Creating Patient Context: Empathy and Attitudes Toward Diabetes Following Virtual Immersion.

BACKGROUND: Pandemic circumstances created challenges for doctor of physical therapy (DPT) students to understand social determinants of health (SDH) in clinical rotations. Instead of canceling clinical rotations, a virtual reality cinema (cine-VR) education series was implemented. The purpose of this project is to describe the effect of this simulated immersion on student empathy and attitudes toward diabetes. METHOD: The DPT students (n=59) participated in 12 cine-VR education modules, completing surveys at three time points as part of coursework. The students completed baseline measures of the Diabetes Attitude Scale-Version 3 (DAS-3) and Jefferson Empathy Scale (JES), and then were immersed in 12 cine-VR modules. One week after module completion, students participated in a class discussion about the modules. The students repeated the JES and DAS-3 scales at postclass and six weeks later. Three subscales from the Presence Questionnaire (PQ) were used to measure the virtual experience. RESULTS: Student scores on three DAS-3 subscales significantly improved on posttest: Attitude toward patient autonomy, Mean: 0.75, SD: 0.45; DISCUSSION: These modules can allow for a shared student experience that improves diabetes attitudes, increases empathy, and fosters meaningful classroom discussion. The cine-VR experience is flexible, and modules allow students to engage in aspects of a patient\u27s life that were not available otherwise

Multi-campus DPT Programmatic Development in a Public University: Leadership Considerations

Background/Purpose: Institutional pressure for expanded revenue streams, coupled with workforce development needs to insure patient access of health resources both drive programmatic expansion of healthcare education programs across multiple campus sites. Such expansion is predicated on deliberate planning and resource acquisition for effective course delivery and successful programmatic outcomes. The University of Nebraska Medical Center’s College of Allied Health Professions opened a second campus site in 2016, located 185 miles from the main campus and the urban corridor of the state. The Doctor of Physical Therapy (DPT) program (and four additional allied health professions) modified traditional course delivery to create a synchronous learning environment, with core and adjunct faculty members actively engaged on both campuses. This administrative case report describes areas of critical consideration for faculty and administrators when expanding DPT programs across multiple sites. Strategies associated with successful implementation are addressed. Case Description. The process of program expansion and implementation are outlined, including challenges, subsequent actions, and successful strategies. Critical elements of program planning and implementation are categorized in the context of: Essential Infrastructure, Essential Functions, and identification of Essential Outcomes to provide evidence that the distance-based curriculum effectively addresses student learning needs. Outcomes: Key considerations related to “essential infrastructure: include resources such as: Administrative/leadership support; community engagement and relationships; qualified personnel; space; equipment; and basic technology (including deployment of a “STAT” team of student technology assistants). “Essential functions” include: Changes associated with the admission process and messaging; curriculum modifications; instructional design assistance; reformulated interprofessional education and practice experiences; faculty development and scholarship, and the serious need to empanel a bi-campus faculty “response team” for vigilance in pragmatic detail and parity of learning experiences. “Essential Outcomes” address the critical focus of protecting a singular program concept from shifting to an asynchronous, satellite format, as well as describing assessment strategies at various levels within the institution. Discussion: The ability to maintain quality brand reputation during multi-campus expansion of a DPT program requires the leverage of resources and talent from multiple and varied stakeholders. This administrative case report describes essential factors that must be deliberately addressed by campus administrators and faculty for successful implementation and outcomes

The development and application of an evaluation questionnaire used to compare opinions towards an audiovisual foodservice training program

