Holt, Sheryl L; Kuperstein, Janice; Effgen, Susan K
Surveys have reported that most school-based physical therapists perceive ideal practices are not commonly implemented in their settings. Our aim was to obtain a more in-depth understanding of these perceptions through open-ended inquiry. Qualitative data were derived from voluntary open-ended responses provided upon completion of a survey regarding school-based physical therapy practice. Of the survey's 561 participants, 250 provided open-ended commentaries that were analyzed using interpretive phenomenology. Six qualitative themes emerged from the open-ended responses, including: In quest: Meeting students' school-based needs via physical therapy; Seeking relatedness: Finding working teams in the school system; Building understanding: Developing a voice/identity in the school context; Stretched beyond limits: Managing workloads; Networking: Coordinating services outside school to meet student needs; Defying definition: What does working in an educational model mean? School-based physical therapists seek to meet educationally relevant physical therapy needs of students, ages 3 to 21 years. Successes appear woven of a multitude of factors such as therapist expertise, team dynamics, and district supports.
Moriarty, Susan; Brown, Suzanne Robben
This case report describes the impact of the post-professional doctor of physical therapy curriculum on the role of one physical therapist employed as a special education related service provider. Physical therapists working in the public school setting play an important role in promoting success for students with physical disabilities as…
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Wynarczuk, Kimberly D; Chiarello, Lisa A; Gohrband, Catherine L
The aims of this study were to (1) describe the practices that school-based physical therapists use in developing student goals, and (2) identify facilitators and barriers to development of goals that are specific to participation in the context of the school setting. 46 school-based physical therapists who participated in a previous study on school-based physical therapy practice (PT COUNTS) completed a questionnaire on goal development. Frequencies and cross tabulations were generated for quantitative data. Open-ended questions were analyzed using an iterative qualitative analysis process. A majority of therapists reported that they frequently develop goals collaboratively with other educational team members. Input from teachers, related services personnel, and parents has the most influence on goal development. Qualitative analysis identified five themes that influence development of participation-based goals: (1) school-based philosophy and practice; (2) the educational environment, settings, and routines; (3) student strengths, needs, and personal characteristics; (4) support from and collaboration with members of the educational team; and (5) therapist practice and motivation. Goal development is a complex process that involves multiple members of the educational team and is influenced by many different aspects of practice, the school environment, and student characteristics.
Kota, Munetsugu; Kudo, Hiroyuki; Okita, Kazuhiko
[Purpose] The survey aimed to clarify the factors that affect physiotherapists' job satisfaction. [Subjects and Methods] To examine factors affecting physical therapists' job satisfaction using a cross-sectional study with a questionnaire survey. Subjects were 193 first-year physical therapists who participated in a newcomer orientation at Hiroshima Prefectural Physical Therapy Association. The questionnaire comprised items concerning physical therapists' satisfaction with their work, motives for becoming physical therapists, education in school, internships, the workplace, and comfort in the workplace. [Results] Subjects were divided into two groups according to their satisfaction with their occupation. The "high satisfaction" group included 157 subjects, and the group "low satisfaction" group included 36 subjects. Using logistic regression analysis, items concerning comfort in the workplace, motives for becoming physical therapists, and learning in school were analysed. [Conclusion] Factors affecting physical therapists' job satisfaction were primarily influenced by previous experience and working conditions.
Schafer, D Sue
The nature of managerial work in the commercial sector has not been studied since the 1970s, and little is known about the work of managers in the health care sector. In this study, the perceived importance of managerial role and skill categories among 3 groups of physical therapists were studied to better understand the work priorities of physical therapist managers. Two groups of subjects were physical therapist managers in hospitals or private practices. A third group consisted of faculty members in professional physical therapist education programs. Respondents (n=343) rated the importance of 75 managerial activities. Responses related to 16 predetermined work categories were placed in rank order by group. A multivariate analysis of variance (MANOVA) was used to identify differences among groups. All groups identified communication, financial control, entrepreneur, resource allocator, and leader as the 5 most important categories and rated technical expert and figurehead as least important. The MANOVA showed differences between faculty members and private practice managers in 15 work categories, between hospital-based managers and private practice managers in 9 categories, and between faculty members and hospital-based managers in 8 categories. Work setting appears to have an impact on level of importance placed on managerial work categories. The strongest candidates for "universal" physical therapist managerial work categories were communication, financial control, and resource allocator.
... bone or a bad injury, you know how hard it can be to do normal things, like walk or throw a baseball. Physical therapy ... sessions, though it can be a lot of hard work to make muscles stronger and learn to do new things. Some kids might see a PT just one ...
Sluijs, E.M.; Zee, J. van der; Kok, G.J.
This article describes differences between physical therapists in terms of the attention they pay to educating patients. The differences between therapists were identified from audiotaped treatment sessions of 1837 patients, recorded by physical therapists in non-institutional care in the
Riendeau, Catherine; Parent-Houle, Valérie; Lebel-Gabriel, Marie Eve; Gauvin, Patrick; Liu, Le Yu; Pearson, Isabelle; Hunt, Matthew R
Qualitative study using interpretive description methodology. The purpose of this study was to better understand how ethical issues are experienced by university sports team athletic therapists and physical therapists. In clinical practice, sports teams are associated with a range of ethical issues. Issues commonly reported in the literature include confidentiality, return-to-play decisions, conflicts of interest, advertising, doping, and use of local anesthetic. To date, there has been limited examination of how athletic therapists and physical therapists involved with sports teams experience these ethical issues, and limited exploration of how these ethical issues, when encountered, are shaped by therapists' professional roles and responsibilities. Semi-structured interviews were conducted with 11 athletic or physical therapists working with sports teams in 5 Canadian provinces. The data were analyzed inductively, using a recursive approach and constant comparative techniques. Four key themes were developed relating to the participants' experiences of ethical issues: establishing and maintaining professional boundaries, striving for respectful and effective collaboration, seeking answers to ethical concerns, and living with the repercussions of challenging decisions. While many ethical issues reported by participants resemble those faced by sports medicine physicians, they are experienced in distinctive ways, due to differences in professional roles and identities. Issues concerning professional boundaries were also more prominent for the study participants than the literature has reported them to be for sports medicine physicians. Effective communication and enhanced collaboration appear to be key elements in managing these ethical challenges.
Cramm, Heidi; Egan, Mary
Poor handwriting is a common reason for referral to school-based occupational therapy. A survey was used to explore the extent to which current practice patterns in Ontario, Canada, align with evidence on effective intervention for handwriting. Knowledge-to-practice gaps were identified related to focus on performance components versus…
Erwin, Heather; Beighle, Aaron; Carson, Russell L.; Castelli, Darla M.
Physical activity (PA) participation levels among youth remain well below national recommendations. Thus, a variety of strategies to promote youth PA have been advocated, including multifaceted, school-based approaches. One identified as having great potential is a comprehensive school physical activity program (CSPAP). The goal of a CSPAP is to…
Naylor, Patti-Jean; Nettlefold, Lindsay; Race, Douglas; Hoy, Christa; Ashe, Maureen C; Wharf Higgins, Joan; McKay, Heather A
Implementation science is an emerging area in physical activity (PA) research. We sought to establish the current state of the evidence related to implementation of school-based PA models to explore 1) the relationship between implementation and health outcomes, and 2) factors that influence implementation. We searched 7 electronic databases (1995-2014) and included controlled studies of school-based PA programmes for healthy youth (6-18 y) measuring at least one physical health-related outcome. For objective 1, studies linked implementation level to student-level health outcome(s). For objective 2, studies reported factors associated with implementation. There was substantial variability in how health outcomes and implementation were assessed. Few studies linked implementation and health outcomes (n=15 interventions). Most (11/15) reported a positive relationship between implementation and at least one health outcome. Implementation factors were reported in 29 interventions. Of 22 unique categories, time was the most prevalent influencing factor followed by resource availability/quality and supportive school climate. Implementation evaluation supports scale-up of effective school-based PA interventions and thus population-level change. Our review serves as a call to action to 1) address the link between implementation and outcome within the school-based PA literature and 2) improve and standardize definitions and measurement of implementation. Copyright © 2015 Elsevier Inc. All rights reserved.
Greenfield, Bruce H
Caring has been identified as a desirable indicator of professional behavior in the physical therapy profession and as a necessary value for good patient care. Yet caring is an elusive concept with multiple meanings. The present aim was to describe the nature of caring in the clinical practice of five experienced physical therapists. Purposive sampling was used to recruit five experienced physical therapists. Each physical therapist underwent a series of in-depth, open-ended interviews that were transcribed and coded for themes based on similarities and differences. The analysis resulted in three themes: ethics of caring, risks and conflicts of caring, and learning to care. The data indicated for four of the five participants that caring constituted an ethics of practice or moral orientation. Their moral orientation influenced moral judgment that was integrated throughout their clinical and ethical decision-making practice. The findings stress the difficulty of caring in a managed care health care environment that results in conflicting demands for physical therapists to care for their patients in a system that increasingly values cost control and profit margin. However, the findings also describe the ultimate rewards associated with the practice of an ethics of caring in physical therapy practice.
Mccoy, Sarah Westcott; Effgen, Susan K; Chiarello, Lisa A; Jeffries, Lynn M; Villasante Tezanos, Alejandro G
We explored relationships of school-based physical therapy to standardized outcomes of students receiving physical therapy. Using a practice-based evidence research design, School Function Assessment (SFA) outcomes of 296 students with disabilities (mean age 7y 4mo [standard deviation 2y]; 166 males, 130 females), served by 109 physical therapists, were explored. After training, therapists completed 10 SFA scales on students at the beginning and end of the school year. Therapists collected detailed weekly data on services (activities, interventions, types, student participation) using the School-Physical Therapy Interventions for Pediatrics (S-PTIP) system. Stepwise linear regressions were used to investigate S-PTIP predictors of SFA outcomes. Predictors of SFA section outcomes varied in strength, with the coefficient of determination (R 2 ) for each outcome ranging from 0.107 to 0.326. Services that correlated positively with the SFA outcomes included mobility, sensory, motor learning, aerobic/conditioning, functional strengthening, playground access interventions, and higher student participation during therapy (standardized β=0.11-0.26). Services that correlated negatively with the SFA outcomes included providing services within student groups, within school activity, with students not in special education, during recreation activities, and with positioning, hands-on facilitation, sensory integration, orthoses, and equipment interventions (standardized β=-0.14 to -0.22). Consideration of outcomes is prudent to focus services. Overall results suggest we should emphasize active mobility practice by using motor learning interventions and engaging students within therapy sessions. No specific interventions predicted positively on all School Function Assessment (SFA) outcomes. Active movement practice seems related to overall better SFA outcomes. Active mobility practice improved SFA participation, mobility, recreation, and activities of daily living. Engaging
Full Text Available Background: Health professions like dentistry, nursing and physical therapy have been reported at high risk for developing workrelated musculoskeletal disorders. Results of studies conducted in these occupational groups may help formulate prevention strategies. However, no such data among physical therapists has been reported in India. Material and Methods: We conducted an online survey among 100 physiotherapists in Delhi. Results: The response rate was 75%. The prevalence of work-related musculoskeletal disorders is found to be high since 92% of them reported to feel some pain after joining physical therapy which affects daily activities and even sometimes forces them to change their work. Physical therapists specialty, gender, furniture used in clinic and duration of patient contact are found to be related to the pain development (p < 0.05. Conclusions: We need to emphasize the role of ergonomics and techniques of patient handling in development of work-related pain symptoms. Med Pr 2015;66(4:459–469
Jorna-Lakke, Sandra; Soer, Remko; Krijnen, Wim; van der Schans, Cees; Reneman, Michiel; Geertzen, Jan
BACKGROUND: Physical therapists' recommendations to patients to avoid daily physical activity can be influenced by the therapists' kinesiophobic beliefs. Little is known about the amount of influence of a physical therapist's kinesiophobic beliefs on a patient's actual lifting capacity during a
Huijg, Johanna M; Dusseldorp, Elise; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; Middelkoop, Barend J C; Duijzer, Geerke; Crone, Mathilde R
Physical therapists play an important role in the promotion of physical activity (PA) and the effectiveness of PA interventions. However, little is known about the extent to which they implement PA interventions following the intervention protocol and about the factors influencing their implementation behaviors. The study objective was to investigate physical therapists' implementation fidelity regarding PA interventions, including completeness and quality of delivery, and influencing factors with a Theoretical Domains Framework-based questionnaire. The study was based on a cross-sectional design. A total of 268 physical therapists completed the Determinants of Implementation Behavior Questionnaire. Questions about completeness and quality of delivery were based on components and tasks of PA interventions as described by the Royal Dutch Society for Physical Therapy. Multilevel regression analyses were used to identify factors associated with completeness and quality of delivery. High implementation fidelity was found for the physical therapists, with higher scores for completeness of delivery than for quality of delivery. Physical therapists' knowledge, skills, beliefs about capabilities and consequences, positive emotions, behavioral regulation, and the automaticity of PA intervention delivery were the most important predictors of implementation fidelity. Together, the Theoretical Domains Framework accounted for 23% of the variance in both total completeness and total quality scores. The cross-sectional design precluded the determination of causal relationships. Also, the use of a self-report measure to assess implementation fidelity could have led to socially desirable responses, possibly resulting in more favorable ratings for completeness and quality. This study enhances the understanding of how physical therapists implement PA interventions and which factors influence their behaviors. Knowledge about these factors may assist in the development of strategies to
Kang, Min-Hyeok; Kwon, Oh-Yun; Kim, Yong-Wook; Kim, Ji-Won; Kim, Tae-Ho; Oh, Tae-Young; Weon, Jong-Hyuk; Lee, Tae-Sik; Oh, Jae-Seop
To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions. The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists.
Reeder, Deborah L.; Arnold, Sandra H.; Jeffries, Lynn M.; McEwen, Irene R.
The Individuals with Disabilities Improvement Act and No Child Left Behind Act broadened the roles of occupational therapists (OTs) and physical therapists (PTs) to include therapist participation in early intervening services including response to intervention (RTI). This case report describes one school district's inclusion of OT and PT in the…
Mulligan, Edward P; DeVahl, Julie
The specialty niche of sports physical therapy has grown at a significant rate over the past 40 years. Despite this growth there is little information or direction from the physical therapy education accreditation body or professional association to guide academic programs on the interest or necessity of this type of practice content in physical therapy professional degree programs. The purpose of this survey study is to report on the prevalence, attitudes, barriers, resources, and faculty expertise in providing required or elective sports physical therapy course work. Cross-sectional descriptive survey. A 57-item questionnaire with branching logic was distributed via a web-based electronic data capture tool to survey all Commission on Accreditation for Physical Therapy Education (CAPTE) accredited and candidate schools in the United States. Response data was analyzed to describe typical educational program profiles, faculty demographics, and correlational factors consistent with the presence or absence of specific sports physical therapy curricular content. Thirty one percent of the schools responded to the survey and the program demographics were consistent with all currently accredited schools in regards to their geography, Carnegie classification, and faculty and student size. Forty three percent of programs offered a required or elective course distinct to the practice of sports physical therapy. Descriptive information regarding the sequencing, curricular make-up, resources, and assessment of content competence is reported. The odds of providing this content nearly doubles for programs that have faculty with sports clinical specialist credentials, accredited sports residency curriculums, or state practice acts that allow sports venue coverage. This survey provides an initial overview of sports physical therapy educational efforts in professional physical therapy degree programs. The data can used to spur further discussion on the necessity, structure, and
Full Text Available Background: Professional burnout results from prolonged exposure to chronic, job-related stressors. According to Christina Maslach, professional burnout is a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment. Literature includes a number of reports on burnout syndrome within health service, but hardly ever do they make any references to physiotherapists. The purpose of this study is assessment of the level of professional burnout in a group of physiotherapists and investigating relationships between the indices of burnout syndrome and selected demographic as well as organizational variables. Material and Methods: The study group consisted of 151 physiotherapists with at least 3 years of experience, employed in various health service outposts in Krakow, Poland. The Maslach Burnout Inventory (MBI was used to measure emotional exhaustion, depersonalization and personal accomplishment. A questionnaire for the description of socio-demographic and work characteristics was used as well. Results: Job burnout among the physiotherapists was manifested by an increased emotional exhaustion and decreased sense of personal achievement. Emotional exhaustion was significantly higher among physical therapists working with adults and employed in hospitals, depersonalization was higher among men, hospital workers and employees with seniority from 15 to 19 years, personal accomplishment was decreased among men and less-educated therapists. Conclusions: The study confirmed that indicators of burnout in physiotherapists are significantly associated with selected demographic and organizational variables. It is necessary to undertake a more exhaustive study of burnout in this group of employees, and implement elements of prevention. Med Pr 2014;65(4:453–462
Zalewski, Kathryn; Alt, Carlynn; Arvinen-Barrow, Monna
Cross-sectional study. To describe readiness for change and barriers to physical activity in older adults and to contrast perceptions of physical therapists and patients using the Barriers to Being Active Quiz. Regular physical activity is vital to recovery after discharge from physical therapy. Physical therapists are positioned to support change in physical activity habits for those transitioning to home care. Understanding of readiness for change and barriers to physical activity could optimize recovery. Thirteen physical therapists enrolled in the study and invited patients who met the inclusion criteria to enroll (79 patients enrolled). The physical therapists provided the ICD-9 code, the physical therapist diagnosis, and completed the Barriers to Being Active Quiz as they perceived their patients would. The enrolled patients provided demographics and filled out the Satisfaction With Life Scale, the stages-of-change scale for physical activity, and the Barriers to Being Active Quiz. Patients were predominantly in the early stages of readiness for change. Both patients and physical therapists identified lack of willpower as the primary barrier to physical activity. Patients identified lack of willpower and social influence as critical barriers more often than physical therapists, whereas physical therapists identified fear of injury and lack of time more often than their patients did. Differences between physical therapists and their patients were noted for fear of injury (z = 2.66, P = .008) and lack of time (z = 3.46, P = .001). The stage of change for physical activity impacted perception of social influence (χ2 = 9.64, Pbarriers to physical activity may allow physical therapists to better tailor intervention strategies to impact physical activity behavior change.
Swisher, Laura Lee; Hiller, Peggy
In June 2009, the House of Delegates (HOD) of the American Physical Therapy Association (APTA) passed a major revision of the APTA Code of Ethics for physical therapists and the Standards of Ethical Conduct for the Physical Therapist Assistant. The revised documents will be effective July 1, 2010. The purposes of this article are: (1) to provide a historical, professional, and theoretical context for this important revision; (2) to describe the 4-year revision process; (3) to examine major features of the documents; and (4) to discuss the significance of the revisions from the perspective of the maturation of physical therapy as a doctoring profession. PROCESS OF REVISION: The process for revision is delineated within the context of history and the Bylaws of APTA. FORMAT, STRUCTURE, AND CONTENT OF REVISED CORE ETHICS DOCUMENTS: The revised documents represent a significant change in format, level of detail, and scope of application. Previous APTA Codes of Ethics and Standards of Ethical Conduct for the Physical Therapist Assistant have delineated very broad general principles, with specific obligations spelled out in the Ethics and Judicial Committee's Guide for Professional Conduct and Guide for Conduct of the Physical Therapist Assistant. In contrast to the current documents, the revised documents address all 5 roles of the physical therapist, delineate ethical obligations in organizational and business contexts, and align with the tenets of Vision 2020. The significance of this revision is discussed within historical parameters, the implications for physical therapists and physical therapist assistants, the maturation of the profession, societal accountability and moral community, potential regulatory implications, and the inclusive and deliberative process of moral dialogue by which changes were developed, revised, and approved.
Satoh, Tomonori; Nemoto, Yuki; Utumi, Takako; Munakata, Masanori
In Japan, physical therapists have usually been involved in physical therapy for patients with functional disorders associated with cerebrovascular or orthopedic diseases in hospitals. With the aging of Japanese society, the number of diseased people will progressively increase; thus, it is important to pay much more attention to disease prevention. In this regard, physical therapists are expected to play a new role in the field of preventive medicine. Metabolic syndrome or central obesity with multiple cardiometabolic risks is associated with a high risk of type 2 diabetes or cardiovascular diseases and is now a central target for early detection and intervention for disease prevention. The incidence of metabolic syndrome increases with age, and men showed a higher incidence of metabolic syndrome than women in all generations. We have been involved in the guidance of workers with metabolic syndrome for a long time, and we conducted a multicenter study to establish effective guidance for these worker. In this paper, we will use our evidence to discuss the role of physical therapists in providing guidance for preventing metabolic syndrome. We are now conducting worksite supporting exercise intervention for workers who were resistant to conventional lifestyle guidance. In addition, the unique role of physical therapists in this new trial will be introduced.
Schuemann, Teresa; Hoogenboom, Barbara J.
The role of the Sports physical therapist (PT) as a part of the sports medical team at marathon-type events varies widely. The PT can assume the role of an emergency medical responder (EMR) whose primary role is the management of the athlete in emergency type situations. The role of the EMR extends beyond the care of the athlete to the care and safety of the spectators. In this role, the PT must be prepared to handle any type of emergency situation, which may occur from medical conditions to acute orthopedic/sports injuries, to medical conditions which may be found in the participants of the race or the spectators. Additional roles of the PT can be in pre-race education, pre-participation screening/physicals, and other concerns by the participant related to injury prevention. Regardless of the role assumed by the PT, prior planning is essential for the safety, security, and maximal performance of the participant and to make the race enjoyable and safe for everyone. Level of Evidence: 5 PMID:24175136
Hawkins, Shawn W; Hawkins, Jeremy R
Therapeutic modalities (TM) are used by sports physical therapists (SPT) but how they are used is unknown. To identify the current clinical use patterns for cryotherapy among SPT. Cross-sectional survey. All members (7283) of the Sports Physical Therapy Section of the APTA were recruited. A scenario-based survey using pre-participation management of an acute or sub-acute ankle sprain was developed. A Select Survey link was distributed via email to participants. Respondents selected a treatment approach based upon options provided. Follow-up questions were asked. The survey was available for two weeks with a follow-up email sent after one week. Question answers were the main outcome measures. Reliability: Cronbach's alpha=>0.9. The SPT response rate = 6.9% (503); responses came from 48 states. Survey results indicated great variability in respondents' approaches to the treatment of an acute and sub-acute ankle sprain. SPT applied cryotherapy with great variability and not always in accordance to the limited research on the TM. Continuing education, application of current research, and additional outcomes based research needs to remain a focus for clinicians. 3.
Camden, Chantal; Rivard, Lisa M; Hurtubise, Karen; Héguy, Léa; Berbari, Jade
Communities of practice (CoPs) are useful knowledge translation (KT) strategies, but little is known about their impact on physical therapists' self-perceived practice. The impact of a CoP on physical therapists' self-perceived practice was evaluated, and factors influencing changes in self-perceived knowledge, skills, and practice related to developmental coordination disorder (DCD) were explored. An explanatory sequential mixed-methods design was used, guided by the Theory of Reasoned Action and Theory of Planned Behavior. Physical therapists participated in a DCD physical therapist CoP, which included 2 full-day, face-to-face workshops, with access to a 5-month online forum between the workshops, and completed questionnaires at 3 time-points: before the first workshop, before accessing the online forum, and following the second workshop. Measures completed before and after the CoP included closed-ended questions providing global scores on therapists' self-perceived knowledge, skills, and practice. Physical therapists' sociodemographic characteristics, information-seeking style, use of the online forum, and behavioral change goals were also collected. Paired t-tests, ANCOVAs, and linear regression models were used to analyze the data. Forty-one physical therapists completed all questionnaires. Their self-perceived knowledge, skills, and practice change scores were significantly higher (+0.47, +1.23, and +2.61, respectively; P behavioral changes influence patient outcomes. © 2017 American Physical Therapy Association
Calley, Darren Q; Jackson, Steven; Collins, Heather; George, Steven Z
Cross-sectional. To evaluate the accuracy with which physical therapists identify fear-avoidance beliefs in patients with low back pain by comparing therapist ratings of perceived patient fear-avoidance to the Fear-Avoidance Beliefs Questionnaire (FABQ), Tampa Scale of Kinesiophobia 11-item (TSK-11), and Pain Catastrophizing Scale (PCS). To compare the concurrent validity of therapist ratings of perceived patient fear-avoidance and a 2-item questionnaire on fear of physical activity and harm, with clinical measures of fear-avoidance (FABQ, TSK-11, PCS), pain intensity as assessed with a numeric pain rating scale (NPRS), and disability as assessed with the Oswestry Disability Questionnaire (ODQ). The need to consider psychosocial factors for identifying patients at risk for disability and chronic low back pain has been well documented. Yet the ability of physical therapists to identify fear-avoidance beliefs using direct observation has not been studied. Eight physical therapists and 80 patients with low back pain from 3 physical therapy clinics participated in the study. Patients completed the FABQ, TSK-11, PCS, ODQ, NPRS, and a dichotomous 2-item fear-avoidance screening questionnaire. Following the initial evaluation, physical therapists rated perceived patient fear-avoidance on a 0-to-10 scale and recorded 2 influences on their ratings. Spearman correlation and independent t tests determined the level of association of therapist 0-to-10 ratings and 2-item screening with fear-avoidance and clinical measures. Therapist ratings of perceived patient fear-avoidance had fair to moderate interrater reliability (ICC2,1 = 0.663). Therapist ratings did not strongly correlate with FABQ or TSK-11 scores. Instead, they unexpectedly had stronger associations with ODQ and PCS scores. Both 2-item screening questions were associated with FABQ-physical activity scores, while the fear of physical activity question was also associated with FABQ-work, TSK-11, PCS, and ODQ scores
Objectives. Non-communicable diseases and limited participation in school physical education have become increasing concerns in South Africa. In response to these concerns, a schoolbased physical activity intervention, Healthnutz, was implemented in three primary schools in Alexandra Township, Johannesburg.
Jang, Ho Young; Kim, You Lim; Lee, Suk Min
[Purpose] The purpose of this study looked into physical therapists? perception and use of balance measures for stroke patients. [Subjects and Methods] Three hundred eighty two physical therapists who understood the purpose of this study, agreed on their participation in this study, were treating or treated stroke patients. A Cross-sectional study based on self-administered questionnaire that had a total of 41 questions was performed in South Korea. 382 questionnaires were used for analysis. ...
Clewley, Derek; Rhon, Dan; Flynn, Tim; Koppenhaver, Shane; Cook, Chad
Physical therapists' familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. The purposes of this study were to identify physical therapists' characteristics related to familiarity of health services utilization and health seeking behaviour, and to assess what health seeking behaviour factors providers felt were related to health services utilization. We administered a survey based on the Andersen behavioural model of health services utilization to physical therapists using social media campaigns and email between March and June of 2017. In addition to descriptive statistics, we performed binomial logistic regression analysis. We asked respondents to rate familiarity with health services utilization and health seeking behaviour and collected additional characteristic variables. Physical therapists are more familiar with health services utilization than health seeking behaviour. Those who are familiar with either construct tend to be those who assess for health services utilization, use health services utilization for a prognosis, and believe that health seeking behaviour is measurable. Physical therapists rated need and enabling factors as having more influence on health services utilization than predisposing and health belief factors. Physical therapists are generally familiar with health services utilization and health seeking behaviour; however, there appears to be a disconnect between what is familiar, what is perceived to be important, and what can be assessed for both health services utilization and health seeking behaviour. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. All rights reserved.
Kern, Ben D.; Graber, Kim C.; Shen, Sa; Hillman, Charles H.; McLoughlin, Gabriella
Background: Socioeconomic status (SES) is the most accurate predictor of academic performance in US schools. Third-grade reading is highly predictive of high school graduation. Chronic physical activity (PA) is shown to improve cognition and academic performance. We hypothesized that school-based PA opportunities (recess and physical education)…
Cluss, Patricia; Lorigan, Devin; Kinsky, Suzanne; Nikolajski, Cara; McDermott, Anne; Bhat, Kiran B.
Background: Childhood obesity increases health risk, and modest physical activity can impact that risk. Schools have an opportunity to help children become more active. Purpose: This study implemented a program offering extra school-day activity opportunities in a rural school district where 37% of students were obese or overweight in 2005 and…
Roush, Susan E; Cox, Kenneth; Garlick, John; Kane, Molly; Marchand, Lauren
Physical therapists' perceptions of sexual boundaries in clinic settings in the United States have not been studied. Given the magnitude of potential consequences of sexual boundary violations, examination of this topic is imperative. The purpose of this study was to describe the perceptions of sexual boundaries among licensed physical therapists in the United States. Licensed physical therapists from Arkansas, Kansas, Maine, Ohio, and Oregon were contacted by email and asked to complete a sexual boundaries questionnaire via Survey Monkey™; 967 surveys (7.3%) were returned. While most physical therapists practice within the profession's Code of Ethics, there are practitioners who date current and former patients, and condone patients' sexual banter in the clinic. Almost half (42%) of the participants acknowledged feeling sexually attracted to a patient. While gender differences were seen throughout the analyses, generally, the demographic and professional variables did not account for meaningful variance. Results were similar to previous research on physiotherapists in other countries. Sexuality is part of the physical therapy practice environment and physical therapists' understanding of sexual boundaries is ambiguous. These data can inform professional conversation on sexual boundaries in physical therapy practice leading to greater understanding and decreased potential for violations.
Jensen, Gail M; Hack, Laurita M; Nordstrom, Terrence; Gwyer, Janet; Mostrom, Elizabeth
This perspective shares recommendations that draw from (1) the National Study of Excellence and Innovation in Physical Therapist Education research findings and a conceptual model of excellence in physical therapist education, (2) the Carnegie Foundation's Preparation for the Professions Program (PPP), and (3) research in the learning sciences. The 30 recommendations are linked to the dimensions described in the conceptual model for excellence in physical therapist education: Culture of Excellence, Praxis of Learning, and Organizational Structures and Resources. This perspective proposes a transformative call for reform framed across 3 core categories: (1) creating a culture of excellence, leadership, and partnership, (2) advancing the learning sciences and understanding and enacting the social contract, and (3) implementing organizational imperatives. Similar to the Carnegie studies, this perspective identifies action items (9) that should be initiated immediately in a strategic and systematic way by the major organizational stakeholders in physical therapist education. These recommendations and action items provide a transformative agenda for physical therapist education, and thus the profession, in meeting the changing needs of society through higher levels of excellence. © 2017 American Physical Therapy Association.
O'Keeffe, Mary; Cullinane, Paul; Hurley, John; Leahy, Irene; Bunzli, Samantha; O'Sullivan, Peter B; O'Sullivan, Kieran
Musculoskeletal physical therapy involves both specific and nonspecific effects. Nonspecific variables associated with the patient, therapist, and setting may influence clinical outcomes. Recent quantitative research has shown that nonspecific factors, including patient-therapist interactions, can influence treatment outcomes. It remains unclear, however, what factors influence patient-therapist interaction. This qualitative systematic review and meta-synthesis investigated patients' and physical therapists' perceptions of factors that influence patient-therapist interactions. Eleven databases were searched independently. Qualitative studies examining physical therapists' and patients' perceptions of factors that influence patient-therapist interactions in musculoskeletal settings were included. Two reviewers independently selected articles, assessed methodological quality using the Critical Appraisal Skills Programme (CASP), and performed the 3 stages of analysis: extraction of findings, grouping of findings (codes), and abstraction of findings. Thirteen studies were included. Four themes were perceived to influence patient-therapist interactions: (1) physical therapist interpersonal and communication skills (ie, presence of skills such as listening, encouragement, confidence, being empathetic and friendly, and nonverbal communication), (2) physical therapist practical skills (ie, physical therapist expertise and level of training, although the ability to provide good education was considered as important only by patients), (3) individualized patient-centered care (ie, individualizing the treatment to the patient and taking patient's opinions into account), and (4) organizational and environmental factors (ie, time and flexibility with care and appointments). Only studies published in English were included. A mix of interpersonal, clinical, and organizational factors are perceived to influence patient-therapist interactions, although research is needed to identify
Brewer, Wayne; Ogbazi, Raluchukwu; Ohl, Devan; Daniels, Jeffry; Ortiz, Alexis
Physical therapists (PTs) work in a variety of healthcare settings with varied levels of physical activity demands placed on them. The purpose of this study is to compare the physical activity (PA) levels between PTs in inpatient versus outpatient environments for one work week using a cross-sectional design. Sixty-one PTs (30 inpatient, 31 outpatient) wore a tri-axial accelerometer and inclinometer for one work-week. The number steps-per-day, PA intensities, energy expenditures and postural positions adopted during the work day were recorded. Significantly longer amounts of time spent sitting was found for inpatient PTs regardless of the significantly higher number of steps-per-day. Outpatient PTs had a higher number of breaks from sedentary activity with those breaks being longer than the inpatient PTs. The percentage of time spent performing moderate-vigorous PA approached significance implying more time was spent performing these types of activities for outpatient PTs. The energy expenditures between the two groups of PTs were not different. This study compared the differences in physical activity levels between physical therapists who worked at inpatient versus outpatient environment as little is known about their activity levels. Inpatient physical therapists took more steps per day than outpatient physical therapists but the outpatient physical therapists were less sedentary and took more frequent and longer breaks from sedentary activities. The energy expenditures were similar between both types of therapists and this may be reflective of the gender and bodyweight differences between the groups that equalizes the energy expenditures. The findings of this study suggests that there are differences in the physical activity demands between inpatient and outpatient physical therapists. The results of this study may serve dual purposes: (1) employers may be able to more accurately describe the expected physical activity demands to future employees; (2
Greicimar de Oliveira
Full Text Available Objective: To evaluate the knowledge of health team from Basic Health Units in the city of Coari-AM, Brazil, on the action of physical therapist in primary care. Methods: A quantitative,exploratory and descriptive study, like a field survey conducted in 11 primary care units in Coari, Amazonas state. The data were collected through a questionnaire comprising closed questions regarding the action of physical therapist in primary care. 76 professionals joinedin the survey by category: (05 physicians, (10 nurses, (08 nursing technicians and (53 community health workers. Results: 61.64% (n = 45 of the professionals working in the family health team reported knowing the action of physical therapist in primary care; 79.45%(n = 58 referred it in secondary level and 69.86% (n = 51 at the tertiary level of health care. Conclusion: This work showed some knowledge of professionals on the professional action of physical therapists in primary care; however, the knowledge for this level presents itself disadvantaged in relation to other levels of health care. We demonstrated that a share of professionals presented difficulties to consider the possibility of physiotherapeuticintervention in diseases mostly worked in primary care, but the reference to the viability of action of physical therapist for different publics was satisfactory. This conclusion does notexhaust the possibility of discussing the proposed theme.
van Bodegom-Vos, Leti; Verhoef, John; Dickmann, Margot; Kleijn, Marjon; van Vliet, Ingrid; Hurkmans, Emalie; van der Wees, Philip; Vliet Vlieland, Thea
Although the increasing complexity and expansion of the body of knowledge in physical therapy have led to specialized practice areas to provide better patient care, the impact of specialization on guideline implementation has been scarcely studied. Objectives The objective of this study was to identify the similarities and differences in barriers to the implementation of a Dutch rheumatoid arthritis (RA) guideline by generalist and specialist physical therapists. Design This observational study consisted of 4 focus group interviews in which 24 physical therapists (13 generalist and 11 specialist physical therapists) participated. Physical therapists were asked to discuss barriers to the implementation of the RA guideline. Data were analyzed qualitatively using a directed approach to content analysis. Both the interviews and the interview analysis were informed by a previously developed conceptual framework. Besides a number of similarities (eg, lack of time), the present study showed important, although subtle, differences in barriers to the implementation of the RA guideline between generalist physical therapists and specialist physical therapists. Generalist physical therapists more frequently reported difficulties in interpreting the guideline (cognitive barriers) and had less favorable opinions about the guideline (affective barriers) than specialist physical therapists. Specialist physical therapists were hampered by external barriers that are outside the scope of generalist physical therapists, such as a lack of agreement about the roles and responsibilities of medical professionals involved in the care of the same patient. The identified differences in barriers to the implementation of the RA guideline indicated that the effectiveness of implementation strategies could be improved by tailoring them to the level of specialization of physical therapists. However, it is expected that tailoring implementation strategies to barriers that hamper both generalist
Collard, D.C.M.; Verhagen, E.A.L.M.; Chin A Paw, M.J.M.; Knol, D.L.; van Mechelen, W.
Objective: To study the effects of a school-based injury prevention program on physical activity injury incidence and severity. Design: Cluster randomized controlled trial performed from January 1, 2006, through July 31, 2007. Setting: Forty Dutch primary schools. Participants: Atotal of 2210
Levac, Danielle; Glegg, Stephanie; Colquhoun, Heather; Miller, Patricia; Noubary, Farzad
Describe the clinical use of virtual reality (VR)/active videogaming (AVG) by physical therapists (PTs) and occupational therapists (OTs) in Canada, identify usage barriers and facilitators, evaluate factors that predict intention to use VR/AVGs, and determine therapists' learning needs. Cross-sectional survey. Online survey of therapists in Canada who were members of 1 of 26 professional PT or OT colleges or associations using the Assessing Determinants Of Prospective Take-up of Virtual Reality (ADOPT-VR2) Instrument. We received 1071 (506 PTs, 562 OTs, 3 dual-trained) responses. Forty-six percent had clinical VR/AVG experience; only 12% reported current use, with the Wii being the most clinically accessible (41%) system. Therapists used VR/AVGs primarily in rehabilitation (32%) and hospital (29%) settings, preferentially targeting balance (39.3%) and physical activity (19.8%) outcomes. Stroke (25.8%), brain injury (15.3%), musculoskeletal (14.9%), and cerebral palsy (10.5%) populations were most frequently treated. Therapists with VR/AVG experience rated all ADOPT-VR2 constructs more highly than did those without experience (P < 0.001). Factors predictive of intention to use VR included the technology's perceived usefulness and therapist self-efficacy in VR/AVG use (P < 0.001). Highest-rated barriers to VR/AVG use were lack of funds, space, time, support staff, and appropriate clients, whereas facilitators included client motivation, therapist knowledge, and management support. Most (76%) respondents were interested in learning more. Understanding use, predictors of use, and learning needs is essential for developing knowledge translation initiatives to support clinical integration of VR/AVGs. Results of this first national survey will inform the creation of resources to support therapists in this field.
Full Text Available Purpose: To evaluate the feasibility of regional physical therapy networks including continuing education in rheumatology. The aim of these networks was to improve care provided by primary care physical therapists by improving specific knowledge, technical and communicative skills and the collaboration with rheumatologists. Methods: In two regions in The Netherlands continuing education (CE programmes, consisting of a 5-day postgraduate training course followed by bimonthly workshops and teaching practices, were organised simultaneously. Network activities included consultations, newsletters and the development of a communication guideline. Endpoint measures included the participation rate, compliance, quality of the CE programme, teaching practices, knowledge, network activities, communication, number of patients treated and patient satisfaction. Results: Sixty-three physical therapists out of 193 practices (33% participated in the project. They all completed the education programmes and were formally registered. All evaluations of the education programmes showed positive scores. Knowledge scores increased significantly directly after the training course and at 18 months. A draft guideline on communication between physical therapists and rheumatologists was developed, and 4 newsletters were distributed. A substantial proportion of physical therapists and rheumatologists reported improved communication at 18 months. The mean number of patients treated by physical therapists participating in the networks increased significantly. Patients' satisfaction scores within the networks were significantly higher than those from outside the networks at 18 months. Conclusions: Setting up a system of networks for continuing education for physical therapists regarding the treatment of patients with rheumatic diseases is feasible. Further research will focus on the effectiveness of the system and its implementation on a larger scale.
Hobfoll, Stevan E.; Penner, Louis A.
Investigated effect of a person's physical attractiveness on a therapist's initial judgment of that person's self-concept. Videotapes and audiotapes were made of interviews with attractive and unattractive males and females. Physically attractive persons of both sexes were rated as having better self-concepts than unattractive persons. (Author)
Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael
Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high
Goldsmith, Joy; Wittenberg-Lyles, Elaine; Frisby, Brandi N; Platt, Christine Small
Entry-level physical therapists provide clinical care for patients with functional mobility limitations. Their care spans the continuum of settings, disease processes, and diagnoses. Although effective communication skills are required to conduct physical therapy work, there is limited instruction provided in physical therapy education and students receive little exposure to seriously or chronically ill patients. The goal of this study was to assess the effects of communication training for the entry-level physical therapist facing palliative and end-of-life communication with patients/families. A pre-post survey design and narrative writing were used to assess the effect of the COMFORT communication training curriculum provided to doctorally trained, graduating physical therapists. The study demonstrated decreased student apprehension about communicating with dying patients and their families, and a comparison of mean scores reflecting the students' communication knowledge, confidence, and behaviors increased in a positive direction. As students became more willing to communicate, they were also more adept at integrating task and relational messages, as well as assimilating emotional support messages for patients and families. This study shows promise for the feasibility and utilization of the COMFORT curriculum for entry-level physical therapists. Further research should address the integration of COMFORT earlier into physical therapy education, as well as assess evidence of COMFORT communication skills in the clinical context.
Elkins, Mark R; Moseley, Anne M; Pinto, Rafael Z
It is unclear whether the Physiotherapy Evidence Database (PEDro) is widely and equally used by physical therapists in Brazil. As PEDro is considered a key resource to support evidence-based physical therapy, analyses of PEDro usage could reflect the extent of dissemination of evidence-based practice. To describe the usage of PEDro among the five regions of the World Confederation for Physical Therapy (WCPT) and, in more detail, in the South American region and Brazil over a 5-year period. PEDro home-page sessions and the number of searches performed were logged for a 5-year period (2010-2014). Absolute usage and relative usage were calculated for each region of the WCPT, each country in the South American region of WCPT, and each Regional Council (CREFITO) in Brazil. Europe had the highest absolute and relative usage among the five regions of the WCPT (971 searches per million-population per year), with the South American region ranked 4th in absolute terms and 3rd in relative terms (486). Within the South American region, Brazil accounted for nearly 60% of searches (755). Analysis at a national level revealed that usage per physical therapist in Brazil is very low across all CREFITOs. The highest usage occurred in CREFITO 6 with 1.3 searches per physical therapist per year. PEDro is not widely and equally used throughout Brazil. Strategies to promote PEDro and to make PEDro more accessible to physical therapists speaking Portuguese are needed.
Russek, Leslie N; LaShomb, Emily A; Ware, Amy M; Wesner, Sarah M; Westcott, Vanessa
Joint hypermobility syndrome (JHS) is one of the most common inherited connective tissue disorders. It causes significant pain and disability for all age groups, ranging from developmental delay among children to widespread chronic pain in adults. Experts in JHS assert that the condition is under-recognized and poorly managed. The aim of this study was to assess US physical therapists' knowledge about JHS compared with other causes of widespread pain and activity limitations: fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis. Cross-sectional, Internet-based survey of randomly selected members of the American Physical Therapy Association and descriptive statistics were used to explore physical therapists' knowledge about JHS, fibromyalgia, juvenile rheumatoid arthritis and adult rheumatoid arthritis, and chi square was used to compare knowledge about the different conditions. The response rate was 15.5% (496). Although 36% recognized the Beighton Scale for assessing joint hypermobility, only 26.8% of respondents were familiar with the Brighton Criteria for diagnosing JHS. Few respondents (11-19%) realized that JHS has extra-articular features such as anxiety disorder, fatigue, headache, delayed motor development, easy bruising and sleep disturbance. Physical therapists working in environments most likely to see patients with JHS underestimated the likely prevalence in their patient population. The results suggest that many physical therapists in the United States are not familiar with the diagnostic criteria, prevalence or common clinical presentation of JHS. Copyright © 2014 John Wiley & Sons, Ltd.
Pechak, Celia; Thompson, Mary
Internationalization is expanding its presence in higher education in the United States. Reflecting this trend that includes incorporating global perspectives in the curricula, physical therapist education programmes increasingly offer international opportunities such as International Service-Learning (ISL) to their students. Service-learning, a teaching strategy that integrates community service with structured learning activities, has gained broad acceptance in health professions education including physical therapy, and is therefore the focus of this paper. The specific purposes of this paper were to identify and analyse the commonalities that existed among established ISL programmes within physical therapist education programmes in terms of structures and processes, and to consider its broader implications for physical therapist education. A descriptive, exploratory study was performed using grounded theory. Snowball and purposive, theoretical sampling yielded 14 faculty members with experience in international service, international learning or ISL in physical therapist education programmes. Faculty were interviewed by phone. Interview transcriptions and course documents were analysed applying grounded theory methodology. Data from eight programmes which met the operational definition of established ISL were used to address the purposes of this paper. Five phases of establishing an ISL programme were identified: development, design, implementation, evaluation, and enhancement. Although no single model exists for ISL in physical therapist education; commonalities in structures and processes were identified in each phase. However, attention to service objectives and outcomes is lacking. While analysis revealed that each programme shared commonalities and demonstrated differences in structures and processes compared with the other programmes, the study demonstrated a general lack of focus on formal community outcomes which raises ethical
Fabíola Maria Sabino Meireles
Full Text Available Objective: To characterize the main strategies and parameters used by physical therapists in difficult mechanical ventilation weaning. Methods: Cross-sectional study including all the physical therapists working in adult Intensive Care Units in three public hospitals in Fortaleza-CE. A questionnaire with closed questions related to difficult mechanical ventilation weaning was applied, with either one or multiple answers. The data was treated with descriptive and non-parametric analysis. Results: Among the parameters mostly used by the 56 interviewed physical therapists for the difficult weaning, were found: current volume reduction (26 - 46.4% and desaturation during aspiration (17 - 30.4%. It was observed that 38 (67.9% alternate T-tube and continuous positive airway pressure (CPAP as strategies for difficult weaning, and 28 (50% reported reducing the pressure support. There was no statistical difference between the strategies used in the studied hospitals, neither correlation between strategies and parameters. Conclusion: It was found that physical therapists have been performing similar strategies, which are also shown in the literature, but this is not the case with the parameters. The parameters used are not supported by the literature.
Barnes, Lisa Jayroe
With the growing multicultural population within the United States, healthcare providers need to be prepared to care for and educate adult clients from various cultural backgrounds. The purpose of the study was to examine the teaching and assessment methods being used by faculty in the education of future physical therapists in teaching the…
Langan, Jeanne; Subryan, Heamchand; Nwogu, Ifeoma; Cavuoto, Lora
With the patient care experience being a healthcare priority, it is concerning that patients with stroke reported boredom and a desire for greater fostering of autonomy, when evaluating their rehabilitation experience. Technology has the potential to reduce these shortcomings by engaging patients through entertainment and objective feedback. Providing objective feedback has resulted in improved outcomes and may assist the patient in learning how to self-manage rehabilitation. Our goal was to examine the extent to which physical and occupational therapists use technology in clinical stroke rehabilitation home exercise programs. Surveys were sent via mail, email and online postings to over 500 therapists, 107 responded. Conventional equipment such as stopwatches are more frequently used compared to newer technology like Wii and Kinect games. Still, less than 25% of therapists' report using a stopwatch five or more times per week. Notably, feedback to patients is based upon objective data less than 50% of the time by most therapists. At the end of clinical rehabilitation, patients typically receive a written home exercise program and non-technological equipment, like theraband and/or theraputty to continue rehabilitation efforts independently. The use of technology is not pervasive in the continuum of stroke rehabilitation. Implications for Rehabilitation The patient care experience is a priority in healthcare, so when patients report feeling bored and desiring greater fostering of autonomy in stroke rehabilitation, it is troubling. Research examining the use of technology has shown positive results for improving motor performance and engaging patients through entertainment and use of objective feedback. Physical and occupational therapists do not widely use technology in stroke rehabilitation. Therapists should consider using technology in stroke rehabilitation to better meet the needs of the patient.
Rotor, Esmerita R; Capio, Catherine M
Clinical reasoning is essential for physical therapists to engage in the process of client care, and has been known to contribute to professional development. The literature on clinical reasoning and experiences have been based on studies from Western and developed nations, from which multiple influencing factors have been found. A developing nation, the Philippines, has distinct social, economic, political, and cultural circumstances. Using a phenomenological approach, this study explored experiences of Filipino physical therapists on clinical reasoning. Ten therapists working in three settings: 1) hospital; 2) outpatient clinic; and 3) home health were interviewed. Major findings were: a prescription-based referral system limited clinical reasoning; procedural reasoning was a commonly experienced strategy while diagnostic and predictive reasoning were limited; factors that influenced clinical reasoning included practice setting and the professional relationship with the referring physician. Physical therapists' responses suggested a lack of autonomy in practice that appeared to stifle clinical reasoning. Based on our findings, we recommend that the current regulations governing PT practice in the Philippines may be updated, and encourage educators to strengthen teaching approaches and strategies that support clinical reasoning. These recommendations are consistent with the global trend toward autonomous practice.
Jones, Taryn M; Dear, Blake F; Hush, Julia M; Titov, Nickolai; Dean, Catherine M
Physical therapist interventions, such as those designed to change physical activity behavior, are often complex and multifaceted. In order to facilitate rigorous evaluation and implementation of these complex interventions into clinical practice, the development process must be comprehensive, systematic, and transparent, with a sound theoretical basis. Intervention Mapping is designed to guide an iterative and problem-focused approach to the development of complex interventions. The purpose of this case report is to demonstrate the application of an Intervention Mapping approach to the development of a complex physical therapist intervention, a remote self-management program aimed at increasing physical activity after acquired brain injury. Intervention Mapping consists of 6 steps to guide the development of complex interventions: (1) needs assessment; (2) identification of outcomes, performance objectives, and change objectives; (3) selection of theory-based intervention methods and practical applications; (4) organization of methods and applications into an intervention program; (5) creation of an implementation plan; and (6) generation of an evaluation plan. The rationale and detailed description of this process are presented using an example of the development of a novel and complex physical therapist intervention, myMoves-a program designed to help individuals with an acquired brain injury to change their physical activity behavior. The Intervention Mapping framework may be useful in the development of complex physical therapist interventions, ensuring the development is comprehensive, systematic, and thorough, with a sound theoretical basis. This process facilitates translation into clinical practice and allows for greater confidence and transparency when the program efficacy is investigated. © 2016 American Physical Therapy Association.
Muldoon, Kathleen M; Armstrong-Heimsoth, Amy; Thomas, Jodi
Congenital cytomegalovirus (cCMV) infections cause more children to have permanent disabilities than Down Syndrome, Fetal Alcohol Syndrome, Spina Bifida, and pediatric HIV/AIDS combined. The risk of infection during pregnancy can be significantly decreased using universal precautions, such as thorough handwashing and cleansing of surfaces and objects that have come into contact with infected body fluids. Children under 3 years of age are commonly asymptomatic excretors of CMV, with the highest viral loads present in saliva. Pediatric therapists have regular close contact with young children, and are thus likely at elevated occupational risk of acquiring CMV. Our objective was to evaluate therapist knowledge of cCMV and its transmission. We recruited American Occupational Therapy Association (AOTA) and American Physical Therapy Association (APTA) members via electronic newsletters and printed flyers from April to September 2015. Participants completed an online, anonymous 24-question survey using Survey Monkey. We compared responses between groups and previously published CMV awareness data using binomial tests of difference of proportions and multiple logistic regression. Our study identified both a low level of therapist awareness and poor demonstrated understanding of cCMV. Self-reported cCMV awareness amongst therapists was greater than awareness in the general population, and equivalent to awareness amongst health care professionals. Whereas 52% of participants self-reported awareness of cCMV, only 18% demonstrated understanding of the behavioral modes of CMV transmission. Fewer therapists reported awareness of cCMV than other, less prevalent conditions. Higher levels of health risk knowledge were associated with greater contact with children. Most participants reported learning about cCMV from the workplace. The knowledge gaps between self-reported awareness of cCMV and demonstrated understanding of modes of transmission described by our results emphasize the
Fredriksen, Per Morten; Hjelle, Ole Petter; Mamen, Asgeir; Meza, Trine J; Westerberg, Ane C
The prevalence of non-communicable diseases (NCDs) is increasing worldwide, also among children. Information about primary prevention of NCD's is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP) study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545) with two control schools (n = 752); all aged 6-11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA) of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL), non-HDL, micro C-reactive protein (mCRP) and long-term blood sugar (HbA1c). In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL), mental health, executive functions, diet and academic performance. HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 ) as of June 20 th - 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.
Per Morten Fredriksen
Full Text Available Abstract Background The prevalence of non-communicable diseases (NCDs is increasing worldwide, also among children. Information about primary prevention of NCD’s is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. Methods The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545 with two control schools (n = 752; all aged 6–11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL, non-HDL, micro C-reactive protein (mCRP and long-term blood sugar (HbA1c. In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL, mental health, executive functions, diet and academic performance. Discussion HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. Trial registration The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 as of June 20th – 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.
Boissonnault, Jill S; Cambier, Ziádee; Hetzel, Scott J; Plack, Margaret M
For health care providers in the United States, the risk for nonfatal violence in the workplace is 16 times greater than that for other workers. Inappropriate patient sexual behavior (IPSB) is directed at clinicians, staff, or other patients and may include leering, sexual remarks, deliberate touching, indecent exposure, and sexual assault. Inappropriate patient sexual behavior may adversely affect clinicians, the organization, or patients themselves. Few IPSB risk factors for physical therapists have been confirmed. The US prevalence was last assessed in the 1990s. The objectives of this study were to determine career and 12-month exposure to IPSB among US physical therapists, physical therapist assistants, physical therapist students, and physical therapist assistant students and to identify IPSB risk factors. This was a retrospective and observational study. An electronic survey was developed; content validity and test-retest reliability were established. Participants were recruited through physical therapist and physical therapist assistant academic programs and sections of the American Physical Therapy Association. Inappropriate patient sexual behavior risk models were constructed individually for any, mild, moderate, and severe IPSB events reported over the past 12 months. Open-ended comments were analyzed using qualitative methods. Eight hundred ninety-two physical therapist professionals and students completed the survey. The career prevalence among respondents was 84%, and the 12-month prevalence was 47%. Statistical risk modeling for any IPSB over the past 12 months indicated the following risks: having fewer years of direct patient care, routinely working with patients with cognitive impairments, being a female practitioner, and treating male patients. Qualitative analysis of 187 open-ended comments revealed patient-related characteristics, provider-related characteristics, and abusive actions. Self-report, clinician memory, and convenience sampling are
Saladin, Lisa; Voight, Michael
In 2013, the American Physical Therapy Association (APTA) adopted an inspiring new vision, "Transforming society by optimizing movement to improve the human experience." This new vision for our profession calls us to action as physical therapists to transform society by using our skills, knowledge, and expertise related to the movement system in order to optimize movement, promote health and wellness, mitigate the progression of impairments, and prevent the development of (additional) disability. The guiding principle of the new vision is "identity," which can be summarized as "The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society." Recognition and validation of the movement system is essential to understand the structure, function, and potential of the human body. As currently defined, the "movement system" represents the collection of systems (cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal) that interact to move the body or its component parts. By better characterizing physical therapists as movement system experts, we seek to solidify our professional identity within the medical community and society. The physical therapist will be responsible for evaluating and managing an individual's movement system across the lifespan to promote optimal development; diagnose impairments, activity limitations, and participation restrictions; and provide interventions targeted at preventing or ameliorating activity limitations and participation restrictions. 5.
