A description of physical therapists' knowledge in managing musculoskeletal conditions

BACKGROUND: Physical therapists increasingly provide direct access services to patients with musculoskeletal conditions, and growing evidence supports the cost-effectiveness of this mode of healthcare delivery. However, further evidence is needed to determine if physical therapists have the requisite knowledge necessary to manage musculoskeletal conditions. Therefore, the purpose of this study was to describe physical therapists' knowledge in managing musculoskeletal conditions. METHODS: This study utilized a cross-sectional design in which 174 physical therapist students from randomly selected educational programs and 182 experienced physical therapists completed a standardized examination assessing knowledge in managing musculoskeletal conditions. This same examination has been previously been used to assess knowledge in musculoskeletal medicine among medical students, physician interns and residents, and across a variety of physician specialties. RESULTS: Experienced physical therapists had higher levels of knowledge in managing musculoskeletal conditions than medical students, physician interns and residents, and all physician specialists except for orthopaedists. Physical therapist students enrolled in doctoral degree educational programs achieved significantly higher scores than their peers enrolled in master's degree programs. Furthermore, experienced physical therapists who were board-certified in orthopaedic or sports physical therapy achieved significantly higher scores and passing rates than their non board-certified colleagues. CONCLUSION: The results of this study may have implications for health and public policy decisions regarding the suitability of utilizing physical therapists to provide direct access care for patients with musculoskeletal conditions

Physicians are a key to encouraging cessation of smoking among people living with HIV/AIDS: a cross-sectional study in the Kathmandu Valley, Nepal

BackgroundHIV care providers may be optimally positioned to promote smoking behaviour change in their patients, among whom smoking is both highly prevalent and uniquely harmful. Yet research on this front is scant, particularly in the developing country context. Hence, this study describes smoking behaviour among people living with HIV/AIDS (PLWHA) in the Kathmandu Valley of Nepal, and assesses the association between experience of physician-delivered smoking status assessment and readiness to quit among HIV-positive smokers.MethodsWe conducted a cross-sectional survey of PLWHA residing in the Kathmandu Valley, Nepal. Data from 321 adult PLWHA were analyzed using multiple logistic regression for correlates of current smoking and, among current smokers, of motivational readiness to quit based on the transtheoretical model (TTM) of behaviour change.ResultsOverall, 47% of participants were current smokers, with significantly higher rates among men (72%), ever- injecting drug users (IDUs), recent (30-day) alcohol consumers, those without any formal education, and those with higher HIV symptom burdens. Of 151 current smokers, 34% were thinking seriously of quitting within the next 6 months (contemplation or preparation stage of behaviour change). Adjusting for potential confounders, experience of physician-delivered smoking status assessment during any visit to a hospital or clinic in the past 12 months was associated with greater readiness to quit smoking (AOR = 3.34; 95% CI = 1.05,10.61).ConclusionsRoughly one-third of HIV-positive smokers residing in the Kathmandu Valley, Nepal, are at the contemplation or preparation stage of smoking behaviour change, with rates significantly higher among those whose physicians have asked about their smoking status during any clinical interaction over the past year. Systematic screening for smoking by physicians during routine HIV care may help to reduce the heavy burden of smoking and smoking-related morbidity and mortality within HIV-positive populations in Nepal and similar settings

The establishment of a primary spine care practitioner and its benefits to health care reform in the United States

It is widely recognized that the dramatic increase in health care costs in the United States has not led to a corresponding improvement in the health care experience of patients or the clinical outcomes of medical care. In no area of medicine is this more true than in the area of spine related disorders (SRDs). Costs of medical care for SRDs have skyrocketed in recent years. Despite this, there is no evidence of improvement in the quality of this care. In fact, disability related to SRDs is on the rise. We argue that one of the key solutions to this is for the health care system to have a group of practitioners who are trained to function as primary care practitioners for the spine. We explain the reasons we think a primary spine care practitioner would be beneficial to patients, the health care system and society, some of the obstacles that will need to be overcome in establishing a primary spine care specialty and the ways in which these obstacles can be overcome.https://doi.org/10.1186/2045-709X-19-1

Perceived stress and coping resource availability as predictors of life satisfaction in young, middle-aged, and older adults

Global satisfaction with life across three age groups (18 to 40 years, 41 to 65 years, and 66 years and above) was investigated. Multiple regressions were computed to examine the separate and joint effects of perceived stress and coping resource availability upon life satisfaction across the three age groups (N = 189). Age differences in perceived stress, coping resource availability, and life satisfaction, were also investigated. Results of this cross-sectional investigation indicated that self-appraisal measures of perceived stress and coping resource effectiveness served as moderate predictors of global life satisfaction, and that for the total sample the combined effects of perceived stress and coping resource effectiveness were better predictors of life satisfaction than either variable considered separately. Perceived stress was found to be a better predictor of life satisfaction for younger adults, and coping resource effectiveness was a better predictor of satisfaction with life for middle-aged and older adults. Significant age differences in life satisfaction, perceived stress, and coping resources were also found. The assessment of perceived stress and coping has important implications for life satisfaction among all age groups, and has particular significance to older adults. By identifying age differences in variables associated with satisfaction with life, more effective efforts can be made to promote physical and psychological well-being in late adulthood

Coping resources, perceived stress, and life satisfaction among Turkish and American university students

This study investigated coping resources (Coping Resources Inventory for Stress), Perceived stress (perceived Stress Scale), and life satisfaction (Satisfaction with Life Scale) among American and Turkish university students. Results support the use of transactional stress constructs in studying life satisfaction with students in both countries. American and Turkish students did not differ significantly in regard to perceived stress, life satisfaction, or an overall measure of coping resources; however, they did differ significantly regarding specific coping resources. Variables entering regression models for predicting life satisfaction differed for students in the two countries and for the sexes within countries, and these models accounted for between 30% and 62% of variance. Social support and a sense of financial freedom were particularly useful in predicting life satisfaction. Coping resources accounted for 54% of variance in perceived stress. There were significant sex differences for both countries, generally favoring males, in regard to specific coping resources