Association of dual task gait performance with cognitive outcomes among older adults: Piloting an inexpensive, portable assessment platform.

Motor assessment has emerged as complementary evidence for the detection of late life cognitive disorders. Clinicians lack inexpensive, accurate, and portable tools for this purpose. To fill this void, the current study piloted measures from the Mizzou Point-of-care Assessment System a multimodal sensor platform. We examined the ability of these motor function measures to distinguish neurocognitive status and assessed their associations with cognitive performance. Data came from 42 older adults, including 16 with mild cognitive impairment (MCI). Participants performed dual task gait, pairing walking with serial subtraction by sevens, along with aa neuropsychological test battery. T-tests revealed that individuals with MCI demonstrated slower stride times (d = .55) and shorter stride lengths (d = .98) compared to healthy older adults. Results from hierarchical regression showed that stride time and stride length predicted cognitive performance across several domains, after controlling for cognitive status and demographics. Cognitive status moderated this relationship for global cognition and attention, wherein gait measures were significantly related to these outcomes for the cognitively normal group, but not the MCI group. Evidence from the current study provided preliminary support that MPASS measures demonstrate expected associations with cognitive performance and can distinguish amongst those with and without cognitive impairment.

Objective Clinical Measurement Tools for Functional Evaluation of the Surgical Patient.

Following knee surgery, clinicians have traditionally used visually rated or time-based assessments of lower extremity movement quality to measure surgical outcomes, plan rehabilitation interventions, and measure success. These methods of assessment are prone to error and do not fully capture a patient's inefficient movement patterns post surgery. Further, currently available systems which objectively measure kinematics during these tasks are expensive and unidimensional. For these reasons, recent research has called for the development of objective and low-cost precision rehabilitation tools to improve clinical measurement of movement tasks. The purpose of this article is to highlight two such tools and their applications to knee surgery. The systems highlighted within this article are the Mizzou Point-of-Care Assessment System (MPASS) and the Mizzou Knee Arthrometer Testing System (MKATS). MPASS has demonstrated high levels of agreement with the gold-standard Vicon system in measuring kinematics during sit-to-stand (R > 0.71), lateral step-down (intraclass correlation coefficient [ICC] > 0.55, apart from ankle flexion), and drop vertical jump tasks (ICC > 0.62), as well as gait (R > 0.87). MKATS has been used to quantify differences in tibiofemoral motion between groups during lateral step-down, step-up-and-over, and step-up/step-down tasks. Objective measurement of clinical tasks using portable and inexpensive instruments, such as the MPASS and MKATS, can help clinicians identify inefficient movement patterns and asymmetries which may damage and wear down supporting structures within the knee and throughout the kinetic chain causing pain and discomfort. Identifying these issues can help clinicians to plan interventions and measure their progress at a lower cost than currently available systems. The MPASS and MKATS are useful tools which have many applications to knee surgery.

Coffee administration to promote return of bowel function after small bowel resection: A randomized, controlled trial.

BACKGROUND: Prolonged ileus occurs in 10%-24% of patients undergoing abdominal surgery. Several trials have found coffee administration reduces postoperative ileus, but this has not been evaluated for small bowel resection. METHODS: Following small bowel resection, patients were randomized to caffeinated coffee or warm water three times a day until the time of first flatus or first bowel movement. Primary outcomes were time from end of procedure to: 1) nasogastric tube removal; and 2) when the discharge order was written. Outcomes were compared using Kaplan-Meier survival curves. RESULTS: Thirty-nine patients received coffee and 40 water. Median days to nasogastric tube removal was 3.4 for the coffee and 4.0 for the water groups (p = 0.002). Median days to discharge order was 6.7 for the coffee and 7.7 for the water groups (p = 0.01). CONCLUSION: Coffee was safe and decreased time to nasogastric tube removal and hospital stay in patients undergoing small bowel resection.

Defining the value of faculty primary care clinical pharmacists.

