Teaching Social Determinants of Health in Physical Therapist Professional Education Programs: Exploring Curricular Approaches and Examining an Assessment Tool

There is a growing emphasis and need for physical therapists (PTs) to serve not only as clinicians but also as advocates to pursue health equity. Clinical practice for preventing and rehabilitating injuries and promoting physical activity will not eliminate health disparities resulting from the social determinants of health (SDH). Leaders in the field of physical therapy have charged physical therapist professional education programs to teach future PTs to address SDH, however, as of August 2023, the Standards and Required Elements for Accreditation of Physical Therapist Education Programs does not specifically require curricular content regarding SDH. The purposes of this dissertation were to explore what is known about teaching SDH in physical therapist professional education programs and examine an assessment tool that programs could use to evaluate student outcomes regarding SDH training. A scoping review of 91 articles describing how SDH is taught in health professional training programs in the United States revealed the only published articles addressing physical therapy were through interprofessional education (IPE). The review demonstrated variability in content, educational methods, assessment methods, and curricular logistics across health professional training programs. Consensual qualitative research methodology was used to explore the phenomenon of teaching SDH content as experienced by core faculty in physical therapist professional education programs. Five themes and associated categories emerged regarding the 14 faculty members’ educational approaches, preparedness, and resources for incorporating SDH into curricula at their respective programs. Finally, pilot testing of the Physical Therapy Social Determinants of Health Scale (PTSDHS) was conducted to assess structural validity and internal consistency of the tool. Exploratory factor analysis suggested a 4-factor model of a 27-item instrument, with 3 of the factors having acceptable internal consistency as subscales. Findings suggest that faculty must look to other health professional training programs to determine how to incorporate SDH content into a physical therapist professional education program’s curriculum and will need to decide what topics and educational approaches are most appropriate for their program and context. Faculty already teaching this content should pursue dissemination to share knowledge and resources. Further development of the PT-SDHS is warranted to provide a robust, validated tool

Addressing a Blind Spot: Altruistic Fear and Religious Bias Motivated Victimization

Fear of victimization is different than actual victimization but has real consequences for individuals’ behaviors and attitudes. Research on fear of victimization in the United States has typically emphasized individuals’ own fears of experiencing violent, sexual, and property crimes. Yet, some studies suggest that fear of crime for other people whose safety one values – significant others, friends, and children – or altruistic fear is more common and often more intense than one’s personal fear of victimization. While some literature exists on the prevalence of altruistic fear in American households, little is known about altruistic fears specifically rooted in the fear of victimization based on a close family member’s or friend’s religious identity. Additionally, some studies suggest that there is a gendered aspect to altruistic fear, where men and women worry and express their fear for loved ones differently. It is likely that these gendered differences manifest in different ways depending on religious tradition. This paper aims to extend the literature on altruistic fear by applying this phenomenon to hate crime victimization, more specifically the fear of victimization based on religious identity

Experimental Investigations of Convective Turbulence in Planetary Cores

The magnetic fields of planets and other bodies are created and sustained due to the turbulent motions of an internal fluid layer, a process known as dynamo action. Forward models are required to characterize the dynamics of rotating convective turbulence driving dynamo action due to the inability to obtain direct measurements of the internal fluid layers of planetary bodies. The characteristic flow velocities and length scales of dynamo systems remain poorly constrained due to the difficulty of modeling realistic planetary core conditions. Thus, the goal of this dissertation is to explore these key properties of core-style convection. To do so, I have conducted novel experiments aimed to better quantify the features of quasi- geostrophic turbulence using the UCLA large-scale rotating convection device, ‘NoMag’.I have completed a systematic study to simultaneously measure the heat transfer and bulk velocities of different rotating convective regimes at some of the most extreme laboratory conditions possible to date. The study of heat transfer is employed in most forward models of core-style convection. In laboratory experiments in particular, due to the relative difficulty of collecting velocity measurements, those of heat transfer alone are assessed, the dynamics of which are assumed to describe the the bulk velocity dynamics of the system. On the contrary, I utilize laser doppler velocimetry to obtain measurements of bulk velocities concurrently with the collection of temperature measurements for the characterization of system heat transfer. I find that heat transfer behavior is consistent with the results of past studies and is largely controlled by boundary layer dynamics. I further find that velocity behaviors do not directly coincide with heat transfer behaviors in the parameter space studied. Instead, I show that a dynamical flow regime of quasi-geostrophic turbulence relevant to core flows is robustly reached, suggesting that it is possible to access realistic bulk dynamics in models that remain far from planetary core conditions.Using the results of this study, I estimate the characteristic length scales of the flows of each experiment. These estimates from my data are compared with length scale estimates of numerous numerical models of planetary core convection. I conclude from this meta-analysis of forwards models that all evidence to date suggests that the theorized characteristic length scales of planetary dynamo systems co-scale with one another and are thus non-separable.In two other studies that comprise the remainder of this dissertation, I further examine the applicability of laboratory models towards planetary settings. An experimental study on the influence of centrifugal buoyancy on rotating convection in water and in liquid metal was completed, where results agree with the recent numerical work of Horn and Aurnou (2018). It is found that the transition from Coriolis to centrifugally dominated convection depends on the strength of the centrifugal buoyancy relative to the gravitational buoyancy and the geometry of the cylinder in which experiments are conducted. These results are useful to ensure that the regime of rotating convection explored in a given experiment is relevant to planetary core flows, i.e. not centrifugally dominated. Separately, I conducted a series of spin up experiments with well-established theory to calibrate the NoMag apparatus and its measuring components. Further, the results from spin up experiments conducted with rough boundaries might have geophysical implications for the possible viscous coupling at Earth’s core mantle boundary, as well as turbulent mixing in the global ocean.The results of the studies presented in this dissertation clarify the relevance of long theorized and poorly tested dynamic length and velocity scalings of planetary core flows. Flows that are quasi-geostrophically turbulent are robustly observed in the laboratory data collected in this dissertation. The need for next generation models of planetary core flows is motivated by the results of the work herein. In particular, studies in which the characteristic length scales of core-style flows are directly quantified will undoubtedly enhance ourunderstanding of the multi-scale turbulent physics driving planetary dynamo systems

