey and focus group were complete 3 weeks after.

RESULTS: Statistically significant decline was found in student perceptions of the importance and likelihood of obtaining and assessing BP following a first clinical experience. Qualitatively, three themes emerged (1) Being a student and agency including reluctance to independently initiate practices; (2) influence of clinic norms such as availability of equipment and consistency of BP monitoring; and (3) personal confidence obtaining, assessing, and interpreting BP influenced by exposure to obtaining, assessing, and interpreting BP.

CONCLUSION: Clinical education appears to have significant influence on students’ perception of the importance of BP assessment. If students encounter and adopt practices deviating from didactic instruction reflecting professional standards, it can expose patients and practitioners to unnecessary risk. Faculty can use these results to better appreciate students’ first clinical experiences and foster agency by discussing practice norms.

PMID:37269031

J Allied Health. 2023 Summer;52(2):89-96.

ABSTRACT

BACKGROUND: An urgent educational need is to examine the current gaps in cultural competence/humility, diversity, equity, inclusion, and accessibility (DEIA) that may significantly affect the teaching and learning environments among students/faculty. This mixed-methods study examined the current level of cultural competemility and perceptions of diversity, equity, and inclusion (DEI)-related challenges and recommendations among students/faculty of health professions.

METHODS: Students and faculty completed a survey including the Inventory for Assessing the Process of Cultural Competemility Among Healthcare Professionals (IAPCC-HCP©) and open-ended questions on their DEI perceptions and needs. Data were analyzed via descriptive statistics and independent t-tests. Qualitative data were coded using thematic content analysis.

OUTCOMES: A total of 100 participants (64 students, 38 faculty) completed the survey. The majority identified as Caucasian or non-Hispanic White and female, and were satisfied with DEIA-related school-level initiatives and familiar with how to use pronouns to reflect all genders. Compared to students, faculty scored slightly higher, although not significantly, in five of six domains, including Cultural Humility, Cultural Awareness, Culture Skill, Cultural Encounters and Cultural Desire. Participants shared their need to address: 1) DEIA gaps in knowledge and Schools of Health Professions curriculum; 2) involvement of students; 3) racism, biases, and discrimination; and 4) recognition of underrepresented groups. Training needs were in the areas of 1) DEIA assessment and training for students and faculty; 2) DEIA school activities; 3) DEIA-informed policies; and 4) modifications to clinical education.

CONCLUSION: The faculty more than students expressed the need to enhance their DEI and cultural knowledge. Our findings can guide further development of educational activities and school-level DEI initiatives in schools of health professions.

PMID:37269026

Cancer Treat Res Commun. 2023 May 25;36:100724. doi: 10.1016/j.ctarc.2023.100724. Online ahead of print.

ABSTRACT

AIM: This study aimed to investigate whether the site of the tumour within the right colon affects survival in patients who underwent right colectomy for colon cancer.

METHODS: An observational retrospective longitudinal study was performed in patients who underwent right colectomy for non-metastatic, invasive right-sided colon cancer. Patients were categorized into two groups based on tumour location: (i) caecum and ascending colon; (ii) hepatic flexure and proximal transverse colon. Demographic and clinical features were characterized, and a survival analysis was performed.

RESULTS: Of the 198 patients enroled in the study, 134 (67.8%) had caecal or ascending colon cancer and 64 (32.3%) had hepatic flexure or transverse colon cancer. Seventy (35.4%) were female and the mean age at the time of surgery was 71.6 (SD 11.4). The groups were comparable with respect to the number of lymph nodes sampled, the pTNM stage, the histological differentiation grade and the likelihood of patients receiving adjuvant chemotherapy. Recurrence rate was nearly twice as high in the hepatic flexure and proximal transverse colon group (12.5% vs 6.7%), but this difference was not statistically significant (p = 0.174). Kaplan-Meier analysis showed no differences in disease-free (p = 0.255) and overall survival (p = 0.258) between the groups.

CONCLUSION: In our population, specific location of right-sided colon cancers does not appear to have an influence on survival. Further investigation is needed to determine if tumour subsite has an impact on the recurrence rate, and whether it should be considered in defining prognosis and treatment.

PMID:37267659 | DOI:10.1016/j.ctarc.2023.100724