Digital Commons Network^™

Simulated Traffic Stops For Neurodiverse Drivers, Addie Wilson

Occupational Therapy Doctorate Capstone Posters

The goal of this capstone project was to create a simulated traffic stop event for neurodiverse drivers to decrease anxieties and promote positive interactions with local law enforcement. This project was completed under the ACOTE standards of project development and clinical skills, and in collaboration with the University of Kentucky Driving Rehabilitation Program and a Certified Driving Rehabilitation Specialist. Previous simulated traffic stops have been completed specifically for the ASD population and showed improvements in anxiety and understanding of traffic stops. Additionally, resources like the Blue Envelope Program have been implemented across the country to allow for interactions between autistic …

Occupational Therapy’S Role In Health, Wellness, And Community Engagement In Rural Texas, Maggie Hall

Occupational Therapy Doctorate Capstone Posters

This Applied Leadership Experience (ALE) and Doctoral Capstone was completed at Colston Physical Rehabilitation & Wellness Center in Kingsville, Texas. The primary ACOTE focus areas addressed were advocacy and education. This capstone aimed to explore community perspectives on health and wellness while identifying gaps in health knowledge and access to community resources and streamline acute care evaluations to minimize readmission rates.

A needs assessment was conducted through community health and wellness questionnaires, stakeholder collaboration, and review of local demographic and health data.  Kingsville, TX is a rural community with higher-than-average rates of poverty and obesity. Findings revealed a need for …

I Am God's Masterpiece- Inclusive Vacation Bible School For Adults With Disabilities, Chelsea Lee M. Beverly

Occupational Therapy Doctorate Capstone Posters

A SWOT analysis revealed a substantial need of local events for adults with IDD, therefore, the goal of this capstone project was to host an event promoting inclusivity in rural communities and offering opportunities for meaningful engagement in social participation and leisure activities in diverse populations. I specifically focused on the community impacts of this project, what the needs were for this area, and how this could benefit the community now and in the future. This event was held on June 6, 2026 from 10am-3pm. Participants were offered engagement opportunities through completing crafts, participating in worship, interactive Bible lessons, outdoor …

Improving Fall Prevention In Assisted Living Through Resident Engagement, Staff Education And Environmental Safety Initiatives, Sarah Emmons

Occupational Therapy Doctorate Capstone Posters

My doctoral capstone project and Applied Leadership Experience (ALE) were completed at Parkview Assisted Living in Danville, Kentucky. The project focused on the ACOTE areas of education, program development, clinical practice, and leadership, with the goal of improving resident safety and independence through evidence-based fall prevention initiatives. A needs assessment was completed through staff interviews, resident observations, collaboration with facility leadership, and a review of current literature. Findings identified opportunities to enhance staff education related to fall prevention, dementia-informed communication, purposeful rounding, and environmental safety. To address these needs, I developed and implemented Steady Steps, a weekly occupation-based balance group …

Expanding Access To Age-Typical Social Experiences For Children With Disabilities: Camp Quest, Megan Duffy

Occupational Therapy Doctorate Capstone Posters

The purpose of this capstone project was to expand access to social participation and community integration experiences for children with disabilities in order to address the gap in access when compared with age-level peers. In order to accomplish this, I developed and administered summer camp programming in partnership with Easterseals Crossroads (ESC), a nonprofit organization that serves individuals with disabilities across the lifespan. In collaboration with a multitude of clinicians, students, topic experts, and organizational members of ESC, I developed camp programming and staff training for Camp QUEST. Following program development, I coordinated and guided the counselors, clinicians, volunteers, students, …

Pre-Writing/Writing Program Development For Elementary School Children With An Emphasis On Sensory Integration, Kayla A. Bingham

Occupational Therapy Doctorate Capstone Posters

For my Capstone project and Applied Leadership Experience I focused on the importance of handwriting in elementary school children. So, the practice setting I chose to complete my project at was three elementary schools in Petoskey, Michigan. Also, my primary ACOTE focus area for this specific project was program development.

