Functional status measures for the COPD patient : a practical categorization

The objective of this study is to review available functional status measures (FSMs) validated for use in the chronic obstructive pulmonary disease (COPD) population and categorizing the measures by their commonalities to formulate a framework that supports clinicians in the selection and application of FSMs. A literature review identifying valid and reliable measures of functional status for people with COPD was undertaken. Measures were thematically analyzed and categorized to develop a framework for clinical application. A variety of measures of activity levels exist, with 35 included in this review. Thematic categorization identified five categories of measures: daily activity, impact, surrogate, performance-based, and disability-based measures. The vast variety of FSMs available for clinicians to apply with people who have COPD may be overwhelming, and selection must be thoughtfully based on the nature of the population being studied/evaluated, and aims of evaluation being conducted, not simply as a standard measure used at the institution. Psychometric testing is a critical feature to a strong instrument and issues of reliability, validity, and responsiveness need to be understood prior to measurement use. Contextual nature of measures such as language used and activities measured is also important. A categorical framework to support clinicians in the selection and application of FSMs has been presented in this article

An Audible Demonstration Of The Speed Of Sound In Bubbly Liquids

The speed of sound in a bubbly liquid is strongly dependent upon the volume fraction of the gas phase, the bubble size distribution, and the frequency of the acoustic excitation. At sufficiently low frequencies, the speed of sound depends primarily on the gas volume fraction. This effect can be audibly demonstrated using a one-dimensional acoustic waveguide, in which the flow rate of air bubbles injected into a water-filled tube is varied by the user. The normal modes of the waveguide are excited by the sound of the bubbles being injected into the tube. As the flow rate is varied, the speed of sound varies as well, and hence, the resonance frequencies shift. This can be clearly heard through the use of an amplified hydrophone and the user can create aesthetically pleasing and even musical sounds. In addition, the apparatus can be used to verify a simple mathematical model known as Wood's equation that relates the speed of sound of a bubbly liquid to its void fraction. (c) 2008 American Association of Physics Teachers.Mechanical Engineerin

A molecular salt of tricyanomethanide anion and a N,N9- dianisylphenazinium dication: cooperative affects of methoxy…methoxy and CMN…N+ intermolecular contacts

A molecular salt of tricyanomethanide anion and a N,N9- dianisylphenazinium dication forms extended supramolecular assemblies that consist of unusual methoxy…methoxy and CMN…N+ intermolecular contacts

"Being Absorbed in That Environment…It’s Just So Beneficial” – The Experiences of Physiotherapy Students in a Situated Learning Pilot Study

In this article, we aim to add to the existing literature on practice-based education. First, we will present a form of situated learning, which involved piloting a new teaching and learning relationship between the university and healthcare setting. Second, we will examine how students made sense of this perspective of practice. Using a phenomenologically oriented approach, this pilot study explored the experiences of entry-level physiotherapy students learning in a classroom environment, facilitated by clinicians, and located on a healthcare partner’s site. Twenty students completed two concurrent, theoretically oriented subjects that did not involve traditional clinical practicum experience. Two individual semi-structured interviews were conducted with students. Data was thematically analysed using an inductive approach. Three inter-related themes emerged. First, meaning-making is enhanced by the relevance and authenticity afforded by immersion in a practice-oriented classroom environment where clinicians facilitate learning. Second, learning from those ‘in practice’ challenges students’ professional and academic accountability. Finally, new educational infrastructures influenced students’ agency in unanticipated ways. This work highlights that students valued contextual learning. While meaning-making was enhanced by the development of key new relationships with others and the environment, these relationships also influenced student agency. Recommendations for health professional curricula are discussed, and include: capitalising on learning with peers, bringing the hidden curriculum into view and creating opportunities for students to navigate uncertainty and change

Which learning activities enhance physical therapist practice? Part 2: Systematic review of qualitative studies and thematic synthesis