BACKGROUND: Demonstrating the value of comprehensive medication management (CMM) within clinical faculty sites is a challenge when balancing patient volume with academic responsibilities. Utilizing an evidence-based implementation system for CMM, faculty primary care clinical pharmacists (PCCPs) standardized CMM within their practice sites. OBJECTIVE: The primary objective of this project was to define the value of faculty PCCPs. METHODS: An Ambulatory Care Summit was hosted to identify opportunities for consistency of CMM. Following the summit, the CMM implementation team (faculty PCCPs and project manager) utilized CMM implementation tools from the Comprehensive Medication Management in Primary Care Research Team. Additionally, a strategic plan was developed to enhance practice management, improve fidelity, and determine key performance indicators (KPIs). Five faculty-mentored student projects assessed value of faculty-delivered CMM in primary care clinics. Data included medication adherence metrics, clinic quality metrics, diabetes metrics, acute healthcare utilization rates, and a physician satisfaction survey. RESULTS: Among those receiving CMM, adherence improved 14% (P = 0.022), 119 clinic quality metrics were achieved, HbA1c ≤ 9% improved 45% (p < 0.001), average HbA1c decreased by 1.73% (p < 0.001), and medication preventable acute care utilization within the referral reason decreased. Over 90% of physicians surveyed agreed the faculty PCCP is a valuable team member, improved patients' health, and improved effectiveness/efficiency. Four student posters were presented at national conferences and 18 student pharmacists were engaged in various aspects of the project. CONCLUSION: Incorporating CMM at faculty primary care clinics provides value. To demonstrate this value, faculty must align KPIs with institution-specific payer contracts.

Caregiver Perceptions of an Interdisciplinary Intensive Therapy Program: A Qualitative Study.

PURPOSE: To explore perceptions of caregivers of children with neurodevelopmental conditions participating in an interdisciplinary intensive therapy program. METHODS: Semi-structured interviews were completed with caregivers. The intensive program consisted of occupational, physical, and/or speech therapy 3 to 6.5 hours/day, 3 to 5 days/week, for 4 weeks. Team-based collaborative goal setting was used to determine each child's plan of care. Reflexive thematic analysis identified interview themes. RESULTS: Thirteen caregivers participated. Children ranged in age from 6 to 13 years; diagnoses included cerebral palsy (n = 10), spina bifida (n = 1), ataxia (n = 1), and stroke (n = 1). An overarching theme of Immersive was identified; other themes included Everybody's Empowered , Principles of Neuroplasticity , Progress Across the ICF (International Classification of Functioning, Disability, and Health) Framework , It Takes a Team , and Benefits Outweigh the Challenges . CONCLUSIONS: Caregivers valued interdisciplinary intensive therapy. For children with complex rehabilitation needs, an interdisciplinary, intensive therapy program may be a viable alternative to traditional therapy models for service delivery.

Relative efficiency of methods to estimate cabbage stem flea beetle (Psylliodes chrysocephala) larval infestation in oilseed rape (Brassica napus).

BACKGROUND: The cabbage stem flea beetle (CSFB; Psylliodes chrysocephala) is an important pest of winter oilseed rape (OSR) crops in Europe. Damage is caused by adults feeding on young leaves and by larvae mining in the leaves and stems. The most common method to estimate the severity of CSFB larval infestation is by plant dissection, which is time consuming and labour intensive. Two alternative methods have been proposed: extraction of larvae from desiccating plants and counting the percentage of leaves with scars left by larvae on plant petioles. These methods are easy to implement and less time consuming than plant dissection but have not been properly validated. RESULTS: OSR plants were sampled in five different experiments and the two alternative methods tested; assessment of the total number of scars per plant as a predictor of the number of larvae was also tested. The number of larvae remaining in plants following various periods of desiccation was checked via plant dissection. We found that the desiccation method is efficient, giving reliable results after 7 days (76% of the total larvae extracted) with good accuracy in estimating the number of larvae per plant (±0.38 larvae per plant). The total number of scars also gives a reliable estimation of the number of larvae (r = 0.76, accuracy of ±1.01 larvae per plant). CONCLUSION: OSR plant desiccation and the total number of scars per plant are reliable methods to estimate CSFB larval infestation and will facilitate monitoring of this cryptic pest stage. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Practical guidance for planning resources required to support publicly-funded adaptive clinical trials.