The goals of my capstone includes: Gathering present information (research, work samples, and classroom observation) of pre-writing skills, hand writing skills, and sensory implications of handwriting for students with ASD/SPD, analyze observation notes to target identified factors that are contributing to difficulties in handwriting in students, develop pre-writing skills interventions …

Understanding The Role Of Occupational Therapy In Hospice Care: A Needs Assessment And Advocacy Project, Keeton Thornsberry

Occupational Therapy Doctorate Capstone Posters

This advocacy and education capstone project used a needs assessment questionnaire and literature review to evaluate perceptions of occupational therapy in hospice care. Findings guided the development of educational resources aimed at increasing awareness, supporting appropriate referrals, and promoting occupational therapy as an integral member of the hospice interdisciplinary team.

The Development And Implementation Of A Music-Based Engagement Toolkit To Support Occupations In Long-Term Care Settings, Clay Rains

Occupational Therapy Doctorate Capstone Posters

This doctoral capstone project, completed as part of the Occupational Therapy Doctorate program, focused on developing, implementing, and evaluating an evidence-based Music-Based Engagement Toolkit to support occupational therapy practitioners working with older adults in long-term care. The Applied Leadership Experience (ALE) was completed at Morning Pointe Senior Living, serving residents with dementia, Parkinson's disease, mild cognitive impairment, and age-related functional decline. The project emphasized the ACOTE focus areas of clinical practice, program development, leadership, and evidence-based practice.

The primary objectives were to create an evidence-based toolkit, implement individualized music interventions during occupational therapy sessions, and evaluate their impact on occupational …

Accessibility And Inclusion Within Girl Scouts, Morgan N. Minter

Occupational Therapy Doctorate Capstone Posters

My 14-week doctoral capstone and Applied Leadership Experience (ALE) was completed with the Girl Scouts of Kentucky’s Wilderness Road Council. Focusing on Program Development and Advocacy, the project aimed to increase accessibility and inclusion through occupational therapy-informed resources and leader education. A literature review and needs assessment identified a need for practical accessibility resources within Girl Scout programming. Drawing on my experience as both a former Girl Scout and occupational therapy student, I recognized opportunities to better support neurodivergent youth and youth with disabilities through evidence-based, inclusive practices. Using evidence review, program observation, and collaboration, I completed an accessibility assessment …

First Responders' Best Friends: A Mental Health And Trauma-Informed Care Program For First Responders, Jordan Postiglione

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

First responders experience consistent exposure to traumatic events in their day-to-day profession, placing them at increased risk for mental health challenges, including stress, burnout, anxiety, depression, and post-traumatic stress disorder.  The First Responder’s Best Friends doctoral capstone quality improvement project aimed to increase mental health and well-being in first responders as well as to bring awareness to the importance of mental health and the impact of trauma.  The capstone project consisted of three different areas of focus: program development and implementation, advocacy, and clinical practice skills.  Program development and implementation was a 12-week mental health program at the Kingston Fire …

Balloon Aortic Valvuloplasty As A Bridge Therapy In Acute Valve Syndrome: A Narrative Review Of Evidence Gaps And Future Directions, Omar Saleh, Omar Jafar, Nicholas Valle, Shirish Yasa, Saleh Mostafa, Raymond L. Benza, Deepak R. Talreja, Benjamin D. Peterson, Matthew R. Summers

Department of Medicine Faculty Publications

Acute valve syndrome (AVS) represents a high-acuity, decompensated presentation of severe aortic stenosis (AS), often manifesting as acute heart failure, cardiogenic shock, or cardiac arrest. Transcatheter aortic valve replacement (TAVR) remains the only durable therapy for severe AS in patients with prohibitive surgical risk, yet AVS patients may be too unstable for standard preprocedural planning. Balloon aortic valvuloplasty (BAV) has re-emerged as a bridge strategy that can provide rapid hemodynamic stabilization and permit subsequent valve replacement. Registry analyses report lower mortality in emergent TAVR compared with BAV, but these comparisons are confounded by procedural indication and unmatched AS severity. Smaller …

Fall Prevention Interventions In Community-Dwelling Older People With Cognitive Impairment: A Systematic Review, Sumattana Glangkarn, Pelden Chejor, Rujira Nonsa-Ard, Kasama Wongprachum, Sirapat Khodseewong, Chaiwut Bourneow, Davina Porock

