Efficacy and Outcome Beliefs of General and Special Education Teachers Working with Culturally Linguistically Diverse Students with Disabilities

The purpose of this study was to understand general and special education teacher perceptions about collective teacher efficacy (CTE), culturally responsive teaching self-efficacy (CRTSE), and culturally responsive instruction outcome expectancy (CRIOE) and the educational success of culturally linguistically diverse students (CLD) with disabilities. Forty-four teachers (16 general educators and 28 special educators) from six Midwestern school districts completed a survey consisting of CTE, CRTSE, and CRIOE. The findings from this study suggest general and special education teacher participants did not perceive themselves or their colleagues as culturally responsive. Yet, general and special education teachers agreed that CRT positively affects student outcomes and believe training can help create a barrier-free environment to facilitate learning for CLD students with disabilities. Participants demonstrated low confidence in CRT practices, mainly using student culture to increase engagement in learning and working with families. Implications for teacher practice include a professional development framework utilizing research-based activities that build CRT efficacy supported by coaching. Keywords: teacher efficacy, collective teacher efficacy, culturally responsive teaching, outcome expectancy, culturally linguistically diverse students with disabilitie

Comparison Of Abdominal Compression Devices In Persons With Abdominal Paralysis Due To Spinal Cord Injury

Comparison of abdominal compression devices in persons with abdominal paralysis due to spinal cord injury. Michaela de Groot, MA, SPT; Jennifer Swartz, MA, SPT; Jennifer Hastings PT, PhD, NCS University of Puget Sound, Tacoma WA Objective: In the United States the incidence of spinal cord injury (SCI) is approximately 17,000 new cases a year and there are estimated to be 282,000 persons living with SCI. Approximately 80% of those injured sustain neurologic lesions that impair the function of the abdominal musculature. In the non-disabled population it is well understood that the strength of the abdominal wall is key to prevention of musculoskeletal pain and improving postural control. The abdominal wall functions to maintain intra-abdominal cavity pressure which in a healthy system works in coordination with intra-thoracic cavity pressure. Paralysis of the abdominal musculature impairs the function of the diaphragm. Use of an abdominal binder is a common intervention following acute SCI.However, the long term daily use of abdominal binders is not common among individuals living with SCI. The purpose of this study is to compare the effectiveness and usability of alternative commercial abdominal compression garments with the usual medical device. Design/Methods: This study follows a single subject design with 5 participants. Inclusion: SCI T6 or above, currently using abdominal binder when seated in the wheelchair, able to don the binder independently or with caregiver assistance. Exclusion: Unable to speak English and communicate either written or electronically, or current skin breakdown. Data was collected over 3 periods of 1 week at a time; participants wore the compression garment for 5 days followed by a rest period of 2 days. In week 1, the participant wore their current abdominal binder. In weeks 2 and 3, an alternative compression device was worn. The alternatives were a compressive tank top and a compressive unisuit (shorts and tank). Physiological measurements and photographs were taken with the current binder, then after a 5 minute acclimation period each without any binder and then the alternative garment. Outcome measures: blood pressure, blood oxygen saturation, forced exhalation volume in 1 second, and heart rate. A daily log was completed twice daily for 5 days per garment with questions asking about participants’ experience. Results: The use of a personal binder resulted in significant increases in systolic blood pressure (SBP) and forced expiratory volume in 1 second (FEV1). The other parameters were not significantly different with or without the personal binder. There was no difference in SBP between the test garments and the personal binders, but the test garments’ support of FEV1 was significantly less. Graphic analysis of experiential trends will be presented. Conclusion: Abdominal compression improves respiratory function and supports BP. The alternative devices provided similar BP support, but less respiratory support. Alternative devices required caregiver assistance. Lack of full UE ROM made the tank option unfeasible. The unisuit offended sensibilities and therefore is not an acceptable device. Support: This study received support from the University of Puget Sound

Investigating Doctor of Physical Therapy Student Stress During Pandemic Related Curricular Changes