Adaptive designs are a class of methods for improving efficiency and patient benefit of clinical trials. Although their use has increased in recent years, research suggests they are not used in many situations where they have potential to bring benefit. One barrier to their more widespread use is a lack of understanding about how the choice to use an adaptive design, rather than a traditional design, affects resources (staff and non-staff) required to set-up, conduct and report a trial. The Costing Adaptive Trials project investigated this issue using quantitative and qualitative research amongst UK Clinical Trials Units. Here, we present guidance that is informed by our research, on considering the appropriate resourcing of adaptive trials. We outline a five-step process to estimate the resources required and provide an accompanying costing tool. The process involves understanding the tasks required to undertake a trial, and how the adaptive design affects them. We identify barriers in the publicly funded landscape and provide recommendations to trial funders that would address them. Although our guidance and recommendations are most relevant to UK non-commercial trials, many aspects are relevant more widely.

Pediatric Physical Therapists' Perceptions of Telehealth Continuation Post-pandemic: A Thematic Analysis of Open-Ended Survey Responses.

PURPOSE: To explore pediatric physical therapists' (PTs) perceptions about continuing telehealth services post-pandemic. METHODS: Two open-ended questions from a larger survey were analyzed using a pragmatic application of thematic analysis. RESULTS: Two hundred two pediatric PTs in the United States responded. Themes included Telehealth During COVID-19, Benefits, Drawbacks , and Recommendations . Telehealth During COVID-19 acknowledged adopting and providing telehealth during a global pandemic was likely different than at other times. Benefits described perceived positive aspects of telehealth for children, families, and PTs, which support continuation of telehealth post-pandemic. Drawbacks described perceived negative aspects of telehealth for children, families, and PTs, which may dissuade continuation. Recommendations described respondents' recommendations for the continuation of telehealth. Ultimately respondents recommended a hybrid model of telehealth and in-person services going forward. CONCLUSIONS: A hybrid model of telehealth and in-person services may have the benefits of increasing access, flexibility, efficiency, communication, and home programming across pediatric practice settings.

Comparison of Azure Kinect overground gait spatiotemporal parameters to marker based optical motion capture.

BACKGROUND: Instrumented measurement of spatiotemporal parameters during walking can provide valuable information on an individual's overall function and health. Efficient, inexpensive, and accurate measurement of overground walking spatiotemporal parameters would be a critical component of providing point-of-care assessments of gait function, concussion recovery, fall-risk, and cognitive decline. Depth cameras combined with skeleton pose tracking algorithms, such as the Microsoft Kinect with body tracking software, have been used to measure walking spatiotemporal parameters. However, the ability of the latest generation Microsoft Kinect sensor, the Azure Kinect, to accurately measure overground walking spatiotemporal parameters has not been evaluated in the literature. RESEARCH QUESTION: The purpose of this work was to compare overground walking spatiotemporal parameters measurements from a 12 camera Vicon optical motion capture system to measurements of a single Azure Kinect with body tracking SDK (software development kit). METHODS: Spatiotemporal parameters of overground walking were simultaneously collected on twenty young healthy participants. Stride length, stride time, step length and step width were derived from ankle joint center locations and measurements from the two instruments were compared using descriptive statistics, scatter plots, Pearson correlation analyses, and Bland-Altman analyses. RESULTS: Pearson correlation coefficients were greater than 0.87 for all spatiotemporal parameters with most parameters demonstrating very strong (> 0.9) agreement. The mean of the differences for stride length between measurements was 35.6 mm for the left limb and 39.1 mm for the right limb, both of which are less than 3% of average stride length. Mean of the differences for step width and stride time were less than 2% and 1% of their averages respectively. SIGNIFICANCE: A single Microsoft Azure Kinect with body tracking SDK can provide clinically relevant measurement of walking spatiotemporal parameters, providing accessible and objective measurements that can improve clinical decision making across a variety of patient populations.