Research outputs 2022 to 2026

Introduction: Falls are a major health concern for older adults, particularly those with cognitive impairment. Many factors contribute to the risk of falls, making it a complex issue to manage. Aim: This systematic review aimed to identify and describe the implementation strategies used for fall prevention in community-dwelling older people with cognitive impairment. Eligibility criteria: The review included studies on fall prevention interventions for community-dwelling adults aged > 50 years with cognitive impairment. Eligible studies were primary research, including experimental, quasi-experimental, qualitative, and mixed methods designs, with detailed implementation strategies. Systematic reviews, protocols, editorials, opinions, commentaries, and conference papers were excluded. …

Neuromotor Function Following Lower-Limb Muscle Or Tendon Injury: Systematic Review And Meta-Analysis, Jack Andringa-Bate, Moath Almusallam, Molly Coventry, Myles C. Murphy, Ebonie Rio, Tania Pizzari

Research outputs 2022 to 2026

Purpose: Alterations in neuromotor function occur following lower-limb injuries and might be a factor in recurrent injury. We evaluated if adults with previous lower-limb muscle or tendon injury demonstrate differences in neuromotor function compared with uninjured or control limbs. Methods: A systematic search of health databases MEDLINE, EMBASE, CINAHL, and SPORTDiscus was conducted from inception until the end of April 2024. Studies evaluating neuromotor function of adults with a history of lower-limb muscle or tendon injury compared to an uninjured contralateral or control limb were included. Inverse variance, random effects meta-analyses were used to generate effect estimates for neuromotor outcomes. …

Effects Of Exercise Interventions On Motor Coordination In Children With Developmental Coordination Disorder (Dcd): A Systematic Review And Meta-Analysis, Changhui Peng, Jinrong He, Kai Xu, Xueping Wu, Dandan Wang, Lei Zhang

Research outputs 2022 to 2026

Background Exercise interventions are recognized as an established therapeutic approach for children with DCD. This review aims to quantify the effectiveness of exercise interventions and examine the influence of potential moderating factors on outcomes. Methods We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, and EBSCO from inception to November 1, 2025. All studies were rigorously screened based on predefined eligibility criteria. Risk of bias was assessed using ROB 2 and ROBINS-I. Effect sizes were calculated as Hedges’ g (g) and pooled under a random-effects model, and potential moderators were examined through subgroup and regression analyses. Results A …

Aerobic Exercise Increases Brain-Derived Neurotrophic Factor (Bdnf) In Sub-Acute Stroke: A Randomized Controlled Trial, Christopher P. Mackay, Suzanne Kuys, Mia Schaumberg, Li Ann Leow, Sandy Brauer

Research outputs 2022 to 2026

Background: Brain-derived neurotrophic factor (BDNF) is a key neurotrophin due to its role in neuron process outgrowth, plasticity, and neuronal survival. Aerobic exercise can induce BDNF release and may ultimately maximize post-stroke recovery. Objectives: This study aimed to determine if a program of moderate-to-high-intensity aerobic exercise increased concentrations of BDNF in subacute stroke survivors compared to usual care. Methods: A parallel-group, RCT was undertaken in people with subacute stroke undergoing rehabilitation. Participants were randomly allocated to usual care (control group) or usual care plus an 8-week program of moderate-high intensity treadmill walking (3 x 30 min sessions per week) (experimental …

Developing Consumer Consensus On Remote Assessment And Management Of Physical Function In Older Adults (Ramp): International Modified Delphi Process, Elsa Dent, Christopher Hurst, Jack Dalla Via, Jackson J. Fyfe, Paul Jansons, Eleanor J. Hayes, Gary Skinner, Marc Sim, Mylene Aubertin-Leheudre, Sabine Britting, Fanny Buckinx, Gavin Connolly, Lora Giangregorio, Jennifer R.A. Jones, Pauline Kelly, Robert Kob, Suzanne N. Morin, Girish Nandakumar, Lucas B.R. Orssatto, Maria Pearson, Daniel Pinto, Esmee M. Reijnierse, Catherine M. Said, Mohamed Salem, Vina P.S. Tan, Rosanna Tran

Research outputs 2022 to 2026

Background: Remote health care delivery, including the use of digital health interventions, is emerging as a tool for assessing and managing physical function, but its design and implementation often overlook the needs and preferences of older adult end users. Objective: The primary aim of this modified Delphi process was to develop consumer consensus on preferences for remote assessment and management of physical function in older adults. Methods: Research and consumer experts of the Remote Assessment and Management of Physical Function in Older Adults (RAMP) Working Group co-developed the Round 1 Delphi survey, which was advertised to consumers (adults aged ≥60 …