The primary purpose of this study was for three select groups to critically appraise the Personal Hygiene for Foodservice Workers sound/slide system. These three groups (Media Specialists, Content Experts and the Learners) were identified in a literature search as being those individuals most directly responsible for evaluating the worth of a program. Three similar but divergent questionnaires were developed for use by the groups. Questionnaire validity was established by means of a DELPHI panel of Media Specialist experts. Reliability was ascertained for two of the questionnaires using the Spearman-Brown formula. The Media Specialist Questionnaire was not tested for reliability, due to the small sample size. The Content Experts consisted of eleven dietitians from seven hospitals (and one nursing home) in the MidWillamette Valley, and thirteen Sanitarians from four Oregon counties that conduct Food Handler training programs for restaurant employees. The Food Handlers from the counties and the Food Service Workers from the hospitals comprised the 163 people in the "Learner" group. The Media Specialist group consisted of ten members, five who acted as the DELPHI panel and five who responded to the questionnaire. Data gathered from the questionnaires were used to measure the differences in opinions among the three groups in their critique of the PHFW program. Data were analyzed on a percentage basis and using a Chi Square statistic to test for significant differences in opinions. Media Specialists were excluded from significance testing, due to their small sample size. Significant associations were observed among the Content Experts and the Learners in four areas: 1) quality of photographs, 2) program organization for understanding of message, 3) program organization and retention, and 4) program length. Both of these groups significantly agreed that the entire program was not interesting and that the narrator's voice was not pleasant, yet stimulating. The Content Experts differed in their opinions in the areas of the accuracy of the program's content, goals, adequate coverage of purpose, and appropriateness for the intended audience. Possible explanations for these results are discussed. The exact role each of these groups should play in the materials selection process needs to be more clearly defined. The research especially conflicts in the area of the Learners and their ability to make wise learning choices. Suggestions for further research are outlined

Does Implementation of a Lifestyle Medicine Curriculum Affect Student Wellness During Doctor of Physical Therapy Education?

Background Current healthcare environments amplify the need for educational systems to forge healthy workforces to withstand stressors. Our study examines the effects of embedding a lifestyle medicine curriculum on student wellness in a Doctor of Physical Therapy (DPT) Program, simultaneously preparing students to implement lifestyle medicine with future patients and communities. Methods In a DPT program, we implemented a lifestyle medicine curriculum grounded within the Social-Ecological Model. This framework emphasizes student success in the program’s pre-clinical phases, creates a purposeful “ripple effect” threading wellness strategies among peers, patients, and communities, and emphasizes wellness as a clinician over the 32-month curriculum. The Five Factor Wellness (FFW) Inventory and Psychological Capital (PC) Questionnaire measured student wellness at matriculation, mid-program, and graduation. We used Social Network Analysis (SNA) to examine the strength and types of peer connections. Results The response rate for two cohorts across the four-year study for the FFW was 100% and 80% (n=100/125) for PC and SNA. Race composition was White (84.0%, n=105), Asian (9.6%, n=12), Native Hawaiian or Pacific Islander (2.4%, n=3), Hispanic or Latino (2.4%, n=3), other-not described (.8%, n=1), and preferred not to answer (.8%, n=1); and 61.6% (n=77) were female. SNA: The average number of close classmate connections increased from 4.7 (0-28) to 12.9 (0-39) at mid-program and to 19.7 (3-43) at graduation. A repeated-measures ANOVA (Bonferroni correction) revealed significant increases in scores: matriculation-mid-program - FFW-coping (1.6, .2-3.0, p=.024), FFW-leisure (3.2, .8-5.5, p=.004), FFW-self-care (2.3, .7-3.9, p=.002), PC-efficacy (2.1, 1.3-2.9, p\u3c.001), PC-optimism (1.6, .5-2.6, p=.002); mid-program-graduation - PC-efficacy (2.3, 1.5-3.0, p\u3c.001), PC-hope (2.4, 1.4-3.4, p\u3c.001), PC-resilience (1.7, .7-2.7, p\u3c.001); matriculation-graduation - FFW-leisure (3.5, .6-6.4, p=.013), PC-efficacy (4.4, 3.3-5.4, p\u3c.001), PC-hope (3.4, 2.4-4.3, p=\u3c.001), PC-resilience (2.2, 1.3-3.1, p\u3c.001), PC-optimism (2.0, 1.0-3.0, p\u3c.001). Conclusion Implementing a lifestyle medicine curriculum contributed to DPT graduates developing close connections among peers for support and friendship, being empowered with coping strategies to regulate responses and manage negative effects of life events, taking responsibility for self-care measures, and improving psychological capital to persevere confidently toward goals. Funding Funding was provided by the College of Allied Health Professions Interprofessional Education Grant and the Physical Therapy Program of the University of Nebraska Medical Center

