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Autonomy with respect to psychostimulant medication for children has proven to be problematic in the face of the many influence processes at work in a climate of uncertainty and controversy over both the diagnosis of attention deficit disorder with or without hyperactivity (ADHD) and the medications associated with it, Ritalin® and analogous medications (RAM). The reconstruction of these influence processes using the framework of social representations theory allowed, in turn, for the reconstruction of a rather complex set of social dynamics based on a review of the literature. Among other things, this investigation revealed a landscape dominated by groups of professionals, where collaboration is more purposive than operative. In this context parents are subject to a concentration of influences in the form of pressure and scientific legitimation exerted mainly by groups of professional and scientific actors. [ABSTRACT FROM AUTHOR]

Fish total mercury concentration ([THg]) has been linked to various fish attributes, but the relative importance of these attributes in accounting for among-individual variation in [THg] has not been thoroughly assessed. We compared the contributions of ontogeny (age, length), growth (growth rate, body condition), and food web position (δ 13 C, δ 15 N) to among-individual variability in [THg] within populations of seven common fishes from 141 north temperate lakes. Ontogenetic factors accounted for most variation in [THg]; age was a stronger and less variable predictor than length for most species. Adding both indices of growth and food web position to these models increased explained variation (R 2 ) in [THg] by 6-25% among species. Fish [THg] at age increased with growth rate, while fish [THg] at length decreased with growth rate, and the effect of body condition was consistently negative. Trophic elevation (inferred from δ 15 N) was a stronger predictor than primary production source (inferred from δ 13 C) for piscivores but not benthivores. Fish [THg] increased with δ 15 N in all species but showed a more variable relationship with δ 13 C. Among-individual variation in [THg] is primarily related to age or size in most temperate freshwater fishes, and effects of growth rate and food web position need to be considered in the context of these ontogenetic drivers., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to explore professional practice leadership models (PPLMs) within the Toronto Academic Health Science Network (TAHSN) by outlining the PPLMs currently in use, identifying elements of the PPLMs from physiotherapists' perspectives, and determining key features of PPLMs that enhance physiotherapy (PT) practice. Methods: In this qualitative, cross-sectional study, we used focus groups to explore physiotherapists' knowledge about their facility's PPLM, physiotherapists' role within the PPLM, the impact of professional practice leaders on PT practice, the impact of the PPLM on physiotherapists' job satisfaction, and the elements of an ideal PPLM. We coded transcripts using qualitative software and followed an inductive data analysis approach to develop themes. Results: We conducted eight focus groups with physiotherapists from six TAHSN facilities (four organizations). Five key features of PPLMs emerged from participants' perspectives: support network, organizational structure, professional development opportunities, influence of the leader in professional practice, and balance of workloads and accountabilities. Each key feature encompassed a group of interrelated elements - that is, components of the PPLMs that influenced PT practice. Conclusions: Our study is the first to explore elements and key features of the PPLMs used in TAHSN facilities as they relate to PT. We provide five recommendations to enhance PPLMs with respect to the PT profession., (© Canadian Physiotherapy Association.)

Purpose: The purpose of this study was to describe clinical instructors' (CIs) comments on the Canadian Physiotherapy Assessment of Clinical Performance (ACP) that reflect areas of strength and areas requiring improvement among internationally educated physical therapists (IEPTs) during supervised clinical internships in a bridging programme. Method: We reviewed the assessment records of 100 IEPTs' clinical performance during two internships each for three successive cohorts of learners in a Canadian bridging programme. We extracted the CIs' text from 385 comment sections of the ACP completed during these internships and analyzed them using qualitative content analysis. Results: The iterative deductive coding process resulted in 36 subcategories: 14 for areas of strength and 22 for areas requiring improvement. We merged the 36 subcategories to produce nine categories: four areas of strength (subjective assessment, treatment, patient confidentiality, and professionalism) and five areas for improvement (objective assessment, clinical reasoning, establishment of treatment goals, communication, confidence, and time management). We then grouped these categories into two broad themes: professional practice and professional conduct. Conclusions: The CIs commended the IEPTs for their clinical competence in subjective assessment, treatment, patient confidentiality, and professionalism. The areas requiring improvement typically required more complex clinical decision-making skills, which may have been challenging for these IEPTs to demonstrate as competently during a short internship., (© Canadian Physiotherapy Association.)

Objective. To implement and assess the impact of a hybrid flipped-classroom activity designed to increase the motivation and confidence of Doctor of Pharmacy (PharmD) students in addressing the opioid crisis. Methods. Third-professional year student pharmacists were provided with reading material developed by federal agencies and professional pharmacy organizations, as well as Georgia-specific information covering medical amnesty and local resources for opioid-overdose prevention prior to class. They then attended a four-hour classroom session that included hearing a lecture on opioid pharmacology and opioid overdose, viewing training videos, and engaging in extensive discussion. The students voluntarily completed pre- and post-intervention assessments regarding opioid abuse and opioid overdose prevention. Results. Seventy of the 107 third-year students enrolled in the course completed the pre-intervention assessment (65% response rate), and 33 of the 70 completed the post-intervention assessment (47% retention rate). The students exhibited a high baseline motivation to assist in combating the opioid crises, but less confidence in their ability to intervene. Significant increases were seen in areas related to student confidence on the post-intervention assessment. Fewer changes were seen in areas related to student motivation. Conclusion. A "hybrid" flipped classroom activity increased the confidence of student pharmacists in their understanding of the physical and adverse effects of opioids and the application of reversal agents. Increased confidence may support increased intervention., (© 2019 American Association of Colleges of Pharmacy.)

