AbstractBackground: Despite the progress that has been made to better understand the potential mechanisms of SMT and its treatment effects, a knowledge gap continues to exist when it comes to identifying the specific factors that contribute to the effective utilization of SMT. The purpose of the study was to explore the perceptions of chiropractic clinicians, interns, and patients regarding what factors during a doctor-patient encounter contribute to the perceived treatment effect associated with SMT. Methods: Participants were recruited from a chiropractic teaching clinic in the United States using convenience sampling. Semi-structured interviews were used as the main form of data collection, which took place from January-April 2024. The data was subsequently analyzed using a grounded theory approach and organized into themes through an iterative open coding process. Results: Six rounds of interviews were conducted for a total of 18 interviews. Each round consisted of one patient who received treatment including SMT, one intern who performed the treatment, and one clinician who oversaw the treatment. After analyzing the interview data, the following five themes were identified: Psychomotor Skills, Treatment Outcome, Significance of Cavitation, Adjunctive Therapies, and Therapeutic Alliance. Conclusion: This qualitative study identified several themes which describe factors that may contribute to the perceived effect associated with SMT. In addition to the psychomotor skills required to perform SMT, educators and practitioners should consider factors such as the therapeutic alliance between patient and provider, use of adjunctive therapies, and assessment of the outcome associated with the intervention.
This study examines the dynamics of the Atlantic salmon (Salmo salar L.) population of the Foyle catchment in Ireland, through the analysis of long-term datasets and extensive field data. In chapter 1 the current conservation status of the salmon is discussed with particular reference to the Foyle.
Chapter 2 considers the interaction between commercial netting and recreational sport angling and the effect of total combined exploitation on an independent measure of population size (redd counts) using a 49 year dataset. The evidence suggests that year class strength is the principal modulator of variation in commercial catches, sport angling catches and spawning escapement.
Chapter 3 examines the role of density-dependence in the Foyle salmon population. A Ricker density-dependent model showed that spawning adult population size significantly predicted variation in the resultant filial generation; however, a significant amount of variation (ca. 68%) remained unexplained. Environmental factors were significant in explaining some of the remaining variance and these influences were linked to specific life stages.
Chapter 4 investigates the effect of marine climatic conditions in the North Atlantic on the abundance of returning migrant Atlantic salmon, using a 126 year dataset of commercial catches and an index of climate in the northern hemisphere, the North Atlantic Oscillation (NAOI). The NAOI when below 0.151 explained a significant proportion of variation in five year running mean catches of migrant Atlantic salmon returning to the River Foyle. This indicates that a significant proportion of the variance in population size in the past was the result of variability in conditions in the marine environment. However, when the NAOI was above 0.151 this relationship uncoupled.
Chapter 5 tests the capacity of local instream and broadscale catchment characteristics to predict 0+ salmon abundance within the Foyle area. This chapter also highlighted the potential detrimental impact of increasing urbanisation on the salmon stocks of the Foyle area.
The aim of this study was to explore the COVID-19 pandemic as it was experienced by people on the front line in residential care settings for older people in the Republic of Ireland (ROI).The COVID-19 pandemic had a disproportionate effect in residential care settings for older people in Ireland.A two-phased mixed methods study was conducted, consisting of an online survey administered shortly after the first wave of the virus to staff, residents and family members and one-to-one interviews with family members shortly after wave 2 of the virus.Isolation, loss of connectedness as well as a reduction in the level/quality of care provision led to significant adverse impacts for both residents and their families. Staff reported high levels of stress, trauma and burnout. Family input to care was suspended, with adverse consequences.The pandemic had an extremely adverse impact on residents, family members and staff in care settings for older people.Strategies to ensure that residents' physical, emotional and social needs and staffs' professional and personal needs are appropriately supported during future waves of the pandemic should now be implemented.
Abstract Background Despite the progress made in better understanding the potential mechanisms of spinal manipulative therapy (SMT) and its treatment effects, a knowledge gap continues to exist when identifying the specific factors that contribute to the perceived treatment effect associated with SMT. The purpose of the study was to explore the perceptions of chiropractic clinicians, interns, and patients regarding what factors during a doctor-patient encounter contribute to the perceived treatment effect associated with SMT. Methods This study used convenience sampling to enroll participants from a chiropractic teaching clinic in the United States. Semi-structured interviews were used as the main form of data collection, which took place from January-April 2024. The data was subsequently analyzed using thematic analysis and organized into themes through an iterative open coding process. Results Six rounds of interviews were conducted for a total of 18 interviews. Each round consisted of one patient who received treatment including SMT, one intern who performed the treatment, and one clinician who oversaw the treatment. After analyzing the interview data, the following five themes were identified: Treatment Outcome, Therapeutic Alliance, Adjunctive Therapies, Significance of Cavitation, and Psychomotor Skills. Each theme consisted of multiple subthemes which were mentioned by the participant groups at varying frequencies. Patients frequently mentioned the importance of improvement in symptoms following treatment, as well as good communication skills and the use of adjunctive therapies. Interns valued functional change following treatment, while clinicians focused on confidence levels and psychomotor skills. There were differing views on the significance of cavitation, ranging from indifference to an indication of a successful treatment. Conclusion This qualitative study identified several themes which describe factors that may contribute to the perceived effect associated with SMT. In addition to the psychomotor skills required to perform SMT, educators and practitioners should consider factors such as the therapeutic alliance between patient and provider, use of adjunctive therapies, and assessment of the outcome associated with the intervention.
Today's flight operations work on pressurised 24/7 timetables. As a result, sleep loss and fatigue are becoming commonplace among pilots and pose a serious threat to flight safety. This study examined the effects of 24 h' sleep deprivation on a variety of psychological measures, cognitive performance tasks and simulated flight. Seven commercial airline pilots completed the Samn-Perelli Crew Status Check (SPC), Profile of Mood States (POMS), Psychomotor Vigilance Task (PVT), Dual-N-Back, Rapid Visual Information Processing Task (RVP), NASA Task Load Index (NASA-TLX) and aviation-specific mathematical calculations as well as a computerised flight simulator task, during which participants were required to answer mid-flight fuel calculations and situational awareness questions (SA). Testing occurred at 3 hour intervals during the final 12 hours of a 24 hour period of continuous wakefulness. Significant impairments in performance were observed on nearly all tests following 20 hours continuous wakefulness. Flying performance was not significantly impaired. Changes in flight performance were found to be consistent with changes in situational awareness. Overall findings showed impairments in mood, cognition and flying performance following 20 hours continuous wakefulness. SA indicates promise as a potential indicator of changes in flying performance as a result of sleep deprivation and fatigue.
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