Relationship Between Theory of Mind, Emotion Recognition, and Social Synchrony in Adolescents With and Without Autism

Difficulty in social communication and interaction is a primary diagnostic feature of ASD. Research has found that adolescents with ASD display various impairments in social behavior such as theory of mind (ToM), emotion recognition, and social synchrony. However, not much is known about the relationships among these dimensions of social behavior. Adolescents with and without ASD participated in the study. ToM ability was measured by viewing social animations of geometric shapes, recognition of facial emotions was measured by viewing pictures of faces, and synchrony ability was measured with a spontaneously arising interpersonal movement task completed with a caregiver and an intentional interpersonal task. Attention and social responsiveness were measured using parent reports. We then examined the relationship between ToM, emotion recognition, clinical measures of attention and social responsiveness, and social synchronization that arises either spontaneously or intentionally. Results indicate that spontaneous synchrony was related to ToM and intentional synchrony was related to clinical measures of attention and social responsiveness. Facial emotion recognition was not related to either ToM or social synchrony. Our findings highlight the importance of biological motion perception and production and attention for more fully understanding the social behavior characteristic of ASD. The findings suggest that the processes underlying difficulties in spontaneous synchrony in ASD are different than the processes underlying difficulties in intentional synchronization

Student wellness during curriculum implementation of a lifestyle medicine approach within the Social-Ecological Model: a longitudinal study

