Men’s Pelvic Health Content in Entry-Level Doctor of Physical Therapy Curricula: A Physical Therapy Clinician Perspective

Introducation Pelvic floor musculature is involved in sexual, bowel, and bladder function, organ support, breathing, and load transfer.1 Sixteen percent of males experience pelvic floor dysfunction (PFD).1 Therefore, it is important for physical therapists to adequately screen male patients to identify PFD either for proper treatment or referral to a men’s pelvic health (MPH) provider. The Academy of Pelvic Health (APH) offers Doctor of Physical Therapy (DPT) curricular guidelines for Women’s Health content, but to date has no published guidelines for MPH. Objective The purpose of this study was to gain clinician perspective to assist in the development of DPT curricular guidelines for MPH content. Participants Licensed physical therapists on the mailing list of the APH. Methods A mixed-methods survey was distributed via email newsletter. Question formats included: yes/no, multiple choice, select all that apply, 5-point Likert scale, and open- ended response(s). Questions regarding the incorporation of, and barriers to, inclusion of MPH content in DPT curricula were included. Descriptive statistics and frequencies were calculated using various functions in Microsoft Excel®. Qualitative data from free response questions were coded and categorized into themes using a grounded theory methodology. Results A total of 203 survey responses were received for quantitative and qualitative data analysis. Student physical therapists and physical therapy assistants were excluded from participation. Conclusion The majority of survey participants agreed that inclusion of MPH education in entry-level DPT curricula is important and that it would be best delivered through a pelvic health course within the curriculum. Clinical Relevance The data received through this survey may be used to assist in the development of MPH curricular guidelines. DPT programs should implement further MPH content to prepare students for proper screening and treatment or referral of patients with PFD. By doing so, patients will receive the necessary treatment more quickly and may experience improved outcomes

Men\u27s Pelvic Health: Exploration of Entry-Level DPT Curricular Content Based on a National Faculty Survey

Introduction The pelvis and its floor play an integral role in everyday quality of life for both women and men. Survey research on women’s health content in Doctor of Physical Therapy (DPT) programs has helped develop curricular structure for entry-level therapists. Characteristics of content presented on men’s pelvic health (MPH) in DPT programs is unknown. 2019: The Section on Women’s Health voted to change their name to the Academy of Pelvic Health to be all inclusive. Objective To examine current entry-level content on MPH in DPT programs, perceived barriers to content delivery, and to support future entry-level curricular development. Participants Program directors or faculty responsible for pelvic health content at CAPTE accredited DPT programs across the United States. Methods Online surveys sent to 239 DPT programs nationally Questions based on literature review and Boissonault’s research. (likert scale, choose all, open-ended) Quantitative and qualitative data regarding MPH content collected: opinions, hours taught, topics covered, barriers, demographics Results Response rate: 23 percent (55 programs) 60.0 percent strongly agree that MPH should be taught in entry-level DPT programs. 23.6 percent reported spending less than 1 hour teaching men’s pelvic health content. 63.3 percent reported “time” as the largest barrier. Qualitative themes: men’s pelvic health curriculum, barriers, plans for inclusion of men’s pelvic health content. Sub-themes: lack of time in DPT curricula, faculty knowledge to instruct, viewed as a specialty PT, lack of curricular guidelines. Conclusions Basic MPH perceived as entry-level by participants and should be included in DPT curriculum. Lumbo-pelvic musculoskeletal dysfunction is a key component to evidence based practice. Male pelvis is an integral part of musculoskeletal dysfunction and perceived as important for entry-level identification and referral. MPH content delivery is inconsistent across programs. Barriers identified include: time constraints, experienced faculty, clinical importance. Clinical Relevance Male pelvic musculoskeletal dysfunction treatment is an entry-level skill. MPH curricular content can improve clinical awareness of pelvic health options for male patients, leading to higher quality recognition and referral. Improvement of care provided by entry-level physical therapists

Defect assessment in offshore structures A procedure

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Handling data uncertainties in event tree analysis

Event tree analysis (ETA) is an established risk analysis technique to assess likelihood (in a probabilistic context) of an accident. The objective data available to estimate the likelihood is often missing (or sparse), and even if available, is subject to incompleteness (partial ignorance) and imprecision (vagueness). Without addressing incompleteness and imprecision in the available data, ETA and subsequent risk analysis give a false impression of precision and correctness that undermines the overall credibility of the process. This paper explores two approaches to address data uncertainties, namely, fuzzy sets and evidence theory, and compares the results with Monte Carlo simulations. A fuzzy-based approach is used for handling imprecision and subjectivity, whereas evidence theory is used for handling inconsistent, incomplete and conflicting data. Application of these approaches in ETA is demonstrated using the example of an LPG release near a processing facility