Introduction: Stress level in physical therapy students has been a focus of research due to multiple documented effects related to physical health, mental health, and ability to learn. Self-reflection has also been a focus of education research, relating it to personal learning, critical thinking, and demonstrable development of professional behaviors and skills. The aim of this study is to investigate student stress in response to programmatic changes wrought by the pandemic and whether stress impacted student self-reflection. Review of literature: Self-reflection is positively associated with growth of professional behavior and academic performance. Student level of self-reflection has been shown to be negatively impacted by stress. Subjects: A convenience sample of 35 students entering the program fall 2019 made up the participants. Methods: Outcome measures were collected six times over two academic years. The Self-Reflection Insight Scale (SRIS) consists of 20 statements rated on a 5-point Likert scale with 3 subscales: need for reflection (N), engaging in reflection (E), and insight (I), scoring from 10 to 100. The Perceived Stress Scale (PSS-10) is a 10-item questionnaire rated on a 4-point Likert scale, scoring from 0 to 40. Results: SRIS scores increased significantly from time 1 to 2, prior to the campus closure; no significant change for times 3 through 6. PSS scores indicated a higher percentage of students reporting a high level of stress at time 3 in the months after campus closure, decreasing significantly from time 3 to 4 during virtual/hybrid learning and increasing from time 5 to 6 as students prepared for clinical internship. No correlation was seen between SRIS and PSS, however a negative correlation was observed between SRIS subscale I and PSS at time 4 and 5. Discussion: Student perceived stress decreased during the study despite a universally stressful time. Student stress increased as students prepared for their first clinical internship experience, consistent with prior research. Initial gains in student self-reflection did not significantly change during the 1.5 years of the pandemic indicating that despite multiple academic and social challenges, students were able to maintain, but not grow, their level of professional self-reflection. Research is needed to further describe the relationship between stress and insight. Conclusion: The Program’s response to pandemic mandates may have positively influenced student stress

The use of Heel Lifts for Individuals with Parkinson’s Disease to Improve Postural Stability.

Background: Parkinson’s Disease (PD) is a progressive, neurodegenerative condition that results in resting tremors, slowed movement (bradykinesia), rigidity, and postural instability. People with PD develop a standing alignment often referred to as a “stooped posture”; flexed hips, kyphotic spine, forward shoulders, forward head, and downward head tilt. Concurrently, this population has high prevalence of impaired standing and dynamic balance, decreased muscle strength, slower gait, and slower anticipatory and reactionary body adjustments. We propose plantarflexion contractures contribute to instability by causing an altered alignment and decreasing the available range for reactive excursion in lower extremity. Purpose: To investigate if postural alignment, perceived stability and balance is impacted by accommodating plantar flexion (PF) contractures, with a heel lift, in individuals with Parkinson’s disease (PD). To investigate the correlation of the Falls Efficacy Scale (FES) to PF contracture severity in order to predict postural instability. Design: Pre-test post-test with no follow up Participants: Convenience sampling of 32 participants. Inclusion Criteria: diagnosed with PD, and independently ambulate 20 ft. without assistive devices. Exclusion Criteria: cannot understand English, and any comorbidities impacting postural stability. Interventions: Participants were assessed for talocrural dorsiflexion ROM. Patients filled in a self-reported Falls Efficacy Scale (FES). Then were assessed for the following outcome measures with and without the use of heel lifts: Sagittal Posture Photo Analysis, Visual Analog Perceived Stability Scale, Tekscan Pressure Sway Map, and Functional Reach Test (FRT). Heel lift size was assigned based on PF contracture severity. Results: Significant findings (p\u3c0.05) include increase in height (mean 1.00 cm) an anterior translation of the hips (mean 2.3cm) and a more upright trunk (mean 1.37 degrees) and head angle (mean 2.61 degrees). The perceived stability increased (mean 0.75) and functional reach decreased (mean 2.22cm). Correlations (R=0.36-0.50) were found between the degree of PF contracture and the reported fear of falling for questions on the FES that involved ADLs that required ambulation. Conclusion: Accommodating PF contractures, on individuals diagnosed with PD, with heel lifts significantly improves perceived stability, upright postural alignment, but also decreases forward reach. Clinical Significance: Heel lifts are a useful treatment to improve postural alignment in the PD population; however, it should be considered an adjunct treatment to joint mobilization and muscle lengthening techniques. References: Bartonek A, Lidbeck CM, Pettersson R, Weidenhielm EB, Eriksson M, Gutierrez- Farewik E. Influence of heel lifts during standing in children with motor disorders. Gait Posture. 2011;34(3):426-431. doi:10.1016/j.gaitpost.2011.06.015. Gross MT, Mercer VS, Lin F-C. Effects of foot orthoses on balance in older adults. J Orthop Sports Phys Ther. 2012;42(7):649-657. doi:10.2519/jospt.2012.3944. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008;79(4):368-376. doi:10.1136/jnnp.2007.131045. Klamroth S, Steib S, Devan S, Pfeifer K. Effects of Exercise Therapy on Postural Instability in Parkinson Disease: A Meta-analysis. J Neurol Phys Ther JNPT. 2016;40(1):3-14. doi:10.1097/NPT.0000000000000117. Rogers ME, Page P, Takeshima N. Balance Training for the Older Athlete. Int J Sports Phys Ther. 2013;8(4):517-530

