{"title":"Pediatric Renal Vein Thrombosis","authors":"T. Lyons, Stephen Shy Ii","doi":"10.7556/jaoa.2019.107","DOIUrl":"https://doi.org/10.7556/jaoa.2019.107","url":null,"abstract":"","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"14 1","pages":"637 - 637"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81196708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie H. Felgoise, J. Branch, Ashley Poole, Laura Levy, M. Becker
Abstract Interprofessional education (IPE) is necessary to ensure that future health care professionals are prepared to provide holistic, patient-centered prevention programs, assessments, diagnoses, treatment plans, and chronic illness management in a collaborative manner. Accrediting bodies such as the Commission on Osteopathic College Accreditation and the American Psychological Association newly require programs to implement instruction and evaluate IPE core competency development in each year of their programs. The IPE core team at the Philadelphia College of Osteopathic Medicine has designed, implemented, and tested an IPE core course over the past 2 years that includes students in osteopathic medicine, clinical psychology, mental health counseling, and physician assistant programs. Throughout this process, the IPE core team has identified strengths, weaknesses, opportunities, and challenges. Cultural considerations, institutional resources, pedagogy for large interdisciplinary groups at different stages of training, and technology and assessment tools for student and course evaluation are all critical considerations.
{"title":"Interprofessional Education: Collaboration and Learning in Action","authors":"Stephanie H. Felgoise, J. Branch, Ashley Poole, Laura Levy, M. Becker","doi":"10.7556/jaoa.2019.109","DOIUrl":"https://doi.org/10.7556/jaoa.2019.109","url":null,"abstract":"Abstract Interprofessional education (IPE) is necessary to ensure that future health care professionals are prepared to provide holistic, patient-centered prevention programs, assessments, diagnoses, treatment plans, and chronic illness management in a collaborative manner. Accrediting bodies such as the Commission on Osteopathic College Accreditation and the American Psychological Association newly require programs to implement instruction and evaluate IPE core competency development in each year of their programs. The IPE core team at the Philadelphia College of Osteopathic Medicine has designed, implemented, and tested an IPE core course over the past 2 years that includes students in osteopathic medicine, clinical psychology, mental health counseling, and physician assistant programs. Throughout this process, the IPE core team has identified strengths, weaknesses, opportunities, and challenges. Cultural considerations, institutional resources, pedagogy for large interdisciplinary groups at different stages of training, and technology and assessment tools for student and course evaluation are all critical considerations.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"39 5-6 1","pages":"612 - 619"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90425301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Submitted October 17, 2018; revision received January 31, 2019; accepted March 21, 2019. A ccess to health care in the rural United States is becoming increasingly difficult. Since 2005, 118 US rural hospitals have closed and almost 700 more are in danger of closing. 1 The decrease in access has resulted in detrimental health outcomes for people residing in rural communities. Recently, the University of North Carolina tracked United States rural hospital closures and gleaned results from 83 hospitals. The results identify 2 main factors for hospital closures: economics and lack of workforce. To remedy economic challenges facing rural hospitals, the Save Rural Hospitals Act/HR 2957 was proposed to Congress. However, the bill is not a sustainable solution for resolving economic challenges and the workforce shortage. Over time, we have seen dramatic reductions in lengths of stay, decreased census, and an exodus of health care professionals among other changes in the current rural hospital infrastructure. These changes have affected the osteopathic medical profession, particularly given our tendency to practice in primary care and rural settings. Osteopathic physicians tend to fill the primary care needs of rural communities at a rate 2.3 to 2.5 times higher than our allopathic colleagues. This article examines current challenges rural hospitals face and offers potential solutions to improve the rural health care delivery model. Implementation of multitiered solutions can improve access to necessary medical care and meet the rural population’s health care needs.
