Doctor of Physical Therapy Student Perceptions of Domestic Versus International Service-Learning Experiences: A Mixed-Methods Approach.

PURPOSE: The purpose of this study was to compare Doctor of Physical Therapy (DPT) students' perceptions of service-learning between domestic and international service-learning experiences (SLEs). METHODS: DPT students participated in semi-structured interviews (n=35) and completed the Service-Learning Benefit (SELEB) scale (n=21). Focus group questions targeted the impact of the SLE on topics related to PT services, social responsibility, cultural competence, and personal commitment to engaging in future service-related activities. The interviews were audio-recorded and transcribed. Incident coding processes analyzed transcripts of the focus groups. Differences in the students' perceptions of the benefit of SLEs using the SELEB were examined using Wilcoxon signed-rank test. RESULTS: Perceived advantages of an international SLE included improved relationship building, social responsibility, citizenship skills, cultural competence, gaining trust of others, and expansion of worldview. Perceived different benefits of the domestic SLE were planning and organizing the experience and improved commitment to the community. Additionally, students who participated in the international SLE cited more barriers (e.g., cost) than in the domestic SLEs. CONCLUSION: DPT students participating in domestic vs international SLEs appear to have different perceptions of SLE. Further research is needed to examine the perspective of other stakeholders involved in domestic and international SLEs.

Berg balance scale and outcome measures in acquired brain injury.

OBJECTIVE: To examine the relationship of the Berg Balance Scale (BBS) to outcome after acquired brain injury. METHODS: Forty consecutive patients with acquired brain injury were admitted for multidisciplinary rehabilitation. Patients were assessed with the BBS. The BBS was originally designed as a quantitative measure of balance and risk for falls in community-dwelling elderly patients. The BBS comprises 14 different tasks graded on a 56-point scale. Community-dwelling elders with a BBS score of < or = 42 have > 90% risk for falls. RESULTS: In our study, there were 27 patients with a low BBS score (< or = 42) and 13 patients with a high BBS score (> or = 43). The discharge total Functional Independence Measure (FIM) scores were lower in the low BBS patients (96.4 +/- 21.2) compared with the high BBS patients (111.5 +/- 12.5) (p < 0.007). The length of stay (LOS) was significantly longer in the low BBS patients (38.9 +/- 18.5 days) compared with the high BBS patients (14.2 +/- 6.1 days; p < 0.000). Among the three patients that experienced falls during their hospitalization, all exhibited low BBS scores. The admission BBS score strongly correlated with admission total FIM scores (r = 0.86; p < 0.000) and moderately correlated with discharge total FIM scores (r = 0.56; p < 0.000) and LOS (r = -0.55; p < 0.000). Using a multiple regression analysis, the admission FIM score was found to be the better predictor of discharge FIM scores, and time admitted after injury was the better predictor of LOS. CONCLUSIONS: Prediction of rehabilitative outcome might be enhanced by the use of the BBS scores in combination with other clinical measures on admission to inpatient acute rehabilitation.

Rapid tranquilization of the violent patient.

Agitated, psychotic patients with the potential for violence pose significant management problems for emergency department staff. With the advent of rapid tranquilization (RT), clinicians were offered a safe, effective method for controlling such patients, eliminating the need for restraints or seclusion rooms. While RT is regarded as a major treatment innovation in psychiatry, nonpsychiatrists are reluctant or unaware of the uses of antipsychotic medication as it pertains to RT. This article provides a brief overview of the pharmacokinetics of antipsychotic medication and reviews the following aspects of RT: route of administration, dosing, time intervals between doses, side effects, and alternative medications for RT. The authors also offer practical guidelines for RT use in the emergency department.