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Reina AM, Beer JM, Renzi-Hammond LM, Zhang D, Padilla HM. Mind Your Heart: A Mindful Eating and Diet Education eHealth Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:54-65. [PMID: 38185491 DOI: 10.1016/j.jneb.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/24/2023] [Accepted: 10/29/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Examine user perceptions of the Mind Your Heart (MYH) program, a mindful eating and nutrition education program delivered via an eHealth system. METHODS Sixteen participants (41.5 ± 13.1 years) completed sample MYH lessons over 3 weeks. We examined changes in mindfulness from the State Mindfulness Scale via text messages sent 3 times per week. We assessed MYH user perceptions in a semistructured interview after 3 weeks. Analyses included Spearman's correlation, repeated measures ANOVA, and thematic analysis. RESULTS State Mindfulness Scale scores were significantly improved (F[1,15] = 5.35, P = 0.01) from week 1 (M = 2.28 ± 0.80) to week 3 (M = 2.75 ± 1.04). Four themes emerged: (1) MYH is supportive of health goals, (2) text messages act as an intervention, (3) facilitators or inhibitors of use, and (4) enhancing engagement. CONCLUSIONS AND IMPLICATIONS Based on participant feedback, the final version of MYH should include example-based learning to translate abstract concepts like mindful eating into action.
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Affiliation(s)
- Anita M Reina
- Institute of Gerontology, College of Public Health, University of Georgia, Athens, GA.
| | - Jenay M Beer
- Institute of Gerontology, College of Public Health, University of Georgia, Athens, GA
| | - Lisa M Renzi-Hammond
- Institute of Gerontology, College of Public Health, University of Georgia, Athens, GA
| | - Donglan Zhang
- Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, NY
| | - Heather M Padilla
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA
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Torre D, Chamberland M, Mamede S. Implementation of three knowledge-oriented instructional strategies to teach clinical reasoning: Self-explanation, a concept mapping exercise, and deliberate reflection: AMEE Guide No. 150. MEDICAL TEACHER 2023; 45:676-684. [PMID: 35938204 DOI: 10.1080/0142159x.2022.2105200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The teaching of clinical reasoning is essential in medical education. This guide has been written to provide educators with practical advice on the design, development, and implementation of three knowledge-oriented instructional strategies for the teaching of clinical reasoning to medical students: Self-explanation (SE), a Clinical Reasoning Mapping Exercise (CREsME), and Deliberate Reflection (DR). We first synthesize the theoretical tenets that support the use of these strategies, including knowledge organization, and development of illness scripts. We then provide a detailed description of the key components of each strategy, emphasizing the practical applications of each one by sharing specific examples. We also explore the potential for a combined application of these strategies in a longitudinal and developmental approach to teaching clinical reasoning at the undergraduate level. Finally, we discuss enablers and barriers in the implementation and integration of these teaching strategies while taking into consideration curricular needs, context, and resources. We are aware that many strategies exist and are not arguing that SE, CReSME, and DR are the most effective ones or the only ones to be adopted. Nevertheless, we selected these strategies because of overarching theoretical principles, empirical evidence supporting their use, and our own experience with them. We are hoping to provide practical advice on the implementation of these strategies to practicing educators who aim at developing an integrated approach to the teaching of clinical reasoning to medical students at different stages of their development.
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Affiliation(s)
- Dario Torre
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Martine Chamberland
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Quebec, Canada
| | - Silvia Mamede
- Institute of Medical Education Research Rotterdam, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Augustin RC, Simonson MG, Rothenberger SD, Lalama C, Bonifacino E, DiNardo DJ, Tilstra SA. The use of podcasts as a tool to teach clinical reasoning: a pseudorandomized and controlled study. Diagnosis (Berl) 2022; 9:323-331. [PMID: 35086184 DOI: 10.1515/dx-2021-0136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/06/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Podcasts have emerged as an efficient method for widespread delivery of educational clinical reasoning (CR) content. However, the impact of such podcasts on CR skills has not been established. We set out to determine whether exposure to expert reasoning in a podcast format leads to enhanced CR skills. METHODS This is a pseudo-randomized study of third-year medical students (MS3) to either a control group (n=22) of pre-established online CR modules, or intervention group (n=26) with both the online modules and novel CR podcasts. The podcasts were developed from four "clinical unknown" cases presented to expert clinician educators. After completing these assignments in weeks 1-2, weekly history and physical (H&P) notes were collected and graded according to the validated IDEA rubric between weeks 3-7. A longitudinal regression model was used to compare the H&P IDEA scores over time. Usage and perception of the podcasts was also assessed via survey data. RESULTS Ninety control and 128 intervention H&Ps were scored. There was no statistical difference in the change of average IDEA scores between intervention (0.92, p=0.35) and control groups (-0.33, p=0.83). Intervention participants positively received the podcasts and noted increased discussion of CR principles from both their ward (3.1 vs. 2.4, p=0.08) and teaching (3.2 vs. 2.5, p=0.05) attendings. CONCLUSIONS This is the first objective, pseudo-randomized assessment of CR podcasts in undergraduate medical education. While we did not demonstrate significant improvement in IDEA scores, our data show that podcasts are a well-received tool that can prime learners to recognize CR principles.
