Manual Therapy in Preadolescent Children: A Delphi Investigation of Physical Therapists in the United States

2021 ◽  
Author(s):  
Jenifer L Dice ◽  
Doug Dendy ◽  
Phillip S Sizer ◽  
Chad E Cook ◽  
Sara Feuling ◽  
...  
Keyword(s):  
United States ◽  
Manual Therapy ◽  
Physical Therapists ◽  
Initial Step ◽  
The United States ◽  
Group Differences ◽  
Electronic Survey ◽  
Craniosacral Therapy ◽  
Barriers To Use ◽  
Composite Scores

ABSTRACT Objective Limited research has investigated the use of manual therapy to treat the preadolescent (0–12 years of age) population with musculoskeletal and neurological impairments. The purpose of this study was to identify the following among physical therapists holding advanced credentials in pediatrics, neurodevelopmental treatment, or manual therapy: (1) consensus regarding effective techniques in the preadolescent population, (2) differences in opinion, and (3) perceived decision-making barriers and factors regarding use of manual therapy techniques. Methods Credentialed physical therapists in the United States were recruited for a 3-round Delphi investigation. An electronic survey in Round 1 identified musculoskeletal and neurological impairments and the manual techniques considered effective to treat such conditions, in addition to factors and barriers. Responses were used to create the second round, during which a 4-point Likert scale was used to score each survey item. A third round of scoring established consensus. Descriptive statistics and composite scores were calculated for each manual technique by impairment. Between-group differences were calculated using Mann–Whitney U with Bonferroni correction. Results Consensus was determined for several concepts. First, neuromuscular techniques were considered effective across all impairments, and joint mobilizations (grades I-IV) were believed to be effective to treat joint and muscle and myofascial impairments. Second, visceral manipulation and craniosacral therapy were considered ineffective in treating most impairments. There was lack of consensus and clear differences of opinion regarding the use of grade V mobilizations and dry needling. Significant barriers to use of manual therapy were: lack of knowledge, lack of evidence, and fear of litigation and harming patients. Conclusion This study is an initial step for developing manual therapy guidelines, research, and educational opportunities regarding manual therapy in pediatric physical therapy.

scholarly journals Evaluation of pharmacists’ awareness of illegal online pharmacies and perceived impact on safe access to medicines

2021 ◽  
Vol 5 ◽  
pp. 239920262110056
Author(s):  
John B Hertig ◽  
Shannon M James ◽  
Connor J Hummel ◽  
Matthew J Rubin
Keyword(s):  
United States ◽  
Healthcare Providers ◽  
Access To Medicines ◽  
The United States ◽  
Pharmacy Education ◽  
Electronic Survey ◽  
Medication Therapy ◽  
Online Pharmacies ◽  
Effective Medication ◽  
Selection Of

Background: An estimated 95% of all online pharmacies operate unlawfully. Illegal online pharmacies distribute substandard and falsified medical products that may result in patient harm and suboptimal treatment, leading to an overall mistrust of medications, healthcare providers, and health systems. As medication experts, pharmacists are trusted to guide patients in selection of safe and effective medication therapy. Objective: The objective of this study was to determine gaps in knowledge and recognition of the negative clinical and safety impacts associated with illegal Internet pharmacies by licensed pharmacists. Methods: A 37-question electronic survey was developed and distributed to pharmacists across the United States by email via a database from the American Pharmacists Association. Descriptive statistics was utilized to analyze data. Results: A total of 347 pharmacists from across the United States responded to at least one question in the survey. In all, 58% of pharmacists reported a lack of confidence in their ability to counsel patients on the identification of illegal pharmacy websites. Fewer than 60% of pharmacists were able to accurately identify the legitimacy of a webpage based on visual characteristics. In addition, 75% of pharmacists reported being unfamiliar with resources available to help consumers identify safe and legitimate online pharmacies. Conclusion: Integration of the topic into pharmacy education curricula, training on available resources, and additional research into the prevalence and impact of illegal pharmacy websites are necessary to ensure that pharmacists and other healthcare professionals are adequately prepared to protect their communities from the threat of illegal online pharmacies.

scholarly journals Intergenerational Mobility in the United States: What We Have Learned from the PSID

2018 ◽  
Vol 680 (1) ◽  
pp. 213-234 ◽  
Author(s):  
Bhashkar Mazumder
Keyword(s):  
United States ◽  
Socioeconomic Status ◽  
Life Cycle ◽  
Intergenerational Mobility ◽  
Panel Study ◽  
The United States ◽  
Group Differences ◽  
Income Dynamics ◽  
Mobility Studies ◽  
Advanced Economies

This article reviews the contributions of the Panel Study of Income Dynamics (PSID) to the study of intergenerational mobility. The PSID enables researchers to track individuals as they form new households and covers many dimensions of socioeconomic status over large portions of the life cycle, making the data ideal for studying intergenerational mobility. Studies have used PSID data to show that the United States is among the least economically mobile countries among advanced economies. The PSID has been instrumental to understanding various dimensions of intergenerational mobility, including occupation; wealth; education; consumption; health; and group differences by gender, race, and region. Studies using the PSID have also cast light on the mechanisms behind intergenerational persistence.

