The Validity, Reliability, Measurement Error, and Minimum Detectable Change of the 30‐Second Fast‐Paced Walk Test in Persons with Knee Osteoarthritis: A Novel Test of Short‐Distance Walking Ability

Objective To develop and establish the reliability, validity, measurement error, and minimum detectable change of a novel 30‐second fast‐paced walk test (30SFW) in persons with knee osteoarthritis (OA) that is easy to administer and can quantify walking performance in persons of all abilities. Methods Twenty females with symptomatic knee OA (mean age [SD] 58.30 [8.05] years) and 20 age‐ and sex‐matched asymptomatic controls (57.25 [8.71] years) participated in the study. Participants completed questionnaires of demographic and clinical data, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the 36‐item Short Form Health Survey (SF‐36) followed by 30SFW performance. Participants returned 2‐7 days later and performed the 30SFW again. Results The knee OA group reported function that was worse than controls (all KOOS subscales; P \u3c 0.0001). The 30SFW intrarater and interrater reliability were excellent [ICC(2,1) = 0.95‐0.99]. Knee OA participants walked a shorter distance in the 30SFW than controls (mean [SD]: OA 44.4 m [9.5 m]; control 58.1 m [7.8 m]; P \u3c 0.0001). Positive strong correlations were found between the 30SFW and the KOOS–Activity of Daily Living, SF‐36‐Physical Functioning, and SF‐36‐Physical Health Composite scores (P \u3c 0.0001). A nonsignificant, weak correlation between 30SFW and SF‐36‐Mental Health scores was present (r = 0.32, P = 0.05). Conclusion The 30SFW has excellent intrarater and interrater reliability. The 30SFW demonstrated excellent known groups, convergent, and discriminant validity as a measure of short‐distance walking ability in persons with knee OA. Clinicians and researchers should consider using the 30SFW to quantify walking ability in persons with knee OA and assess walking ability change

Mind Mapping: A Strategy to Promote Interprofessional Collaboration among Health Science Students

Purpose/Background: This presentation will provide participants with an understanding of what mind mapping is and engage participants in a discussion and hands on experience of how mind mapping can be used to prepare students for interprofessional collaborative practice and integrate patient centered models of care. Managing a patient’s plan of care requires health care practitioners to share and integrate data in order to formulate a plan of care. How to engage with other disciplines is often developed during student’s clinical educational experiences. Assisting and engaging students during the academic portion are essential to prepare them for interprofessional collaborative practice. Mind Mapping is an innovative instructional strategy which focuses on integrating information using a 360 non-linear approach. Mind maps require learners to think not only in a curvilinear manner but also use visuospatial relationships which flow from a central concept. For students, using this 360 approach to explore and connect concepts and themes a rich environment for content integration emerges. Mind mapping is emerging as a positive teaching and learning strategy for health science students however there has been limited evidence supporting its efficacy in interprofessional education. Descriptions of Program Mind mapping can be infused at several points within an interprofessional curriculum. Faculty can model for students their own integration of knowledge by creating and sharing their mind maps. Alternately, IPE student groups can create mind maps and thereby engage in self-directed active learning. These options provide rich experiences for students to work on integrating content knowledge across disciplines for the development of robust interprofessional patient-centered care. Preliminary Result on Mind Mapping used in an interprofessional curriculum as well as students’ perceptions will be shared. Conclusion /Relevance to interprofessional education or practice Using a mind maps non-linear approach to learning provides may further aid student’s ability to critically reflect upon and analyze the necessary information, to develop and modify a patient’s interprofessional plan of care. This model of infusion of mind maps can be utilized in interprofessional curricular to prepare students for collaborative practice. Learning Objectives: Participants will be able to: describe the tenets associated with the development of a mind map for IPE discuss a model of infusion of mind maps for interprofessional education and collaborations recognize how to integrate mind maps into their interprofessional curricular model

Pediatric Liver Transplantation: Then and Now

This paper reviews the past 50 years of liver transplantation in children from the perspective of patient demographics, perioperative patient management, surgical techniques, immunosuppression and patient outcomes

Barriers and Facilitators to Use of a Clinical Evidence Technology for Management of Skin Problems in Primary Care: Insights from Mixed Methods

Background: A previous cluster-randomized controlled trial tested the effectiveness of a clinical evidence technology (CET), VisualDx, for skin problems seen by Primary Care Providers (PCPs). Based on patient report, there was no effect on time to problem resolution or return appointments. Objective: To explain, from the provider perspective, why the CET did not make a difference in the clinical trial and to identify barriers and facilitators to use. Methods: Mixed methods study design. Providers from both arms completed a survey about their use of VisualDx and information-seeking during and after the trial. Active arm providers participated in interviews to explore their opinions and experiences using VisualDx. Behavioral steps of the evidence-based medicine (EBM) paradigm informed the 6 step model. Results: PCPs found VisualDx easy to use (median 3 on a 1-4 scale), but found it only somewhat useful (median 2 on a 1-4 scale). PCPs with fewer years in practice used it more often and found it easier to use. Interviews identified facilitators and barriers to using VisualDx. Facilitators included diagnostic uncertainty, positive attitude, easy access, utility for diagnosis and therapy decisions, and utility for patient communication. Barriers included confidence in dermatology, preference for other sources, interface difficulty, and retrieval of irrelevant diagnoses and images. Some PCPs reported positive impacts on patient treatment and fewer referrals; others saw no difference. PCPs found VisualDx easy to access, but some found the interface difficult to use. They found it useful and relevant at times, but also frustrating and time-consuming. They used other sources in addition to, or instead of, VisualDx. Conclusion: PCPs did not perceive VisualDx as “useful” often enough for them to use it frequently or exclusively, thereby reducing the likelihood of its making a difference in patient-level outcomes such as problem resolution and return appointments