Messias, Iracimara de Anchieta; Okuno, Emico; Colacioppo, Sérgio
Measure physical therapists' exposure to the electric and magnetic fields produced by 17 shortwave diathermy devices in physical therapy clinics in the city of Presidente Prudente, São Paulo State, Brazil. Compare the observed values with the exposure levels recommended by the International Commission on Non-ionizing Radiation Protection (ICNIRP). Observe the efficacy of Faraday cages as a means of protecting physical therapists from exposure to oscillating electric and magnetic fields. Electric and magnetic field measurements were taken at four points during actual physical therapy sessions: in proximity to the operator's pelvis and head, the devices' electrical cables, and the electrodes. The measuring equipment was a Wandel & Goltermann EMR-200. The values obtained in proximity to the electrodes and cables were 10 to 30 times higher than ICNIRP's recommended occupational reference levels. In the shortwave diathermy treatment rooms with Faraday cages, the fields were even higher than in treatment rooms not so equipped-principally the magnetic field, where the values were more than 100 times higher than the ICNIRP exposure limit. The electric and magnetic field intensities obtained in this study are generally above the exposure levels recommend in ICNIRP standards. It was also observed that the Faraday cage offers physical therapists no protection, and instead, increases their level of exposure.
Jensen, Gail M; Nordstrom, Terrence; Mostrom, Elizabeth; Hack, Laurita M; Gwyer, Janet
The Carnegie Foundation for the Advancement of Teaching commissioned the Preparation for the Professions Program, a qualitative study of professional education in 5 professions: medicine, nursing, law, engineering, and clergy. These studies identified curricular structures, instructional practices, assessment approaches, and environmental characteristics that support the preparation of professionals and led to educational reforms. The physical therapy profession has not had any in-depth, national investigation of physical therapist education since the Catherine Worthingham studies conducted more than 50 years ago. This research was a Carnegie-type study, investigating elements of excellence and innovation in academic and clinical physical therapist education in the United States. Five physical therapist education researchers from across the United States used a qualitative multiple-case study design. Six academic and 5 clinical programs were selected for the study. The academic institutions and clinical agencies studied were diverse in size, institutional setting, geography, and role in residency education. Qualitative case studies were generated from review of artifacts, field observations, and interviews (individual and focus group), and they provided the data for the study. A conceptual framework grounded in 3 major dimensions was generated, with 8 supporting elements: (1) culture of excellence (shared beliefs and values, leadership and vision, drive for excellence, and partnerships), (2) praxis of learning (signature pedagogy, practice-based learning, creating adaptive learners, and professional formation), and (3) organizational structures and resources. Building on the work of the Carnegie Foundation's Preparation for the Professions Program, a conceptual model was developed, representing the dimensions and elements of excellence in physical therapist education that is centered on the foundational importance of a nexus of linked and highly valued aims of
Miles, Jean D; Staples, William H; Lee, Daniel J
Home care physical therapists (PTs) are inconsistent regarding cognitive screening, possibly because screening tools were traditionally considered the domain of other home care disciplines, or because therapists perceive their dementia training to be inadequate. A cross sectional study was designed to survey home care therapists' attitudes and beliefs about the management of persons with dementia and to find out whether any specific cognitive tools or measures are currently used. A 5-point Likert-type survey was administered to home care PTs via an online survey. Three state home care associations and individual home care agencies agreed to share the survey link. The survey was also made available to American Physical Therapy Association members through the Home Health and Geriatric Section listservs. Two hundred fifty-one PTs opened the survey and 233 completed the survey. Respondents included 180 females and 53 males. Seventy-four had a bachelor's degree (BS), 53 held a master's degree (MS), 104 had achieved a doctor of physical therapy (DPT) or doctor of philosophy (PhD) degree, and 2 did not provide this information. Significant differences were found between those with the highest doctoral degrees and those with master's or bachelor's degrees (P = .01) regarding whether they were qualified to screen (strongly agree, agree) for cognitive deficits. Therapists with the highest degrees also attended continuing education for dementia training more than those with less formal education (P = .042.) Gender differences were found in 2 questions regarding positive outcomes (P = .010 and .42); for both questions, males were more likely to believe that dementia has a negative impact. Eighty-seven percent indicated that PTs are qualified (strongly agree, agree), but only 53% said that they possess the necessary skills (strongly agree, agree) to perform cognitive screens. Specialty certification revealed significant differences in several of the questions. No significance
Hinman, Rana S; Delany, Clare M; Campbell, Penelope K; Gale, Janette; Bennell, Kim L
Integrated models of care are recommended for people with knee osteoarthritis (OA). Exercise is integral to management, yet exercise adherence is problematic. Telephone-based health coaching is an attractive adjunct to physical therapist-prescribed exercise that may improve adherence. Little is known about the perceptions and interpretations of physical therapists, telephone coaches, and patients engaged in this model of care. The purpose of this study was to explore how stakeholders (physical therapists, telephone coaches, and patients) experienced, and made sense of, being involved in an integrated program of physical therapist-supervised exercise and telephone coaching for people with knee OA. A cross-sectional qualitative design drawing from symbolic interactionism was used. Semistructured interviews with 10 physical therapists, 4 telephone coaches, and 6 patients with painful knee OA. Interviews were audiorecorded, transcribed, and analyzed using thematic analysis informed by grounded theory. Four themes emerged: (1) genuine interest and collaboration, (2) information and accountability, (3) program structure, and (4) roles and communication in teamwork. Patients reported they appreciated personalized, genuine interest from therapists and coaches and were aware of their complementary roles. A collaborative approach, with defined roles and communication strategies, was identified as important for effectiveness. All participants highlighted the importance of sharing information, monitoring, and being accountable to others. Coaches found the lack of face-to-face contact with patients hampered relationship building. Therapists and coaches referred to the importance of teamwork in delivering the intervention. The small number of physical therapists and telephone coaches who delivered the intervention may have been biased toward favorable experiences with the intervention and may not be representative of their respective professions. Integrated physical therapy and
Sibley, Kathryn M.; Straus, Sharon E.; Inness, Elizabeth L.; Salbach, Nancy M.
Background Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. Objective The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. Design This was a cross-sectional study. Methods A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. Results Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed “Up & Go” Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. Limitations The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. Conclusions Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall. PMID:21868613
Full Text Available Dementia is a disease characterized by cognitive impairment and physical decline that worsens over time. Exercise is one lifestyle factor that has been identified as a potential means of reducing or delaying progression of the symptoms of dementia, maximizing function and independence. The purpose of this study was to explore physical therapists' (PTs experiences and reflections on facilitating high-intensity functional exercise with older people living with dementia, in residential care home settings. The study used a qualitative design based on interviews, individually or in small groups, with seven PTs engaged as leaders in the training of older people with dementia. The interviews were analyzed with a modified Grounded Theory method with focus on constant comparisons. To increase trustworthiness the study used triangulation within investigators and member checking. The core category "Discover and act in the moment-learn over time" reflects how the PTs continuously developed their own learning in an iterative process. They built on previous knowledge to communicate with residents and staff and to tailor the high intensity training in relation to each individual at that time point. The category "Be on your toes" highlights how the PTs searched for sufficient information about each individual, before and during training, by eliciting the person's current status from staff and by interpreting the person's body language. The category "Build a bond with a palette of strategies" describes the importance of confirmation to build up trust and the use of group members and the room to create an interplay between exercise and social interaction. These findings highlight the continuous iterative process of building on existing knowledge, sharing and reflecting, being alert to any alterations needed for individuals that day, communication skills (both with residents and staff and building a relationship and trust with residents in the effective delivery
Landry, Michel D; Hack, Laurita M; Coulson, Elizabeth; Freburger, Janet; Johnson, Michael P; Katz, Richard; Kerwin, Joanne; Smith, Megan H; Wessman, Henry C Bud; Venskus, Diana G; Sinnott, Patricia L; Goldstein, Marc
Health human resources continue to emerge as a critical health policy issue across the United States. The purpose of this study was to develop a strategy for modeling future workforce projections to serve as a basis for analyzing annual supply of and demand for physical therapists across the United States into 2020. A traditional stock-and-flow methodology or model was developed and populated with publicly available data to produce estimates of supply and demand for physical therapists by 2020. Supply was determined by adding the estimated number of physical therapists and the approximation of new graduates to the number of physical therapists who immigrated, minus US graduates who never passed the licensure examination, and an estimated attrition rate in any given year. Demand was determined by using projected US population with health care insurance multiplied by a demand ratio in any given year. The difference between projected supply and demand represented a shortage or surplus of physical therapists. Three separate projection models were developed based on best available data in the years 2011, 2012, and 2013, respectively. Based on these projections, demand for physical therapists in the United States outstrips supply under most assumptions. Workforce projection methodology research is based on assumptions using imperfect data; therefore, the results must be interpreted in terms of overall trends rather than as precise actuarial data-generated absolute numbers from specified forecasting. Outcomes of this projection study provide a foundation for discussion and debate regarding the most effective and efficient ways to influence supply-side variables so as to position physical therapists to meet current and future population demand. Attrition rates or permanent exits out of the profession can have important supply-side effects and appear to have an effect on predicting future shortage or surplus of physical therapists. © 2016 American Physical Therapy
Constrained practice is routinely encountered by physical therapists and may limit the physical therapist's primary moral responsibility-which is to help the patient to become well again. Ethical practice under such conditions requires a certain moral character of the practitioner. The purposes of this article are: (1) to provide an ethical analysis of a typical patient case of constrained clinical practice, (2) to discuss the moral implications of constrained clinical practice, and (3) to identify key moral principles and virtues fostering ethical physical therapist practice. The case represents a common scenario of discharge planning in acute care health facilities in the northeastern United States. An applied ethics approach was used for case analysis. The decision following analysis of the dilemma was to provide the needed care to the patient as required by compassion, professional ethical standards, and organizational mission. Constrained clinical practice creates a moral dilemma for physical therapists. Being responsive to the patient's needs moves the physical therapist's practice toward the professional ideal of helping vulnerable patients become well again. Meeting the patient's needs is a professional requirement of the physical therapist as moral agent. Acting otherwise requires an alternative position be ethically justified based on systematic analysis of a particular case. Skepticism of status quo practices is required to modify conventional individual, organizational, and societal practices toward meeting the patient's best interest.
Andrews, A Williams; Folger, Stephen E; Norbet, Shannon E; Swift, Lindsay C
Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.
Jette, Diane U; Halbert, James; Iverson, Courtney; Miceli, Erin; Shah, Palak
Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. The study used an observational design. A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Forty-eight percent of participants used standardized outcome measures. The majority of participants (>90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.
Booth, Michael; Okely, Anthony
Paediatric overweight and obesity is recognised as one of Australia's most significant health problems and effective approaches to increasing physical activity and reducing energy consumption are being sought urgently. Every potential approach and setting should be subjected to critical review in an attempt to maximise the impact of policy and program initiatives. This paper identifies the strengths and limitations of schools as a setting for promoting physical activity. The strengths are: most children and adolescents attend school; most young people are likely to see teachers as credible sources of information; schools provide access to the facilities, infrastructure and support required for physical activity; and schools are the workplace of skilled educators. Potential limitations are: those students who like school the least are the most likely to engage in health-compromising behaviours and the least likely to be influenced by school-based programs; there are about 20 more hours per week available for physical activity outside schools hours than during school hours; enormous demands are already being made on schools; many primary school teachers have low levels of perceived competence in teaching physical education and fundamental movement skills; and opportunities for being active at school may not be consistent with how and when students prefer to be active.
Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann
This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. © 2015 American Physical Therapy Association.
Vialu, Carlo; Doyle, Maura
The Individuals with Disabilities Education Act (IDEA) includes physical therapy (PT) as a related service that may be provided to help students with disabilities benefit from their education. However, the IDEA does not provide specific guidance for the provision of school-based PT, resulting in variations in practice across the United States. The authors examined 22 state and local education agency guidelines available online to find commonalities related to the determination of a student's need for PT. Seven commonalities found: educational benefit, team decision, need for PT expertise, establishment of Individualized Education Program (IEP) goal before determining need for PT, distinction between medical and educational PT, the student's disability adversely affects education, and the student's potential for improvement. These commonalities are discussed in relation to current PT and special education literature. This article suggests applying these commonalities as procedural requirements and questions for discussion during an IEP team meeting.
Johansen, Danielle Louise Nørager; Skovgaard, Thomas; Møller, Niels Christian
condensed into a total amount of 63 factors, arranged into nine overall categories, and prioritized by the national expert group in the questionnaire (1.School leadership, 2.Co-workers, 3.Resources, 4.Policy level, 5.Organizational/cultural level, 6.Pupils, 7.Physical surroundings, 8.Intervention context......, and 9.External factors). Based on five expert interviews, outliers from the questionnaire was examined. Finally, at the workshop, five of the nine overall categories were rated as particularly relevant and important (School leadership, Co-workers, Policy level, Resources and Organizational/cultural...... level). Conclusions All nine overall categories are deemed as decisive for sustainable implementation of school-based PA. However, School leadership were singled out as a particular important category, since commitment at this level is deemed a pre-requisite for many of the other factors....
Dwyer, John J M; Allison, Kenneth R; LeMoine, Karen N; Adlaf, Edward M; Goodman, Jack; Faulkner, Guy E J; Lysy, Daria C
Adolescents spend considerable time at school and thus it is important to understand their opportunities for school-based physical activity. This study surveyed Ontario secondary schools to identify the range of structured opportunities and their engagement by students. A questionnaire was mailed to key informants in 600 randomly selected secondary schools in Ontario, for which 474 respondents (79%) returned completed questionnaires. Curriculum-based physical education (PE) classes in grade nine were reported to be offered in all schools and these classes in grades 10, 11 and 12 were offered in almost all schools. Student enrollment in PE decreased from grades 9 to 12 (97.9%, 49.6%, 43.3% and 35.9%, respectively). Respondents reported that funding, timetable, facilities and resources made it somewhat difficult to implement the health and physical education curriculum in their schools. About two-thirds (65.5%) of the schools had an intramural program and 15.0% of students participated in it, whereas 97.2% of the schools had an inter-school sports program and 25.0% of students participated in it. Supervision issues made it difficult to provide intramural programs and funding made it difficult to provide inter-school sports programs. Although provision of physical activity opportunities in Ontario appears satisfactory, actual engagement by students is low. The results suggest that strategies to increase student participation in PE, intramural programs, and inter-school sports programs need further consideration.
Kruijsen-Terpstra, Anne J A; Ellens, Mariëlle; Ketelaar, Marjolijn; Verschuren, Olaf; Di Rezze, Briano; Gorter, Jan Willem; Visser-Meily, Anne M A; Jongmans, Marian J.
Aims: To (1) describe the child- and context-focused behaviors of physical and occupational therapists, and (2) compare the behaviors of therapists in a standard therapy session with those of therapists trained to deliver child- and context-focused services. Method: Videos of 49 therapy sessions
Kruijsen-Terpstra, Anne J A; Ellens, Mariëlle; Ketelaar, Marjolijn; Verschuren, Olaf; Di Rezze, Briano; Gorter, Jan Willem; Visser-Meily, Anne M A; Jongmans, Marian J
AIMS: To (1) describe the child- and context-focused behaviors of physical and occupational therapists, and (2) compare the behaviors of therapists in a standard therapy session with those of therapists trained to deliver child- and context-focused services. METHOD: Videos of 49 therapy sessions
van Lieshout, Remko; Pisters, Martijn F; Vanwanseele, Benedicte; de Bie, Rob A; Wouters, Eveline J; Stukstette, Mirelle J
Partial weight bearing is frequently instructed by physical therapists in patients after lower-limb trauma or surgery. The use of biofeedback devices seems promising to improve the patient's compliance with weight-bearing instructions. SmartStep and OpenGo-Science are biofeedback devices that provide real-time feedback. For a successful implementation, usability of the devices is a critical aspect and should be tested from a user's perspective. To describe the usability from the physical therapists' and a patients' perspective of Smartstep and OpenGo-Science to provide feedback on partial weight bearing during supervised rehabilitation of patients after lower-limb trauma or surgery. In a convergent mixed-methods design, qualitative and quantitative data were collected. Usability was subdivided into user performance, satisfaction and acceptability. Patients prescribed with partial weight bearing and their physical therapists were asked to use SmartStep and OpenGo-Science during supervised rehabilitation. Usability was qualitatively tested by a think-aloud method and a semi-structured interview and quantitatively tested by the System-Usability-Scale (SUS) and closed questions. For the qualitative data thematic content analyses were used. Nine pairs of physical therapists and their patients participated. The mean SUS scores for patients and physical therapists were for SmartStep 70 and 53, and for OpenGo-Science 79 and 81, respectively. Scores were interpreted with the Curved Grading Scale. The qualitative data showed that there were mixed views and perceptions from patients and physical therapists on satisfaction and acceptability. This study gives insight in the usability of two biofeedback devices from the patient's and physical therapist's perspective. The overall usability from both perspectives seemed to be acceptable for OpenGo-Science. For SmartStep, overall usability seemed only acceptable from the patient's perspective. The study findings could help
Kawabata, Masato; Chua, Khai Leng; Chatzisarantis, Nikos L D
Regular participation in moderate-to-vigorous physical activity (MVPA) is important to manage obesity. Physical education (PE) is considered to play an important role in promoting lifelong participation in physical activity (PA) because it provides an existing network where cost-effective interventions can be implemented to produce sustainable change in health behavior. However, the association between compulsory school PA (e.g., PE lessons) and body composition levels has received mixed support in the literature. Therefore, the present study aimed to investigate whether a school-based intervention targeting salient PA benefits and barriers grounded on the theory of planned behavior would promote young people's participation in MVPA during leisure time and reduce body mass index (BMI) of overweight students. A total of 171 students from 3 secondary schools in Singapore underwent the control condition followed by the intervention condition. Both the conditions consisted of PE lessons twice per week over 4 weeks. In the control condition, PE teachers encouraged students to participate in PA during leisure time without providing persuasive message. While in the intervention condition, PE teachers delivered persuasive messages that targeted the salient benefits and barriers associated with PA to the students at the last 5 to 10 min of each PE lesson. PA levels over a week were measured objectively with wrist-mounted GENEActiv Original accelerometers and subjectively with self-reporting questionnaires three times (Baseline, Post 1, and Post 2) in each condition. Student's self-reported PA level was measured using the Leisure-Time Physical Activity Participation Questionnaire and the International Physical Activity Questionnaire, and their attitudes, intentions, subjective norms and perceived behavior control towards leisure-time PA were measured with a questionnaire based on the theory of planned behavior. Furthermore, students' intention, determination and
Rexen, C T; Ersbøll, A K; Møller, N C
First, this study aimed to investigate if four extra physical education (PE) lessons per week improved children's development in physical fitness. Second, to investigate if the extra PE lessons improved development in physical fitness for children with lower levels of fitness at baseline...
Holden, Melanie A; Nicholls, Elaine E; Young, Julie; Hay, Elaine M; Foster, Nadine E
Within the UK, differences exist between physical therapists' use of exercise for patients with knee osteoarthritis (OA) and recent exercise recommendations. This may be explained by their underlying attitudes and beliefs. We aimed to describe UK physical therapists' attitudes and beliefs regarding exercise and knee OA, and understand and explain them. A survey was mailed to 2,000 UK-based chartered physical therapists that included 23 attitude statements derived from recently published recommendations. Semistructured telephone interviews were conducted with a purposeful sample of questionnaire respondents (n = 24), and were recorded and analyzed thematically. The questionnaire response rate was 58% (n = 1,152); 538 respondents reported treating a patient with knee OA in the last 6 months. The survey highlighted uncertainty about potential benefits of exercise for knee OA: only 56% largely/totally agreed that knee problems are improved by local exercise. Although exercise adherence was deemed important, it was seen as the patient's, not the therapist's, responsibility. Interviews revealed an underlying biomedical model of care of knee pain, with knee OA viewed as a progressive degenerative condition. A paternalistic treatment approach was evident. Health care systems presented a number of barriers to best practice, including limited opportunity to provide followup. Although the attitudes and beliefs of physical therapists may help to explain differences between current practice and recent exercise recommendations, the wider health care system also plays a part. Further research is needed to support meaningful shifts in physical therapy care in line with the best practice recommendations.
Rasberry, Catherine N; Lee, Sarah M; Robin, Leah; Laris, B A; Russell, Lisa A; Coyle, Karin K; Nihiser, Allison J
The purpose of this review is to synthesize the scientific literature that has examined the association between school-based physical activity (including physical education) and academic performance (including indicators of cognitive skills and attitudes, academic behaviors, and academic achievement). Relevant research was identified through a search of nine electronic databases using both physical activity and academic-related search terms. Forty-three articles (reporting a total of 50 unique studies) met the inclusion criteria and were read, abstracted, and coded for this synthesis. Findings of the 50 studies were then summarized. Across all the studies, there were a total of 251 associations between physical activity and academic performance, representing measures of academic achievement, academic behavior, and cognitive skills and attitudes. Slightly more than half (50.5%) of all associations examined were positive, 48% were not significant, and 1.5% were negative. Examination of the findings by each physical activity context provides insights regarding specific relationships. Results suggest physical activity is either positively related to academic performance or that there is not a demonstrated relationship between physical activity and academic performance. Results have important implications for both policy and schools. Copyright © 2010 Elsevier Inc. All rights reserved.
Christiansen, Lars B.; Lund-Cramer, Pernille; Brondeel, Ruben
Purpose Physical activity at school can improve the mental health of all children – especially if it targets children's developmental needs and is carried out in a positive social climate. The purpose of the present study was to examine the effect of a 9-month school intervention focusing......) PE lessons, 2) in-class activity outside PE, and 3) physical activity during break-time. It used a cluster-randomized design to select 24 Danish schools either for intervention or for control. Survey data on self-perception variables, socio-demographics and physical activity was collected prior...... on physical self-worth, self-perceived sport competence, body attractiveness, social competences and global self-worth in children aged 10–13 years. Methods Taking self-determination theory as its starting point, the intervention was developed and pilot-tested in close co-operation with schools. It targeted 1...
Hynynen, S-T; van Stralen, M M; Sniehotta, F F; Araújo-Soares, V; Hardeman, W; Chinapaw, Mai J M; Vasankari, T.; Hankonen, N.
Lack of physical activity (PA) and high levels of sedentary behaviour (SB) have been associated with health problems. This systematic review evaluates the effectiveness of school-based interventions to increase PA and decrease SB among 15-19-year-old adolescents, and examines whether intervention
González-Cutre, David; Sierra, Ana C.; Beltrán-Carrillo, Vicente J.; Peláez-Pérez, Manuel; Cervelló, Eduardo
The authors analyzed the effects of a multidimensional intervention to promote physical activity (PA) in school, based on self-determination theory. The study involved 88 students, between 14 and 17 years old, who were divided into a control group (n = 59) and an experimental group (n = 29). In the experimental group, a 6-month intervention was…
Takemasa, Seiichi; Abe, Yoko; Nagao, Toru; Murakami, Masahito; Koeda, Hideki; Naruse, Susumu; Gotou, Makoto; Uesugi, Masayuki; Inoue, Yuri; Nanba, Yoshihumi
[Purpose] This study explored the roles of physical therapists (PTs) in living environment maintenance, which is essential for living securely and stably at home, and examines how physical therapists can fulfill these roles more efficiently and effectively. [Subjects and Methods] A questionnaire on living environment maintenance was given to PTs working at randomly selected hospitals, health care facilities for the elderly requiring long-term care, home-visit nursing stations, and other such facilities and directly providing physical therapy to the home-bound elderly disabled. The subjects of the study were 77 PTs who returned valid responses. [Results] For awareness of systems for living environment maintenance, PTs were more aware of the system based on the Long-Term Care (LTC) Insurance Act than the system based on the Act on Welfare for the Home-Bound Elderly Disabled. PTs who have worked at two or more types of medical, welfare, and intermediate institutions were more aware of such systems than PTs who have worked at only one type. For PTs handling living environment maintenance for the home-bound elderly disabled, approximately 80% of respondents answered that they have handled some living environment maintenance, and PTs with longer clinical experience have handled more living environment maintenance cases. [Conclusion] The results demonstrated that PTs understand their living environment maintenance work well and handle the work. The results, however, also suggested that educational and operational improvements are urgently required for PTs handling living environment maintenance essential for the lives of the home-bound elderly disabled.
Some EDs are finding that the unique skill sets offered by physical therapists (PT) can be an asset to emergency care while also improving the patient experience. Experts say PTs are particularly valuable in the management of musculoskeletal pain and injuries, but they are also being used for wound care, gait training, and balance assessment. ED administrators say consistent, daily coverage is essential to making a PT program successful; otherwise, ED clinicians will neglect to use their services. PTs need to be comfortable with proactively marketing their skills to other ED clinicians who may not be used to having access to this resource. Experts say PT services in the ED can be reimbursed at a level that is consistent with reimbursement in other inpatient and outpatient settings.
Black, Lisa L; Jensen, Gail M; Mostrom, Elizabeth; Perkins, Jan; Ritzline, Pamela D; Hayward, Lorna; Blackmer, Betsy
The goal in studying expertise is not merely to describe ways in which experts excel but also to understand how experts develop in order to better facilitate the development of novices. The study of novice progression helps us to understand what successful versus unsuccessful learning looks like. This understanding is critical, as autonomous practice places increased demands for advanced clinical judgments and the ability to assume professional responsibilities. The purpose of this study was to explore the experiences, learning, and development of promising novice therapists throughout their first year of practice in the United States. A longitudinal, multiple-site qualitative case study method was used for within-case and across-case analysis. A purposive sample of 11 promising new graduates from 4 physical therapist education programs participated. Investigators followed the graduates throughout their first year of practice. Data sources included: (1) semistructured interviews conducted at baseline and every 3 months thereafter for 1 year, (2) reflective journals completed at regular intervals, and (3) review of academic and clinical education records and résumés. Four themes emerged: (1) the clinical environment influenced the novice physical therapists' performance, (2) participants learned through experience and social interaction and learning was primarily directed toward self, (3) growing confidence was directly related to developing communication skills, and (4) therapists were engaged in professional identity formation and role transitions. The findings suggest there are common experiences and themes that emerge as novice physical therapists develop. Although research has been conducted on expertise in physical therapy, few longitudinal investigations have explored the development of therapists across transitions from graduate to novice to expert practitioner. This study explored and described the learning and development of graduates during their first
Jette, Diane U; Bertoni, Alicia; Coots, Renee; Johnson, Heidi; McLaughlin, Catherine; Weisbach, Cody
The purpose of this study was to qualitatively explore clinical instructors' (CIs) perceptions of students' behaviors that comprise entry-level clinical performance, as well as how those perceptions were integrated into their decision making. The participants were 21 physical therapists who were CIs for physical therapist students. Using a grounded theory approach, we conducted interviews, asking the question, "What is it about students' performance that makes you see them as entry-level therapists?" We determined common themes among the interviews and developed a schema to explain the decision-making process. Participants identified 7 attributes that, when demonstrated to a sufficient degree, illustrated to them students' ability to practice at the entry level. Those attributes were knowledge, clinical skills, safety, clinical decision making, self-directed learning, interpersonal communication, and professional demeanor. Participants viewed these attributes in concert to form a subjective "gut feeling" that a student demonstrated entry-level performance. A final theme emerged suggesting a definition of entry-level performance as "mentored independence." Participants reported evaluating students' performance based on attributes similar to those suggested by the American Physical Therapy Association's Physical Therapist Clinical Performance Instrument and previous research. However, subjectivity also was involved in their decision about whether students were able to practice at the entry level. Participants also concluded that entry-level students need not be independent in all clinical situations.
Discussion: This study confirmed the rate of prevalence of work-related musculoskeletal disorders and injuries in occupational and physical therapists, with wrist and lumbar being the most affected. The promotion of therapist’s knowledge about MSD and following ergonomic principles and new approaches in the treatment may lower or prevent MSD.
Davies, Robyn; Hanna, Elizabeth; Cott, Cheryl
To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students. In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach. Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision. Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff.
As physical therapists increase autonomous practice, medical error becomes more important to public safety and public perceptions of the profession. The purpose of this study was to describe malpractice by physical therapists in the United States based on physical therapist malpractice reports in the National Practitioner Data Bank between January 1, 1991, and December 31, 2004. A frequency analysis of data related to physical therapist malpractice reports was performed. The relationship between size of malpractice payment and public policy related to access to physical therapist services and malpractice experience was explored. A total of 664 malpractice reports were found in the study period (mean, 47.73 events annually). California had 114 malpractice events, while Maine and Wyoming had none. The median payment amount for physical therapist malpractice was $10,000 to $15,000. "Treatment-related" events and events related to "improper technique" were the most common reasons for a malpractice report. Incidence of malpractice by physical therapists is low (estimated at 2.5 events/10,000 working therapists/year), and the average malpractice payment is small (public policy related to direct patient access to physical therapy services.
Van Alstyne, Linda S; Harrington, Kendra L; Haskvitz, Esther M
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) negatively affects quality of life and sexual function in men of all ages. Typical treatment with antibiotic and antimicrobial drugs often is not successful. The purpose of this case report is to describe a multimodal physical therapy intervention that included manual therapy techniques applied to the pelvic floor in 2 patients who were unsuccessfully treated with the biomedical model of prescription drug therapies. Two men, aged 45 years and 53 years and diagnosed with chronic prostatitis, were referred for physical therapy following unsuccessful pharmacological treatment. The patients were treated with manual therapy techniques applied to the pelvic floor and instructed in progressive muscle relaxation, flexibility exercises, and aerobic exercises. Changes in the patients' National Institutes of Health Chronic Prostatitis Symptom Index revealed differences between preintervention and postintervention scores reflecting decreased pain and improved quality of life. One patient improved from a score of 25 (total possible score = 43) before treatment to a score of 0 after treatment, and the other patient improved from a score of 29 to a score of 21. Manual therapy techniques applied to the pelvic floor and performed by a physical therapist specially trained in these techniques, along with progressive muscle relaxation, flexibility exercises, and aerobic exercises, appeared to be beneficial to both patients in reducing pain and improving sexual function.
Loong, Claudine; Leo, Latasha; Goh, Danielle; Lim, Pei Sin; Loke, Wai Mun
Limited data are available on the effectiveness of the school-based structured fitness and wellness program to influence dietary quality and physical activity levels in Singaporean adolescents. The study examined if a 20-h (over 10 weeks) school-based structured fitness and wellness module affects the diet quality indices, energy intakes, physical activity levels and the associated energy expenditures in a group of healthy, male adolescents with low diet quality and physical activity levels. Participant demography, anthropometry, dietary intake and daily physical activity were obtained at the beginning, mid-point and end of the 10-week program. Physical activity levels were assessed accelerometrically over a 1-weekday period. Dietary intake were taken using a structured 7-day food diary, and diet quality assessed using the Diet Quality Index-International (DQI-I). The 31 enrolled participants (age 19.8 ± 0.6 years) with body mass index (BMI) (19.8 ± 0.6 kg/m2) followed diets of low diet quality scores (48.3 ± 9.6 out of 100) and engaged in 3.87 ± 2.00 h of physical activity daily before the start of the intervention. Their dietary quality and physical activity levels did not change significantly throughout the intervention period. They scored poorly in the moderation and overall balance components of the diet quality assessment. The physical activity duration correlated inversely to the diet quality scores. Our results suggest that the prescribed school-based fitness and wellness module was ineffective in influencing the diet quality and physical activity levels of Singaporean male adolescents with low diet quality and physical activity levels.
Silva, Anderson A; Bittencourt, Natália F N; Mendonça, Luciana M; Tirado, Marcella G; Sampaio, Rosana F; Fonseca, Sérgio T
To analyze the profile of Brazilian physical therapists working with soccer and volleyball professional teams, by verifying their level of education (graduate or undergraduate), as well as their role and insertion within the interdisciplinary team. Structured questionnaires were administered to forty-nine physical therapists working at soccer, volleyball clubs and Brazilian national teams. These questionnaires provided data on social demographic, characteristics of the work environment and organization of clinical practice and its domains. From the 49 participants in this study only five were female. Mean age of all participants was 32.2 years. The majority of the sports physical therapists had specialization degrees in different areas (78.2%), were hired through referral (78.2%), worked more than 8 hours a day or were exclusively dedicated to their clubs (80.0%) and earned seven to ten Brazilian minimal wages (58.2%). They reported to have participation in the domains of emergency care (87.3%), prevention (92.7%), functional rehabilitation (98.2%) and return to competition (100%). They had interdisciplinary relationships with physical educators during functional rehabilitation programs (70.9%) and with physicians in the decision process of return to activity after rehabilitation (74.5%) and on the veto of an athlete to take part in practices or matches (63.6%). Therapists also complained of threats to their professional autonomy, specially directed by the team's physician. There is still a need to invest in continuing education of sports physical therapists with the objective to improve their educational level and to strengthen their professional autonomy.
Haarman, Juliet A M; Maartens, Erik; van der Kooij, Herman; Buurke, Jaap H; Reenalda, Jasper; Rietman, Johan S
During gait training, physical therapists continuously supervise stroke survivors and provide physical support to their pelvis when they judge that the patient is unable to keep his balance. This paper is the first in providing quantitative data about the corrective forces that therapists use during gait training. It is assumed that changes in the acceleration of a patient's COM are a good predictor for therapeutic balance assistance during the training sessions Therefore, this paper provides a method that predicts the timing of therapeutic balance assistance, based on acceleration data of the sacrum. Eight sub-acute stroke survivors and seven therapists were included in this study. Patients were asked to perform straight line walking as well as slalom walking in a conventional training setting. Acceleration of the sacrum was captured by an Inertial Magnetic Measurement Unit. Balance-assisting corrective forces applied by the therapist were collected from two force sensors positioned on both sides of the patient's hips. Measures to characterize the therapeutic balance assistance were the amount of force, duration, impulse and the anatomical plane in which the assistance took place. Based on the acceleration data of the sacrum, an algorithm was developed to predict therapeutic balance assistance. To validate the developed algorithm, the predicted events of balance assistance by the algorithm were compared with the actual provided therapeutic assistance. The algorithm was able to predict the actual therapeutic assistance with a Positive Predictive Value of 87% and a True Positive Rate of 81%. Assistance mainly took place over the medio-lateral axis and corrective forces of about 2% of the patient's body weight (15.9 N (11), median (IQR)) were provided by therapists in this plane. Median duration of balance assistance was 1.1 s (0.6) (median (IQR)) and median impulse was 9.4Ns (8.2) (median (IQR)). Although therapists were specifically instructed to aim for the
Physical therapists are trained and obligated to deliver optimal health care and put patients first above all else. In the changing health-care environment, health-care organizations are grappling with controlling cost and increasing revenues. Moral distress may be created when physical therapists' desire to provide optimal care conflicts with their organization's goals to remain financially viable or profitable. Moral distress has been associated with low perception of ethical environment, professional burnout, and high turnover in organizations. This study identified groups who may be vulnerable to low perception of organizational ethical environment and identified self-reported strategies to remedy these perceptions. An ethics environment questionnaire was mailed to a random sample of 1200 physical therapists in Georgia. Respondents (n = 340) were analyzed by age, workplace setting, and position in organization. Therapists working in skilled nursing/assisted living environments scored the lowest on the questionnaire and voiced concerns regarding their ethical work environments. Owners and executives perceived their organizations to be more ethical than front-line clinicians. Respondent concerns included high productivity standards, aggressive coding/billing policies, decreased reimbursement, and increased insurance regulation. Possible solutions included more frequent communication between management and clinicians about ethics, greater professional autonomy, and increased training in business ethics and finance.
Rexen, C T; Ersbøll, A K; Møller, N C; Klakk, H; Wedderkopp, N; Andersen, L B
First, this study aimed to investigate if four extra physical education (PE) lessons per week improved children's development in physical fitness. Second, to investigate if the extra PE lessons improved development in physical fitness for children with lower levels of fitness at baseline. This study was a longitudinal controlled school-based study. The study population consisted of 10 Danish public schools with children in preschool to fourth grade (cohorts 0-4) with 2.5-year follow-up. Six schools had extra PE and four schools had normal PE. In total 1247 children were included (normal PE = 536, extra PE = 711). Development in fitness was analyzed using a composite z-score from six fitness tests. Multilevel mixed-effects linear regression was used to examine the association between school type and development in fitness. Extra PE increased the total development of composite z-score units among children enrolled in cohort 4 and borderline in cohort 3 with 1.06 (95% confidence interval 0.48-1.65) and 0.52 z-score units (-0.06 to 1.09), respectively. Children in the lower 50 percentiles increased their development with 0.47 (0.08-0.85) z-score units. Extra PE in schools improved development in fitness for cohort 4 and borderline for cohort 3 among all children. Extra PE improved fitness development across all cohorts among children with low fitness levels. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available Abstract Background The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. Methods A total of 300 children (grade 3; 8-9 years of age from six schools in Granada (Spain will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school or a control group (no intervention school; 50 children. Outcomes will include physical activity (measured by accelerometry, physical fitness (assessed using the ALPHA fitness battery, and anthropometry (height, weight and waist circumference. Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires, academic achievement (grades from the official school’s records, and health-related quality of life (child and parental questionnaires. To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. Discussion The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.
Tercedor, Pablo; Villa-González, Emilio; Ávila-García, Manuel; Díaz-Piedra, Carolina; Martínez-Baena, Alejandro; Soriano-Maldonado, Alberto; Pérez-López, Isaac José; García-Rodríguez, Inmaculada; Mandic, Sandra; Palomares-Cuadros, Juan; Segura-Jiménez, Víctor; Huertas-Delgado, Francisco Javier
The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions) to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. A total of 300 children (grade 3; 8-9 years of age) from six schools in Granada (Spain) will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school) or a control group (no intervention school; 50 children). Outcomes will include physical activity (measured by accelerometry), physical fitness (assessed using the ALPHA fitness battery), and anthropometry (height, weight and waist circumference). Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires), academic achievement (grades from the official school's records), and health-related quality of life (child and parental questionnaires). To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.
Pelvic organ prolapse is a fairly common condition that imposes significant symptoms, diminished quality of life, social burden, financial expense, and surgical risk on women. As evidence supporting the benefit of pelvic-floor muscle training in nonsurgical management of pelvic organ prolapse grows, physical therapists are becoming a provider of choice interacting with women affected by pelvic organ prolapse. This perspective article will review recent research on tissue characteristics of 3 key components of pelvic organ support: skeletal muscle, ligament, and vaginal wall. This information will be summarized as implications for physical therapists. An improved understanding of pelvic-floor tissue in women with and without pelvic organ prolapse will provide a more comprehensive appreciation of the interaction of multiple systems in the disorder. © 2017 American Physical Therapy Association.
Lau, Carrie; Chitussi, Danielle; Elliot, Sarah; Giannone, Jennifer; McMahon, Mary-Katherine; Sibley, Kathryn M; Tee, Alda; Matthews, Julie; Salbach, Nancy M
Educating people with stroke about community-based exercise programs (CBEPs) is a recommended practice that physical therapists are well positioned to implement. The aim of this study was to evaluate the provision of education about CBEPs to people with stroke, barriers to providing education, and preferences for resources to facilitate education among physical therapists in neurological practice. A cross-sectional e-survey of physical therapists treating adults with stroke in Ontario, Canada, was conducted. A link to the questionnaire was emailed to physical therapists in a provincial stroke network, a provincial physical therapy association, and on hospital and previous research lists. Responses from 186 physical therapists were analyzed. The percentage of respondents who reported providing CBEP education was 84.4%. Only 36.6% reported typically providing education to ≥7 out of 10 patients with stroke. Physical (90.5%) and preventative (84.6%) health benefits of exercise were most frequently discussed. Therapists reported most commonly delivering education at discharge (73.7%). Most frequently cited barriers to educating patients were a perceived lack of suitable programs (53.2%) and a lack of awareness of local CBEPs (23.8%). Lists of CBEPs (94.1%) or brochures (94.1%) were considered to be facilitators. The percentage of physical therapists providing CBEP education varied across acute, rehabilitation, and public outpatient settings. The percentage of physical therapists providing education may have been overestimated if respondents who deliver CBEP education were more likely to participate and if participants answered in a socially desirable way. Even though a high proportion of physical therapists provide CBEP education, education is not consistently delivered to the majority of patients poststroke. Although a CBEP list or brochure would facilitate education regarding existing CBEPs, efforts to implement CBEPs are needed to help overcome the lack of suitable
Greenberg, Elliot M; Greenberg, Eric T; Albaugh, Jeffrey; Storey, Eileen; Ganley, Theodore J
Study Design Cross-sectional survey. Background Recovery from anterior cruciate ligament reconstruction (ACLR) requires an intensive course of post-operative rehabilitation. Although guidelines outlining evidence-based rehabilitation recommendations have been published, the actual practice patterns of physical therapists are unknown. Objectives To analyze the current landscape of clinical practice as it pertains to rehabilitation progression and the use of time and objective criteria following ACLR. Methods An online survey was distributed to members of the orthopaedics, sports and private practice sections of the American Physical Therapy Association (APTA) between January and March 2017. Results 1074 responses were analyzed. Supervised physical therapy was reported to last ≤5 months by 56% of the sample. The most frequent time frame for activity progression was: 3-4 months (58%) for jogging, 4-5 months (51%) for modified sports activity and 9-12 months (40%) for unrestricted sports participation. Greater than 80% of the sample reported using strength and functional measures during rehabilitation. Of those that assessed strength, 56% used manual muscle testing as their only means of strength testing. Single limb hop testing (89%) was the most frequently reported measure utilized to begin modified sports activity. Performance criteria for strength and functional tests varied significantly across all phases of rehabilitation. Of the 45% that reported utilizing patient reported outcome measures, only a small proportion of those concerned fear or athletic confidence scales (10%). Conclusions Considerable variation exists amongst APTA members with regards to rehabilitation following ACLR. This variability in practice may contribute to suboptimal outcomes and confusion among practitioners and patients. J Orthop Sports Phys Ther, Epub 22 May 2018. doi:10.2519/jospt.2018.8264.
Cássia Cristina Braghini
Full Text Available Abstract Introduction: Since 2008, with the establishment of Family Health Support Centers (NASF, physiotherapists have been listed among professionals to be included in the team. Physical therapists have many assignments in the NASF, which are conducted through group sessions, in the households, with complementary and integrative practices, lectures and referrals to reference services. Objective: To analyze role and obstacles to the realization of the work of the physiotherapists in NASF. Methods: This is a qualitative research, guided by the case study method. The population was composed by eight physiotherapists active in NASF. Participant observation and semi-structured interviews with physiotherapists were used for data collection. Results: The actions performed by physiotherapists consist of group assistance, home visits, ear therapy and oxygen therapy and activities of health education and disease prevention. As for the barriers, these included lack of training to work at NASF; structural and organizational impediments; insufficient workload and fragility of professional training to work with public health. Conclusion: The role of physiotherapists is in line, in part, with the guidelines recommended by NASF, but principles as matrix support and collective pacts need to be strengthened.
Sword, David O; Thomas, K Jackson; Wise, Holly H; Brown, Deborah D
Sophisticated high-fidelity human simulation (HFHS) manikins allow for practice of both evaluation and treatment techniques in a controlled environment in which real patients are not put at risk. However, due to high demand, access to HFHS by students has been very competitive and limited. In the present study, a basic CPR manikin with a speaker implanted in the chest cavity and internet access to a variety of heart and breath sounds was used. Students were evaluated on their ability to locate and identify auscultation sites and heart/breath sounds. A five-point Likert scale survey was administered to gain insight into student perceptions on the use of this simulation method. Our results demonstrated that 95% of students successfully identified the heart and breath sounds. Furthermore, survey results indicated that 75% of students agreed or strongly agreed that this manner of evaluation was an effective way to assess their auscultation skills. Based on performance and perception, we conclude that a simulation method as described in this paper is a viable and cost-effective means of evaluating auscultation competency in not only student physical therapists but across other health professions as well.
Costa, Larissa R; Costa, José L R; Oishi, Jorge; Driusso, Patricia
The Brazilian Health System is organized on a regional and hierarchical form with three levels of complexity of health care. The Primary Care represents the first element of a continuing health care process, complemented by specialized actions. However, the centrality of the specialized care is still a problem in Brazil, especially in the private sector. Studies on the distribution of professionals in the health system allowing the formulation of appropriate policies are needed. To investigate the distribution of physical therapists in the levels of complexity of health care and between public and private establishments, according to data from the National Register of Health Service Providers (NRHSP). A descriptive cross-sectional study was performed considering NRHSP-national bank data collected in March 2010 and demographic census 2010 data. Data were analyzed through descriptive statistics techniques. We identified 53,181 registries of physical therapists, 60% linked to the private sector. Only 13% of all entries were linked to primary care. The predominance in specialized care occurred in the public sector (65%) and private sector (100%). The specialized establishments of private sector linked to the southeast region (16,043) were the main sites of physical therapists. Only the public sector in the south had a majority in the Primary Care. When considering the sizes of the cities, there is focus on specialist care in bigger cities. This study identified the concentration of physical therapists in the specialized care, mostly in metropolis and big cities and in the private sector, with restricted to participation in the primary care.
Gibbs, Karen A; Furney, Steven R
Physical therapist practice is grounded in patient management principles encompassing all body systems and focuses on prevention, education, and functional outcomes. As such, management of the integumentary system crosses all practice settings, emphasizing the importance that basic integumentary content be adequately addressed during entry-level education. The purpose of this qualitative study was to compare the self-reported integumentary knowledge and skill of recent graduates to profession-determined expectations for education. Participants were 7 licensed physical therapists experienced in wound management. Semi-structured interview data were recorded, transcribed, and coded. A matrix compiling professional expectations for integumentary education was utilized to identify topics as absent, covered only briefly, or covered only during clinical rotations. Compression, vascular screening, infection, factors impacting healing, modalities, dressings, wound measurements, topicals, and sutures/staples were among the most commonly reported areas of deficiency. While integumentary care makes up a small percentage of physical therapy practice, it is a significant part of a comprehensively educated therapist. This study found participants did not perceive themselves to have received the minimum entry-level integumentary knowledge and skill deemed necessary by the profession. Study results are supported by current literature and demonstrate the need for integumentary curriculum review in entry-level programs.
Kriemler, S; Meyer, U; Martin, E
School-based interventions are thought to be the most universally applicable and effective way to counteract low physical activity (PA) and fitness although there is controversy about the optimal strategy to intervene.......School-based interventions are thought to be the most universally applicable and effective way to counteract low physical activity (PA) and fitness although there is controversy about the optimal strategy to intervene....
Rosenthal, Michael D; Ziemke, Gregg W; Bush, Matthew L; Halfpap, Joshua
Navy physical therapists (PTs) have been a part of ship's company aboard Aircraft Carriers since 2002 due to musculoskeletal injuries being the number one cause of lost duty time and disability. This article describes a decade of physical therapy services provided aboard aircraft carriers. A retrospective survey was conducted to evaluate the types of services provided, volume of workload, value of services provided, and impact of PTs on operational readiness for personnel aboard Naval aircraft carriers. Thirty-four reports documenting workload from PTs stationed onboard aircraft carriers were collected during the first decade of permanent PT assignment to aircraft carriers. This report quantifies a 10-yr period of physical therapy services (PT and PT Technician) in providing musculoskeletal care within the carrier strike group and adds to existing literature demonstrating a high demand for musculoskeletal care in operational platforms. A collective total of 144,211 encounters were reported during the 10-yr period. The number of initial evaluations performed by the PT averaged 1,448 per assigned tour. The average number of follow-up appointments performed by the PT per tour was 1,440. The average number of treatment appointments per tour provided by the PT and PT technician combined was 1,888. The average number of visits per patient, including the initial evaluation, was 3.3. Sixty-five percent (65%) of the workload occurred while deployed or out to sea during training periods. It was estimated that 213 medical evacuations were averted over the 10-yr period. There were no reports of adverse events or quality of care reviews related to the care provided by the PT and/or PT technician. Access to early PT intervention aboard aircraft carriers was associated with a better utilization ratio (lower average number of visits per condition) than has been reported in prior studies and suggests an effective utilization of medical personnel resources. The impact of Navy PTs
Vieira, Edgar Ramos; Gadotti, Inae Caroline; Colosi, Conner; Rylak, James; Wylie, Travis; Armijo-Olivo, Susan
Purpose: It is unclear how physical therapists in Florida currently treat people with knee osteoarthritis and whether current best evidence is used in clinical decision making. Methods: We conducted a survey of physical therapists in Florida. We assessed the perceived effectiveness and actual use of physical therapy (PT) interventions and quantified the association between the actual use of interventions and different characteristics of physical therapists. Results: A total of 413 physical therapists completed the survey. Most respondents perceived therapeutic exercise (94%) and education (93%) as being effective or very effective. Interventions least perceived as effective or very effective were electrotherapy (28%), wedged insole (20%), and ultrasound (19%). Physical therapists who followed the principles of evidence-based practice were more likely to use therapeutic exercise (OR 3.89; 95% CI: 1.21, 12.54) and education (OR 3.63; 95% CI: 1.40, 9.43) and less likely to use ultrasound (OR 0.32; 95% CI: 0.16, 0.63) and electrotherapy (OR 0.32; 95% CI: 0.17, 0.58). Results also indicated that older physical therapists were more likely to use ultrasound (OR 3.57; 95% CI: 1.60, 7.96), electrotherapy (OR 2.53; 95% CI: 1.17, 5.47), kinesiology tape (OR 3.82; 95% CI: 1.59, 9.18), and ice (OR 1.95; 95% CI: 1.02, 3.73). Conclusions: In line with clinical guidelines, most physical therapists use therapeutic exercise and education to treat people with knee osteoarthritis. However, interventions that lack scientific support, such as electrotherapy and ultrasound, are still used. A modifiable therapist characteristic, adherence to evidence-based practice, is positively associated with the use of interventions supported by scientific evidence. PMID:28154442
Christensen, Nicole; Black, Lisa; Furze, Jennifer; Huhn, Karen; Vendrely, Ann; Wainwright, Susan
Although clinical reasoning abilities are important learning outcomes of physical therapist entry-level education, best practice standards have not been established to guide clinical reasoning curricular design and learning assessment. This research explored how clinical reasoning is currently defined, taught, and assessed in physical therapist entry-level education programs. A descriptive, cross-sectional survey was administered to physical therapist program representatives. An electronic 24-question survey was distributed to the directors of 207 programs accredited by the Commission on Accreditation in Physical Therapy Education. Descriptive statistical analysis and qualitative content analysis were performed. Post hoc demographic and wave analyses revealed no evidence of nonresponse bias. A response rate of 46.4% (n=96) was achieved. All respondents reported that their programs incorporated clinical reasoning into their curricula. Only 25% of respondents reported a common definition of clinical reasoning in their programs. Most respondents (90.6%) reported that clinical reasoning was explicit in their curricula, and 94.8% indicated that multiple methods of curricular integration were used. Instructor-designed materials were most commonly used to teach clinical reasoning (83.3%). Assessment of clinical reasoning included practical examinations (99%), clinical coursework (94.8%), written examinations (87.5%), and written assignments (83.3%). Curricular integration of clinical reasoning-related self-reflection skills was reported by 91%. A large number of incomplete surveys affected the response rate, and the program directors to whom the survey was sent may not have consulted the faculty members who were most knowledgeable about clinical reasoning in their curricula. The survey construction limited some responses and application of the results. Although clinical reasoning was explicitly integrated into program curricula, it was not consistently defined, taught, or
Salway, Ruth E.; Sebire, Simon J.; Solomon-Moore, Emma; Thompson, Janice L.; Jago, Russell
Background Physical activity in children is associated with better physical and mental health but many children do not meet physical activity guidelines. Friendship groups are potentially an important influence on children’s physical activity and sedentary time. This paper examines the association between children of physical activity and sedentary time in school-based same-sex friendship networks, for both moderate-to-vigorous intensity physical activity (MVPA) and sedentary time. Moreover, ...
Gudjonsdottir, Bjorg; Arnadottir, Hervor A; Gudmundsson, Halldor S; Juliusdottir, Sigrun; Arnadottir, Solveig A
Professionals who embrace evidence-based practice (EBP) continually search for research evidence, appraise, and apply it, while interacting with each client in his/her situation. This dynamic learning process takes a substantial commitment from professionals and requires a positive attitude toward EBP. The main objective of this research was to explore the following: 1) distinct dimensions of attitudes toward adoption of EBP among physical therapists and social workers and 2) the relationship between these dimensions of attitudes and selected background characteristics of the compared professions. Cross-sectional web-based surveys were conducted in 2012 and 2013 on a population-based sample from the Icelandic Physical Therapy Association and the Icelandic Association of Social Workers. The participants were 214 physical therapists (76.3% women) and 163 social workers (92.2% women). The Evidence-Based Practice Attitude Scale (EBPAS) and its four subscales were used to survey dimensions of attitudes toward EBP. Scores on the total EBPAS range from zero to five, with a higher score indicating a more positive attitude toward EBPs. Linear regression was used to explore the relationship between the EBPAS scales and selected background variables. The overall response rate was 39%. Both professions generally held positive attitudes toward adoption of EBP, with an average EBPAS total score of 3.06 (SD = 0.46). The professionals' background characteristics were independently related to at least one dimension of attitudes toward EBP. More positive attitudes were associated with being a physical therapist, a woman, in a younger age group, having a graduate degree, working with individual clients, and having at least five same-profession coworkers. The results may be useful to design continuing education focusing on EBP. Such inventions should be targeted to professional attitudes, background, and other contextual factors.
Cochrane, C G; Farley, B G; Wilhelm, I J
The purposes of this study were to determine the current status of physical therapists' preparation to work with handicapped and at-risk infants and their families and to identify needs for infant- and family-focused training materials and curricula. Results of a telephone survey of 73 physical therapy programs and a follow-up mail survey of 14 physical therapy programs with infancy specialization options are presented. Students in entry-level programs and postprofessional master's degree programs with infancy specializations commonly received instruction in infancy-related topics. Many students received minimal or no exposure to family-related content. Family assessment and intervention were identified as the areas of highest priority for development of training materials and curricula. The results of this study provide direction for the design of infant- and family-focused training materials and curricula in physical therapy.
