A qualitative study of the clinical practice of graduates of a problem-based physical therapy program

The purpose of this study was to examine the perspectives of three graduates of a problem-based leaning (PBL) physical therapy (PT) program about their clinical practice. The study used the qualitative methods of observations, interviews, and journaling to gather the data. Three sessions of audiotaped interviews and two observation sessions were conducted with three exemplars from Nova Southeastern University PBL PT program. Each participant also maintained a reflective journal. The data were analyzed using content analysis. A systematic filing system was used by employing a mechanical means of maintaining and indexing coded data and sorting data into coded classifications of subtopics or themes. All interview transcripts, field notes from observations, and journal accounts were read, and index sheets were appropriately annotated. From the findings of the study, it was noted that, from the participants' perspectives, they were practicing at typically expected levels as clinicians. The attributes that governed the perspectives of the participants about their physical therapy clinical practice included flexibility, reflection, analysis, decision-making, self-reliance, problem-solving, independent thinking, and critical thinking. Further, the findings indicated that the factors that influenced those attributes included the PBL process, parents' value system, self-reliant personality, innate personality traits, and deliberate choice. Finally, the findings indicated that the participants' perspectives, for the most part, appeared to support the espoused efficacy of the PBL educational approach. In conclusion, there is evidence that the physical therapy clinical practice of the participants were positively impacted by the PBL curriculum. Among the many attributes they noted which governed these perspectives, problem-solving, as postulated by Barrows, was one of the most frequently mentioned benefits gained from their PBL PT training. With more schools adopting the PBL approach, this research will hopefully add to the knowledge base regarding the efficacy of embracing a problem-based learning instructional approach in physical therapy programs. ^

Subject -centered and problem -based approaches to teaching clinical competence in physical therapy

Physical therapy students must apply the relevant information learned in their academic and clinical experience to problem solve in treating patients. I compared the clinical cognitive competence in patient care of second-year masters students enrolled in two different curricular programs: modified problem-based (M P-B; n = 27) and subject-centered (S-C; n = 41). Main features of S-C learning include lecture and demonstration as the major teaching strategies and no exposure to patients or problem solving learning until the sciences (knowledge) have been taught. Comparatively, main features of M P-B learning include case study in small student groups as the main teaching strategy, early and frequent exposure to patients, and knowledge and problem solving skills learned together for each specific case. Basic and clinical orthopedic knowledge was measured with a written test with open-ended items. Problem solving skills were measured with a written case study patient problem test yielding three subscores: assessment, problem identification, and treatment planning. ^ Results indicated that among the demographic and educational characteristics analyzed, there was a significant difference between groups on ethnicity, bachelor degree type, admission GPA, and current GPA, but there was no significant difference on gender, age, possession of a physical therapy assistant license, and GRE score. In addition, the M P-B group achieved a significantly higher adjusted mean score on the orthopedic knowledge test after controlling for GRE scores. The S-C group achieved a significantly higher adjusted mean total score and treatment management subscore on the case study test after controlling for orthopedic knowledge test scores. These findings did not support their respective research hypotheses. There was no significant difference between groups on the assessment and problem identification subscores of the case study test. The integrated M P-B approach promoted superior retention of basic and clinical science knowledge. The results on problem solving skills were mixed. The S-C approach facilitated superior treatment planning skills, but equivalent patient assessment and problem identification skills by emphasizing all equally and exposing the students to more patients with a wider variety of orthopedic physical therapy needs than in the M P-B approach. ^

Risk based post closure care analysis for Florida landfills

Subtitle D of the Resource Conservation and Recovery Act (RCRA) requires a post closure period of 30 years for non hazardous wastes in landfills. Post closure care (PCC) activities under Subtitle D include leachate collection and treatment, groundwater monitoring, inspection and maintenance of the final cover, and monitoring to ensure that landfill gas does not migrate off site or into on site buildings. The decision to reduce PCC duration requires exploration of a performance based methodology to Florida landfills. PCC should be based on whether the landfill is a threat to human health or the environment. Historically no risk based procedure has been available to establish an early end to PCC. Landfill stability depends on a number of factors that include variables that relate to operations both before and after the closure of a landfill cell. Therefore, PCC decisions should be based on location specific factors, operational factors, design factors, post closure performance, end use, and risk analysis. The question of appropriate PCC period for Florida’s landfills requires in depth case studies focusing on the analysis of the performance data from closed landfills in Florida. Based on data availability, Davie Landfill was identified as case study site for a case by case analysis of landfill stability. The performance based PCC decision system developed by Geosyntec Consultants was used for the assessment of site conditions to project PCC needs. The available data for leachate and gas quantity and quality, ground water quality, and cap conditions were evaluated. The quality and quantity data for leachate and gas were analyzed to project the levels of pollutants in leachate and groundwater in reference to maximum contaminant level (MCL). In addition, the projected amount of gas quantity was estimated. A set of contaminants (including metals and organics) were identified as contaminants detected in groundwater for health risk assessment. These contaminants were selected based on their detection frequency and levels in leachate and ground water; and their historical and projected trends. During the evaluations a range of discrepancies and problems that related to the collection and documentation were encountered and possible solutions made. Based on the results of PCC performance integrated with risk assessment, projection of future PCC monitoring needs and sustainable waste management options were identified. According to these results, landfill gas monitoring can be terminated, leachate and groundwater monitoring for parameters above MCL and surveying of the cap integrity should be continued. The parameters which cause longer monitoring periods can be eliminated for the future sustainable landfills. As a conclusion, 30 year PCC period can be reduced for some of the landfill components based on their potential impacts to human health and environment (HH&E).