Purpose: Clinical education is an integral component of the curriculum of all physical therapy (PT) entry-to-practice programmes in Canada. The literature indicates that working with and assessing students performing below expectations (SPBE) can be procedurally and emotionally difficult. Our study aimed to explore the experiences of clinical instructors (CIs) and the decision-making process involved when supervising SPBE in PT. Method: A total of 19 in-depth, semi-structured interviews were conducted with CIs, transcribed, and coded using qualitative thematic analysis. Results: Four factors appeared to be important for CIs when they were deciding how to assess SPBE: (1) features of student performance, (2) factors related to the CIs, (3) academic and clinical facility influencers, and (4) strategies and available resources. Concerns about safety and professional behaviour, a student's clinical reasoning skills, and a lack of progression were key factors that CIs considered in recommending a final grade. CIs were more likely to recommend a failing grade if there was a series of repeated incidents rather than an isolated incident. Conclusions: We make several recommendations for the student, CI, and facilities to consider to better support and facilitate the process of working with SPBE in PT clinical education., (© Canadian Physiotherapy Association.)

Purpose: We describe the numerical ratings assigned by clinical instructors to the performance of internationally educated physical therapists (IEPTs) during their clinical internships while enrolled in a bridging programme. Method: We conducted a secondary analysis of the quantitative data for IEPT learners attending the Ontario Internationally Educated Physical Therapist Bridging Program using the Canadian Physiotherapy Assessment of Clinical Performance (ACP) tool. We extracted the scores from each IEPT's ACP form at the midterm and final evaluations for two internships and conducted a descriptive analysis. Results: We obtained 318 data sets for 61 IEPTs. By the final point of the second internship, (1) items about communication pertaining to ethical professional relationships, conducting oneself within legal and ethical requirements, and respecting the individuality and autonomy of the client had high mean ratings; (2) most items rated achieved advanced intermediate performance and many indicated entry-level performance; and (3) most IEPTs (84%) either had high scores throughout or improved from lower scores to at least advanced intermediate performance. Conclusions: Items relating to professional conduct and effective communication in professional relationships were relatively high among the IEPTs. By the end of the second internship, most IEPTs in this bridging programme had improved their clinical performance toward or up to the entry-level standard for Canadian physiotherapists., (© Canadian Physiotherapy Association.)

Background: Clinical work-based internships form a key component of health professions education. Integral to these internships, academic health science partnerships (AHSPs) exist between universities and teaching hospitals. Our qualitative descriptive study explored the perspectives of hospital leadership on AHSPs: what they are composed of, and the facilitators and barriers to establishing and sustaining these partnerships., Methods: Fifteen individuals in a variety of hospital leadership positions were purposively sampled to participate in face-to-face interviews, after which a thematic analysis was conducted., Results: Participants reported that healthcare and hospital infrastructure shapes and constrains the implementation of clinical education. The strength of the hospitals' relationship with the medical profession facilitated the partnership, however other health professions' partnerships were viewed less favourably. Participants emphasized the value of hospital leaders prioritizing education. Further, our findings highlighted that communication, collaboration, and involvement are considered as both facilitators and barriers to active engagement. Lastly, opportunities stemming from the partnership were identified as research, current best practice, improved patient care, and career development., Conclusion: Our study found that AHSPs involve the drive of the university and hospitals to gain valued capital, or opportunities. Reciprocal communication, collaboration, and involvement are modifiable components that are integral to optimizing AHSPs., Competing Interests: Conflicts of interest: There are no conflicts of interest for any of the authors.

Purpose: The aim of this study was to understand the nature and extent of clinical instructors' (CIs') involvement in the clinical education of internationally educated physical therapists (IEPTs) while exploring CIs' perceptions of the similarities among and differences between IEPTs and Canadian-trained students. Method: In this qualitative descriptive study, 13 semi-structured interviews were conducted with CIs who were involved in a bridging programme for IEPTs. Data were coded using NVivo version 10, and common themes emerged through qualitative thematic analysis. Results: The majority of CIs perceived IEPTs' backgrounds to be diverse as a result of their varied previous clinical experience, physiotherapy scope of practice, and life stressors. Their diverse backgrounds contributed to the similarities and differences found in their skills, their personal motivation, and the education process, leading to successes and challenges in the clinical environment. Conclusions: Differences between IEPTs and Canadian-trained students stem from IEPTs' diverse backgrounds. Recognizing this diversity while demonstrating cultural competence will promote a successful clinical experience for both IEPT learners and CIs, which will ultimately facilitate the integration of IEPTs into the Canadian health care system.

