Physical Therapy Faculty, Clinical Instructors, and Employer Expectations for New DPT Graduates in the Acute Care Setting

Purpose: The purpose of this study was to determine how the expectations of new graduate physical therapists held by physical therapy faculty (PTF), clinical instructors (CIs), and employers (PTE) compared in the acute care (AC) setting, and determine if graduates are meeting the entry-level expectations of the three stakeholders in acute care. Methods: This mixed method study used Survey Monkey to gather data from participants. Faculty, CIs and PTEs were recruited from CAPTE accredited DPT programs. The current survey used the top 25 characteristics developed by the Delphi study by Gazsi to determine level of agreement of importance among the three participant groups for entry-level performance in acute care. Results: The study had 399 participants. Of the 25 characteristics, 7 were ranked most important by more than 75% of all participant groups combined. Two characteristics – safe and reliable – were consistently ranked highest by all 3 participant groups. Four significant differences among groups were for the characteristics of recognition of red flags, critical thinker, problem solver, and team player. A majority (82.4%) reported that new graduates were meeting expectations. Conclusions: Although the majority of participants reported that new graduates were meeting expectations, the implication of differences in expectations among some of the participants is that these differences should be considered in curricula development. Key words: DPT education, employer expectations, DPT entry-level expectation

Cost Outcomes of Physical Therapist Providers Compared to Primary Care Providers in the Treatment of Musculoskeletal Patients in a Military Treatment Facility: A Retrospective Chart Review”

Purpose: The purpose of this study was to compare the cost of physical therapist (PT) management of patients with musculoskeletal (MSK) disorders to management by traditional primary care managers (PCMs); medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods: This is a retrospective study of electronic medical records using an exploratory, non-experimental, cross-sectional, and quantitative design method. The records of patients with MSK disorders were assessed at an Air Force military medical clinic for 18 months from January 2016 through June 2017. Results: PT management of MSK patients resulted in a significantly lower rate of imaging studies, NSAIDS, and cost of care when compared to MDs, DOs, PAs, or ARNPs. Patients with MSK disorders managed by PTs had no significant difference in return-to-work rate when compared to MDs, DOs, PAs, or ARNPs. Conclusions:The military model of physical therapy direct access care has been shown to be cost effective when compared to care provided by traditional primary care managers

The Impact of Welfare Reform on Rural Alabamians

This exploratory study compared Alabama welfare leavers from two types of rural counties with those from two types of metropolitan counties. It was based on telephone interviews conducted during the summer of 1999 with a random sample of 4 16 people who had left TANF between July and November 1998. There were no statistically significant differences among leavers by county type in the likelihood they were employed and, if employed, in the rate of pay, number of hours worked weekly, or the types of benefits available at the job. Although many respondents no longer received benefits they had received while on TANF (Medicaid, Food Stamps, help receiving child support), county type was unrelated to losing such benefits. There was some suggestion that those residing in persistent poverty counties might have a harder time reaching self sufficiency that those residing in other rural counties. These results must be interpreted with caution due to the exploratory nature ofthe study and the relatively positive economic climate existing when the data were gathered

Ovarian stimulation and oocyte cryopreservation in females and transgender males aged 18 years or less: a systematic review

BackgroundFertility preservation is an important healthcare focus in the paediatric and adolescent population when gonadotoxic treatments are required. Ovarian stimulation (OS) resulting in oocyte cryopreservation is a well-established fertility preservation option in the adult population. It’s utility, however, is little known in young patients. The purpose of this review was to synthesise the available literature on OS in patients ≤18 years old, to identify gaps in current research and provide suggestions for future research directions.MethodsUsing PRISMA guidelines, a systematic review of the literature was performed for all relevant full-text articles published in English in Medline, Embase, the Cochrane Library and Google Scholar databases. The search strategy used a combination of subject headings and generic terms related to the study topic and population. Two reviewers independently screened studies for eligibility, extracted data and assessed the risk of bias. Characteristics of the studies, objectives and key findings were extracted and summarised in a narrative synthesis.ResultsDatabase search and manual review identified 922 studies, 899 were eliminated based on defined exclusion criteria. Twenty-three studies were included and comprised 468 participants aged ≤18 years who underwent OS (median 15.2, range 7-18 years old). Only three patients were premenarchal, and four patients were on treatment to suppress puberty. Patients had OS for a broad range of indications including oncology treatment, transgender care and Turner syndrome. A total of 488 cycles of OS were completed, with all but 18 of these cycles (96.3%) successfully resulting in cryopreserved mature oocytes (median 10 oocytes, range 0-35). Fifty-three cycles (9.8%) were cancelled. Complications were rare (<1%). One pregnancy was reported from a female who had OS aged 17 years old.ConclusionThis systematic review demonstrates that OS and oocyte cryopreservation is achievable in young females however there are only a few cases in the literature describing OS in premenarcheal children or those who have suppressed puberty. There is little proof that OS can lead to pregnancy in adolescents, and no proof that this can be achieved in premenarchal girls. Therefore it should be regarded as an innovative procedure for adolescents and experimental for premenarcheal girls.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=265705, identifier CRD42021265705