Zwinkels, Maremka; Verschuren, Olaf; Balemans, Astrid; Lankhorst, Kristel; Te Velde, Saskia; van Gaalen, Leendert; de Groot, Janke; Meilij, JMA; Takken, Tim
Objective: To investigate the effects of a school-based once-a-week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability. Methods: This controlled clinical trial included 71 children and adolescents from four schools
Baharudin, Azli; Zainuddin, Ahmad Ali; Manickam, Mala A; Ambak, Rashidah; Ahmad, Mohamad Hasnan; Naidu, Balkish Mahadir; Cheong, Siew Man; Ying, Chan Ying; Saad, Hazizi Abu; Ahmad, Noor Ani
The importance of physical activity to health is well recognized. Good health habits should begin from a young age. This article aims to explore physical activity among Malaysian school adolescents and factors associated with it. Data from the Malaysian School-Based Nutrition Survey (MSNS), comprising a nationally representative sample of school-going children aged 10 to 17 years, were used. The overall prevalence of physically inactive adolescents was 57.3%. Age in years (adjusted odds ratio = 1.2; 95% confidence interval = 1.16-1.23), gender - females (adjusted odds ratio = 2.9; 95% confidence interval = 2.66-3.10), afternoon school session, breakfast consumption (no breakfast and irregular breakfast), body mass index status (obese and underweight), and body weight perception (underweight perceivers) were significant factors associated with physical inactivity among Malaysian adolescents. Thus, there is evidence that programs to promote physical activity in this group should consider the combination of the aforementioned factors at the household, school, and community levels. © 2014 APJPH.
Benson, Jeryl DiSanti
The purpose of this study was to explore the role of occupation in school-based occupational therapy practice. The research questions were (1) How do school-based occupational therapists describe the role of occupation during intervention? (2) Which theories of occupation do school-based occupational therapists associate with their own practice?…
Passier, Leanne; McPhail, Steven
Physiotherapy and occupational therapy are two professions at high risk of work related musculoskeletal disorders (WRMD). This investigation aimed to identify risk factors for WRMD as perceived by the health professionals working in these roles (Aim 1), as well as current and future strategies they perceive will allow them to continue to work in physically demanding clinical roles (Aim 2). A two phase exploratory investigation was undertaken. The first phase included a survey administered via a web based platform with qualitative open response items. The second phase involved four focus group sessions which explored topics obtained from the survey. Thematic analysis of qualitative data from the survey and focus groups was undertaken. Overall 112 (34.3%) of invited health professionals completed the survey; 66 (58.9%) were physiotherapists and 46 (41.1%) were occupational therapists. Twenty-four health professionals participated in one of four focus groups. The risk factors most frequently perceived by health professionals included: work postures and movements, lifting or carrying, patient related factors and repetitive tasks. The six primary themes for strategies to allow therapists to continue to work in physically demanding clinical roles included: organisational strategies, workload or work allocation, work practices, work environment and equipment, physical condition and capacity, and education and training. Risk factors as well as current and potential strategies for reducing WRMD amongst these health professionals working in clinically demanding roles have been identified and discussed. Further investigation regarding the relative effectiveness of these strategies is warranted.
Lander, Natalie; Eather, Narelle; Morgan, Philip J; Salmon, Jo; Barnett, Lisa M
Fundamental movement skill (FMS) competence is positively associated with physical activity (PA). However, levels of both FMS and PA are lower than expected. Current reviews of interventions to improve FMS and PA have shown that many school-based programs have achieved positive outcomes, yet the maintenance of these interventions is variable. Teachers play a central role in the success and longevity of school-based interventions. Despite the importance of teacher engagement, research into the nature and quality of teacher training in school-based PA and FMS interventions has received little attention. The aim of this systematic review was to investigate the type and quantity of teacher training in school-based physical education PA and/or FMS interventions, and to identify what role teacher training had on the intervention outcome. A systematic search of eight electronic databases was conducted. Publication date restrictions were not implemented in any database, and the last search was performed on 1 March 2015. School physical education-based interventions facilitated by a school teacher, and that included a quantitative assessment of FMS competence and/or PA levels were included in the review. The search identified 39 articles. Eleven of the studies measured FMS, 25 studies measured PA and three measured both FMS and PA. Nine of the studies did not report on any aspect of the teacher training conducted. Of the 30 studies that reported on teacher training, 25 reported statistically significant intervention results for FMS and/or PA. It appears that teacher training programs: are ≥ 1 day; provide comprehensive subject and pedagogy content; are framed by a theory or model; provide follow-up or ongoing support; and measure teacher satisfaction of the training, are more effective at improving student outcomes in FMS and/or PA. However, the provision of information regarding the characteristics of the teacher training was largely inadequate. Therefore, it was
Gazsi, Claudia C; Oriel, Kathryn N
A goal when designing the Physical Therapy Program at Lebanon Valley College (LVC) was to maximize vertical and horizontal integration of course content related to (a) medical Spanish, (b) geriatrics, and (c) health promotion through a service learning engagement. Seventeen Doctor of Physical Therapy students from LVC participated in a fall risk screening at a local senior center in a Spanish-speaking neighborhood. The screen included the single leg stance, timed-up-and-go (TUG), and functional reach tests. The students screened 30 participants over a 3-hour time period. Following the screening event, students were asked to reflect on their experience. Reflections revealed that the activity supported integration of concurrent didactic course material and Core Values, reinforced cultural issues presented the previous year, and convinced students that physical therapists have a distinct and important role in primary and secondary prevention in meeting the needs of the Spanish-speaking elderly community.
Ricketts Thomas C
Full Text Available Abstract Background Health Human Resource (HHR ratios are one measure of workforce supply, and are often expressed as a ratio in the number of health professionals to a sub-set of the population. In this study, we explore national trends in HHR among physical therapists (PTs across Canada. Methods National population data were combined with provincial databases of registered physical therapists in order to estimate the HHR ratio in 2005, and to establish trends between 1991 and 2005. Results The national HHR ratio was 4.3 PTs per 10,000 population in 1991, which increased to 5.0 by 2000. In 2005, the HHR ratios varied widely across jurisdictions; however, we estimate that the national average dropped to 4.8 PTs per 10,000. Although the trend in HHR between 1991 and 2005 suggests positive growth of 11.6%, we have found negative growth of 4.0% in the latter 5-years of this study period. Conclusion Demand for rehabilitation services is projected to escalate in the next decade. Identifying benchmarks or targets regarding the optimal number of PTs, along with other health professionals working within inter professional teams, is necessary to establish a stable supply of health providers to meet the emerging rehabilitation and mobility needs of an aging and increasingly complex Canadian population.
Annette Quinto Romani
Full Text Available AbstractChildhood obesity and inactivity is a significant public health problem that also has economic consequences. Therefore, economists have a role to play in determining the causal impacts. The influences of childhood background on outcomes can, usefully, be broken down into the effect of family, school and peer. To combat the raising childhood obesity, schools have been advocated as a potential area. This paper analyses whether increasing physical activity in a school context can contribute to health improvement using multiple outcomes. We address the issue by using a unique longitudinal data set of, respectively, 1087 (BMI and 1047 (fitness schoolchildren attending 37 state schools in the Municipality of Aalborg, Denmark. The effect is identified by using a randomized experiment that creates an exogenous increase in physical activity. Surprisingly, we find that the intervention did not have the expected impact on schoolchildren’s health, and the scant evidence we have points towards a negative effect. A plausible explanation is that the results mask important heterogeneity. Another plausible explanation is that the results also capture any compensating behaviour that schoolchildren engage in by being less active out of school. From a public-policy perspective, increasing physical activity in a school context seems to increase the ‘gap’ in child health and ‘crowd-out’ outside-school physical activity. Consequently, a supportive cost-benefit case might exist if parental behaviour is assumed to be affected by school resources and endogenous.
Barrett-Williams, Shannon L; Franks, Padra; Kay, Christi; Meyer, Adria; Cornett, Kelly; Mosier, Brian
Power Up for 30 (PU30) is a schoolwide intervention that encourages schools to provide an additional 30 minutes of physical activity during the school day, beyond physical education. The objective of this study was to evaluate the impact of PU30 on Georgia public elementary schools and their students. A total of 719 of 1320 public elementary schools in Georgia that were sent a baseline survey about school physical activity during October 2013 to September 2014 completed the survey, 160 of which were asked to complete a second survey. In the interim (March to June 2015), half (80) of these schools implemented the PU30 program. The interim surveys, which were completed during March to June 2015, assessed opportunities for student physical activity and staff member professional development focused on student physical activity. Compared with schools that had not implemented the program, more schools using the PU30 program reported offering before- and after-school physical activity programs. Forty-four of 78 (57%) PU30 schools compared with 20 of 53 (38%) non-PU30 schools offered before-school physical activity programs. Likewise, more PU30 schools than non-PU30 schools offered after-school physical activity programs (35% vs 16%), and a greater proportion of students at PU30 schools compared with non-PU30 schools met fitness benchmarks: recess 5 days per week (91% [288 of 323] vs 80% [273 of 341]), offering ≥11 minutes per day of classroom-based physical activity (39% [53 of 136] vs 25% [47 of 189] for kindergarten through second grade; 20% [37 of 187] vs 6% [9 of 152] for grades 3 through 5), and receiving physical activity-related professional development time (42% [136 of 323] vs 14% [48 of 341]). The surveys provided a statewide picture of the physical activity opportunities offered to students and staff members in Georgia elementary schools and demonstrated the effective use of a comprehensive, multicomponent program to offer more school-based physical activity
Macdonald, Heather M; Kontulainen, Saija A; Khan, Karim M; McKay, Heather A
This 16-month randomized, controlled school-based study compared change in tibial bone strength between 281 boys and girls participating in a daily program of physical activity (Action Schools! BC) and 129 same-sex controls. The simple, pragmatic intervention increased distal tibia bone strength in prepubertal boys; it had no effect in early pubertal boys or pre or early pubertal girls. Numerous school-based exercise interventions have proven effective for enhancing BMC, but none have used pQCT to evaluate the effects of increased loading on bone strength during growth. Thus, our aim was to determine whether a daily program of physical activity, Action Schools! BC (AS! BC) would improve tibial bone strength in boys and girls who were pre- (Tanner stage 1) or early pubertal (Tanner stage 2 or 3) at baseline. Ten schools were randomized to intervention (INT, 7 schools) or control (CON, 3 schools). The bone-loading component of AS! BC included a daily jumping program (Bounce at the Bell) plus 15 minutes/day of classroom physical activity in addition to regular physical education. We used pQCT to compare 16-month change in bone strength index (BSI, mg2/mm4) at the distal tibia (8% site) and polar strength strain index (SSIp, mm3) at the tibial midshaft (50% site) in 281 boys and girls participating in AS! BC and 129 same-sex controls. We used a linear mixed effects model to analyze our data. Children were 10.2+/-0.6 years at baseline. Intervention boys tended to have a greater increase in BSI (+774.6 mg2/mm4; 95% CI: 672.7, 876.4) than CON boys (+650.9 mg2/mm4; 95% CI: 496.4, 805.4), but the difference was only significant in prepubertal boys (p=0.03 for group x maturity interaction). Intervention boys also tended to have a greater increase in SSIp (+198.6 mm3; 95% CI: 182.9, 214.3) than CON boys (+177.1 mm3; 95% CI: 153.5, 200.7). Change in BSI and SSIp was similar between CON and INT girls. Our findings suggest that a simple, pragmatic program of daily activity
Development and Evaluation of an Implementation Strategy for Collecting Data in a National Registry and the Use of Patient-Reported Outcome Measures in Physical Therapist Practices: Quality Improvement Study.
Meerhoff, Guus A; van Dulmen, Simone A; Maas, Marjo J M; Heijblom, Karin; Nijhuis-van der Sanden, Maria W G; Van der Wees, Philip J
In 2013, the Royal Dutch Society for Physical Therapy launched the program "Quality in Motion." This program aims to collect data from electronic health record systems in a registry that is fed back to physical therapists, facilitating quality improvement. The purpose of this study was to describe the development of an implementation strategy for the program and to evaluate the feasibility of building a registry and implementing patient-reported outcome measures (PROMs) in physical therapist practices. A stepwise approach using mixed methods was established in 3 consecutive pilots with 355 physical therapists from 66 practices. Interim results were evaluated using quantitative data from a self-assessment questionnaire and the registry and qualitative data from 21 semistructured interviews with physical therapists. Descriptive statistics and McNemar's symmetry chi-squared test were used to summarize the feasibility of implementing PROMs. PROMs were selected for the 5 most prevalent musculoskeletal conditions in Dutch physical therapist practices. A core component of the implementation strategy was the introduction of knowledge brokers to support physical therapists in establishing the routine use of PROMs in clinical practice and to assist in executing peer assessment workshops. In February 2013, 30.3% of the physical therapist practices delivered 4.4 completed treatment episodes per physical therapist to the registry; this increased to 92.4% in November 2014, delivering 54.1 completed patient episodes per physical therapist. Pre- and posttreatment PROM use increased from 12.2% to 39.5%. It is unclear if the participating physical therapists reflect a representative sample of Dutch therapists. Building a registry and implementing PROMs in physical therapist practices are feasible. The routine use of PROMs needs to increase to ensure valid feedback of outcomes. Using knowledge brokers is promising for implementing the program via peer assessment workshops. © 2017
Vander Ploeg, Kerry A; McGavock, Jonathan; Maximova, Katerina; Veugelers, Paul J
Comprehensive school health (CSH) is a multifaceted approach to health promotion. A key objective of CSH is to foster positive health behaviors outside of school. This study examined the 2-year change in physical activity during and after school among students participating in a CSH intervention in Edmonton, Alberta, Canada. This was a quasi-experimental, pre-post trial with a parallel, nonequivalent control group. Intervention schools had to be located in socioeconomically disadvantaged neighborhoods. In the spring of 2009 and 2011, pedometer recordings (7 full days) and demographic data were collected from cross-sectional samples of fifth grade students from 10 intervention schools and 20 comparison schools. A total of 1157 students participated in the study. Analyses were adjusted for potential confounders and the clustered design. Relative to 2009, children in 2011 were more active on schools days (1172 steps per day; P affect children's physical activity during and outside of school. Results of this study justify broader implementation of effective CSH interventions for physical activity promotion and obesity prevention in the long term.
Full Text Available Abstract Background Studies examining the relationship between physical fitness and obesity in children have had mixed results despite their interrelationship making intuitive sense. We examined the relationship between physical fitness and overweight and obesity in a large sample of adolescents in the Republic of Seychelles (Indian Ocean, African region. Methods All students of four grades of all secondary schools performed nine physical fitness tests. These tests assessed agility, strength and endurance, and included the multistage shuttle run, a validated measure of maximal oxygen uptake. Weight and height were measured, body mass index (BMI calculated, and "overweight" and "obesity" were defined based on the criteria of the International Obesity Task Force. We defined "lean" weight as age- and sex-specific BMI th percentile. Age- and sex-specific percentiles for each fitness test were calculated. "Good" performance was defined as a result ≥75th percentile. Results Data were available in 2203 boys and 2143 girls from a total of 4599 eligible students aged 12–15 years. The prevalence of overweight (including obesity was 11.2% (95% confidence interval: 9.9–12.4 in boys and 17.5% (15.9–19.1 in girls. For 7 of the 9 tests, the relationship between BMI and fitness score, as assessed by locally weighted regression, was characterized by a marked inverse J shape. Students with normal body weight achieved "good" performance markedly more often than overweight or obese students on 7 of the 9 tests of fitness and more often than lean children. For example, good performance for the multistage shuttle run was achieved by 25.6% (SE: 2.1 of lean students, 29.6% (0.8 of normal weight students, 7.9% (1.3 of overweight students and 1.2% (0.9 of obese students. Conclusion This cross-sectional study shows a strong inverse relationship between fitness and excess body weight in adolescents. Improving fitness in adolescents, likely through increasing
Full Text Available Abstract Background As concern about youth obesity continues to mount, there is increasing consideration of widespread policy changes to support improved nutritional and enhanced physical activity offerings in schools. A critical element in the success of such programs may be to involve students as spokespeople for the program. Making such a public commitment to healthy lifestyle program targets (improved nutrition and enhanced physical activity may potentiate healthy behavior changes among such students and provide a model for their peers. This paper examines whether student's "public commitment"--voluntary participation as a peer communicator or in student-generated media opportunities--in a school-based intervention to prevent diabetes and reduce obesity predicted improved study outcomes including reduced obesity and improved health behaviors. Methods Secondary analysis of data from a 3-year randomized controlled trial conducted in 42 middle schools examining the impact of a multi-component school-based program on body mass index (BMI and student health behaviors. A total of 4603 students were assessed at the beginning of sixth grade and the end of eighth grade. Process evaluation data were collected throughout the course of the intervention. All analyses were adjusted for students' baseline values. For this paper, the students in the schools randomized to receive the intervention were further divided into two groups: those who participated in public commitment activities and those who did not. Students from comparable schools randomized to the assessment condition constituted the control group. Results We found a lower percentage of obesity (greater than or equal to the 95th percentile for BMI at the end of the study among the group participating in public commitment activities compared to the control group (21.5% vs. 26.6%, p = 0.02. The difference in obesity rates at the end of the study was even greater among the subgroup of students who
Gyer, Giles; Michael, Jimmy; Inklebarger, James
Hand injury is the second most common work-related musculoskeletal injury among physical therapists (PTs) and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. PTs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury. Copyright © 2018 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.
Full Text Available Abstract Background Physical activity (PA rates decline precipitously during the high school years and are consistently lower among adolescent girls than adolescent boys. Due to cultural barriers, this problem might be exacerbated in female Iranian adolescents. However, little intervention research has been conducted to try to increase PA participation rates with this population. Because PA interventions in schools have the potential to reach many children and adolescents, this study reports on PA intervention research conducted in all-female Iranian high schools. Methods A randomized controlled trial was conducted to examine the effects of two six-month tailored interventions on potential determinants of PA and PA behavior. Students (N = 161 were randomly allocated to one of three conditions: an intervention based on Pender's Health Promotion model (HP, an intervention based on an integration of the health promotion model and selected constructs from the Transtheoretical model (THP, and a control group (CON. Measures were administered prior to the intervention, at post-intervention and at a six-month follow-up. Results Repeated measure ANOVAs showed a significant interaction between group and time for perceived benefits, self efficacy, interpersonal norms, social support, behavioral processes, and PA behavior, indicating that both intervention groups significantly improved across the 24-week intervention, whereas the control group did not. Participants in the THP group showed greater use of counter conditioning and stimulus control at post-intervention and at follow-up. While there were no significant differences in PA between the HP and CON groups at follow-up, a significant difference was still found between the THP and the CON group. Conclusion This study provides the first evidence of the effectiveness of a PA intervention based on Pender's HP model combined with selected aspects of the TTM on potential determinants to increase PA among
Ormshaw, Michael James; Kokko, Sami Petteri; Villberg, Jari; Kannas, Lasse
Purpose: The purpose of this paper is to utilise the collective opinion of a group of Finnish experts to identify the most important learning outcomes of secondary-level school-based health education, in the specific domains of physical activity and nutrition. Design/ Methodology/ Approach: The study uses a Delphi survey technique to collect the…
Escartí, Amparo; Liops-Goig, Ramon; Wright, Paul M.
Purpose: The Teaching Personal and Social Responsibility (TPSR) model was developed to foster responsibility and teach life skills that transfer to various settings. The purpose of this study was to assess the implementation fidelity of a school-based TPSR program in physical education and other subject areas. Method: Systematic observation was…
Full Text Available Abstract Background The benefits of physical activity for the mental health and well-being of children and young people are well-established. Increased physical activity during school hours is associated with better physical, psychological and social health and well‐being. Unfortunately many children and young people exercise insufficiently to benefit from positive factors like well-being. The main aim of this study is to develop, implement and evaluate a multi-component, school-based, physical activity intervention to improve psychosocial well-being among school-aged children and youths from the 4th to the 6th grade (10–13 years. Methods A four-phased intervention – design, pilot, RCT, evaluation - is carried out for the development, implementation and evaluation of the intervention which are guided by The Medical Research Council framework for the development of complex interventions. 24 schools have been randomized and the total study population consists of 3124 children (baseline, who are followed over a period of 9 months. Outcome measure data at the pupil level are collected using an online questionnaire at baseline and at follow-up, 9 months later with instruments for measuring primary (general physical self-worth and secondary outcomes (self-perceived sport competences, body attractiveness, scholastic competences, social competences and global self-worth; enjoyment of PA; self-efficacy; and general well-being that are both valid and manageable in setting-based research. The RE-AIM framework is applied as an overall instrument to guide the evaluation. Discussion The intervention focuses on the mental benefits of physical activity at school, which has been a rather neglected theme in health promotion research during recent decades. This is unfortunate as mental health has been proclaimed as one of the most important health concerns of the 21st century. Applying a cluster RCT study design, evaluating the real-world effectiveness of
Smedegaard, Søren; Christiansen, Lars Breum; Lund-Cramer, Pernille; Bredahl, Thomas; Skovgaard, Thomas
The benefits of physical activity for the mental health and well-being of children and young people are well-established. Increased physical activity during school hours is associated with better physical, psychological and social health and well-being. Unfortunately many children and young people exercise insufficiently to benefit from positive factors like well-being. The main aim of this study is to develop, implement and evaluate a multi-component, school-based, physical activity intervention to improve psychosocial well-being among school-aged children and youths from the 4 th to the 6 th grade (10-13 years). A four-phased intervention - design, pilot, RCT, evaluation - is carried out for the development, implementation and evaluation of the intervention which are guided by The Medical Research Council framework for the development of complex interventions. 24 schools have been randomized and the total study population consists of 3124 children (baseline), who are followed over a period of 9 months. Outcome measure data at the pupil level are collected using an online questionnaire at baseline and at follow-up, 9 months later with instruments for measuring primary (general physical self-worth) and secondary outcomes (self-perceived sport competences, body attractiveness, scholastic competences, social competences and global self-worth; enjoyment of PA; self-efficacy; and general well-being) that are both valid and manageable in setting-based research. The RE-AIM framework is applied as an overall instrument to guide the evaluation. The intervention focuses on the mental benefits of physical activity at school, which has been a rather neglected theme in health promotion research during recent decades. This is unfortunate as mental health has been proclaimed as one of the most important health concerns of the 21 st century. Applying a cluster RCT study design, evaluating the real-world effectiveness of the intervention, this study is one of the largest
Corkery, Marie B; Edgar, Kristen L; Smith, Christine E
To explore the clinical practice of physical therapists and examine adherence to clinical guidelines for treating patients with whiplash associated disorders (WAD). A cross-sectional electronic survey was sent to 1484 licensed physical therapists from the Orthopedic Section of the American Physical Therapy Association and the American Academy of Orthopedic Manual Physical Therapists. The survey included demographic data and two clinical vignettes describing patients with acute and chronic WAD. The chi-square test was used to analyze responses. There were 291(19.6%) responses to the survey. Of those, 237 (81.4%) provided data for vignette 1 and 204 (70.1%) for vignette 2. One hundred and eighty (76.6%) respondents reported familiarity with evidence-based or clinical practice guidelines for treating patients with WAD. Of those, 71.5% (n = 128) indicated that they followed them more than 50% of the time. Therapists with an advanced certification were more likely to be familiar with clinical guidelines than those who were not certified (Ppsychological distress and some outcome measures. Significant differences in clinical practice (P<0.01) were found between therapists who were and were not familiar with guidelines and those with and without an advanced certification. Advanced certification and knowledge of guidelines appeared to play a role in the clinical practice of physical therapists treating patients with WAD. Further research is needed to explore factors affecting knowledge translation from research to clinical practice and to evaluate the outcomes of patients with WAD when clinical guidelines are applied in practice.
This study investigated the relationship between presenteeism and work-related musculoskeletal disorders (WMSDs) among physical therapists (PTs) in the Republic of Korea. Questionnaires were given to 600 PTs in the Republic of Korea. General and occupational characteristics and the prevalence of presenteeism and absenteeism were self-reported on the questionnaire. Stepwise regression analyses were used to evaluate the effects of presenteeism and other variables on general and occupational characteristics. Of the 490 PTs who responded, 399 (81.4%) reported at least one WMSD. There was a low incidence rate of absenteeism, but work impairment scores indicate there was a high incidence of presenteeism. In the stepwise regression analyses, the incidence of WMSDs was highest in cases of presenteeism. The results of this study demonstrate that there is a high incidence rate of WMSDs in Republic of Korean PTs, that WMSDs are related to presenteeism and that PTs demonstrate high presenteeism and low absenteeism.
Landry Michel D
Full Text Available Abstract Background Recruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. Methods A longitudinal dataset of registered PTs in Ontario (1999-2007 was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed. Results There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%. Conclusion Among all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors.
Background Recruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs) in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. Methods A longitudinal dataset of registered PTs in Ontario (1999-2007) was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC) or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed. Results There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%. Conclusion Among all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors. PMID:22643111
Tuyl, Lara J; Mackney, Jennifer H; Johnston, Catherine L
Sternal precautions are utilized within many hospitals with the aim of preventing the occurrence of sternal complications (eg, infection, wound breakdown) following midline sternotomy. The evidence base for sternal precaution protocols, however, has been questioned due to a paucity of research, unknown effect on patient outcomes, and possible discrepancies in pattern of use among institutions. The objective of this study was to investigate and document the use of sternal precautions by physical therapists in the treatment of patients following median sternotomy in hospitals throughout Australia, from immediately postsurgery to discharge from the hospital. A cross-sectional, observational design was used. An anonymous, Web-based survey was custom designed for use in the study. The questionnaire was content validated, and the online functionality was assessed. The senior cardiothoracic physical therapist from each hospital identified as currently performing cardiothoracic surgery (N=51) was invited to participate. The response rate was 58.8% (n=30). Both public (n=18) and private (n=12) hospitals in all states of Australia were represented. Management protocols reported by participants included wound support (n=22), restrictions on lifting and transfers (n=23), and restrictions on mobility aid use (n=15). Factors influencing clinical practice most commonly included "workplace practices/protocols" (n=27) and "clinical experience" (n=22). Limitations The study may be limited by response bias. Significant variation exists in the sternal precautions and protocols used in the treatment of patients following median sternotomy in Australian hospitals. Further research is needed to investigate whether the restrictions and precautions used are necessary and whether protocols have an impact on patient outcomes, including rates of recovery and length of stay.
Salbach, Nancy M; Veinot, Paula; Jaglal, Susan B; Bayley, Mark; Rolfe, Danielle
Understanding how to structure educational interventions and resources to facilitate physical therapists' application of the research literature is required. The objective of this study was to explore physical therapists' preferences for strategies to facilitate their access to, evaluation and implementation of the stroke research literature in clinical practice. In-depth, qualitative telephone interviews were conducted with 23 physical therapists who treat people with stroke in Ontario, Canada and who had participated in a previous survey on evidence-based practice. Data were analysed using a constant comparative approach to identify emergent themes. Participants preferred online access to research summaries or systematic reviews to save time to filter and critique research articles. To enable access in the workplace, an acceptable computer-to-staff ratio, permission to access web sites and protected work time were suggested. Participants considered personal digital assistants as excellent tools for quick access to online resources but were unsure of their advantage over a desktop computer. Therapists favoured use of non-technical language, glossaries of research terms and quality ratings of studies to ease understanding and appraisal. Teleconferencing or videoconferencing overcame geographical but not scheduling barriers to accessing education. To achieve behaviour change in clinical practice, therapists preferred multiple interactive, face-to-face education sessions in a group format, with opportunities for case-based learning and practice of new skills. Physical therapists prefer technology-assisted access to resources and education and favour attending multiple interactive, expert-facilitated education sessions incorporating opportunities for case-based learning and practice of new skills to change behaviour related to evidence-based practice. © 2010 Blackwell Publishing Ltd.
Full Text Available ABSTRACT Background: The understanding of the pathomechanics of shoulder impingement has evolved over the years. Likewise, assessment techniques and effective treatment strategies have also been developed. Physical therapists should keep up-to-date on the current evidence. Objective: This study explored the practices currently used by Indian physical therapists for the assessment and management of shoulder impingement syndrome (SIS. Method: Using an online questionnaire, therapists were asked to declare the causes, methods of assessment and their choices of physical therapy techniques for the management of SIS. The proportions of therapists using different techniques were analyzed descriptively, and comparisons across gender, experience level, and training were made. Data were analyzed to see if the choices of respondents compared with their responses for etiology. Results: A total of 211 responses were analyzed. Most respondents (>75% believed that overuse and abnormal motion/posture are the most significant causes of SIS. However, fewer respondents reported assessing posture (60.2% and dyskinesis, especially in women (24.2%. Ninety-four percent of the respondents reported using exercises, but exercise prescription was rather generic. Therapists additionally trained in the techniques of joint mobilization or taping declared using these techniques more frequently. The use of interferential therapy and ultrasound was reported by 89.5% and 98.4% of respondents, respectively Conclusion: Most therapists declared awareness of current recommended practices, but patient assessment, exercise prescription, and use of electrotherapy modalities were only partially based on current evidence. The study helps to identify gaps in current physical therapy approaches to SIS in India.
Emad T. Ahmed
Full Text Available Background: Physical therapy often is used in the management of work-related low back pain (LBP. Little information, however, is known about work related low back pain that may occur in physical therapy experts themselves. Work related low back agony speaks to one of the real wellbeing issues that happen in well-beings experts. The point of this study is to examine the pervasiveness of work related low back pain in physical therapy experts, and its connection to the way of work. Methods: One hundred and seven physical therapy experts working at general hospitals at Taif, KSA took part in this study, their age ranged from 25 to 60 years, and they were complaining from low back pain for more than 3 months and their current pain for at least three or more weeks. Every subject was requested to finish the Oswestry Low Back Pain Disability Index Questionnaires that comprised of 15 close-ended inquiries. Results: We analyzed Data by utilizing descriptive statistics to gauge the predominance of low back pain in physical therapy experts and to explore connection between back pain and hospital facility work. Out of two hundred thirty physical therapist advisor, one hundred and ten (47.8% physical specialists finished/gave back the surveys. three polls were rejected from investigation since members had missed a few things in filling the survey. In this manner, just information from 107 members was utilized to figure the predominance rates. It was found that the commonness of work related low back pain in physical therapy expert is equivalent 72%. It was found that a connection between the works related low back pain and age, proficient rank, and specialty. Conclusion: There is a higher occurrence of work related back pain among physiotherapist expert and this may be impacted by age, proficient rank and specialty.
Zwinkels, Maremka; Verschuren, Olaf; Balemans, Astrid; Lankhorst, Kristel; Te Velde, Saskia; van Gaalen, Leendert; de Groot, Janke; Visser-Meily, Anne; Takken, Tim
To investigate the effects of a school-based once-a-week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability. This controlled clinical trial included 71 children and adolescents from four schools for special education [mean age 13.7 (2.9) years, range 8-19, 55% boys]. Participants had various chronic health conditions including cerebral palsy (37%), other neuromuscular (44%), metabolic (8%), musculoskeletal (7%), and cardiovascular (4%) disorders. Before recruitment and based on the presence of school-based sports, schools were assigned as sport or control group. School-based sports were initiated and provided by motivated experienced physical educators. The sport group ( n = 31) participated in a once-a-week school-based sports program for 6 months, which included team sports. The control group ( n = 40) followed the regular curriculum. Anaerobic performance was assessed by the Muscle Power Sprint Test. Secondary outcome measures included aerobic performance, VO 2 peak, strength, physical activity, blood pressure, arterial stiffness, body composition, and the metabolic profile. A significant improvement of 16% in favor of the sport group was found for anaerobic performance ( p = 0.003). In addition, the sport group lost 2.8% more fat mass compared to the control group ( p = 0.007). No changes were found for aerobic performance, VO 2 peak, physical activity, blood pressure, arterial stiffness, and the metabolic profile. Anaerobic performance and fat mass improved following a school-based sports program. These effects are promising for long-term fitness and health promotion, because sports sessions at school eliminate certain barriers for sports participation and adding a once-a-week sports session showed already positive effects for 6 months. This trial was registered with the Dutch Trial Registry (NTR4698).
Full Text Available ObjectiveTo investigate the effects of a school-based once-a-week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability.MethodsThis controlled clinical trial included 71 children and adolescents from four schools for special education [mean age 13.7 (2.9 years, range 8–19, 55% boys]. Participants had various chronic health conditions including cerebral palsy (37%, other neuromuscular (44%, metabolic (8%, musculoskeletal (7%, and cardiovascular (4% disorders. Before recruitment and based on the presence of school-based sports, schools were assigned as sport or control group. School-based sports were initiated and provided by motivated experienced physical educators. The sport group (n = 31 participated in a once-a-week school-based sports program for 6 months, which included team sports. The control group (n = 40 followed the regular curriculum. Anaerobic performance was assessed by the Muscle Power Sprint Test. Secondary outcome measures included aerobic performance, VO2 peak, strength, physical activity, blood pressure, arterial stiffness, body composition, and the metabolic profile.ResultsA significant improvement of 16% in favor of the sport group was found for anaerobic performance (p = 0.003. In addition, the sport group lost 2.8% more fat mass compared to the control group (p = 0.007. No changes were found for aerobic performance, VO2 peak, physical activity, blood pressure, arterial stiffness, and the metabolic profile.ConclusionAnaerobic performance and fat mass improved following a school-based sports program. These effects are promising for long-term fitness and health promotion, because sports sessions at school eliminate certain barriers for sports participation and adding a once-a-week sports session showed already positive effects for 6 months.Clinical Trial RegistrationThis trial was registered with the Dutch Trial Registry (NTR
Thomas, Susie; Mackintosh, Shylie
Discharge from the hospital is a high risk transition period for older adults at risk of falls. Guidelines relevant to physical therapists for managing this risk are well documented, but commonly not implemented. This project implemented an intervention to improve physical therapists' adherence to key guideline recommendations for managing risk of falls on discharge from one hospital. A pretest-posttest study design was undertaken and was underpinned by the Theoretical Domains Framework (TDF) to aid in the design of interventions to increase physical therapists' adherence to guideline recommendations and to identify barriers to these interventions. A multifaceted intervention was implemented, including the establishment of a governance committee, education sessions, development of a "pathway" to guide practice, modification of an existing standardized assessment proforma, development of standardized processes and indicators for handover, increasing availability of educational handouts, audit and feedback processes, and allocation of dedicated staffing to oversee falls prevention within the physical therapy department. There were significant improvements in physical therapist behavior leading to key guideline recommendations being met, including: the proportion of patients who were identified to be at risk of falls (6.3% preintervention versus 94.8% postintervention) prior to discharge, an increase in documentation of clinical handover at discharge (68.6% preintervention versus 90.9% postintervention), and improvement in the quality of this documented clinical handover (34.9% of case notes met 5 criteria preintervention versus 92.9% postintervention). The approach was resource intensive and consequently may be difficult to replicate at other sites. A multifaceted intervention underpinned by the TDF, designed to modify physical therapists' behavior to improve adherence to guideline recommendations for managing risk of falls on discharge from one hospital, was
Austin, Tricia M; Richter, Randy R; Frese, Tracy
Evidence-based practice (EBP) in rehabilitation is increasingly recognized as important. Despite the importance of EBP, physical therapists' knowledge of EBP varies. Journal clubs have been used to educate clinicians about EBP. This discussion paper describes the partnership between academic faculty members and a physical therapist at a community hospital, and the process used to develop a framework to implement an evidence-based journal club. The partnership blended the expertise of academic faculty members and a physical therapist with knowledge of EBP who served as the liaison between members of the partnership team and the clinicians at the community hospital. The three-step framework developed enabled the clinicians to learn about critical appraisal, participate in guided practice of critical appraisal with the liaison, and lead critical appraisal of a paper with the assistance of the liaison as needed. This process could be easily replicated by other partnerships between academic faculty members and clinicians. Developing partnerships like the one described enables academicians to provide service to the profession, may enhance physical therapists' knowledge of the principles of EBP and may encourage EBP.
Hanna, Elizabeth; Cott, Cheryl
ABSTRACT Purpose: To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students. Method: In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach. Results: Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision. Conclusions: Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff. PMID:22379263
Smith, Heather D; Bogenschutz, Elizabeth D; Bayliss, Amy J; Altenburger, Peter A; Warden, Stuart J
Professional meetings, such as the American Physical Therapy Association's (APTA's) Combined Sections Meeting (CSM), provide forums for sharing information relevant to physical therapy. An indicator of whether therapists fully disseminate their work is the number of full-text peer-reviewed publications that result. The purposes of this study were: (1) to determine the full-text publication rate of work presented in abstract form at CSM and (2) to investigate factors influencing this rate. A systematic search was undertaken to locate full-text publications of work presented in abstract form within the Orthopaedic and Sports Physical Therapy sections at CSM between 2000 and 2004. Eligible publications were published within 5 years following abstract presentation. The influences of APTA section, year of abstract presentation, institution of origin, study design, sample size, study significance, reporting of a funding source, and presentation type on full-text publication rate were assessed. Characteristics of full-text publications were explored. Work presented in 1 out of 4 abstracts (25.4%) progressed to full-text publication. Odds of full-text publication increased if the abstract originated from a doctorate-granting or "other" institution, reported findings of an experimental study, reported a statistically significant finding, included a larger sample size, disclosed a funding source, or was presented as a platform presentation. More than one third (37.8%) of full-text publications were published in the Journal of Orthopaedic and Sports Physical Therapy or Physical Therapy, and 4 out of 10 full-text publications (39.2%) contained at least one major change from information presented in abstract form. The full-text publication rate for information presented in abstract form within the Orthopaedic and Sports Physical Therapy sections at CSM is low relative to comparative disciplines. Caution should be exercised when translating information presented at CSM into
Tao, Yu-Hui; Wu, Yu-Lung; Huang, Wan-Yun
The evidence literature suggests that physical therapy practitioners are subjected to a high probability of acquiring work-related injuries, but only a few studies have specifically investigated Taiwanese physical therapy practitioners. This study was conducted to determine the relationships among individual and group hospital-level factors that contribute to the medical expenses for the occupational injuries of physical therapy practitioners in Taiwan. Physical therapy practitioners in Taiwan with occupational injuries were selected from the 2013 National Health Insurance Research Databases (NHIRD). The age, gender, job title, hospitals attributes, and outpatient data of physical therapy practitioners who sustained an occupational injury in 2013 were obtained with SAS 9.3. SPSS 20.0 and HLM 7.01 were used to conduct descriptive and hierarchical linear model analyses, respectively. The job title of physical therapy practitioners at the individual level and the hospital type at the group level exert positive effects on per person medical expenses. Hospital hierarchy moderates the individual-level relationships of age and job title with the per person medical expenses. Considering that age, job title, and hospital hierarchy affect medical expenses for the occupational injuries of physical therapy practitioners, we suggest strengthening related safety education and training and elevating the self-awareness of the risk of occupational injuries of physical therapy practitioners to reduce and prevent the occurrence of such injuries.
Nash, David A; Friedman, Jay W; Kardos, Thomas B; Kardos, Rosemary L; Schwarz, Eli; Satur, Julie; Berg, Darren G; Nasruddin, Jaafar; Mumghamba, Elifuraha G; Davenport, Elizabeth S; Nagel, Ron
In 1921, New Zealand began training school dental nurses, subsequently deploying them throughout the country in school-based clinics providing basic dental care for children. The concept of training dental nurses, later to be designated dental therapists, was adopted by other countries as a means of improving access to care, particularly for children. This paper profiles six countries that utilise dental therapists, with a description of the training that therapists receive in these countries, and the context in which they practice. Based on available demographic information, it also updates the number of dental therapists practising globally, as well as the countries in which they practice. In several countries, dental therapy is now being integrated with dental hygiene in training and practice to create a new type of professional complementary to a dentist. Increasingly, dental therapists are permitted to treat adults as well as children. The paper also describes the status of a current initiative to introduce dental therapy to the United States. It concludes by suggesting that dental therapists can become valued members of the dental team throughout the world, helping to improve access to care and reducing existing disparities in oral health.
van Benten, E.; Pool, J.J.; Mens, J; Pool-Goudzwaard, A.L.
STUDY DESIGN: Systematic review of the literature. OBJECTIVES: To review and assess the peer-reviewed literature on the effectiveness of physical therapy interventions in treating lumbopelvic pain during pregnancy. BACKGROUND: Current guidelines on interventions for lumbopelvic pain during pregnancy
Rijken, P.M.; Dekker, J.
Objectives: To provide an overview of the numbers of patients with selected chronic diseases treated by rehabilitation therapists (physical therapists, occupational therapists, exercise therapists and podiatrists). The study was performed to get quantitative information on the degree to which
Carlson, Joseph J; Eisenmann, Joey C; Pfeiffer, Karin A; Jager, Kathleen B; Sehnert, Scott T; Yee, Kimbo E; Klavinski, Rita A; Feltz, Deborah L
Abstract Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-discipl...
Oosting, Ellen; Dronkers, Jaap; Hoogeboom, Thomas; van Meeteren, Nico; Speelman, Willem Marie
To get insight into personal meaning of a person involved in a physical therapy intervention. Mrs. A, a 76-year-old woman is referred to a physical therapist (PT) for assessment of functioning and training before total hip arthroplasty (THA). The patient, her daughter, and PT were asked to write a story about their daily life. Stories were analyzed according to the narrative scheme based on a method to find meaning in daily life, which consists of four phases: 1. Motivation; 2. Competences; 3. Performance; and 4. Mrs. A was mainly motivated by her will to do enjoyable social activities and stay independent. Although she tried her best to undertake activities (performance) that made her proud (evaluation), her pain and physical limitations were anti-competences that motivated her to attend healthcare. Although the PT seemed to be aware of personal participation goals, her main motivation was to improve and evaluate functions and activities. The daughter was motivated by good relationships and did not see herself as informal caregiver. The narrative method was a valuable tool to clarify motivations, competences, and values in the process of creating personal meaning related to functioning. This knowledge could help caregivers in applying patient-centered goal-setting and treatment on a participation level. Implications for rehabilitation Personal meaning of people's functioning within their daily context can be clarified from daily life stories. This case report demonstrates that motivations and goals may differ between patient and therapist; the PT seems to focus on improving and evaluating functions and activities, while the patient seems to focus her motivations and personal meaning on participation. This approach may help in patient-centered goal-setting at the level of activities and participation.
Bruno T. Saragiotto
Full Text Available Background: Musculoskeletal injuries occur frequently in elite athletes. Understanding what professionals who work with patients with sports injuries think about prevention has been suggested as an important aspect to improve the effectiveness of programs to prevent sports injuries. Objectives: To describe and characterize the opinions of physical therapists, physicians and trainers on 'risk factors' and 'prevention of injury' in elite athletes. Method: This is a qualitative study with semi-structured interviews with members of the medical and technical department of the Brazilian delegation who participated in the Pan American Games of Guadalajara 2011. The interview was conducted using two questions: 1 "What do you think can cause injuries in athletes participating in your sport?" 2 "What do you do to prevent injuries in your sport?" The interviews were analyzed in two stages, the identification of thematic units, followed by the categorization and grouping of thematic units. Results: We interviewed a total of 30 professionals. Regarding question 1, the main factors attributed as responsible for injury were over-training and incorrect sports techniques. Regarding question 2, the main reported strategies used to prevent injuries were muscle strengthening, nutritional counseling and guidance. Conclusions: The main factors affecting the appearance of lesions were over-training, incorrect sports technique, inadequate nutrition and factors related to the athlete's behavior. The main injury prevention strategies were muscle strengthening, nutritional counseling and guidance.
Hunter, Stephen; Leatherdale, Scott T.; Storey, Kate; Carson, Valerie
Background Adolescence is characterized by low moderate- to vigorous- intensity physical activity (MVPA) levels. Targeting the school setting can increase MVPA among a large proportion of adolescents. However, school-based physical activity interventions for adolescents remain largely ineffective. Therefore, the purpose of this study was to examine how naturally-occurring changes to school physical activity policy, recreational programming, public health resources, and the physical environmen...
Lind, Rune Rasmussen; Geertsen, Svend Sparre; Ørntoft, Christina; Madsen, Mads; Larsen, Malte Nejst; Dvorak, Jiri; Ritz, Christian; Krustrup, Peter
Recent studies have shown promising effects of physical activity on cognitive function, but there is a need to investigate this link in real-life settings such as schools. Hence, the objective of the present pilot study was to investigate whether the school-based physical activity programme "FIFA 11 for Health" for Europe could improve cognitive performance in preadolescent Danish children. The pilot study used an 11-week cluster-randomised intervention study design. School classes were randomly assigned to either a control group (CG) (n = 93 children, age = 11.8, s = 0.2 years), which performed the obligatory daily school-based physical activity (5 × 45 minutes per week); or an intervention group (IG) (n = 838 children, age = 11.9, s = 0.4 years), which substituted 2 × 45 minutes per week of the daily school physical activity with the "FIFA 11 for Health" for Europe programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up. The IG improved their cognitive performance compared to the CG for psychomotor function (56, s x - = 22 ms, p school-based physical activity programme "FIFA 11 for Health" for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt to disentangle the effects of "FIFA 11 for Health" for Europe on cognitive performance by investigating the characteristics of the programme's physical activity.
Wells, Cherie; Kolt, Gregory S; Marshall, Paul; Bialocerkowski, Andrea
Pilates exercise is recommended for people with chronic low back pain (CLBP). In the literature, however, Pilates exercise is described and applied differently to treat people with CLBP. These differences in the definition and application of Pilates exercise make it difficult to evaluate its effectiveness. The aim of this study was to establish consensus regarding the definition and application of Pilates exercise to treat people with CLBP. A panel of Australian physical therapists who are experienced in treating people with CLBP using Pilates exercise were surveyed using the Delphi technique. Three electronic questionnaires were used to collect the respondents' opinions. Answers to open-ended questions were analyzed thematically, combined with systematic literature review findings, and translated into statements about Pilates exercise for people with CLBP. Participants then rated their level of agreement with these statements using a 6-point Likert scale. Consensus was achieved when 70% of the panel members strongly agreed, agreed, or somewhat agreed (or strongly disagreed, disagreed, or somewhat disagreed) with an item. Thirty physical therapists completed all 3 questionnaires and reached consensus on the majority of items. Participants agreed that Pilates exercise requires body awareness, breathing, movement control, posture, and education. It was recommended that people with CLBP should undertake supervised sessions for 30 to 60 minutes, twice per week, for 3 to 6 months. Participants also suggested that people with CLBP would benefit from individualized assessment and exercise prescription, supervision and functional integration of exercises, and use of specialized equipment. Item consensus does not guarantee the accuracy of findings. This survey reflects the opinion of only 30 physical therapists and requires validation in future trials. These findings contribute to a better understanding of Pilates exercise and how it is utilized by physical therapists to
Kinslow, Brian; De Heer, Hendrik D; Warren, Meghan
Functional limitations are associated with decreased physical activity and increased body mass index. The purpose of this study was to assess the prevalence of functional limitations among adults who reported receiving health professional advice to exercise more or lose weight, and to assess involvement of health professionals, including physical therapists, in weight loss efforts with these individuals. A cross-sectional analysis of U.S. adults from the 2011 to 2014 National Health and Nutrition Examination Survey (n = 5,480). Participant demographics, health history, and functional limitations were assessed via self-report and examination. Frequency distributions were calculated using SAS® analytical software, accounting for the complex survey design. Population estimates were calculated using the American Community Survey. 31.0% of individuals (n = 1,696), representing a population estimate of 35 million adults, advised to exercise more or lose weight by a health professional reported one or more functional limitation. Of the 31%, 57.6% attempted weight loss, and 40.1% used exercise for weight loss. Few sought health professional assistance. Physical therapists were not mentioned. Few individuals with functional limitations advised to lose weight or increase exercise seek health professional assistance for weight loss. Physical therapists have an opportunity to assist those with functional limitations with exercise prescription.
Resaland, G K; Andersen, Lars Bo; Mamen, A
The aim of this study was to describe changes in children's cardiorespiratory fitness (CRF) following a school-based physical activity (PA) intervention. In total, 259 children (age 9.3+/-0.3 years) were invited to participate, of whom 256 participated. The children from the intervention school (63...... boys, 62 girls) carried out 60-min PA over 2 school years. The children from the control school (62 boys, 69 girls) had the regular curriculum-defined amount of physical education in school, i.e. 45 min twice weekly. One hundred and eighty-eight children (73.4%) successfully completed both the baseline...
Resaland, G K; Anderssen, S A; Holme, I M
at the I-school carried out 60 min of PA daily. The PA lessons were planned, organized and led by expert physical education (PE) teachers. In the C-school, children were offered the normal 45 min of PE twice weekly. The intervention resulted in a greater beneficial development in systolic (P=0......The aim of this study was to investigate the effect of a 2-year school-based physical activity (PA) intervention in 9-year-old children on cardiovascular disease (CVD) risk factors. One intervention school (I-school) (n=125) and one control school (C-school) (n=131) were included. The children...
van Benten, Esther; Pool, Jan; Mens, Jan; Pool-Goudzwaard, Annelies
Systematic review of the literature. To review and assess the peer-reviewed literature on the effectiveness of physical therapy interventions in treating lumbopelvic pain during pregnancy. Current guidelines on interventions for lumbopelvic pain during pregnancy differ in their recommendations for assessment and intervention. Recent publications may allow revising current recommendations for the treatment of this complex problem. An electronic search strategy was conducted in PubMed, PEDro, Scopus, and CINAHL of literature published from January 1992 to November 2013. Two authors independently assessed all abstracts for eligibility. Articles were independently rated for quality by 2 authors, using the Cochrane Back Review Group criteria for methodological quality. Where possible, effect sizes were calculated for the different interventions. A total of 22 articles (all randomized controlled trials) reporting on 22 independent studies were included. Overall, the methodological quality of the studies was moderate. Data for 4 types of interventions were considered: a combination of interventions (7 studies, n = 1202), exercise therapy (9 studies, n = 2149), manual therapy (5 studies, n = 360), and material support (1 study, n = 115). All included studies on exercise therapy, and most of the studies on interventions combined with patient education, reported a positive effect on pain, disability, and/or sick leave. Evidence-based recommendations can be made for the use of exercise therapy for the treatment of lumbopelvic pain during pregnancy. Therapy, level 1a-. J Orthop Sports Phys Ther 2014;44(7):464-473. Epub 10 May 2014. doi:10.2519/jospt.2014.5098.
Christina Danielli Coelho de Morais Faria
Full Text Available Abstract Introduction: Motor impairments, which are prevalent in stroke subjects, require physical therapy (PT rehabilitation. In primary care in the Brazilian Public Health System, PT are part of the Núcleo de Apoio à Saúde da Família (NASF. Objective: To describe the PT assistance provided to stroke patients in a primary healthcare center. Methods: The records of all stroke patients (n = 44; 69.23 ± 13.12 years identified by the health professionals were analyzed. Using keyword recognition, frequency analysis of the services offered by the PT was performed. Subjects were classified according to the Modified Rankin Scale. Results: In the 44 records, 45.5% had a description of the assistance provided by any professional of the NASF and 36.4% of the PT care. PT care was provided at the subject’s home (94.2% and at the healthcare center (5.8%. The PT practices were identified as: orientation (93.8%, evaluation (87.5%, exercises (50%, follow-up (37.5%, referral to another service or to undergrad PT students (18.8%, and referral to other NASF professionals (12.5%. Most of the subjects were classified as having mild/moderate disability. Conclusion: The minority of records had registration of attendance by the NASF PT. The majority of the sessions occurred at the subject’s home, which reveals a practice focused on individual care. The orientation was common, which illustrates that in primary care there is a focus on empowerment for health self-improvement. Follow-up was not common, despite clinical guidelines state that stroke subjects should be monitored at least once a year by the rehabilitation team.
Tilson, Julie K; Mickan, Sharon
There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists' integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura's social cognitive theory and Malcolm Knowles's adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a "Best Practices List" - a list of locally generated, evidence-based, actionable behaviors relevant to the groups' clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program - an educational program designed to
Kitano, Kosuke; Asakawa, Takashi; Kamide, Naoto; Yorimoto, Keisuke; Yoneda, Masaki; Kikuchi, Yutaka; Sawada, Makoto; Komori, Tetsuo
To verify the effects of structured home-based exercises without supervision by a physical therapist in patients with early-stage amyotrophic lateral sclerosis (ALS). A historical controlled study that is part of a multicenter collaborative study. Rehabilitation departments at general hospitals and outpatient clinics with a neurology department. Patients (N=21) with ALS were enrolled and designated as the home-based exercise (Home-EX) group, and they performed unsupervised home-based exercises. As a control group, 84 patients with ALS who underwent supervised exercise with a physical therapist for 6 months were extracted from a database of patients with ALS and matched with the Home-EX group in terms of their basic attributes and clinical features. The Home-EX group was instructed to perform structured home-based exercises without supervision by a physical therapist that consisted of muscle stretching, muscle training, and functional training for 6 months. The primary outcome was the score on the ALS Functional Rating Scale-Revised (ALSFRS-R), which is composed of 3 domains: bulbar function, limb function, and respiratory function. The score ranges from 0 to 48 points, with a higher score indicating better function. In the Home-EX group, 15 patients completed the home-based exercises for 6 months, and 6 patients dropped out because of medical reasons or disease progression. No adverse events were reported. The Home-EX group was found to have a significantly higher respiratory function subscore and total score on the ALSFRS-R than the control group at follow-up (P<.001 and P<.05, respectively). Structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Gerber, Markus; Pühse, Uwe
Stressful experiences occupy a central role in most etiological models of developmental psychopathology. Stress alone, however, insufficiently explains negative health outcomes. This raises the question why some children and adolescents are more vulnerable to the development of psychopathological symptoms than others. The primary purpose of this research was to demonstrate whether leisure time physical activity and self-esteem protect against stress-induced health problems. The findings are based on a cross-sectional study of 407 Swiss boys and girls (M=14.01 years). All variables are self-reported. Analyses of covariance were applied to test for main and moderator effects. The findings suggest that school-based stress and psychosomatic complaints are important issues during adolescence. The results show that a higher level of psychosomatic complaints accompanies stress. Surprisingly, psychosomatic complaints and physical activity were unrelated. Likewise, no association was found between physical activity and stress. In contrast, students with high self-esteem reported significantly less complaints and a lower extent of perceived stress. Finally, the results do not support the stress-moderation hypothesis. Neither physical activity nor self-esteem buffered against the detrimental effects of school-based stress on psychosomatic health. The findings lend support to previous research with German-speaking samples but are in marked contrast to Anglo-Saxon studies, which generally support the role of physical activity as a moderator of the health-illness relationship. In this investigation, developmental features and methodological limitations may have accounted for the insignificant results.
Hinman, R S; Nelligan, R K; Bennell, K L; Delany, C
To explore the experience of patients and physical therapists with Skype for exercise management of knee osteoarthritis (OA). This was a qualitative study. The Donabedian model for quality assessment in health care (structure, process, and outcomes) informed semistructured individual interview questions. The study involved 12 purposively sampled patients with knee OA who received physical therapist-prescribed exercise over Skype, and all therapists (n = 8) who delivered the intervention in a clinical trial were interviewed about their experiences. Interviews were audio recorded and transcribed. Two investigators undertook coding and analysis using a thematic approach. Six themes arose from both patients and therapists. The themes were Structure: technology (easy to use, variable quality, set-up assistance helpful) and patient convenience (time efficient, flexible, increased access); Process: empowerment to self-manage (facilitated by home environment and therapists focusing on effective treatment) and positive therapeutic relationships (personal undivided attention from therapists, supportive friendly interactions); and Outcomes: satisfaction with care (satisfying, enjoyable, patients would recommend, therapists felt Skype more useful as adjunct to usual practice) and patient benefits (reduced pain, improved function, improved confidence and self-efficacy). A seventh theme arose from therapists regarding process: adjusting routine treatment (need to modify habits, discomfort without hands-on, supported by research environment). Patients and physical therapists described mostly positive experiences using Skype as a service delivery model for physical therapist-supervised exercise management of moderate knee OA. Such a model is feasible and acceptable and has the potential to increase access to supervised exercise management for people with knee OA, either individually or in combination with traditional in-clinic visits. © 2017, American College of Rheumatology.