The effect of an ankle-foot orthosis on tibiofemoral motion during step-up and step-down in healthy adults.

BACKGROUND: Solid ankle-foot orthoses (SAFOs) are frequently prescribed in conditions such as cerebral palsy and stroke. Although gait is improved in the short term, long-term effects of limiting ankle and foot motion during functional activities on joints such as the knee have not been investigated. Our study purpose was to compare tibiofemoral (TF) motion in shoe and SAFO conditions in healthy adults to inform future studies in clinical populations. METHODS: A custom-made device using electromagnetic sensors was used to collect three-dimensional TF rotation data while 29 healthy adult participants (female participants = 19, age = 24.4 ± 4.5 years) performed step-up/step-down in shoe and SAFO conditions. RESULTS: In the SAFO condition during step-up, extent of motion was greater in frontal and transverse planes and less in the sagittal plane. Discrete values at 0%-10% of the cycle in sagittal, 50%-100% in frontal, and 40%-100% in transverse planes were statistically different, producing more abduction and external rotation. In the SAFO condition during step-down, extent of motion was significantly greater in the frontal and transverse planes. Discrete values were statistically different in 40%-60% of the cycle in sagittal, 0%-30% and 70%-90% in frontal, and 0%-30% and 70%-90% in transverse planes, producing more abduction and external rotation in the first half of the cycle and more adduction and internal rotation in the second half of the cycle. CONCLUSIONS: An SAFO affects triplanar TF kinematics in healthy adults during step-up/step-down. Future investigations into ankle-foot orthosis prescription and TF motion in clinical populations will facilitate optimal ankle-foot orthosis prescription and knee function in the long term.

Endometrial scratch in women undergoing first-time IVF treatment: a systematic review and meta-analysis of randomized controlled trials.

The endometrial scratch procedure is an IVF 'add-on' sometimes provided prior to the first IVF cycle. A 2019 systematic review concluded that there was insufficient evidence to show whether endometrial scratch has a significant effect on pregnancy outcomes (including live birth rate, LBR) when undertaken prior to the first IVF cycle. Further evidence was published following this review, including the Endometrial Scratch Trial (ISRCTN23800982). The objective of the current review was to synthesize and critically appraise the evidence for the clinical effectiveness and safety of the endometrial scratch procedure in women undergoing their first IVF cycle. Databases searched include MEDLINE, Embase, CINAHL and ClinicalTrials.gov. Eligible randomized controlled trials included women undergoing IVF for the first time that reported the effectiveness and/or safety of the endometrial scratch procedure; 12 studies were included. Meta-analysis showed no evidence of a significant effect of the endometrial scratch on LBR (10 trials, odds ratio [OR] 1.17, 95% confidence interval [CI] 0.76-1.79) or other pregnancy outcomes. This review confirms that there is a lack of evidence that endometrial scratch improves pregnancy outcomes, including LBR, for women undergoing their first IVF cycle. Clinicians are recommended not to perform this procedure in individuals undergoing their first cycle of IVF.

Comparison of Azure Kinect and optical retroreflective motion capture for kinematic and spatiotemporal evaluation of the sit-to-stand test.