{"title":"Save Rural Health Care: Time for a Significant Paradigm Shift","authors":"Brandon Isaacs","doi":"10.7556/jaoa2019.098","DOIUrl":"https://doi.org/10.7556/jaoa2019.098","url":null,"abstract":"Submitted October 17, 2018; revision received January 31, 2019; accepted March 21, 2019. A ccess to health care in the rural United States is becoming increasingly difficult. Since 2005, 118 US rural hospitals have closed and almost 700 more are in danger of closing. 1 The decrease in access has resulted in detrimental health outcomes for people residing in rural communities. Recently, the University of North Carolina tracked United States rural hospital closures and gleaned results from 83 hospitals. The results identify 2 main factors for hospital closures: economics and lack of workforce. To remedy economic challenges facing rural hospitals, the Save Rural Hospitals Act/HR 2957 was proposed to Congress. However, the bill is not a sustainable solution for resolving economic challenges and the workforce shortage. Over time, we have seen dramatic reductions in lengths of stay, decreased census, and an exodus of health care professionals among other changes in the current rural hospital infrastructure. These changes have affected the osteopathic medical profession, particularly given our tendency to practice in primary care and rural settings. Osteopathic physicians tend to fill the primary care needs of rural communities at a rate 2.3 to 2.5 times higher than our allopathic colleagues. This article examines current challenges rural hospitals face and offers potential solutions to improve the rural health care delivery model. Implementation of multitiered solutions can improve access to necessary medical care and meet the rural population’s health care needs.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"9 1","pages":"551 - 555"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88143747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael S Selby, Austin Gillette, ya J K Raval, Maliha Taufiq, Michael J. Sampson
Abstract Modern human bipedality is unique and requires lumbar lordosis, whereas chimpanzees, our closest relatives, have short lumbar spines rendering them incapable of lordosis. To facilitate lordosis, humans have longer lumbar spines, greater lumbosacral angle, dorsally wedged lumbar vertebral bodies, and lumbar zygapophyseal joints with both increasingly coronal orientation and further caudal interfacet distances. These features limit modern lower lumbar spine and lumbosacral joint ailments, albeit imperfectly. The more coronal zygapophyseal orientation limits spondylolisthesis, while increasing interfacet distance may limit spondylolysis. Common back pain, particularly in people who are obese or pregnant, may result from increased lumbar lordosis, causing additional mass transfer through the zygapophyseal joints rather than vertebral bodies. Reduction in lumbar lordosis, such as in flatback syndrome from decreased lumbosacral angle, can also cause back pain. Human lumbar lordosis is necessary for placing the trunk atop the pelvis and presents a balancing act not required of our closest primate relatives.
{"title":"Modern Medical Consequences of the Ancient Evolution of a Long, Flexible Lumbar Spine","authors":"Michael S Selby, Austin Gillette, ya J K Raval, Maliha Taufiq, Michael J. Sampson","doi":"10.7556/jaoa.2019.105","DOIUrl":"https://doi.org/10.7556/jaoa.2019.105","url":null,"abstract":"Abstract Modern human bipedality is unique and requires lumbar lordosis, whereas chimpanzees, our closest relatives, have short lumbar spines rendering them incapable of lordosis. To facilitate lordosis, humans have longer lumbar spines, greater lumbosacral angle, dorsally wedged lumbar vertebral bodies, and lumbar zygapophyseal joints with both increasingly coronal orientation and further caudal interfacet distances. These features limit modern lower lumbar spine and lumbosacral joint ailments, albeit imperfectly. The more coronal zygapophyseal orientation limits spondylolisthesis, while increasing interfacet distance may limit spondylolysis. Common back pain, particularly in people who are obese or pregnant, may result from increased lumbar lordosis, causing additional mass transfer through the zygapophyseal joints rather than vertebral bodies. Reduction in lumbar lordosis, such as in flatback syndrome from decreased lumbosacral angle, can also cause back pain. Human lumbar lordosis is necessary for placing the trunk atop the pelvis and presents a balancing act not required of our closest primate relatives.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"98 4-6","pages":"622 - 630"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91495980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher N. Matthews, Danielle C Estrada, M. George-Weinstein, Kerin M. Claeson
Abstract The osteopathic undergraduate medical education standards have evolved over the past 2 decades to require undergraduate medical student participation in research and scholarly activity. The authors’ objective was to review those evolving standards and develop a model for introducing the principles and practice of research that combines core content with experiential learning. They identified fundamental topics pertinent to the research process and herein provide their recommendations for incorporating these topics into the curriculum as self-study, online modules, and team-based and active learning exercises. The authors’ proposed educational model would provide an avenue for osteopathic medical schools to meet the requirements for scholarly activity. Increasing students' and residents' knowledge of the research process will lay the foundation for their engagement is research and scholarly activity and their practice of evidence-based medicine.
