The influence of body painting on L4 spinous process palpation accuracy in novice palpators

OBJECTIVES

Current literature remains inconclusive regarding the best methodology to accurately palpate lumbar spinous processes (SP). Body painting (BP) uses markers to draw anatomical structures on the skin's surface. While BP can be a useful tool for engaging learners, it is unknown whether it improves palpation accuracy. The purpose of this study was to investigate whether the addition of body painting to palpation education improves lumbar spinous process palpation accuracy in first-year Doctor of Physical Therapy (DPT) students.

METHODS

Thirty-eight DPT students were randomized into a traditional palpation group and a body painting (BP) group. Each group received identical instruction on palpating the lumbar spine, with the BP group additionally drawing lumbar SPs on their laboratory partner with a marker. Students were then assessed on their ability to accurately palpate the L4 SP on randomly assigned subjects. Two Certified Registered Nurse Anesthetists (CRNAs) used ultrasound imaging to confirm the location of each student's palpation. Palpation time was also recorded. The BP group also completed a survey on the learning experience.

RESULTS

Forty-five percent of students were able to accurately palpate the L4 SP. There was no significant difference (p = 0.78) in palpation accuracy between the traditional and BP group, although students in the BP group were randomly assigned subjects with a significantly (p = 0.005) higher BMI. Ninety-five percent of students were able to palpate within one spinal level of the L4 SP. Students in the BP group reported that the BP activity facilitated learning and active participation. There was no significant difference in palpation time (p = 0.98) between groups. There was a fair correlation (r=-0.41) between palpation accuracy and subject BMI.

DISCUSSION/CONCLUSION

While body painting was an enjoyable activity to incorporate into palpation laboratory, it is unclear whether it enhanced lumbar SP palpation accuracy in first-year DPT students.

Optimising mopane worm (Gonimbrasia belina) processing for improved nutritional and microbial quality

Mopane worms (Gonimbrasia belina) is an important source of food and contribute to the nutrition of people who consume them. However, the traditional processing methods may have detrimental effects on the nutritional value and should also guarantee microbial quality. In this study, the nutritional composition and microbial quality of mopane worms processed under different boiling time (0-20 min) and drying temperature (40-60 °C) conditions were investigated and optimised using response surface methodology. An increase in the boiling time at the lowest drying temperature resulted in an increase in protein content and reduction in coliform counts. The optimum conditions of boiling for 20 min and drying at 40 °C resulted in mopane worms with a protein content of 49.4% DW and coliform counts <1.5 log cfu/g. In addition, high concentrations of crude fibre (13.6% DW) and fat (20.2% DW), as well as Fe (19.0 mg/100 g) and Zn (17.9 mg/100 g) were also recorded. A decrease in the total bacterial count, Escherichia coli and yeasts and moulds at the boiling time ≥20 min irrespective of the drying temperature suggested that exposure to heat reduced the microbial growth and contamination. Reduction of the mopane worms' moisture content (<7%) due to drying further slowed down the rate of microbial growth. The optimal processing conditions (boiling for 20 min and drying at 40 °C) are recommended for pretreatment of mopane worms prior to further processing into various products.

Ketorolac versus acetaminophen for treatment of acute fever in the emergency department

BACKGROUND

The purpose of this preliminary study was to compare acetaminophen to ketorolac for treating patients with fever in the emergency department (ED).

METHODS

In this prospective, randomized, double-blind pilot study, patients were enrolled as a convenience sample during a 6-month study period. All subjects 18 years or older with a temperature of 100.4 degrees F or higher were eligible. Investigators gave patients 10 mg of oral ketorolac or 750 mg of oral acetaminophen. The temperature and pulse were rechecked at 30, 60, and 90 minutes. Patients recorded discomfort on a visual analog scale (VAS) at 30, 60, and 90 minutes.

RESULTS

A total of 17 patients were enrolled. A t test showed no difference in temperatures, and the Mann-Whitney nonparametric test showed no difference in VAS scores.

CONCLUSION

In this preliminary study comparing ketorolac with acetaminophen for febrile illness in the ED, we found no difference in efficacy between the two medications.

Factorial equivalence of the Wechsler Memory Scale: revised across standardization and clinical samples

A two-phased analysis of the WMS-R is reported In the first phase, confirmatory factor analyses of the WMS-R standardization sample were conducted in order to identify a baseline model against which to compare two large samples of substance abusers These analyses revealed that most of the exploratory factor models reported in the literature were plausible representations of the WMS-R, however, a three-factor oblique model representing Attention/Concentration, Verbal Memory, and Visual Memory emerged as the best fitting model In the second phase, we conducted multi-sample factor analyses to test the generality of this model in two large samples of inpatients at an addiction recovery unit The results revealed that the factor loadings, subtest error variances (reliabilities), factor variances, and factor covariances were identical across groups Thus the factor structure of the WMS-R appears to be unaltered in these clinical groups Researchers may thus make meaningful comparisons of the dimensions indexed by the WMS-R between normal samples and neuropsychological groups with diffuse pathology.

