Quality in physical therapist clinical education: a systematic review.

BACKGROUND: Many factors affect student learning throughout the clinical education (CE) component of professional (entry-level) physical therapist education curricula. Physical therapist education programs (PTEPs) manage CE, yet the material and human resources required to provide CE are generally overseen by community-based physical therapist practices. PURPOSE: The purposes of this systematic review were: (1) to examine how the construct of quality is defined in CE literature and (2) to determine the methodological rigor of the available evidence on quality in physical therapist CE. METHODS: This study was a systematic review of English-language journals using the American Physical Therapy Association's Open Door Portal to Evidence-Based Practice as the computer search engine. The search was categorized using terms for physical therapy and quality and for CE pedagogy and models or roles. Summary findings were characterized by 5 primary themes and 14 subthemes using a qualitative-directed content analysis. RESULTS: Fifty-four articles were included in the study. The primary quality themes were: CE framework, CE sites, structure of CE, assessment in CE, and CE faculty. The methodological rigor of the studies was critically appraised using a binary system based on the McMaster appraisal tools. Scores ranged from 3 to 14. LIMITATIONS: Publication bias and outcome reporting bias may be inherent limitations to the results. CONCLUSION: The review found inconclusive evidence about what constitutes quality or best practice for physical therapist CE. Five key constructs of CE were identified that, when aggregated, could construe quality.

Adolescent caesarean delivery in the US military health care system.

OBJECTIVES: Determine cesarean delivery (CD) rates and associated demographics among military dependent teenagers. METHODS: United States military health care claims records of live births from 2003-2006 to 13- through 19-year-old dependent children were analyzed using logistic regression. RESULTS: The CD rate rose from 17% in 2003 to 20% in 2006. Rates were significantly higher for ages 18 and 19, for African American sponsors' children, and those who gave birth in a civilian facility. Rates did not differ significantly by sponsor's military rank. CONCLUSIONS: Teenagers in the military health care system have increasing rates of CD. Independent demographic risk factors for teenage CD include age > 17 years, sponsor's race African American, and delivery at a civilian facility.

Births to adolescents in the U.S. military healthcare system.

PURPOSE: To describe the rate and sociodemographic profile of live births to adolescents having U.S. Department of Defense healthcare coverage because of parental military service. METHODS: All live births identified from the M2 database during 2003-2006 to 10- to 23-year olds in this population were stratified and compared. RESULTS: Birth rates rose in the 18- to 19- and 20- to 23-year-old groups over the 4 years studied (p < 0.05). Daughters of active duty personnel had higher live birth rates than daughters of retirees (7.1 vs. 6.1 age 15-17; p < 0.05). Birth rates differed among dependents of junior enlistees, senior enlistees, and officers (7.1, 9.4, 3.8, respectively; p < 0.0001). CONCLUSIONS: Adolescent dependents in this system have an increasing, though low, live birth rate. Those with active duty sponsors have a significantly higher rate than their age-matched peers with retired sponsors. Further study is warranted to identify factors unique to this population that may influence birth patterns.

Synthesis, characterization, and evaluation of [Ir(ppy)2(vpy)Cl] as a polymer-bound oxygen sensor.

This study reports new luminescent oxygen sensors in which the luminophore is covalently bound to the polymer matrix and compares their behavior to related sensors in which the luminophore is dispersed within the matrix. The cyclometalated iridium complex [Ir(ppy)(2)(vpy)Cl], 1, has been synthesized and characterized spectroscopically (absorption and emission) and by 1-D and 2-D (1)H NMR, elemental analysis, and X-ray crystallography. Complex 1 was attached via hydrosilation to hydride-terminated poly(dimethylsiloxane) (PDMS), yielding material 2. Successful luminophore attachment was determined spectroscopically from the emission properties, and through the altered physical behavior of 2 compared to a dispersion of 1 in PDMS. Hydrosilation of 1 with dimethylphenylsilane yielded [Ir(ppy)(2)(DMPSEpy)Cl], 3, which was fully characterized and used to probe the effect of hydrosilation on the spectroscopic properties of the luminophore. Evaluation of 2 as a luminescent oxygen sensor revealed significantly improved sensitivity over dispersions of 1 in PDMS. Material 2 was also blended with polystyrene (PS) to improve the physical properties of the sensor films. The blend sensors exhibited increased sensitivity relative to films of 2 alone and maintained short response times to rapid changes in air pressure. In contrast, 1 partitioned into the PS phase when dispersed in a PDMS/PS blend, resulting in longer sensor response times.