Variation in pediatric stereoelectroencephalography practice among pediatric neurosurgeons in the United States: survey results

2021 ◽  
pp. 1-9
Author(s):  
Benjamin C. Kennedy ◽  
Joshua Katz ◽  
Jacob Lepard ◽  
Jeffrey P. Blount
Keyword(s):  
United States ◽  
The United States ◽  
Median Number ◽  
Pediatric Epilepsy ◽  
Case Volume ◽  
Median Response ◽  
Younger Patients ◽  
Electronic Survey ◽  
Survey Results ◽  
Survey Responses

OBJECTIVE Stereoelectroencephalography (SEEG) has become widespread in the United States during the past decade. Many pediatric neurosurgeons practicing SEEG may not have had experience with this technique during their formal training, and the literature is mostly limited to single-center series. As a result, implementation of this relatively new technique may vary at different institutions. The authors hypothesized that aspects of SEEG experience, techniques, and outcomes would vary widely among programs across the country. METHODS An electronic survey with 35 questions addressing the categories of training and experience, technique, electrode locations, and outcomes was sent to 128 pediatric epilepsy surgeons who were potential SEEG users. RESULTS Sixty-one pediatric fellowship-trained epilepsy surgeons in the United States responded to the survey. Eighty-nine percent were actively using SEEG in their practice. Seventy-two percent of SEEG programs were in existence for less than 5 years, and 68% were using SEEG for > 70% of their invasive monitoring. Surgeons at higher-volume centers operated on younger patients (p < 0.001). Most surgeons (70%) spent 1–3 hours per case planning electrode trajectories. Two-thirds of respondents reported a median implant duration of 5–7 days, but 16% reported never having an implant duration > 5 days, and 16% reported having had implants stay in place for > 4 weeks. The median response for the median number of electrodes initially implanted was 12 electrodes, although 19% of respondents reported median implants of 5–8 electrodes and 17% reported median implants of 15–18 electrodes. Having a higher volume of SEEG cases per year was associated with a higher median number of electrodes implanted (p < 0.001). Most surgeons found SEEG helpful in defining an epileptic network and reported that most of their SEEG patients undergo focal surgical treatment. CONCLUSIONS SEEG has been embraced by the pediatric epilepsy surgery community. Higher case volume is correlated with a tendency to place more electrodes and operate on younger patients. For most parameters addressed in the survey, responses from surgeons clustered around a norm, though additional findings of substantial variations highlight differences in implementation and philosophy among pediatric epilepsy programs.

A Survey of Pediatric Dentists on the Treatment Timing and Modalities for White Spot Lesions in the United States

2019 ◽  
Vol 43 (1) ◽  
pp. 27-33
Author(s):  
Traci Saito ◽  
Jae Hyun Park ◽  
Curt Bay
Keyword(s):  
United States ◽  
The United States ◽  
Pediatric Dentistry ◽  
White Spot ◽  
Treatment Modalities ◽  
White Spot Lesions ◽  
Electronic Survey ◽  
Treatment Timing ◽  
Pediatric Dentist ◽  
Pediatric Dentists

Purpose: The purpose of this study was to estimate the prevalence of white spot lesions (WSLs) in various practice settings and patient populations, and to gather information about the treatment timing and modalities used by pediatric dentists in the United States. Study design: A fourteen question, multiple choice, electronic survey was developed and distributed to 6,092 active American Academy of Pediatric Dentistry (AAPD) members. Results: A total of 625 active members responded, garnering a 9.7% response rate. Before treatment, there were significantly more WSLs reported in Corporate practice than Multi-Doctor Practice (P=0.002), and significantly more WSLs in Academics/Hospital-Based Practices than in Multi-Doctor Practices (P=0.002). For WSLs after treatment, there were significantly more WSLs in Academic/Hospital-Based practices than in single-practitioner settings (P=0.003). Approximately 38% of pediatric dentists preferred to treat WSLs before, during or after orthodontic treatment, while 23% treat only before and 20% treat only after treatment. The three most common treatment modalities for WSLs, were prescription fluoride toothpaste (5000 ppm), fluoride varnish, and fluoride rinse. Approximately 47% of respondents reported they were “very comfortable” treating WSLs and 31.0% felt “comfortable.” Conclusions: The prevalence of WSLs differed across types of practice. There is no agreement among pediatric dentist as to timing and treatment modalities for WSLs.

