Physical therapy following total hip arthroplasty (THA) is intended to maximize a patient's range of motion and function and improve the quality of life. No universally accepted standard of care exists for physical therapy among physicians or therapists. However, it may be crucial to enhance efforts to more fully elucidate contributing parameters that affect patient experiences. The purpose of this study was to evaluate various factors contributing to patient satisfaction with postoperative physical therapy. One hundred consecutive patients (110 hips) who underwent THA were prospectively surveyed for satisfaction with postoperative physical therapy. All surveys were filled out anonymously by the patients, and investigators were blinded to clinical outcomes and who was surveyed. Seventy-six percent of patients reported being satisfied with their rehabilitation experiences. Factors, including patient age and sex, duration of therapy, number of patients per session, continuity of care with the same therapist, amount of hands-on time spent with the therapist, number of patients per session, and total number of sessions completed, were significantly correlated with patient satisfaction. Co-pay amount did not significantly affect patient satisfaction. These factors may be underappreciated by physicians and physical therapists. To maximize patient satisfaction with physical therapy, physicians should identify institutions whose therapists are willing to spend adequate hands-on time during one-on-one or small-group sessions while maintaining the greatest possible continuity of care with a single provider.
A recent surge in textbooks studies has revealed a closer link with neoliberalism and the way they construct neoliberal subjects. This paper uses Foucauldian governmentality as the conceptual lens to analyze the neoliberal discourses in EFL textbooks used in English Access Microscholarship (EAM)—one of the US‐aided global ELT programs in Pakistan. English language learners' views on course outcomes and textbooks were also examined. The study shows that among others, English as a neoliberal life skill, celebrity culture, consumerism, entrepreneurship, and individual and corporate social responsibility dominate textbooks. It is thus found that textbooks play an important role in neoliberalizing learners. Moreover, English language learners perceive English as a key to economic success. They also value consumerism, branding, and personal responsibility. In light of the study findings, we suggest a decolonial option, reflective activism, and post‐method pedagogy as possible alternatives at the micro‐, meso‐, and macro‐levels to resist the discourses of neoliberalism and colonial power patterns entrenched in a postcolonial society like Pakistan.
This study aims to investigate EFL teachers' perceptions on Computer Assisted Language Learning in English language classrooms. For the last 15 years, there has been great interest in researching teachers' perceptions, thinking and beliefs towards implementation of ICT in English language teaching classrooms. As teachers' perceptions shape and determine language teaching and learning practice. To investigate the problem, 47 in service teachers of Higher Secondary Schools were taken as participants, out of which there were 14 females and 33 males. A questionnaire was administered among the EFL teachers based on investigation of beliefs and perspectives of EFL teachers. Findings of the study suggest that use of online web chats and other connecting forums are practiced by EFL teachers to interact with the students. Furthermore, preparing lectures to use computers and getting help for material development is highly frequent.
Introduction Solriamfetol is a new daily dopamine and norepinephrine reuptake inhibitor indicated for improving daytime wakefulness in adults with obstructive sleep apnea (OSA) and narcolepsy. It was FDA-approved on 3/20/2019. In this report, we present a patient with refractory idiopathic hypersomnia (IHS) who benefitted from off-label use of solriamfetol at a private sleep center. Report of Case A 37-year-old non-obese female previously diagnosed with IHS vs narcolepsy, presented in 2015 with excessive daytime sleepiness since her mid-teens. She also had a history of periodic limb movement (PLM) and anxiety and trialed clonazepam, which caused daytime hangover effects. At her previous office, she began sodium oxybate but had psychiatric side effects, and was thus started on methylphenidate. Modafinil was added due to build-up of tolerance. Three separate polysomnographies (PSG) over 9 years revealed similar findings of mild snoring without OSA, PLM with variable arousals. Multiple sleep latency testing (MSLT) showed very rapid sleep onset <4 min and no sleep-onset REM periods. The patient never had cataplexy but occasional hypnogogic hallucinations and sleep paralysis. All studies to-date suggested IHS, less likely narcolepsy without cataplexy, and at her initial visit, the patient trialed armodafinil instead of modafinil, and methylphenidate was weaned down. When seen again in 2017, the patient reported persistent daytime sleepiness on methylphenidate and modafinil (PSG-MSLT showed sleep latencies ~3.5 min on 5/5 nap opportunities), without cataplexy. When seen 9/2019, patient continued to have daytime sleepiness and fatigue. She was then weaned off methylphenidate and modafinil, and started on solriamfetol. Since then, she has been doing well solely on solriamfetol 75mg BID. Conclusion Off-label use of solriamfetol for IHS has been demonstrated to be effective in a treatment-resistant patient at a private sleep center. More data and further discussion in support of its off-label use are warranted for this patient population.
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