ABSTRACT
OBJECTIVE: Examine outcomes for the National Parkinson Foundation (NPF) Allied Team Training for Parkinson (ATTP), an interprofessional education (IPE) program in Parkinson's disease (PD) and team-based care for medicine, nursing, occupational, physical and music therapies, physician assistant, social work and speech-language pathology disciplines. BACKGROUND: Healthcare professionals need education in evidence-based PD practices and working effectively in teams. Few evidence-based models of IPE in PD exist. METHODS: Knowledge about PD, team-based care, the role of other disciplines and attitudes towards healthcare teams were measured before and after a protocol-driven training program. Knowledge, attitudes and practice changes were again measured at 6-month post-training. Trainee results were compared to results of controls. RESULTS: Twenty-six NPF-ATTP trainings were held across the U.S. (2003-2013). Compared to control participants (n = 100), trainees (n = 1468) showed statistically significant posttest improvement in all major outcomes, including self-perceived (p < 0.001) and objective knowledge (p < 0.001), Understanding Role of Other Disciplines (p < 0.001), Attitudes Toward Health Care Teams Scale (p < 0.001), and the Attitudes Toward Value of Teams (p < 0.001) subscale. Despite some decline, significant improvements were largely sustained at six-month post-training. Qualitative analyses confirmed post-training practice changes. CONCLUSIONS: The NPF-ATTP model IPE program showed sustained positive gains in knowledge of PD, team strategies and role of other disciplines, team attitudes, and important practice improvements. Further research should examine longer-term outcomes, objectively measure practice changes and mediators, and determine impact on patient outcomes.
Subject(s)
Allied Health Personnel/education , Clinical Competence , Education, Medical/methods , Education, Nursing/methods , Parkinson Disease/therapy , Patient Care Team , Case-Control Studies , Curriculum , Educational Measurement , Female , Humans , Male , Music Therapy/education , Occupational Therapy/education , Physical Therapists/education , Physician Assistants/education , Social Work/education , Speech-Language Pathology/educationABSTRACT
Ten patients with migraine with prolonged aura were studied for the presence of mitochondrial DNA point mutations utilizing DNA isolated from blood and hair samples. We analyzed for nine point mutations reported in patients with MELAS (A3243G, C3256T, T3271C, T3291C, A5814G, T8356C, T9957C, G13513A, and A13514G) and three secondary LHON mutations (T4216C, A4917G, and G13708A). None of the patients tested had any of these mutations in mitochondrial DNA. However, one patient was found to have a tRNA(Gln) A4336G mitochondrial DNA variant. From this study it appears that migraine with prolonged aura is not an oligosymptomatic form of MELAS and is not related to secondary LHON mutations. The significance of the tRNA A4336G variant is unknown.
Subject(s)
DNA, Mitochondrial/genetics , Migraine with Aura/genetics , Point Mutation , Base Sequence , Humans , Migraine with Aura/pathology , RNA, Transfer, Gln/genetics , Time FactorsABSTRACT
To investigate how clinical fieldwork educators and academic fieldwork coordinators view the impact of the changing health care environment on student fieldwork education, current practice, and future of the profession, a 48-item questionnaire assessing the influence of recent changes in the health care system on fieldwork education was sent to 125 occupational therapy fieldwork educators and coordinators (response rate 62.4%). Differences between fieldwork educators and coordinators were analyzed statistically using nonparametric methods. Alpha level was set at p < 0.01 for all statistical comparisons. Fieldwork educators and coordinators agreed productivity expectations, number of hours worked, and time spent in documentation have increased, while job security, time for continuing education, and quality of patient care under the current reimbursement system have decreased, but diverged on several other issues. Fieldwork educators believed reimbursement issues did not affect their ability to accept fieldwork students, whereas academic coordinators believed declining reimbursement had negatively affected fieldwork educators' ability to accept students. Factors thought to facilitate the fieldwork shortage included cost reductions, changes in reimbursement, and increased productivity demands on clinicians.
Subject(s)
Allied Health Personnel/education , Delivery of Health Care/trends , Education, Professional/organization & administration , Faculty , Occupational Therapy/education , Preceptorship/organization & administration , Allied Health Personnel/economics , Attitude of Health Personnel , Efficiency , Humans , Occupational Therapy/economics , Reimbursement Mechanisms , Surveys and Questionnaires , United StatesABSTRACT
The valence model of emotion, which posits cerebral lateralization for positive and negative emotional processing, was investigated in patients with unilateral mesial temporal lobe epilepsy (TLE) and controls by measuring skin conductance levels (SCLs) and heart rate (HR) while positive and negative emotional photographs were viewed. Left TLEs exhibited selective SCL hyperarousal when viewing negative emotional slides relative to controls and right TLEs. In contrast, right TLEs showed no significant differences compared with the other groups. Results are consistent with left hemispheric specialization for positive emotional expression. Dysfunction of left mesial temporal lobe structures may result in autonomic hyperarousal and a release of the unrestrained negative emotional tendencies of the right hemisphere.