{"title":"Integrating the Principles and Practice of Scholarly Activity Into Undergraduate Medical Education: A Narrative Review and Proposed Model for Implementation","authors":"Christopher N. Matthews, Danielle C Estrada, M. George-Weinstein, Kerin M. Claeson","doi":"10.7556/jaoa.2019.103","DOIUrl":"https://doi.org/10.7556/jaoa.2019.103","url":null,"abstract":"Abstract The osteopathic undergraduate medical education standards have evolved over the past 2 decades to require undergraduate medical student participation in research and scholarly activity. The authors’ objective was to review those evolving standards and develop a model for introducing the principles and practice of research that combines core content with experiential learning. They identified fundamental topics pertinent to the research process and herein provide their recommendations for incorporating these topics into the curriculum as self-study, online modules, and team-based and active learning exercises. The authors’ proposed educational model would provide an avenue for osteopathic medical schools to meet the requirements for scholarly activity. Increasing students' and residents' knowledge of the research process will lay the foundation for their engagement is research and scholarly activity and their practice of evidence-based medicine.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"103 42","pages":"598 - 611"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91408917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher N. Matthews, Danielle C Estrada, M. George-Weinstein, Kerin M. Claeson, Michael B. Roberts
Abstract Context Analyzing factors that may enhance osteopathic applicants’ likelihood of matching is warranted given that United States osteopathic and allopathic residency programs will have a single accreditation system in 2020. Objectives To determine the impact of research accomplishments and experiences on osteopathic and allopathic residency matching. Methods Analysis of variance, t test, and odds ratios were used to examine data from the National Resident Matching Program Charting Outcomes from 2016 and 2018. Relationships between match status and medical degree, specialty matching, and mean numbers of research accomplishments and experiences in the Main Residency Match were analyzed. Results Matched osteopathic and allopathic applicants had significantly greater numbers of research accomplishments (mean [SD], 5.18 [4.34]) than unmatched applicants (3.66 [2.87]) (P=.006). Applicants who matched (mean [SD], 2.81 [1.64]) had similar numbers of research experiences to those who did not match (2.43 [1.26]) (P=.068). Matched and unmatched allopathic applicants’ research accomplishments (5.91 [3.72]) were significantly greater than that of osteopathic applicants (2.60 [2.90]) (P<.001). Significant differences also were found between the means of research experiences of matched and unmatched osteopathic (mean [SD], 1.73 [1.21]) and allopathic applicants (3.36 [1.25], P<.001). Matched and unmatched osteopathic applicants’ had similar means for research accomplishments (mean [SD], 3.00 [3.64] and 2.20 [1.84], respectively; P=.242) and experiences (1.79 [1.31] and 1.66 [1.12], respectively; P=.664). By contrast, significant differences were found between the numbers of research accomplishments for matched (mean [SD], 6.97 [4.07]) vs unmatched (4.86 [3.02]) allopathic applicants (P=.007). The only subspecialty for which research experiences of osteopathic applicants correlated with matching was physical medicine and rehabilitation (OR, 2.75; 95% CI, 1.30-5.84). Conclusion Research seems to have a greater influence on matching for allopathic than osteopathic applicants. Although both osteopathic and allopathic programs have standards pertaining to scholarly activity, allopathic medical schools may place a greater emphasis on research. Increasing osteopathic medical students’ exposure to research is predicted to enhance their competitiveness for matching and help develop skills relevant to the practice of evidence-based medicine.
