Experiences of physical therapists during the COVID-19 pandemic: an interpretive phenomenological analysis.

INTRODUCTION: The COVID-19 pandemic is the most fundamental challenge to the healthcare system in current generations. Physical therapists (PTs), as essential members of the healthcare team, were impacted substantially. Understanding their experiences during this unique and challenging time would help PTs manage the pandemic and future crises in healthcare. It may also reveal professional changes that may persist through the pandemic and beyond. PURPOSE: To describe the experiences of PTs in the New York metropolitan area during the initial wave of the pandemic. METHODS: This was an interpretive phenomenological study. Data were collected during 8 focus groups of 2-3 PTs each in August and September 2020 via videoconference. Audio recordings of the groups were transcribed, and data were coded in 3 rounds. RESULTS: Twenty-two PTs from a range of settings participated. Four themes were identified: (1) Everything was disrupted; (2) It was not safe; (3) It was overwhelming; and (4) There was a professional transformation. In hospitals, participants described chaos, poor communication, and unsafe working environments. In outpatient settings, participants described job instability and challenges adapting to telehealth. As the pandemic progressed inpatient PTs felt safer, gained confidence, and became critical members of interdisciplinary care teams. Outpatient therapists adapted to telehealth and experienced rising caseloads as patients returned to therapy. CONCLUSION: Physical therapists experienced a variety of challenges during the initial phases of the pandemic. As the pandemic progressed, they redefined practice.

Using the NLN Faculty Preparation for Global Experiences Toolkit for Successful Application for the Fulbright Scholar Award.

With an increasingly global world and the migration of diverse populations, nurse faculty have opportunities to learn and share varied perspectives through involvement internationally in research, teaching, and practice. The National League for Nursing (NLN) joins with the World Health Organization and the International Council of Nurses to promote international nursing standards. One way in which nursing faculty can contribute to this goal is by pursuing international education, research, and service as a Fulbright scholar. The NLN Faculty Preparation for Global Experiences Toolkit complements resources offered through the Fulbright program in the preparation of a competitive Fulbright application.

Nursing documentation of pressure ulcers in nursing homes: comparison of record content and patient examinations.

AIM: The aim of this study was to describe the accuracy and quality of nursing documentation of the prevalence, risk factors and prevention of pressure ulcers, and compare retrospective audits of nursing documentation with patient examinations conducted in nursing homes. DESIGN: This study used a cross-sectional descriptive design. METHOD: A retrospective audit of 155 patients' records and patient examinations using the European Pressure Ulcer Advisory Panel form and the Braden scale, conducted in January and February 2013. RESULTS: The prevalence of pressure ulcers was 38 (26%) in the audit of the patient records and 33 (22%) in patient examinations. A total of 17 (45%) of the documented pressure ulcers were not graded. When comparing the patient examinations with the patient record contents, the patient records lacked information about pressure ulcers and preventive interventions.

Effect of Physical Therapy Students' Clinical Experiences on Clinician Productivity.

BACKGROUND: Physical therapy clinical education experiences (CEEs) are difficult to secure, particularly first-level CEEs. Our purpose was to determine 1) what impact student full-time CEEs have on PT clinician productivity and 2) whether there is a productivity difference between first vs final CEEs. METHODS: Productivity logs, including possible factors impacting productivity, were distributed to clinician-student pairings on first and final CEEs. Two-week baseline data (without a student) were compared to weeks 1 and 6 (with a student) for 31 logs using a 2x4 repeated-measures ANOVA. In a subset of 17 logs for CEEs 8 weeks or longer, a 2x5 repeated-measures ANOVA was performed. RESULTS: There was a significant increase in the number of patients seen and CPT units billed by both levels of CEEs comparing weeks 1 and 6. In the subset of CEEs, 8 weeks or longer, there was a significant increase in the number of patients treated per hour at week 6 and a trend toward a change at week 8 when compared to baseline week A. The factors selected as impacting productivity were census (59%) and staffing (32%). CONCLUSION: Physical therapy clinician-student pairings showed an overall increase in productivity during both full-time first and final level CEEs.

Activating mutations in FGFR3 and HRAS reveal a shared genetic origin for congenital disorders and testicular tumors.

Genes mutated in congenital malformation syndromes are frequently implicated in oncogenesis, but the causative germline and somatic mutations occur in separate cells at different times of an organism's life. Here we unify these processes to a single cellular event for mutations arising in male germ cells that show a paternal age effect. Screening of 30 spermatocytic seminomas for oncogenic mutations in 17 genes identified 2 mutations in FGFR3 (both 1948A>G, encoding K650E, which causes thanatophoric dysplasia in the germline) and 5 mutations in HRAS. Massively parallel sequencing of sperm DNA showed that levels of the FGFR3 mutation increase with paternal age and that the mutation spectrum at the Lys650 codon is similar to that observed in bladder cancer. Most spermatocytic seminomas show increased immunoreactivity for FGFR3 and/or HRAS. We propose that paternal age-effect mutations activate a common 'selfish' pathway supporting proliferation in the testis, leading to diverse phenotypes in the next generation including fetal lethality, congenital syndromes and cancer predisposition.

Clinical dividends from the molecular genetic diagnosis of craniosynostosis.

A dozen years have passed since the first genetic lesion was identified in a family with craniosynostosis, the premature fusion of the cranial sutures. Subsequently, mutations in the FGFR2, FGFR3, TWIST1, and EFNB1 genes have been shown to account for approximately 25% of craniosynostosis, whilst several additional genes make minor contributions. Using specific examples, we show how these discoveries have enabled refinement of information on diagnosis, recurrence risk, prognosis for mental development, and surgical planning. However, phenotypic variability can present a significant challenge to the clinical interpretation of molecular genetic tests. In particular, the difficulty of analyzing the complex interaction of genetic background and prenatal environment in determining clinical features, limits the value of identifying low penetrance mutations.

Clinical dividends from the molecular genetic diagnosis of craniosynostosis.

A dozen years have passed since the first genetic lesion was identified in a family with craniosynostosis, the premature fusion of the cranial sutures. Subsequently, mutations in the FGFR2, FGFR3, TWIST1, and EFNB1 genes have been shown to account for approximately 25% of craniosynostosis, whilst several additional genes make minor contributions. Using specific examples, we show how these discoveries have enabled refinement of information on diagnosis, recurrence risk, prognosis for mental development, and surgical planning. However, phenotypic variability can present a significant challenge to the clinical interpretation of molecular genetic tests. In particular, the difficulty of analyzing the complex interaction of genetic background and prenatal environment in determining clinical features, limits the value of identifying low penetrance mutations.

Fibroblast growth factor receptor 2, gain-of-function mutations, and tumourigenesis: investigating a potential link.

Activating germline mutations in the fibroblast growth factor receptor (FGFR) gene family have been identified in several dominantly inherited skeletal disorders; in the case of FGFR3, the same somatically arising mutations have also been isolated from a variety of tumour tissues. Whilst the role of FGFR2 mutations in congenital syndromes has been well documented, their relationship with cancer has not been clearly defined. Based on evidence that gain-of-function mutations in FGFR2 drive positive selection in adult spermatogonia, the present study investigated, by denaturing high-performance liquid chromatography (DHPLC), DNA sequencing, and restriction digestion, the prevalence of FGFR2 mutations in 58 tumour cell lines of various types, and 29 testicular germ cell tumour samples. Although sequence variations and allelic imbalance were identified in FGFR2, none of the previously documented dominant mutations was detected in any of the tumour types examined. This suggests that gain-of-function FGFR2 mutations are not commonly encountered in tumourigenesis and specifically excludes a major contribution in testicular tumours.