Full Text Available Introduction & Objective: Participation in regular physical activity is associated with a variety of positive outcomes for young people. Physical activity (PA rates decline precipitously during the high school years and are consistently lower among adolescent girls than among adolescent boys. In order to stop or diverse this negative trend, there are necessary interventions based on various theories and models to promote physical activity in girls. Materials & Methods: This randomized control study evaluated the effectiveness of a 24-week exercise education program based on Pender’s Health Promotion model to improve cognitive and psychosocial factors associated with physical activity and to promote physical activity in adolescent girls (n =106. The program included educational sessions and tailored counseling. Results: There was an increase of 45 minutes for daily physical activity in the experimental group compared to their baseline. After intervention, the training group had a positive significant progression in stages along with significant improvements in self efficacy, enjoyment of physical activity, interpersonal influences, planning for physical activity, and also a decrease in perceived barriers to physical activity and competing preferences (p ≤ .0001-0.04. Conclusion: Findings of this study showed the positive effect of program on stage of change and potential determinants of the behavior of physical activity. The high proportion of the people in action and maintenance in experimental group compared to the baseline and the attainment of recommend criteria for physical activity are promising findings of school-based intervention based on Pender’s health promotion model.
Jaglal Susan B
Full Text Available Abstract Background Despite evidence of the benefits of research use in post-acute stroke rehabilitation where compliance with clinical practice guidelines has been associated with functional recovery and patient satisfaction, the rate of reliance on the research literature in clinical decision making among physical therapists is low. More research examining factors that motivate physical therapists to consider research findings in neurological practice is needed to inform efforts to intervene. The objective of this study was to identify practitioner, organizational, and research characteristics associated with research use among physical therapists providing services post-stroke. Methods A cross-sectional mail survey of physical therapists providing services to people with stroke in Ontario, Canada was conducted. The survey questionnaire contained items to evaluate practitioner and organizational characteristics and perceptions of research considered to influence evidence-based practice (EBP, as well as the frequency of using research evidence in clinical decision making in a typical month. Ordinal regression was used to identify factors associated with research use. Results The percentage of respondents reporting research use in clinical decision making 0 to 1, 2 to 5, or 6+ times in a typical month was 33.8%, 52.9%, and 13.3%, respectively (n = 263. Academic preparation in the principles of EBP, research participation, service as a clinical instructor, self-efficacy to implement EBP, a positive attitude towards research, perceived organizational support of research use, and Internet access to bibliographic databases at work were each associated with research use and placed in the final regression model. In the final model (n = 244, academic preparation in EBP, EBP self-efficacy, agreement that research findings are useful, and research participation each remained significantly associated with research use after adjusting for the effects of
Lind, Rune Rasmussen; Geertsen, Svend Sparre; Ørntoft, Christina
programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up. RESULTS: The IG improved their cognitive performance compared to the CG for psychomotor function (56, sx- = 22 ms, p attention (39, sx- = 17 ms......, p = .012) and working memory (79, sx- = 35 ms, p = .020). CONCLUSION: This pilot study provides evidence that the school-based physical activity programme "FIFA 11 for Health" for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt...
Domazet, Sidsel Louise; Froberg, Karsten; Hillman, Charles H.; Andersen, Lars Bo; Bugge, Anna
Background Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12–14 years old adolescents. Methods A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD) age: 12.9 (0.6) years) completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects). The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness. Results No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p’s>0.05) or mathematics skills (p>0.05). An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4–38.6) and body-mass index in boys (-0.22 kg/m2 (95% CI: -0.39–0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0–9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p’s>0.05). Conclusions No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing
Full Text Available Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12-14 years old adolescents.A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD age: 12.9 (0.6 years completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects. The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness.No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p's>0.05 or mathematics skills (p>0.05. An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4-38.6 and body-mass index in boys (-0.22 kg/m2 (95% CI: -0.39-0.05. Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0-9. Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p's>0.05.No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing executive functioning or mathematics skills compared
Tarp, Jakob; Domazet, Sidsel Louise; Froberg, Karsten; Hillman, Charles H; Andersen, Lars Bo; Bugge, Anna
Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12-14 years old adolescents. A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD) age: 12.9 (0.6) years) completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects). The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness. No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p's>0.05) or mathematics skills (p>0.05). An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4-38.6) and body-mass index in boys (-0.22 kg/m2 (95% CI: -0.39-0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0-9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p's>0.05). No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing executive functioning or mathematics skills compared to a
Champion, Katrina E; Newton, Nicola C; Spring, Bonnie; Wafford, Q Eileen; Parmenter, Belinda J; Teesson, Maree
Six key behavioural risk factors (risky alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and unhealthy sleep patterns) have been identified as strong determinants of chronic disease, such as cardiovascular disease, diabetes and cancers. School-based interventions targeting these multiple health risk behaviours among adolescents have the potential to halt the trajectory towards later disease, whilst online and mobile technology interventions offer advantages in terms of student engagement, reach and scalability. Despite this, the efficacy of eHealth school-based interventions targeting these six health risk behaviours among adolescents has not been evaluated. The proposed systematic review aims to address this by determining the nature and efficacy of existing eHealth school-based interventions targeting multiple health risk behaviours among adolescents. A systematic search of the MEDLINE, Embase, PsycINFO and Cochrane Library databases will be conducted to identify eligible published papers. Eligible studies will be randomised controlled trials, including cluster randomised controlled trials, of interventions targeting two or more of the following lifestyle risk behaviours: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and sleep. Eligible studies will be those evaluating interventions delivered in a secondary school setting among participants 11-18 years of age, via an eHealth platform (Internet, computers of mobile technology). Two reviewers will independently screen studies for eligibility, extract data and assess the risk of bias. Study outcomes will be summarised in a narrative synthesis, and meta-analyses will be conducted where it is appropriate to combine studies. It is anticipated that the results from this review will serve to inform the development of future eHealth multiple health behaviour interventions for adolescents by identifying common characteristics of effective programs and highlighting
Wells, Cherie; Kolt, Gregory S; Marshall, Paul; Bialocerkowski, Andrea
The effectiveness of Pilates exercise for treating people with chronic low back pain (CLBP) is yet to be established. Understanding how to identify people with CLBP who may benefit, or not benefit, from Pilates exercise and the benefits and risks of Pilates exercise will assist in trial design. The purpose of this study was to establish a consensus regarding the indications, contraindications, and precautions of Pilates exercise and the potential benefits and risks of Pilates exercise for people with CLBP. A panel of 30 Australian physical therapists experienced in the use of Pilates exercise were surveyed using the Delphi technique. Three electronic questionnaires were used to collect participant opinions. Answers to open-ended questions were analyzed thematically, combined with research findings, and translated into statements about Pilates exercise. Participants then rated their level of agreement with statements using a 6-point Likert scale. Consensus was achieved when 70% of panel members agreed or disagreed with an item. Thirty physical therapists completed the 3 questionnaires. Consensus was reached on 100% of items related to the benefits, indications, and precautions of Pilates exercise, on 50% of items related to risks, and on 56% of items related to contraindications. Participants agreed that people who have poor body awareness and maladaptive movement patterns may benefit from Pilates exercise, whereas those with pre-eclampsia, unstable spondylolisthesis, or a fracture may not benefit. Participants also agreed that Pilates exercise may improve functional ability, movement confidence, body awareness, posture, and movement control. The findings reflect the opinions of only 30 Australian physical therapists and not all health professionals nationally or internationally. These findings, therefore, need to be verified in future research trials. These findings contribute to a better understanding of the indications, contraindications, and precautions of
Salway, Ruth E; Sebire, Simon J; Solomon-Moore, Emma; Thompson, Janice L; Jago, Russell
Physical activity in children is associated with better physical and mental health but many children do not meet physical activity guidelines. Friendship groups are potentially an important influence on children's physical activity and sedentary time. This paper examines the association between children of physical activity and sedentary time in school-based same-sex friendship networks, for both moderate-to-vigorous intensity physical activity (MVPA) and sedentary time. Moreover, considering the methodological challenges of conducting and interpreting these analyses, we provide examples of how to analyse these data and interpret results to encourage further work in the area. Accelerometer data for 1223 children, aged 8-9 years, were collected in 2015-2016 and analysed in 2017. Mean accelerometer minutes of MVPA and sedentary time were calculated. Children named up to four school friends and same-sex school-based friendship networks were constructed. Network models, which include correlation between friends, were fitted by sex. Both MVPA and sedentary time were found to be associated via the friendship networks, for both boys and girls. The network autocorrelation was 0.21 (95% CI: 0.15 to 0.26) for boys' MVPA, and 0.14 (95% CI: 0.07 to 0.21) for sedentary time. Network autocorrelation between girls was weaker, with 0.13 (95% CI: 0.06 to 0.19) for MVPA and 0.11 (95% CI: 0.05 to 0.17) for sedentary time. Physical activity and sedentary time of boys and girls are associated with the physical activity and sedentary time respectively of others within same-sex friendship networks, and these associations are comparable to other known factors. In this study, the correlation between friends was stronger for boys than girls, and stronger for MVPA than for sedentary time. These findings suggest that friendship networks play a part in understanding children's physical activity and sedentary time and could play a valuable role in developing effective interventions.
Maas, Marjo J M; van Dulmen, Simone A; Sagasser, Margaretha H; Heerkens, Yvonne F; van der Vleuten, Cees P M; Nijhuis-van der Sanden, Maria W G; van der Wees, Philip J
Clinical practice guidelines are intended to improve the process and outcomes of patient care. However, their implementation remains a challenge. We designed an implementation strategy, based on peer assessment (PA) focusing on barriers to change in physical therapy care. A previously published randomized controlled trial showed that PA was more effective than the usual strategy "case discussion" in improving adherence to a low back pain guideline. Peer assessment aims to enhance knowledge, communication, and hands-on clinical skills consistent with guideline recommendations. Participants observed and evaluated clinical performance on the spot in a role-play simulating clinical practice. Participants performed three roles: physical therapist, assessor, and patient. This study explored the critical features of the PA program that contributed to improved guideline adherence in the perception of participants. Dutch physical therapists working in primary care (n = 49) organized in communities of practice (n = 6) participated in the PA program. By unpacking the program we identified three main tasks and eleven subtasks. After the program was finished, a questionnaire was administered in which participants were asked to rank the program tasks from high to low learning value and to describe their impact on performance improvement. Overall ranking results were calculated. Additional semi-structured interviews were conducted to elaborate on the questionnaires results and were transcribed verbatim. Questionnaires comments and interview transcripts were analyzed using template analysis. Program tasks related to performance in the therapist role were perceived to have the highest impact on learning, although task perceptions varied from challenging to threatening. Perceptions were affected by the role-play format and the time schedule. Learning outcomes were awareness of performance, improved attitudes towards the guideline, and increased self-efficacy beliefs in
Quaresma, A M; Palmeira, A L; Martins, S S; Minderico, C S; Sardinha, L B
The aim of this study was to explore the effects of social support and behavioral regulation of exercise on physical activity (PA) and quality of life (QoL), in a Portuguese school-based intervention. We hypothesized that serial mediation effects would be present leading to greater levels of PA and QoL. The sample comprised 1042 students (549 boys), aged 10-16 years, BMI = 19.31 ± 3.51, allocated to two groups of schools: control (n = 207) and intervention (n = 835). This study will report the 24 months results of the program, which aimed to develop healthy lifestyles. Questionnaires were used to measure PA, QoL, motivation to exercise and social support. There was no direct impact of the intervention on QoL or PA. Serial mediation analyses were conducted. Social support (P motivation (P = 0.085) increased more on intervention group. Indirect effects were observed in all serial mediation models. The positive indirect effects on PA and QoL were explained by the increase on peer/parent support in serial with the increase in intrinsic motivation (P motivation (P school-based intervention promoted the development of social support and motivational mechanisms that explained higher levels of PA and QoL. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Norma J. MacIntyre
Full Text Available Recent high-level evidence favours therapeutic ultrasound (US for reducing pain in people with knee osteoarthritis (OA. It is unknown how current practice patterns align with current evidence regarding US efficacy and whether physical therapists perceive a need for further high-level evidence. We conducted a descriptive electronic survey to characterize the beliefs and use of US among physical therapists in Ontario treating people with nonsurgical knee OA. Most of the 123 respondents (81% reported at least some use of US with 45% using it often or sometimes. The main goal for using US was to reduce pain in the surrounding soft tissue (n=66 and/or the knee joint (n=43. Almost half (46% endorsed the belief that US is likely to be beneficial for clients with nonsurgical knee OA. Most respondents (85% expressed interest in the results of a randomized controlled trial evaluating the effectiveness of US on pain and physical function. Patterns of use reflect the respondents’ belief that US is likely to be beneficial for knee OA pain.
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Rationale and study protocol of the EASY Minds (Encouraging Activity to Stimulate Young Minds) program: cluster randomized controlled trial of a primary school-based physical activity integration program for mathematics
Riley, Nicholas; Lubans, David R; Holmes, Kathryn; Morgan, Philip J
Background Novel strategies are required to increase school-based physical activity levels of children. Integrating physical activity in mathematics lessons may lead to improvements in students’ physical activity levels as well as enjoyment, engagement and learning. The primary aim of this study is to evaluate the impact of a curriculum-based physical activity integration program known as EASY Minds (Encouraging Activity to Stimulate Young Minds) on children’s daily school time physical activ...
Keogh, Alison; Matthews, James; Segurado, Ricardo; Hurley, Deirdre A
Provider training programs are frequently underevaluated, leading to ambiguity surrounding effective intervention components. The purpose of this study was to assess the effectiveness of a training program in guiding physical therapists to deliver the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) group education and exercise intervention (ISRCTN49875385), using a communication style underpinned by self-determination theory (SDT). This was an assessment of the intervention arm training program using quantitative methods. Thirteen physical therapists were trained using mixed methods to deliver the SOLAS intervention. Training was evaluated using the Kirkpatrick model: (1) Reaction-physical therapists' satisfaction with training, (2) Learning-therapists' confidence in and knowledge of the SDT-based communication strategies and intervention content and their skills in applying the strategies during training, and (3) Behavior-8 therapists were audio-recorded delivering all 6 SOLAS intervention classes (n = 48), and 2 raters independently coded 50% of recordings (n = 24) using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behavior Scale (CCBS), and an intervention-specific measure. Reaction: Physical therapists reacted well to training (median [IRQ]; min-max = 4.7; [0.5]; 3.7-5.0). Learning: Physical therapists' confidence in the SDT-based communication strategies and knowledge of some intervention content components significantly improved. Behavior: Therapists delivered the intervention in a needs-supportive manner (median HCCQ = 5.3 [1.4]; 3.9-6.0; median CCBS = 6.6 ([0.5]; 6.1-6.8; median intervention specific measure = 4.0 [1.2]; 3.2-4.9). However, "goal setting" was delivered below acceptable levels by all therapists (median 2.9 [0.9]; 2.0-4.0). The intervention group only was assessed as part of the process evaluation of the feasibility trial. Training effectively guided physical therapists to be needs
Youth with physical disabilities participate less in sports compared to their typically developing peers. In 2011, only 26% of Dutch youth with physical disabilities participate at least once a week in sports compared to 71% of the typically developing youth. This has negative consequences regarding
Dunleavy, Kim; Kubo Slowik, Amy
Sexual violence has been identified as one of the most common predictors of posttraumatic stress disorder (PTSD). This case report describes the emergence of delayed PTSD symptoms, disclosure of history of sexual trauma, and the influence of re-experiencing, avoidance, and hyperarousal symptoms on physical therapy treatment. A 60-year-old woman was seen for treatment of low back pain. of a discord between fear of falling and no balance impairments led to disclosure of sexual assault by a physician at 19 years of age. The patient's PTSD symptoms emerged after 10 weeks of physical therapy. The physical therapists monitored somatic responses and body language closely and modified and planned treatment techniques to avoid PTSD triggers and limit hyperarousal. Collaborative communication approaches included reinforcement of cognitive-behavioral strategies introduced by her psychotherapists. Trauma-cognizant approaches supported the patient's efforts to manage PTSD symptoms sufficiently to tolerate physical therapy and participate in a back care class. Nonlinear psychological healing is illustrated. Symptoms of PTSD may emerge during physical therapy treatment, and patient-sensitive responses to disclosure are important. The trauma-cognizant approach (2-way communication, patient-centered management, and integration of psychological elements into clinical decision making) helped identify and respond to triggers. The physical therapists reinforced cognitive-behavioral strategies introduced by psychotherapists to manage PTSD symptoms. Patient-centered care with further refinement to a trauma-cognizant approach may play an important role in assisting patients with PTSD or a history of sexual trauma to manage symptoms while addressing rehabilitation needs.
Burges Watson, Duika; Adams, Jean; Azevedo, Liane B; Haighton, Catherine
Physical activity is critical to improving health and well-being in children. Quantitative studies have found a decline in activity in the transition from primary to secondary education. Exergames (active video games) might increase physical activity in adolescents. In January 2011 exergame dance mat systems were introduced in to all secondary schools across two local authority districts in the UK. We performed a quasi-experimental evaluation of a natural experiment using a mixed methods design. The quantitative findings from this work have been previously published. The aim of this linked qualitative study was to explore the implementation of the dance mat scheme and offer insights into its uptake as a physical activity intervention. Embedded qualitative interviews at baseline and 12 month follow-up with purposively selected physical education teachers (n = 20) and 25 focus groups with a convenience sample of pupils (n = 120) from five intervention schools were conducted. Analysis was informed by sociology of translation approach. At baseline, participants (both teachers and pupils) reported different expectations about the dance mats and how they could be employed. Variation in use was seen at follow-up. In some settings they were frequently used to engage hard to reach groups of pupils. Overall, the dance mats were not used routinely to increase physical activity. However there were other unanticipated benefits to pupils such as improved reaction time, co-ordination and mathematic skills. The use of dance mats was limited in routine physical education classes because of contextual issues (school/government policy) technological failures (batteries/updates) and because of expectations about how and where they could be used. Our linked quantitative study (previously published) suggested that the dance mats were not particularly effective in increasing physical activity, but the qualitative results (reported here) show that the dance mats were not used
Duika Burges Watson
Full Text Available Abstract Background Physical activity is critical to improving health and well-being in children. Quantitative studies have found a decline in activity in the transition from primary to secondary education. Exergames (active video games might increase physical activity in adolescents. In January 2011 exergame dance mat systems were introduced in to all secondary schools across two local authority districts in the UK. We performed a quasi-experimental evaluation of a natural experiment using a mixed methods design. The quantitative findings from this work have been previously published. The aim of this linked qualitative study was to explore the implementation of the dance mat scheme and offer insights into its uptake as a physical activity intervention. Methods Embedded qualitative interviews at baseline and 12 month follow-up with purposively selected physical education teachers (n = 20 and 25 focus groups with a convenience sample of pupils (n = 120 from five intervention schools were conducted. Analysis was informed by sociology of translation approach. Results At baseline, participants (both teachers and pupils reported different expectations about the dance mats and how they could be employed. Variation in use was seen at follow-up. In some settings they were frequently used to engage hard to reach groups of pupils. Overall, the dance mats were not used routinely to increase physical activity. However there were other unanticipated benefits to pupils such as improved reaction time, co-ordination and mathematic skills. The use of dance mats was limited in routine physical education classes because of contextual issues (school/government policy technological failures (batteries/updates and because of expectations about how and where they could be used. Conclusions Our linked quantitative study (previously published suggested that the dance mats were not particularly effective in increasing physical activity, but the qualitative
Lind, Rune Rasmussen; Geertsen, Svend Sparre; Ørntoft, Christina Øyangen
, p = .012) and working memory (79, sx– = 35 ms, p = .020). Conclusion: This pilot study provides evidence that the school-based physical activity programme “FIFA 11 for Health” for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt...... programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up. Results: The IG improved their cognitive performance compared to the CG for psychomotor function (56, sx– = 22 ms, p attention (39, sx– = 17 ms...
Aveni, Eléonore; Bauer, Brent; Ramelet, Anne-Sylvie; Kottelat, Yolande; Decosterd, Isabelle; Finti, Guillaume; Ballabeni, Pierluigi; Bonvin, Eric; Rodondi, Pierre-Yves
To assess the attitudes of physicians, nurses, physical therapists, and midwives toward complementary medicine (CM) at a Swiss academic hospital and toward its use for treating chronic pain. The cross-sectional survey took place from October to December 2013. An e-mail sent to 4925 healthcare professionals (1969 physicians, 2372 nurses, 145 physical therapists, and 111 midwives) working at Lausanne University Hospital, Switzerland, invited them to answer a web-based questionnaire. The questionnaire was answered by 1247 healthcare professionals (response rate: 25.3%). Of these, 96.1% strongly agreed or agreed that CM could be useful for the treatment of chronic pain, with more nurses (96.7%) and midwives (100%) than physicians (93.8%) agreeing that CM could be useful (P chronic pain. Respondents listed migraine (74.7%), tension headaches (70.6%), and low back pain (70.1%) as three main conditions for which they would refer patients for acupuncture. The three therapies with which respondents were the most unfamiliar were neuraltherapy (57.2%), mindfulness-based stress reduction (MBSR) (54.1%), and biofeedback (51.9%). Over half of respondents, 58.3%, had never referred a patient to a CM practitioner. A total of 84.3% of the respondents felt that they lacked the knowledge to inform their patients about CM. Copyright © 2016 Elsevier Inc. All rights reserved.
Lau, Patrick Wing Chung; Wang, Jing Jing; Maddison, Ralph
Active videogames (AVGs) that require body movements to play offer a novel opportunity to turn a traditionally sedentary behavior into a physically active one. We sought to determine the effect of a school-based AVG intervention on Chinese children's aerobic fitness, physical activity (PA) level, and PA-related psychological correlates. Eighty 8-11-year-old Chinese children (55 males) were recruited from one Hong Kong primary school and were allocated at random to either an AVG intervention or control group. Children in the intervention group played an AVG, Xbox 360, twice per week during after-school hours, each for 60 minutes over 12 weeks in duration. The control group received no intervention. Children's body-mass index (BMI), objective PA, aerobic fitness (maximum oxygen consumption [VO 2max ]), PA task efficacy, barrier efficacy, and enjoyment were assessed. Compared with the control group, significant increases were found in the intervention group in VO 2max [mean and 95% confidence interval (CI): 1.58 (0.74, 2.42) mL/(kg·min)], objective moderate-to-vigorous PA [6.73 (1.70, 11.76) min/day], and total PA [27.19 (9.33, 45.04) min/day], but not for BMI. No significant differences in PA task efficacy, barrier efficacy, and enjoyment were observed. A 12-week (60 minutes × twice per week) school-based AVG intervention can improve Chinese children's aerobic fitness and PA level. These findings indicated that AVGs could be used as an alternative means to engage Chinese children in PA in school setting. However, the treatment effects of AVGs on PA-related psychological correlates and body composition need more investigation.
Eichhorn, C; Bodner, L; Liebl, S; Scholz, U; Wozniak, D; Möstl, M; Ungerer-Röhrich, U; Nagel, E; Loss, J
The high prevalence of overweight among children and adolescents has led to an increase in school-based prevention programmes. The aim of the present paper is to present the concept of an initiative called "BEO'S" as well as the experience made with the implementation und acceptance of this programme in the participating schools. Different from the majority of school-based projects for healthy eating and physical activity, BEO'S pursues a systemic approach that includes the whole school and is tailored to the school's respective resources. Characteristics are (1) the participation of teachers, students, parents, and caretakers, (2) the motivation and empowerment of schools to plan and implement activities by themselves, (3) the focus on environmental approaches, and (4) addressing and considering the individual school's needs and resources. The university project team supports the schools by individual counselling as well as providing information materials, trainings and workshops for teachers, an internet page, newsletters, and financial support. In the school years 2007/08 and 2008/09, BEO'S was conducted at 14 primary and secondary schools in the district of Oberfranken, Bavaria. It was extended to other schools in 2009/10. The short- and mid-term goals are the improvement of the school's environments as well as the eating behaviour and physical activity of the students. In the long run, it is intended to prevent obesity and improve the students' health and school performance. The implementation processes showed that the teachers for physical education and domestic science as well as the headmasters were especially committed. The participation of the teaching staff, the students and the parents proved to be difficult, however. The schools implemented many activities for healthy eating and physical activity, but the planning process was not very systematic: needs assessment, status quo analysis, identification of successful strategies and definition of aims was
Full Text Available Abstract Background Physical activity levels decline markedly among girls during adolescence. School-based interventions that are multi-component in nature, simultaneously targeting curricular, school environment and policy, and community links, are a promising approach for promoting physical activity. This report describes the rationale, design and baseline data from the Girls in Sport group randomised trial, which aims to prevent the decline in moderate-to-vigorous intensity physical activity (MVPA among adolescent girls. Methods/Design A community-based participatory research approach and action learning framework are used with measurements at baseline and 18-month follow-up. Within each intervention school, a committee develops an action plan aimed at meeting the primary objective (preventing the decline in accelerometer-derived MVPA. Academic partners and the State Department of Education and Training act as critical friends. Control schools continue with their usual school programming. 24 schools were matched then randomized into intervention (n = 12 and control (n = 12 groups. A total of 1518 girls (771 intervention and 747 control completed baseline assessments (86% response rate. Useable accelerometer data (≥10 hrs/day on at least 3 days were obtained from 79% of this sample (n = 1199. Randomisation resulted in no differences between intervention and control groups on any of the outcomes. The mean age (SE of the sample was 13.6 (± 0.02 years and they spent less than 5% of their waking hours in MVPA (4.85 ± 0.06. Discussion Girls in Sport will test the effectiveness of schools working towards the same goal, but developing individual, targeted interventions that bring about changes in curriculum, school environment and policy, and community links. By using community-based participatory research and an action learning framework in a secondary school setting, it aims to add to the body of literature on effective school-based
School based assessment module for invasion games category in physical education. ... This study identify the level of basic skills of invasion games category when using School Based Assessment Module. ... AJOL African Journals Online.
Salmoirago-Blotcher, Elena; Druker, Sue; Meyer, Florence; Bock, Beth; Crawford, Sybil; Pbert, Lori
Cardiovascular prevention is more effective if started early in life, but available interventions to promote healthy lifestyle habits among youth have been ineffective. Impulsivity in particular has proven to be an important barrier to the adoption of healthy behaviors in youth. Observational evidence suggests that mindfulness interventions may reduce impulsivity and improve diet and physical activity. We hypothesize that mindfulness training in adjunct to traditional health education will improve dietary habits and physical activity among teenagers by reducing impulsive behavior and improving planning skills. The Commit to Get Fit study is a pilot cluster randomized controlled trial examining the feasibility, acceptability and preliminary efficacy of school-based mindfulness training in adjunct to traditional health education for promotion of a healthy diet and physical activity among adolescents. Two schools in central Massachusetts (30 students per school) will be randomized to receive mindfulness training plus standard health education (HE-M) or an attention-control intervention plus standard health education (HE-AC). Assessments will be conducted at baseline, intervention completion (2 months), and 8 months. Primary outcomes are feasibility and acceptability. Secondary outcomes include physical activity, diet, impulsivity, mood, body mass index, and quality of life. This study will provide important information about feasibility and preliminary estimates of efficacy of a school-delivered mindfulness and health education intervention to promote healthy dietary and physical activity behaviors among adolescents. Our findings will provide important insights about the possible mechanisms by which mindfulness training may contribute to behavioral change and inform future research in this important area. Copyright © 2015 Elsevier Inc. All rights reserved.
Martínez-Vizcaíno, Vicente; Sánchez-López, Mairena; Notario-Pacheco, Blanca; Salcedo-Aguilar, Fernando; Solera-Martínez, Montserrat; Franquelo-Morales, Pablo; López-Martínez, Sara; García-Prieto, Jorge C; Arias-Palencia, Natalia; Torrijos-Niño, Coral; Mora-Rodríguez, Ricardo; Rodríguez-Artalejo, Fernando
Studies that have examined the impact of a physical activity intervention on cardiometabolic risk factors have yielded conflicting results. The objective of this study was to assess the impact of a standardized physical activity program on adiposity and cardiometabolic risk factors in schoolchildren. Cluster randomized trial study of 712 schoolchildren, 8-10 years, from 20 public schools in the Province of Cuenca, Spain. The intervention (MOVI-2) consisted of play-based and non-competitive activities. MOVI-2 was conducted during two 90-minute sessions on weekdays and one 150-minute session on Saturday mornings every week between September 2010 and May 2011. We measured changes in adiposity (overweight/obesity prevalence, body mass index [BMI], triceps skinfold thickness [TST], body fat %, fat-free mass, waist circumference) and other cardiometabolic risk factors (LDL-cholesterol, triglycerides/HDL-cholesterol ratio, insulin, C-reactive protein and blood pressure). The analyses used mixed regression models to adjust for baseline covariates under cluster randomization. Among girls, we found a reduction of adiposity in intervention versus control schools, with a decrease in TST (-1.1 mm; 95% confidence interval [CI] -2.3 to -0.7), body fat % (-0.9%; 95% CI -1.3 to -0.4), waist circumference (-2.7 cm; 95% CI -4.5 to -0.9), and an increase in fat-free mass (0.3 kg; 95% CI 0.01 to 0.6). The intervention also led to lower serum LDL-cholesterol and insulin levels. Among boys, a reduction in waist circumference (-1.4 cm; 95% CI -2.6 to -0.1; P = 0.03), and an increase in fat-free mass (0.5 kg; 95% CI 0.2 to 0.9; P = 0.003) was associated with the intervention versus control schools. The prevalence of overweight/obesity or underweight, BMI, and other cardiometabolic risk factors was not modified by the intervention. No important adverse events were registered. An extracurricular intervention of non-competitive physical activity during an academic year, targeting all
Angell, Maureen E.; Bailey, Rita L.; Nicholson, Joanna K.; Stoner, Julia B.
This article provides a practitioner-friendly synthesis of existing literature on family involvement in the management of dysphagia for school-age. Research reviewed includes family perspectives on programs, therapists, and characteristics that comprise effective family involvement in school-based dysphagia management programs. Also included are…
E. Whitney Evans
Full Text Available Background. Less than half of American children meet national physical activity (PA recommendations. This study tested the feasibility, acceptability, and preliminary effectiveness of using wearable PA monitors to increase PA in school-age children. Methods. In Phase 1 of this study, conducted in 2014, 32 fifth-grade students enrolled in a low-resource middle school were given a waist-worn Fitbit Zip monitor for 4 weeks to test its feasibility (adherence and acceptability. Adherence, wear time of ≥8 hours per day, was examined. Feedback was solicited from parents through structured interviews. In Phase 2, conducted in 2015, 42 sixth-grade students were assigned, by classroom, to one of three conditions (Fitbit + goal and incentive-based intervention, Fitbit only, or control to test the feasibility of the wrist-worn Fitbit Charge and its preliminary effectiveness in increasing PA over 6 weeks. Results. In Phase 1, average adherence was 64.1%. In Phase 2, it was 73.4% and 80.2% for participants in the Fitbit + intervention and Fitbit only groups, respectively (p=.07. After controlling for baseline values, weight status, and sex, there were no significant group differences in changes in MVPA or steps from baseline to follow-up. Conclusions. While moderately acceptable, wearable PA monitors did not increase PA levels in this sample. They may be more effective within a coordinated school-based physical activity program.
Silvestre, Rafaela Luisa Silva; Vandenberghe, Luc
The present article discusses possible uses of the therapist's feelings to enhance treatment following Kohlenberg and Tsai's conceptualization of the therapist-client relationship. Four vignettes from a case study involving a couple are used as illustrative material. It is argued that the therapist's feelings can serve as clues for identifying…
Youngdeok Kim, Marc Lochbaum
Full Text Available Ethnic minority children living in high poverty neighborhoods are at high risk of having insufficient physical activity (PA during school days and, thus, the importance of school as a place to facilitate PA in these underserved children has been largely emphasized. This study examined the levels and patterns of PA in minority children, with particular focus on the relative contributions of regular physical education (PE and school-based afterschool PA program in promoting moderate- and vigorous-intensity PA (MVPA during school days. PA data were repeatedly measured using a Polar Active accelerometer across multiple school days (M = 5.3 days per child, from seventy-five ethnic minority children attending a Title I public elementary school in a high-poverty neighborhood in the US. The minutes and percentage of MVPA accumulated during school, PE, and afterschool PA program were compared to the current recommendations (≥30-min of MVPA during school hours; and ≥50% of MVPA during PE or afterschool PA program as well as by the demographic characteristics including sex, grade, ethnicity, and weight status using a general linear mixed model that accounts for repeated observations. On average, children spent 41.6 mins (SE = 1.8 of MVPA during school hours and of those, 14.1 mins (SE = 0.6 were contributed during PE. The average proportion of time spent in MVPA during PE was 31.3% (SE = 1.3, which was significantly lower than the recommendation (≥50% of MVPA, whereas 54.2% (SE = 1.2 of time in afterschool PA program were spent in MVPA. The percentage of monitoring days meeting current recommendations were 69.5% (SE = 0.03, 20.8% (SE = 0.02, and 59.6% (SE = 0.03 for during school, PE, and afterschool PA program, respectively. Our findings highlighted that school-based afterschool PA, in addition to regular PE classes, could be of great benefit to promote PA in minority children during school days. Further research and practice are still needed to
Riddle Daniel L
Full Text Available Abstract Background Approximately 20% of patients report persistent and disabling pain following total knee arthroplasty (TKA despite an apparently normally functioning prosthesis. One potential risk factor for unexplained persistent pain is high levels of pain catastrophizing. We designed a three-arm trial to determine if a pain coping skills training program, delivered prior to TKA, effectively reduces function-limiting pain following the procedure in patients with high levels of pain catastrophizing. Methods/design The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Discussion The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Trial Registration NCT
Pettersen, Gunn; Rosenvinge, Jan H; Bakland, Maria; Wynn, Rolf; Mathisen, Therese Fostervold; Sundgot-Borgen, Jorunn
Women with bulimia nervosa and binge eating disorder often suffer for many years before they seek professional help. Evidence-based treatments like cognitive-behavioural therapy (CBT) might be poorly accessible, and about 50% of those who receive CBT respond to it. Such outcome may reflect the heterogeneous nature of eating disorders, and addressing this heterogeneity calls for expanding the portfolio of treatment options. In particular, it is important to explore such options' acceptability, tolerability and affordability expressed through experiences with the treatment. This protocol outlines the rationale and design of a qualitative study. It captures experiences from patients and therapists who were involved in a randomised controlled trial (RCT) exploring the efficacy of a new group-based treatment programme combining physical exercise and dietary therapy. 15 patients with bulimia nervosa or binge eating disorder, 10 therapists (physical trainers and dietitians) and 6-10 patients who dropped out of the RCT will be semistructurally interviewed. All interviews will be analysed using a systematic text condensation approach. Results will be presented in peer-reviewed international journals, and at relevant international conferences. Key findings will be available to study participants as well as to patient organisations and health authorities. The overall study meets the intent and requirements of the Health Research Act and the Declaration of Helsinki. It is approved by the regional committee for medical research ethics (2013/1871). NCT02079935; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Rivard, Lisa M; Russell, Dianne J; Roxborough, Lori; Ketelaar, Marjolijn; Bartlett, Doreen J; Rosenbaum, Peter
The use of knowledge brokers (KBs) has been recommended as a mechanism to facilitate the use of research evidence in clinical practice. However, little has been written regarding the practical implementation of the KB role. This article (1) describes the brokering activities of 24 pediatric physical therapist KBs (in Ontario, Alberta, and British Columbia, Canada), and (2) reports KBs' perceptions of the utility of their role and their experiences with the brokering process. A mixed-methods research design was used in this investigation, which was part of a larger knowledge translation (KT) study that demonstrated the effectiveness of using KBs to implement a group of evidence-based measurement tools into practice. The KBs completed weekly activity logs, which were summarized and described. Semi-structured telephone interviews with KBs were analyzed qualitatively to provide insight into their perceptions of their role and the brokering process. Major interview themes were identified and verified through member checking. Brokering activities varied considerably as KBs adapted to meet the needs of their colleagues. The KBs indicated that they highly valued the connection to the research community and spoke of the enthusiastic engagement of their physical therapist colleagues (and others in their organization) in the brokering process. They discussed the importance of understanding the practice context and organizational factors that could affect knowledge transfer. The KBs spoke of the need to dedicate time for the role and had a strong sense of the supports needed to implement a KB role in future. Considerable variation in brokering activities was demonstrated across KB participants. The KBs perceived their role as useful and indicated that organizational commitment is crucial to the success of this KT strategy.
Ferrante, Daniel; Linetzky, Bruno; Ponce, Miguel; Goldberg, Lucila; Konfino, Jonathan; Laspiur, Sebastián
In 2007 and 2012, the Global School-Based Student Health Survey (GSHS) and the Global Youth Tobacco Survey (GYTS) were implemented to estimate the prevalence of risk behaviors and protection factors among 13 to 15 year-old adolescents. To assess changes in dietary, body weight, tobacco and physical activity indicators in the past five years. Cross-sectional study. A randomized, two-stage sampling with 600 schools selected at a national level was used. Students from randomly selected courses were invited to answer a self-administered questionnaire (either the GSHS or the GYTS). In 2012, the GSHS was completed by 20 697 students from 544 schools, while the GYTS was completed by 2062 students from 73 schools. Between 2007 and 2012, overweight and obesity prevalence significantly increased (overweight: 24.5% in 2007, 28.6% in 2012; obesity 4.4% in 2007, 5.9% in 2012), while the consumption of sugar-sweetened beverages and fast food remained high. A slight improvement was observed in the level of physical activity (12.7% in 2007, 16.7% in 2012), although it remains below what is recommended. The prevalence of tobacco use was reduced (24.5% in 2007, 19.6% in 2012), but access to tobacco products and exposure to secondhand smoke remains high in public places, including schools. The spread of the overweight and obesity epidemic calls for a need to consolidate actions tending towards a healthy diet and physical activity. Despite a decrease in the prevalence of tobacco use, it is necessary to continue strengthening tobacco control actions.
de Meij, Judith S B; van der Wal, Marcel F; van Mechelen, Willem; Chinapaw, Mai J M
The aim of the present study was to investigate factors influencing the adoption, implementation, and institutionalization process of JUMP-in-a multilevel school-based physical activity promotion program-to optimize the dissemination of the intervention and improve its effectiveness. The process evaluation concerned the constraints and success and failure factors at sociopolitical, organizational, user, and intervention levels. A mixed methods approach including qualitative and quantitative data was conducted during two school years (2006-2008). JUMP-in was successfully embedded in the Amsterdam municipal policy and in the organizational structure and daily practices of the sectors involved. A general impeding factor was the complexity of the multilevel programme requiring multidisciplinary collaboration between organizations. In addition, there was a discrepancy between the recommendation to standardize and simplify the innovation and the need to tailor the strategies to local environmental, social, and cultural aspects. This process evaluation provides challenges and remedies for managing discrepancies between prerequisites for an effective innovation and demands of daily implementation practice. The main recommendations are (a) standardized, simplified guidelines; (b) stepwise implementation; (c) formalized coalitions, integration of policy, and synchronization of tasks and protocols; and (d) smart planning and control by clear communication and feedback instruments. If these recommendations are incorporated into the JUMP-in intervention and organization, increased effectiveness and long-term effects can be expected.
... Do APTA represents more than 100,000 members: physical therapists, physical therapist assistants, and students of physical therapy. Other Popular Resources: - Member Directory - Annual Reports ...
Weatherson, Katie A; McKay, Rhyann; Gainforth, Heather L; Jung, Mary E
In British Columbia Canada, a Daily Physical Activity (DPA) policy was mandated that requires elementary school teachers to provide students with opportunities to achieve 30 min of physical activity during the school day. However, the implementation of school-based physical activity policies is influenced by many factors. A theoretical examination of the factors that impede and enhance teachers' implementation of physical activity policies is necessary in order to develop strategies to improve policy practice and achieve desired outcomes. This study used the Theoretical Domains Framework (TDF) to understand teachers' barriers and facilitators to the implementation of the DPA policy in one school district. Additionally, barriers and facilitators were examined and compared according to how the teacher implemented the DPA policy during the instructional school day. Interviews were conducted with thirteen teachers and transcribed verbatim. One researcher performed barrier and facilitator extraction, with double extraction occurring across a third of the interview transcripts by a second researcher. A deductive and inductive analytical approach in a two-stage process was employed whereby barriers and facilitators were deductively coded using TDF domains (content analysis) and analyzed for sub-themes within each domain. Two researchers performed coding. A total of 832 items were extracted from the interview transcripts. Some items were coded into multiple TDF domains, resulting in a total of 1422 observations. The most commonly coded TDF domains accounting for 75% of the total were Environmental context and resources (ECR; n = 250), Beliefs about consequences (n = 225), Social influences (n = 193), Knowledge (n = 100), and Intentions (n = 88). Teachers who implemented DPA during instructional time differed from those who relied on non-instructional time in relation to Goals, Behavioural regulation, Social/professional role and identity, Beliefs about
Katie A. Weatherson
Full Text Available Abstract Background In British Columbia Canada, a Daily Physical Activity (DPA policy was mandated that requires elementary school teachers to provide students with opportunities to achieve 30 min of physical activity during the school day. However, the implementation of school-based physical activity policies is influenced by many factors. A theoretical examination of the factors that impede and enhance teachers’ implementation of physical activity policies is necessary in order to develop strategies to improve policy practice and achieve desired outcomes. This study used the Theoretical Domains Framework (TDF to understand teachers’ barriers and facilitators to the implementation of the DPA policy in one school district. Additionally, barriers and facilitators were examined and compared according to how the teacher implemented the DPA policy during the instructional school day. Methods Interviews were conducted with thirteen teachers and transcribed verbatim. One researcher performed barrier and facilitator extraction, with double extraction occurring across a third of the interview transcripts by a second researcher. A deductive and inductive analytical approach in a two-stage process was employed whereby barriers and facilitators were deductively coded using TDF domains (content analysis and analyzed for sub-themes within each domain. Two researchers performed coding. Results A total of 832 items were extracted from the interview transcripts. Some items were coded into multiple TDF domains, resulting in a total of 1422 observations. The most commonly coded TDF domains accounting for 75% of the total were Environmental context and resources (ECR; n = 250, Beliefs about consequences (n = 225, Social influences (n = 193, Knowledge (n = 100, and Intentions (n = 88. Teachers who implemented DPA during instructional time differed from those who relied on non-instructional time in relation to Goals, Behavioural regulation, Social
Gunawardena, Nalika; Kurotani, Kayo; Indrawansa, Susantha; Nonaka, Daisuke; Mizoue, Tetsuya; Samarasinghe, Diyanath
School health promotion has been shown to improve the lifestyle of students, but it remains unclear whether school-based programs can influence family health. We developed an innovative program that enables school children to act as change agents in promoting healthy lifestyles of their mothers. The objective of this study was to examine the effect of the child-initiated intervention on weight, physical activity and dietary habit of their mothers. A 12-month cluster randomized trial was conducted, with school as a cluster. Participants were mothers with grade 8 students, aged around 13 years, of 20 schools in Homagama, Sri Lanka. Students of the intervention group were trained by facilitators to acquire the ability to assess noncommunicable disease risk factors in their homes and take action to address them, whereas those of the comparison group received no intervention. Body weight, step count and lifestyle of their mothers were assessed at baseline and post-intervention. Multi-level multivariable linear regression and logistic regression were used to assess the effects of intervention on continuous and binary outcomes, respectively. Of 308 study participants, 261 completed the final assessment at 12 month. There was a significantly greater decrease of weight and increase of physical activity in the intervention group. The mean (95% confidence interval) difference comparing the intervention group with the control group was -2.49 (-3.38 to -1.60) kg for weight and -0.99 (-1.40 to -0.58) kg/m(2) for body mass index. The intervention group had a 3.25 (95% confidence interval 1.87-5.62) times higher odds of engaging in adequate physical activity than the control group, and the former showed a greater number of steps than the latter after intervention. The intervention group showed a greater reduction of household purchase of biscuits and ice cream. A program to motivate students to act as change agents of family's lifestyle was effective in decreasing weight and
Laura Maria Tomazi Neves
Full Text Available O estudo visou avaliar o conhecimento de fisioterapeutas e graduandos em Fisioterapia sobre diagnóstico e atendimento de urgência à parada cardiorrespiratória. A amostra foi composta de 72 estudantes e 108 fisioterapeutas, dos quais 64 atuam no ambiente extra-hospitalar e 44 no ambiente hospitalar. Foi aplicado aos participantes um questionário sobre ressuscitação cardiopulmonar (RCP baseado nas diretrizes da American Heart Association de 2005. As respostas foram analisadas estatisticamente. Quanto ao diagnóstico da parada cardíaca, os grupos comportaram-se de maneira semelhante, optando pela avaliação da"presença de pulso e respiração". Quanto à seqüência de atendimento da RCP, a seqüência preconizada foi corretamente indicada por 52,8% do grupo estudante, 65,9% do subgrupo hospitalar e 40,6% do subgrupo extra-hospitalar. Quanto à relação compressão/ventilação, apenas 4,1% do grupo estudante, ninguém do extra-hospitalar e 25% do subgrupo hospitalar indicaram a relação preconizada atualmente. Quase todos (94% os participantes reconheceram a importância do conhecimento em RCP para o fisioterapeuta. Assim, a maioria dos atuais e futuros fisioterapeutas reconhecem a importância da RCP para sua atuação profissional, mas têm conhecimento insuficiente sobre o tema e apenas uma pequena parcela busca atualizar-se.This study aimed at assessing undergraduates' and physical therapists' knowledge on diagnosing and emergency treating cardiopulmonary arrest. Subjects were 72 students and 108 physical therapists - of which 64 were active in non-hospital environment and 44 in hospitals - who answered a questionnaire on cardiopulmonary resuscitation (CPR based on the American Heart Association 2005 guidelines. Answers were statistically analysed. As to diagnosing cardiopulmonary arrest, groups behaved similarly, having chosen the option"absence of consciousness, pulse and breath". Concerning the pattern of CPR assistance, the
Colgrove, Yvonne M; VanHoose, Lisa D
Doctor of physical therapy (DPT) student learning about role delineation of physical therapist assistants (PTAs) is essential to ethical and legal practice. Survey assessment of three DPT student cohorts compared collaborative interprofessional case-based learning with PTA students to traditional curriculum delivery strategies. Control cohorts were assessed one time. The intervention group was assessed pre-intervention, immediately post-intervention, and after completing a full-time clinical experience. The case-based learning covered 46% of survey content, allowing for the assessment of content-specific material and potential learning through collaboration. Following the educational intervention, the intervention group improved significantly in areas inside and outside the case-based study content, outscoring both control groups on 25-34% of the survey items. Following the clinical experience, the intervention group declined answer accuracy for patient evaluation and treatment implementation, suggesting unlearning. Improvement in the administrative section was observed after the clinical experience. Perceptions of the tasks within the PTA role were diminished while tasks outside the scope of practice appeared clarified following the clinical experience. While case-based collaborative intraprofessional learning proves effective in student learning about the PTA role, changes following the clinical experience raise questions about the influence of the clinical environment on learning and the practical application of recently learned knowledge.
Full Text Available Abstract Background Chile has suffered a fast increase in childhood obesity in the last 10 years. As a result, several school programmes have been implemented, however the effectiveness of these needs to be evaluated to identify and prioritize strategies to curve this trend. Methods Cluster randomized controlled trial. Twelve primary public schools chosen at random over three regions of the country will take part in this study. The sample size consisted of a total of 1,655 children. For each region one school will be selected for each of the three nutritional intervention modes and one school will be selected as the control group. The intervention modes consist of the following: Healthy Kiosk and nutritional education (KSEAN; Optimized physical activity (AFSO; Healthy Kiosk and nutritional education (KSEAN + optimized physical activity (AFSO; Control group. The effectiveness of each intervention will be evaluated by determining the nutritional condition of each child by measuring percentage of body fat, BMI and the z-score of the BMI. This study will also identify the eating behaviours, nutritional knowledge and fitness of each child, along with the effective time of moderate activity during physical education classes. Discussion A protocol to evaluate the effectiveness of a school based intervention to control and/or reduce the rates of childhood obesity for children between 6 and 10 years of age was developed. The protocol was developed in line with the Declaration of Helsinski, the Nüremberg Code and the University of Chile Guidelines for ethical committees, and was approved by the INTA, Universidad de Chile ethical committee on Wednesday 12 March 2014. There is consensus among researchers and health and education personnel that schools are a favourable environment for actions to prevent and/or control childhood obesity. However a lack of evidence on the effectiveness of interventions to date has led some to question the wisdom of
Bustos, Nelly; Olivares, Sonia; Leyton, Bárbara; Cano, Marcelo; Albala, Cecilia
Chile has suffered a fast increase in childhood obesity in the last 10 years. As a result, several school programmes have been implemented, however the effectiveness of these needs to be evaluated to identify and prioritize strategies to curve this trend. Cluster randomized controlled trial. Twelve primary public schools chosen at random over three regions of the country will take part in this study. The sample size consisted of a total of 1,655 children. For each region one school will be selected for each of the three nutritional intervention modes and one school will be selected as the control group. The intervention modes consist of the following: Healthy Kiosk and nutritional education (KSEAN); Optimized physical activity (AFSO); Healthy Kiosk and nutritional education (KSEAN) + optimized physical activity (AFSO); Control group. The effectiveness of each intervention will be evaluated by determining the nutritional condition of each child by measuring percentage of body fat, BMI and the z-score of the BMI. This study will also identify the eating behaviours, nutritional knowledge and fitness of each child, along with the effective time of moderate activity during physical education classes. A protocol to evaluate the effectiveness of a school based intervention to control and/or reduce the rates of childhood obesity for children between 6 and 10 years of age was developed. The protocol was developed in line with the Declaration of Helsinski, the Nüremberg Code and the University of Chile Guidelines for ethical committees, and was approved by the INTA, Universidad de Chile ethical committee on Wednesday 12 March 2014. There is consensus among researchers and health and education personnel that schools are a favourable environment for actions to prevent and/or control childhood obesity. However a lack of evidence on the effectiveness of interventions to date has led some to question the wisdom of allocating resources to programmes. This is the first study
Bodegom-Vos, L. van; Verhoef, J.; Dickmann, M.; Kleijn, M.; van Vliet, I.; Hurkmans, E.; Wees, P.J. van der; Vliet Vlieland, T.
BACKGROUND: Although the increasing complexity and expansion of the body of knowledge in physical therapy have led to specialized practice areas to provide better patient care, the impact of specialization on guideline implementation has been scarcely studied. Objectives The objective of this study
Study protocol: the Fueling Learning through Exercise (FLEX) study - a randomized controlled trial of the impact of school-based physical activity programs on children's physical activity, cognitive function, and academic achievement.
Wright, Catherine M; Duquesnay, Paula J; Anzman-Frasca, Stephanie; Chomitz, Virginia R; Chui, Kenneth; Economos, Christina D; Langevin, Elizabeth G; Nelson, Miriam E; Sacheck, Jennifer M
Physical activity (PA) is critical to preventing childhood obesity and contributes to children's overall physical and cognitive health, yet fewer than half of all children achieve the recommended 60 min per day of moderate-to-vigorous physical activity (MVPA). Schools are an ideal setting to meeting PA guidelines, but competing demands and limited resources have impacted PA opportunities. The Fueling Learning through Exercise (FLEX) Study is a randomized controlled trial that will evaluate the impact of two innovative school-based PA programs on children's MVPA, cognitive function, and academic outcomes. Twenty-four public elementary schools from low-income, ethnically diverse communities around Massachusetts were recruited and randomized to receive either 100 Mile Club® (walking/running program) or Just Move™ (classroom-based PA program) intervention, or control. Schoolchildren (grades 3-4, approximately 50 per school) were recruited to participate in evaluation. Primary outcome measures include PA via 7-day accelerometry (Actigraph GT3X+ and wGT3X-BT), cognitive assessments, and academic achievement via state standardized test scores. Additional measures include height and weight, surveys assessing psycho-social factors related to PA, and dietary intake. School-level surveys assess PA infrastructure and resources and intervention implementation. Data are collected at baseline, mid-point (5-6 months post-baseline), and post-intervention (approximately 1.5 years post-baseline). Demographic data were collected by parents/caregivers at baseline. Mixed-effect models will test the short- and long-term effects of both programs on minutes spent in MVPA, as well as secondary outcomes including cognitive and academic outcomes. The FLEX study will evaluate strategies for increasing children's MVPA through two innovative, low-cost, school-based PA programs as well as their impact on children's cognitive functioning and academic success. Demonstration of a relationship
Study protocol: the Fueling Learning through Exercise (FLEX study – a randomized controlled trial of the impact of school-based physical activity programs on children’s physical activity, cognitive function, and academic achievement
Catherine M. Wright
Full Text Available Abstract Background Physical activity (PA is critical to preventing childhood obesity and contributes to children’s overall physical and cognitive health, yet fewer than half of all children achieve the recommended 60 min per day of moderate-to-vigorous physical activity (MVPA. Schools are an ideal setting to meeting PA guidelines, but competing demands and limited resources have impacted PA opportunities. The Fueling Learning through Exercise (FLEX Study is a randomized controlled trial that will evaluate the impact of two innovative school-based PA programs on children’s MVPA, cognitive function, and academic outcomes. Methods Twenty-four public elementary schools from low-income, ethnically diverse communities around Massachusetts were recruited and randomized to receive either 100 Mile Club® (walking/running program or Just Move™ (classroom-based PA program intervention, or control. Schoolchildren (grades 3–4, approximately 50 per school were recruited to participate in evaluation. Primary outcome measures include PA via 7-day accelerometry (Actigraph GT3X+ and wGT3X-BT, cognitive assessments, and academic achievement via state standardized test scores. Additional measures include height and weight, surveys assessing psycho-social factors related to PA, and dietary intake. School-level surveys assess PA infrastructure and resources and intervention implementation. Data are collected at baseline, mid-point (5–6 months post-baseline, and post-intervention (approximately 1.5 years post-baseline. Demographic data were collected by parents/caregivers at baseline. Mixed-effect models will test the short- and long-term effects of both programs on minutes spent in MVPA, as well as secondary outcomes including cognitive and academic outcomes. Discussion The FLEX study will evaluate strategies for increasing children’s MVPA through two innovative, low-cost, school-based PA programs as well as their impact on children’s cognitive
Sehnert Scott T
Full Text Available Abstract Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA. In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU faculty, clinicians, and health profession students was formed to "(Spartner" with elementary school physical education (PE teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (Spartnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1 improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2 increase the number of students achieving national recommendations for PA and nutrition; and 3 increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. Methods/Design This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students
Carlson, Joseph J; Eisenmann, Joey C; Pfeiffer, Karin A; Jager, Kathleen B; Sehnert, Scott T; Yee, Kimbo E; Klavinski, Rita A; Feltz, Deborah L
The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU) faculty, clinicians, and health profession students was formed to "(S)partner" with elementary school physical education (PE) teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (S)partnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1) improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2) increase the number of students achieving national recommendations for PA and nutrition; and 3) increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly) designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students (Spartners). The final 10 minutes of each lesson
Elbe, Anne-Marie; Wikman, Johan Michael; Zheng, Miky
This study investigates the enjoyment and cohesion of school children participating in a school-based high-intensity physical activity (PA) intervention. Both enjoyment and cohesion have been found to be important factors for adherence to regular physical and sport activity, an important outcome...... of PA interventions. The sample consisted of 300 pupils (mean age: 9.3 years; 52.7% female) assigned to a team sport intervention, an individual sport intervention, or a control group for 10 months. The Physical Activity Enjoyment Scale and Youth Sport Environment Questionnaire were used to measure...