Integrating values education into an allied health curriculum; Part II

Values education involves the explicit attempt to teach individuals about values and the process of valuing. An overview of popular approaches to values education includes inculcation, value clarification, moral development, and value analysis. Each approach is presented by detailing the purpose, teaching methods, and an instructional model. Methods of incorporating these approaches into an allied health curriculum are offered along with sample student learning activities.

Integrating values education into an allied health curriculum. Part I

Values education involves the explicit attempt to teach individuals about values and the process of valuing. An overview of popular approaches to values education includes inculcation, value clarification, moral development, and value analysis. Each approach will be presented by detailing the purpose, teaching methods, and an instructional model. Methods of incorporating these approaches into an allied health curriculum are offered along with sample student learning activities.

Loss of plasmids containing cloned inserts coding for novobiocin resistance or novobiocin sensitivity in Haemophilus influenzae

Plasmids pNov1 and pNov1s , coding for resistance and sensitivity to novobiocin, respectively, were readily lost from wild-type Haemophilus influenzae but retained in a strain lacking an inducible defective prophage. The plasmid loss could be partly or wholly eliminated by a low-copy-number mutation in the plasmid or by the presence of certain antibiotic resistance markers in the host chromosome. Release of both phage HP1c1 , measured by plaque assay, and defective phage, measured by electron microscopy, was increased when the plasmids were present. The frequency of recombination between pNov1 and the chromosome, causing the plasmid to be converted to pNov1s , could under some circumstances be decreased from the normal 60 to 70% to below 10% by the presence of a kanamycin resistance marker in the chromosome. This suggested that a gene product coded for by the plasmid, the expression of which was affected by the kanamycin resistance marker, was responsible for the high recombination frequency. Evidence was obtained from in vitro experiments that the gene product was a gyrase.

Isolation of a Bacillus subtilis 168 derivative sensitive to defective bacteriophage PBSX

A derivative of Bacillus subtilis strain 168 sensitive to defective bacteriophages PBSX and PBSZ has been isolated. This particular strain, RUB824, carries the genetic information for defective bacteriophage PBSX.

Cardiovascular depressant effect of protamine sulphate: experimental study and clinical implications

The mechanisms underlying protamine-induced hypotension and bradycardia were the subject of this investigation. Six groups of dogs with intact circulation were tested in controlled circumstances with various drugs. The following parameters were observed: femoral arterial pressure, central venous pressure, left ventricular pressure and its rate of rise, left ventricular contractile element velocity of shortening, maximal Vce, and cardiac output. The six groups were studied under these pharmacological conditions: ganglionic and adrenal medullary block with hexamethonium chlroide, postganglionic parasympathetic blockade by atropine sulphate, alpha and beta adrenergic receptor block by phenoxybenzamine and propranolol respectively, and depletion of endogenous histamine by compound 48/80 (a condensation product of p-methoxyphenethyl methylamine with formaldehyde). The last group was put on extracorporeal circulation to isolate the vascular tree from the heart. The effect of the drug on this isolated vasculature was observed by recording the femoral arterial pressure. Our findings show that the hypotension and bradycardia are produced by a direct effect of protamine on the myocardium and peripheral vascular system.

Mechanism responsible for the cardiovascular depressant. Effect of protamine sulfate

The mechanism of protamine-induced hypotension and bradycardia was investigated in anesthetized, heparinized dogs. Several groups of animals with intact circulation were studied for their responses to protamine under control conditions and following the administration of various pharmacological agents. The parameters observed include femoral arterial pressure (FAP), central venous pressure (CVP), left ventricular pressure (LVP) and its rate of rise (dp/dt), left ventricular contractile element velocity of shortening (Vce), maximal Vce (V max) and cardiac output (CO). Various groups were studied under the following pharmacological conditions: autonomic cholinergic blockade by atropine; alpha and beta adrenergic receptor blockade using phenoxybenzamine and propranolol respectively; ganglionic and adrenal medullary block using hexamethonium, and depletion of endogenous histamine by means of compound 48/80. Another group was placed on total cardiopulmonary bypass thus isolating the heart from the peripheral circulation. The effect of protamine on the vascular tree alone was then observed by monitoring FAP before and after protamine administration. The findings indicate that the cardiovascular effects of protamine are produced by a direct effect on the myocardium and vascular tree.