Barriers and Facilitators to Use of a Clinical Evidence Technology in the Management of Skin Problems in Primary Care: Insights from Mixed Methods

Objective: Few studies have examined the impact of a single clinical evidence technology (CET) on provider practice or patient outcomes from the provider’s perspective. A previous cluster-randomized controlled trial with patient-reported data tested the effectiveness of a CET (i.e., VisualDx) in improving skin problem outcomes but found no significant effect. The objectives of this follow-up study were to identify barriers and facilitators to the use of the CET from the perspective of primary care providers (PCPs) and to identify reasons why the CET did not affect outcomes in the trial. Methods: Using a convergent mixed methods design, PCPs completed a post-trial survey and participated in interviews about using the CET for the management of patients’ skin problems. Data from both methods were integrated. Results: PCPs found the CET somewhat easy to use but only occasionally useful. Less experienced PCPs used the CET more frequently. Data from interviews revealed barriers and facilitators at four steps of evidence-based practice: clinical question recognition, information acquisition, appraisal of relevance, and application with patients. Facilitators included uncertainty in dermatology, intention for use, convenience of access, diagnosis and treatment support, and patient communication. Barriers included confidence in dermatology, preference for other sources, interface difficulties, presence of irrelevant information, and lack of decision impact. Conclusion: PCPs found the CET useful for diagnosis, treatment support, and patient communication. However, the barriers of interface difficulties, irrelevant search results, and preferred use of other sources limited its positive impact on patient skin problem management

Parameter Sensitivity Test of SWAT Hydrological Model on Two Different Resolutions (Case Study: Sub-Das Cisadane Hulu, West Java)

A sensitivity analysis of SWAT parameters conducted on different input resolutions. The analysis will determine the input parameters that have the most influence on the role of output.Resolution of different inputs in the SWAT analysis, parameters can produce different inputs so as to cause the effect on output. The purpose of this study was to identify the level of sensitivity of the parameters in the model SWAT on two different resolutions, i.e. 1: 100 000 and 1: 250 000. A sensitivity test wasconducted manually by using the method that is absolute sensitivity to change (either increase or decrease) in each data base SWAT model parameters one by one while the other parameters fixed. NSE value of calibration for both of scale resolution demonstrates the similar NSE value, with the category on a daily simulation quite satisfactory (values   NSE 0.55 and 0.54), while the monthly simulation as very satisfactory (NSE value of 0.80 and 0.82). The level of sensitivity parameters is divided into three groups: sensitive, less sensitive and insensitive. Simulation daily and monthly for both of scale shows the parameter-sensitive parameters are the same that Alpha_BNK (baseflow alpha factor for bank storage) , CN2 (moisture condition II curve number), CH_K2 (effective hydraulic conductivity in main channel alluvium), CH_N2 (manning’s “n” value for the main channel), ESCO (soil evaporation compensation factor), GW_Delay (groundwater delay), and GW_Revap (groundwater “revap” coefficient)

A Method for Providing High-volume Interprofessional Simulation Encounters in Physical and Occupational Therapy Education Programs

With an increasing emphasis on interprofessional education within the allied health professions, simulation has potential for being a useful teaching modality for providing collaborative learning experiences for occupational and physical therapist students. However, there are many challenges associated with conducting simulations with large numbers of students. We describe the design, planning, cost, and support staff time required for conducting an interprofessional simulation of the intensive care setting, including a methodology for maximizing resources and student opportunities for participation for 64 physical and occupational therapy students over a 4-hour time period. Qualitative analyses of student experiences are also presented

Exploration of Grit and Emotional Intelligence and Success in a Doctor of Physical Therapy Program

Background: Higher education programs that admit students to sequential curricula incur a substantial financial loss when an enrolled student fails to continue in the program for whatever reason. In many instances, the seat cannot be filled, and valuable tuition dollars often over $90,000 per student is lost to the institution. In addition to financial loss, Doctor of Physical Therapy (DPT) programs are required to report and explain rates to the Commission for Accreditation of Physical Therapy Education (CAPTE). Admission committees at Doctor of Physical Therapy programs seek candidates that will be successful in the program and pass the National Physical Therapy Examination (NPTE). Purpose: The purpose of this study was to explore relationships of non-cognitive characteristics (grit and emotional intelligence) and Grade Point Average (GPA) in the first year of a DPT program with the intent to potentially identify students who might benefit from remediation/intervention to prevent attrition. Methods: Forty-two students in the first year of a Doctor of Physical Therapy program completed the Grit scale and the Mayers-Salovey Emotional Intelligence test early in the fall semester of year one. Results: There were no significant relationships between grit or emotional intelligence and academic success in the first year of a DPT program. Conclusions: The current study provides preliminary information related to non-cognitive factors of grit and emotional intelligence and success in a Doctor of Physical Therapy program