Romney, Wendy; Salbach, Nancy; Parrott, James Scott; Deutsch, Judith E
Little is known about the process of engaging key stakeholders to select and design a knowledge translation (KT) intervention to increase the use of an outcome measure using audit and feedback. The purpose of this case report was to describe the development of a KT intervention designed with organizational support to increase physical therapists' (PTs) use of a selected outcome measure in an inpatient sub-acute rehabilitation hospital. Eleven PTs who worked at a sub-acute rehabilitation hospital participated. After determining organizational support, a mixed methods barrier assessment including a chart audit, questionnaire, and a focus group with audit and feedback was used to select an outcome measure and design a locally tailored intervention. The intervention was mapped using the Theoretical Domains Framework (TDF). One investigator acted as knowledge broker and co-designed the intervention with clinician and supervisor support. The 4-m walk test was selected through a group discussion facilitated by the knowledge broker. Support from the facility and input from the key stakeholders guided the design of a tailored KT intervention to increase use of gait speed. The intervention design included an interactive educational meeting, with documentation and environmental changes. Input from the clinicians on the educational meeting, documentation changes and placement of tracks, and support from the supervisor were used to design and locally adapt a KT intervention to change assessment practice among PTs in an inpatient sub-acute rehabilitation hospital. Implementation and evaluation of the intervention is underway.
Children's Aid Society, 2012
School Based Health Centers (SBHC) are considered by experts as one of the most effective and efficient ways to provide preventive health care to children. Few programs are as successful in delivering health care to children at no cost to the patient, and where they are: in school. For many underserved children, The Children's Aid Society's…
The family therapist performs specific activities associated with his functions as a therapist, consultant, and intermediary. The intermediary function is based upon concepts associated with symbolic interactionism. (Author)
Grill, Eva; Gloor-Juzi, Thomas; Huber, Erika O; Stucki, Gerold
To operationalize items based on categories of the International Classification of Functioning, Disability and Health (ICF) relevant to patient problems that are addressed by physiotherapeutic interventions in the acute hospital, and to test the reliability of these items when applied by physiotherapists. A selection of 124 ICF categories was operation-alized in a formal decision-making and consensus process. The reliability of the newly operationalized item list was tested with a cross-sectional study with repeated measurements. The item writing process resulted in 94 dichotomous and 30 polytomous items. Data were collected in a convenience sample of 28 patients with neurological, musculoske-letal, cardiopulmonary, or internal organ conditions, requiring physical therapy in an acute hospital. Fifty-six percent of the polytomous and 68% of the dichotomous items had a raw agreement of 0.7 or above, whereas 36% of all polytomous and 34% of all dichotomous items had a kappa coefficient of 0.7 and above. The study supports that the ICF is adaptable to professional and setting-specific needs of physiotherapists. Further research towards the development of reliable instruments for physiotherapists based on the ICF seems justified. :
Kathleen De Oliveira
Full Text Available Purpose: As the United States health care model progresses towards medical teams and the country’s population continues to diversify, the need for health professional education programs to develop and implement culturally specific interprofessional education (IPE becomes increasingly imperative. A wide range of models exists for delivering and implementing IPE in health education, but none have included the cultural components that are vital in educating the health professional. Methods: A cross-cultural decentralized IPE model for physician assistant (PA and physical therapy (PT students was developed. This three-part IPE series was created using an established cultural curricular model and began with the exploration of self, continued with the examination of various dimensions of culture, and concluded with the exploration of the intersection between health and culture. We assessed student satisfaction of the IPE experiences and students’ engagement and attitudes towards IPE using a three-item open-ended questionnaire administered after each cross-cultural activity and the Interprofessional Education Series Survey (IESS upon the completion of the series. Results: IESS responses showed that PA and PT students reported benefits in interprofessional collaboration and cultural awareness and expressed overall satisfaction with the series. Qualitative analysis revealed growth in student response depth consistent with the scaffolded focus of each IPE module in the series. Conclusion: The trends in this three-part series suggest that institutions looking to develop culturally inclusive IPE educational initiatives may have success through a decentralized model mirroring the effective cultural progression focused on addressing exploration of self, examination of various dimensions of culture, and exploration of the intersection between health and culture.
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Executive Function, Behavioral Self-Regulation, and School Related Well-Being Did Not Mediate the Effect of School-Based Physical Activity on Academic Performance in Numeracy in 10-Year-Old Children. The Active Smarter Kids (ASK Study
Katrine N. Aadland
Full Text Available Inconsistent findings exist for the effect of school-based physical activity interventions on academic performance. The Active Smarter Kids (ASK study revealed a favorable intervention effect of school-based physical activity on academic performance in numeracy in a subsample of 10-year-old elementary schoolchildren performing poorer at baseline in numeracy. Aiming to explain this finding, we investigated the mediating effects of executive function, behavioral self-regulation, and school related well-being in the relation between the physical activity intervention and child’s performance in numeracy. An ANCOVA model with latent variable structural equation modeling was estimated using data from 360 children (the lower third in academic performance in numeracy at baseline. The model consisted of the three latent factors as mediators; executive function, behavioral self-regulation, and school related well-being. We found no mediating effects of executive function, behavioral self-regulation or school related well-being in the relationship between the ASK intervention and academic performance in numeracy (p ≥ 0.256. Our results suggest that the effect of the intervention on performance in numeracy in the present sample is not explained by change in executive function, behavioral self-regulation, or school related well-being. We suggest this finding mainly could be explained by the lack of effect of the intervention on the mediators, which might be due to an insufficient dose of physical activity.Trial registration: Clinicaltrials.gov registry, trial registration number: NCT02132494.
Executive Function, Behavioral Self-Regulation, and School Related Well-Being Did Not Mediate the Effect of School-Based Physical Activity on Academic Performance in Numeracy in 10-Year-Old Children. The Active Smarter Kids (ASK) Study.
Aadland, Katrine N; Aadland, Eivind; Andersen, John R; Lervåg, Arne; Moe, Vegard F; Resaland, Geir K; Ommundsen, Yngvar
Inconsistent findings exist for the effect of school-based physical activity interventions on academic performance. The Active Smarter Kids (ASK) study revealed a favorable intervention effect of school-based physical activity on academic performance in numeracy in a subsample of 10-year-old elementary schoolchildren performing poorer at baseline in numeracy. Aiming to explain this finding, we investigated the mediating effects of executive function, behavioral self-regulation, and school related well-being in the relation between the physical activity intervention and child's performance in numeracy. An ANCOVA model with latent variable structural equation modeling was estimated using data from 360 children (the lower third in academic performance in numeracy at baseline). The model consisted of the three latent factors as mediators; executive function, behavioral self-regulation, and school related well-being. We found no mediating effects of executive function, behavioral self-regulation or school related well-being in the relationship between the ASK intervention and academic performance in numeracy ( p ≥ 0.256). Our results suggest that the effect of the intervention on performance in numeracy in the present sample is not explained by change in executive function, behavioral self-regulation, or school related well-being. We suggest this finding mainly could be explained by the lack of effect of the intervention on the mediators, which might be due to an insufficient dose of physical activity. Trial registration: Clinicaltrials.gov registry, trial registration number: NCT02132494.
Dudley, Dean A.; Pearson, Phil; Okely, Anthony D.; Cotton, Wayne G.
Physical activity affords a host of physical and cognitive benefits for children. Physical education classes are one such venue where children can reap recommended amounts of physical activity. However, little research has explored evidence-based physical education instruction, particularly in culturally and linguistically diverse schools. No…
Tucker, Sharon; Lanningham-Foster, Lorraine M.
School-based childhood obesity prevention programs have grown in response to reductions in child physical activity (PA), increased sedentariness, poor diet, and soaring child obesity rates. Multiple systematic reviews indicate school-based obesity prevention/treatment interventions are effective, yet few studies have examined the school nurse role…
Davis, Teresa K
School-based health centers in high schools provide a unique setting in which to deliver risk-reduction and resilience-building services to adolescents. The traditional health care system operating in the United States focuses on the treatment of illness and disease rather than on preventing problems originating from health risk behaviors. Nurse practitioners can promote healthy behavior in adolescents through linkages to parents, schools, and community organizations; by conducting individual risk assessments; and by providing health education and access to creative health programs that build resilience and promote protective factors. With a focus on wellness, nurse practitioners as advanced practice nurses and specialists in disease prevention and health promotion can establish students' health priorities in the context of the primary health care they deliver on a daily basis.
Vancampfort, Davy; Rosenbaum, Simon; Probst, Michel; Connaughton, Joanne; du Plessis, Christy; Yamamoto, Taisei; Stubbs, Brendon
Research has only recently started to consider the importance and applicability of physical activity (PA) for people with bipolar disorder (BD). The aim of the current study is to highlight 10 pertinent PA research questions in people with BD. The International Organization of Physical Therapy in Mental Health executed a consultation with all National organizations (n=13) to identify the most salient questions to guide future research on PA in BD. We identified the following 10 questions: (1) What are the benefits of PA for people with BD? (2) What are the most prominent safety issues for PA prescription in BD? (3) What is the optimal PA prescription for people with BD? (4) What are the key barriers to PA among people with BD? (5) What are the most effective motivational strategies for ensuring PA adoption and maintenance in BD? (6) How do we translate PA research into community practice? (7) If one treatment goal is increased physical activity, what type of professionals are needed as part of a multidisciplinary team? (8) How do we incorporate PA as a vital sign in clinical practice? (9) How can we prevent sedentary behavior in BD? (10) What is the most appropriate PA assessment method? We did not consult people with BD. Addressing these questions is critical for developing evidence-based approaches for promoting and sustaining an active lifestyle in BD. Ultimately, achieving this will reduce the burden of cardiovascular disease and improve the quality of life of this population. Copyright © 2016 Elsevier B.V. All rights reserved.
Creed, Torrey A.; Jager-Hyman, Shari; Pontoski, Kristin; Feinberg, Betsy; Rosenberg, Zachary; Evans, Arthur; Hurford, Matthew O.; Beck, Aaron T.
A growing literature supports cognitive therapy (CT) as an efficacious treatment for youth struggling with emotional or behavioral problems. Recently, work in this area has extended the dissemination of CT to school-based settings. The current study has two aims: 1) to examine the development of therapists' knowledge and skills in CT, an…
Kelly, Jennifer F; Greene, Beverly
Despite the presence of some literature that has addressed the characteristics of the African American female therapist, most psychotherapy training proceeds with the assumption that therapists are members of dominant groups, and most of the psychological and psychotherapy literature has been written by therapists and psychologists who come from dominant cultural perspectives. Not as much has been written about psychological paradigms or the process of psychotherapy from the perspective of the therapist who is not a dominant group member. This article explores both the common and divergent experiences that we, the authors, share as African American female therapists and the different reactions we frequently elicit in clients. We also explore how individual differences in our physical appearances, personal backgrounds, and different characteristics of our respective practices elicit distinct responses from clients that we believe are based on differences between us, despite the fact that we are both African American women. We believe that many of the stereotypes that affect perceptions of African American female clients also exist for African American female therapists. We will address how the intersection of gender, race, and sexual orientation of the client highlights the complexity of culturally competent practice. PsycINFO Database Record (c) 2010 APA, all rights reserved.
Reddy, Rajakumari P.; Hirisave, Uma
Play has been recognized as an essential component to children's healthy development. Schools of play therapy differ philosophically and technically, but they all embrace the therapeutic and developmental properties of play. This case report is an illustration of how a 6-year-old child with emotional disorder was facilitated to express concerns in child-centered play therapy. The paper discusses the therapist's narration of the child's play. PMID:24860228
Rationale and study protocol of the EASY Minds (Encouraging Activity to Stimulate Young Minds) program: cluster randomized controlled trial of a primary school-based physical activity integration program for mathematics.
Riley, Nicholas; Lubans, David R; Holmes, Kathryn; Morgan, Philip J
Novel strategies are required to increase school-based physical activity levels of children. Integrating physical activity in mathematics lessons may lead to improvements in students' physical activity levels as well as enjoyment, engagement and learning. The primary aim of this study is to evaluate the impact of a curriculum-based physical activity integration program known as EASY Minds (Encouraging Activity to Stimulate Young Minds) on children's daily school time physical activity levels. Secondary aims include exploring the impact of EASY Minds on their engagement and 'on task' behaviour in mathematics. Grade 5/6 classes from eight public schools in New South Wales, Australia will be randomly allocated to intervention (n = 4) or control (n = 4) groups. Teachers from the intervention group will receive one day of professional development, a resource pack and asked to adapt their lessons to embed movement-based learning in their daily mathematics program in at least three lessons per week over a six week period. Intervention support will be provided via a weekly email and three lesson observations. The primary outcomes will be children's physical activity levels (accelerometry) across both the school day and during mathematics lessons (moderate-to-vigorous physical activity and sedentary time). Children's 'on-task' behaviour, enjoyment of mathematics and mathematics attainment will be assessed as secondary outcomes. A detailed process evaluation will be undertaken. EASY Minds is an innovative intervention that has the potential to improve key physical and academic outcomes for primary school aged children and help guide policy and practice regarding the teaching of mathematics. Australian and New Zealand Clinical Trials Register ACTRN12613000637741 13/05/2013.
Sebire, Simon J; Edwards, Mark J; Campbell, Rona; Jago, Russell; Kipping, Ruth; Banfield, Kathryn; Tomkinson, Keeley; Garfield, Kirsty; Lyons, Ronan A; Simon, Joanne; Blair, Peter S; Hollingworth, William
Physical activity levels are low amongst adolescent girls, and this population faces specific barriers to being active. Peer influences on health behaviours are important in adolescence and peer-led interventions might hold promise to change behaviour. This paper describes the protocol for a feasibility cluster randomised controlled trial of Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led intervention aimed at increasing adolescent girls' physical activity levels. A two-arm cluster randomised feasibility trial will be conducted in six secondary schools (intervention n = 4; control n = 2) with year 8 (12-13 years old) girls. The intervention will operate at a year group level and consist of year 8 girls nominating influential peers within their year group to become peer-supporters. Approximately 15 % of the cohort will receive 3 days of training about physical activity and interpersonal communication skills. Peer-supporters will then informally diffuse messages about physical activity amongst their friends for 10 weeks. Data will be collected at baseline (time 0 (T0)), immediately after the intervention (time 1 (T1)) and 12 months after baseline measures (time 2 (T2)). In this feasibility trial, the primary interest is in the recruitment of schools and participants (both year 8 girls and peer-supporters), delivery and receipt of the intervention, data provision rates and identifying the cost categories for future economic analysis. Physical activity will be assessed using 7-day accelerometry, with the likely primary outcome in a fully-powered trial being daily minutes of moderate-to-vigorous physical activity. Participants will also complete psychosocial questionnaires at each time point: assessing motivation, self-esteem and peer physical activity norms. Data analysis will be largely descriptive and focus on recruitment, attendance and data provision rates. The findings will inform the sample size required for a
Tarp, Jakob; Domazet, Sidsel Louise; Froberg, Karsten
an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness. RESULTS....../m2 (95% CI: -0.39-0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0-9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between...
Torrey A. Creed
Full Text Available A growing literature supports cognitive therapy (CT as an efficacious treatment for youth struggling with emotional or behavioral problems. Recently, work in this area has extended the dissemination of CT to school-based settings. The current study has two aims: 1 to examine the development of therapists’ knowledge and skills in CT, an evidence-based approach to promoting student well-being, and 2 to examine patterns of narrative feedback provided to therapists participating in the program. As expected, school therapists trained in CT demonstrated significant gains in their knowledge of CT theory and in their demonstration of CT skills, with the majority of therapists surpassing the accepted threshold of competency in CT. In addition, an examination of feedback content suggested that narrative feedback provided to therapists most frequently consisted of positive feedback and instructions for future sessions. Suggestions for future research regarding dissemination of CT are discussed in light of increasing broad access to evidence based practices.
Elbe, Anne-Marie; Wikman, Johan Michael; Zheng, Miky; Larsen, Malte Nejst; Nielsen, Glen; Krustrup, Peter
This study investigates the enjoyment and cohesion of school children participating in a school-based high-intensity physical activity (PA) intervention. Both enjoyment and cohesion have been found to be important factors for adherence to regular physical and sport activity, an important outcome of PA interventions. The sample consisted of 300 pupils (mean age: 9.3 years; 52.7% female) assigned to a team sport intervention, an individual sport intervention, or a control group for 10 months. The Physical Activity Enjoyment Scale and Youth Sport Environment Questionnaire were used to measure enjoyment and cohesion. The Yo-Yo IR1C test determined fitness improvements. Results showed that enjoyment and cohesion (social) measured at the beginning of the intervention significantly predict fitness improvements achieved after 10 months. No differing developmental effects over time could be found in the intervention groups with regard to cohesion and enjoyment when comparing them to the control group. However, enjoyment and cohesion (social) significantly decreased in the groups that performed individual sports. Team sports seem to be more advantageous for the development of enjoyment and cohesion, which are both factors that positively impact the health outcomes of the intervention.
Griffith, G. M.; Barbakou, A.; Hastings, R. P.
Background: Little is known about the work-related well-being of applied behaviour analysis (ABA) therapists who work in school-based contexts and deliver ABA interventions to children with autism. Methods: A questionnaire on work-related stress (burnout), general distress, perceived supervisor support and coping was completed by 45 ABA therapists…
Fairclough, Stuart J; McGrane, Bronagh; Sanders, George; Taylor, Sarah; Owen, Michael; Curry, Whitney
PE lessons are the formal opportunity in schools for promotion of physical activity and fitness. This study aimed to evaluate the effectiveness of a pilot PE intervention on physical activity, fitness, and psychosocial outcomes. Participants were 139 children aged 10-11 years from four schools. For six weeks children in two schools received a twice-weekly pilot 'Born to Move' (BTM) physical activity (PA) and fitness intervention alongside one regular PE lesson. Children in the two comparison (COM) schools received their regular twice weekly PE lessons. Outcomes were lesson time and whole-day light (LPA), moderate (MPA), vigorous (VPA), and MVPA, and sedentary time, muscular fitness, cardiorespiratory fitness (CRF), and lesson-specific perceived exertion, enjoyment, and perceived competence. Outcomes were assessed at baseline (T0), midway through the intervention (T1), and at the end (T2) using ANOVAs and ANCOVAs. Intervention fidelity was measured using child and teacher surveys at T2 and analysed using Chi-square tests. The BTM group engaged in moderate PA for significantly more lesson time (29.4 %) than the COM group (25.8 %; p = .009, d = .53). The amount of moderate-to-vigorous PA (MVPA) during the T1 BTM lesson contributed 14.0 % to total MVPA, which was significantly more than the COM group's T1 PE lesson (11.4 %; p competence increased in both groups (p fitness, and psychosocial outcomes. Further, BTM was enjoyed by the children, and valued by the teachers. This study can inform the design of a modified larger-scale cluster RCT evaluation.
Brooks Lyndon O
Full Text Available Abstract Background The purpose of this paper was to evaluate the long-term impact of a childhood motor skill intervention on adolescent motor skills and physical activity. Methods In 2006, we undertook a follow-up of motor skill proficiency (catch, kick, throw, vertical jump, side gallop and physical activity in adolescents who had participated in a one-year primary school intervention Move It Groove It (MIGI in 2000. Logistic regression models were analysed for each skill to determine whether the probability of children in the intervention group achieving mastery or near mastery was either maintained or had increased in subsequent years, relative to controls. In these models the main predictor variable was intervention status, with adjustment for gender, grade, and skill level in 2000. A general linear model, controlling for gender and grade, examined whether former intervention students spent more time in moderate-to-vigorous physical activity at follow-up than control students. Results Half (52%, n = 481 of the 928 MIGI participants were located in 28 schools, with 276 (57% assessed. 52% were female, 58% in Grade 10, 40% in Grade 11 and 54% were former intervention students. At follow-up, intervention students had improved their catch ability relative to controls and were five times more likely to be able to catch: ORcatch = 5.51, CI (1.95 – 15.55, but had lost their advantage in the throw and kick: ORthrow = .43, CI (.23 – .82, ORkick = .39, CI (.20 – .78. For the other skills, intervention students appeared to maintain their advantage: ORjump = 1.14, CI (.56 – 2.34, ORgallop = 1.24, CI (.55 – 2.79. Intervention students were no more active at follow-up. Conclusion Six years after the 12-month MIGI intervention, whilst intervention students had increased their advantage relative to controls in one skill, and appeared to maintain their advantage in two, they lost their advantage in two skills and were no more active than controls
Stuart J. Fairclough
Full Text Available Abstract Background PE lessons are the formal opportunity in schools for promotion of physical activity and fitness. This study aimed to evaluate the effectiveness of a pilot PE intervention on physical activity, fitness, and psychosocial outcomes. Methods Participants were 139 children aged 10–11 years from four schools. For six weeks children in two schools received a twice-weekly pilot ‘Born to Move’ (BTM physical activity (PA and fitness intervention alongside one regular PE lesson. Children in the two comparison (COM schools received their regular twice weekly PE lessons. Outcomes were lesson time and whole-day light (LPA, moderate (MPA, vigorous (VPA, and MVPA, and sedentary time, muscular fitness, cardiorespiratory fitness (CRF, and lesson-specific perceived exertion, enjoyment, and perceived competence. Outcomes were assessed at baseline (T0, midway through the intervention (T1, and at the end (T2 using ANOVAs and ANCOVAs. Intervention fidelity was measured using child and teacher surveys at T2 and analysed using Chi-square tests. Results The BTM group engaged in moderate PA for significantly more lesson time (29.4 % than the COM group (25.8 %; p = .009, d = .53. The amount of moderate-to-vigorous PA (MVPA during the T1 BTM lesson contributed 14.0 % to total MVPA, which was significantly more than the COM group’s T1 PE lesson (11.4 %; p < .001, d = .47. The BTM group were significantly more active during the whole-day (p < .05 and the school-day (p < .01. In both groups push-up test performance increased (p < .001 and CRF test performance decreased (p < .01. Perceived exertion, enjoyment, and perceived competence increased in both groups (p < .05, but the BTM group rated their enjoyment of the T1 BTM lesson higher than the COM group rated their PE lesson (p = .02, d = .56. The children’s and teachers’ responses to the intervention indicated that the delivery aims of enjoyment
Full Text Available Abstract Background In 2005, we reported on the success of Comprehensive School Health (CSH in improving diets, activity levels, and body weights. The successful program was recognized as a "best practice" and has inspired the development of the Alberta Project Promoting active Living and healthy Eating (APPLE Schools. The project includes 10 schools, most of which are located in socioeconomically disadvantaged areas. The present study examines the effectiveness of a CSH program adopted from a "best practice" example in another setting by evaluating temporal changes in diets, activity levels and body weight. Methods In 2008 and 2010, we surveyed grade 5 students from approximately 150 randomly selected schools from the Canadian province of Alberta and students from 10 APPLE Schools. Students completed the Harvard Youth/Adolescent Food Frequency Questionnaire, questions on physical activity, and had their height and weight measured. Multilevel regression methods were used to analyze changes in diets, activity levels, and body weight between 2008 and 2010. Results In 2010 relative to 2008, students attending APPLE Schools were eating more fruits and vegetables, consuming fewer calories, were more physically active and were less likely obese. These changes contrasted changes observed among students elsewhere in the province. Conclusions These findings provide evidence on the effectiveness of CSH in improving health behaviors. They show that an example of "best practice" may lead to success in another setting. Herewith the study provides the evidence that investments for broader program implementation based on "best practice" are justified.
Background In 2005, we reported on the success of Comprehensive School Health (CSH) in improving diets, activity levels, and body weights. The successful program was recognized as a "best practice" and has inspired the development of the Alberta Project Promoting active Living and healthy Eating (APPLE) Schools. The project includes 10 schools, most of which are located in socioeconomically disadvantaged areas. The present study examines the effectiveness of a CSH program adopted from a "best practice" example in another setting by evaluating temporal changes in diets, activity levels and body weight. Methods In 2008 and 2010, we surveyed grade 5 students from approximately 150 randomly selected schools from the Canadian province of Alberta and students from 10 APPLE Schools. Students completed the Harvard Youth/Adolescent Food Frequency Questionnaire, questions on physical activity, and had their height and weight measured. Multilevel regression methods were used to analyze changes in diets, activity levels, and body weight between 2008 and 2010. Results In 2010 relative to 2008, students attending APPLE Schools were eating more fruits and vegetables, consuming fewer calories, were more physically active and were less likely obese. These changes contrasted changes observed among students elsewhere in the province. Conclusions These findings provide evidence on the effectiveness of CSH in improving health behaviors. They show that an example of "best practice" may lead to success in another setting. Herewith the study provides the evidence that investments for broader program implementation based on "best practice" are justified. PMID:22413778
Robbins, Lorraine B; Pfeiffer, Karin Allor; Wesolek, Stacey M; Lo, Yun-Jia
The purpose was to evaluate the reach, dose, and fidelity of Guys Only Activity for Life (G.O.A.L.), a 7-week pilot intervention conducted from February to March 2011 to increase 6th and 7th grade boys' moderate-to-vigorous physical activity (MVPA). One middle school was randomly assigned to the G.O.A.L. intervention and another from the same urban school district in the Midwestern U.S. to a comparison condition. Thirty boys, ages 10-14 years, participated in each school. The intervention, guided by the Health Promotion Model (HPM) and Self-Determination Theory (SDT), consisted of a 90-min after-school physical activity club 4 days/week and one motivational interviewing session with a registered (school) nurse. Data were gathered via attendance records, club observations, heart rate monitors, audio-taping of motivational interviewing sessions, and surveys. On average boys attended the club 2.11 days/week (SD=.86). A trained independent process evaluator reported that the physical activity club instructors provided the boys with the opportunity for a mean of 25.8 min/day of MVPA. Using a four-point Likert scale (1=disagree a lot; 4=agree a lot), the process evaluator perceived that the club was delivered with high fidelity and adherence to the underlying theories (M=3.48; SD=0.39). Sessions with the nurse lasted an average of 13 min, 29 s. All boys attended. Two trained independent coders indicated that the nurse demonstrated at least beginning proficiency for all tasks associated with motivational interviewing, with the exception of using sufficient open- as opposed to closed-ended questions and reflections compared to questions. Fidelity related to session delivery and adherence to the theories was high (M=3.83; SD=0.19). The process evaluation data indicated that strategies are needed to increase attendance and boys' MVPA during the club time. Copyright © 2013 Elsevier Ltd. All rights reserved.
‘Let’s Move It’ – a school-based multilevel intervention to increase physical activity and reduce sedentary behaviour among older adolescents in vocational secondary schools: a study protocol for a cluster-randomised trial
Full Text Available Abstract Background Physical activity (PA has been shown to decline during adolescence, and those with lower education have lower levels of activity already at this age, calling for targeted efforts for them. No previous study has demonstrated lasting effects of school-based PA interventions among older adolescents. Furthermore, these interventions have rarely targeted sedentary behaviour (SB despite its relevance to health. The Let’s Move It trial aims to evaluate the effectiveness and the cost-effectiveness of a school-based, multi-level intervention, on PA and SB, among vocational school students. We hypothesise that the intervention is effective in increasing moderate-to-vigorous-intensity physical activity (MVPA, particularly among those with low or moderate baseline levels, and decreasing SB among all students. Methods The design is a cluster-randomised parallel group trial with an internal pilot study. The trial is conducted in six vocational schools in the Helsinki Metropolitan area, Finland. The intervention is carried out in 30 intervention classes, and 27 control classes retain the standard curriculum. The randomisation occurs at school-level to avoid contamination and to aid delivery. Three of the six schools, randomly allocated, receive the ‘Let’s Move It’ intervention which consists of 1 group sessions and poster campaign targeting students’ autonomous PA motivation and self-regulation skills, 2 sitting reduction in classrooms via alterations in choice architecture and teacher behaviour, and 3 enhancement of PA opportunities in school, home and community environments. At baseline, student participants are blind to group allocation. The trial is carried out in six batches in 2015–2017, with main measurements at pre-intervention baseline, and 2-month and 14-month follow-ups. Primary outcomes are for PA, MVPA measured by accelerometry and self-report, and for SB, sedentary time and breaks in sedentary time (accelerometry
Carrier, Annie; Levasseur, Mélanie; Bédard, Denis; Desrosiers, Johanne
Occupational therapy interventions in the community, a fast expanding practice setting, are central to an important social priority, the ability to live at home. These interventions generally involve only a small number of home visits, which aim at maximising the safety and autonomy of community-dwelling clients. Knowing how community occupational therapists determine their interventions, i.e. their clinical reasoning, can improve intervention efficacy. However, occupational therapists are often uninformed about and neglect the importance of clinical reasoning, which could underoptimise their interventions. To synthesise current knowledge about community occupational therapists' clinical reasoning. A scoping study of the literature on community occupational therapists' clinical reasoning was undertaken. Fifteen textbooks and 25 articles, including six focussing on community occupational therapists' clinical reasoning, were reviewed. Community occupational therapists' clinical reasoning is influenced by internal and external factors. Internal factors include past experiences, expertise and perceived complexity of a problem. One of the external factors, practice context (e.g. organisational or cultural imperatives, physical location of intervention), particularly shapes community occupational therapists' clinical reasoning, which is interactive, complex and multidimensional. However, the exact influence of many factors (personal context, organisational and legal aspects of health care, lack of resources and increased number of referrals) remains unclear. Further studies are needed to understand better the influence of internal and external factors. The extent to which these factors mould the way community occupational therapists think and act could have a direct influence on the services they provide to their clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.
Full Text Available Abstract Background Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure. A major contributing factor is physical inactivity which is closely linked to bone health, cardiovascular disease risk, fitness and psychological factors. The school seems to provide an excellent setting to enhance levels of physical activity (PA. However, there is insufficient data from previous school-based intervention trials on how to enhance overall PA. It is also unknown whether an intervention aimed at increasing PA is effective in improving the children's health. The purpose of this paper is to outline the design of a school-based randomized, controlled trial (RCT aiming to increase overall PA and to improve fitness and health in 6- to 13-year-old children. Methods/Design 15 schools were randomized to the intervention (n = 9 or the control (n = 6 group, stratified by geographic region (urban vs. rural and by age (1st and 5th grade. Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum. The intervention during one academic year consisted of: 1. two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week, 2. short PA breaks (2–5 min each during academic lessons, 3. PA home work, and 4. adaptation of recreational areas around the school. All children underwent anthropometric measurements, blood pressure assessment, fitness testing, measurement of PA and they filled out questionnaires. At least 70% of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry. The primary endpoints of the study after one year were an increase in total PA by accelerometry, an increase in aerobic fitness measured by the 20 m shuttle run, a decrease in percent body fat derived from
Seruya, Francine M; Hinojosa, Jim
The professional and organizational commitment of paediatric occupational therapists working in two distinct practice settings, schools and medically based settings, was investigated. A web-based survey program was used to administer a questionnaire to occupational therapists employed in New York, New Jersey and Connecticut. The study employed social identity theory as a guiding perspective in understanding therapists' professional and organizational commitment. One hundred and fifty-seven paediatric therapists responded to the Professional Commitment Questionnaire and the Organizational Commitment Questionnaire to gauge their commitment to both the profession and their employing organizations. Results indicated that paediatric therapists, regardless of employment setting, have high professional commitment. Paediatric occupational therapists employed in medically based settings indicated statistically significant higher organizational commitment than their school-based counterparts. For therapists that work in school settings, the presence of a professional cohort did not influence professional commitment scores. As the study employed a web-based survey methodology, only individuals who were members of associations and had access to a computer and the Internet were able to participate. Further study might include widening the participant pool as well as adding additional instruments to explore both professional and organizational commitment on a more national scale. Copyright 2010 John Wiley & Sons, Ltd.
Maas, M.J.M.; Dulmen, S.A. van; Sagasser, M.H.; Heerkens, Y.F.; Vleuten, C.P.M. van der; Nijhuis, M.W.; Wees, P.J. van der
BACKGROUND: Clinical practice guidelines are intended to improve the process and outcomes of patient care. However, their implementation remains a challenge. We designed an implementation strategy, based on peer assessment (PA) focusing on barriers to change in physical therapy care. A previously
James, Joan K.; Williams, Theresa
In this research study, we hear the voices of middle school students, preservice teachers, and practicing middle school teachers in support of school-based experiential outdoor education. The benefits of engaging youth in memorably relevant learning, immersing them in physically active, field-based education, and providing them with authentic,…
Silva, Anderson M.; Costa, Lucíola C. M.; Comper, Maria L.; Padula, Rosimeire S.
BACKGROUND: The Modified Fresno Test was developed to assess knowledge and skills of both physical therapy (PT) professionals and students to use evidence-based practice (EBP). OBJECTIVES: To translate the Modified Fresno Test into Brazilian-Portuguese and to evaluate the test's reproducibility. METHOD: The first step consisted of adapting the instrument into the Brazilian-Portuguese language. Then, a total of 57 participants, including PT students, PT professors and PT practitioners, completed the translated instrument. The responses from the participants were used to evaluate reproducibility of the translated instrument. Internal consistency was calculated using the Cronbach's alpha. Reliability was calculated using the intraclass correlation coefficient (ICC) for continuous variables, and the Kappa coefficient (K) for categorical variables. The agreement was assessed using the standard error of the measurement (SEM). RESULTS: The cross-cultural adaptation process was appropriate, providing an adequate Brazilian-Portuguese version of the instrument. The internal consistency was good (α=0.769). The reliability for inter- and intra-rater assessment were ICC=0.89 (95% CI 0.82 to 0.93); for evaluator 1 was ICC=0.85 (95% CI 0.57 to 0.93); and for evaluator 2 was ICC=0.98 (95% CI 0.97 to 0.99). The SEM was 13.04 points for inter-rater assessment, 12.57 points for rater 1 and 4.59 points for rater 2. CONCLUSION: The Brazilian-Portuguese language version of the Modified Fresno Test showed satisfactory results in terms of reproducibility. The Modified Fresno Test will allow physical therapy professionals and students to be evaluated on the use of understanding EBP. PMID:26786079
Silva, Anderson M; Costa, Lucíola C M; Comper, Maria L; Padula, Rosimeire S
The Modified Fresno Test was developed to assess knowledge and skills of both physical therapy (PT) professionals and students to use evidence-based practice (EBP). To translate the Modified Fresno Test into Brazilian-Portuguese and to evaluate the test's reproducibility. The first step consisted of adapting the instrument into the Brazilian-Portuguese language. Then, a total of 57 participants, including PT students, PT professors and PT practitioners, completed the translated instrument. The responses from the participants were used to evaluate reproducibility of the translated instrument. Internal consistency was calculated using the Cronbach's alpha. Reliability was calculated using the intraclass correlation coefficient (ICC) for continuous variables, and the Kappa coefficient (K) for categorical variables. The agreement was assessed using the standard error of the measurement (SEM). The cross-cultural adaptation process was appropriate, providing an adequate Brazilian-Portuguese version of the instrument. The internal consistency was good (α=0.769). The reliability for inter- and intra-rater assessment were ICC=0.89 (95% CI 0.82 to 0.93); for evaluator 1 was ICC=0.85 (95% CI 0.57 to 0.93); and for evaluator 2 was ICC=0.98 (95% CI 0.97 to 0.99). The SEM was 13.04 points for inter-rater assessment, 12.57 points for rater 1 and 4.59 points for rater 2. The Brazilian-Portuguese language version of the Modified Fresno Test showed satisfactory results in terms of reproducibility. The Modified Fresno Test will allow physical therapy professionals and students to be evaluated on the use of understanding EBP.
Anderson M. Silva
Full Text Available BACKGROUND: The Modified Fresno Test was developed to assess knowledge and skills of both physical therapy (PT professionals and students to use evidence-based practice (EBP. OBJECTIVES: To translate the Modified Fresno Test into Brazilian-Portuguese and to evaluate the test's reproducibility. METHOD: The first step consisted of adapting the instrument into the Brazilian-Portuguese language. Then, a total of 57 participants, including PT students, PT professors and PT practitioners, completed the translated instrument. The responses from the participants were used to evaluate reproducibility of the translated instrument. Internal consistency was calculated using the Cronbach's alpha. Reliability was calculated using the intraclass correlation coefficient (ICC for continuous variables, and the Kappa coefficient (K for categorical variables. The agreement was assessed using the standard error of the measurement (SEM. RESULTS: The cross-cultural adaptation process was appropriate, providing an adequate Brazilian-Portuguese version of the instrument. The internal consistency was good (α=0.769. The reliability for inter- and intra-rater assessment were ICC=0.89 (95% CI 0.82 to 0.93; for evaluator 1 was ICC=0.85 (95% CI 0.57 to 0.93; and for evaluator 2 was ICC=0.98 (95% CI 0.97 to 0.99. The SEM was 13.04 points for inter-rater assessment, 12.57 points for rater 1 and 4.59 points for rater 2. CONCLUSION: The Brazilian-Portuguese language version of the Modified Fresno Test showed satisfactory results in terms of reproducibility. The Modified Fresno Test will allow physical therapy professionals and students to be evaluated on the use of understanding EBP.
Oliveira, Kathleen De; North, Sara; Beck, Barbra; Hopp, Jane
As the United States health care model progresses towards medical teams and the country's population continues to diversify, the need for health professional education programs to develop and implement culturally specific interprofessional education (IPE) becomes increasingly imperative. A wide range of models exists for delivering and implementing IPE in health education, but none have included the cultural components that are vital in educating the health professional. A cross-cultural decentralized IPE model for physician assistant (PA) and physical therapy (PT) students was developed. This three-part IPE series was created using an established cultural curricular model and began with the exploration of self, continued with the examination of various dimensions of culture, and concluded with the exploration of the intersection between health and culture. We assessed student satisfaction of the IPE experiences and students' engagement and attitudes towards IPE using a three-item open-ended questionnaire administered after each cross-cultural activity and the Interprofessional Education Series Survey (IESS) upon the completion of the series. IESS responses showed that PA and PT students reported benefits in interprofessional collaboration and cultural awareness and expressed overall satisfaction with the series. Qualitative analysis revealed growth in student response depth consistent with the scaffolded focus of each IPE module in the series. The trends in this three-part series suggest that institutions looking to develop culturally inclusive IPE educational initiatives may have success through a decentralized model mirroring the effective cultural progression focused on addressing exploration of self, examination of various dimensions of culture, and exploration of the intersection between health and culture.
Bergh, Ingunn H; Bjelland, Mona; Grydeland, May; Lien, Nanna; Andersen, Lene F; Klepp, Knut-Inge; Anderssen, Sigmund A; Ommundsen, Yngvar
There is limited knowledge as to whether obesity prevention interventions are able to produce change in the determinants hypothesized to precede change in energy balance-related behaviors in young people. The aim of this study was to evaluate the effect of a multi-component intervention on a wide range of theoretically informed determinants of physical activity (PA) and sedentary behavior (SB). Moderation effects of gender, weight status and parental education level and whether the perceived intervention dose received influenced the effects were also explored. The HEIA study was a 20-month school-based, randomized controlled trial to promote healthy weight development. In total, 1418 11-year-olds participated at baseline and post-intervention assessment. Enjoyment, self-efficacy, perceived social support from parents, teachers and friends related to PA, perceived parental regulation of TV-viewing and computer/game-use and perceived social inclusion at schools were examined by covariance analyses to assess overall effects and moderation by gender, weight status and parental education, mid-way and post-intervention. Covariance analyses were also used to examine the role of intervention dose received on change in the determinants. At mid-way enjoyment (p = .03), perceived social support from teachers (p = .003) and self-efficacy (p = .05) were higher in the intervention group. Weight status moderated the effect on self-efficacy, with a positive effect observed among the normal weight only. At post-intervention results were sustained for social support from teachers (p = .001), while a negative effect was found for self-efficacy (p = .02). Weight status moderated the effect on enjoyment, with reduced enjoyment observed among the overweight. Moderation effects for parental education level were detected for perceived social support from parents and teachers. Finally, positive effects on several determinants were observed among those receiving a high
Bergh Ingunn H
Full Text Available Abstract Background There is limited knowledge as to whether obesity prevention interventions are able to produce change in the determinants hypothesized to precede change in energy balance-related behaviors in young people. The aim of this study was to evaluate the effect of a multi-component intervention on a wide range of theoretically informed determinants of physical activity (PA and sedentary behavior (SB. Moderation effects of gender, weight status and parental education level and whether the perceived intervention dose received influenced the effects were also explored. Methods The HEIA study was a 20-month school-based, randomized controlled trial to promote healthy weight development. In total, 1418 11-year-olds participated at baseline and post-intervention assessment. Enjoyment, self-efficacy, perceived social support from parents, teachers and friends related to PA, perceived parental regulation of TV-viewing and computer/game-use and perceived social inclusion at schools were examined by covariance analyses to assess overall effects and moderation by gender, weight status and parental education, mid-way and post-intervention. Covariance analyses were also used to examine the role of intervention dose received on change in the determinants. Results At mid-way enjoyment (p = .03, perceived social support from teachers (p = .003 and self-efficacy (p = .05 were higher in the intervention group. Weight status moderated the effect on self-efficacy, with a positive effect observed among the normal weight only. At post-intervention results were sustained for social support from teachers (p = .001, while a negative effect was found for self-efficacy (p = .02. Weight status moderated the effect on enjoyment, with reduced enjoyment observed among the overweight. Moderation effects for parental education level were detected for perceived social support from parents and teachers. Finally, positive effects on several
Soley, Georgia; Marshall, Renee; Chambliss, Catherine
Research has indicated that premature termination of therapy is sometimes due to a conflict in goal and outcome expectations between therapists and family members of clients. The present study requested both therapists and parents of child clients to complete questionnaires to determine if there is congruence between therapist and parental…
Full Text Available Objetivo. Conocer la orientación empática de los alumnos de la carrera de kinesiología de dos escuelas de la región metropolitana. Sujetos y métodos. Este trabajo corresponde a una investigación analítica de corte transversal realizada entre los meses de marzo y noviembre del año 2006. Participaron 274 alumnos de un universo de 351 correspondientes a los niveles I, III y V de la carrera de kinesiología de la Universidad de Chile y la Universidad Mayor. Se aplicó la escala de empatía médica de Jefferson (EEMJ. Para el análisis de los datos, se utilizó la prueba U no paramétrica de Wilcoxon-Mann-Whitney y la prueba no paramétrica de Kruskal-Wallis. Resultados. Se obtuvieron mayores puntuaciones en la EEMJ con significación estadística en el tercer y quinto nivel de la carrera con relación al primero (p Aim. To know the empathetic orientation of the physical therapist's students in two schools of the metropolitan region. Subjects and methods. This work is an analytical cross-sectional research, carried out between the months on March and November, 2006. 274 out of 351 students participated, who belonged to the levels I, III and V of the Universidad de Chile and Universidad Mayor Physical Therapy Programs. The Jefferson Scale of Physician Empathy (JSPE was applied. For data analysis, the non-parametrical Wilcoxon-Mann-Whitney test and the non-parametrical Kruskal-Wallis test were used. Results. Higher scores in the JSPE with statistical significance were obtained in the third and fifth level of the program compared with the first one (p < 0.05. No significant differences were found in the scores related to gender. Conclusions. There exists higher scores obtained in the JSPE in students who are in more advanced levels of the Physical Therapy Program, being this difference significant in both universities. The scores obtained in the JSPE do not have statistical significance in relation to the variable gender in both universities.
The results of the study confirmed the hypothesis that greater patient identification with the therapist, as defined by increased similarity between the patient's and therapist's semantic differential ratings, moderately correlated with more successful therapy outcome. (Author)
Brown, Cary A; Schell, Jennifer; Pashniak, Lisa M
Occupational therapists (OTs) work in all areas of health and wellbeing. The work is physically and psychologically demanding, but OTs are often not diligent about recognizing and attending to the workplace health and safety issue of fatigue in their own work settings. The purpose of this paper is to determine current issues and the evidence-base as presented in the literature so as to develop awareness and best practice interventions for fatigue reduction and management in occupational therapists' workplace. A comprehensive search strategy was carried out by the medical librarian on the study team and themes were extracted from the relevant literature by the study team. The literature revealed little research directly addressing occupational therapy workplace fatigue and we expanded our review of the evidence-base across all healthcare workers to identify publications of particular relevance to occupational therapists. This background paper is an important first step to raising awareness among OTs, guide key stakeholders regarding contributing factors to, and consequences of, OTs' workplace fatigue, and set research direction. Knowing which factors influencing workplace fatigue are shared across healthcare professionals and which are unique to OTs can also help organizations develop more tailored workplace fatigue risk reduction programs. This review concludes with a list of existing guidelines and tools for developing workplace fatigue risk assessment and management programs relevant to occupational therapists.
Chaney, Sita E.; Piercy, Fred P.
Developed Feminist Family Therapist Behavior Checklist to identify feminist family therapy skills. Used checklist to rate family therapy sessions of 60 therapists in variety of settings. Checklist discriminated between self-reported feminists and nonfeminists, between men and women, and between expert categorizations of feminist and nonfeminist…
Moyers, Theresa B; Miller, William R
One of the largest determinants of client outcomes is the counselor who provides treatment. Therapists often vary widely in effectiveness, even when delivering standardized manual-guided treatment. In particular, the therapeutic skill of accurate empathy originally described by Carl Rogers has been found to account for a meaningful proportion of variance in therapeutic alliance and in addiction treatment outcomes. High-empathy counselors appear to have higher success rates regardless of theoretical orientation. Low-empathy and confrontational counseling, in contrast, has been associated with higher drop-out and relapse rates, weaker therapeutic alliance, and less client change. The authors propose emphasis on empathic listening skills as an evidence-based practice in the hiring and training of counselors to improve outcomes and prevent harm in addiction treatment. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Do school-based interventions focusing on physical activity, fitness, or fundamental movement skill competency produce a sustained impact in these outcomes in children and adolescents? A systematic review of follow-up studies.
Lai, Samuel K; Costigan, Sarah A; Morgan, Philip J; Lubans, David R; Stodden, David F; Salmon, Jo; Barnett, Lisa M
The aim of this systematic review was to determine whether typically developing children and adolescents (aged 3-18 years) who have participated in school-based interventions have sustained outcomes in PA, fitness, and/or FMS. A systematic search of six electronic databases (CINAHL® Plus with Full Text, Ovid MEDLINE®, SPORTDiscus™, Scopus, PsycINFO® and ERIC) was conducted from 1995 to 26 July 2012. Included studies were school-based studies (including randomized controlled trials, longitudinal cohort, quasi-experimental, and experimental) that had a positive effect at post intervention in at least one variable and had a follow-up PA, fitness, or FMS assessment at least 6 months after the post-intervention assessment. Risk of bias assessment was guided by the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. The search identified 14 articles, and some studies addressed multiple outcomes: 13 articles assessed PA; three assessed fitness; and two assessed FMS. No study in this review met four key methodological criteria that have been shown to influence results, i.e., clarity on the randomization process, assessor blinding, analyzing participants in their original groups, and retaining sufficient participants through the entire study. Three-quarters (ten of 13) of the studies addressing PA, reported PA behavior change maintenance. The length of follow-up ranged from 6 months to 20 years, and the degree of PA difference reported was between 3 and 14 min per day. Only one of the three studies assessing fitness reported a sustained impact, whilst both studies that assessed FMS reported maintenance of effects. It is likely that PA is a sustainable outcome from interventions in children and adolescents, and there is reasonable evidence that interventions of longer than 1 year and interventions that utilize a theoretical model or framework are effective in producing this sustained impact. It would seem probable that FMS are a sustainable
Background Extracurricular school-based sports are considered to be an ideal means of reaching children who are not active in community sports. The purposes of this study were to examine the extent to which pupils not engaging in community sports do participate in extracurricular school-based sports, and to assess whether extracurricular school-based sports participants are more physically active and/or more autonomously motivated towards sports in daily life than children who do not participate in extracurricular school-based sports. Methods One thousand forty-nine children (53.7% boys; M age = 11.02 years, SD = 0.02) out of 60 classes from 30 Flemish elementary schools, with an extracurricular school-based sports offer, completed validated questionnaires to assess physical activity (Flemish Physical Activity Questionnaire) and motivation (Behavioral Regulations in Physical Education Questionnaire). Multilevel regression analyses were conducted to examine the data generated from these questionnaires. Results More than three quarters of the children (76%) reported participating in extracurricular school-based sports during the current school year and 73% reported engaging in organized community sports. Almost two third of the children (65%) not participating in community sports stated that they did participate in extracurricular school-based sports. Extracurricular school-based sports participants were significantly more physically active than children not participating in extracurricular school-based sports (β = 157.62, p sports participation × community sports participation) were found for autonomous motivation, with boys engaging in extracurricular school-based sports but not in community sports being significantly more autonomously motivated towards sports than boys not engaging in community or extracurricular school-based sports (β = 0.58, p = 0.003). Such differences were not noted among girls. Conclusions If extracurricular school-based sports are offered
Rens, Lezahn; Joosten, Annette
A collaborative approach with teachers is required when providing community-based occupational therapy to educationally at risk children. Collaborators share common goals and interact and support each other but challenges arise in providing collaborative occupational therapy in settings outside the school environment. The aim of this study was to capture experiences of teachers and occupational therapists working within a school-based occupational therapy program to determine if their experiences could inform collaborative practice. In this pilot study, participant responses to questionnaires (n = 32) about their experiences formed the basis for focus groups and individual interviews. Two focus group were conducted, one with teachers (n = 11) and one with occupational therapy participants (n = 6). Individual interviews were conducted with the supervising occupational therapist, school principal and two leading teachers. Descriptive statistics were used to analyse the data from closed questions, and thematic analysis using a constant comparison approach was used to analyse open ended questions, focus groups and interviews. Three main themes emerged: (i) the need for occupational therapists to spend time in the school, to explain their role, build relationships, understand classroom routines and the teacher role; (ii) occupational therapists need to not see themselves as the expert but develop equal partnerships to set collaborative goals and (iii) occupational therapists advocating for all parties to be informed throughout the occupational therapy process. The pilot study findings identified teacher and therapist experiences within the school setting that could inform improved collaborative practice with teachers and community-based occupational therapists and these findings warrant further investigation. © 2013 Occupational Therapy Australia.
Scaling-up an efficacious school-based physical activity intervention: Study protocol for the ?Internet-based Professional Learning to help teachers support Activity in Youth? (iPLAY) cluster randomized controlled trial and scale-up implementation evaluation
Lonsdale, Chris; Sanders, Taren; Cohen, Kristen E.; Parker, Philip; Noetel, Michael; Hartwig, Tim; Vasoncellos, Diego; Kirwan, Morwenna; Morgan, Philip; Salmon, Jo; Moodie, Marj; McKay, Heather; Bennie, Andrew; Plotnikoff, Ron; Cinelli, Renata L.
Abstract Background Despite the health benefits of regular physical activity, most children are insufficiently active. Schools are ideally placed to promote physical activity; however, many do not provide children with sufficient in-school activity or ensure they have the skills and motivation to be active beyond the school setting. The aim of this project is to modify, scale up and evaluate the effectiveness of an intervention previously shown to be efficacious in improving children’s physic...
Reed, S M
The interdisciplinary team approach to patient care provides an answer to the fragmentation and confusion patients feel when dealing with our complex healthcare system. Even though the team approach has been in use for the past two decades, implementation of a successful team is very difficult and rarely sustained over a significant period of time. This is especially true in general hospitals and in physical rehabilitation programs that spring from general hospitals where the physician and the nurse are the traditional care group. Occupational therapists, as they establish roles on interdisciplinary teams as staff members and team leaders, will require a knowledge of what makes a team function effectively. They can use this knowledge to evaluate the status of their own team and contribute to changes that will insure its long-term success. Six key issues should be addressed during the planning stage of any new healthcare team to insure its continued viability. These issues are: program philosophy, client focus, role clarification, collaboration and information sharing, policies and procedures, and staff supportiveness.
Yusoff, Fadhli; Saari, Riyanti; Naidu, Balkish M; Ahmad, Noor Ani; Omar, Azahadi; Aris, Tahir
The National School-Based Health Survey 2012 was a nationwide school health survey of students in Standard 4 to Form 5 (10-17 years of age), who were schooling in government schools in Malaysia during the period of data collection. The survey comprised 3 subsurveys: the Global School Health Survey (GSHS), the Mental Health Survey, and the National School-Based Nutrition Survey. The aim of the survey was to provide data on the health status of adolescents in Malaysia toward strengthening the adolescent health program in the country. The design of the survey was created to fulfill the requirements of the 3 subsurveys. A 2-stage stratified sampling method was adopted in the sampling. The methods for data collection were via questionnaire and physical examination. The National School-Based Health Survey 2012 adopted an appropriate methodology for a school-based survey to ensure valid and reliable findings. © 2014 APJPH.
Scutter, Sheila; Halkett, Georgia
An important factor in professional status is the ongoing development of the area as a result of research findings. However, involvement by radiation therapists in research, publication and higher degree study is limited. The aim of the current study was to investigate the attitudes of radiation therapists towards research, and to investigate the major factors contributing to their limited participation in research. To achieve this, an anonymous questionnaire was developed and distributed to radiation therapists working at the Royal Adelaide Hospital (RAH). The study found that radiation therapists at the RAH are interested in research but there are several factors that limit their involvement. These factors include limited knowledge about research processes, lack of support and lack of time to undertake research. Copyright (2003) Australian Institute of Radiography
... through tough times like: family problems school problems bullying health problems They help with feelings like: sadness anger ... Therapy for ADHD School Counselors Finding Low-Cost Mental Health Care Going to a Therapist Why Do People ...
Nomden, Jettie G.; Slagers, Anton J.; Bergman, Geert; Winters, Jan C.; Kropmans, Thomas J. B.; Dijkstra, Pieter U.