Lymphocyte Subpopulation Number and Function in Infancy

Normal values for percentages of lymphocyte subpopulations and functional responses to mitogen stimulation in infancy are not well established. In the present study, lymphocyte subpopulations were examined in umbilical cord blood samples and in peripheral blood samples drawn before 7 and 24 months of age (mean age 10.4 months) from a healthy population of infants born in Tucson, Arizona. Results indicate significant increases occurred from birth to later infancy in the percentages of total T cells (CD3), T-cell subsets (CD4, CD8) and B cells (CD20). The CD4/CD8 ratio and the functional responses to ConA and PWM mitogens significantly decreased from birth to later infancy. PHA responsiveness did not show a significant change. Results from cross-sectional analyses (n=271) were supported in a smaller longitudinal subset (n=37). There were no detectable ethnic- or gender-related differences in cord blood or samples obtained in later infancy. The normal values established in this study will be useful in studies of immune-system maturation and in the clinical evaluation of newborns, infants, and toddlers suspected of either acquired or congenital immune-deficiency states

The health of women and girls determines the health and well-being of our modern world: A White Paper From the International Council on Women's Health Issues

The International Council on Women's Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women's health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl's health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally

Performing thinking in action: the meletē of live coding

Within this article, live coding is conceived as a meletē, an Ancient Greek term used to describe a meditative thought experiment or exercise in thought, especially understood as a preparatory practice supporting other forms of critical — even ethical — action. Underpinned by the principle of performing its thinking through 'showing the screen', live coding involves 'making visible' the process of its own unfolding through the public sharing of live decision-making within improvisatory performance practice. Live coding can also be conceived as the performing of 'thinking-in-action', a live and embodied navigation of various critical thresholds, affordances and restraints, where its thinking-knowing cannot be easily transmitted nor is it strictly a latent knowledge or 'know how' activated through action. Live coding involves the live negotiation between receptivity and spontaneity, between the embodied and intuitive, between an immersive flow experience and split-attention, between human and machine, the known and not yet known. Moreover, in performing 'thinking-in-action', live coding emerges as an experimental site for reflecting on different perceptions and possibilities of temporal experience within live performance: for attending to the threshold between the live and mediated, between present and future-present, proposing even a quality of atemporality or aliveness

An economic model to establish the costs associated with routes to presentation for patients with multiple myeloma in the UK

Objectives Patients with myeloma often face significant diagnostic delay, with up to one-third of UK patients diagnosed after an emergency presentation (EP). Compared with other routes, patients presenting as an emergency have more advanced disease, increased complications, and poorer prognosis. Methods An economic model was developed using a decision-tree framework and lifetime time horizon to estimate costs related to different presentation routes (EP, general practitioner [GP] 2-week wait, GP urgent, GP routine, and consultant to consultant) for UK patients diagnosed as having myeloma. After diagnosis, patients received one of 3 first-line management options (observation, active treatment, or end-of-life care). Inputs were derived from UK health technology assessments and targeted literature reviews, or based on authors’ clinical experience where data were unavailable. Active treatment, complication, and end-of-life care costs were included. Results The average per-patient cost of treating myeloma (across all routes) was estimated at £146 261. The average per-patient cost associated with EP (£152 677) was the highest; differences were minimal compared with GP 2-week wait (£149 631) and consultant to consultant (£147 237). GP urgent (£140 025) and GP routine (£130 212) were associated with marginally lower costs. Complication (£42 252) and end-of-life care (£11 273) costs were numerically higher for EP than other routes (£25 021-£38 170 and £9772-£10 458, respectively). Conclusions An economic benefit may be associated with earlier diagnosis, gained via reduced complication and end-of-life care costs. Strategies to expedite myeloma diagnosis and minimize EPs have the potential to improve patient outcomes and may result in long-term savings that could offset any upfront costs associated with their implementation

Meta-analysis of genome-wide association studies of asthma in ethnically diverse North American populations.

Asthma is a common disease with a complex risk architecture including both genetic and environmental factors. We performed a meta-analysis of North American genome-wide association studies of asthma in 5,416 individuals with asthma (cases) including individuals of European American, African American or African Caribbean, and Latino ancestry, with replication in an additional 12,649 individuals from the same ethnic groups. We identified five susceptibility loci. Four were at previously reported loci on 17q21, near IL1RL1, TSLP and IL33, but we report for the first time, to our knowledge, that these loci are associated with asthma risk in three ethnic groups. In addition, we identified a new asthma susceptibility locus at PYHIN1, with the association being specific to individuals of African descent (P = 3.9 × 10(-9)). These results suggest that some asthma susceptibility loci are robust to differences in ancestry when sufficiently large samples sizes are investigated, and that ancestry-specific associations also contribute to the complex genetic architecture of asthma