Purpose The student-life experience is an ideal time to implement lifelong wellness behaviors needed for the professional role. The ongoing effects of the COVID pandemic have amplified the need for Doctor of Physical Therapy (DPT) educational programs to train an emerging workforce that can, through personal wellness, withstand the stressors of personal and professional lives. The study purpose is to: a) evaluate the change in student wellness from matriculation to mid-program to completion after implementation of a curriculum based on a lifestyle medicine approach within the Social-Ecological Model, and b) compare student wellness between cohorts that matriculated before and during the COVID pandemic. Methods/Description We implemented curricular interventions to promote student wellness and professional formation in the fall of 2019. Students first study healthy behaviors for themselves, followed by learning experiences around the professional formation as a healthy clinician, and finally health promotion for patients and communities. We also modified program policies (e.g., holistic admissions, attendance, tutoring, faculty advising) to be student-centered. Three student cohorts in the DPT program at a Midwest academic medical center agreed to participate. Cohort19 (C19, n = 66) matriculated in 2019, Cohort20 (C20, n=66) in 2020, and Cohort21 (C21, n=64) in 2021. Participants completed the Five Factor Wellness Inventory (FFW) at matriculation into the 32-month program. C19 and C20 completed the FFW midway through the program as planned. Remaining assessments will occur as scheduled at program midpoint and completion. The FFW inventory is the gold standard for identifying central factors for healthy living. The wellness score is composed of 5 “Selfs” (Essential, Social, Creative, Physical, and Coping) made up of 17 domains where the acceptance of personal responsibility and choice have positive effects on well-being. A one-way ANOVA was used to compare FFW scores of all 3 cohorts at matriculation. Paired sample t-tests were used to compare results of C19 and C20 at mid-program and over time (matriculation and mid-program). Results/Outcomes The curriculum revisions and policy modifications were implemented in fall 2019. There were unexpected COVID-directed health measures beginning in March 2020 resulting in a move to more virtual activities that were not planned in our curriculum and new pressures related to student wellness. Three cohorts of DPT students (C19, C20, C21) completed the FFW at matriculation. Additionally, C19 and C20 completed the FFW at mid-program. The response rate for the FFW across all cohorts and time points was 100%. Comparison across cohorts: At matriculation, one of 17 FFW domain scores was found to be significantly different across cohorts. The score for the exercise domain (physical self) was significantly higher (p=.046) for C19 (pre-COVID) compared to C21. However, at mid-program for C19 and C20 (both during COVID), scores were significantly lower in C19 compared to C20 in five domains: culture (p=.004) and gender identification (p=.005) (essential self), nutrition (p=.037) (physical self), leisure (p=.020) and self-worth (p=.035) (coping self). Comparison over time: A comparison of FFW scores between matriculation and mid-program for C19 showed a significant increase in self-care scores (p\u3c.001 ) (essential self). For C20 scores significantly increased at mid-program in the coping self domains of leisure (p=.001) and stress management (p=.025), friendship (p=.018) (social self), and nutrition (p=.001) (physical self) leading to a significant improvement in overall FFW score (p=.037). Conclusions To optimally train a health workforce, faculty are studying methods to promote student wellness as part of student professional formation along with the curriculum for the PT of the future. Our study shows higher wellness scores in several domains in cohorts matriculating after COVID compared to before. This finding is interesting as it could indicate students entering professional school were potentially more prepared in terms of healthy behaviors due to the public health news surrounding COVID . Our study shows that components of student wellness may be improving due, in part , to the curriculum interventions and policies supporting wellness. These are important findings especially given the intended curriculum delivery was interrupted by directed health measures beginning in March 2020. The future direction is to continue to assess outcome measures through the end-of-program. In addition, we are analyzing additional measures of wellness such as psychological capital of hope, confidence, resilience and optimism, and social capital measuring connections with others for a sense of belonging. Our curriculum and supportive policies could be a model to demonstrate how student wellness can be aligned with a lifestyle medicine approach within the individual, relationship, community and society components of the Social-Ecological Model. REFERENCES Bezner JR. Promoting Health and Wellness: Implications for Physical Therapist Practice. Phys Ther. 2015; 95(10):1433-1444. Brooke, T., Brown, M., Orr, R., & Gough, S. (2020). Stress and burnout: exploring postgraduate physiotherapy students’ experiences and coping strategies. BMC Medical Education, 20(1), 1-11. Centers for Disease Control.Social Ecological Model. https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html; Materials developed by Dahlberg LL, Krug EG. Violence: a global public health problem. In: Krug E, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, eds. World Report on Violence and Health.Geneva, Switzerland: World Health Organization; 2002:1-21. Coffey DS, Eliot K, Goldblatt E, et al. A multifaceted systems approach to addressing stress within health professions education and beyond [discussion paper]. National Academy of Medicine website. https://nam.edu/wp-content/uploads/2017/01/Multifacted-Systems-Approach-to-Addressing-Stress-Within-Health-Professions-Education-and-Beyond.pdf Published January 30, 2017. Dean D. (2009) Physical therapy in the 21st century (Part II): Evidence-based practice within the context of evidence-informed practice, Physiotherapy Theory and Practice, 25:5-6, 354-368. Douris, P. C., D\u27Agostino, N. A., Mathew, S. K., Anderson, R. P., Bauman, K. M., Tiangtham, S. A., ... & Hall, C. A. (2020). The physiological and psychological effects of the first year of an entry-level physical therapist education program on students. Journal of Physical Therapy Education, 34(3), 186-191. Myers JE, Sweeny TJ. Five Factor Wellness Inventory. Mindgarden https://www.mindgarden.com/99-five-factor-wellness-inventory. Accessed 3.15.202

Impairments of Social Motor Synchrony Evident in Autism Spectrum Disorder

Social interactions typically involve movements of the body that become synchronized over time and both intentional and spontaneous interactional synchrony have been found to be an essential part of successful human interaction. However, our understanding of the importance of temporal dimensions of social motor synchrony in social dysfunction is limited. Here, we used a pendulum coordination paradigm to assess dynamic, process-oriented measures of social motor synchrony in adolescents with and without autism spectrum disorder (ASD). Our data indicate that adolescents with ASD demonstrate less synchronization in both spontaneous and intentional interpersonal coordination. Coupled oscillator modeling suggests that ASD participants assembled a synchronization dynamic with a weaker coupling strength, which corresponds to a lower sensitivity and decreased attention to the movements of the other person, but do not demonstrate evidence of a delay in information transmission. The implication of these findings for isolating an ASD-specific social synchronization deficit that could serve as an objective, bio-behavioral marker is discussed