Abstractions to support dynamic adaptation of communication frameworks for user-centric communication

The convergence of data, audio and video on IP networks is changing the way individuals, groups and organizations communicate. This diversity of communication media presents opportunities for creating synergistic collaborative communications. This form of collaborative communication is however not without its challenges. The increasing number of communication service providers coupled with a combinatorial mix of offered services, varying Quality-of-Service and oscillating pricing of services increases the complexity for the user to manage and maintain ‘always best’ priced or performance services. Consumers have to manually manage and adapt their communication in line with differences in services across devices, networks and media while ensuring that the usage remain consistent with their intended goals. This dissertation proposes a novel user-centric approach to address this problem. The proposed approach aims to reduce the aforementioned complexity to the user by (1) providing high-level abstractions and a policy based methodology for automated selection of the communication services guided by high-level user policies and (2) providing services through the seamless integration of multiple communication service providers and providing an extensible framework to support the integration of multiple communication service providers. The approach was implemented in the Communication Virtual Machine (CVM), a model-driven technology for realizing communication applications. The CVM includes the Network Communication Broker, the layer responsible for providing a network-independent API to the upper layers of CVM. The initial prototype for the NCB supported only a single communication framework which limited the number, quality and types of services available. Experimental evaluation of the approach show the additional overhead of the approach is minimal compared to the individual communication services frameworks. Additionally the automated approach proposed out performed the individual communication services frameworks for cross framework switching.

Risk Based Post Closure Care Analysis for Florida Landfills

Subtitle D of the Resource Conservation and Recovery Act (RCRA) requires a post closure period of 30 years for non hazardous wastes in landfills. Post closure care (PCC) activities under Subtitle D include leachate collection and treatment, groundwater monitoring, inspection and maintenance of the final cover, and monitoring to ensure that landfill gas does not migrate off site or into on site buildings. The decision to reduce PCC duration requires exploration of a performance based methodology to Florida landfills. PCC should be based on whether the landfill is a threat to human health or the environment. Historically no risk based procedure has been available to establish an early end to PCC. Landfill stability depends on a number of factors that include variables that relate to operations both before and after the closure of a landfill cell. Therefore, PCC decisions should be based on location specific factors, operational factors, design factors, post closure performance, end use, and risk analysis. The question of appropriate PCC period for Florida’s landfills requires in depth case studies focusing on the analysis of the performance data from closed landfills in Florida. Based on data availability, Davie Landfill was identified as case study site for a case by case analysis of landfill stability. The performance based PCC decision system developed by Geosyntec Consultants was used for the assessment of site conditions to project PCC needs. The available data for leachate and gas quantity and quality, ground water quality, and cap conditions were evaluated. The quality and quantity data for leachate and gas were analyzed to project the levels of pollutants in leachate and groundwater in reference to maximum contaminant level (MCL). In addition, the projected amount of gas quantity was estimated. A set of contaminants (including metals and organics) were identified as contaminants detected in groundwater for health risk assessment. These contaminants were selected based on their detection frequency and levels in leachate and ground water; and their historical and projected trends. During the evaluations a range of discrepancies and problems that related to the collection and documentation were encountered and possible solutions made. Based on the results of PCC performance integrated with risk assessment, projection of future PCC monitoring needs and sustainable waste management options were identified. According to these results, landfill gas monitoring can be terminated, leachate and groundwater monitoring for parameters above MCL and surveying of the cap integrity should be continued. The parameters which cause longer monitoring periods can be eliminated for the future sustainable landfills. As a conclusion, 30 year PCC period can be reduced for some of the landfill components based on their potential impacts to human health and environment (HH&E).

Best Practices: Lessons Learned by a South Florida Non-Profit Community Based Organization while Designing and Implementing a Career Exploration Evidence Informed Framework in Urban Communities

All A’s was designed to support of the agency’s family strengthening initiatives in South Florida. All A’s uses evidence informed strategies poised to be an inclusive curriculum that teaches self-determination and adaptive behavior skills. The framework incorporates problem based learning and adult learning theory and follows the Universal Design for Learning. Since 2012, the agency has served over 8500 youth and 4,000 adults using the framework. The framework addresses educational underachievement and career readiness in at risk populations. It is used to enhance participants AWARENESS of setting SMART goals to achieve future goals and career aspirations. Participants are provided with ACCESS to resources and opportunities for creating and implementing an ACTION plan as they pursue and ACHIEVE their goals. All A’s promotes protective factors and expose youth to career pathways in Science, Technology, Engineering and Math (STEM) related fields. Youth participate in college tours, job site visits, job shadowing, high school visits, online college and career preparation assistance, service learning projects, STEM projects, and the Winning Futures© mentoring program. Adults are assisted with résumé development; learn job search strategies, interview techniques, job shadowing experiences, computer and financial literacy programs. Adults and youth are also given the opportunity to complete industry-recognized certifications in high demand industries (food service, general labor, and construction), and test preparation for the General Educational Development Test.

