Becoming JEDI Warriors in Physical Therapy Research: A Multifaceted Approach.

The COVID-19 pandemic and recent incidents of social injustice exposed the systemic racism and discrimination in health care and clinical research that perpetuate systemic inequities. This perspective utilizes the acronym JEDI (justice, equity, diversity, and inclusion) as a vision for addressing inequities in physical therapy research. The need to go beyond diversity and focus on inclusion, equity, and justice is emphasized to achieve transformation within physical therapy research. The prevailing research paradigms are examined, acknowledging that research can perpetuate inequities and reinforcing the importance of integrating JEDI principles into the research process. The underrepresentation of diverse researchers in physical therapy is discussed, as well as the barriers faced by underrepresented researchers and research participants. Funding disparities are also highlighted, emphasizing the need for JEDI principles in research funding practices. How other health professions' associations are addressing JEDI in research is also explored. The authors propose a framework for action, utilizing the concepts of the socioecological model to identify gaps in JEDI within physical therapy research at different levels of influence and conclude by emphasizing the importance of justice in dismantling inequitable systems and urge the physical therapy research community to become JEDI warriors to bring about transformative change. IMPACT: By championing cultures that value justice, equity, diversity, and inclusion, individuals within the physical therapy research community have the potential to ignite a powerful transformation in society. The authors envision a future where JEDI warriors emerge, embracing the spirit of "Do or do not. There is no try," to forge a research community that is inclusive for all.1 Drawing inspiration from this mindset, this perspective seeks to empower individuals to harness the force of a JEDI warrior, fostering cultures that value justice, embrace inclusive methodologies, and ensure equitable access to resources and opportunities for researchers and participants.

Disparities in Physical Therapy Outcomes Based on Race and Ethnicity: A Scoping Review.

OBJECTIVE: This scoping review synthesizes and summarizes the evidence on racial and ethnic disparities in outcomes after physical therapist treatment. METHODS: Four databases from 2001 through 2021 were searched for articles reporting physical therapy outcomes across racial and ethnic groups. The Arksey and O'Malley's methodological framework was adapted for this scoping review. Two reviewers screened the abstracts and 5 reviewers screened full texts for inclusion. Five reviewers extracted information including study design, diagnoses, setting, outcomes reported, the domains the outcomes measured, and racial and ethnic groups included. To identify disparities, summarized differences in outcomes (better, worse, no difference) for each racial and ethnic group compared to White patients were calculated. RESULTS: Of 1511 abstracts screened, 65 met inclusion criteria, 57 of which were observational designs. All 65 articles included non-Hispanic White patients as the reference group. A majority of the physical therapy outcomes reported by race were for Black patients and/or Hispanic or Latino patients, whereas outcomes for Asian, American Indian, Alaskan Native, and/or Native Hawaiians or Pacific Islander patients were reported infrequently. Most articles reported disparities in health outcomes for patients in the inpatient rehabilitation setting (n = 48) and for adults (n = 59) with neurologic diagnoses (n = 36). Compared to White patients, worse outcomes were reported more frequently for all marginalized racial and ethnic groups after physical therapy, with the exception of marginalized groups having the same or better outcomes for successful post-rehabilitation community discharge. CONCLUSION: Gaps remain in understanding outcome disparities beyond older adult and neurologic populations as well as for musculoskeletal diagnoses frequently treated by physical therapists. IMPACT: The presence of racial and ethnic disparities in physical therapy outcomes should motivate physical therapists to understand the mechanisms underlying disparities and focus on social and structural drivers of health inequity in their clinical decision-making.

Successful Cardiac Surgical Management in a Trisomy 21 Child After Long-Term Hospitalization Associated With Bronchopneumonia and Hepatitis C Virus Seropositivity: A Case Report.

A 31-month-old girl with trisomy 21 (Down syndrome) was seen in the emergency department of pediatrics because of oxygen desaturation associated with features of lower respiratory tract infections. She was born at full term and diagnosed with congenital heart disease (CHD) having ventricular septal defect (VSD), and patent ductus arteriosus (PDA); consequently, she underwent corrective surgery after adequate optimization of treatment. Incidentally, she was detected to have the presence of anti-hepatitis C virus (HCV) antibodies. In this case report, we mainly focus on the multi-modal approach to medical and surgical management.