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Affiliation(s)
- Ryan C Augustin
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael G Simonson
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Scott D Rothenberger
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Research on Health Care (CRHC) Data Center, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Christina Lalama
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Research on Health Care (CRHC) Data Center, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eliana Bonifacino
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Deborah J DiNardo
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Sarah A Tilstra
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Cromley JG, Dai T, Fechter TS, Nelson FE, Van Boekel M, Du Y. Development of a Tool to Assess Inference-Making and Reasoning in Biology. JOURNAL OF MICROBIOLOGY & BIOLOGY EDUCATION 2021; 22:e00159-21. [PMID: 34594465 PMCID: PMC8442032 DOI: 10.1128/jmbe.00159-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 04/08/2021] [Indexed: 06/13/2023]
Abstract
Making inferences and reasoning with new scientific information is critical for successful performance in biology coursework. Thus, identifying students who are weak in these skills could allow the early provision of additional support and course placement recommendations to help students develop their reasoning abilities, leading to better performance and less attrition within biology courses. Researchers across universities partnered to develop a measure to assess students' inference-making abilities in biology. We describe the development of the inference-making and reasoning in biology assessment (IMRB). The IMRB is a 15-item multiple-choice assessment that uses short paragraphs of content-from the most-used textbook-taught at the end of a semester of survey biology courses designed for science majors. Based on our research, when the IMRB is conducted at the beginning of a semester, it measures deductive reasoning with new biology information, is fair across various student groups, and is reliable. The IMRB can be used with or without SAT or ACT scores to place students into regular undergraduate introductory biology courses, to predict grades in such courses, and/or to identify students who may need extra support or remediation in reasoning with new biology information. The IMRB is available free of charge to interested faculty and researchers.
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Affiliation(s)
- Jennifer G Cromley
- Department of Educational Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Ting Dai
- Department of Educational Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | | | - Frank E Nelson
- Department of Biology, Temple University, Philadelphia, Pennsylvania, USA
| | - Martin Van Boekel
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Yang Du
- Department of Educational Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
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Kurunsaari M, Tynjälä P, Piirainen A. Stories of professional development in physiotherapy education. Physiother Theory Pract 2021; 38:1742-1755. [PMID: 33620012 DOI: 10.1080/09593985.2021.1888341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examines graduating physiotherapy students' narratives related to their professional development. The data comprised interviews with 33 graduating physiotherapy students. The data were analyzed using the narrative analysis approach. As a result, five different story models were identified. The descriptive story models were named: 1) "Study path dominated by life changes"; 2) "Realizing the connection between physiotherapy theory and practice"; 3) "Self-regulated and practical-oriented learning path"; 4) "Becoming a critical developer"; and 5) "Multiprofessional working towards expertise". In students' stories, there appeared different turning points that illustrated especially meaningful episodes during the process of their professional development to be a physiotherapist. From a pedagogical point of view, two important features appeared: the importance of connecting theory and practice and the role of clinical supervisors.
