Achieving Competence: Clinical Instructors\u27 Perspective

Purpose: The profession of physical therapy uses physical therapist clinical instructors to educate students in the clinical education portion of the curriculum. The requirements to become a clinical instructor are minimal and non- specific regarding formal training and development. A variety of educational opportunities is available to clinical instructors, but the evidence in the physical therapy literature is conflicting regarding the effectiveness of these programs. Additionally, no previous research regarding the meaning of competence, nor the pathway to achieving competence as a clinical instructor was found. Therefore, the purpose of this study was to describe the experience of achieving competence as perceived by clinical instructors who have chosen different paths toward becoming effective CIs. Methods: This study utilized phenomenological methodology to explore the meaning of clinical instructor competence and the experience of achieving competence from the perspectives of the clinical instructors themselves. Data was collected through the use of focus groups, semi-structured interviews and written statements. Data was analyzed for themes using thematic analysis. Participants: A purposive sample of twenty-nine physical therapist clinical instructors was recruited to participate in five focus groups, each group consisted of 5-7 participants. Results: An overarching theme of “Empowerment” emerged from the data analysis of the transcriptions and field notes. This overarching theme was supported by eight themes which resonated across the five focus groups. These themes were 1: The meaning of competence, 2: “My first student”, 3: Finding the way, 4: Feeling supported, 5: A fork in the road, 6: Barriers to achieving competence, 7: The “ah-ha” moment, 8: “Ongoing road”. Conclusion: The results of this study provide a description and interpretation of the meaning of clinical instructor competence and the journey of achieving competence. These findings can inform and empower clinical instructors on their own journey to competence. CCCEs may also find a deeper awareness of the meaning of competence and the importance of providing support for CIs. The physical therapy education community and it’s professional bodies can also be informed by these findings in establishing a definition of clinical instructor competence. As well as give direction to future efforts and programs designed to prepare clinicians to effectively educate students in the clinic setting

Arabinoxyloglucan Oligosaccharides May Contribute to the Antiadhesive Properties of Porcine Urine after Cranberry Consumption

© 2019 As part of our continuing investigation for interesting biological activities of native medicinal plants, thirty-nine plants, obtained from diverse areas in Saudi Arabia and Yemen, were screened for insecticidal activity against yellow fever mosquito Aedes aegypti (L.). Out of the 57 organic extracts, Saussurea lappa, Ocimum tenuiflorum, Taraxacum officinale, Nigella sativa, and Hyssopus officinalis exhibited over 80% mortality against adult female Ae. aegypti at 5 μg/mosquito. In the larvicidal bioassay, the petroleum ether extract of Aloe perryi flowers showed 100% mortality at 31.25 ppm against 1st instar Ae. aegypti larvae. The ethanol extract of Saussurea lappa roots was the second most active displaying 100% mortality at 125 and 62.5 ppm. Polar active extracts were processed using LC-MS/MS to identify bioactive compounds. The apolar A. perryi flower extract was analyzed by headspace SPME-GC/MS analysis. Careful examination of the mass spectra and detailed interpretation of the fragmentation pattern allowed the identification of various biologically active secondary metabolites. Some compounds such as caffeic and quinic acid and their glycosides were detected in most of the analyzed fractions. Additionally, luteolin, luteolin glucoside, luteolin glucuronide and diglucuronide were also identified as bioactive compounds in several HPLC fractions. The volatile ketone, 6-methyl-5-hepten-2-one was identified from A. perryi petroleum ether fraction as a major compound

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Early Assurance Model for Physical Therapy Education: A Descriptive Study

Introduction: Various curriculum models for Doctor of Physical Therapy (DPT) education exist across the country. The purpose of this study was to provide an updated description of the Early Assurance (EA) program model, including administrative variables for institutional leaders to consider. This descriptive study may help equip students to choose an educational program that suits their desires and enable institutions to consider models that fit their needs given their typical admission draw, the local environment, student debt, and resources available. Applications to DPT programs are on the decline while there continues to be an expansion of programs. Institutions are looking for innovative models to address the changing landscape of higher education. Methods: An electronic survey was deployed to all Commission on Accreditation in Physical Therapy Education accredited DPT programs and contained 33 multiple-choice and free text questions. Responses were received from 30 EA programs and 60 programs without EA (non-EA). Quantitative data were reported in percentages and means, and a thematic analysis was used to determine themes from free text responses. Results: Admission criteria, progression criteria, majors leading to the DPT degree, and management of admissions processes varied across the programs. Four themes emerged from the non-EA programs regarding why they do not offer an EA pathway. Seventeen (28% of respondents) indicated they are now reviewing and considering an EA pathway. Conclusion: A variety of pathways leading into DPT graduate programs exist and may benefit students. Specifically, these variations may allow students to choose a program that fits their particular needs. The results of the study may inform prospective students who can utilize this information to ask more specific questions as they consider DPT programs. Moreover, as many allied health programs have accelerated pathways to the terminal degree, institutions can utilize these findings to inform decisions about EA programs and how these programs may address declines in admissions and retentio