BACKGROUND: The sit-to-stand test (STS) is commonly used to evaluate functional capabilities within a variety of clinical populations. Traditionally STS is a timed test, limiting the depth of information which can be gained from its evaluation. The Azure Kinect has the potential to add in-depth analysis to STS. Despite these potential benefits, the recently released (2019) Azure Kinect has yet to be evaluated for its ability to accurately assess STS. RESEARCH QUESTIONS: Purposes of this work were to compare data captured during STS using both a 12 camera Vicon motion capture system and the Azure Kinect; and to calculate kinematic and spatiotemporal variables related to the four phases of the STS cycle. METHODS: Spatiotemporal and kinematic measures for STS were simultaneously collected by both devices for 15 participants. Cycle waveforms were compared for right and left hip and knee flexion/extension angular displacement, right and left hip and knee flexion/extension angular velocity, and knee-to-ankle separation ratio. Evaluated discrete outcome variables included: phase time points, maximum knee extension velocity from phases 3 to 4, medial-lateral pelvic sway range, and total time to completion. Waveform summary data were compared using R, R2, and RMSE. Discrete variables were analyzed using Spearman's Rank correlation coefficient. RESULTS: R and R2 values between the two systems indicated high levels of correlation (all R values > 0.711, all R2 values > 0.660). Although there was an overall high level of agreement between waveform shapes, high RMSE values indicated some minor tracking errors for Kinect within the STS cycle. Spearman's Rank correlation coefficient indicated high levels of correlation between the systems for discrete variables (all R values > 0.89), with the exception of medial-lateral pelvic sway range. SIGNIFICANCE: The Azure Kinect provides valuable insight into STS movement strategies allowing for improved precision in clinical decision making across multiple clinical populations.

Endometrial scratch to increase live birth rates in women undergoing first-time in vitro fertilisation: RCT and systematic review.

BACKGROUND: In vitro fertilisation is a widely used reproductive technique that can be undertaken with or without intracytoplasmic sperm injection. The endometrial scratch procedure is an in vitro fertilisation 'add-on' that is sometimes provided prior to the first in vitro fertilisation cycle, but there is a lack of evidence to support its use. OBJECTIVES: (1) To assess the clinical effectiveness, safety and cost-effectiveness of endometrial scratch compared with treatment as usual in women undergoing their first in vitro fertilisation cycle (the 'Endometrial Scratch Trial') and (2) to undertake a systematic review to combine the results of the Endometrial Scratch Trial with those of previous trials in which endometrial scratch was provided prior to the first in vitro fertilisation cycle. DESIGN: A pragmatic, multicentre, superiority, open-label, parallel-group, individually randomised controlled trial. Participants were randomised (1 : 1) via a web-based system to receive endometrial scratch or treatment as usual using stratified block randomisation. The systematic review involved searching electronic databases (undertaken in January 2020) and clinicaltrials.gov (undertaken in September 2020) for relevant trials. SETTING: Sixteen UK fertility units. PARTICIPANTS: Women aged 18-37 years, inclusive, undergoing their first in vitro fertilisation cycle. The exclusion criteria included severe endometriosis, body mass index ≥ 35 kg/m2 and previous trauma to the endometrium. INTERVENTIONS: Endometrial scratch was undertaken in the mid-luteal phase of the menstrual cycle prior to in vitro fertilisation, and involved inserting a pipelle into the cavity of the uterus and rotating and withdrawing it three or four times. The endometrial scratch group then received usual in vitro fertilisation treatment. The treatment-as-usual group received usual in vitro fertilisation only. MAIN OUTCOME MEASURES: The primary outcome was live birth after completion of 24 weeks' gestation within 10.5 months of egg collection. Secondary outcomes included implantation, pregnancy, ectopic pregnancy, miscarriage, pain and tolerability of the procedure, adverse events and treatment costs. RESULTS: One thousand and forty-eight (30.3%) women were randomised to treatment as usual (n = 525) or endometrial scratch (n = 523) and were followed up between July 2016 and October 2019 and included in the intention-to-treat analysis. In the endometrial scratch group, 453 (86.6%) women received the endometrial scratch procedure. A total of 494 (94.1%) women in the treatment-as-usual group and 497 (95.0%) women in the endometrial scratch group underwent in vitro fertilisation. The live birth rate was 37.1% (195/525) in the treatment-as-usual group and 38.6% (202/523) in the endometrial scratch group: an unadjusted absolute difference of 1.5% (95% confidence interval -4.4% to 7.4%; p = 0.621). There were no statistically significant differences in secondary outcomes. Safety events were comparable across groups. No neonatal deaths were recorded. The cost per successful live birth was £11.90 per woman (95% confidence interval -£134 to £127). The pooled results of this trial and of eight similar trials found no evidence of a significant effect of endometrial scratch in increasing live birth rate (odds ratio 1.03, 95% confidence interval 0.87 to 1.22). LIMITATIONS: A sham endometrial scratch procedure was not undertaken, but it is unlikely that doing so would have influenced the results, as objective fertility outcomes were used. A total of 9.2% of women randomised to receive endometrial scratch did not undergo the procedure, which may have slightly diluted the treatment effect. CONCLUSIONS: We found no evidence to support the theory that performing endometrial scratch in the mid-luteal phase in women undergoing their first in vitro fertilisation cycle significantly improves live birth rate, although the procedure was well tolerated and safe. We recommend that endometrial scratch is not undertaken in this population. TRIAL REGISTRATION: This trial is registered as ISRCTN23800982. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 10. See the NIHR Journals Library website for further project information.