Do Combined Resistance And Aerobic Exercise Programs Cause An Interference Effect In Women With Breast Cancer? A Systematic Review And Network Meta-Analysis, Pedro Lopez, Anderson Rech, Maria Petropoulou, Caroline B. Silveira, Talita Molinari, Cindranne Torres Muller, Priscila Casara, Francesco Bettariga, Favil Singh, Régis Radaelli

Research outputs 2022 to 2026

Background: Exercise medicine has gained significant recognition owing to its demonstrated benefits throughout the breast cancer treatment continuum. While resistance exercise (RE) promotes improvements in lean mass and muscle strength, aerobic exercise (AE) enhances cardiorespiratory fitness, with several studies investigating both exercise modes in patients with breast cancer. However, because of an effect often referred to as interference effect, it is hypothesised that combining resistance and aerobic exercise (COMB) may compromise gains in lean mass and muscle strength and other outcomes in cancer populations. Objective: This study aims to investigate the presence of an interference effect from prescribing COMB compared …

Efficacy And Effectiveness Of Melatonin For The Management Of Musculoskeletal Pain: A Systematic Review And Meta-Analysis Of Placebo And Active Controlled Trials, Kangchao Wu, Ting Him Ho, Paula R. Beckenkamp, Michelle Hall, Hanzhi Zhang, James Puterflam, Karin Due Bruun, Jianhua Lin, Christopher Gordon, Ron Grunstein, Manuela L. Ferreira, Paulo Ferreira

Research outputs 2022 to 2026

Melatonin may provide benefits for managing musculoskeletal (MSK) pain, and this review evaluated its efficacy and effectiveness on pain intensity and sleep quality. We searched 6 databases from inception to April 2025 and included randomized controlled trials in people with chronic or postoperative MSK pain reporting pain or sleep outcomes. Comparators included placebo or active controls (eg, analgesics). Random-effects meta-analyses were performed using mean differences with 95% confidence intervals. Subgroup analyses were conducted by comparator type. Sensitivity analyses included only low-risk studies. Certainty of evidence was assessed using GRADE. Twenty-three studies (2028 participants) were included. For people with chronic MSK …

P38 Mapk Is Involved In Epigenetic Regulation Of Fibrotic Genes In Replication Induced Senescence In Lung Fibroblasts, Shan Zhu, Jennifer Q. Zhou, Kan Wang, Ming-Lei Guo, Yan Sanders

Department of Biomedical and Translational Sciences Faculty Publications

Fibroblast activation is essential for tissue repair following injury; however, prolonged activation drives pathological fibrosis. Idiopathic pulmonary fibrosis (IPF), a progressive and age-associated lung disease, is characterized by aberrant fibroblast activation, with increasing evidence implicating senescent and near-senescent fibroblasts in its pathogenesis. However, the underlying mechanisms remain poorly defined. In this study, we investigated whether histone modification is involved in TGF-β1 treated lung fibroblasts and contributes to the fibrotic phenotype. Human IMR90 lung fibroblasts at low and high population doubling levels (LPDL and HPDL), as well as primary IPF fibroblasts, were used in this study. In response to TGF-β1, both …

Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Incidentally Diagnosed During Post-Stroke Rehabilitation: A Case Report, Ching-Yun Liao, Chung-Hao Chao, Chih-Chin Hsu

Rehabilitation Practice and Science

背景

髓鞘少突膠質細胞糖蛋白抗體相關疾病（MOGAD）是一種罕見的自體免疫發炎性疾病，主要涉及中樞神經系統（CNS），其主要特徵是視神經、腦部和脊髓脫髓鞘。我們報告一例最初疑似復發性中風的病例，該病例在住院中風復健期間最終確診為MOGAD。

病例概要

49歲女性，左側大腦半球梗塞，在中風後復健期間出現多次右側肢體肌力下降伴隨失語症。這些神經功能波動偏離了典型卒中的預期復健軌跡。卒中發作兩個月後行腦部磁振造影（MRI）檢查，結果顯示右側內囊後肢、腦橋及C1脊髓出現多處新發病灶。後續血清學檢查顯示抗髓鞘少突膠質細胞糖蛋白（MOG）IgG抗體陽性，而水通道蛋白4（AQP4）抗體陰性，確診為MOGAD。患者接受了甲潑尼龍治療及充分的復健治療，追蹤期間肌力顯著改善，未見脫髓鞘病灶復發。