Objective. Post-professional physical therapy expertise requires career-long participation in learning activities. Understanding physical therapists’ lived experience of learning activities provides novel insight into how best to enhance physical therapist practice from the perspective of the learner. The purpose of this study was to explore qualified physical therapists’ experiences, beliefs, and perspectives with regard to learning activities and professional development. Methods. Eight databases were searched for studies published from inception through December 2018. Study selection included mixed-methods and qualitative studies exploring physical therapists’ experiences, perspectives, beliefs and attitudes. Thematic synthesis was performed, and the GRADE-Confidence in the Evidence from Reviews of Qualitative research (CERQual) was used to assess the level of confidence in the findings. Forty-one studies with 719 participants were included. Results. The key findings include physical therapists’ perceptions that worthwhile post professional learning requires more than attendance at professional development courses. Physical therapists perceived that worthwhile learning requires connection with others and being “taken out of ones’ comfort zone.” Sufficient time and accessible, trustworthy resources were also valued. Conclusions. Moderate- to low-level evidence suggests that the choice of professional development activities and education design for qualified physical therapists should consider the inclusion of connected activities, activities that take participants out of comfort zones, time to practice, and trustworthy resources that are easily accessible. Future research should evaluate the effectiveness of learning activities encompassing these factors, prioritizing those that minimize the barriers of time and distance. Impact. This study adds to the profession’s understanding of physical therapists’ lived experience of learning activities, providing novel insight into how best to enhance physical therapist practice from the perspective of the learner

Which learning activities enhance physical therapist practice? Part 1: Systematic review and meta-analysis of quantitative studies

Objective. Following graduation from professional education, the development of clinical expertise requires career-long participation in learning activities. The purpose of study was to evaluate which learning activities enhanced physical therapist practice. Methods. Eight databases were searched for studies published from inception through December 2018. Articles reporting quantitative data evaluating the effectiveness of learning activities completed by qualified physical therapists were included. Study characteristics and results were extracted from the 26 randomized controlled trials that met the inclusion criteria. Clinician (knowledge, affective attributes, and behavior) and patient related outcomes were extracted. Results: There was limited evidence that professional development courses improved physical therapist knowledge. There was low-level evidence that peer assessment and feedback was more effective than case discussion at improving knowledge (SMD = 0.35, 95%CI = 0.09-0.62). Results were inconsistent for the effect of learning activities on affective attributes. Courses with active learning components appeared more effective at changing physical therapist behavior. The completion of courses by physical therapists did not improve patient outcomes; however, the addition of a mentored patient interaction appeared impactful. Conclusions. Current evidence suggests active approaches, such as peer assessment and mentored patient interactions, should be used when designing learning activities for physical therapists. Further high-quality research focused on evaluating the impact of active learning interventions on physical therapist practice and patient outcomes is now needed. Impact. This study is a first step in determining which learning activities enhance clinical expertise and practice would enable the physical therapy profession to make informed decisions about the allocation of professional development resources

Using Telemedicine to Provide Education for the Symptomatic Patient with Chronic Respiratory Disease

Technology-enabled learning, using computers, smartphones, and tablets, to educate patients on their respiratory disease and management has grown over the last decade. This shift has been accelerated by the global COVID-19 pandemic and the need to socially distance for public health. Thirteen recently published papers examined experience, knowledge, skills and attitude acquisition, behaviour change, and impact on health outcomes of patient education using technology (websites and mobile device applications) for people with chronic respiratory disease. Technology-enabled patient education that includes relevant information, with activities that encourage the patient to interact with the digital platform, appears to lead to better patient experience and may increase learning and behaviour change with improved quality of life. Developing online relationships with healthcare providers, lower digital capabilities, and poor access to a computer/smartphone/tablet, appear to be barriers that need to be overcome for equity in access. Maintaining the principles of quality educational design, ensuring interactive experiences for patient involvement in the educational activities, patient co-design, healthcare professionals connecting with experts in the field of technology-enabled learning for development of education models, and ongoing research lead to the best patient outcomes in technology-enabled education for respiratory disease