The endometrial scratch is a simple procedure that involves 'scratching' the lining of the womb (the endometrium). Several small studies have shown that undertaking this before the first in vitro fertilisation cycle may improve live birth rates; however, other studies have contradicted this. This large study was carried out to confirm whether or not having an endometrial scratch before the first in vitro fertilisation cycle would increase the number of women having a live birth compared with those having 'usual' in vitro fertilisation treatment (known as the 'control' group). We collected information about pregnancy, miscarriage, stillbirth, pain during the procedure and costs of treatment to find out if there were any meaningful differences. A total of 1048 women aged between 18 and 37 years were randomly allocated to the two groups, so participants had a 50% chance of having the endometrial scratch. Women were followed up throughout their pregnancy to ascertain the outcome of their in vitro fertilisation cycle. Although the live birth rate was 1.5% higher in the endometrial scratch group (38.6%) than in the control group (37.1%), the difference was not large enough to show any benefit of having the procedure. Other outcomes did not differ significantly between the two groups. However, the procedure was safe and tolerable. We found that the cost of treatment was, on average, £316 per participant higher in the group that received endometrial scratch than in the control group; the difference was not large enough to show that receiving endometrial scratch was more cost-effective. We combined the results of this trial with those of previous trials that looked to answer a similar question, and found that, overall, the endometrial scratch procedure does not enhance the chances of achieving a live birth. We conclude that endometrial scratch before first-time in vitro fertilisation does not improve the outcome of treatment, and we recommend that this procedure is not undertaken prior to a first cycle of in vitro fertilisation.

Qualitative Exploration of the Continuation of a Journal Club Experience by DPT Graduates in Their First Year of Practice.

PURPOSE: To explore the experience of doctorate of physical therapy (DPT) graduates participating in a journal club (JC) during their first year of practice after completing a JC intervention in the last didactic semester of their entry-level program. PARTICIPANTS: n=7 DPTs participating in a JC during the first year of practice. METHODS: A qualitative approach including semi-structured interviews and guided by a conceptual model for first-year PT practice was used. Interviews were transcribed verbatim and thematic data analysis was conducted. RESULTS: Six themes were identified: 1) sense of community, 2) maintaining accountability, 3) variety of perspectives, 4) informed clinical practice, 5) facilitated professional role adoption, and 6) challenges. Participants also provided recommendations for other recent graduates interested in beginning a JC. CONCLUSIONS: Exposure to a JC experience during the didactic phase of PT education may encourage graduates to embrace this professional behavior. Timing and meaningfulness of the JC intervention may be important factors to consider during implementation. New graduate participation in a JC may provide important support during the first year of practice. Most importantly, participation in a JC with an established community, such as fellow DPT graduates, may increase the salience and impact of this experience.

Costs and staffing resource requirements for adaptive clinical trials: quantitative and qualitative results from the Costing Adaptive Trials project.