結論

本案例凸顯了復健科醫師在早期發現類似中風的神經發炎性疾病的關鍵作用。復健科醫師處於獨特的領先地位，能夠透過持續的功能監測識別「危險信號」；任何偏離預期復健路徑或無法解釋的神經功能波動都應促使醫生進行進一步檢查。早期識別此類非典型模式，並及時進行免疫治療和多學科康復，可以預防永久性功能衰退，並優化長期預後。

Glucagon-Like Peptide-1-Based Therapies And The Intersection Of Metabolic And Skin Disease, Ana Ormaza-Vera, Clinton W. Enos

Department Dermatology Faculty Publications

[Introduction] To the Editor: The development of the glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) and the dual glucose-dependent insulinotropic polypeptide/GLP-1RAs is revolutionizing the management of metabolic disease. Perhaps most impressive is that their clinical significance extends far beyond their approved indications and touches seemingly every organ system, even the skin.

The Effect Of In-Game Cervical Exercises On Shoulder Internal Rotation Range Of Motion And External Rotator Strength In Baseball Pitchers, Vincent Ceasrine, Christine Ferraro, Jason K. Grimes

Physical Therapy Faculty Publications

Background

Consensus is lacking regarding the underlying cause of two prevalent risk factors for shoulder and elbow pain in overhead throwing athletes: loss of shoulder internal rotation (IR) range of motion (ROM) and strength of the external rotators (ER). Consideration of cervical spine contribution may have important implications for rehabilitation and coaching of overhead throwers.

Purpose

The purpose of this study was to investigate the effect of performing active cervical retraction and retraction with extension exercises between innings of pitching a simulated game on shoulder IR ROM and ER strength following completion of the game.

Study Design

Randomized controlled study …

Beyond Weight Loss: Effects Of Trx Suspension Training Combined With Caloric Restriction On Thyroid Function And Mental Well-Being In Obese Hypothyroid Women, Siavash Naddafha, Christopher Taber

Physical Therapy Faculty Publications

Background

The rate of metabolism decreases in hypothyroid patients; hypothyroidism is associated with body mass increases; due to this and other factors, depression, anxiety, and stress increase, which, alongside the disease state and psychological problems, causes the quality of life to suffer.

Objectives

The purpose of this research is to investigate the effect of caloric restriction along with TRX exercise on body mass, thyroid hormones, and psychological measures in obese and overweight women with hypothyroidism.

Methods

34 women aged 18–50 with hypothyroidism and a body mass index above 25 participated in this study. They were divided into three groups: a …

Unusual Case Of Pelvic Fracture Urethral Distraction Defect, Varuni Pragya, Madhukesh Rudramurthy, Siddalinga Murthy G

Digital Journal of Clinical Medicine

INTRODUCTION

Urinary bladder ruptures are an uncommon injury, occurring in less than 1% of all blunt abdominal trauma. Extraperitoneal bladder ruptures are generally associated with pelvic fractures and usually managed nonoperatively but open surgery is required when these injuries are associated with additional trauma to structures like prostate and urethra.

CASE PRESENTATION

We report our experience with a 32-year-old male who suffered a head on collision with a four-wheeler while driving a two-wheeler in a road traffic accident. He presented to the hospital with abdominal and pelvic pain, difficulty in passing urine and swelling of the scrotum. His X Ray …

Use Of Transcranial Magnetic Stimulation As An Assessment Of Corticospinal Excitability In Individuals With Persistent Postural Perceptual Dizziness, Elizabeth Cornforth

Theses and Dissertations

Persistent postural-perceptual dizziness (PPPD) is a common, disabling, chronic vestibular disorder whereby individuals experience symptoms of non-vertiginous dizziness, unsteadiness, and sway or rocking that are present most hours of the day, most days of the week. Individuals with PPPD have been noted to have an increased burden of dizziness and reduced quality of life compared to other dizziness diagnoses. The cause of PPPD is not well understood which can lead to years of diagnostic testing, failed therapies, and poor symptom management. It is important to understand PPPD pathophysiology so that optimal treatment interventions can be developed for this disorder to …