The object of this study was to assess interobserver reliability in 23 tests concerning physical examination of the shoulder girdle. A physical therapist and a physical therapist/manual therapist independently performed a physical examination of the shoulder girdle in 91 patients with shoulder
Tong, Siu Yin Annie; Adamson, Bob
The value of student voices in dialogues about learning improvement is acknowledged in the literature. This paper examines how the views of students regarding School-based Assessment (SBA), a significant shift in examination policy and practice in secondary schools in Hong Kong, have largely been ignored. The study captures student voices through…
Bryan, Hazel; Burstow, Bob
The notion of the "teacher as researcher" has been in the education lexicon since the mid-1970s. School-based research, we suggest, is currently enjoying something of a renaissance, flourishing within the emerging, complex school landscape. This empirical research engages with 25 school leaders to explore the ways in which…
Clark, Mary Kristen; Flynn, Perry
Purpose: We reflect on Alan Kamhi's (2011) prologue on balancing certainty and uncertainty as it pertains to school-based practice. Method: In schools, rational thinking depends on effective team processes, much like professional learning communities. We consider the conditions that are required for rational thinking and how rational team dialogue…
George, Patricia, Ed.; Potter, Eugenia Cooper, Ed.
School-based management (SBM), sometimes called site-based management, is fast becoming the hottest restructuring item in the arsenal of reformers, teachers' unions, governors, and legislators who want to change the traditional ways in which schools and school districts do business. This document comprises three main sections with contributions…
Information and Communication technology and school based assessment (SBA) is practice that broadens the form mode, means and scope of assessment in the school using modern technologies in order to facilitate and enhance learning. This study sought to ascertain the efficacy of Information and Communication ...
Brassard, Marla R.; Fiorvanti, Christina M.
Child abuse is a leading cause of emotional, behavioral, and health problems across the lifespan. It is also preventable. School-based abuse prevention programs for early childhood and elementary school children have been found to be effective in increasing student knowledge and protective behaviors. The purpose of this article is to help school…
Characteristics of art therapists in rehabilitative therapy Objectives: This study examines the sociodemographic, qualification- and activity-related characteristics of art therapists working in the field of rehabilitation. In 2013, an analysis of occupational groups was carried out in Germany, with the objective of describing the art therapists working there.A total of 2,303 complete datasets were submitted. From this group, those therapists mainly working in the field of rehabilitation/follow-up care/participation of disabled persons (according to Social Security Code VI and IX, n = 302) were selected and described. Most art therapists are female (average age 45 years) and largelywork part-time. Music and art therapy are the most common venues.More than 80% have a graduate degree. Methods of quality management are used.More than half of the therapists working in rehabilitation hospitals are employed in the field of psychosomatic medicine. Both individual and group therapy (each patient attending 1-2 times a week) are common. The results provide an overview of art therapy in the field of rehabilitation and show the spread in rehabilitation. Further research is indicated.
Sebire, Simon J; Edwards, Mark J; Campbell, Rona; Jago, Russell; Kipping, Ruth; Banfield, Kathryn; Kadir, Bryar; Garfield, Kirsty; Lyons, Ronan A; Blair, Peter S; Hollingworth, William
Physical activity levels are low amongst adolescent girls, and this population faces specific barriers to being active. Peer influences on health behaviours are important in adolescence, and peer-led interventions might hold promise to change behaviour. This paper describes the protocol for a feasibility cluster randomised controlled trial of Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led intervention aimed at increasing adolescent girls' physical activity levels. In addition, this paper describes an update that has been made to the protocol for the PLAN-A feasibility cluster randomised controlled trial. A two-arm cluster randomised feasibility trial will be conducted in six secondary schools (intervention n = 4; control n = 2) with year 8 (12-13 years old) girls. The intervention will operate at a year group level and consist of year 8 girls nominating influential peers within their year group to become peer supporters. Approximately 15% of the cohort will receive 3 days of training about physical activity and interpersonal communication skills. Peer supporters will then informally diffuse messages about physical activity amongst their friends for 10 weeks. Data will be collected at baseline (time 0 (T0)), immediately after the intervention (time 1 (T1)) and 12 months after baseline measures (time 2 (T2)). In this feasibility trial, the primary interest is in the recruitment of schools and participants (both year 8 girls and peer supporters), delivery and receipt of the intervention, data provision rates and identifying the cost categories for future economic analysis. Physical activity will be assessed using 7-day accelerometry, with the likely primary outcome in a fully powered trial being daily minutes of moderate-to-vigorous physical activity. Participants will also complete psychosocial questionnaires at each time point: assessing motivation, self-esteem and peer physical activity norms. Data analysis will be
Danielson, Anton; Thorsson, Ola; Karlsson, Magnus K; Wollmer, Per; Andersen, Lars B; Dencker, Magnus
We assessed whether baseline measurements of physical activity, aerobic fitness, body fat and abdominal fat were predictors of changes in body fat measurements over a two-year period. The study comprised of 204 children aged 9.8 ± 0.6 years with a normal body mass distribution, who recruited from four schools in middle-class areas of Malmö, Sweden, from 2001 to 2004. Peak oxygen uptake and physical activity were measured at baseline. Body fat was measured by dual-energy X-ray absorptiometry at baseline and two years later. Physical activity, aerobic fitness and total body fat or abdominal fat were predictors of change in total body fat or abdominal fat over a period of two years. Changes in the percentage of body fat were not related to any of the baseline measurements. Our two-year follow-up of children with a mean age of 9.8 years at baseline showed that physical activity, aerobic fitness and body fat or abdominal fat predicted changes in total body fat or abdominal fat, but not the percentage of body fat. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Szeto, Grace P Y; Cheng, Andy S K; Lee, Edwin W C; Schonstein, Eva; Gross, Douglas P
This is a discussion paper to examine the issues surrounding management of work-related injuries by physiotherapists and occupational therapists in Hong Kong. Therapists working in public hospitals are faced with managing injured workers with limited resources and this frequently results in suboptimal outcomes. In this paper, five experienced therapists critically reviewed the current practices in the physiotherapy and occupational therapy professions in Hong Kong, with regard to managing patients with work injuries. In many hospitals, therapists still practice with a disease-based model focusing on symptom relief and restoration of general physical function. We collated information about current programs initiated by physiotherapists and occupational therapists to provide more strategic intervention strategies for early screening of high-risk patients and adaptive biopsychosocial interventions targeting return-to-work outcomes. Clinical and system-level barriers and facilitators of a major paradigm shift towards work disability prevention are discussed. Physiotherapists and occupational therapists need to develop more strategic collaborations and actively voice out the need for major systematic changes within the local healthcare system, in order to provide a more effective management approach in line with the concept of Work Disability Prevention.
Music therapists in palliative and cancer care settings often use singing and vocal interventions. Although benefits for these interventions are emerging, more information is needed on what type of singing interventions are being used by credentialed music therapists, and what goal areas are being addressed. To assess music therapists' perceptions on how they use singing and vocal interventions in palliative and cancer care environments. Eighty credentialed music therapists from Canada and the United States participated in this two-part convergent mixed-methods study that began with an online survey, followed by individual interviews with 50% (n = 40) of the survey participants. In both palliative and cancer care, singing client-preferred music and singing for relaxation were the most frequently used interventions. In palliative care, the most commonly addressed goals were to increase self-expression, improve mood, and create a feeling of togetherness between individuals receiving palliative care and their family. In cancer care, the most commonly addressed goals were to support breathing, improve mood, and support reminiscence. Seven themes emerged from therapist interviews: containing the space, connection, soothing, identity, freeing the voice within, letting go, and honoring. Music therapists use singing to address the physical, emotional, social, and spiritual goals of patients, and described singing interventions as accessible and effective. Further research is recommended to examine intervention efficacy and identify factors responsible that contribute to clinical benefit. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: email@example.com
Full Text Available Somatology therapists have a demanding occupation, both physically and emotionally. Long working hours coupled with handling clients on a daily basis, notwithstanding the strain of ensuring high quality client care, are all aspects that place pressure on the therapist. These aspects, in the backdrop of a lack of self-management of a therapist, could result in impaired judgement and substandard performance in the workplace. The purpose of this study included exploring and describing the experiences of private somatology therapists in self-management, from which recommendations for improved self-management within private somatology practices were described. For the purpose of this study, self-management was defined as a method of managing not only the interaction with clients and work stressors, but also the feelings of the therapists, by practising a variety of techniques such as self-discipline. A descriptive, exploratory and contextual qualitative design was followed. The accessible population consisted of therapists (n = 15 practising at six private somatology facilities in the Pretoria North region. Purposeful sampling was followed. Ten individual unstructured interviews as well as a pilot study were conducted in which field notes were taken. Open-coding data analysis identified four themes with subthemes. Lincoln and Guba’s model was used to ensure trustworthiness and ethical considerations were followed throughout the process. Informed consent was granted by the private somatology practices and the therapists. One of the themes indicated that self-management strategies should be displayed, in order to gain a sense of control. The study identified that there is a definite need to nurture the therapist within this demanding working environment which we call the somatology practice.
Gumpel, T P; Meadan, H
An important first step in understanding school-based violence is understanding children's subjective perceptions of the phenomena. Understanding these perceptions is likely to be a major factor in determining the integrity of both prevalence and intervention studies. We investigated how elementary and secondary aged children perceived school-based violence. A sample of 979 children from a nested random sample of elementary (grades 3-6) and middle school (grades 7-8) classrooms in Jerusalem participated in this study. To understand children's perception of school violence, we used an instrument composed of 19 dichotomous items, each presenting a one-line description of a behaviour, which the respondent would define as either 'intentionally harmful' or not. Eighth graders were significantly less likely to label the behaviours described as violent compared to all other grades; and seventh graders were less likely as compared to third, fourth and fifth graders; also, some between-gender differences were found. The respondents often view the behaviours described as intentional and aggressive; this finding should serve as an impetus to widen the scope of school-based violence interventions to include these behaviours, especially for younger children.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration School-Based... Gadsden County. SUMMARY: HRSA will be transferring a School-Based Health Center Capital (SBHCC) Program... support the expansion of services at school-based health centers will continue. SUPPLEMENTARY INFORMATION...
Investigação dos métodos avaliativos utilizados por fisioterapeutas na especificidade da neurologia funcional Investigación de los métodos de evaluación utilizados por fisioterapeutas en la especificidad de la neurología funcional Investigation of the evaluative methods used by physical therapists in the specificity of the functional neurology
Juliana dos Santos Llano
ínicas de la ciudad de Campo Grande/MS. Los datos fueron analizados por medio de estadística descriptiva e inferencial (test χ², sobre un nivel de significancia de 5% (pNeurofunctional clinical evaluation represents one of the most important activities of physical therapists. However, differences in diagnostic methods cause discrepancies between physical therapy prescription and prognosis. Thus, the aim of this study was to analyze and discuss the evaluation methods and techniques used by physical therapists bound to popular healthcare assistance, in the specificity of the neurofunctional area. To accomplish this research, a cross-sectional design study was conducted. The sample consisted of physical therapists specialized in neurofunctional rehabilitation registered in the Regional Council for Physical Therapy and Occupational Therapy of Mato Grosso do Sul (Conselho Regional de Fisioterapia e Terapia Ocupacional, CREFITO - 13, who work in hospitals, universities and clinics of the city of Campo Grande, Brazil. Data were analyzed using descriptive and inferential (χ² statistics, under a 5% level of significance (p<0.05. Regarding the results, all physical therapists had concluded graduation five years before. Responses regarding the physical examination were similar between professors and clinical physical therapists (p=0.81, which did not happen on the anamnesis (p=0.02. Items such as cognitive functions and social determinants of health were answered by less than 15% of subjects, and about 70% of respondents said they do, but do not register, the patients' evaluation. In conclusion, there is not a standardization of the physiotherapeutic neurofunctional evaluation, making it difficult to unify the prescriptive and prognostic analysis of clinical cases. The responses indicate a dependence of professional vision in the disease aspect, with little appreciation of health social issues.
Shaw, Dorothy R
Many studies have investigated the impact of pediatric Cognitive Rehabilitation Therapy (CRT) upon intellectual functioning after traumatic brain injury; however, relatively few have identified efficacious treatment in a school setting. The purpose is to present a variety of CRT strategies that would be useful to a teacher or therapist working with students who are learning disabled or who have who have had a traumatic brain injury (TBI). This article investigates the particular challenges in learning which result from impaired cognition, and suggests techniques for improving memory and executive functioning. Students who are learning disabled or who have TBI face social and emotional issues that impact their learning. Special therapeutic interventions are necessary to assist with orienting to their setting, integrating with peers, and coping with distressing emotions. Students with TBI can adapt and flourish in a school based setting provided that therapies and learned strategies are targeted to their specific needs.
Keng, Shian-Ling; Waddington, Emma; Lin, Xiangting Bernice; Tan, Michelle Su Qing; Henn-Haase, Clare; Kanter, Jonathan W
Functional Analytic Psychotherapy (FAP) is a behavioral psychotherapy intervention that emphasizes the development of an intimate and intense therapeutic relationship as the vehicle of therapeutic change. Recently, research has provided preliminary support for a FAP therapist training (FAPTT) protocol in enhancing FAP competency. The present study aimed to expand on this research by examining the effects of FAPTT on FAP-specific skills and competencies and a set of broadly desirable therapist qualities (labelled awareness, courage and love in FAPTT) in a sample of therapist trainees in Singapore. The study also evaluated the feasibility and acceptability of FAP in the Singaporean context. Twenty-five students enrolled in a master's in clinical psychology program were recruited and randomly assigned to receive either eight weekly sessions of a FAPTT course or to a waitlist condition. All participants completed measures assessing empathy, compassionate love, trait mindfulness, authenticity and FAP-specific skills and competencies pre- and post-training, and at 2-month follow-up. A post-course evaluation was administered to obtain participants' qualitative feedback. Results indicated that compared with the waitlisted group, FAPTT participants reported significant increases in overall empathy, FAP skill and treatment acceptability from pre- to post-training. Improvements were observed on several outcome variables at 2-month follow-up. Participants reported finding the training to be both feasible and acceptable, although several raised issues related to the compatibility of the treatment with the local cultural context. Overall, the findings suggest that FAPTT is effective for improving specific FAP competencies and selected broadly desirable therapist qualities among therapist trainees. Copyright © 2016 John Wiley & Sons, Ltd. Functional Analytic Therapy (FAP) therapist training protocol was effective in improving empathy and FAP skills among Singaporean therapist
Exposição ocupacional de fisioterapeutas aos campos elétrico e magnético e a eficácia das gaiolas de Faraday Occupational exposure of physical therapists to electric and magnetic fields and the efficacy of Faraday cages
Iracimara de Anchieta Messias
Full Text Available OBJETIVO: Medir a exposição de fisioterapeutas aos campos elétrico e magnético produzidos por 17 equipamentos de diatermia de ondas curtas (DOC de clínicas de fisioterapia da cidade de Presidente Prudente, São Paulo, Brasil. Comparar os valores medidos com os níveis de exposição recomendados pelo ICNIRP (International Commission on Non-Ionizing Radiation Protection. Observar a eficácia das gaiolas de Faraday como medida de proteção à exposição dos fisioterapeutas aos campos elétrico e magnético oscilantes. MÉTODOS: As medidas dos campos elétrico e magnético foram realizadas durante sessões reais de tratamento fisioterápico, em quatro pontos: nas proximidades da pelve e da cabeça do operador, dos cabos elétricos dos aparelhos e dos eletrodos de aplicação. O equipamento de medição utilizado foi o EMR-200 da Wandell & Goltermann. RESULTADOS: Os valores obtidos nas proximidades dos eletrodos e cabos estavam de 10 a 30 vezes acima dos níveis de referência ocupacionais recomendados pela ICNIRP. Nas salas de tratamento com DOC com gaiola de Faraday, os campos encontrados foram ainda mais altos que os das salas sem esse revestimento, principalmente o campo magnético, com valores superiores a 100 vezes o limite de exposição da ICNIRP. CONCLUSÕES: As intensidades dos campos elétrico e magnético obtidas neste trabalho estão, de modo geral, acima dos níveis de exposição recomendados pelas normas da ICNIRP. Além disso observou-se que a gaiola de Faraday não fornece proteção aos fisioterapeutas mas aumenta os níveis de exposição aos quais estão submetidos estes profissionais.OBJECTIVE: Measure physical therapists' exposure to the electric and magnetic fields produced by 17 shortwave diathermy devices in physical therapy clinics in the city of Presidente Prudente, São Paulo State, Brazil. Compare the observed values with the exposure levels recommended by the International Commission on Non-ionizing Radiation
Morgan, Emily H.; Houser, Robert F.; Au, Lauren E.; Sacheck, Jennifer M.
School-based body mass index (BMI) notification programs are often used to raise parental awareness of childhood overweight and obesity, but how BMI results are associated with physical fitness and diet is less clear. This study examined the relationship between BMI, fitness, and diet quality in a diverse sample of urban schoolchildren…
Lakes, Kimberley D.; Hoyt, William T.
The impact of school-based Tae Kwon Do training on self-regulatory abilities was examined. A self-regulation framework including three domains (cognitive, affective, and physical) was presented. Children (N = 207) from kindergarten through Grade 5 were randomly assigned by homeroom class to either the intervention (martial arts) group or a…
Brown, Kelly J.; Block, Audrey J.
Evaluated a school-based program that served female adolescents with histories of physical, sexual, or emotional abuse. Found that participation produced healthier beliefs and attitudes about alcohol and other drug use and reduced initiation of tobacco and marijuana use. Findings support enrolling younger girls before they develop negative…
Asmundsd ttir, ELIN EBBA; Kaplan, SUSAN
The purpose of this study was to assess the readiness of occupational therapists in Iceland to accept a professional as opposed to a technical view of the profession. Most Icelandic occupational therapists were educated in other countries, with little emphasis on liberal arts, sciences and research. The first Icelandic occupational therapy programme, a university-level programme, was founded in 1997. All Icelandic occupational therapists were surveyed. Eighty-seven questionnaires were sent out and 80 (92%) were returned and used for statistical analysis. The results of the study showed that Icelandic occupational therapists valued academic skills over technical skills, emphasizing occupational therapy theory unique to the profession and research to validate practice. More recognition among other health professionals was considered the most needed change in the profession. The results of the study showed that the clinicians' attitudes confirmed in general what is emphasized in the curriculum and in students' fieldwork. Further research is needed to explore whether the Icelandic occupational therapy profession succeeds in promoting research and recognition by other health professions.
Anderson, Gail, Ed.; Hill, Marcia, Ed.
One of the murkier areas of feminist therapy ethics involves decisions about children and adolescents within mental health settings. Some of those ethical dilemmas are covered in this text, which provides a feminist focus on the mental health rights and needs of children. The book addresses specific practices intended to help therapists organize…
Korelitz, Ann; Schulder, Diane
Discusses a pilot study in which joint consultations with a family therapist and a matrimonial attorney were offered to 10 couples and one woman contemplating divorce. Videotaped sessions. Suggests joint consultations can be useful in helping couples understand the psychological and legal implications of conflicts expressed during separation.…
Martini, Janie L.
It can be concluded from the results of the two studies described here that value similarity between client and therapist is related to therapists' ratings of client improvement. This phenomenon can be expected in therapies irrespective of theoretical orientation. (Author)
Zuroff, David C; McBride, Carolina; Ravitz, Paula; Koestner, Richard; Moskowitz, D S; Bagby, R Michael
Differences between therapists in the average outcomes their patients achieve are well documented, and researchers have begun to try to explain such differences (Baldwin & Imel, 2013). Guided by Self-Determination Theory (Deci & Ryan, 2000), we examined the effects on outcome of differences between therapists in their patients' average levels of autonomous and controlled motivation for treatment, as well as the effects of differences among the patients within each therapist's caseload. Between and within-therapist differences in the SDT construct of perceived relational support were explored as predictors of patients' motivation. Nineteen therapists treated 63 patients in an outpatient clinic providing manualized interpersonal therapy (IPT) for depression. Patients completed the BDI-II at pretreatment, posttreatment, and each treatment session. The Impact Message Inventory was administered at the third session and scored for perceived therapist friendliness, a core element of relational support. We created between-therapists (therapist-level) scores by averaging over the patients in each therapist's caseload; within-therapist (patient-level) scores were computed by centering within each therapist's caseload. As expected, better outcome was predicted by higher levels of therapist-level and patient-level autonomous motivation and by lower levels of therapist-level and patient-level controlled motivation. In turn, autonomous motivation was predicted by therapist-level and patient-level relational support (friendliness). Controlled motivation was predicted solely by patient self-critical perfectionism. The results extend past work by demonstrating that both between-therapists and within-therapist differences in motivation predict outcome. As well, the results suggest that therapists should monitor their interpersonal impact so as to provide relational support. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Putnam, Cynthia; Cheng, Jinghui; Seymour, Gregory
Brain injuries (BIs) are a major public health issue. Clinical experience and literature have identified that it is often challenging to motivate people who have had a BI to engage in repetitive exercises commonly prescribed for rehabilitation. As a result, some therapists include commercial active videogames (AVGs) in their therapy sessions to help make repetitive actions fun and engaging. In this project, we explored how the therapists used commercial AVGs to better understand the major barriers and enablers of use. We interviewed 17 therapists from two rehabilitation hospitals who work with people who have had a BI. After the interviews were transcribed, we identified salient themes. At the time of the interviews, therapists were using only the Nintendo(®) (Kyoto, Japan) Wii™ console. Common therapeutic goals included balance and weight shifting. Several patient factors, such as cognitive and physical abilities, age, and previous gaming experience, were considered important considerations when deciding to use games. Therapists also indicated many desired changes to games, including better control/interface, better feedback, and the ability to adjust timing, challenge, and stimulation levels. When considering therapy-centered game design, the needs of both therapists and patients should be considered. There is a necessary balance to consider in game design: They need to (a) be perceived as fun, (b) meet therapy goals, and (c) address therapists' needs (e.g., adjustability to address a range of patient abilities). Additionally, there is a need for a wide variety of available games to address novelty and personal preferences.
Dirkse, Dale; Hadjistavropoulos, Heather D; Hesser, Hugo; Barak, Azy
Therapist-assisted Internet-delivered cognitive behavior therapy (ICBT) involves elements of expressive writing through secure messaging with a therapist. Expressive writing has been associated with psychological and physical health benefits in past research; furthermore, certain linguistic dimensions in expressive writing have been identified as particularly beneficial to health, such as less frequent use of negative emotion words and greater use of positive emotion words. No research, to date, has analyzed linguistic dimensions in client communication over the course of therapist-assisted ICBT for individuals with symptoms of generalized anxiety. This naturalistic study examined messages sent to therapists during the course of ICBT using linguistic analysis, and explored covariation of word use with symptom improvement. Data were obtained from patients with symptoms of generalized anxiety (N = 59) who completed 12 modules of therapist-assisted ICBT and rated symptoms of anxiety, depression, and panic at the beginning of each module. Linguistic analysis categorized text submitted to therapists into different word categories. Results found that patients' use of negative emotion, anxiety, causation, and insight words reduced over the course of treatment, while past tense words increased. Furthermore, negative emotion words significantly covaried with symptom ratings over the course of treatment. While causal statements cannot be made, findings improve our understanding of patient communication in ICBT and suggest that the further study of linguistic dimensions as psychological indicators and the potential utility of expressive writing strategies in therapist-assisted ICBT may be worthwhile.
Drury, Darrel W.
This report critiques the movement to decentralize decision making in public education. It provides an indepth examination of school-based management (SBM) with the aim of revealing why this type of reform seems to have had so little payoff for students. It addresses several key questions: What are the objectives of SBM, and are these objectives…
Pérez Solís, D; Díaz Martín, J J; Álvarez Caro, F; Suárez Tomás, I; Suárez Menéndez, E; Riaño Galán, I
Intervention for childhood obesity is a public health priority. The purpose of this study was to evaluate the effectiveness of an elementary school-based intervention against obesity in children. Non-randomised controlled trial was conducted on children from first to fifth grade from two public schools of Avilés (Spain). The intervention lasted for 2 school years comprising healthy diet workshops, educational chats, educational meetings, informative written material, and promotion of physical activities. Primary outcome measure was body mass index z-score. Secondary outcomes included: obesity and overweight prevalence, waist circumference, dietary habits, and physical activity. A total of 382 (177 girls, 205 boys) out of 526 pupils of both schools were included in the study. Complete anthropometric data were obtained in 340 of the 382 individuals. Compared to children in control group, those in intervention group decreased body mass index z-score from 1.14 to 1.02 (P=.017), and improved KIDMED score from 7.33 to 7.71 points (P=.045). The percentage of students who carried on an optimal diet increased from 42.6% to 52.3% (P=.021). There were no statistical differences in the prevalence of obesity and overweight, or in waist circumference between the intervention and control groups. This school-based program resulted in modest beneficial changes in body mass index and diet quality. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.
Berger, Lauren K.; Zane, Nolan; Hwang, Wei-Chin
This study examined the relationship between therapist characteristics, therapeutic orientations, person-level and agency-level practices with cultural competency among 221 Los Angeles County community mental health clinicians. Results from an online survey indicated that compared to White therapists, ethnic minority therapists were more personally involved in communities of color, more likely to use a cultural framework in clinical practice, and perceived their agencies to be more culturally sensitive. Ethnic minority therapists also reported greater multicultural (MC) awareness and better MC counseling relationships with their clients than White therapists. Personal involvement in communities of color accounted for ethnic differences in MC awareness and MC counseling relationships. Compared to therapists with a strictly non-behavioral (psychodynamic or humanistic) orientation, therapists with an eclectic (or integrative) therapy orientation reported having a higher level of community knowledge. Therapists with an eclectic orientation reported greater MC awareness than therapists with a non-behavioral orientation, while both eclectic and behavioral (cognitive behavioral or behavior modification) therapists recounted better MC counseling relationships with their clients than therapists with a non-behavioral orientation. Community knowledge mediated eclectic vs. non-behavioral therapeutic orientation differences in MC awareness. Agency resources/linkages and outreach both moderated the relationship between therapeutic orientation and MC skills. Results suggest that if therapists become more personally involved with diverse populations, they will feel more culturally aware and feel like they have a better relationship with ethnic minority clients. PMID:25580187
This paper describes a qualitative study involving in-depth interviews with women who identify themselves as feminist family therapists. It includes a summary of the themes identified in these three questions: How did you become a feminist family therapist? How do you DO feminist family therapy? What does it mean to be a feminist family therapist?…
Reid, Denise; Naseer, Zahid
An online survey was conducted with 72 Canadian occupational therapists to (1) explore if and how occupational therapists were aware of "arising moments" in clinical practice, which are moments that give rise to emotions, sensations, and thoughts, and (2) to examine therapists' responses to questions related to mindfulness. Participants described arising moments through an open-ended survey question. Framework analysis was used to develop key themes and subthemes. A modified Philadelphia Mindfulness Awareness (PHLMS) subscale with two additional survey questions "understanding of living in the moment and being present, and awareness of mindfulness" (sum = PAM) were used as indicators of mindfulness. There were significant differences in the means of PHLMS mindfulness among therapists working in diverse practice areas (F = 3.63, p = .009). Posthoc analysis revealed that therapists working in mental health had higher mean PHLMS-mindfulness scores than in all other groups. There were no significant differences in PAM mindfulness among the practice areas (ANOVA, F = 2.15, p = .08). However, posthoc tests showed that the participants in the mental health practice area had a significant difference with one group, general physical health. Findings have implications for practice in occupational therapy and education about mindfulness in occupational therapy.
Impact of school-based vegetable garden and physical activity coordinated health interventions on weight status and weight-related behaviors of ethnically diverse, low-income students: Study design and baseline data of the Texas, Grow! Eat! Go! (TGEG cluster-randomized controlled trial
Full Text Available Abstract Background Coordinated, multi-component school-based interventions can improve health behaviors in children, as well as parents, and impact the weight status of students. By leveraging a unique collaboration between Texas AgriLife Extension (a federal, state and county funded educational outreach organization and the University of Texas School of Public Health, the Texas Grow! Eat! Go! Study (TGEG modeled the effectiveness of utilizing existing programs and volunteer infrastructure to disseminate an enhanced Coordinated School Health program. The five-year TGEG study was developed to assess the independent and combined impact of gardening, nutrition and physical activity intervention(s on the prevalence of healthy eating, physical activity and weight status among low-income elementary students. The purpose of this paper is to report on study design, baseline characteristics, intervention approaches, data collection and baseline data. Methods The study design for the TGEG study consisted of a factorial group randomized controlled trial (RCT in which 28 schools were randomly assigned to one of 4 treatment groups: (1 Coordinated Approach to Child Health (CATCH only (Comparison, (2 CATCH plus school garden intervention [Learn, Grow, Eat & Go! (LGEG], (3 CATCH plus physical activity intervention [Walk Across Texas (WAT], and (4 CATCH plus LGEG plus WAT (Combined. The outcome variables include student’s weight status, vegetable and sugar sweetened beverage consumption, physical activity, and sedentary behavior. Parents were assessed for home environmental variables including availability of certain foods, social support of student health behaviors, parent engagement and behavior modeling. Results Descriptive data are presented for students (n = 1369 and parents (n = 1206 at baseline. The sample consisted primarily of Hispanic and African American (53 % and 18 %, respectively and low-income (i.e., 78 % eligible for Free and
World Federation of Occupational Therapists
Full Text Available The purpose of this document is to state the World Federation of Occupational Therapists’ (WFOT position on the use of telehealth for the delivery of occupational therapy services. Telehealth is the use of information and communication technologies (ICT to deliver health-related services when the provider and client are in different physical locations. Additional terms used to describe this service delivery model include: tele-occupational therapy, telerehabilitation, teletherapy, telecare, telemedicine, and telepractice, among other terms. Telehealth may be used by occupational therapy practitioners for evaluation, intervention, monitoring, supervision, and consultation (between remote therapist, client, and/or local health-care provider as permitted by jurisdictional, institutional, and professional regulations and policies governing the practice of occupational therapy.Occupational therapy services via telehealth should be appropriate to the individuals, groups and cultures served,and contextualized to the occupations and interests of clients. Important considerations related to licensure/registration, collaboration with local occupational therapists, client selection, consent to treat, professional liability insurance, confidentiality, personal and cultural attributes, provider competence/standards of care, reimbursement/payer guidelines, and authentic occupational therapy practice are discussed.
Aug 13, 2012 ... the most suitable items with which to create a scale for each construct. .... the parents of these children were unable to afford luxury foods, and therefore ... hours in girls and boys and an increase in the consumption of fruit and ...
Mulholland, Susan; Derdall, Michele
Recruitment issues in occupational therapy have been a long-standing concern for the profession. This descriptive study explored the strategies currently being used by employers to recruit occupational therapists for employment purposes. An 18-item survey was mailed to 251 sites where occupational therapists work in Alberta and Saskatchewan. There was a 64% response rate and data from 130 surveys were analyzed. The results indicate that employers continue to rely on a wide variety of strategies for advertising and recruiting, the most prevalent being word of mouth, postings at universities, and providing student fieldwork placements. In turn, the most effective recruitment strategies were listed as word of mouth, advertising in the general media, and providing student fieldwork placements. Various examples of financial incentives offered by employers were also listed. Many participants identified recent changes in recruitment strategies such as making a move towards web site job postings. PRACTICE IMPLICATIONS. The results suggest strategies for employers to target for recruiting occupational therapists and illustrate to both employers and students the importance of fieldwork in recruitment and hiring.
As an older woman therapist, I find that my life experience grounds me in my work with people of all ages and backgrounds as they deal with life crises, aging issues, and loss. People with whom I work in therapy appreciate the fact that I am older and have had varied life experiences. Gender issues are still central to my work with clients whether I am working with a man or a woman. I am an integrative therapist, with a background in cognitive-behavioral therapy and gestalt therapy. Therapists need to help clients to identify less with their aging bodies and our culture's view of attractiveness, shifting instead to a paradigm that values life experience and the cultivation of wisdom. We need to find ways of embracing what we have learned about life instead of extolling youthful values. As I get older, I more fully appreciate a constructivism framework and life-cycle perspective, focusing on making sense of clients' life narratives. Storytelling and memoirs have both provided a framework for working with clients on coping with the many changes and challenges of life that bring them to therapy and added another layer to my integrative therapeutic work. © 2015 Wiley Periodicals, Inc.
Noronha, Sandhya; Anderson, Deborah; Lee, Michelle M; Krumdick, Nathaniel D; Irwin, Kent E; Burton-Hess, Judith; Ciancio, Mae; Wallingford, Minetta; Workman, Gloria M
Interprofessional collaboration for healthcare requires a better understanding of the commonalities and differences in student perceptions of professionalism. 217 students in five programs (PA 71, PT 46, OT 29, CP 12, and BMS 59) completed a 22-item survey (response rate 79.5%). A Likert scale grading from 1 (hardly ever) to 5 (always) was used to assess professional attitudes and behaviors. A mixed-model MANOVA, supplemented with post-hoc analyses, showed significant group by time interactions for 5 items. Sensitivity to differences and diversity of other people increased for BMS students, but decreased for PT students. Timeliness increased for BMS students, but did not change for PA students. Seeking out new learning experiences increased for BMS students, but did not change for PA or PT students. Taking a group leadership role increased for BMS students, decreased for PT students, while PA and OT students showed no change. Volunteering time to serve others decreased for OT and PA students, while BMS and BM students showed no change. It is plausible that these findings emerge from differences in program curricula and specific training objectives. The findings provide initial insight to educators on ways that attitudes and behaviors pertaining to professionalism sometimes vary among students in different health science programs.
Distribution of physical therapists working on public and private establishments in different levels of complexity of health care in Brazil Distribuição de fisioterapeutas entre estabelecimentos públicos e privados nos diferentes níveis de complexidade de atenção à saúde
Larissa R. Costa
Full Text Available BACKGROUND: The Brazilian Health System is organized on a regional and hierarchical form with three levels of complexity of health care. The Primary Care represents the first element of a continuing health care process, complemented by specialized actions. However, the centrality of the specialized care is still a problem in Brazil, especially in the private sector. Studies on the distribution of professionals in the health system allowing the formulation of appropriate policies are needed. OBJECTIVES: To investigate the distribution of physical therapists in the levels of complexity of health care and between public and private establishments, according to data from the National Register of Health Service Providers (NRHSP. METHOD: A descriptive cross-sectional study was performed considering NRHSP-national bank data collected in March 2010 and demographic census 2010 data. Data were analyzed through descriptive statistics techniques. RESULTS: We identified 53,181 registries of physical therapists, 60% linked to the private sector. Only 13% of all entries were linked to primary care. The predominance in specialized care occurred in the public sector (65% and private sector (100%. The specialized establishments of private sector linked to the southeast region (16,043 were the main sites of physical therapists. Only the public sector in the south had a majority in the Primary Care. When considering the sizes of the cities, there is focus on specialist care in bigger cities. CONCLUSIONS: This study identified the concentration of physical therapists in the specialized care, mostly in metropolis and big cities and in the private sector, with restricted to participation in the primary care.CONTEXTUALIZAÇÃO: O Sistema Único de Saúde (SUS é organizado de forma regionalizada e hierarquizada, apresentando três níveis de complexidade de atenção à saúde. A atenção primária à saúde (APS representa o primeiro elemento de um continuado
Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott
The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to
Guthrie, James W.
Recommends the implementation of school-based management systems as one way to meet government demands for educational reform. Describes the functions of principals, school advisory councils, school-site budgeting and accounting, and annual planning and performance reports in successful school-based management systems. Presents examples of…
... to achieve its statutory roles, objectives and aspirations. We suggest that the adoption of School-based management by way of increasing the principals' sphere of influence would facilitate effective service delivery in schools. Keywords: school-based management, principals' effectiveness, public secondary schools.
The study examined community participation in the School-Based Management Committees (SBMC), the challenges hindering participation, and strategies for fostering efficacy of the School Based Management Committee. The number 340 schools were selected from the population of 2543 public primary schools in ...
Neal, Richard G.
This book examines school-based management and provides strategies to implement management changes. The 14 chapters examine the components of good schools, including clarity of purpose, leadership, professionalism, lack of bureaucratic control, competition, and choice. The text describes the components of school-based management and the need for…
Martin, Michael J.; Henry, Anna
The purpose of this study was to develop a substantive theory for community development by school-based agriculture programs through grounded theory methodology. Data for the study included in-depth interviews and field observations from three school-based agriculture programs in three non-metropolitan counties across a Midwestern state. The…
School-based data and management of technological innovations in public secondary schools in Cross River State. ... Global Journal of Educational Research ... Result indicated that: there is no significant positive relationship between school-based data and principals management of technological innovation.
Bucey, Janet C.; Provident, Ingrid M.
This article evaluates a peer mentoring experience for school-based practitioners and its effect on collaborative consultation practices. Best practice and public school policy promote the use of collaborative consultation services but school-based practitioners report significant barriers in achieving effective collaborative consultation…
Viney, L L
When clients come to psychotherapy they are distressed, this distress usually being expressed in the form of anxiety, hostility, depression and helplessness. This study explored the sequences of emotional distress expressed by clients and acknowledged by therapists, and examined their associations with other factors. The transcripts of five therapists (two single sessions each) were content-analysed: they used personal construct, client centered, rational-emotive, Gestalt and transactional analysis therapy. Log-linear analyses of appropriate contingency table cell frequencies were conducted to test associations between identified sequences and the two variables of therapist and timing of completion of the sequence. Therapist-client sequences of Anxiety-Anxiety, Anxiety-Hostility and Helplessness-Hostility were found to be associated more with the personal construct and client centred therapists than with the rational-emotive therapist. Client-therapist sequences of Anxiety-Anxiety, Helplessness-Anxiety and Helplessness-Helplessness were more often found with the client centred therapist than the other therapists. For most of these sequences timing had an effect, yet timing rarely interacted with the therapist variable. The findings are discussed in terms of their relevance to the theoretical positions represented, the shortcomings of the research and the value of this methodology in studies linking therapy process with outcome.
From the beginning of clinical psychoanalysis, analysts have been at risk of succumbing to yearnings for intimacy and contact that are stirred up by the heat of the analytic encounter. Recently, as theoretical developments have encouraged us to create moments of meeting (Stern et al. 1998) and have urged us to tolerate the feelings stimulated by enactments, these risks have increased. The author points out that foregoing the realization of this yearning within the analytic relationship and the resultant mourning for the loss of a fantasy or illusion carries a heavy personal price tag for the therapist. © 2013 The Psychoanalytic Quarterly, Inc.
Kallstrom, Thomas J; Myers, Timothy R
The role of the respiratory therapist (RT) is expanding with the growing acceptance and use of the disease-management paradigm for managing chronic diseases. RTs are key members of the asthma disease-management team, in acute-care settings, patients' homes, out-patient clinics, emergency departments, and in the community. Utilizing RTs as disease managers allows patients to be treated faster and more appropriately, discharged to home sooner, and decreases hospital admissions. RT are leaders in the emerging field of asthma disease management.
Kinzie, J D
In the treatment of severe posttraumatic stress disorder (PTSD), much emphasis is put on techniques, especially behavioral therapies. Such techniques negate the importance of the therapist as an individual in the treatment of complex PTSD as presented in severely traumatized refugees. The specific difficulties encountered by this population and the therapist responses are discussed: the need to tell the trauma story and the therapist's ability to listen; the patient's need for constancy and therapist's ability to stay; the patient's need to give and the therapist's ability to receive; the patient's problem with evil and the therapist's ability to believe. Case examples illustrate the approach and then discuss how generalizable this experience is to other populations. Research implications are suggested.
King, Gillian; Wright, Virginia; Russell, Dianne J
Despite widespread educational and promotional efforts, paediatric rehabilitation therapists still do not systematically or routinely use outcome measures. A review of contextual and psychosocial factors affecting therapists' use of outcome measures was performed, incorporating information from past studies of barriers to therapists' use of measures and more recent information about measure use, knowledge brokering and expert practice. This cumulative and contextual overview provided insights into how many therapists may approach practice. Therapists' beliefs in the importance of establishing effective relationships may lead them to place less value on formal measurement, to adopt a less rigorous and more pragmatic approach to ascertaining whether outcomes are achieved, and to avoid measures that may show little improvement. A relational goal-oriented approach to practice is proposed in which therapists adopt a broader facilitative and educational role with families about the importance of the measurement process.
Oosterhoff, Marije; Bosma, Hans; van Schayck, Onno C P; Joore, Manuela A
A uniform approach for costing school-based lifestyle interventions is currently lacking. The objective of this study was to develop a template for costing primary school-based lifestyle interventions and apply this to the costing of the "Healthy Primary School of the Future" (HPSF) and the "Physical Activity School" (PAS), which aim to improve physical activity and dietary behaviors. Cost-effectiveness studies were reviewed to identify the cost items. Societal costs were reflected by summing up the education, household and leisure, labor and social security, and health perspectives. Cost inputs for HPSF and PAS were obtained for the first year after implementation. In a scenario analysis, the costs were explored for a hypothetical steady state. From a societal perspective, the per child costs were €2.7/$3.3 (HPSF) and €- 0.3/$- 0.4 (PAS) per day during the first year after implementation, and €1.0/$1.2 and €- 1.3/$- 1.6 in a steady state, respectively (2016 prices). The highest costs were incurred by the education perspective (first year: €8.7/$10.6 (HPSF) and €4.0/$4.9 (PAS); steady state: €6.1/$7.4 (HPSF) and €2.1/$2.6 (PAS)), whereas most of the cost offsets were received by the household and leisure perspective (first year: €- 6.0/$- 7.3 (HPSF) and €- 4.4/$- 5.4 (PAS); steady state: €- 5.0/$- 6.1 (HPSF) and €- 3.4/$- 4.1 (PAS)). The template proved helpful for costing HPSF and PAS from various stakeholder perspectives. The costs for the education sector were fully (PAS) and almost fully (HPSF) compensated by the savings within the household sector. Whether the additional costs of HPSF over PAS represent value for money will depend on their relative effectiveness.
Full Text Available School-age children are important drivers of annual influenza epidemics yet influenza vaccination coverage of this population is low despite universal publicly funded influenza vaccination in Alberta, Canada. Immunizing children at school may potentially increase vaccine uptake. As parents are a key stakeholder group for such a program, it is important to consider their concerns.We explored parents' perspectives on the acceptability of adding an annual influenza immunization to the immunization program that is currently delivered in Alberta schools, and obtained suggestions for structuring such a program.Forty-eight parents of children aged 5-18 years participated in 9 focus groups. Participants lived in urban areas of the Alberta Health Services Calgary Zone.Three major themes emerged: Advantages of school-based influenza vaccination (SBIV, Disadvantages of SBIV, and Implications for program design & delivery. Advantages were perceived to occur for different populations: children (e.g. emotional support, families (e.g. convenience, the community (e.g. benefits for school and multicultural communities, the health sector (e.g. reductions in costs due to burden of illness and to society at large (e.g. indirect conduit of information about health services, building structure for pandemic preparedness, building healthy lifestyles. Disadvantages, however, might also occur for children (e.g. older children less likely to be immunized, families (e.g. communication challenges, perceived loss of parental control over information, choices and decisions and the education sector (loss of instructional time. Nine second-level themes emerged within the major theme of Implications for program design & delivery: program goals/objectives, consent process, stakeholder consultation, age-appropriate program, education, communication, logistics, immunizing agent, and clinic process.Parents perceived advantages and disadvantages to delivering annual seasonal
Beidas, Rinad S; Edmunds, Julie M; Cannuscio, Carolyn C; Gallagher, Mark; Downey, Margaret Mary; Kendall, Philip C
Consultation is an effective implementation strategy to improve uptake of evidence-based practices for youth. However, little is known about what makes consultation effective. The present study used qualitative methods to explore therapists perspectives about consultation. We interviewed 50 therapists who had been trained 2 years prior in cognitive-behavioral therapy for child anxiety. Three themes emerged regarding effective elements of consultation: (1) connectedness with other therapists and the consultant, (2) authentic interactions around actual cases, and (3) the responsiveness of the consultant to the needs of individual therapists. Recommendations for the design of future consultation endeavors are offered.
Morris, Matthew C.; Kouros, Chrystyna D.; Janecek, Kim; Freeman, Rachel; Mielock, Alyssa; Garber, Judy
Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Last program compared to a waitlist control condition. Knowledge gains from pre- to post-interv...
Myers, David; Hayes, Jeffrey A
Therapist decisions about self-disclosure depend theoretically upon both content and context, such as the quality of the therapeutic relationship. In this analogue study, 224 undergraduates viewed 1 of 3 videos for which the working alliance was described as positive or negative and in which a therapist made general self-disclosures, countertransference disclosures, or no disclosures. Interaction effects indicated that participants rated sessions as deeper and the therapist as more expert when the therapist made general disclosures compared to no disclosures, but only when the alliance was positive. When the alliance was negative, participants perceived sessions as shallower and the therapist as less expert when the therapist made either general or countertransference disclosures compared to no disclosures. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Adler, Jonathan M
This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice. © 2012 Wiley Periodicals, Inc.
Thomas, Roger E; McLellan, Julie; Perera, Rafael
Helping young people to avoid starting smoking is a widely endorsed public health goal, and schools provide a route to communicate with nearly all young people. School-based interventions have been delivered for close to 40 years. The primary aim of this review was to determine whether school smoking interventions prevent youth from starting smoking. Our secondary objective was to determine which interventions were most effective. This included evaluating the effects of theoretical approaches; additional booster sessions; programme deliverers; gender effects; and multifocal interventions versus those focused solely on smoking. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Tobacco Addiction Group's Specialised Register, MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, Health Star, and Dissertation Abstracts for terms relating to school-based smoking cessation programmes. In addition, we screened the bibliographies of articles and ran individual MEDLINE searches for 133 authors who had undertaken randomised controlled trials in this area. The most recent searches were conducted in October 2012. We selected randomised controlled trials (RCTs) where students, classes, schools, or school districts were randomised to intervention arm(s) versus a control group, and followed for at least six months. Participants had to be youth (aged 5 to 18). Interventions could be any curricula used in a school setting to deter tobacco use, and outcome measures could be never smoking, frequency of smoking, number of cigarettes smoked, or smoking indices. Two reviewers independently assessed studies for inclusion, extracted data and assessed risk of bias. Based on the type of outcome, we placed studies into three groups for analysis: Pure Prevention cohorts (Group 1), Change in Smoking Behaviour over time (Group 2) and Point Prevalence of Smoking (Group 3). One hundred and thirty-four studies involving 428,293 participants met the inclusion criteria. Some
Molete, M P; Chola, L; Hofman, K J
The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand (Wits) has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale. In 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters. The total economic costs were R813.701 (US$76,048). The cost of screening and treatment per patient were R331 (US$31) and R743 (US$69) respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %. Expanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.
Physical Therapy & FSHD Facioscapulohumeral Muscular Dystrophy A Guide for Patients & Physical Therapists Authors: Wendy M. King, P.T., Assistant ... Shree Pandya, P.T., M.S., Assistant Professor, Neurology & Physical Medicine and Rehabilitation A publication of the FSH ...
Brown, Lily A; Craske, Michelle G; Glenn, Daniel E; Stein, Murray B; Sullivan, Greer; Sherbourne, Cathy; Bystritsky, Alexander; Welch, Stacy S; Campbell-Sills, Laura; Lang, Ariel; Roy-Byrne, Peter; Rose, Raphael D
This study explores the relationships between therapist variables (cognitive behavioral therapy [CBT] competence, and CBT adherence) and clinical outcomes of computer-assisted CBT for anxiety disorders delivered by novice therapists in a primary care setting. Participants were recruited for a randomized controlled trial of evidence-based treatment, including computer-assisted CBT, versus treatment as usual. Therapists (anxiety clinical specialists; ACSs) were nonexpert clinicians, many of whom had no prior experience in delivering psychotherapy (and in particular, very little experience with CBT). Trained raters reviewed randomly selected treatment sessions from 176 participants and rated therapists on measures of CBT competence and CBT adherence. Patients were assessed at baseline and at 6-, 12-, and 18-month follow-ups on measures of anxiety, depression, and functioning, and an average Reliable Change Index was calculated as a composite measure of outcome. CBT competence and CBT adherence were entered as predictors of outcome, after controlling for baseline covariates. Higher CBT competence was associated with better clinical outcomes whereas CBT adherence was not. Also, CBT competence was inversely correlated with years of clinical experience and trended (not significantly, though) down as the study progressed. CBT adherence was inversely correlated with therapist tenure in the study. Therapist competence was related to improved clinical outcomes when CBT for anxiety disorders was delivered by novice clinicians with technology assistance. The results highlight the value of the initial training for novice therapists as well as booster training to limit declines in therapist adherence. © 2012 Wiley Periodicals, Inc.
Smith, A.J.M.; Kleijn, W.C.; Hutschemaekers, G.J.M.
This article describes a qualitative study of 63 difficult therapeutic situations described by 26 therapists. The study was part of research on specific reactions of therapists to traumatized clients. The research questions for the current analyses focused on the categorization of difficult
Andolfi, Maurizio; Angelo, Claudio
Compares the therapist's function to that of a theatrical director who revises a play, the family drama, which the actors continue to recite according to an old script with a foregone conclusion. To achieve his goal, the therapist uses certain contextual elements to construct an alternative 'reading' of events. (Author)
Curtin, Catherine A.
Little research in the existing literature attempts to define feminist therapy by incorporating the specific experiences and philosophies of those who describe themselves as feminist therapists. Even less information is available about the perceptions of their clients. Therapists and their clients answered questions about the theoretical…
Informed consent was granted by the private somatology practices and the therapists. One of the themes indicated that self-management strategies should be displayed, in order to gain a sense of control. The study identified that there is a definite need to nurture the therapist within this demanding working environment ...
Art therapists increasingly are turning to educational and presentation technology to expand awareness of their field and to inform others in mental health care. This trend supports inquiry into how art therapists interact with and emotionally respond to the demands of technology. This paper presents a qualitative study that used 3 art-based focus…
School-based human papillomavirus vaccination: An opportunity to increase knowledge about cervical cancer and improve uptake of ... Poor knowledge about cervical cancer plays a role in limiting screening uptake. HPV ... Article Metrics.
Resources available for school based mental health services in Enugu urban and head teachers' knowledge of childhood mental health problems. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) ...
Blair, Heather A.; Stanford, Kathy
Details about a two-year ethnographic case study research in middle school boys to understand school literacy are presented. The study revealed that boys resist many school-based practices by transforming the assigned literacy work.
Regner, M; Sabatowski, R
Medical Devices Law is a relatively new legal system, which has replaced the Medical Devices Regulations still well-known in Germany. German Medical Devices Law is based on European directives, which are, in turn, incorporated into national law by the Medical Devices Act. The Medical Devices Act is a framework law and covers a number of regulations that address specific topics within Medical Devices Law. In turn, in individual regulations, reference is made to guidelines, recommendations, etc. from other sources that provide detailed technical information on specific topics. Medical Devices Law is a very complex legal system, which needs to be permanently observed due to constant updating and adjustment. In the current article, the design and the structure of the system will be described, but special emphasis will be laid on important problem areas that need to be considered when applying and operating medical products, in this case by pain therapists in particular.
Wallén, Eva Flygare; Müllersdorf, Maria; Christensson, Kyllike; Marcus, Claude
This study evaluates a multifactorial school-based intervention with the aim of decreasing cardiometabolic risk factors by means of a healthy lifestyle, primarily with daily physical activity and healthy food during school hours, at an upper secondary school for students with intellectual disabilities. The outcome is measured in terms of…
Process evaluations of large-scale school based programs are necessary to aid in the interpretation of the outcome data. The Louisiana Health (LA Health) study is a multi-component childhood obesity prevention study for middle school children. The Physical Education (PEQ), Intervention (IQ), and F...
De La Rue, Lisa; Polanin, Joshua R.; Espelage, Dorothy L.; Pigott, Terri D.
The incidence of violence in dating relationships has a significant impact on young people, including decreased mental and physical health. This review is the first to provide a quantitative synthesis of empirical evaluations of school-based programs implemented in middle and high schools that sought to prevent or reduce incidents of dating…
Thomas, R; Perera, R
Smoking rates in adolescents are rising in some countries. Helping young people to avoid starting smoking is a widely endorsed goal of public health, but there is uncertainty about how to do this. Schools provide a route for communicating with a large proportion of young people, and school-based programmes for smoking prevention have been widely developed and evaluated. To review all randomized controlled trials of behavioural interventions in schools to prevent children (aged 5 to12) and adolescents (aged 13 to18) starting smoking. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Tobacco Addiction Group's Specialized Register, MEDLINE, EMBASE, PsyclNFO, ERIC, CINAHL, Health Star, Dissertation Abstracts and studies identified in the bibliographies of articles. Individual MEDLINE searches were made for 133 authors who had undertaken randomized controlled trials in this area. Types of studies: those in which individual students, classes, schools, or school districts were randomized to the intervention or control groups and followed for at least six months. Children (aged 5 to12) or adolescents (aged 13 to18) in school settings. Types of interventions: Classroom programmes or curricula, including those with associated family and community interventions, intended to deter use of tobacco. We included programmes or curricula that provided information, those that used social influences approaches, those that taught generic social competence, and those that included interventions beyond the school into the community. We included programmes with a drug or alcohol focus if outcomes for tobacco use were reported. Types of outcome measures: Prevalence of non-smoking at follow up among those not smoking at baseline. We did not require biochemical validation of self-reported tobacco use for study inclusion. We assessed whether identified citations were randomized controlled trials. We assessed the quality of design and execution, and
Colli, Antonello; Tanzilli, Annalisa; Dimaggio, Giancarlo; Lingiardi, Vittorio
The aim of this study was to examine the relationship between therapists' emotional responses and patients' personality disorders and level of psychological functioning. A random national sample of psychiatrists and clinical psychologists (N=203) completed the Therapist Response Questionnaire to identify patterns of therapists' emotional response, and the Shedler-Westen Assessment Procedure-200 to assess personality disorders and level of psychological functioning in a randomly selected patient currently in their care and with whom they had worked for a minimum of eight sessions and a maximum of 6 months (one session per week). There were several significant relationships between therapists' responses and patients' personality pathology. Paranoid and antisocial personality disorders were associated with criticized/mistreated countertransference, and borderline personality disorder was related to helpless/inadequate, overwhelmed/disorganized, and special/overinvolved countertransference. Disengaged countertransference was associated with schizotypal and narcissistic personality disorders and negatively associated with dependent and histrionic personality disorders. Schizoid personality disorder was associated with helpless/inadequate responses. Positive countertransference was associated with avoidant personality disorder, which was also related to both parental/protective and special/overinvolved therapist responses. Obsessive-compulsive personality disorder was negatively associated with special/overinvolved therapist responses. In general, therapists' responses were characterized by stronger negative feelings when working with lower-functioning patients. Patients' specific personality pathologies are associated with consistent emotional responses, which suggests that clinicians can make diagnostic and therapeutic use of their responses to patients.