Prevalence of Lyme Disease in Ixodes scapularis Ticks in Southeastern Minnesota and West Central Wisconsin

Lyme Disease is a common, widespread disease in the U.S. that is transmitted to humans through the bite of an infected Ixodes tick. The majority of Lyme Disease cases are found in Minnesota and Wisconsin, as well as along the East Coast in states ranging from Maine to Virginia. It was hypothesized that the Mississippi River acts as a barrier against the spread of Lyme Disease between Wisconsin and Minnesota. Ixodes ticks were collected from both sides of the river during legal white-tailed deer hunts from 2005-2012. A PCR was developed that amplified Borrelia burgdorferi (Lyme Disease) in ticks. In order to determine if the DNA was intact and viable, a multiplex PCR was developed to amplify both tick and Borrelia DNA simultaneously. Results are still being collected and analyzed at this time. Once both Ixodes and Borrelia DNA consistently amplify in a single reaction, multiple samples of female Ixodes ticks will be tested to determine if the ticks are positive or negative for Borrelia DNA.https://openriver.winona.edu/urc2019/1020/thumbnail.jp

Sexual Dysfunction as a Marker of Cardiovascular Disease in Males With 50 or More Years of Type 1 Diabetes

OBJECTIVE Vascular dysfunction is a major contributor to diabetes complications. It is also the primary physiologic cause of erectile dysfunction and considered an independent predictor of cardiovascular disease (CVD) in males over age 40 years. A cohort of individuals with 50 or more years of type 1 diabetes, Joslin Medalists, have low rates of small but not large vessel complications. This study aims to identify the prevalence and longitudinal association of sexual dysfunction (SD) with CVD in Joslin Medalists. RESEARCH DESIGN AND METHODS Description and association of self-assessment of SD in males of the Medalist cohort by self-reported sexual problems with CVD. SD is validated through the use of the abbreviated International Index of Erectile Dysfunction (IIEF). RESULTS Of 301 males in the Medalist Study, 69.8% reported a history of SD. Unadjusted risk factors included elevated glycated hemoglobin (HbA1c) (P = 0.02), elevated BMI (P = 0.03), higher total cholesterol (P = 0.02), lower HDL (P 0.05) with SD. Current report of SD (IIEF score ≤17) in a subset of Medalists was significantly correlated with self-reported longitudinal SD. CONCLUSIONS SD in those with extreme-duration type 1 diabetes is independently associated with CVD, representing a large-vessel pattern. The findings suggest that SD may predict CVD in those with type 1 diabetes of long duration. These individuals have also been found to be relatively free of microvascular complications