Breathing Evaluation and Retraining as an Adjunct to Manual Therapy

Back and neck pain are extremely common reasons for patients seeking manual therapy treatment. Epidemiological evidence supports a link between breathing difficulties and back pain. Since trunk muscles perform both postural and breathing functions, it is theorized that disruption in one function can negatively impact the other. Altered breathing mechanics can change respiratory chemistry and therefore pH causing smooth muscle constriction, altered electrolyte balance and decreased tissue oxygenation. These changes can profoundly impact any body system. Increased excitability in the muscular and nervous systems may be most relevant to a manual therapist. Respiratory function can be tested via capnography which measures CO2 at the end of exhale known as End Tidal CO2 (ETCO2). ETCO2 closely reflects arterial CO2 in people with normal cardiopulmonary function.A case series of twenty nine outpatients with neck or back pain who had plateaued with manual therapy and exercise were identified all of whom were found to have low ETCO2. Breathing retraining improved ETCO2, pain and function in all patients with 93% achieving at least a clinically important change in either pain or function.Screening for breathing dysfunction using capnography may improve patient outcomes in those patients where manual therapy, exercise and education do not provide full resolution of symptoms. © 2010 Elsevier Ltd

P-36 Assessing Reliability of the PTSE Tool for the Evaluation of Clinical Instructors

Introduction: A reliable tool to assess Clinical Instruction is essential to maximizing Physical Therapist student clinical education experiences. The purpose of this study was to analyze the reliability of the PTSE. Methods: Quasi-experimental design with test-retest. Subjects: 101 Students. Procedure: The PTSE survey sent, twice once to obtain scores which were reviewed with the CI and again for scores which were not reviewed with the CI. Statistical Analysis: Descriptive statistics were used for demographics variables; paired t-test to determine difference between first and second survey; an interclass correlation coefficient (ICC) test to determine reliability from first to second survey and frequencies and percentages for the 5 point Likert scale. Differences were considered significant if at the .05 probability. Results: 142 student surveys. For the student responses from the first to the second survey, there was a significant difference in 12 of the 29 PTSE questions, ranging from .001-.049. An ICC showed moderate to good reliability. Discussion: The significant difference found on the t-test suggests the possibility of unreliability however the ICC shows moderate- good reliability. Conclusion: Based on the ICC and the small difference in scores the statistical analysis suggests that the PTSE is a reliable tool for CI evaluation

Using social networks theory as a complementary perspective to the study of organizational change

This paper contributes to the literature on organizational change by examining organizations as social entities embedded in inter-organizational networks. In contrast with extant research that focuses on macro environmental and internal factors to explain organizational change, we put forth the social network surrounding the firm as a major driver of any change process. Specifically, we examine organizational change as driven by the organizations' positions and relations in an interorganizational network, and advance a set of theory driven propositions on innovation, imitation, inertia, structural equivalence and structural positioning. Our conceptual discussion demonstrates that inter-organizational networks are important in complementing the macro-environment and internal organizational factors for the study of organizational changes. We conclude with a discussion on normative implications for organizations and avenues for future research

Applying polygenic risk scoring for psychiatric disorders to a large family with bipolar disorder and major depressive disorder

Psychiatric disorders are thought to have a complex genetic pathology consisting of interplay of common and rare variation. Traditionally, pedigrees are used to shed light on the latter only, while here we discuss the application of polygenic risk scores to also highlight patterns of common genetic risk. We analyze polygenic risk scores for psychiatric disorders in a large pedigree (n similar to 260) in which 30% of family members suffer from major depressive disorder or bipolar disorder. Studying patterns of assortative mating and anticipation, it appears increased polygenic risk is contributed by affected individuals who married into the family, resulting in an increasing genetic risk over generations. This may explain the observation of anticipation in mood disorders, whereby onset is earlier and the severity increases over the generations of a family. Joint analyses of rare and common variation may be a powerful way to understand the familial genetics of psychiatric disorders