{"title":"Evaluating the Influence of Research on Match Success for Osteopathic and Allopathic Applicants to Residency Programs","authors":"Christopher N. Matthews, Danielle C Estrada, M. George-Weinstein, Kerin M. Claeson, Michael B. Roberts","doi":"10.7556/jaoa.2019.102","DOIUrl":"https://doi.org/10.7556/jaoa.2019.102","url":null,"abstract":"Abstract Context Analyzing factors that may enhance osteopathic applicants’ likelihood of matching is warranted given that United States osteopathic and allopathic residency programs will have a single accreditation system in 2020. Objectives To determine the impact of research accomplishments and experiences on osteopathic and allopathic residency matching. Methods Analysis of variance, t test, and odds ratios were used to examine data from the National Resident Matching Program Charting Outcomes from 2016 and 2018. Relationships between match status and medical degree, specialty matching, and mean numbers of research accomplishments and experiences in the Main Residency Match were analyzed. Results Matched osteopathic and allopathic applicants had significantly greater numbers of research accomplishments (mean [SD], 5.18 [4.34]) than unmatched applicants (3.66 [2.87]) (P=.006). Applicants who matched (mean [SD], 2.81 [1.64]) had similar numbers of research experiences to those who did not match (2.43 [1.26]) (P=.068). Matched and unmatched allopathic applicants’ research accomplishments (5.91 [3.72]) were significantly greater than that of osteopathic applicants (2.60 [2.90]) (P<.001). Significant differences also were found between the means of research experiences of matched and unmatched osteopathic (mean [SD], 1.73 [1.21]) and allopathic applicants (3.36 [1.25], P<.001). Matched and unmatched osteopathic applicants’ had similar means for research accomplishments (mean [SD], 3.00 [3.64] and 2.20 [1.84], respectively; P=.242) and experiences (1.79 [1.31] and 1.66 [1.12], respectively; P=.664). By contrast, significant differences were found between the numbers of research accomplishments for matched (mean [SD], 6.97 [4.07]) vs unmatched (4.86 [3.02]) allopathic applicants (P=.007). The only subspecialty for which research experiences of osteopathic applicants correlated with matching was physical medicine and rehabilitation (OR, 2.75; 95% CI, 1.30-5.84). Conclusion Research seems to have a greater influence on matching for allopathic than osteopathic applicants. Although both osteopathic and allopathic programs have standards pertaining to scholarly activity, allopathic medical schools may place a greater emphasis on research. Increasing osteopathic medical students’ exposure to research is predicted to enhance their competitiveness for matching and help develop skills relevant to the practice of evidence-based medicine.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"40 1","pages":"588 - 596"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78971027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher A. Butts, Jacqueline J. Speer, J. Brady, Ryan J. Stephenson, Erik Langenau, R. Ditomasso, Kerin Fresa, M. Becker, A. Sesso
Abstract Background Despite a diverse range of curricular advancements to address the difficult transition from classroom learning to clinical training during medical education, hurdles persist. A 4-week course was designed at the Philadelphia College of Osteopathic Medicine (PCOM) to make this transition easier. Objectives To determine whether PCOM students’ comfort and preparedness increased after taking a 4-week clinical transition course before third-year clinical clerkships, and to determine whether faculty perceptions of student preparedness and comfort were improved after participation in the course compared with previous third-year students. Methods Second-year osteopathic medical students at PCOM participated in a 4-week course, Introduction to Clinical Clerkship (I2C). The course included 16 small-group exercises, which all took place before students began their third-year clerkship rotations. The exercises in the course extended beyond the skills learned during their classroom years. Students were given a pre- and postcourse survey to evaluate their comfort level with 58 different aspects of clinical practice. Participating faculty were surveyed to evaluate their perception of student preparedness and comfort compared with previous third-year students who had not undergone the exercise. Results After completing the I2C course, third-year osteopathic medical students (n=232) reported increased comfort with 57 of the 58 learning objectives and each of the 5 coded clinical competency areas (patient assessment, effective communication, hospital logistics, procedural skills, and core knowledge) (P<.01). Preceptors reported that students who completed the I2C course were more prepared (54.5%) and more comfortable (63.4%) with clinical duties, as compared with their recollections of previous third-year osteopathic medical students. Conclusion Within the 5 competencies, students on average felt more comfortable and were perceived by faculty as better prepared than previous students who had not taken the I2C course. The establishment of a preclinical transition exercise appears to help bridge the gap between the preclinical and clinical years. This learning model allows medical students to feel both more comfortable and better prepared throughout the transition from classroom learning to clinical rotations.