Purpose: This study explored the factors that influence mentors in the profession of physiotherapy (PT) in Canada when engaging in a mentorship relationship. Methods: We conducted a quantitative, cross-sectional, Web-based survey. The target population consisted of Canadian physiotherapists who had experience as mentors. We used a modified Dillman approach to disseminate an online questionnaire to members of the Canadian Physiotherapy Association and its divisions using their respective e-blasts. We collected data on the nature and extent, facilitators, barriers, and benefits of mentorship and then analyzed them using descriptive statistics. Results: A total of 302 respondents were included in this study. They reported being a mentor to fellow PT colleagues (91%), undergraduate students (85%), graduate students (64%), and inter-professional colleagues (64%). We found that although many factors facilitated the respondents' ability to mentor, barriers to mentorship had minimal impact. Responses also reflected many perceived benefits of mentorship. Conclusions: This study provides novel evidence relating to the experience of mentorship from the perspective of mentors in the profession of PT. It reinforces the literature by highlighting the positive aspects of mentorship, and it underscores the continued need for support from professional associations, institutions, and physiotherapists to improve current mentorship experiences in PT.

Although empathy is widely promoted as a beneficial practice across both intergroup and interpersonal contexts, the implications of being the target of empathy for the target's own psychological state are unclear. Three experiments examined how being the target of empathy affects goal-directed cognition outcomes related to a psychological sense of power, namely, the ability to maintain goal focus and readiness to ask for more in negotiations. We reasoned that because individuals typically empathize with others they perceive as disadvantaged and needing support, trying to empathize would raise individuals up in terms of such outcomes at the same time as it pushed the targets of their empathy down in a complementary fashion. Results were consistent with these predictions across intergroup and intragroup interaction. The findings thus suggest that individuals' efforts to empathize can undermine the targets of their empathy in a subtle manner by hindering their ability to pursue their goals., (© 2015 by the Society for Personality and Social Psychology, Inc.)

Two studies demonstrated that active efforts to appreciate a romantic partner's unique point of view (imagine-other perspective-taking) lead individuals lower in self-esteem (LSEs) to feel less loved by their partner and less satisfied with their relationship as a result. These effects were evident regardless of whether individuals' perspective-taking efforts involved reflecting specifically on a disagreement with their partner (Study 2) or not (Study 1). The studies thus identify a new path through which perspective-taking efforts can detract from relational well-being, one to which LSEs are uniquely vulnerable. Results from an open-ended thought-listing task administered in Study 2 confirmed that increased cognitive energy LSEs devoted to drawing (negative) metaperceptual inferences about their partner's evaluation of them contributed to the negative effect of imagine-other perspective-taking on their perceived regard. No such effects were evident for individuals higher in self-esteem, and imagine-self perspective-taking instead exerted a general positive influence on individuals' evaluations of their partner.

Purpose: To describe Canadian Master of Physical Therapy (MPT) students' knowledge, attitudes, and practices regarding peer mentorship., Methods: A quantitative cross-sectional survey study was conducted. An online questionnaire was sent to 945 MPT students via e-mail, using a modified Dillman approach. Data were analyzed using descriptive statistics to describe the knowledge, attitudes, and practices of Canadian MPT students., Results: A total of 260 MPT students (27.5%) responded to the questionnaire. Most respondents (68.7%) did not have any experience in a peer mentorship relationship during their MPT programme. A few respondents (5.4%) reported having received formal training on peer mentorship as part of their PT curriculum. Respondents generally held positive attitudes toward peer mentorship: 65.9% agreed that including peer mentorship is important, 89.5% agreed that peer mentorship can assist with learning in clinical internships, and 84.1% agreed that peer mentorship can help the transition from student to professional. Most respondents (52.5%) did not participate in a peer mentorship relationship during a typical month., Conclusions: MPT students' attitudes toward peer mentorship are positive, yet their knowledge of and resources for peer mentorship are limited, and few students have been involved in peer mentorship practices. The findings highlight the importance of university programme support to provide a nurturing environment and structure to overcome barriers, promote commitment, and facilitate successful participation. The evidence from this study provides a rationale to support and guide peer mentorship programming for Canadian MPT students.

The authors report a series of 154 cases reports of 89 female and 65 men who were treated by dielectrolysis using a corticosteroid, bethamethasone phosphate (Celestene injectable). The ionization technique is recalled as: nature of the current, generator, electrodes, methods, as well as the protocol. Patients suffered mostly from rheumatologic diseases in particular scapulohumeral periarthritis, arthrosis, epicondylitis and abarticular syndromes, often long-standing and resistant to current therapeutics. This serie also comprises 15 Dupuytren's contractures and La Peyronie's diseases. The very favorable results state as good and very good in 82%. The authors emphasize the excellent tolerance of this therapeutic method which allows a profitable utilization of corticotherapy without any risk.