Liedberg, Gunilla M; Björk, Mathilda; Hensing, Gunnel
Women and men are shaped over the courses of their lives by culture, society and human interaction according to the gender system. Cultural influences on individuals' social roles and environment are described in occupational therapy literature, but not specifically from a gender perspective. The purpose of this qualitative study was to explore how a sample of occupational therapists perceives the 'gender' concept. Four focus group interviews with 17 occupational therapists were conducted. The opening question was: 'How do you reflect on the encounter with a client depending on whether it is a man or a woman?' The transcribed interviews were analysed and two main themes emerged: 'the concept of gender is tacit in occupational therapy' and 'client encounters'. The occupational therapists expressed limited theoretical knowledge of 'gender'. Furthermore, the occupational therapists seemed to be 'doing gender' in their encounters with the clients. For example, in their assessment of the client, they focussed their questions on different spheres: with female clients, on the household and family; with male clients, on their paid work. This study demonstrated that occupational therapists were unaware of the possibility that they were 'doing gender' in their encounters with clients. There is a need to increase occupational therapists' awareness of their own behaviour of 'doing gender'. Furthermore, there is a need to investigate whether gendered perceptions will shorten or lengthen a rehabilitation period and affect the chosen interventions, and in the end, the outcome for the clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.
Pepping, Christopher A; Lyons, Anthony; Morris, Eric M J
Lesbian, gay, bisexual, and transgender (LGBT) people seek psychotherapy at high rates, and the importance of providing culturally appropriate and LGBT-affirmative psychotherapy has been widely acknowledged. Despite this, remarkably little research has investigated the effects of therapist training in LGBT-affirmative psychotherapy. Here we examined the effectiveness of a training protocol for LGBT-affirmative psychotherapy with 96 mental health professionals, ranging in therapeutic experience from LGBT clients following the training. Therapists also displayed reductions in homo-negativity and trans-negativity. Therapists' characteristics did not influence the extent to which they benefited from training. Specifically, years of clinical experience, therapist religiosity, and therapist psychological flexibility were unrelated to changes in attitudes, knowledge, and skills. The results of this study clearly suggest that providing training in LGBT-affirmative psychotherapy can enhance therapists' attitudes, knowledge, and skills. Of particular importance is that the benefits associated with such training appear to hold regardless of therapists' characteristics. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Burckell, Lisa A; Goldfried, Marvin R
Psychotherapy research concerning lesbian, gay, and bisexual (LGB) individuals has focused on matching clients on gender and sexual orientation, yet has not considered how factors such as therapeutic skill, presenting problem, and cohort membership may influence preference for therapists. This study was designed to identify those therapist qualities that sexual-minority individuals prefer and to determine how the presenting problem influences therapist choice. Forty-two nonheterosexual adults between 18 and 29 years old ranked 63 therapist characteristics from "Extremely Uncharacteristic" to "Extremely Characteristic" when seeking treatment for a problem in which their sexual orientation was salient and one in which it was not. The analyses of both conditions yielded clusters of items reflecting therapist characteristics that participants considered unfavorable, neutral, beneficial, and essential. Participants valued therapists who had LGB-specific knowledge as well as general therapeutic skills, whereas they indicated that they would avoid therapists who held heterocentric views. Application of these findings to clinical practice and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Ahmed, Ameena T; Oshiro, Caryn E; Loharuka, Sheila; Novotny, Rachel
Childhood obesity prevention is a national priority. School-based gardening has been proposed as an innovative obesity prevention intervention. Little is known about the perceptions of educators about school-based gardening for child health. As the success of a school-based intervention depends on the support of educators, we investigated perceptions of educators about the benefits of gardening programs to child health. Semi-structured interviews of 9 middle school educators at a school with a garden program in rural Hawai'i were conducted. Data were analyzed using a grounded theory approach. Perceived benefits of school-based gardening included improving children's diet, engaging children in physical activity, creating a link to local tradition, mitigating hunger, and improving social skills. Poverty was cited as a barrier to adoption of healthy eating habits. Opinions about obesity were contradictory; obesity was considered both a health risk, as well as a cultural standard of beauty and strength. Few respondents framed benefits of gardening in terms of health. In order to be effective at obesity prevention, school-based gardening programs in Hawai'i should be framed as improving diet, addressing hunger, and teaching local tradition. Explicit messages about obesity prevention are likely to alienate the population, as these are in conflict with local standards of beauty. Health researchers and advocates need to further inform educators regarding the potential connections between gardening and health.
Oshiro, Caryn E; Loharuka, Sheila; Novotny, Rachel
Background Childhood obesity prevention is a national priority. School-based gardening has been proposed as an innovative obesity prevention intervention. Little is known about the perceptions of educators about school-based gardening for child health. As the success of a school-based intervention depends on the support of educators, we investigated perceptions of educators about the benefits of gardening programs to child health. Methods Semi-structured interviews of 9 middle school educators at a school with a garden program in rural Hawai‘i were conducted. Data were analyzed using a grounded theory approach. Results Perceived benefits of school-based gardening included improving children's diet, engaging children in physical activity, creating a link to local tradition, mitigating hunger, and improving social skills. Poverty was cited as a barrier to adoption of healthy eating habits. Opinions about obesity were contradictory; obesity was considered both a health risk, as well as a cultural standard of beauty and strength. Few respondents framed benefits of gardening in terms of health. Conclusions In order to be effective at obesity prevention, school-based gardening programs in Hawai‘i should be framed as improving diet, addressing hunger, and teaching local tradition. Explicit messages about obesity prevention are likely to alienate the population, as these are in conflict with local standards of beauty. Health researchers and advocates need to further inform educators regarding the potential connections between gardening and health. PMID:21886287
Li, Linda C; Maetzel, Andreas; Davis, Aileen M; Lineker, Sydney C; Bombardier, Claire; Coyte, Peter C
To estimate the incremental cost-effectiveness (ICE) of services from a primary therapist compared with traditional physical therapists and/or occupational therapists for managing rheumatoid arthritis (RA), from the societal perspective. Patients with RA were randomly assigned to the primary therapist model (PTM) or traditional treatment model (TTM) for approximately 6 weeks of rehabilitation treatment. Health outcomes were expressed in terms of quality-adjusted life years (QALYs), measured with the EuroQol instrument at baseline, 6 weeks, and 6 months. Direct and indirect costs, including visits to health professionals, use of investigative tests, hospital visits, use of medications, purchases of adaptive aids, and productivity losses incurred by patients and their caregivers, were collected monthly. Of 144 consenting patients, 111 remained in the study after the baseline assessment: 63 PTM (87.3% women, mean age 54.2 years, disease duration 10.6 years) and 48 TTM (79.2% women, mean age 56.8 years, disease duration 13.2 years). From a societal perspective, PTM generated higher QALYs (mean +/- SD 0.068 +/- 0.22) and resulted in a higher mean cost ($6,848 Canadian, interquartile range [IQR] $1,984-$9,320) compared with TTM (mean +/- SD QALY -0.017 +/- 0.24; mean costs $6,266, IQR $1,938-$10,194) in 6 months, although differences were not statistically significant. The estimated ICE ratio was $13,700 per QALY gained (95% nonparametric confidence interval -$73,500, $230,000). The PTM has potential to be an alternative to traditional physical/occupational therapy, although it is premature to recommend widespread use of this model in other regions. Further research should focus on strategies to reduce costs of the model and assess the long-term economic consequences in managing RA and other rheumatologic conditions.
Benson, Jeryl D.; Elkin, Kathleen; Wechsler, Julie; Byrd, Lindsey
This study aims to explore the perceptions of parents of children receiving occupational therapy in educational settings, understand the importance of the parent/occupational therapist relationship and its impact on the outcomes of therapy. In addition, this study aims to reveal best practices when providing services within the school system in…
Bennett-Levy, James; Finlay-Jones, Amy
Prior to 2000, personal practice (PP) for therapists mostly meant personal therapy. Recently a new landscape of PPs has emerged, with meditation-based programs and therapy self-practice/self-reflection (SP/SR) programs playing an increasing role in training and personal/professional development. The challenge now for practitioners and researchers is to refocus on the role of PPs in training and professional development. Are PPs of value - or not? Do they have a role in therapist development? How might PPs enhance therapist skilfulness? Do different PPs act in similar or different ways? Currently, the PP literature lacks a theoretical framework to guide practitioners in their choice of PPs or researchers in their choice of research questions and measures. The purpose of this article is to provide such a framework, the Personal Practice (PP) model. The PP model proposes primary impacts of PPs in four domains: personal development/wellbeing, self-awareness, interpersonal beliefs/attitudes/skills and reflective skills. The model also suggests a secondary impact on therapists' conceptual/technical skills when therapists use reflection to consider the implications of their PP for their "therapist self". We offer some suggestions to enhance the quality of future research, and conclude that PPs may play an important and perhaps unique role in therapist training.
Al Aloola, Noha Abdullah; Nissen, Lisa; Alewairdhi, Huda Abdullaziz; Al Faryan, Nawaf; Saini, Bandana
This study sought to investigate parents' needs and preferences for school-based asthma support in Saudi Arabian primary schools. Semi-structured qualitative interviews were conducted in the period between November 2015 and February 2016, with a convenience sample that comprised Saudi parents and carers of children with asthma. Recruitment of participants was primarily driven through Saudi primary schools; passive snowballing and social networks were used to boost participation rates further. Interviews were audio-recorded, transcribed verbatim, translated and data were thematically organised using a latent content analysis approach. Twenty interviews were conducted. Six themes emerged from the interviews and were grouped into three major categories: (1) general asthma management issues; (2) school-based asthma management issues; and (3) communication dissatisfaction. Participants expressed concern at schools' social and physical environments and a lack of confidence in the ability of schools to manage their child's asthma, especially when their child was ill. Most of the participants advocated for staff training and school community engagement to improve the management of asthma in Saudi primary schools. This research clearly describes a need for school-based asthma support, including asthma-related policies, procedures and education on asthma and first aid in Saudi primary schools.
Dowd, E T; Hingst, A G
The theory of neurolinguistic programming predicts that a therapist's matching of a client's primary representational system, as expressed in the client's predicates, should result in increased therapist's rapport and social influence. This hypothesis was tested in an actual interview situation. Six relatively inexperienced therapists, two each in predicate matching, predicate mismatching, and predicate no-matching conditions, conducted a 30-min. interview with nine undergraduate student volunteers each, for a total of 54 subjects. After the appropriate interview condition was completed, subjects rated ther therapists on the Counselor Rating Form and the Counseling Evaluation Inventory. No significant differences among the three conditions on any of the measures were found. Results are compared with those of previous research on assessment and primary representational matching in analogue situations.
Brooks, Shavaughn Ashley Nikita
Occupational Therapists working with patients with Guillain-Barre Syndrome (GBS) are tasked with collaborating with the patient to achieve maximal functional recovery. Although much has been published about recovery after GBS from a scientific perspective; this article combines occupational therapy principles with the personal experiences of an occupational therapist who herself suffered from GBS. This commentary outlines important considerations for providing intervention to patients with GB...
Bolderston, Amanda; Lewis, Donna; Chai, Martin J.
Aims: This study explores radiation therapists' understanding and interpretations of the concept of caring within their profession. Background: Health professions' concepts of care have been explored in disciplines such as nursing and medicine. However, there has been little previous attempt to describe what caring means to radiation therapists. Methods: A qualitative phenomenological approach was used and 27 radiation therapists were interviewed in four focus groups. Discussions were transcribed and analysis was performed to identify themes from the data. Results: Three overarching themes emerged from the data: human connection established between radiation therapists and patients, technical care as the use of technology and procedures in treatment planning and delivery, and the therapist's unique identity as compared to other professions. Conclusions: The concept of care was seen by radiation therapists primarily as a supportive relationship with the patient but they were unable to agree if the technical aspects and procedures were considered a part of caring. Further research is needed to further examine the connection between technology and care.
Anaby, Dana; Law, Mary; Teplicky, Rachel; Turner, Laura
The environment plays a key role in supporting children's participation and can serve as a focus of intervention. This study aimed to elicit the perceptions and experiences of occupational therapists who had applied the PREP approach--Pathways and Resources for Engagement and Participation. PREP is a novel 12-week intervention for youth with physical disabilities, aimed at improving participation in leisure community-based activities by modifying aspects of the environment. Using a qualitative post-intervention only design, 12 therapists took part in individual semi-structured interviews, in which the therapists reflected on their experience using PREP to enable participation. A thematic analysis was conducted. Four themes emerged from the data; two of which were informative in nature, describing elements of the PREP intervention that target multi-layered composition of the environment and use strategies that involve leveraging resources and problem solving. The two remaining themes were reflective in nature, illustrating a new take on the Occupational Therapy role and re-positioning the concept of participation in therapy practices. Results emphasize aspects of the environment that can serve as effective targets of intervention, guided by the PREP approach. Findings can broaden the scope and focus of occupational therapy practice by redefining views on participation and the environment.
Play therapists are increasingly being employed in schools, yet there is confusion among many health, education and social care practitioners about the role of play therapists. This paper explains how play therapists position themselves and what they do through an examination of the therapeutic relationship between the therapist and child. It…
Jordan, Lorien S; Seponski, Desiree M
A crucial and overlooked facet of social justice in family therapy is political and policy advocacy. Family therapists have unique insight into how social policies and political discourse shapes clients' lives and the life of our profession. Such knowledge can inform policymakers and political debate, yet few family therapists are trained to engage in political action. In this randomized, national survey of licensed family therapists' (N = 174), we explore beliefs about and barriers to engagement in political and policy processes. The findings suggest that there are significant barriers and uncertainties surrounding family therapists' engagement, including time, feelings of efficacy, and interest. Given these barriers we discuss practical suggestions for clinicians and family therapy training programs. © 2017 American Association for Marriage and Family Therapy.
David A. Wolfe
Full Text Available This paper presents a school-based primary prevention program (The Fourth R to prevent adolescent dating violence, and related risk behaviors. The cornerstone of The Fourth R is a 21-lesson skillbased curriculum delivered by teachers who receive specialized training, that promotes healthy relationships, and targets violence, high-risk sexual behavior, and substance use among adolescents. The Fourth R was evaluated in a cluster randomized trial in 20 schools. Results indicated that teaching youth healthy relationships and skills as part of their curriculum reduced physical dating violence, and increased condom use 2.5 years later.
Yeh, Yun-Jy; Hayes, Jeffrey A
Therapist self-disclosure has been theorized and found to have both positive and negative effects. These effects depend, in part, on the nature of the disclosure. This study sought to examine the differential effects of therapist disclosures of more and less resolved countertransference issues on perceptions of therapists and therapy sessions. Using an analogue method, undergraduate participants (N = 116) were randomly assigned to watch one of two videos in which a therapist disclosed personal issues that were relatively resolved or relatively unresolved. As hypothesized, therapist disclosure of issues that were more resolved caused the therapist to be rated as more attractive and trustworthy and instilled greater hope than therapist disclosure of less resolved issues. The type of therapist disclosure, however, did not affect ratings of the expertness of the therapist, the depth or smoothness of the session, or the perceived universality between client and therapist. Implications of the results for the judicious use of self-disclosure are discussed.
Boccio, Dana E.
Suicide remains the third leading cause of death among young people in the United States. Considering that youth who contemplate suicide generally exhibit warning signs before engaging in lethal self-harm, school-based mental health professionals can play a vital role in identifying students who are at risk for suicidal behavior. Nevertheless, the…
Pierce, Lawrence C.
School-based management is an educational reform intended to reverse the trend toward increasing centralization of school administration. Though it has been claimed that centralization increases financial and educational equity, aids efficiency, and eases administration, examination of these claims reveals them to be based too often on incomplete,…
Albert, David A.; McManus, Joseph M.; Mitchell, Dennis A.
School-based health centers (SBHCs) often are located in high-need schools and communities. Dental service is frequently an addition to existing comprehensive services, functioning in a variety of models, configurations, and locations. SBHCs are indicated when parents have limited financial resources or inadequate health insurance, limiting…
Reveruzzi, Bianca; Buckley, Lisa; Sheehan, Mary
Background: This review examines the breadth of first aid training delivered to school students and the components that are age appropriate to adolescents. Method: Eligible studies included school-based first aid interventions targeting students aged between 10 and 18 years. Online databases were searched, for peer-reviewed publications available…
Piana, Natalia; Ranucci, Claudia; Buratta, Livia; Foglia, Elena; Fabi, Marta; Novelli, Francesca; Casucci, Simone; Reginato, Elisa; Pippi, Roberto; Aiello, Cristina; Leonardi, Alessia; Romani, Giannermete; De Feo, Pierpaolo; Mazzeschi, Claudia
Objective: To describe an innovative school-based intervention to promote healthy lifestyles. To evaluate its effects on children's food habits and to highlight the key components which contribute most to the beneficial effects obtained from children's, teachers' and parents' perspectives. Design: An educational tool to improve personal awareness,…
In 2005, a survey was conducted among all the 27 high schools of Aden, which revealed low levels of knowledge on major prevention measures, and a high level of stigma and discrimination towards people living with HIV (PLWH). The results served as a baseline for implementing a school-based peer education ...
Nir, Adam E.; Miran, Meir
Purpose: The purpose of this paper is to examine the extent to which the introduction of school-based management (SBM) affects schools' incomes and educational equity? Design/methodology/approach: An analysis of financial reports coming from 31 SBM schools during a period of four sequential years reveals that the overall inequity among schools has…
Augustyniak, Kristine M.; Brooks, Morgan; Rinaldo, Vincent J.; Bogner, Roselind; Hodges, Shannon
School-based professionals have entered the 21st century with a heightened call to address the emotional and behavioral concerns of youth. While cognitive-behavioral therapies and psychoeducational groups have demonstrated moderate effects with children and adolescents, there is little available research to assist clinicians in refining treatments…
Dinkmeyer, Don, Jr.; Carlson, Jon
Decades after consultation has become a mandated function of school counselors, consultants still seek effective ways to deliver this essential role. This book, geared towards mental health professionals, provides a set of skills for working with the school-based population. The ideas, based on Adlerian psychology, present a theory of consultation…
Rocha, Ana Cristina; Leal, Cláudia; Duarte, Cidália
Portugal, like many other countries, faces obstacles regarding school-based sexuality education. This paper explores Portuguese schools' approaches to implementing sexuality education at a local level, and provides a critical analysis of potential strengths and weaknesses. Documents related to sexuality education in a convenience sample of 89…
Adults may facilitate or obstruct healthy sexual behaviours by adolescents; hence information on their attitude towards adolescent sexual behaviour, including contraceptive use is important. The attitude of teachers to school-based adolescent reproductive health services was assessed among two hundred and twenty three ...
Fairchild, Thomas N., Ed.
School-based helpers are helping professionals who work within educational settings and whose training and primary responsibility is to promote the mental health of students. Few resource materials provide these helpers with needed information and practical strategies--this text tries to meet that need. The 12 chapters here cover a wide range of…
Olsson, Tina M.; Ferrer-Wreder, Laura; Eninger, Lilianne
Commentators interested in school-based prevention programs point to the importance of economic issues for the future of prevention efforts. Many of the processes and aims of prevention science are dependent upon prevention resources. Although economic analysis is an essential tool for assessing resource use, the attention given economic analysis…
Thompson, John L.; And Others
The manual outlines the processes, policies, and actual program implementation of one component of a Minnesota program for emotionally disturbed adolescents (Project SAIL): the development of school-based therapy/intervention groups. The characteristics of SAIL students are described, and some considerations involved in providing group services…
Pokorny, S; Jason, L; Schoeny, M
Objective: To extend research on the relation of school based contextual norms to current smoking among adolescents by using three analytic techniques to test for contextual effects. It was hypothesised that significant contextual effects would be found in all three models, but that the strength of these effects would vary by the statistical rigor of the model.
The purpose of this study was to evaluate a school-based pediatric obesity program for elementary children. Children (n = 782) were between the ages of 7 and 9 and in the 2nd grade. A total of 323 (189 males) children who exceeded the 85th percentile for BMI were randomized into an integrated health...
Velsor-Friedrich, Barbara; Richards, Maryse; Militello, Lisa K.; Dean, Kyle C.; Scott, Darrick; Gross, Israel M.; Romeo, Edna
Research conducted on youth exposure to violence has generally focused on documenting the prevalence of community violence and its emotional and behavioral implications. However, there is a dearth of information related to the impact of violence on the implementation and evaluation of community and school-based programs. This commentary examines…
In Canada, school-based decision making is a political expedient to co-opt public support for public education at the same time as financial resources to schools are being curtailed. School councils are advisory in nature and have no statutory position in either school or school-system decisions. (17 references) (MLF)
Ward, Kirsten; Quinn, Helen; Menzies, Robert; McIntyre, Peter
As adolescents have become an increasingly prominent target group for vaccination, school-based vaccination has emerged as an efficient and effective method of delivering nationally recommended vaccines to this often hard to reach group. School-based delivery of vaccines has occurred in Australia for over 80 years and has demonstrated advantages over primary care delivery for this part of the population. In the last decade school-based vaccination programs have become routine practice across all Australian states and territories. Using existing records and the recollection of experts we have compiled a history of school-based vaccination in Australia, primarily focusing on adolescents. This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Attorney General's Department, Robert Garran Offices, National Circuit, Barton ACT 2600 or posted at http://www.ag.gov.au/cca.
The purpose of this study was to identify the current practice and problems of school based supervision in government primary schools of Jile Timuga Woreda of Oromia Zone. A descriptive survey design of research methodology was employed. Regarding sampling, there were 39 primary schools grouped in 10 cluster ...
Kimber, Megan; Ehrich, Lisa Catherine
Purpose: The paper seeks to apply the theory of the democratic deficit to school-based management with an emphasis on Australia. This theory was developed to examine managerial restructuring of the Australian Public Service in the 1990s. Given similarities between the use of managerial practices in the public service and government schools, the…
Mampane, Ruth; Huddle, Christelle
This study reports on the outcomes of educational psychology school-based intervention. The aim was to determine whether the intervention served as an educational pathway to resilience. Through a concurrent mixed-methods research design interpreted through a pragmatic lens, academic school performance of students in a rural school was used as an…
Sandra L. Curtis
This survey study investigated the lives and practices of those in North America who self-identify as feminist music therapists. Earlier reports from this survey studied: 1) the experiences of music therapists, with a comparison of men, women, and their 1990 counterparts (Curtis, 2013d); 2) the experiences of music therapists who self-identify as community music therapists (Curtis, 2015); and 3) the experiences of music therapists in Canada as they compare with their U.S. counterparts (Curtis...
Araujo, Amanda Costa; Filho, Rúben Negrão; Oliveira, Crystian B; Ferreira, Paulo H; Pinto, Rafael Z
In the low back pain (LBP) field, therapeutic alliance is considered a non-specific factor of interventions associated with improvements in clinical outcomes. However, there is a paucity of studies aimed to evaluate measurement properties of tools used to objectively quantify the alliance between therapist and patients, such as the Working Alliance Inventory (WAI) and Session Rating Scale (SRS). To translate and cross-culturally adapt the short-form version of WAI - therapist and SRS into Brazilian Portuguese; to investigate the measurement properties, of the WAI-Patient, WAI-Therapist and SRS in patients with LBP and their physical therapists, respectively. One hundred patients with LBP and 18 physical therapists were recruited from physical therapy clinics in Brazil. Therapeutic alliance measures were collected at the initial assessment, prior to the second session, and at 2-month follow-up. The measurement properties investigated were reproducibility, internal consistency, ceiling/floor effects and responsiveness. Although WAI-Patient, WAI-Therapist and SRS were considered to have acceptable test-retest reliability (ICC2,1 > 0.70), these questionnaires showed problems with other measurement properties. WAI-Patient showed problems with internal consistency (i.e. Cronbach's alpha 15% of participants with the maximum score) and poor internal responsiveness were found for the WAI-Patient (Effect size = 0.15; 84% CI: 0.04 to 0.29) and for the SRS (Effect size = 0.05; 84% CI: -0.22 to 0.11). The WAI-Therapist revealed slightly better measurement properties. We identified psychometric limitations with most measurement properties of the WAI questionnaires and SRS. Future studies are needed to refine these tools.
Dilks, Sarah; Tasker, Fiona; Wren, Bernadette
This paper reports on a subset of findings from a wider ranging grounded theory analysis of therapy and recovery processes in psychosis. It describes therapist activities involved in maintaining an observational perspective during therapy and the links between these and other therapist activities. Grounded theory was used to examine the qualitative data collected. An initial sample of 19 taped therapy sessions and 23 interviews with psychologists and their clients was collected. This sample was extended through the collection of three further interviews with psychoanalytically aware psychologists. The data were analysed using grounded theory. A grounded theory model of therapy processes in psychosis was developed that conceptualized therapist actions as providing an observational scaffold to support the client's efforts in moving to new perspectives on their situation. Consistent with the understanding of the core therapy activity as a dialogical process, this set of therapist actions was understood as occurring alongside other therapist activities involved in managing emotion and building a relationship in therapy. The central activity of therapy in psychosis was understood as a dialogical process continuously negotiated between therapist and client in conversation and was conceptually summarized in the grounded theory as 'building bridges to observational perspectives'. However, the active and strategic efforts of psychologists to sustain the dialogue implied a particular assumption of responsibility for maintaining this process. In particular, therapists appeared to be 'working to maintain observational perspectives', 'managing emotion', and 'doing relationship' during the therapy conversation as part of the joint effort with clients to build bridges to new observational perspectives on distress and psychosis. © 2012 The British Psychological Society.
Butzer, Bethany; Ebert, Marina; Telles, Shirley; Khalsa, Sat Bir S
Substantial interest has begun to emerge around the implementation of yoga interventions in schools. Researchers have found that yoga practices may enhance skills such as self-regulation and prosocial behavior, and lead to improvements in students' performance. These researchers, therefore, have proposed that contemplative practices have the potential to play a crucial role in enhancing the quality of US public education. The purpose of the present study was to provide a summary and comparison of school-based yoga programs in the United States. Online, listserv, and database searches were conducted to identify programs, and information was collected regarding each program's scope of work, curriculum characteristics, teacher-certification and training requirements, implementation models, modes of operation, and geographical regions. The online, listserv, and database searches took place in Boston, MA, USA, and New Haven, CT, USA. Thirty-six programs were identified that offer yoga in more than 940 schools across the United States, and more than 5400 instructors have been trained by these programs to offer yoga in educational settings. Despite some variability in the exact mode of implementation, training requirements, locations served, and grades covered, the majority of the programs share a common goal of teaching 4 basic elements of yoga: (1) physical postures, (2) breathing exercises, (3) relaxation techniques, and (4) mindfulness and meditation practices. The programs also teach a variety of additional educational, social-emotional, and didactic techniques to enhance students' mental and physical health and behavior. The fact that the present study was able to find a relatively large number of formal, school-based yoga programs currently being implemented in the United States suggests that the programs may be acceptable and feasible to implement. The results also suggest that the popularity of school-based yoga programs may continue to grow.
Butzer, Bethany; Ebert, Marina; Telles, Shirley; Khalsa, Sat Bir S.
Context Substantial interest has begun to emerge around the implementation of yoga interventions in schools. Researchers have found that yoga practices may enhance skills such as self-regulation and prosocial behavior, and lead to improvements in students’ performance. These researchers, therefore, have proposed that contemplative practices have the potential to play a crucial role in enhancing the quality of US public education. Objective The purpose of the present study was to provide a summary and comparison of school-based yoga programs in the United States. Design Online, listserv, and database searches were conducted to identify programs, and information was collected regarding each program’s scope of work, curriculum characteristics, teacher-certification and training requirements, implementation models, modes of operation, and geographical regions. Setting The online, listserv, and database searches took place in Boston, MA, USA, and New Haven, CT, USA. Results Thirty-six programs were identified that offer yoga in more than 940 schools across the United States, and more than 5400 instructors have been trained by these programs to offer yoga in educational settings. Despite some variability in the exact mode of implementation, training requirements, locations served, and grades covered, the majority of the programs share a common goal of teaching 4 basic elements of yoga: (1) physical postures, (2) breathing exercises, (3) relaxation techniques, and (4) mindfulness and meditation practices. The programs also teach a variety of additional educational, social-emotional, and didactic techniques to enhance students’ mental and physical health and behavior. Conclusions The fact that the present study was able to find a relatively large number of formal, school-based yoga programs currently being implemented in the United States suggests that the programs may be acceptable and feasible to implement. The results also suggest that the popularity of school-based
Grinshtain, Yael; Gibton, Dan
Purpose: The purpose of this paper is to understand how primary school principals in Israel cope with the gaps between authority and responsibility in their work, deriving from partially implemented decentralization processes, and how this relates to school-based management (SBM) and accountability principles. Design/methodology/approach: Using…
Panagiotidou, K; Zervas, I
Social changes and developments in medical science prompted mental health professionals to adopt new roles in relation to their self-disclosure practices. The physician-patient relationship has balanced on a different level, promoting the equity and the autonomy of the second. The contemporary patient is better informed, asks more questions and requires more answers. The boundaries between "professional" and "personal" are less strict and patients believe that they have a right to know whether the personal experiences (educational, clinical, research) of their therapists enable them to understand and help them. Although the latest version of the American Psychological Association's Ethics Code (APA, 2002) offers no explicit guidance on therapist self-disclosure, it incorporates an implicit message that therapists can no longer choose non-disclosure without having considered the issue carefully. Non-disclosure is no longer the easy answer, as it may affect adversely the therapeutic relationship and the therapeutic effect. These new circumstances prompted representatives of all psychotherapeutic orientations to reconsider traditional positions on therapist self-disclosure, to adapt to the diverse needs of the patients and the modern requirements of the therapeutic process and to define the framework within which its conduct is not only safe but also effective. This review attempts to describe the concept of therapist self-disclosure and its use and its functions in Cognitive-Behavioral Therapy, following a history of the term in other major therapeutic schools (psychoanalytic, client-centered and systemic). As the focus of any psychotherapy is the patient himself, we added reports of patients' experiences by their therapists' disclosures. Those descriptions reveal clearly not only the benefits of therapist self-disclosure but also the dangers posed by improper use. Finally, we attempt to set a framework in the form of proposals, as these result from existing
Doran, Jennifer M; Gómez-Penedo, Juan Martín; Safran, Jeremy D; Roussos, Andrés
The aim of the current study was to design and evaluate a therapist version of the Alliance Negotiation Scale (ANS). The ANS was created in order to operationalize the construct of dyadic negotiation in psychotherapy and to augment existing conceptualizations of the working alliance. The ANS has existed only as a client self-report form since its inception and has demonstrated promise as a psychotherapy process measure. This research intended to develop a complementary therapist self-report version of the measure. The scale creation process is discussed in detail, and the results of a preliminary psychometric investigation are reported. The ANS-Therapist version (ANS-T) was developed using a sample of therapists (n = 114) through a principal components analysis procedure. The ANS-T contains 9 unidimensional items and was moderately correlated with therapist-reported working alliance (r = .468). The results of the study support the composition of the ANS-T and provide initial support for the reliability and validity of the measure. Copyright © 2018 John Wiley & Sons, Ltd.
Alessi, Edward J; Dillon, Frank R; Kim, Hillary Mi-Sung
The current study tested a conceptual model based on social-cognitive theory (Bandura, 1986), highlighting the influence of attitudes toward sexual minority individuals, training hours, affirmative counseling self-efficacy, and beliefs about affirmative practice on therapist engagement in lesbian and gay affirmative practice. We recruited via the Internet 443 heterosexual psychologists (n = 270), clinical social workers (n = 110), and marriage and family therapists (n = 63) residing in various parts of the United States. The majority of participants identified as female (70%) and White (88%). A path analysis indicated that beliefs and affirmative counseling self-efficacy mediated associations between attitudes and therapist engagement in affirmative practice. Furthermore, self-efficacy mediated the relation between training hours and engagement in affirmative practice. Results suggest that more affirmative attitudes are linked with higher levels of affirmative counseling self-efficacy and more positive beliefs, which in turn positively influences therapist engagement in affirmative practice. Additionally, more hours of training influence affirmative counseling self-efficacy, which in turn correlates with higher levels of therapist engagement in affirmative practice. The discussion includes implications for affirmative practice training. (c) 2015 APA, all rights reserved).
Parcsi, Lisa; Curtin, Michael
Returning to work after maternity leave can be a challenging, anxious and fraught experience for women, and has been portrayed in the literature as a generally negative experience. Interestingly, although occupational therapists were predominantly women, no research was found focussing on their experiences of returning to work after maternity leave. The aim of this research was to gain an insight into occupational therapists' experiences of returning to work following maternity leave. Principles of interpretive phenomenological analysis were used to explore the individual experiences of six Australian occupational therapists returning to work after a period of maternity leave. Individual semi-structured interviews lasting up to 90 minutes were conducted. Interviews were audio-recorded, transcribed and then analysed. Two major themes emerged from the analysis of interviews: compromise and feeling valued. The experience of returning to work was a process of compromise in which women found strategies to cope with their changing roles and demands, to find a balance between home and work life. The women wanted to feel valued by their managers and co-workers, as this enabled them to feel comfortable and confident with some of the compromises they made. Occupational therapists returning to work after maternity leave will make compromises so that they can balance their home and work life. Occupational therapists value managers and co-workers who understand the compromises women make when returning to work following maternity leave and who create a supportive workplace that acknowledges and values their contribution. © 2013 Occupational Therapy Australia.
Haugland, Bente Storm Mowatt; Raknes, Solfrid; Haaland, Aashild Tellefsen; Wergeland, Gro Janne; Bjaastad, Jon Fauskanger; Baste, Valborg; Himle, Joe; Rapee, Ron; Hoffart, Asle
Anxiety disorders are prevalent among adolescents and may have long-lasting negative consequences for the individual, the family and society. Cognitive behavioral therapy (CBT) is an effective treatment. However, many anxious youth do not seek treatment. Low-intensity CBT in schools may improve access to evidence-based services. We aim to investigate the efficacy of two CBT youth anxiety programs with different intensities (i.e., number and length of sessions), both group-based and administered as early interventions in a school setting. The objectives of the study are to examine the effects of school-based interventions for youth anxiety and to determine whether a less intensive intervention is non-inferior to a more intensive intervention. The present study is a randomized controlled trial comparing two CBT interventions to a waitlist control group. A total of 18 schools participate and we aim to recruit 323 adolescents (12-16 years). Youth who score above a cutoff on an anxiety symptom scale will be included in the study. School nurses recruit participants and deliver the interventions, with mental health workers as co-therapists and/or supervisors. Primary outcomes are level of anxiety symptoms and anxiety-related functional impairments. Secondary outcomes are level of depressive symptoms, quality of life and general psychosocial functioning. Non-inferiority between the two active interventions will be declared if a difference of 1.4 or less is found on the anxiety symptom measure post-intervention and a difference of 0.8 on the interference scale. Effects will be analyzed by mixed effect models, applying an intention to treat procedure. The present study extends previous research by comparing two programs with different intensity. A brief intervention, if effective, could more easily be subject to large-scale implementation in school health services. ClinicalTrials.gov, NCT02279251 . Registered on 15 October 2014. Retrospectively registered.
Ciccarelli, Marina; Portsmouth, Linda; Harris, Courtenay; Jacobs, Karen
Introduction of notebook computers in many schools has become integral to learning. This has increased students' screen-based exposure and the potential risks to physical and visual health. Unhealthy computing behaviours include frequent and long durations of exposure; awkward postures due to inappropriate furniture and workstation layout, and ignoring computer-related discomfort. Describe the framework for a planned school-based health promotion program to encourage healthy computing behaviours among middle school students. This planned program uses a community- based participatory research approach. Students in Year 7 in 2011 at a co-educational middle school, their parents, and teachers have been recruited. Baseline data was collected on students' knowledge of computer ergonomics, current notebook exposure, and attitudes towards healthy computing behaviours; and teachers' and self-perceived competence to promote healthy notebook use among students, and what education they wanted. The health promotion program is being developed by an inter-professional team in collaboration with students, teachers and parents to embed concepts of ergonomics education in relevant school activities and school culture. End of year changes in reported and observed student computing behaviours will be used to determine the effectiveness of the program. Building a body of evidence regarding physical health benefits to students from this school-based ergonomics program can guide policy development on the healthy use of computers within children's educational environments.
Ribeiro, Robespierre Q C; Alves, Luciana
To assess the efficacy of two school-based programmes to promote students' willingness to engage in lifestyle changes related to eating habits and physical activity behaviours. Elementary school-based health promotion intervention, designed as a multicomponent experimental study, based on a behavioural epidemiological model. Nine intervention and eight comparative public and private elementary schools. The goal was to determine the impact on the longitudinally assessed outcomes of two programmes that addressed healthy nutrition and active living in a cohort of 2038 children. The evaluations used pre-intervention and follow-up student surveys that were based on the Transtheoretical Model of the stages of behaviour change. In the intervention group, there were significant (P motivated teachers. The comparison group did not show significant differences between the pre- and post-intervention times for any of the stages of behaviour. The intervention programme encouraged the students to make healthy lifestyle choices related to eating habits and physical activity behaviours.
Raymond, Marie-Hélène; Demers, Louise; Feldman, Debbie Ehrmann
To compare the preferences of occupational therapists, elderly people, and adults with disabilities regarding prioritization criteria for occupational therapy waiting lists in home care. Discrete choice experiment survey. Survey mailed to occupational therapists working in home care and community-dwelling elderly or disabled persons. A sample (N=714) of home-based occupational therapists (n=241), elderly persons from a bank of research participants (n=226), and adults with physical disabilities recruited through community organizations (n=247). Not applicable. The dependent variable was whether the referral scenario was prioritized or not in each question. The results were analyzed through logistic regression using conditional logit models. Prioritization preferences differed between groups (Ppeople who had a few falls (odds ratio vs no falls, 48.7), whereas elderly people and adults with disabilities most strongly prioritized people who were unable to enter and exit the home (odds ratio vs no difficulty entering and exiting the home, 30.8 for elderly people and 16.8 for persons with disabilities.) CONCLUSIONS: Our results highlight the gap between the priorities of home-based occupational therapists and their target clientele. Although further inquiry is needed to inform priority setting, the findings emphasize the importance of public or patient involvement in decisions on waiting list prioritization. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Frühauf, Sarah; Figlioli, Patrick; Caspar, Franz
In psychotherapy, therapist and patient influence each other constantly. We aimed to investigate how therapists respond to patient impression management and influence tactics. For 60 videotaped intake interviews, judges rated therapist responses to patient tactics as neutral, desired, or undesired from the patient perspective. Judges rated the therapist responses in 57% as neutral, in 40% as desired, and in 2% as undesired by the patients. The proportions of response outcomes varied across tactics. Therapist responses were unrelated to therapist and patient sex. Therapist experience was related to their responses to the tactic Supplication. Overall, some patient tactics seem to be more challenging for therapists than others. Awareness of such response tendencies can help therapists prepare their reactions to certain patient impression management and influence tactics. Implications for training and research are presented.
Roien, Line Anne; Graugaard, Christian; Simovska, Venka
pupils 6 to 12 years of age. Design/methodology/approach - The paper draws upon the methodology of systematic research mapping and presents a broad overview of research on sexuality education in a school setting for pupils aged 6-16. We searched the leading bibliographic databases in the field, i...... a rare, if not the first, comprehensive overview of research on school-based sexuality education including a focus on school children 6 to 12 years of age.......Purpose - The purpose of this paper is to map and discuss the overall characteristics of international research on school-based sexuality education, published in academic journals, with a particular focus on the framing of non-conservative approaches including sex education research targeting...
Lotterman, Jenny H
This article focuses on the relational treatment of a male patient presenting with sexual and erotic feelings toward the therapist. The use of relational psychotherapy allowed us to collaborate in viewing our therapeutic relationship as a microcosm of other relationships throughout the patient's life. In this way, the patient came to understand his fears of being close to women, his discomfort with his sexuality, and how these feelings impacted his ongoing romantic and sexual experiences. Use of the therapist's reactions to the patient, including conscious and unconscious feelings and behaviors, aided in the conceptualization of this case. Working under a relational model was especially helpful when ruptures occurred, allowing the patient and therapist to address these moments and move toward repair. The patient was successful in making use of his sexual feelings to understand his feelings and behaviors across contexts. © 2013 Wiley Periodicals, Inc.
Ekberg, Katie; Lecouteur, Amanda
Cognitive behavioural therapy (CBT) is an internationally recognised method for treating depression. However, many of the techniques involved in CBT are accomplished within the therapy interaction in diverse ways, and with varying consequences for the trajectory of therapy session. This paper uses conversation analysis to examine some standard ways in which therapists propose suggestions for behavioural change to clients attending CBT sessions for depression in Australia. Therapists' proposal turns displayed their subordinate epistemic authority over the matter at hand, and emphasised a high degree of optionality on behalf of the client in accepting their suggestions. This practice was routinely accomplished via three standard proposal turns: (1) hedged recommendations; (2) interrogatives; and (3) information-giving. These proposal turns will be examined in relation to the negotiation of behavioural change, and the implications for CBT interactions between therapist and client will be discussed.
Ickes, Melinda J; McMullen, Jennifer; Haider, Taj; Sharma, Manoj
The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data. A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.
Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N
Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused
Melinda J. Ickes
Full Text Available Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1 primary research; (2 overweight or obesity prevention interventions; (3 school-based; (4 studies published between 1 January 2002 through 31 December 2013; (5 published in the English language; (6 child-based interventions, which could include parents; and (7 studies that reported outcome data. Results: A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Discussion: Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.
Casciotti, Dana; Smith, Katherine C.; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C.
BACKGROUND In 2007, legislation was proposed in 24 states and the District of Columbia for school-based HPV vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. METHODS We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005-2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. RESULTS Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. CONCLUSIONS If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages, and promote informed decision-making by parents and students. PMID:25099421
Han Gyu Kim
Full Text Available Purpose:This study was designed to determine the effects of a school-based obesity-management program on obese primary school children. Methods:A total of 995 children (6–12 years old in a primary school were screened in March 2008, and of those, 101 obese students (44 boys and 57 girls, body mass index (BMI ?#249;5 percentile were enrolled for a study group. The school- based, obesity management program, which includes physical exercise and nutritional education, was conducted as part of an extracurricular program for 12 weeks. The measurement of height, weight, waist circumference, blood pressure (BP, and bioelectrical impedance analysis (BIA was performed before and after the program. Results:Height and weight increased significantly (P<0.05. The BMI and obesity index decreased significantly (P<0.01. Systolic and diastolic BP decreased significantly (P<0.01. BMI decreased in 61.4% of boys and 66.7% of girls. Protein and basal metabolic rate (BMR increased significantly on the BIA (P<0.01. Fat decreased significantly (P<0.05. The total body water (TBW and percent body fat (PBF decreased significantly (P<0.01. The changes in protein, fat, TBW, PBF, and BMR significantly correlated to the change in BMI (P<0.05. In a multiple logistic regression analysis, BMI change was significantly correlated to the changes in protein and fat content (P<0.01. Conclusion:The school-based obesity management program is a very effective way to manage obesity for obese primary school children.
Evans, Charlotte E L; Albar, Salwa Ali; Vargas-Garcia, Elisa J; Xu, Fei
School-based interventions are relatively new and were first introduced in the United States in the 1990s. Early programs were mainly education based with many of the findings now embedded in school policy in the form of a healthy eating curriculum. More recent school programs have taken education outside the classroom and attempted to engage parents as well as teachers. Environmental changes such as improving the quality of foods available at lunchtime and at other times during the school day are now common. Reviews of evaluations of school-based programs have demonstrated that they are effective and successfully improve dietary quality such as increasing fruit and vegetable intake and decreasing sweet and savory snacks and sweetened drinks; not just in school but over the whole day and particularly in younger school children. School-based interventions are also effective at reducing obesity if components to increase physical activity and reduce sedentary behaviors are also targeted but not if only dietary behaviors are tackled. Most of the high-quality evaluation studies using randomized controlled trials have been carried out in high-income countries as they are costly to run. However, middle-income countries have benefitted from the information available from these evaluation studies and many are now starting to fund and evaluate school-based programs themselves, resulting in unique problems such as concomitant under- and overnutrition being addressed. Action for the future demands more focus on populations most at risk of poor dietary quality and obesity in order to reduce inequalities in health and on adolescents who have not benefited as much as younger children from school-based interventions. This will involve innovative solutions within schools as well as targeting the food environment outside schools such as reducing the density of fast-food outlets and marketing of sweet and savory snacks and drinks. © 2015 Elsevier Inc. All rights reserved.
Hill, Clara E; Knox, Sarah; Crook-Lyon, Rachel E; Hess, Shirley A; Miles, Joe; Spangler, Patricia T; Pudasaini, Sakar
Our objectives were to describe the frequency of therapists' dreams about their clients and clients' dreams about their therapists, to determine how therapists and clients who had such dreams differed from those who did not have such dreams, whether therapy process and outcome differed for those who had and did not have such dreams, and to describe the content and consequences of these dreams. Thirteen doctoral student therapists conducted psychodynamic psychotherapy with 63 clients in a community clinic. Therapists who had dreams about clients had higher estimated and actual dream recall than did therapists who did not dream about clients. Qualitative analyses indicated that therapists' dreams yielded insights about the therapist, clients, and therapy; therapists used insights in their work with the clients. Among the clients, only two (who were particularly high in attachment anxiety and who feared abandonment from their therapists) reported dreams that were manifestly about their therapists. Therapists-in-training dreamed more about their clients than their clients dreamed about them. Dreams about clients can be used by therapists to understand themselves, clients, and the dynamics of the therapy relationship.
There have been three physics meetings since the last CMS week: “physics days” on March 27-29, the Physics/ Trigger week on April 23-27 and the most recent physics days on May 22-24. The main purpose of the March physics days was to finalize the list of “2007 analyses”, i.e. the few topics that the physics groups will concentrate on for the rest of this calendar year. The idea is to carry out a full physics exercise, with CMSSW, for select physics channels which test key features of the physics objects, or represent potential “day 1” physics topics that need to be addressed in advance. The list of these analyses was indeed completed and presented in the plenary meetings. As always, a significant amount of time was also spent in reviewing the status of the physics objects (reconstruction) as well as their usage in the High-Level Trigger (HLT). The major event of the past three months was the first “Physics/Trigger week” in Apri...
Doll, Beth; Nastasi, Bonnie K.; Cornell, Laura; Song, Samuel Y.
School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in…
Eke, Chidi Idi; Singh, Shakila
School-based violence is serious, and on the rise in South African schools. The violence affects learners, teachers, communities and the management of schools. Towards finding possible ways to manage school violence, this article presents social networking as a strategic tool in the management of school-based violence in high schools, based on the…
Contends that familiar and comfortable family therapy theories were not designed to deal with violence and may help maintain collective avoidance of the issue of violence among family therapists. Explores limitations of therapeutic neutrality and dangers inherent in some interventions. Concludes that effective amelioration of family violence…
Akroyd, Duane; Caison, Amy; Adams, Robert D.
Purpose: As cancer caregivers, radiation therapists experience a variety of stresses that may develop into burnout, which has been demonstrated to impact patient care, employee health, and organizational effectiveness. The purpose of the study was to assess the levels of radiation therapists' burnout at three stages. Additionally, the ability of selected workplace variables to predict each of the three stages of burnout was examined. Methods and Materials: We used descriptive and inferential statistical analyses on reliable and valid instruments, which measured stress, burnout, and social support. Results: Radiation therapists have high levels of the first two stages of burnout: emotional exhaustion and depersonalization. Although personal stress, organizational stress, guidance, reassurance of worth, and work load predicted 50% or more of the variance in emotional exhaustion and depersonalization, their predictive ability for personal accomplishment was low. Conclusion: Efforts to alleviate burnout among radiation therapists within an organization should have positive effects, including increased quality of patient care, improved quality of work life, higher levels of job satisfaction, and commitment and lower staff turnover
Journal of Child and Adolescent Mental Health ... The parent-child-therapist alliance: A case study using a strategic approach. Thirusha Naidu, Sheethal Behari. Abstract. In this paper we present a single case study of a clinical approach that ...
Hills, Caroline; Ryan, Susan; Warren-Forward, Helen; Smith, Derek R
'Generation Y' is a descriptor of those therapists born between 1982 and 2000. According to generational theory, each generation have unique characteristics due to the social and historical factors they have experienced during their formative years. Occupational therapy educators have reported on 'Generation Y' characteristics observed in occupational therapy students. This study aimed to investigate if managers considered there was a 'Generation Y' therapist and their observed characteristics in practice, as well as successful management strategies used to maximise their potential in the workplace. A hard copy survey based on the 'Generation Y' literature was sent to all managers listed on an Australian University database. Almost all respondents considered there was a 'Generation Y' therapist. Overall, managers reported characteristics of this staff group as being hard working, confident with technology, needing positive feedback and demanding professional development opportunities. Managers also reported that this group may be a challenge to retain in work positions. Managers also viewed 'Generation Y' staff as a positive energy and considered that in the future they will be of benefit to the profession. While there may be generational differences between therapists in the workplace, inclusive management styles may be the most appropriate management approach. Career guidance, facilitating creativity, increasing work responsibility and integrating new technologies like social networking into practice may be appropriate strategies for this staff group, to facilitate both their professional development and to retain them in the profession. © 2013 Occupational Therapy Australia.
Provides background information on music therapy. Discusses how music therapy works in the public school setting and offers advice to music teachers. Explores music therapy and the Individuals with Disabilities Education Act, addressing the benefits of having access to music therapists. (CMK)
Wolowitz, Howard Martin
Discusses the Morris and Suckerman report on experimental studies testing the Rogerian hypothesis that phobic desensitization occurs as a function of therapist warmth versus the behavioral explanation that desensitization is a function of reciprocal inhibition. Morris and Suckerman respond to the critique. (Author/EJT)
Therapeutic interventions are guided as much by a therapist's philosophy as they are by an understanding of psychological and therapeutic principles. An individual gravitates toward ... The intention of the authors was to focus specifically on their lived experience with a view to observing how the different historically situated ...
Martínez Fernández, Carmen; Hernández-Aguado, Ildefonso; Torres Cantero, Alberto M
There is growing social concern about school violence but little is known about how this situation is experienced in the schools. The objective of this study was to know the perception that School's head masters have of the school-based hostility, on their causes, how they value current preventive strategies, and their recommendations to develop future preventive interventions. We conducted an exploratory study with 14 semistructured interviews of School's head masters. Interviews were conducted at the Schools between May and June 2003 in 1 independent school, 9 state comprehensive schools, and 4 other comprehensive schools within the city of Alicante. The perception of the head masters is that the prevalence of violence is low, more verbal than physical and within gender. They identify lack of punctuality, absenteeism and lack of interest as forms of hostility. As causes they identified age, family problems, school environment, society, media (TV and video-games) and poor language skills. Preventive methods in use were, on one hand, extra-lessons and transversal contents foreseen in the Education Law and common to all schools, and, on the other hand, ideological and pedagogical contents which were specific of some centres. Recommendations focused in demands for increased economic support and skilled human resources. School-based violence is not perceived as an alarming school issue, nor by its magnitude neither by the immediate causes and students' characteristics to which it is associated. A heavier emphasis is placed on external and environmental causes perceived as much more difficult to confront.
Lima-Serrano, Marta; Lima-Rodríguez, Joaquín S
Given that lifestyleshave similar determinants and that school-based interventions are usually targeted at all the risks that affect adolescents, the objective of this systematic review was to summarize the characteristics and effects of school-based interventions acting on different behavioral domains of adolescent health promotion. The review process was conducted by two independent reviewers who searched PubMed, Scopus, PsycINFO, and ERIC databases for experimental or observational studies with at least two measures of results published from 2007 to 2011, given that the research information available doubles every 5 years. Methodological quality was assessed with a standardized tool. Information was extracted from 35 studies aiming to prevent risk behaviors and promote healthy nutrition, physical activity, and mental and holistic health. Activities were based on theoretical models and were classified into interactive lessons, peer mediation, environmental changes, parents' and community activities, and tailored messages by computer-assisted training or other resources, usually including multiple components. In some cases, we identified some moderate to large, short- and long-term effects on behavioral and intermediate variable. This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Beutler, Larry E.; And Others
This study attempts to (1) assess the effects of therapist credibility and patient-therapist similarity on interpersonal persuasion; and (2) to further assess the relationship between patient attitude change and psychotherapy outcome. (HMV)
Hara, Kimberley M; Aviram, Adi; Constantino, Michael J; Westra, Henny A; Antony, Martin M
Although client-perceived therapist empathy relates to positive therapy outcomes, including in cognitive behavioral therapy (CBT), little is known about how empathy exerts its ameliorative effect. One possible way is by promoting clients' subsequent homework compliance, a variable that also predicts positive outcomes in CBT. The present study sought to investigate simultaneously, in the context of 43 therapist-client dyads receiving 15 sessions of CBT for generalized anxiety disorder, (1) the association of early client-perceived therapist empathy (averaged over sessions 1, 3, 5) with mid-treatment client homework compliance (averaged over sessions 6, 8, 10); (2) the association of mid-treatment homework compliance on client posttreatment worry severity; and (3) the indirect effect of early perceived therapist empathy on posttreatment worry through mid-treatment homework compliance. Given that clients were nested within therapists, we examined both within- and between-therapist differences in clients' ratings of therapist empathy and homework compliance, and tested both of these indices as predictors of the relevant dependent variables in a multilevel model. At the within-therapist level (i.e., differences between clients within a given therapist's caseload), greater early empathy was associated with greater mid-treatment homework compliance. At the between-therapist level (i.e., differences between therapists across all of their cases), greater between-therapist homework compliance was related to lower posttreatment worry. Finally, homework compliance was not found to mediate the relationship between empathy and posttreatment outcome. The results underscore the importance of parsing client and therapist effects, and are discussed with regard to their training and research implications.
Seifert, Anna M; Stotz, Nicole; Metz, Alexia E
To gather information on occupational therapy practitioners' use and opinions of apps, an online survey was distributed to occupational therapy practitioners licensed in the state of Ohio. The survey sought information regarding clinical populations and skill areas for which apps are used, potential barriers to use of apps and preferred apps/app features. OTs working in medical and education-based settings and with clients of all ages responded to the survey. Over half (53%) reported not using apps in therapy, with "not having access to the technology at work" being the leading reason endorsed. Of practitioners who did report using apps, the majority used them with ≤25% of their case load and primarily used tablets to do so. Clinicians indicated that they use apps for a wide variety of reasons, including to promote skill building and to support the therapeutic process. Preferred features included the ability to grade difficulty up/down, multiple uses and accurate feedback. Recommendations from peers were the most commonly reported way respondents found new apps. The results suggest that occupational therapy practitioners employ clinical reasoning when implementing apps in therapy. Possible ways to improve access to apps for therapists who would like to implement them are discussed. Implications for Rehabilitation Many occupational therapy practitioners are using apps with at least a portion of their caseloads. Therapists select apps based on peer recommendations, most commonly selecting those which promote skill building and support the therapeutic process. More therapists might make use of apps if potential barriers were reduced or eliminated, including availability of technology in the clinical practice setting, therapist training and education, therapist input into app development and an enhanced evidence base.