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Affiliation(s)
- Merja Kurunsaari
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland.,Faculty of Health and Sport Sciences, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Päivi Tynjälä
- Finnish Institute for Educational Research, University of Jyväskylä, Jyväskylä, Finland
| | - Arja Piirainen
- Faculty of Health and Sport Sciences, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Harris N, Bacon CEW. Developing Cognitive Skills Through Active Learning: A Systematic Review of Health Care Professions. ACTA ACUST UNITED AC 2019. [DOI: 10.4085/1402135] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
ObjectiveTo systematically review current literature to determine whether active learning is more successful than passive learning at producing cognitive skills in health care professions students.Data SourcesAn electronic search was conducted in 4 databases: EBSCO-CINAHL, EBSCO-Sport Discus, Educational Resources Information Center, and PubMed. Search terms included: millennial AND health education, active learning AND knowledge retention, flipped classroom AND learning outcomes, problem based learning AND learning outcomes, problem based learning AND student confidence, active learning AND critical thinking, higher order thinking AND active learning.Study SelectionWe included studies if they were published in English between 2007 and 2017 and evaluated outcomes of an active learning intervention. Studies of nonhealth care disciplines, practicing health care practitioners, or studies that did not address the primary research questions were excluded.Data ExtractionStudy design, health care discipline, intervention used, assessment measures, outcome(s) measures, main results, and conclusions were extracted from each article, as appropriate.Data SynthesisArticles were categorized based on capacity to answer 1 or both of the research questions. Conclusions were summarized according to the learning technique used and its effectiveness in regard to studied learning outcome. Out of 85 studies on lower-order cognition, 61 (72%) indicated active learning techniques were effective at achieving improved recall, understanding, and/or application of course material. Of 69 studies on higher-order cognition, 58 (84%) supported active learning over passive instruction for improving students' confidence in or performance of analytical, evaluative, and creative skills.ConclusionsActive learning produces gains to both lower- and higher-order cognition at levels equal to, and more often, greater than the use of passive learning methods. Despite this evidence, we believe more high-quality, well-designed prospective studies using validated assessment measures are needed to endorse the value of these methods in producing cognitive skills.
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Affiliation(s)
- Nicolette Harris
- Department of Athletic Training, Florida International University, Miami
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Matilde INE, Eid RAC, Nunes AF, Ambrozin ARP, Moura RH, Carnieli-Cazati D, Timenetsky KT. Bronchial hygiene techniques in patients on mechanical ventilation: what are used and why? ACTA ACUST UNITED AC 2018; 16:eAO3856. [PMID: 29694610 PMCID: PMC5968793 DOI: 10.1590/s1679-45082018ao3856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 10/02/2017] [Indexed: 11/22/2022]
Abstract
Objective To analyze and describe the maneuvers most commonly used in clinical practice by physical therapists and the reasons for choosing them. Methods A prospective multicenter study using a questionnaire. The sample consisted of physical therapists from five hospitals (three private hospitals, a teaching hospital and a public hospital). Results A total of 185 questionnaires were filled in. Most professionals had graduated 6 to 10 years before and over had over 10 years of intensive care unit experience. The most often used maneuvers were vibrocompression, hyperinflation, postural drainage, tracheal suction and motor mobilization. The most frequent reason for choosing these maneuvers was “I notice they are more efficient in clinical practice.” Conclusion Physical therapy is mostly based on individual experience acquired in the clinical practice, and not on the scientific literature.
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Gummesson C, Sundén A, Fex A. Clinical reasoning as a conceptual framework for interprofessional learning: a literature review and a case study. PHYSICAL THERAPY REVIEWS 2018. [DOI: 10.1080/10833196.2018.1450327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Christina Gummesson
- Center for Teaching and Learning at the Faculty of Medicine, Lund University, Lund, Sweden
| | - Anne Sundén
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Angelika Fex
- Department of Health Sciences, Lund University, Lund, Sweden
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Montpetit-Tourangeau K, Dyer JO, Hudon A, Windsor M, Charlin B, Mamede S, van Gog T. Fostering clinical reasoning in physiotherapy: comparing the effects of concept map study and concept map completion after example study in novice and advanced learners. BMC MEDICAL EDUCATION 2017; 17:238. [PMID: 29191189 PMCID: PMC5709960 DOI: 10.1186/s12909-017-1076-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 11/16/2017] [Indexed: 05/31/2023]
Abstract