{"title":"Introduction to Clerkship: Bridging the Gap Between Preclinical and Clinical Medical Education","authors":"Christopher A. Butts, Jacqueline J. Speer, J. Brady, Ryan J. Stephenson, Erik Langenau, R. Ditomasso, Kerin Fresa, M. Becker, A. Sesso","doi":"10.7556/jaoa.2019.101","DOIUrl":"https://doi.org/10.7556/jaoa.2019.101","url":null,"abstract":"Abstract Background Despite a diverse range of curricular advancements to address the difficult transition from classroom learning to clinical training during medical education, hurdles persist. A 4-week course was designed at the Philadelphia College of Osteopathic Medicine (PCOM) to make this transition easier. Objectives To determine whether PCOM students’ comfort and preparedness increased after taking a 4-week clinical transition course before third-year clinical clerkships, and to determine whether faculty perceptions of student preparedness and comfort were improved after participation in the course compared with previous third-year students. Methods Second-year osteopathic medical students at PCOM participated in a 4-week course, Introduction to Clinical Clerkship (I2C). The course included 16 small-group exercises, which all took place before students began their third-year clerkship rotations. The exercises in the course extended beyond the skills learned during their classroom years. Students were given a pre- and postcourse survey to evaluate their comfort level with 58 different aspects of clinical practice. Participating faculty were surveyed to evaluate their perception of student preparedness and comfort compared with previous third-year students who had not undergone the exercise. Results After completing the I2C course, third-year osteopathic medical students (n=232) reported increased comfort with 57 of the 58 learning objectives and each of the 5 coded clinical competency areas (patient assessment, effective communication, hospital logistics, procedural skills, and core knowledge) (P<.01). Preceptors reported that students who completed the I2C course were more prepared (54.5%) and more comfortable (63.4%) with clinical duties, as compared with their recollections of previous third-year osteopathic medical students. Conclusion Within the 5 competencies, students on average felt more comfortable and were perceived by faculty as better prepared than previous students who had not taken the I2C course. The establishment of a preclinical transition exercise appears to help bridge the gap between the preclinical and clinical years. This learning model allows medical students to feel both more comfortable and better prepared throughout the transition from classroom learning to clinical rotations.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"11 1","pages":"578 - 587"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75969413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Beverly, Rochelle G. Rennie, E. Guseman, A. Rodgers, Amber M. Healy
Abstract Context Diabetes distress is an affective condition that addresses an individual's frustrations, worries, and concerns about living with diabetes. It is associated with fewer self-care behaviors, suboptimal glycemic control, and lower quality of life (QOL). For these reasons, diabetes care guidelines recommend routine assessment of diabetes distress. Objective To assess diabetes distress in a university population. Methods This study was conducted using a descriptive, cross-sectional design. Researchers assessed diabetes distress and other psychosocial factors via an electronic anonymous survey among students, faculty, and staff at a large university in the Midwest. Results A total of 173 participants completed the survey (mean [SD] age, 35.1 [16.7] years), with 108 [62.4%] female and 142 [82.1%] white participants). Eighty-five participants had type 1 diabetes mellitus (T1DM), and 88 had type 2 diabetes mellitus (T2DM). Of the 85 T1DM participants, 23 (27.4%) reported high diabetes distress, and 27 (30.7%) T2DM participants reported high diabetes distress. Sixteen T1DM (18.8%) and 15 T2DM (17.0%) participants screened positive for severe depression. Severe depression was associated with high distress for both T1DM and T2DM participants (T1DM: χ2=28.845, P<.001; T2DM: χ2=20.679, P<.001). Participants with T1DM reported more frequent self-care behaviors (mean [SD], 62.3 [17.1] vs 52.2 [19.2]; P<.001), but lower diabetes QOL (63.3 [14.1] vs 68.5 [15.5]; P=.021) compared with T2DM participants. No differences were observed in depressive symptoms, diabetes self-efficacy, and coping styles. Linear regression models showed that high diabetes distress scores (standardized β=.323, P=.025; standardized β=.604, P<.001) were independently associated with higher hemoglobin A1C levels and lower diabetes QOL after controlling for depressive symptoms, age, and gender in T1DM participants. Similarly, high diabetes distress scores (standardized β=.434, P<.001) were associated with lower diabetes QOL in T2DM participants after controlling for the same variables. Conclusion High diabetes distress levels were associated with lower diabetes QOL for both T1DM and T2DM participants. These findings suggest that attending or working at a university may be associated with high diabetes distress scores and lower diabetes QOL. Additional research with a larger, more diverse sample from multiple universities is needed to confirm these findings.