BACKGROUND: Adaptive designs offer great promise in improving the efficiency and patient-benefit of clinical trials. An important barrier to further increased use is a lack of understanding about which additional resources are required to conduct a high-quality adaptive clinical trial, compared to a traditional fixed design. The Costing Adaptive Trials (CAT) project investigated which additional resources may be required to support adaptive trials. METHODS: We conducted a mock costing exercise amongst seven Clinical Trials Units (CTUs) in the UK. Five scenarios were developed, derived from funded clinical trials, where a non-adaptive version and an adaptive version were described. Each scenario represented a different type of adaptive design. CTU staff were asked to provide the costs and staff time they estimated would be needed to support the trial, categorised into specified areas (e.g. statistics, data management, trial management). This was calculated separately for the non-adaptive and adaptive version of the trial, allowing paired comparisons. Interviews with 10 CTU staff who had completed the costing exercise were conducted by qualitative researchers to explore reasons for similarities and differences. RESULTS: Estimated resources associated with conducting an adaptive trial were always (moderately) higher than for the non-adaptive equivalent. The median increase was between 2 and 4% for all scenarios, except for sample size re-estimation which was 26.5% (as the adaptive design could lead to a lengthened study period). The highest increase was for statistical staff, with lower increases for data management and trial management staff. The percentage increase in resources varied across different CTUs. The interviews identified possible explanations for differences, including (1) experience in adaptive trials, (2) the complexity of the non-adaptive and adaptive design, and (3) the extent of non-trial specific core infrastructure funding the CTU had. CONCLUSIONS: This work sheds light on additional resources required to adequately support a high-quality adaptive trial. The percentage increase in costs for supporting an adaptive trial was generally modest and should not be a barrier to adaptive designs being cost-effective to use in practice. Informed by the results of this research, guidance for investigators and funders will be developed on appropriately resourcing adaptive trials.

Trends in Pharmacy College Admission Test Requirements and Utilization Across Colleges and Schools of Pharmacy.

Objective. To identify national trends among US pharmacy schools and colleges in their requirements for the Pharmacy College Admission Test (PCAT) and underlying rationales for not requiring pharmacy school applicants to take it.Methods. An electronic survey regarding the following was sent to all US pharmacy programs: current and future PCAT requirements for applicants, use of the PCAT or other means to assess applicants' written communication skills, use of unofficial PCAT scores, and, if applicable, the rationale for not requiring applicants to submit PCAT scores. Data analysis was performed using Excel.Results. One hundred five (73%) of 144 schools and colleges of pharmacy responded to the survey. Twelve institutions discontinued the PCAT requirement between the 2018-2019 and 2019-2020 admissions cycles. The most commonly selected reason for discontinuation was a desire to increase pharmacy applications by reducing admission barriers. Pharmacy schools nationwide had concerns regarding high PCAT registration fees. The majority of pharmacy programs that used PCAT scores in their application process indicated that they always, often, or sometimes invited applicants for an interview before they had received the applicant's official PCAT scores. The majority of pharmacy programs considered applicants' PCAT writing score in making their admissions decisions. Other methods used included onsite essays and personal statements.Conclusion. At the time of this study the majority of US pharmacy schools required applicants to submit the PCAT scores before being considered for admission to pharmacy school; however, the use of this examination has declined nationally.

Adoption of Telehealth by Pediatric Physical Therapists During COVID-19: A Survey Study.

PURPOSE: To describe the characteristics of pediatric physical therapy telehealth practice during COVID-19. METHODS: An anonymous, online survey was distributed to pediatric physical therapists (PTs) in the United States who transitioned to telehealth during COVID-19. RESULTS: Two hundred five respondents completed all quantitative questions. Ninety-six percent reported never providing telehealth previously and only 14.6% had formal training. More than 35% reported 76% to 100% of their caseload transitioned to telehealth. Most respondents perceived that telehealth was somewhat or very effective for caregivers (90.3%) and children (77.1%) and felt somewhat or very confident providing telehealth (73.2%). However, those practicing in school-based settings rated perceived effectiveness and confidence lower than PTs in other settings. Ultimately, 76.1% of respondents would consider providing telehealth in the future. CONCLUSION: The forced transition of pediatric PTs to the telehealth model during the COVID-19 pandemic resulted in positive experiences for many, supporting wider adoption in the future.