Integrating Hippotherapy Into Interprofessional Aphasia Rehabilitation: A Feasibility Pilot Study, Bethany H. Wenger

Graduate Student Theses, Dissertations, & Professional Papers

Background and Significance: Stroke remains a leading cause of disability in the United States, affecting over 2.5 million individuals annually. Stroke-related motor and communication deficits often co-occur, increasing challenges for recovery, increasing social isolation, depression, and dependency. Hippotherapy has emerged as a novel treatment approach for neurorehabilitation; however, its application within interprofessional models for individuals with stroke-related motor and communication impairments remains underexplored. This study examines the feasibility, fidelity, and acceptability of an interprofessional intervention using hippotherapy for adults with chronic post-stroke aphasia, the purpose of which is to generate methodological guidance for future controlled trials.

Methods: A non-randomized, single-group …

Transitioning To Life After Sport: Empowering Former College Varsity Athletes To Live More Healthfully, Linda Piacentine, Taylor L. Wolf, Jacob J. Capin

Physical Therapy Faculty Research and Publications

Introduction: 

The transition out of competitive sport comes with a range of psychosocial challenges for athletes, particularly when retirement is involuntary (e.g., due to injury). Little is known about the health of former athletes who often manage prior injuries and changing biopsychosocial factors.

Purpose: 

Identify the unique experiences of varsity athletes during college and as they transition to life after college sports and determine the facilitators, barriers, and needs of college varsity athletes to engage in a physically active and healthy lifestyle after competitive sport retirement.

Methods: 

Thirty former college varsity athletes (15F, 15M; mean age 23 ± 1 yrs; …

Le Parcours Des Travailleurs Immigrants Blessés Et Son Incidence Sur L’Alliance Thérapeutique : Une Étude De Cas Longitudinale En Contexte De Réadaptation Au Travail Au Québec, Maude Arsenault, Jessica Dubé, Daniel Côté

Études primaires

Cette étude explore l’incidence du parcours prélésionnel des travailleuses et travailleurs immigrants (TI) blessés sur l’alliance thérapeutique (AT) en réadaptation au travail. À partir d’une ethnographie longitudinale menée dans une clinique québécoise, sept trajectoires ont été analysées selon leurs dimensions migratoires, socioprofessionnelles et linguistiques. Les résultats montrent que le déclassement professionnel, la précarité de l’emploi, les barrières linguistiques et les expériences de racisme fragilisent la construction du lien de confiance et la définition partagée des objectifs de retour au travail. Lorsque l’emploi prélésionnel est perçu comme transitoire ou inadéquat, l’obligation institutionnelle d’y retourner crée une rupture symbolique qui entre en …

Entry Requirements As Predictors Of Early Academic Success And Student Performance In Undergraduate Occupational Therapy Education, Eileen Du Plooy, Daleen Casteleijn, Denise Franzsen, Gopika Ramkilawon

Journal of Occupational Therapy Education

The selection process for health sciences programs such as occupational therapy is complex, involving a combination of academic and non-academic selection criteria as entry requirements. This study aimed to investigate the predictive value of entry requirement variables on academic performance during the first and second year of an undergraduate occupational therapy program in South Africa. A quantitative, cross-sectional design was utilized, and the sample included 129 first- and second- year occupational therapy students. Data was collected retrospectively through educational data mining of university records and institutional dashboards. The variables analyzed included National Senior Certificate Grade12 (NSC12) grades (Mathematics, Life Sciences, …

A Scholarly Exploration Of Teaching Strategies For Learning About Pediatric Sleep, Laura J. Carpenter, Amanda M. Buono

Journal of Occupational Therapy Education

The occupation of sleep is an area of occupational therapy practice for which many practitioners report a lack of confidence and/or knowledge to properly address. The current study addresses this concern by studying the effects of a learning module on students’ confidence and knowledge to address pediatric sleep. The study used a pre-test, post-test non-experimental design and collected survey responses from 48 entry-level occupational therapy students in three different programs. The lecture portion of the module included content about both assessing and intervening, while the case study emphasized intervention-planning only. Results indicated significant gains in knowledge overall (z = …