糖尿病痛苦是一种情感状况，解决了个人的挫折，担忧和关注生活与糖尿病。它与自我护理行为较少、血糖控制欠佳和生活质量(QOL)降低有关。由于这些原因，糖尿病护理指南建议对糖尿病困扰进行常规评估。目的了解大学人群糖尿病窘迫状况。方法本研究采用描述性横断面设计。研究人员通过对中西部一所大型大学的学生、教师和工作人员进行电子匿名调查，评估了糖尿病困扰和其他社会心理因素。结果共173名参与者完成调查(平均[SD]年龄35.1[16.7]岁)，其中女性108名(62.4%)，白人142名(82.1%)。85名参与者患有1型糖尿病(T1DM)， 88名患有2型糖尿病(T2DM)。在85名T1DM参与者中，23名(27.4%)报告了高糖尿病窘迫，27名(30.7%)T2DM参与者报告了高糖尿病窘迫。16名T1DM参与者(18.8%)和15名T2DM参与者(17.0%)筛查出重度抑郁症阳性。T1DM和T2DM患者重度抑郁均与高抑郁相关(T1DM: χ2=28.845, P< 0.001;T2dm: χ2=20.679, p < 0.001)。T1DM患者报告更频繁的自我保健行为(mean [SD]， 62.3 [17.1] vs 52.2 [19.2];P< 0.001)，但糖尿病患者的生活质量较低(63.3 [14.1]vs 68.5 [15.5];P= 0.021)。在抑郁症状、糖尿病自我效能和应对方式方面没有观察到差异。线性回归模型显示，较高的糖尿病困扰评分(标准化β=。323, P = .025;标准化的β=。604, P<.001)与T1DM参与者在控制抑郁症状、年龄和性别后较高的血红蛋白A1C水平和较低的糖尿病生活质量独立相关。同样，高糖尿病痛苦评分(标准化β=。434, P< 0.001)与T2DM参与者较低的糖尿病生活质量相关。结论T2DM和T1DM患者糖尿病焦虑水平高与较低的糖尿病生活质量相关。这些发现表明，在大学就读或工作可能与较高的糖尿病痛苦评分和较低的糖尿病生活质量有关。需要从多所大学获得更大、更多样化的样本进行进一步的研究来证实这些发现。
{"title":"High Prevalence of Diabetes Distress in a University Population","authors":"E. Beverly, Rochelle G. Rennie, E. Guseman, A. Rodgers, Amber M. Healy","doi":"10.7556/jaoa.2019.099","DOIUrl":"https://doi.org/10.7556/jaoa.2019.099","url":null,"abstract":"Abstract Context Diabetes distress is an affective condition that addresses an individual's frustrations, worries, and concerns about living with diabetes. It is associated with fewer self-care behaviors, suboptimal glycemic control, and lower quality of life (QOL). For these reasons, diabetes care guidelines recommend routine assessment of diabetes distress. Objective To assess diabetes distress in a university population. Methods This study was conducted using a descriptive, cross-sectional design. Researchers assessed diabetes distress and other psychosocial factors via an electronic anonymous survey among students, faculty, and staff at a large university in the Midwest. Results A total of 173 participants completed the survey (mean [SD] age, 35.1 [16.7] years), with 108 [62.4%] female and 142 [82.1%] white participants). Eighty-five participants had type 1 diabetes mellitus (T1DM), and 88 had type 2 diabetes mellitus (T2DM). Of the 85 T1DM participants, 23 (27.4%) reported high diabetes distress, and 27 (30.7%) T2DM participants reported high diabetes distress. Sixteen T1DM (18.8%) and 15 T2DM (17.0%) participants screened positive for severe depression. Severe depression was associated with high distress for both T1DM and T2DM participants (T1DM: χ2=28.845, P<.001; T2DM: χ2=20.679, P<.001). Participants with T1DM reported more frequent self-care behaviors (mean [SD], 62.3 [17.1] vs 52.2 [19.2]; P<.001), but lower diabetes QOL (63.3 [14.1] vs 68.5 [15.5]; P=.021) compared with T2DM participants. No differences were observed in depressive symptoms, diabetes self-efficacy, and coping styles. Linear regression models showed that high diabetes distress scores (standardized β=.323, P=.025; standardized β=.604, P<.001) were independently associated with higher hemoglobin A1C levels and lower diabetes QOL after controlling for depressive symptoms, age, and gender in T1DM participants. Similarly, high diabetes distress scores (standardized β=.434, P<.001) were associated with lower diabetes QOL in T2DM participants after controlling for the same variables. Conclusion High diabetes distress levels were associated with lower diabetes QOL for both T1DM and T2DM participants. These findings suggest that attending or working at a university may be associated with high diabetes distress scores and lower diabetes QOL. Additional research with a larger, more diverse sample from multiple universities is needed to confirm these findings.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"83 1","pages":"556 - 568"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75633075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Inseparable Bond Between Research and Medical Education","authors":"M. George-Weinstein","doi":"10.7556/jaoa.2019.108","DOIUrl":"https://doi.org/10.7556/jaoa.2019.108","url":null,"abstract":"","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"62 1","pages":"548 - 550"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78122312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Noto-Bell, Brittany N Vogel, Danielle E Senn