Physical dynamic simulation of shipboard power system components in a distributed computational environment

Shipboard power systems have different characteristics than the utility power systems. In the Shipboard power system it is crucial that the systems and equipment work at their peak performance levels. One of the most demanding aspects for simulations of the Shipboard Power Systems is to connect the device under test to a real-time simulated dynamic equivalent and in an environment with actual hardware in the Loop (HIL). The real time simulations can be achieved by using multi-distributed modeling concept, in which the global system model is distributed over several processors through a communication link. The advantage of this approach is that it permits the gradual change from pure simulation to actual application. In order to perform system studies in such an environment physical phase variable models of different components of the shipboard power system were developed using operational parameters obtained from finite element (FE) analysis. These models were developed for two types of studies low and high frequency studies. Low frequency studies are used to examine the shipboard power systems behavior under load switching, and faults. High-frequency studies were used to predict abnormal conditions due to overvoltage, and components harmonic behavior. Different experiments were conducted to validate the developed models. The Simulation and experiment results show excellent agreement. The shipboard power systems components behavior under internal faults was investigated using FE analysis. This developed technique is very curial in the Shipboard power systems faults detection due to the lack of comprehensive fault test databases. A wavelet based methodology for feature extraction of the shipboard power systems current signals was developed for harmonic and fault diagnosis studies. This modeling methodology can be utilized to evaluate and predicate the NPS components future behavior in the design stage which will reduce the development cycles, cut overall cost, prevent failures, and test each subsystem exhaustively before integrating it into the system.

Adults Learning Math Online: A Surprising Harmony

Adults returning to school face challenges including overcoming math anxiety. Many choose online courses as they balance life and work schedules. Online math courses therefore can be restructured to prevent math anxiety by catering to individual learning styles, providing tools that aid concept attainment, and using problem-based learning strategies.

Physical dynamic simulation of shipboard power system components in a distributed computational environment

Shipboard power systems have different characteristics than the utility power systems. In the Shipboard power system it is crucial that the systems and equipment work at their peak performance levels. One of the most demanding aspects for simulations of the Shipboard Power Systems is to connect the device under test to a real-time simulated dynamic equivalent and in an environment with actual hardware in the Loop (HIL). The real time simulations can be achieved by using multi-distributed modeling concept, in which the global system model is distributed over several processors through a communication link. The advantage of this approach is that it permits the gradual change from pure simulation to actual application. In order to perform system studies in such an environment physical phase variable models of different components of the shipboard power system were developed using operational parameters obtained from finite element (FE) analysis. These models were developed for two types of studies low and high frequency studies. Low frequency studies are used to examine the shipboard power systems behavior under load switching, and faults. High-frequency studies were used to predict abnormal conditions due to overvoltage, and components harmonic behavior. Different experiments were conducted to validate the developed models. The Simulation and experiment results show excellent agreement. The shipboard power systems components behavior under internal faults was investigated using FE analysis. This developed technique is very curial in the Shipboard power systems faults detection due to the lack of comprehensive fault test databases. A wavelet based methodology for feature extraction of the shipboard power systems current signals was developed for harmonic and fault diagnosis studies. This modeling methodology can be utilized to evaluate and predicate the NPS components future behavior in the design stage which will reduce the development cycles, cut overall cost, prevent failures, and test each subsystem exhaustively before integrating it into the system.

An investigation of the effects of a school-based intervention on feelings of personal expressiveness in multi-problem adolescent youth

This study was conducted to determine the effects of the Changing Lives Program intervention on troubled adolescents' feelings of personal expressiveness, believed to be one domain of positive identity development. Forty-three intervention and twenty nonintervention comparison control participants were given a battery of pre-, post-, and follow-up assessments including the Personally Expressive Questionnaire (Waterman, 1995), which was used to derive participants' feelings of personal expressiveness scores. Using Repeated Measures Analysis of Multivariate Analysis (RMANOVA), a significant four-way interaction of Time X Condition X Gender X Ethnicity was found relative to the Control, Roy's Ɵ = .166, F(2,47) = 3.899, p < .027 indicating that intervention participants' feelings of personal expressiveness did increase significantly relative to the control group. Furthermore, the results suggest differential outcomes based on ethnicity, suggesting the need for future study with respect to specificity of effects and mechanisms of identity formation in differing ethnic subgroups.