scholarly journals A Survey of COVID-19 Preparedness Among Hospitals in Idaho

2020 ◽  
Vol 41 (9) ◽  
pp. 1003-1010 ◽  
Author(s):  
Anubhav Kanwar ◽  
Susan Heppler ◽  
Kalpana Kanwar ◽  
Christopher K. Brown
Keyword(s):  
United States ◽  
The United States ◽  
Respiratory Pathogens ◽  
Critical Access Hospitals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nurse Administrators ◽  
Electronic Survey ◽  
Hospital Preparedness ◽  
Federal Guidelines

AbstractBackground:SARS-CoV-2 has been implicated in the largest recorded coronavirus outbreak to date. Initially, most COVID-19 cases were in China, but the virus has spread to more than 184 countries worldwide, and the United States currently has more cases than any other country.Objective:With person-to-person spread expanding in the United States, we describe hospital preparedness for managing suspected and confirmed COVID-19 patients.Design:Cross-sectional survey focused on various elements of respiratory disease preparedness.Setting:Critical access hospitals (CAHs) and acute-care hospitals (ACHs) in Idaho.Methods:The electronic survey was sent to infection preventionists (IPs) and nurse administrators in 44 hospitals in Idaho.Results:Overall, 32 (73%) hospitals responded to the survey. Participating facilities reported their preparedness with respect to existing, formalized structures for managing infectious disease incidents—specifically COVID-19—as well as availability of resources, such as isolation rooms and personal protective equipment, for safely managing suspected and confirmed COVID-19 cases.Conclusions:Hospitals covered by the survey had varying levels of preparedness for managing COVID-19 cases, with differences across the various categories of interest in this study. Although the study reveals strengths, including in application of emergency management and infection control frameworks, it also suggests that other areas, such as consistent implementation of federal guidelines and requirements for infection prevention, are potential areas for strengthening preparedness for SARS-CoV-2 and other respiratory pathogens with pandemic potential.

scholarly journals Investing the Time: Group Differences in Cultural Capital Development Among U.S. Adolescents

2020 ◽  
Vol 7 (5) ◽  
pp. 465-486
Author(s):  
Karam Hwang
Keyword(s):  
United States ◽  
Cultural Capital ◽  
Asian American ◽  
Time Use ◽  
The United States ◽  
Group Differences ◽  
Time Investment ◽  
Nationally Representative ◽  
Capital Development ◽  
Technical Capacity

This study examines the extent of class and racial inequalities in cultural capital development among recent adolescent cohorts in the United States. Informed by several decades of cultural capital research, I compare participation in four dimensions of cultural capital proposed by prior scholarship—highbrow consumption, omnivorous consumption, technical capacity, and social competence—by using nationally representative time-diary data to test for group differences in time-use patterns. Time investment has been long theorized but seldom tested as the means through which individuals develop cultural capital. Activities associated with technical capacity appear to have the greatest potential as the bases for both class and racial exclusions, as group differences are evident in both the prevalence and duration of participation. Smaller race and class differences are evident for omnivorous consumption, and low participation in highbrow activities is evident across all groups. Distinct patterns of time-use among Asian American adolescents suggest they are simultaneously advantaged and disadvantaged in their cultural capital acquisition, speaking to debates regarding their relative status in the United States.

scholarly journals Workforce Projections 2010–2020: Annual Supply and Demand Forecasting Models for Physical Therapists Across the United States

2016 ◽  
Vol 96 (1) ◽  
pp. 71-80 ◽  
Author(s):  
Michel D. Landry ◽  
Laurita M. Hack ◽  
Elizabeth Coulson ◽  
Janet Freburger ◽  
Michael P. Johnson ◽  
...  
Keyword(s):  
United States ◽  
Physical Therapists ◽  
Supply And Demand ◽  
Demand Forecasting ◽  
Policy Issue ◽  
The United States ◽  
Attrition Rate ◽  
Supply Side ◽  
Imperfect Data ◽  
Workforce Projections

BackgroundHealth human resources continue to emerge as a critical health policy issue across the United States.ObjectiveThe 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.DesignA 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.MethodsSupply 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.ResultsThree 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.LimitationsWorkforce 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.ConclusionsOutcomes 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.

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