Abstract Context Ankle plantarflexion is thought to play an important role in swimming performance; thus, coaches and swimmers often seek ways to increase range of motion (ROM) in the ankles. Objective To assess whether osteopathic manipulative treatment (OMT), specifically applying the muscle energy technique (MET) principle of post–isometric relaxation, increases ankle plantarflexion and therefore improves swimming performance. Methods Healthy young male and female competitive swimmers were randomly assigned to either a control, sham, or MET group. At baseline, ankle plantarflexion was measured via goniometer, and a 25-yard flutter kick swim with a kickboard was timed. After receiving the ascribed intervention, the ankle plantarflexion measurements and timed flutter kick were repeated. The initial plantarflexion measurement was retrospectively used to determine the presence of somatic dysfunction, by way of restricted motion, with reference to expected normal ranges based on age and gender. Paired t tests were used to analyze the pre- to postintervention changes in ROM and flutter kick speed within each group. Results Fifty-five swimmers (32 girls and 23 boys; mean age, 12 years) participated in this study. Sixteen participants were in the control group, 17 in the sham group, and 22 in the MET intervention group. Among participants with restricted ROM, those in the MET group showed a statistically significant increase in ankle plantarflexion for the left and right ankles (P=.041 and P=.011, respectively). There was no significant difference in ROM of the control or sham groups. For flutter kick speed, there was no significant pre- to postintervention difference in any group. Conclusion Although a single application of MET, using post–isometric relaxation, on participants with restricted ROM immediately significantly increased swimmers’ ROM for bilateral ankle plantarflexion, it did not immediately improve their swimming performance.
{"title":"Effects of Post–Isometric Relaxation on Ankle Plantarflexion and Timed Flutter Kick in Pediatric Competitive Swimmers","authors":"Lauren Noto-Bell, Brittany N Vogel, Danielle E Senn","doi":"10.7556/jaoa.2019.100","DOIUrl":"https://doi.org/10.7556/jaoa.2019.100","url":null,"abstract":"Abstract Context Ankle plantarflexion is thought to play an important role in swimming performance; thus, coaches and swimmers often seek ways to increase range of motion (ROM) in the ankles. Objective To assess whether osteopathic manipulative treatment (OMT), specifically applying the muscle energy technique (MET) principle of post–isometric relaxation, increases ankle plantarflexion and therefore improves swimming performance. Methods Healthy young male and female competitive swimmers were randomly assigned to either a control, sham, or MET group. At baseline, ankle plantarflexion was measured via goniometer, and a 25-yard flutter kick swim with a kickboard was timed. After receiving the ascribed intervention, the ankle plantarflexion measurements and timed flutter kick were repeated. The initial plantarflexion measurement was retrospectively used to determine the presence of somatic dysfunction, by way of restricted motion, with reference to expected normal ranges based on age and gender. Paired t tests were used to analyze the pre- to postintervention changes in ROM and flutter kick speed within each group. Results Fifty-five swimmers (32 girls and 23 boys; mean age, 12 years) participated in this study. Sixteen participants were in the control group, 17 in the sham group, and 22 in the MET intervention group. Among participants with restricted ROM, those in the MET group showed a statistically significant increase in ankle plantarflexion for the left and right ankles (P=.041 and P=.011, respectively). There was no significant difference in ROM of the control or sham groups. For flutter kick speed, there was no significant pre- to postintervention difference in any group. Conclusion Although a single application of MET, using post–isometric relaxation, on participants with restricted ROM immediately significantly increased swimmers’ ROM for bilateral ankle plantarflexion, it did not immediately improve their swimming performance.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"19 1","pages":"569 - 577"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85427675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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