Defending the Art of Physical Therapy: Expanding Inquiry and Crafting Culture in Support of Therapeutic Alliance

Title: Defending the Art of Physical Therapy: Expanding Inquiry and Crafting Culture in Support of Therapeutic Alliance Authors: Nicole Brun-Cottan1, SPT, Danny McMillian PT DSc.1, Jennifer Hastings, PT PhD. ,NCS.1 Affiliations 1. School of Physical Therapy, University of Puget Sound, Tacoma WA, USA. Theory/Body: The successful practice of physical therapy within the biopsychosocial construct requires a professional culture that places value on the interpersonal relationships that foster healing and the face time required to build those relationships. The unfortunate truth is that pressures on current practice are not facilitating this dynamic approach. The drive for increased productivity, cost effectiveness and ultimately, profit, are changing the landscape in which we practice. For-profit entities are placing an emphasis on data-driven practice patterns and tying reimbursement to performance on standardized outcomes measures. The data that drives these models is often not informed by physical therapists, and changes are being imposed by payers without adequate regard for the impact on quality of life for both patients and practitioners. This phenomenon is fueled by an overemphasis on quantitative research in evidence based medicine and an under-appreciation of clinical expertise and patient values. This imbalance undermines the holistic, patient-centered approach that has been the basis for physical therapy since its inception. In this paper an argument is presented that we are losing the art of practicing physical therapy. Authors suggests that in order to preserve defining characteristics of the profession, there is an urgent need to redirect our research agenda and PT education with a focus on the study of contextual and psycho-social factors that influence treatment outcomes. Recent research findings indicate that the effect of therapeutic alliance may be as important to outcomes as the chosen intervention. The authors suggest that excellence in DPT education must incorporate education addressing the vital importance of therapeutic alliance and also include training in the skills for developing such unique intentional relationships. References 1.Hall AM, Ferreira PH, Maher CG, Latimer J, Ferreira ML. The Influence of the Therapist Patient Relationship on Treatment Outcome in Physical Rehabilitation: A Systematic Review. Physical Therapy. 2010;90(8):1099-1110. doi:10.2522/ptj.20090245. 2.Kayes NM, McPherson KM. Human technologies in rehabilitation: “Who” and “How” we are with our clients. Disability & Rehabilitation. 2012;34(22):1907-1911 5p. doi:10.3109/09638288.2012.670044. 3. Rosin T. Fee-for-service vs. value-based care: 6 points of debate raised by health policy experts. http://www.beckershospitalreview.com/finance/fee-for-service-vs-value-based-care-6-points-of-debate-raised-by-health-policy-experts.html

Investigating Professional Development: Comparing Students Self-Assessment with Assessment of the Clinical Instructors

Investigating Professional Development: Comparing Students Self-Assessment with Assessment of the Clinical Instructors Johana Kontarovsky, SPT Mentor: Jennifer Hastings PT, PhD Background: Professional behavior and self-assessment are aspects that are paramount to being a successful medical professional. Purpose: This purpose of this study was to look at the development of professionalism in the cohort of 2020 at our institution. The concept was to investigate the students’ use of reflection as a foundation for personal and professional development. Methods: The Self Reflection and Insight Scale (SRIS) was given to the SPTs September and December 2017 as well as May of 2020. The class of 2020 Clinical Performance Instrument (CPI) questions addressing professionalism were evaluated for the first and second internships. Numerical scores from the CI and student were recorded and key words were identified in the SPTs and Clinical Instructors (CI) comments. Results: The SRIS showed a significant change in total scale score and the subscale of “need for self-reflection” between the start and the end of the first semester. No significant change between time two and time three. Students consistently rated themselves lower than the CI on the objective measures of professional behavior and professional development. The difference was statistically significant for the first internship only. Conclusion: SPTs did not demonstrate a continuum of progressing self-reflection or professional development. There is a possibility that these results were in part due to the stress experienced by the students during the pandemic