Nursing in white-majority populations tends to be associated with white women. https://www.selleckchem.com/products/rimiducid-ap1903.html Yet as Western Europe and North America undergo demographic shifts, such associations are challenged as people of different racial and national backgrounds take on positions in nursing and other professional roles in healthcare. This article explores the work experiences of nurses from diverse backgrounds as they confront intersecting forms of sexism, racism, and nativism in the Netherlands. We use the conceptual framework of "appropriate labor" to help explain these experiences in connection with the wider climate of Dutch native homogeneity and race and racism denial. These findings have implications for work policies that might better support minority nurses in contexts of increasing superdiversity while also challenging wider cultural norms in the Netherlands that continue to associate nursing with whiteness and deny the presence of racism.Reflexivity is a key feature in qualitative research, essential for ensuring rigor. As a nurse practitioner with decades of experience with individuals who have chronic diseases, now embarking on a PhD, I am confronted with the question "how will my clinical experiences shape my research?" Since there are few guidelines to help researchers engage in reflexivity in a robust way, deeply buried aspects that may affect the research may be overlooked. The purpose of this paper is to consider the affordances of combining autoethnography (AE) with visual methods to facilitate richer reflexivity. Reflexive activities such as free writing of an autobiographical narrative, drawings of clinical vignettes, and interviews conducted by an experienced qualitative researcher were analyzed to probe and make visible perspectives that may impact knowledge production. Two key themes reflecting my values-fostering advocacy and favoring independence and autonomy were uncovered with this strategy.Natural disasters may have catastrophic and long-lasting impacts on communities' physical, economic, and social infrastructure. Slow recovery of educational services following such events is likely to cause traumatic stress in children, lead families to out-migrate, and affect the community's overall social stability. Methods for quantifying and assessing the restoration process of educational systems and their dependencies on other supporting infrastructure have not received adequate attention. This study introduces, for the first time, a new framework to evaluate the functionality, recovery, and resilience of a school system following severe earthquake events. The framework considers both the quantity and quality of education services provided, school enrollment, and staff employment, as well as the interaction between various agents such as staff, students, parents, administration, and community. A virtual testbed community, Centerville, is utilized to highlight the application of this framework. The impact of school reopening policies on the number of students enrolled as well as the potential for homeschooling is also considered. The availability of various enrollment alternatives for students, backup classroom space and functioning utility systems, and facilitation of staff and supplies transfer between schools substantially increase the resilience of the education service.
Achilles tendinopathy is a frequent sports injury, and extracorporeal shock wave therapy (ESWT) has been proposed as a treatment.

To compare outcomes between ESWT and other nonsurgical intervention (including sham shock wave therapy) in Achilles tendinopathy patients.

Systematic review; Level of evidence, 2.

We included 5 randomized controlled trials and 3 case-control studies published between 2005 and 2018. We analyzed pain scores and other outcomes that were reported in more than 3 of the 8 studies.

ESWT was associated with significantly better scores than comparison therapy on the visual analog scale for pain (
< .01), American Orthopaedic Foot & Ankle Society scale (
= .01), Likert scale for satisfaction (
= .03), Roles and Maudsley scale (
< .01), Victorian Institute of Sports Assessment-Achilles questionnaire (
< .01), and numerical rating scale (
= .02). The 2 patient groups did not differ significantly in tenderness (
= .34) or pain threshold (
= .24). Subgroup analysis showed that ESWT led to better VAS pain scores than comparison treatments at both low-energy level (0.06-0.11 mJ/mm
) and medium-energy level (0.12-0.25 mJ/mm
) and at both shorter (<6 months) and longer (≥6 months) follow-up.

ESWT improves pain and functional outcomes in patients with Achilles tendinopathy. Further research is needed to determine the optimal energy level.
ESWT improves pain and functional outcomes in patients with Achilles tendinopathy. Further research is needed to determine the optimal energy level.
Lower extremity physical performance measures (PPMs), which can objectively quantify functional ability, are an attractive adjuvant to patient-reported outcome (PRO) instruments. However, few tests have been validated for use in hip instability.

To evaluate 4 different PPMs for their ability to differentiate between young adults with hip dysplasia indicated for treatment with periacetabular osteotomy (PAO) and asymptomatic controls and to test inter- and intratest reliability and relationship with popular hip PRO instruments.

Cohort study (diagnosis); Level of evidence, 2.

A total of 24 symptomatic patients aged 15 to 39 years (100% female) with hip dysplasia (lateral center-edge angle <25°) indicated for treatment with PAO completed the visual analog scale (VAS) for pain, Hip disability and Osteoarthritis Outcome (HOOS) Pain subscale, HOOS Short Version (HOOS PS), International Hip Outcome Tool Short Version (iHOT-12), modified Harris Hip Score (mHHS), Patient Reported Outcome Measurement Informatasure testing demonstrated excellent test-retest reliability. Timed stair ascent and sit-to-stand testing in particular were correlated strongly with physical function PRO instruments. PPMs may be a viable and well-received adjuvant to PRO instrument administration for patients with nonarthritic hip conditions, and investigation of the ability of PPMs to assess surgical outcomes for hip dysplasia is warranted.