An intronic SNP in the thyroid hormone receptor β gene is associated with pituitary cell-specific over-expression of a mutant thyroid hormone receptor β2 (R338W) in the index case of pituitary-selective resistance to thyroid hormone

<p>Abstract</p> <p>Background</p> <p>The syndrome of resistance to thyroid hormone (RTH) is caused by mutations in the thyroid hormone receptor β gene (<it>THRB</it>). The syndrome varies from asymptomatic to diffuse hypothyroidism, to pituitary-selective resistance with predominance of hyperthyroid signs and symptoms. The wide spectrum of clinical presentation is not completely attributable to specific <it>THRB </it>mutations. The <it>THRB </it>gene encodes two main isoforms, TR β1 which is widely distributed, and TR β2, whose expression is limited to the cochlea, retina, hypothalamus, and pituitary. Recent data demonstrated that in mice an intron enhancer region plays a critical role in the pituitary expression of the β2 isoform of the receptor. We thus hypothesized that polymorphisms in the human homologous region could modulate the pituitary expression of the mutated gene contributing to the clinical presentation of RTH.</p> <p>Methods</p> <p>Screening and <it>in vitro </it>characterization of polymorphisms of the intron enhancer region of the <it>THRB </it>gene in the index case of pituitary-selective RTH.</p> <p>Results</p> <p>The index case of pituitary-selective resistance is characterized by the missense R338W exon 9 mutation in <it>cis </it>with two common SNPs, rs2596623T and rs2596622C, located in the intron enhancer region of the <it>THRB </it>gene. Reporter gene assay experiments in GH3 pituitary-derived cells indicate that rs2596623T generates an increased pituitary cell-specific activity of the TR β2 promoter suggesting that rs2596623T leads to pituitary over-expression of the mutant allele.</p> <p>Conclusions</p> <p>The combined coding mutation and non-coding SNP therefore generate a tissue-specific dominant-negative condition recapitulating the patient's peculiar phenotype. This case illustrates the role of regulatory regions in modifying the clinical presentation of genetic diseases.</p

Pseudomonas uvaldensis sp. nov., a bacterial pathogen causing onion bulb rot

A Gram-stain-negative, aerobic and non-spore-forming bacterial strain, designated 20TX0172T, was isolated from a rotting onion bulb in Texas, USA. The results of phylogenetic analysis based on the 16S rRNA sequence indicated that the novel strain represented a member of the genus Pseudomonas and had the greatest sequence similarities with Pseudomonas kilonensis 520-20T (99.3 %), Pseudomonas corrugata CFBP 2431T (99.2 %), and Pseudomonas viciae 11K1T (99.2 %) but the 16S rRNA phylogenetic tree displayed a monophyletic clade with Pseudomonas mediterranea CFBP 5447T. In the phylogenetic trees based on sequences of four housekeeping genes (gap1, gltA, gyrB and rpoD), the novel strain formed a separate branch, indicating that the strain was distinct phylogenetically from known species of the genus Pseudomonas. The genome-sequence-derived average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) values between the novel isolate and P. mediterranea DSM 16733T were 86.7 and 32.7 %, respectively. These values were below the accepted species cutoff threshold of 96 % ANI and 70 % dDDH, affirming that the strain represented a novel species. The genome size of the novel species was 5.98 Mbp with a DNA G+C content of 60.8 mol%. On the basis of phenotypic and genotypic characteristics, strain 20TX0172T represents a novel species of the genus Pseudomonas. The name Pseudomonas uvaldensis sp. nov. is proposed. The type strain is 20TX0172T (=NCIMB 15426T=CIP 112022T).Specialty Crops Research Initiative Award from the United States Department of Agriculture (USDA) National Institute of Food and Agriculture; Texas A&M AgriLife Vegetable Seed Grant and Texas A&M AgriLife Research Strategic Initiative Assistantship.https://www.microbiologyresearch.org/content/journal/ijsemBiochemistryForestry and Agricultural Biotechnology Institute (FABI)GeneticsMicrobiology and Plant PathologyPlant Production and Soil SciencePlant Scienc