Freedman, Sara A; Tuval Mashiach, Rivka
Shared traumatic reality occurs when therapists are doubly exposed to a traumatic event, both through their clients' experience, along with their own direct exposure. Studies have shown that a shared traumatic reality can lead to both positive and negative outcomes for therapists. Most studies have examined these reactions sometime after the end of the traumatic event, and less is known about reactions that occur during a traumatic event. In addition, most studies have assumed, rather than examined, indirect exposure. In this study, we extend this literature by examining direct and indirect exposure of therapists during a war situation, and their psychological reactions. Over a period of two months in 2014, 70% of the Israeli population was exposed to rocket fire. Geographical areas differed in terms of amount of exposure, and its potential danger. 151 therapists living throughout Israel were assessed via an Internet based survey in the middle of the war, and were assessed for the effects on their professional and personal lives, degree of burnout, ways of coping and symptoms levels of PTSD and psychological distress. These indicate that significant differences in direct exposure occurred depending on place of residence. PTSD levels were related to higher direct exposure, as well as prior trauma exposure, but not to indirect exposure. Indirect exposure, as measured by increased workload, was related to increased distress and emotional exhaustion. These data shed light on the effects of direct and indirect exposure to a shared traumatic experience of war amongst therapists. The data support previous studies showing a greater effect of direct exposure on PTSD. Since indirect exposure appears to negatively impact burnout and psychological distress, rather than PTSD, this study shows that symptoms other than PTSD should be the result of in a shared traumatic reality.
Swinkels, I.C.S.; Ende, C.H.M. van den; Bakker, D. de; Wees, Ph.J van der; Hart, D.L.; Deutscher, D.; Bosch, W.J.H. van den; Dekker, J.
Clinical databases in physical therapy provide increasing opportunities for research into physical therapy theory and practice. At present, information on the characteristics of existing databases is lacking. The purpose of this study was to identify clinical databases in which physical therapists
Safdie, Margarita; Cargo, Margaret; Richard, Lucie; Lévesque, Lucie
Ecological intervention programs are recommended to prevent overweight and obesity in children. The National Institute of Public Health (INSP) in Mexico implemented a successful ecological intervention program to promote healthy lifestyle behaviors in school age children. This study assessed the integration of ecological principles and Social Cognitive Theory (SCT) constructs in this effective school-based obesity prevention program implemented in 15 elementary schools in Mexico City. Two coders applied the Intervention Analysis Procedure (IAP) to "map" the program's integration of ecological principles. A checklist gauged the use of SCT theory in program activities. Thirty-two distinct intervention strategies were implemented in one setting (i.e., school) to engage four different target-groups (students, parents, school representatives, government) across two domains (Nutrition and Physical Activity). Overall, 47.5% of the strategies targeted the school infrastructure and/or personnel; 37.5% of strategies targeted a key political actor, the Public Education Secretariat while fewer strategies targeted parents (12.5%) and children (3%). More strategies were implemented in the Nutrition domain (69%) than Physical Activity (31%). The most frequently used SCT construct within both intervention domains was Reciprocal Determinism (e.g., where changes to the environment influence changes in behavior and these behavioral changes influence further changes to the environment); no significant differences were observed in the use of SCT constructs across domains. Findings provide insight into a promising combination of strategies and theoretical constructs that can be used to implement a school-based obesity prevention program. Strategies emphasized school-level infrastructure/personnel change and strong political engagement and were most commonly underpinned by Reciprocal Determinism for both Nutrition and Physical Activity.
Staples, William H.; Killian, Clyde B.
A survey was sent to every skilled nursing home (N = 495) in Indiana regarding the demographics, education, and whether the severity of dementia impacts the attitudes of people in physical therapy practice. Physical therapists (PTs) and physical therapist assistants (PTAs) practicing in nursing homes spend considerable time (44.0%) working with…
Goodwin, Annabelle Michelle
In this study, I explore the ways in which feminist family therapists encourage exploration of, resistance to, and collusion with, oppression. I explore qualitatively the critical dialogues, both inner, and with others, that feminist family therapists employ to address oppressive systems. My research questions are: a. How do family therapists who identify as feminist describe how their feminist identities and ideas about feminism have evolved over time? b. How do feminist family therapists re...
A remarkable amount of progress has been made in Physics since the last CMS Week in June given the exponential growth in the delivered LHC luminosity. The first major milestone was the delivery of a variety of results to the ICHEP international conference held in Paris this July. For this conference, CMS prepared 15 Physics Analysis Summaries on physics objects and 22 Summaries on new and interesting physics measurements that exploited the luminosity recorded by the CMS detector. The challenge was incorporating the largest batch of luminosity that was delivered only days before the conference (300 nb-1 total). The physics covered from this initial running period spanned hadron production measurements, jet production and properties, electroweak vector boson production, and even glimpses of the top quark. Since then, the accumulated integrated luminosity has increased by a factor of more than 100, and all groups have been working tremendously hard on analysing this dataset. The September Physics Week was held ...
McCombie, Randy P.
Purpose: The purpose of this study was to survey occupational therapists (OTs) and occupational therapy assistants (OTAs) on their attitudes toward a possible move to the entry-level doctorate as the mandated singular point of entry into the profession for OTs. Method: The study surveyed a random sample of 600 OTs and 600 OTAs from two…
Bruschini, Marco; Carli, Antonella; Burla, Franco
Healthcare workers are exposed to work related stresses that significantly increase their risk of burnout. To evaluate and compare burnout and work related stress levels in three categories of health professionals: physiotherapists, speech therapists and occupational therapists. A convenience sample of 391 health professionals participated, including 210 physiotherapists, 101 speech therapists and 80 occupational therapists. We collected general socio-demographic information and administered the standardized Italian version of the Maslach Burnout Inventory (MBI) and the Health and Safety Executive (HSE) Management Standards Indicator Tool. We found the proportion of professionals with high-risk scores in the three dimensions of the MBI to be as follows: Emotional Exhaustion 32%, Depersonalisation 13% and Personal Accomplishment 9%. Overall, 14% of participants were at high risk of burnout. No significant differences were found between the three professional categories. Five subscales of the HSE were associated with burnout: Control (p < 0.01), Management support (p < 0.01), Relationship (p < 0.05), Role (p < 0.01), and Change (p < 0.05). Like all health care workers, rehabilitation professionals are at a high risk of burnout. There are common mechanisms underlying burnout in the different professional groups investigated. Further research in occupational health in rehabilitation settings is needed to prevent burnout.
There have been numerous developments in the physics area since the September CMS week. The biggest single event was the Physics/Trigger week in the end of Octo¬ber, whereas in terms of ongoing activities the “2007 analyses” went into high gear. This was in parallel with participation in CSA07 by the physics groups. On the or¬ganizational side, the new conveners of the physics groups have been selected, and a new database for man¬aging physics analyses has been deployed. Physics/Trigger week The second Physics-Trigger week of 2007 took place during the week of October 22-26. The first half of the week was dedicated to working group meetings. The ple¬nary Joint Physics-Trigger meeting took place on Wednesday afternoon and focused on the activities of the new Trigger Studies Group (TSG) and trigger monitoring. Both the Physics and Trigger organizations are now focused on readiness for early data-taking. Thus, early trigger tables and preparations for calibr...
The CPT project came to an end in December 2006 and its original scope is now shared among three new areas, namely Computing, Offline and Physics. In the physics area the basic change with respect to the previous system (where the PRS groups were charged with detector and physics object reconstruction and physics analysis) was the split of the detector PRS groups (the old ECAL-egamma, HCAL-jetMET, Tracker-btau and Muons) into two groups each: a Detector Performance Group (DPG) and a Physics Object Group. The DPGs are now led by the Commissioning and Run Coordinator deputy (Darin Acosta) and will appear in the correspond¬ing column in CMS bulletins. On the physics side, the physics object groups are charged with the reconstruction of physics objects, the tuning of the simulation (in collaboration with the DPGs) to reproduce the data, the provision of code for the High-Level Trigger, the optimization of the algorithms involved for the different physics analyses (in collaboration with the analysis gr...
Chapman, Jason E.; Schoenwald, Sonja K.
The current study investigated relations among ethnic similarity in caregiver-therapist pairs of youth participating in Multisystemic Therapy, therapist adherence, and youth long-term behavioral and criminal outcomes. Participants were 1,979 youth and families treated by 429 therapists across provider organizations in 45 sites. Relations were…
Shanklin, Jennifer E.
This work includes a discussion of the concept of self-efficacy, originally introduced by Albert Bandura, as it pertains to the therapist-trainee. Therapist self-efficacy has only recently gained attention theoretically as well as empirically. Measures used to assess the self-efficacy of the therapist are highlighted as well as factors…
Brunink, Sharon A.; Schroeder, Harold E.
Findings indicated that expert therapists were similar in their communication of empathy, the basis for their therapeutic relationships. Theoretical orientation, however, differentially influenced use of direct guidance and facilitative techniques, interview content, therapist self-disclosure, therapist initiative, and supportive therapy climate.…
Demirci, Nevzat; Demirci, Pervin Toptas; Demirci, Erdal
This study was planned to determine the effects of school-based exercise practices (SBEP) on obesity and health-related quality of life (HRQL) in 9-11 year old girls. Participants consist of girls students from 9-11 years old in two state schools in Kars. Intervention Group (n: 85) courses of games and physical activities (CGPA) and SBEP…
Full Text Available Robot based therapy is one of the prevalent therapeutic approaches in motor stroke rehabilitation. It is often used in hospitals in combination with conventional therapy. In order to optimize human-robot interaction, we aim to investigate how a therapist physically supports patients during motor training of the upper extremities. This paper presents the design of a flexible textile sensor matrix, which measures the pressure exerted between therapist and patient during direct haptic interaction as well as the hand position and orientation in space. The matrix contains 144 sensors which enables measuring pressure intensity and localization of areas where the pressure is applied. The measurement matrix was evaluated with four healthy participants.
Physics Week: plenary meeting on physics groups plans for startup (14–15 May 2008) The Physics Objects (POG) and Physics Analysis (PAG) Groups presented their latest developments at the plenary meeting during the Physics Week. In the presentations particular attention was given to startup plans and readiness for data-taking. Many results based on the recent cosmic run were shown. A special Workshop on SUSY, described in a separate section, took place the day before the plenary. At the meeting, we had also two special DPG presentations on “Tracker and Muon alignment with CRAFT” (Ernesto Migliore) and “Calorimeter studies with CRAFT” (Chiara Rovelli). We had also a report from Offline (Andrea Rizzi) and Computing (Markus Klute) on the San Diego Workshop, described elsewhere in this bulletin. Tracking group (Boris Mangano). The level of sophistication of the tracking software increased significantly over the last few months: V0 (K0 and Λ) reconstr...
Lotrean, Lucia Maria; Trofor, Antigona; Mihălţan, Florin; Santillan, Edna Arillo
School-based health education has the potential to inform and educate young people, in order to promote healthy behaviours among them, which will help to prevent diseases and social problems. The present study gives an overview of several ethical issues which must be considered in different phases of school-based smoking prevention programs. This will help health educators, public health professionals and researchers in their activity of health education in schools. The ethical issues must be taken into consideration during all the activities and refer to the involvement of officials, schools, parents, young people who participate into the program, authors and persons/institutions responsible with the implementation, evaluation or funding of the programs. The application into practice of these ethical principles, influence the quality of the health education, its acceptability BY the target group and the correctness of results. Also, it prevents possible problems and misunderstandings between persons and institutions involved in the health education and smoking prevention process, which could seriously affect and even destroy implementation of such health education activities.
Thakore, Rachel V; Apfeld, Jordan C; Johnson, Ronald K; Sathiyakumar, Vasanth; Jahangir, A Alex; Sethi, Manish K
Violence has recently been reported among a primarily young, minority population in Nashville, Tennessee. School-based programs have been proven as effective methods of reducing violent behavior, beliefs, and actions that lead to violence among adolescents. Investigators implemented a rigorous search for an appropriate school-based violence prevention program for Metropolitan Nashville middle school students utilizing a systematic review and discussion group with victims of violence. 27 programs nation-wide were reviewed and 2 discussion groups with African American males under the age of 25 admitted to a level 1 trauma center for assault-related injuries were conducted. Our findings led to a single, evidence-based conflict resolution program. In conjunction with educators, we evaluated the program's effectiveness in a pilot study in a Nashville middle school with high rates of violence. 122 students completed the conflict resolution program and described their behavior and experiences with violence in a pre-test/post-test self-rate questionnaire. Results showed a significant decrease in violent behavior and an increase in students' competencies to deal with violence (p less than 0.05). This study shows that a reduction in violent behavior and beliefs among middle school students can be achieved through the implementation of a targeted violence intervention program. A larger-scale intervention is needed to develop more conclusive evidence of effectiveness. © 2015 KUMS, All rights reserved.
Katz, Cara; Bolton, Shay-Lee; Katz, Laurence Y; Isaak, Corinne; Tilston-Jones, Toni; Sareen, Jitender
Suicide is one of the leading causes of death among youth today. Schools are a cost-effective way to reach youth, yet there is no conclusive evidence regarding the most effective prevention strategy. We conducted a systematic review of the empirical literature on school-based suicide prevention programs. Studies were identified through MEDLINE and Scopus searches, using keywords such as "suicide, education, prevention and program evaluation." Additional studies were identified with a manual search of relevant reference lists. Individual studies were rated for level of evidence, and the programs were given a grade of recommendation. Five reviewers rated all studies independently and disagreements were resolved through discussion. Sixteen programs were identified. Few programs have been evaluated for their effectiveness in reducing suicide attempts. Most studies evaluated the programs' abilities to improve students' and school staffs' knowledge and attitudes toward suicide. Signs of Suicide and the Good Behavior Game were the only programs found to reduce suicide attempts. Several other programs were found to reduce suicidal ideation, improve general life skills, and change gatekeeper behaviors. There are few evidence-based, school-based suicide prevention programs, a combination of which may be effective. It would be useful to evaluate the effectiveness of general mental health promotion programs on the outcome of suicide. The grades assigned in this review are reflective of the available literature, demonstrating a lack of randomized controlled trials. Further evaluation of programs examining suicidal behavior outcomes in randomized controlled trials is warranted. © 2013 Wiley Periodicals, Inc.
Reveruzzi, Bianca; Buckley, Lisa; Sheehan, Mary
This review examines the breadth of first aid training delivered to school students and the components that are age appropriate to adolescents. Eligible studies included school-based first aid interventions targeting students aged between 10 and 18 years. Online databases were searched, for peer-reviewed publications available as at August 2014. A total of 20 journal articles were relevant to the review. Research supported programs with longer durations (3 hours or more). Most programs taught resuscitation alone and few included content that was context-specific and relevant to the target group. The training experience of the facilitator did not appear to impact on student outcomes. Incorporating both practical and didactic components was found to be an important factor in delivering material and facilitating the retention of knowledge. Educational resources and facilitator training were found to be common features of effective programs. The review supports first aid in school curriculum and provides details of key components pertinent to design of school-based first aid programs. The findings suggest that first aid training may have benefits wider than the uptake and retention of knowledge and skills. There is a need for future research, particularly randomized controlled trials to aid in identifying best practice approaches. © 2016, American School Health Association.
Mason, Liam; Grey, Nick; Veale, David
Allocation of trainee therapist cases is often performed based on intuition and clinical circumstances, with lack of empirical evidence on the role of severity of presenting problem. This has the potential to be anxiety-provoking for supervisors, trainees and service users themselves. To determine how therapist experience interacts with symptom severity in predicting client outcomes. An intention-to-treat analysis of annual outcome data for primary and secondary care clients seen by a specialist anxiety disorders service. 196 clients were stratified into mild, moderate and baseline severe symptoms of anxiety (GAD-7) and depression (PHQ-9). We measured percentage change on these measures, as well as number of sessions and therapy dropout. We also examined rates of reliable and clinically significant change on disorder-specific measures. We hypothesized that qualified therapists would achieve better outcomes than trainees, particularly for severe presentations. Overall, outcomes were comparable between trainee and qualified therapists on all measures, and trainees additionally utilized fewer therapy sessions. There was however an interaction between anxiety severity (GAD-7) and therapist group, such that severely anxious clients achieved greater symptom improvement with qualified as compared to trainee therapists. Further, for trainee but not qualified therapists, baseline anxiety was negatively associated with rate of reliable and clinically significant change on disorder-specific measures. These findings indicate generally favourable outcomes for trainee therapists delivering manualized treatments for anxiety disorders. They additionally suggest that trainee therapists may benefit from additional support when working with clients that present with severe anxiety.
Ziv-Beiman, Sharon; Keinan, Giora; Livneh, Elad; Malone, Patrick S; Shahar, Golan
We report a first randomized clinical trial examining the effect of immediate and non-immediate therapist self-disclosure in the context of a brief integrative psychotherapy for mild to moderate distress. A total of 86 patients with mild to moderate forms of distress were randomly divided into three 12-session integrative psychotherapy conditions based primarily on [Hill, C. E. (2009). Helping skills: Facilitating, exploration, insight, and action (3rd ed.). Washington, DC: American Psychological Association.] three-stage model. Therapists trained in this treatment modality were instructed to use either immediate self-disclosure (expressing feelings towards the patient/treatment/therapeutic relationship) or non-immediate self-disclosure (expressing personal or factual information regarding the therapist's life outside the treatment). In the comparison condition, the therapists were instructed to refrain from self-disclosure altogether. Immediate therapist self-disclosure reduced psychiatric symptoms among patients with elevated pretreatment symptoms (as assessed by the Brief Symptoms Inventory) and bolstered a favorable perception of the therapist. Therapists in both the immediate and non-immediate self-disclosure group evaluated themselves more favorably than their counterparts in the non-disclosure group. Therapist self-disclosure, particularly of the immediate type, might enhance the effect of brief integrative treatment on psychiatric symptoms of high symptomatic patients and contribute to favorable perception of therapists.
Roel C. J. Hermans
Full Text Available BackgroundTo improve the effectiveness of school-based programs that aim to promote adolescents’ healthy food choices, it is essential to understand the views and behaviors of the target group. This study aimed to get a better understanding of adolescents’ food and health perceptions and their willingness to be involved in a specific school-based prevention program, i.e., the Dutch “Healthy School Canteen Program.”MethodsThis study used a mixed-methods research design. First, seven semi-structured focus groups were conducted using a selective sample of 42 Dutch adolescents (25 girls, 17 boys, aged 13–16 years. Second, an online survey among 133 adolescent respondents (72 girls, 61 boys, aged 12–19 years using snowball sampling was conducted. Content analysis was performed to make inferences about the focus group discussions, whereas statistical analyses were conducted to analyze the survey data.ResultsFindings from the group discussions indicated that healthy eating was only an issue of importance when adolescents perceived negative physical changes (e.g., with regard to looks or physical performance. Adolescents also indicated that they clearly wanted to make their own food and beverage choices at school. The quantitative data indicated that taste, price, and variety were seen as the most important aspects of a healthy food assortment (mean scores 8.1, 7.8, and 7.7 on a 10-point scale, respectively. In general, a majority of the adolescents (64% expressed that students should be involved in the organization of a healthy food environment in schools. At the same time, however, adolescents were not willing to participate themselves. This was mostly because they were skeptical about their ideas being heard and put into action by their schools.ConclusionSchool-based prevention programs, such as the Healthy School Program, should take into account that adolescents have a low risk perception of unhealthy eating and are seeking food
Full Text Available Introduction: Sleep deficiency is a significant, largely overlooked issue for persons with dementia (PWD, and is associated with physical and mental health problems, increased caregiver burden, and increased likelihood of institutionalization. Despite the high prevalence of sleep deficiency in PWD, most health care professionals lack knowledge of the relationship between sleep problems and dementia. This project aimed to determine the feasibility of an archived online presentation, a knowledge translation (KT strategy to increase therapists’ understanding of the impact of blue-spectrum light on sleep in PWD. Method: Therapists who participated in a previous sleep and dementia survey were recruited via email. Participants completed a pre-knowledge test, accessed an online presentation regarding the relationship between sleep and light, and completed a post-test. Results: On average there was a 22% improvement in knowledge scores and participants were positive about the KT strategy being accessible, applicable, and evidence based. Conclusion: For a sample of therapists self-identified as specializing in geriatric rehabilitation, online audio-visual resources appear to be a feasible KT strategy to disseminate information and increase occupational therapists’ knowledge regarding the evidence-based relationship between blue-spectrum light and sleep in PWD. Further study is required to determine if this increased knowledge translates to practice settings.
Full Text Available The aim of this study is to analyze the relationship between the personal style of the therapist, attachment style and personality trait. It was used the personal style of the therapist questionnaire (PST – Q, the Argentinean attachment inventory and the big five inventory. The study sample consisted of 120 psychotherapists average age of 36.28 years (SD = 9.65, and the average years of experience was 7.90 years (SD = 8.04. The analysis of the results showed that there is a positive, significant and low intensity between the personality factor of openness to experience and personal style of involvement, a negative correlation, significant and of medium intensity between low extraversion factor correlation and mode not anxious romantic attachment and a significant positive relationship between the low–intensity factor neuroticism personality and how anxious romantic attachment.
A lot has transpired on the “Physics” front since the last CMS Bulletin. The summer was filled with preparations of new Monte Carlo samples based on CMSSW_3, the finalization of all the 10 TeV physics analyses [in total 50 analyses were approved] and the preparations for the Physics Week in Bologna. A couple weeks later, the “October Exercise” commenced and ran through an intense two-week period. The Physics Days in October were packed with a number of topics that are relevant to data taking, in a number of “mini-workshops”: the luminosity measurement, the determination of the beam spot and the measurement of the missing transverse energy (MET) were the three main topics. Physics Week in Bologna The second physics week in 2009 took place in Bologna, Italy, on the week of Sep 7-11. The aim of the week was to review and establish how ready we are to do physics with the early collisions at the LHC. The agenda of the week was thus pac...
A lot has transpired on the “Physics” front since the last CMS Bulletin. The summer was filled with preparations of new Monte Carlo samples based on CMSSW_3, the finalization of all the 10 TeV physics analyses [in total 50 analyses were approved] and the preparations for the Physics Week in Bologna. A couple weeks later, the “October Exercise” commenced and ran through an intense two-week period. The Physics Days in October were packed with a number of topics that are relevant to data taking, in a number of “mini-workshops”: the luminosity measurement, the determination of the beam spot and the measurement of the missing transverse energy (MET) were the three main topics. Physics Week in Bologna The second physics week in 2009 took place in Bologna, Italy, on the week of Sep 7-11. The aim of the week was to review and establish (we hoped) the readiness of CMS to do physics with the early collisions at the LHC. The agenda of the...
Scaling-up an efficacious school-based physical activity intervention: Study protocol for the ‘Internet-based Professional Learning to help teachers support Activity in Youth’ (iPLAY cluster randomized controlled trial and scale-up implementation evaluation
Full Text Available Abstract Background Despite the health benefits of regular physical activity, most children are insufficiently active. Schools are ideally placed to promote physical activity; however, many do not provide children with sufficient in-school activity or ensure they have the skills and motivation to be active beyond the school setting. The aim of this project is to modify, scale up and evaluate the effectiveness of an intervention previously shown to be efficacious in improving children’s physical activity, fundamental movement skills and cardiorespiratory fitness. The ‘Internet-based Professional Learning to help teachers support Activity in Youth’ (iPLAY study will focus largely on online delivery to enhance translational capacity. Methods/Design The intervention will be implemented at school and teacher levels, and will include six components: (i quality physical education and school sport, (ii classroom movement breaks, (iii physically active homework, (iv active playgrounds, (v community physical activity links and (vi parent/caregiver engagement. Experienced physical education teachers will deliver professional learning workshops and follow-up, individualized mentoring to primary teachers (i.e., Kindergarten – Year 6. These activities will be supported by online learning and resources. Teachers will then deliver the iPLAY intervention components in their schools. We will evaluate iPLAY in two complementary studies in primary schools across New South Wales (NSW, Australia. A cluster randomized controlled trial (RCT, involving a representative sample of 20 schools within NSW (1:1 allocation at the school level to intervention and attention control conditions, will assess effectiveness and cost-effectiveness at 12 and 24 months. Students’ cardiorespiratory fitness will be the primary outcome in this trial. Key secondary outcomes will include students’ moderate-to-vigorous physical activity (via accelerometers, fundamental movement
Anderson, Timothy; Crowley, Mary Ellen J; Himawan, Lina; Holmberg, Jennifer K; Uhlin, Brian D
Therapist effects, independent of the treatment provided, have emerged as a contributor to psychotherapy outcomes. However, past research largely has not identified which therapist factors might be contributing to these effects, though research on psychotherapy implicates relational characteristics. The present Randomized Clinical Trial tested the efficacy of therapists who were selected by their facilitative interpersonal skills (FIS) and training status. Sixty-five clients were selected from 2713 undergraduates using a screening and clinical interview procedure. Twenty-three therapists met with 2 clients for 7 sessions and 20 participants served in a no-treatment control group. Outcome and alliance differences for Training Status were negligible. High FIS therapists had greater pre-post client outcome, and higher rates of change across sessions, than low FIS therapists. All clients treated by therapists improved more than the silent control, but effects were greater with high FIS than low FIS therapists. From the first session, high FIS therapists also had higher alliances than low FIS therapists as well as significant improvements on client-rated alliance. Results were consistent with the hypothesis that therapists' common relational skills are independent contributors to therapeutic alliance and outcome.
In my master’s degree thesis I focus on the opinions of a sample group of speech and language therapists working on partner cooperation with parents. In the theoretical part I describe various models of cooperation, which includes partnership model as well. I define the concept of partnership, on the basis of expert knowledge of various authors. I also define the difference between the concepts of partnership and cooperation. I list the elements of partnership mentioned by the authors. In ...
There is a need to find out the association between school-based physical activity, including physical education and academic performance among school-aged youth. To better understand these connections, this research paper first finds out the independent variables upon which academic performance depends. Study is from a range of physical activity contexts, including school-based physical education, recess, classroom-based physical activity and extracurricular physical activity. In his attempt...
Gupta, Sangeeta; Paterson, Margo L; Lysaght, Rosemary M; von Zweck, Claudia M
Work-related stress and burnout have been found to lead to job dissatisfaction, low-organizational commitment, absenteeism, and high turnover. The purpose of this study was to examine the burnout experiences of occupational therapists practicing in Ontario and to describe the practice implications and coping strategies employed. Data for this mixed methods study were collected using the Maslach Burnout Inventory-General Survey, Areas of Worklife Survey, focus groups, and interviews in the hermeneutics tradition. High levels of emotional exhaustion were reported by 34.8% of participants, high levels of cynicism by 43.5%, and low professional efficacy by 24.6%. Practice issues included excessive demands on time, conflict, and lack of autonomy and respect. Coping strategies included spending time with family and maintaining professional/personal balance, control of work responsibilities, maintaining a sense of humor, and self-awareness/self-monitoring. This study contributes to understanding the practice challenges for occupational therapists, factors that contribute to therapist burnout, and strategies employed to maintain competent practice.
Maviş, Ilknur; St Louis, Kenneth O; Özdemir, Sertan; Toğram, Bülent
The study sought to identify clinical beliefs and attitudes of speech and language therapists (SLTs) in Turkey and to compare them to previous research on SLTs in the USA and UK. The Clinician Attitudes Toward Stuttering (CATS) inventory was administered by mail to nearly all-practicing SLTs in Turkey (n=61). Turkish SLTs, whose caseloads contained a substantial number of people who stutter, agreed with CATS items suggesting psychological causes and problems for those who stutter. They strongly believed therapy should focus on parent counseling for preschoolers who stutter as well as adolescents. They were not optimistic about carrying out stuttering therapy nor about the likelihood that children who stutter could be effectively treated. Attitudes toward stuttering by clinicians who treat them are important considerations in the conduct and outcomes of stuttering therapy. Additionally, SLTs working with stuttering clients should benefit from professional views and clinical experiences of their colleagues from surveys such as this one. The reader will be able to describe: (a) the components of the CATS, (b) common themes in Turkish speech and language therapists' attitudes toward stuttering, (c) differences between the attitudes of speech and language therapists from Turkey versus the United States and the United Kingdom. Copyright © 2013 Elsevier Inc. All rights reserved.
Craft was the first therapeutic occupation of occupational therapy. Since the early days of the profession, the value of craft in practice is a topic that has been discussed with fluctuating interest. Recent discussions by occupational therapists have reinforced that although craft is relevant to occupational therapy, there are uncertainties about its place in contemporary practice. Presently, scholars have identified that occupation is both the center of human experience and the core of our profession. Therefore, this study aimed to begin to clarify the meaning of craft to practice today by gaining a deep understanding of the meanings that one occupational therapist attributes to craft. Using narrative inquiry, data were gathered through a conversation held between the research participant and myself. A reflexive journal was also kept to support this data gathering process. Narrative analysis enabled intimate engagement with the data and the emergence of themes and sub-themes. The findings, in the form of an interpretive story, suggest first, that craft-making has therapeutic value; second, that reasoning about the therapeutic use of craft is similar to reasoning about other therapeutic activities; and third, that personal experience with craft-making can influence the selection of craft as therapeutic media. From this study, further research into the impact personal and professional experiences can have on choice of therapeutic media and an analysis of the sociopolitical context of the meanings that occupational therapists attribute to craft-making is suggested.
Hallberg, N; Johansson, M; Timpka, T
Due to recent reforms, the demands on the people working in community-oriented health care service are increasing. The individual providers need professional knowledge and skills to perform their tasks quickly and safely. The individuals are also confronted with new tasks and situations of which they lack experience. At the same time, the resources for education and development are decreasing. The aim of this paper is to describe the implementation of a prototype computer network service to support occupational therapists in their daily work. A customized Quality Function Deployment (QFD) model, including participatory design elements, was used for: (a) identification of the occupational therapists' needs; and (b) for the transformation of these needs to prioritized design attributes. The main purpose of the prototype was to improve the visualization of the design attributes that were found to support the occupational therapists. An additional purpose was to be able to evaluate the design attributes and further improve them. The specific aim of this article is to describe the initial prototype with respect both to the tools and the information content.
The all-plenary format of the CMS week in Cyprus gave the opportunity to the conveners of the physics groups to present the plans of each physics analysis group for tackling early physics analyses. The presentations were complete, so all are encouraged to browse through them on the Web. There is a wealth of information on what is going on, by whom and on what basis and priority. The CMS week was followed by two CMS “physics events”, the ICHEP08 days and the physics days in July. These were two weeks dedicated to either the approval of all the results that would be presented at ICHEP08, or to the review of all the other Monte-Carlo based analyses that were carried out in the context of our preparations for analysis with the early LHC data (the so-called “2008 analyses”). All this was planned in the context of the beginning of a ramp down of these Monte Carlo efforts, in anticipation of data. The ICHEP days are described below (agenda and talks at: http://indic...
There have been two plenary physics meetings since the December CMS week. The year started with two workshops, one on the measurements of the Standard Model necessary for “discovery physics” as well as one on the Physics Analysis Toolkit (PAT). Meanwhile the tail of the “2007 analyses” is going through the last steps of approval. It is expected that by the end of January all analyses will have converted to using the data from CSA07 – which include the effects of miscalibration and misalignment. January Physics Days The first Physics Days of 2008 took place on January 22-24. The first two days were devoted to comprehensive re¬ports from the Detector Performance Groups (DPG) and Physics Objects Groups (POG) on their planning and readiness for early data-taking followed by approvals of several recent studies. Highlights of POG presentations are included below while the activities of the DPGs are covered elsewhere in this bulletin. January 24th was devo...
Bast, Lotus Sofie; Due, Pernille; Bendtsen, Pernille
prevention trial-the X:IT study. METHODS: A cluster-randomized trial testing is a multi-component intervention to prevent smoking among adolescents in 94 Danish elementary schools (51 intervention, 43 control schools). Participants were grade 7 pupils (mean age 12.5 years). Data was collected by electronic...... into account the complexity of the concept nor the intervention. The objective of the present study was to develop an overall quantitative measure of implementation fidelity, to examine the degree of implementation fidelity and the association of implementation and effect of a randomized school-based smoking...... questionnaires among pupils at baseline (n = 4161), the first follow-up (n = 3764), and the second follow-up (n = 3269) and among school coordinators at intervention schools at the first and second follow-up (50 and 39 coordinators). INTERVENTION: The intervention included three components: (1) smoke-free school...
Rienzo, B A; Button, J W; Wald, K D
School-based health centers (SBHCs) provide access to health services by bringing providers to children (and sometimes parents) and furnishing low cost services in an atmosphere of trust. While the number of SBHCs has continued to grow and some clinics have continued to expand their services, others have barely survived and some have even closed. This study investigated factors, particularly political forces, that affected the success of SBHCs. Using a national survey of clinic directors, this study assessed clinic success in terms both of longevity and service delivery. Findings indicate the factors most consistently and significantly associated with success include not only measures of "need" (school size and percent African-American enrollment or population) but of "politics" (citizen political ideology and Southern conservatism). Thus, politics matters more than previous studies suggested.
Defined as the scientific study of matter and energy, physics explains how all matter behaves. Separated into modern and classical physics, the study attracts both experimental and theoretical physicists. From the discovery of the process of nuclear fission to an explanation of the nature of light, from the theory of special relativity to advancements made in particle physics, this volume profiles 10 pioneers who overcame tremendous odds to make significant breakthroughs in this heavily studied branch of science. Each chapter contains relevant information on the scientist''s childhood, research, discoveries, and lasting contributions to the field and concludes with a chronology and a list of print and Internet references specific to that individual.
The time period between the last CMS week and this June was one of intense activity with numerous get-together targeted at addressing specific issues on the road to data-taking. The two series of workshops, namely the “En route to discoveries” series and the “Vertical Integration” meetings continued. The first meeting of the “En route to discoveries” sequence (end 2007) had covered the measurements of the Standard Model signals as necessary prerequisite to any claim of signals beyond the Standard Model. The second meeting took place during the Feb CMS week and concentrated on the commissioning of the Physics Objects, whereas the third occurred during the April Physics Week – and this time the theme was the strategy for key new physics signatures. Both of these workshops are summarized below. The vertical integration meetings also continued, with two DPG-physics get-togethers on jets and missing ET and on electrons and photons. ...
The months that have passed since the last CMS Bulletin have been a very busy and exciting time for CMS physics. We have gone from observing the very first 8TeV collisions produced by the LHC to collecting a dataset of the collisions that already exceeds that recorded in all of 2011. All in just a few months! Meanwhile, the analysis of the 2011 dataset and publication of the subsequent results has continued. These results come from all the PAGs in CMS, including searches for the Higgs boson and other new phenomena, that have set the most stringent limits on an ever increasing number of models of physics beyond the Standard Model including dark matter, Supersymmetry, and TeV-scale gravity scenarios, top-quark physics where CMS has overtaken the Tevatron in the precision of some measurements, and bottom-quark physics where CMS made its first discovery of a new particle, the Ξ*0b baryon (candidate event pictured below). Image 2: A Ξ*0b candidate event At the same time POGs and PAGs...
Since the last CMS Week, all physics groups have been extremely active on analyses based on the full 2010 dataset, with most aiming for a preliminary measurement in time for the winter conferences. Nearly 50 analyses were approved in a “marathon” of approval meetings during the first two weeks of March, and the total number of approved analyses reached 90. The diversity of topics is very broad, including precision QCD, Top, and electroweak measurements, the first observation of single Top production at the LHC, the first limits on Higgs production at the LHC including the di-tau final state, and comprehensive searches for new physics in a wide range of topologies (so far all with null results unfortunately). Most of the results are based on the full 2010 pp data sample, which corresponds to 36 pb-1 at √s = 7 TeV. This report can only give a few of the highlights of a very rich physics program, which is listed below by physics group...
Uhlig, S.; Dimitriadis, Theo; Hackvoort, Laurien; Scherder, E.J.A.
Music therapists use rap and singing for at-risk youth and young adults in different treatment settings. However, it is unclear how often and what kind of interventions they apply, and what kind of treatment goals are pursued. The purpose of this study was to examine approaches of music therapists
Larson, Nicole; Davey, Cynthia S; Caspi, Caitlin E; Kubik, Martha Y; Nanney, Marilyn S
The promotion of healthy eating and physical activity within school settings is an important component of population-based strategies to prevent obesity; however, adolescents may be vulnerable to weight-related messages, as rapid development during this life stage often leads to preoccupation with body size and shape. This study examines secular trends in secondary school curricula topics relevant to the prevention of unhealthy weight-control behaviors; describes cross-sectional associations between weight-related curricula content and students' use of weight-control behaviors; and assesses whether implementation of school-based obesity-prevention policies/practices is longitudinally related to students' weight-control behaviors. The Minnesota School Health Profiles and Minnesota Student Survey (grades 9 and 12) data were used along with National Center for Education Statistics data to examine secular trends, cross-sectional associations (n=141 schools), and longitudinal associations (n=42 schools). Students self-reported their height and weight along with past-year use of healthy (eg, exercise), unhealthy (eg, fasting), and extreme (eg, use laxatives) weight-control behaviors. Descriptive statistics, generalized estimating equations, and generalized linear regression models accounting for school-level demographics. There was no observable pattern during the years 2008 to 2014 in the mean number of curricula topics addressing unhealthy weight-control behaviors, despite an increase in the prevalence of curricula addressing acceptance of body-size differences. Including three vs fewer weight-control topics and specifically including the topic of eating disorders in the curricula was related to a lower school-level percent of students using any extreme weight-control behaviors. In contrast, an overall measure of implementing school-based obesity-prevention policies/practices (eg, prohibited advertising) was unrelated to use of unhealthy or extreme behaviors
Liu, Lili; Miguel Cruz, Antonio; Rios Rincon, Adriana; Buttar, Vickie; Ranson, Quentin; Goertzen, Darrell
The aim of this study was to examine what factors affect the acceptance behavior and use of new technologies for rehabilitation by therapists at a large rehabilitation hospital in Canada. A self-administrated paper-based survey was created by adapting scales with high levels of internal consistency in prior research using the Unified Theory of Acceptance and Use of Technology (UTAUT). Items were scored on a 7-point Likert scale, ranging from "strongly disagree (1)" to "strongly agree (7)". The target population was all occupational therapists (OT) and physical therapists (PT) involved with the provision of therapeutic interventions at the hospital. Our research model was tested using partial least squares (PLS) technique. Performance expectancy was the strongest salient construct for behavioral intention to use new technologies in rehabilitation, whereas neither effort expectancy nor social influence were salient constructs for behavioral intention to use new technologies; (4) facilitating condition and behavioral intention to use new technologies were salient constructs for current use of new technologies in rehabilitation, with facilitating condition the strongest salient for current use of new technologies in rehabilitation. In a large rehabilitation hospital where use of new technologies in rehabilitation is not mandatory, performance expectancy, or how the technology can help in therapists' work, was the most important factor in determining therapists' acceptance and use of technologies. However, effort expectancy and social influence constructs were not important, i.e. therapists were not influenced by the degree of difficulty or social pressures to use technologies. Behavioral intention and facilitating condition, or institutional support, are related to current use of new technologies in rehabilitation.
Chawla, Nattapon; Panza, Alessio; Sirikulchayanonta, Chutima; Kumar, Ramesh; Taneepanichskul, Surasak
Childhood obesity has become a major public health issue today. The prevalence of obesity and overweight is increasing in both adults and children. Childhood obesity in Thailand has more than doubled since the 1960s and a recent study reported that overweight and obesity in Thais is the 5th highest in Asia. The present study objective was to evaluate the effectiveness of a life-skills, multicomponent, school-based intervention on child nutritional status. A quasi-experimental design was conducted in two-groups (control and intervention schools) on 453 students attending grade levels 4-5 in Bangkok. Two schools were selected for control, and two schools for intervention groups. The interventions included education, diet, physical activity (PA), food-environment, school builtenvironment, and life-skills components. Subjects were measured at baseline and at 6 months post-treatment. The intervention group had significant differences in overall healthy practices (+1.5 mean difference, p=0.048), dietary habits, physical activity, lower total cholesterol (TC) levels (-2.43 mean, p=0.019) and higher high density lipoprotein cholesterol (HDL-C) levels (+4.06 p=0.028) as compared to the control. A higher reduction of overweight individuals among the intervention group over the intervention period was observed. Physical activity and consumption of vegetables increased while consumption of high-caloric snacks and fast foods decreased in children after the intervention. This study indicated that a multidisciplinary approach in school-based interventions is most likely to be effective in preventing children from becoming overweight in the long term. More research should be conducted on school-based interventions with longer intervention periods and higher sustainability.
Chawla, N.; Panza, A.; Kumar, R.
Childhood obesity has become a major public health issue today. The prevalence of obesity and overweight is increasing in both adult and children. Childhood obesity in Thailand has more than doubled since the 1960s and a recent study reported that overweight and obesity in Thai is the 5th highest in Asia. The present study objective is to evaluate the effectiveness of a life skills multicomponent school-based intervention on children's nutritional status. Methods: A quasi-experimental design was conducted in two-groups (control and intervention schools) on 453 students attending grade levels 4-5 in Bangkok. Two schools were selected for control, and two schools for intervention groups. The intervention included education, dietary, physical activity, food-environment, school built-environment, and life skills components. Outcomes were measured at baseline and post-treatment measured after 6 months. Results: The intervention group had significant improvements in healthier practice (+1.5 mean difference, p=0.048) on dietary habits and physical activity, lowered cholesterol levels (-2.43 mean, p=0.019), and higher HDL levels (+4.06 p=0.028) as compared to control. A higher reduction of overweight individuals among the intervention group over the intervention period was observed. Physical activity and consumption of vegetable increased while consumption of high-caloric snacks and fasts food decreased in children after the intervention. Conclusion: Childhood overweight and obesity is a serious public health problem based on its increasing rates and the associated health risks. This study indicated that multidisciplinary approach on school-based interventions is likely most effective to prevent children becoming overweight in long term. More research should be conducted on school-based intervention with longer intervention periods with higher sustainability. (author)
Morris, Matthew C; Kouros, Chrystyna D; Janecek, Kim; Freeman, Rachel; Mielock, Alyssa; Garber, Judy
Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Lastprogramcomparedtoawaitlistcontrolcondition.(*) Knowledge gains from pre- to post-intervention were assessed in 5 domains: safe versus unsafe people; safe choices; problem-solving; clear disclosure; and assertiveness. Participants were 1177 students (46% White, 26% African American, 15% Hispanic, 4% Asian American, 6% Other) in grades 1 through 6 from 14 public schools in Tennessee. Multilevel models accounting for the nesting of children within schools revealed large effect sizes for the intervention versus control across all knowledge domains (d's ranged from 1.56 to 2.13). The effectiveness of the program was moderated by mean per capita income and rates of substantiated cases of child abuse and neglect in the community. Intervention effects were stronger for youth living in lower as compared to higher income counties, and for youth attending schools in counties with lower as compared to higher abuse/neglect rates. Child characteristics (sex, race) did not moderate intervention effects. This research identified two community-level factors that predicted the effectiveness of a CSA education and prevention program designed to improve children's knowledge of personal safety skills. School-based CSA prevention programs may require modification for communities with higher rates of child abuse and neglect. Copyright © 2016 Elsevier Ltd. All rights reserved.
Oswald, W.; Hutting, N.; Engels, J.A.; Staal, J.B.; Nijhuis-Van der Sanden, M.W.G.; Heerkens, Y.F.
BACKGROUND: Musculoskeletal disorders are the main complaints for visiting a physical therapist (PT) in primary health care; they have a negative effect on an individual's quality of life and result in a major cost to society. Qualitative research has shown that physical therapists (PTs) treating
... decrease medications requirements. Aerobic exercise such as walking, biking and swimming for 30 minutes four-five days a week is very helpful and can lead to an improvement in your health, along with resistive training to increase your muscle ...
The collisions last year at 900 GeV and 2.36 TeV provided the long anticipated collider data to the CMS physics groups. Quite a lot has been accomplished in a very short time. Although the delivered luminosity was small, CMS was able to publish its first physics paper (with several more in preparation), and commence the commissioning of physics objects for future analyses. Many new performance results have been approved in advance of this CMS Week. One remarkable outcome has been the amazing agreement between out-of-the-box data with simulation at these low energies so early in the commissioning of the experiment. All of this is testament to the hard work and preparation conducted beforehand by many people in CMS. These analyses could not have happened without the dedicated work of the full collaboration on building and commissioning the detector, computing, and software systems combined with the tireless work of many to collect, calibrate and understand the data and our detector. To facilitate the efficien...
The Physics Groups are actively engaged on analyses of the first data from the LHC at 7 TeV, targeting many results for the ICHEP conference taking place in Paris this summer. The first large batch of physics approvals is scheduled for this CMS Week, to be followed by four more weeks of approvals and analysis updates leading to the start of the conference in July. Several high priority analysis areas were organized into task forces to ensure sufficient coverage from the relevant detector, object, and analysis groups in the preparation of these analyses. Already some results on charged particle correlations and multiplicities in 7 TeV minimum bias collisions have been approved. Only one small detail remains before ICHEP: further integrated luminosity delivered by the LHC! Beyond the Standard Model measurements that can be done with these data, the focus changes to the search for new physics at the TeV scale and for the Higgs boson in the period after ICHEP. Particle Flow The PFT group is focusing on the ...
the PAG conveners
The delivered LHC integrated luminosity of more than 1 inverse femtobarn by summer and more than 5 by the end of 2011 has been a gold mine for the physics groups. With 2011 data, we have submitted or published 14 papers, 7 others are in collaboration-wide review, and 75 Physics Analysis Summaries have been approved already. They add to the 73 papers already published based on the 2010 and 2009 datasets. Highlights from each physics analysis group are described below. Heavy ions Many important results have been obtained from the first lead-ion collision run in 2010. The published measurements include the first ever indications of Υ excited state suppression (PRL synopsis), long-range correlation in PbPb, and track multiplicity over a wide η range. Preliminary results include the first ever measurement of isolated photons (showing no modification), J/ψ suppression including the separation of the non-prompt component, further study of jet fragmentation, nuclear modification factor...
Physics-wise, the CMS week in December was dominated by discussions of the analyses that will be carried out in the “next six months”, i.e. while waiting for the first LHC collisions. As presented in December, analysis approvals based on Monte Carlo simulation were re-opened, with the caveat that for this work to be helpful to the goals of CMS, it should be carried out using the new software (CMSSW_2_X) and associated samples. By the end of the week, the goal for the physics groups was set to be the porting of our physics commissioning methods and plans, as well as the early analyses (based an integrated luminosity in the range 10-100pb-1) into this new software. Since December, the large data samples from CMSSW_2_1 were completed. A big effort by the production group gave a significant number of events over the end-of-year break – but also gave out the first samples with the fast simulation. Meanwhile, as mentioned in December, the arrival of 2_2 meant that ...
2012 has started off as a very busy year for the CMS Physics Groups. Planning for the upcoming higher luminosity/higher energy (8 TeV) operation of the LHC and relatively early Rencontres de Moriond are the high-priority activities for the group at the moment. To be ready for the coming 8-TeV data, CMS has made a concerted effort to perform and publish analyses on the 5 fb−1 dataset recorded in 2011. This has resulted in the submission of 16 papers already, including nine on the search for the Higgs boson. In addition, a number of preliminary results on the 2011 dataset have been released to the public. The Exotica and SUSY groups approved several searches for new physics in January, such as searches for W′ and exotic highly ionising particles. These were highlighted at a CERN seminar given on 24th January. Many more analyses, from all the PAGs, including the newly formed SMP (Standard Model Physics) and FSQ (Forward and Small-x QCD), were approved in February. The ...
The period since the last CMS Bulletin has been historic for CMS Physics. The pinnacle of our physics programme was an observation of a new particle – a strong candidate for a Higgs boson – which has captured worldwide interest and made a profound impact on the very field of particle physics. At the time of the discovery announcement on 4 July, 2012, prominent signals were observed in the high-resolution H→γγ and H→ZZ(4l) modes. Corroborating excess was observed in the H→W+W– mode as well. The fermionic channel analyses (H→bb, H→ττ), however, yielded less than the Standard Model (SM) expectation. Collectively, the five channels established the signal with a significance of five standard deviations. With the exception of the diphoton channel, these analyses have all been updated in the last months and several new channels have been added. With improved analyses and more than twice the i...
Bell, Anne C.
The purpose of this study has been to consider the eco-pedagogical promise of school-based habitat restoration. How does the practice of restoration foster a lived sense of being in a more-than-human world1 while inviting alternative approaches to teaching and learning? What opportunities does it offer to resist the societal forces and patterns, reinforced through the school system, which are eroding and effacing human relationships with other life? A literature review sets the broader context for an in-depth exploration of the experiences and understandings of participants (students, teachers, parents) involved in a case study. I proceeded with my research on the assumption that both the discursive and non-discursive dimensions of habitat restoration were key to appreciating its eco-pedagogical potential. Through participant observation over a ten month period, interviewing and a survey, I listened to some of the ways that habitat restoration challenged the typically disembodied, decontextualized organization of schooling by privileging hands-on involvement and encouraging attentive, caring relationships within the human and natural communities of which students were a part. I investigated particular storylines and metaphors which encoded and supported participants' endeavours, especially with regard to their potential to disrupt human-centered values and beliefs. This study suggests that the promise of habitat restoration lies in the openings created to attune to and interact with human and nonhuman others in fully embodied, locally situated and personally meaningful ways. Participants overwhelmingly attested to the importance of the experience of restoration which many deemed to be memorable and motivating and to provide fertile ground for future engagements in/for nature and society. As participants attended to the nuances and complexities of their interactions with a specific place and its inhabitants, their intimate involvement added a depth of feeling and
Brauhardt, Anne; de Zwaan, Martina; Herpertz, Stephan; Zipfel, Stephan; Svaldi, Jennifer; Friederich, Hans-Christoph; Hilbert, Anja
While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance. In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study), therapist adherence using the newly developed Adherence Control Form (ACF) was determined by trained raters in randomly selected 418 audio-taped CBT sessions of 89 patients (25% of all sessions). Observer-rated therapeutic alliance, interview-based and self-reported patient and therapist characteristics were assessed. Three-level multilevel modeling was applied. The ACF showed adequate psychometric properties. Therapist adherence was excellent. While significant between-therapist variability in therapist adherence was found, within-therapist variability was non-significant. Patient and therapist characteristics did not predict the therapist adherence. The therapist adherence positively predicted the therapeutic alliance. The ACF demonstrated its utility to assess therapist adherence in CBT for BED. The excellent levels of therapist adherence point to the internal validity of the CBT within the INTERBED-study serving as a prerequisite for empirical comparisons between treatments. Variability between therapists should be addressed in therapist trainings and dissemination trials. Copyright © 2014 Elsevier Ltd. All rights reserved.
Nelson, Helen; Giles, Susan; McInnes, Heather; Hitch, Danielle
The recruitment and retention of a skilled occupational therapy workforce is highlighted as a key issue for the profession, and yet there have been relatively few studies into the career progression of occupational therapists. A qualitative, naturalistic approach was adopted to answer the research question, using semi-structured interviews to gather data. Eleven purposefully selected participants at an Australian health service were interviewed as part of this study. Categories representing the most common themes and topics supplied by participants within their individual interviews were identified and consolidated by the research team. The trustworthiness of this study was supported by strategies to maximise its credibility, dependability and confirmability. Four main themes were elicited from the data - (i) Readiness for progression, (ii) Tools and processes, (iii) Expectations and (iv) What I wish I had known first. Within these themes, related findings were also identified by both Grade 2 and Grade 3 staff. This study indicates that the readiness of occupational therapists to climb the career ladder is influenced by the tools and processes they can utilise, and the expectations they have around the realities of their new position. With hindsight, participants highlighted some things they wish they had known at the time of transition, which appeared to have been implicit. This study is the first to address the common issues for occupational therapy staff around progression between grade levels. It therefore provides a basis for further research in other practice settings and for the development of supports for therapists climbing the career ladder. © 2015 Occupational Therapy Australia.
Séfora Gomez Portela
Full Text Available This research aimed at understanding and reflecting on the perceptions of occupational therapists regarding the implementation of palliative care in home care. This is an exploratory, qualitative study, through semi-structured interviews, conducted in the second semester of 2012 with eight occupational therapists with experience in palliative care in the city of São Paulo. Content analysis identified four themes: characterization and professional trajectory in the field, understanding the concepts of palliative care, home care and palliative care, and occupational therapy and palliative care in home care. The results suggest that the role of the occupational therapist in this field has taken place at different levels of health care, being addressed to people with varying needs. The use of the concept of palliative care by the interviewees exceeds the notion of end of life, following the changes in the epidemiological transition. They understand that professional services follow the trend of national palliative care services with focus on specialized levels, but manifest the importance of its implementation in primary and home care. Among the barriers to practice, they identified the complexity of “being at home “, peculiarities of palliative care with high cost demands, lack of infrastructure and implementation of the current policy. Professional training and scientific roduction in the area were viewed as inadequate, although they identified a call for change. The interviewees recognized palliative care in home care as a strong professional field, but one still requiring study and discussions regarding its limits and conditions of implementation, especially in the Unified Health System.
Bradford, Brent; Kell, Shannon; Forsberg, Nick
The development of fundamental movement skills is essential in quality physical education. It has become widely accepted that school-age children who fail to reach the automatic phase in fundamental movement-skill development may choose physically inactive and unhealthy lifestyles. Therefore, physical educators must continue to discover ways to…
Aherne, Cian; Coughlan, Barry; Surgenor, Paul
A sense of disconnection for people who are suicidal seems to be a key construct of previous literature. Therapists' ways of encountering and understanding people who are suicidal have not been previously researched in depth using qualitative methodologies. The current study aims to develop a theoretical framework for the role played by connectedness in relation to suicide based on the perspectives of psychotherapists working in the field of suicide intervention. Psychotherapists (N = 12) from a suicide intervention service in Ireland were interviewed in relation to connectedness and suicide. The interviews were analysed using Constructivist Grounded Theory. A tentative theoretical model for connectedness in relation to suicide was developed. Therapists view self-disconnect as at the core of suicidality and note that toxic relationships also play a critical role. Therapeutic connection can present as a life-saving paradox for people who are suicidal. Risk of death and therapeutic endeavour may present as challenging dynamics for working with people who are suicidal. Some discussion points include the worth of self-compassion development for people who are suicidal, the rephrasing of "psychotherapy" when trying to save someone's life and the emphasis on relationship skills for all healthcare professionals who encounter people who are suicidal. Clinical or methodological significance of this article: This article is one of the first in which therapists are interviewed about their understandings of suicide and the processes of suicide in the therapeutic space. It offers novel insights about how people who are suicidal present in therapy and what may be contributing to this presentation. The research also gives insights on the struggles for therapists working with people who are suicidal and who may be ambiguous about the prospect of therapy and connecting. The study also offers important direction for future studies in relation to what requires further discussion
Larsen, Anette Enemark
A client-centered approach is on the health care agenda in many European countries (1), and amongst these Denmark (2). It is described as the foundation for Occupational Therapy (OT) (3), a code of professional conduct (4,5), and defined as a partnership between client and therapist (3). The goal...... is to empower a client to fulfil his/her occupational roles in a variety of environments, leading to an increase in intervention efficacy and client perception of intervention quality (3). However, it is known to be challenging (1,3). Given the importance of this approach, there has been limited exploration...