Addressing the Enduring Primary Care Physician Shortage in The United States: The Direct and Indirect Effects of Gender on the Medical Specialty Decision-Making Process

Background: There has been an enduring primary care (PC) physician shortage in the United States (U.S.) for decades, which is projected to worsen. With women entering PC at significantly higher rates than men, the aim of this study was to explore various pathways through which gender may affect the medical specialty decision-making process. Methods: Using data from the National Survey of Attitudes and Choices in Medical Education and Training (ACMET) II on a sample of 492 medical residents, this study employed structural equation modeling (SEM) to explore how gender shaped residents’ preferences for future practice and their perceptions of PC, and how their experiences with faculty affected the medical specialty decision-making process. Results: As expected, women were significantly more likely than men to report choosing PC. This study also found that there were several indirect pathways through which gender affects specialty choice, including through negative perceptions about PC and the time spent with PC faculty in medical school. Conclusion: Given the multiple pathways through which gender affects the medical specialty decision-making process, this study highlights a need for gender-specific interventions when addressing the enduring PC physician shortage in the U.S. Specifically, the results of this study suggest that increasing the time that male medical students spend in PC through structural changes in medical education might mitigate negative perceptions about PC and encourage males to enter PC at higher rates. Future research should assess the effectiveness of such gender-specific interventions

P3_8 Narnia and the Theory of Special Relativity

We investigated the velocities Narnia would have to be moving at relative to Earth for the different lengths of time that pass in Narnia compared to on Earth in ’The Chronicles of Narnia’ books. The relative velocities that were calculated at different points when the book characters visited it ranged from 295599.350 km s^(−1) to 299792.3676 km s^(−1). We then calculated the corresponding distances of Narnia from Earth, which were found to range from ∼4270 Mpc to ∼4330 Mpc

P3_6 Space Cannon

In this paper, we investigate the possibility of firing spacecraft into orbit using a cannon (likely either a coilgun or railgun). We discover that a cannon capable of doing such things would have to fire the craft at around 8.2 km s^-1, and be at least 1142 km long, to avoid placing the craft’s inhabitants under fatal accelerative forces

P3_7 Journey to the Centre of the Earth

In this paper we investigate how far down a tunnel directly towards the centre of the Earth a human could get and survive. This is calculated to be 1.65 km for a tunnel beginning in the UK. We then calculate how far a human could go on their journey to the centre of the Earth inside a refrigerator that maintains an air temperature of 20◦C within it using the power generated by all of the on- and offshore wind farms in the UK. This was found to be 54.3 km

P3_3 Dirty Deeds Done Dirt Fast - The Feasibility of Tusk’s Infinite Spin

In JoJo’s Bizarre Adventure, Tusk: Act IV is able to trap people by using the power of ’Infinite Spin.’ Assuming this imprisonment is caused by a Kerr black hole, it was found that the speed at which a fingernail would need to spin to create such a body is in the order of 1014 rad/s. However, even the smallest real event horizon would be hundreds of metres across, and the slightest change in nail shape or rate of spin could cause the black hole to massively change in size