Running Head: The role, benefits and selectionThe role, benefits and selection of sport psychology consultants: Perceptions of youth-sport coaches and parents Abstract 1 Objectives: With practitioners needing to be 'more things to more people', it is essential to 2 understand third-party consumer perceptions of the role and benefits of sport psychology 3 consultants (SPC), and the characteristics that may influence such services being sought. 4Design: A qualitative thematic analysis approach was used in Study 1 and a cross-sectional conjoint 5 analysis approach was employed in Study 2. 6Methods: In Study 1, 22 participants (11 youth-sport coaches, 11 parents) took part in semi-7 structured interviews to investigate, a) understanding the SPC role, b) the benefits of seeking the 8 services of an SPC, and, c) the salient characteristics of an SPC that would influence judgments on 9 preference and likelihood to seek consultant services on behalf of their athlete/child. In Study 2, a 10 total of 115 participants (51 youth-sport coaches, 64 parents) rated 32 practitioner profiles 11 generated from Study 1, with a conjoint analysis employed to determine the relative importance of 12 SPC characteristics. 13Results: SPCs were viewed by youth-sport coaches and parents as practitioners who can help 14 athletes enhance their performance and well-being, which would be of benefit to athletes. The SPC 15 attribute most important to coaches and parents was interpersonal skills, with a preferred SPC 16 profile also including a high level of experience and training, and a known reputation. 17Conclusions: SPCs are viewed by youth-sport coaches and parents as experts regarding 18 performance enhancement and well-being. SPCs with strong interpersonal skills, extensive 19 experience and training, and a known reputation are preferred by coaches and parents. Findings 20 reinforce the importance of educating those responsible for the ongoing development of athletes to 21 the role and benefits of SPCs, and for SPC training to ensure that interpersonal skills development 22opportunities are available. 23 24
The imperatives of the Affordable Care Act to reduce 30-day readmissions present challenges and opportunities for nurse administrators. The literature suggests success in reducing readmissions through enhancing patient-centered discharge processes, focusing on medication reconciliation, improving coordination with community-based providers, and effective patient self-management of their disease and treatment. Evidence-based interventions addressing low health literacy, when used with all patients, hold promise to promote understanding and self-management. Strategies addressing low health literacy aimed at reducing 30-day readmissions are identified and discussed.
Ancatomny of the Parts (f Crural Hernia. -Cause antl Formation of the Rupture.-Operation for its Radical Cure. -Sources of Failure and Danger. -Operation for the Radical Cure of Hernia after Kelotomy for Strangulation.-Umbilical Hernia.-Evolutionary Failures.-Antatomy.-Varieties.-Tavis.-Operation for Radical Cure.--Choice of Cases.-Review of the variouts MIethods of Attempting a Radical Citre of Hernia in Ancient and Modern Timnes.-Classification of Cases for Selection of Operation.-Conclusion. Anatomy of Crural Hernia.-In the hollow of the groin below the inner extremity of Poupart's ligament, and forming, with the deep and superficial abdominal rings, an inverted triang,le, of which it is the apex, lies the saphenous opening.Formed by the separation of the fascia lata into two layers, of which the outer or iliac part is advanced forwards by its attachment along the whole length of Poupart's ligament, and the inner or pubic portion, covering the sloping surface of the adductor and pectineus muscles, is attached to the pectineal line, and continued behind the sheath of the femoral vessels to be continuous with the ilio-psoas fascia, and connected with the capsule of the hip-joint; the saphenous opening presents an oval outline, looking forwards and a little dowvnwards and inwards.The outer border curves sharply inwards in a falciform manner, lies in front of the femoral vessels, and is attached to and blended with Gimlbernat's ligament by a process about half an inch wide, Hey's ligament, important to surgeons, because it crosses the upper part of the crural canal, and may be the seat of strangulation.Below, the falciform edge passes under the saphena vein, which curves over it to join the common femoral vein, receiving, as it does so, the veins which accompany the superficial branches of the common femoral artery, nlamely, the two external pubic, the epigastric, and the circumflex iliac.The first two pass inwards, the next upwards, and the last outwards.They supply the numerous lymphatic glands which lie in two groups in this situation, the upper directed obliquely along Poupart's ligament above and invested by Scarpa's fascia, and the lower lying parallel and internal to the saphena vein. Nearly all the afferent ducts of these glands pass in a body through the saphenous opening, the inner part of the femoral sheath, and the crural ring, to join the deep iliac and lumbar glands. The saphenous opening is covered in by a layer of fascia connected with its borders, called, from the numerous holes which transmit these lymphatics and some of the vessels, the cribriform fascia. This is blended, superficially, with the deep layer of superficial fascia of the thigh, and, deeply, with the inner part of the sheath of the femoral vessels.By detaching Hey's ligament from Poupart's, and turning down the fascia lata and cribriform fascia, the sheath of the femoral vessels is brouaht to view. It is arranged in three compartments ; the outer for the common femoral artery, the middle one for the vein, and the inner one, smaller ...
causing low output and death. In the remaining 21 patients the cause of death was unrelated to mechanical valve failure. All of the patients in whom this phenomenon of triangulation of the aortic root was noted had undergone aortic valve replacement using the Starr-Edwards model No 2320, in which the three cage struts are cloth covered. This model was discontinued in 1976 and the current models use three stellite struts without the cloth covering. While the older models probably had greater potential to cause outflow obstruction with incorporation of the cloth covered struts into the aortic wall, the tendency to cause triangular deformity with this style of valve prosthesis remains. Although the risk of acute failure and the operative mortality associated with artificial heart valves are small, the medium and long term morbidity is not negligible. Current mechanical prostheses may well prove superior to those used previously but they are not trouble free. Conservative valve reconstruction needs to be encouraged.
And now, gentlemen, I have passed in review, far too briefly, the points which appear to me most interesting wvhen the eye glances back over the varied, smooth and rugged, lighbt and dark, fertile and sterile regions whichi a man passes over as time carries him, but too quickly, from youtlh to age. To me the retrospect is cheering; it has given me fresh hope for the continuied advance of our knowledge and for the pro. gressive usefulness of our profession. I feel, as I have lightly passed ,over the records of the profession's work and gains in the last forty years, that we have played no uinworthy part in the great drama, and that among the restless activity of modern times and the marvellous growth of newly born sciences, an old art has not stood still, but with ever increasing power is still, as it has always been, the Friend of Alan, and a very present lielp in time of need. ADDRESS IN SURGERY.
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