BACKGROUND Health profession learners can foster clinical reasoning by studying worked examples presenting fully worked out solutions to a clinical problem. It is possible to improve the learning effect of these worked examples by combining them with other learning activities based on concept maps. This study investigated which combinaison of activities, worked examples study with concept map completion or worked examples study with concept map study, fosters more meaningful learning of intervention knowledge in physiotherapy students. Moreover, this study compared the learning effects of these learning activity combinations between novice and advanced learners. METHODS Sixty-one second-year physiotherapy students participated in the study which included a pre-test phase, a 130-min guided-learning phase and a four-week self-study phase. During the guided and self-study learning sessions, participants had to study three written worked examples presenting the clinical reasoning for selecting electrotherapeutic currents to treat patients with motor deficits. After each example, participants engaged in either concept map completion or concept map study depending on which learning condition they were randomly allocated to. Students participated in an immediate post-test at the end of the guided-learning phase and a delayed post-test at the end of the self-study phase. Post-tests assessed the understanding of principles governing the domain of knowledge to be learned (conceptual knowledge) and the ability to solve new problems that have similar (i.e., near transfer) or different (i.e., far transfer) solution rationales as problems previously studied in the examples. RESULTS Learners engaged in concept map completion outperformed those engaged in concept map study on near transfer (p = .010) and far transfer (p < .001) performance. There was a significant interaction effect of learners' prior ability and learning condition on conceptual knowledge but not on near and far transfer performance. CONCLUSIONS Worked examples study combined with concept map completion led to greater transfer performance than worked examples study combined with concept map study for both novice and advanced learners. Concept map completion might give learners better insight into what they have and have not yet learned, allowing them to focus on those aspects during subsequent example study.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC H3C 3J7 Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Joseph-Omer Dyer
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC H3C 3J7 Canada
- Centre de pédagogie appliquée aux sciences de la santé (CPASS), Université de Montréal, Montreal, QC Canada
| | - Anne Hudon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC H3C 3J7 Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Monica Windsor
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, QC H3C 3J7 Canada
| | - Bernard Charlin
- Centre de pédagogie appliquée aux sciences de la santé (CPASS), Université de Montréal, Montreal, QC Canada
- Department of Neurology, Montreal General Hospital, Montreal, QC Canada
| | - Sílvia Mamede
- Institute of Medical Education Research Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Tamara van Gog
- Department of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Education, Utrecht University, Utrecht, The Netherlands
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Joseph C, Conradsson D, Nilsson Wikmar L, Rowe M. Structured feedback on students' concept maps: the proverbial path to learning? BMC MEDICAL EDUCATION 2017; 17:90. [PMID: 28545431 PMCID: PMC5445291 DOI: 10.1186/s12909-017-0930-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 05/16/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Good conceptual knowledge is an essential requirement for health professions students, in that they are required to apply concepts learned in the classroom to a variety of different contexts. However, the use of traditional methods of assessment limits the educator's ability to correct students' conceptual knowledge prior to altering the educational context. Concept mapping (CM) is an educational tool for evaluating conceptual knowledge, but little is known about its use in facilitating the development of richer knowledge frameworks. In addition, structured feedback has the potential to develop good conceptual knowledge. The purpose of this study was to use Kinchin's criteria to assess the impact of structured feedback on the graphical complexity of CM's by observing the development of richer knowledge frameworks. METHODS Fifty-eight physiotherapy students created CM's targeting the integration of two knowledge domains within a case-based teaching paradigm. Each student received one round of structured feedback that addressed correction, reinforcement, forensic diagnosis, benchmarking, and longitudinal development on their CM's prior to the final submission. The concept maps were categorized according to Kinchin's criteria as either Spoke, Chain or Net representations, and then evaluated against defined traits of meaningful learning. RESULTS The inter-rater reliability of categorizing CM's was good. Pre-feedback CM's were predominantly Chain structures (57%), with Net structures appearing least often. There was a significant reduction of the basic Spoke- structured CMs (P = 0.002) and a significant increase of Net-structured maps (P < 0.001) at the final evaluation (post-feedback). Changes in structural complexity of CMs appeared to be indicative of broader knowledge frameworks as assessed against the meaningful learning traits. CONCLUSIONS Feedback on CM's seemed to have contributed towards improving conceptual knowledge and correcting naive conceptions of related knowledge. Educators in medical education could therefore consider using CM's to target individual student development.
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Affiliation(s)
- Conran Joseph
- Department of Physiotherapy, University of the Western Cape, Cape Town, South Africa
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - David Conradsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function Stockholm, Stockholm, Sweden
| | - Lena Nilsson Wikmar
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Healthcare Centre, Stockholm County Council, Stockholm, Sweden
| | - Michael Rowe
- Department of Physiotherapy, University of the Western Cape, Cape Town, South Africa
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