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Background: The addition of hybrid accelerated Doctor of Physical Therapy (DPT) Education programs has raised some doubts surrounding the quality of DPT education. While objective graduate outcomes suggest that graduates from a hybrid, 2-year DPT program are comparable with the national average in terms of licensure pass rates, there remains concern that students/graduates from these programs would have less knowledge, skill, and clinical expertise and threaten to damage the reputation and credibility of the DPT degree. Objectives: The purpose of this study was to evaluate clinical instructor perception of hybrid, 2-year educated DPT students in comparison to traditionally trained DPT students in terms of quality of clinical performance. Methods: For this study, data was extracted from the Clinical Internship Evaluation Tool (CIET) for analysis of student competency regarding patient management and clinical instructor perception of student performance compared to traditionally, non-hybrid educated students. Results: Student outcomes on the CIET indicated that students were performing at the level of a competent clinician for familiar patient cases and performing at an appropriate level for their current education. Students were also rated by clinical instructors as equally prepared as traditionally based students for the clinical experience. Conclusions: The results of this study suggest that clinical instructors' perceptions describe no differences of student preparedness in the clinical environment between students in this hybrid accelerated cohort and traditionally prepared students. Implications for Physiotherapy Practice: Hybrid-educated DPT students can be as prepared in the clinical environment as traditionally trained students. [ABSTRACT FROM AUTHOR]

This symposium introduction reflects on themes of tradition and innovation in the work of Antonio ('Nino') Cassese. These themes were central to Cassese's own thinking, in ways drawn out by the three symposium articles on aspects of his life and work, and they play important roles in international law more broadly. In exploring these themes in a loosely biographical inquiry, the introduction also poses questions about the nature of biographical writing in international law and its relation to memorialization and historicization of law's recent past. [ABSTRACT FROM AUTHOR]

Rationale: A recent randomized controlled trial revealed that a multicomponent sepsis transition and recovery (STAR) program delivered through specialized nurse navigators was effective in reducing a composite of 30-day readmission and mortality. Better understanding of patterns of care provided by the STAR program is needed to promote implementation and dissemination of this effective program. Objectives: This study characterizes individual care activities and distinct "packages" of care delivered by the STAR program. Methods: We performed a secondary analysis of data from the intervention arm of the IMPACTS (Improving Morbidity during Post–Acute Care Transitions for Sepsis) randomized controlled trial, conducted at three urban hospitals in the southeastern United States from January 2019 to March 2020. We used a structured data collection process to identify STAR nurse navigator care activities from electronic health record documentation. We then used latent class analysis to identify groups of patients receiving distinct combinations of intervention components. We evaluated differences in patient characteristics and outcomes between groups receiving distinct intervention packages. Results: The 317 sepsis survivors enrolled into the intervention arm of the IMPACTS trial received one or more of nine unique care activities delivered by STAR nurse navigators (care coordination, health promotion counseling, emotional listening, symptom management, medication management, chronic disease management, addressing social determinants of health, care setting advice and guidance, and primary palliative care). Patients received a median of three individual care activities (interquartile range, 2–5). Latent class analysis revealed four distinct packages of care activities delivered to patients with different observable characteristics and different frequency of 30-day readmission and mortality. Conclusions: We identified nine care activities delivered by an effective STAR program and four distinct latent classes or packages of intervention delivery. These results can be leveraged to increase widespread implementation and provide targets to augment future program delivery. [ABSTRACT FROM AUTHOR]

Systematically evaluate the comparative effectiveness of dry needling (DN) or local acupuncture to various types of wet needling (WN) for musculoskeletal pain disorders (MPD). Seven databases (PubMed, PEDro, SPORTDiscus, CINAHL, Scopus, Embase, and Cochrane Central Register of Controlled Trials) were searched following PROSPERO registration. Randomized clinical trials were included if they compared DN or local acupuncture with WN for MPD. Primary outcomes were pain and/or disability. The Revised Cochrane Collaboration tool (RoB 2.0) assessed the risk of bias. Twenty-six studies were selected. Wet Needling types included cortisone (CSI) (N = 5), platelet-rich plasma (PRP) (N = 6), Botox (BoT) (N = 3), and local anesthetic injection (LAI) (N = 12). Evidence was rated as low to moderate quality. Results indicate DN produces similar effects to CSI in the short-medium term and superior outcomes in the long term. In addition, DN produces similar outcomes compared to PRP in the short and long term and similar outcomes as BoT in the short and medium term; however, LAI produces better pain outcomes in the short term. Evidence suggests the effectiveness of DN to WN injections is variable depending on the injection type, outcome time frame, and diagnosis. In addition, adverse event data were similar but inconsistently reported. PROSPERO Registration: 2019 CRD42019131826 Dry needling produces similar effects for pain and disability in the short and medium term compared to cortisone, Botox, and platelet-rich plasma injections. Local anesthetic injection may be more effective at reducing short-term pain. Long-term effects on pain and disability are similar between dry needling and platelet-rich plasma injections, but dry needling may produce better long-term outcomes than cortisone injections. The available adverse event data is similar between dry and wet needling. The conclusions from this study may be beneficial for patients and clinicians for considering risk and cost benefit analyses. [ABSTRACT FROM AUTHOR]

The article literary criticism is presented of the book "International Law and the Politics of History" by Anne Orford on politics of making history and law. It mentions rather than looking to history in a doomed attempt to find a new ground for formalist interpretations of what past legal texts really mean or what international regimes are really for, Orford urges lawyers and historians to embrace the creative role they play in making rather than finding the meaning of international law.

Systematic review. Physical therapists often use cervicothoracic and thoracic manual techniques to treat musculoskeletal disorders of the upper quarter ,however, the overall effectiveness of this approach remains to be elucidated. This systematic review explored studies that examined the short- and long-term effectiveness of manual physical therapy directed at the cervicothoracic and thoracic region in the management of upper quarter musculoskeletal conditions. The electronic databases MEDLINE, AMED, CINAHL, and Embase were searched from their inception through 30 October 2020. Eligible clinical trials included those where human subjects treated with cervicothoracic and/or thoracic manual procedures were compared with a control group or other interventions. The methodological quality of individual studies was assessed using the PEDro scale. The initial search returned 950 individual articles. After the screening of titles and abstracts, full texts were reviewed by two authors, with 14 articles determined to be eligible for inclusion. PEDro scores ranged from 66 to 10 (out of a maximum score of 10). In the immediate to 52-week follow-up period, studies provided limited evidence that cervicothoracic and thoracic manual physical therapy may reduce pain and improve function when compared to control/sham or other treatments. Evidence provides some support for the short-termeffectiveness of cervicothoracic and thoracic manual physical therapy in reducing pain and improving function in people experiencing upper quarter musculoskeletal disorders. Evidence is lacking for long-term effectiveness as only two studies explored outcomes beyond 26 weeks and this was for patient-perceived improvement. CRD42020219456 [ABSTRACT FROM AUTHOR]

Six internal medicine physicians reviewed STAR navigator notes in study patients' medical records and recorded whether interventions related to medications occurred and used granular EHR review to characterize the medication errors that were addressed. Sepsis survivors may be particularly vulnerable to medication errors because new medications are frequently started (e.g., antibiotics), home medications are frequently held during the acute phase, and physiologic changes may influence dose and tolerance of medications. [Extracted from the article]

B Introduction: b In the IMPACTS trial, a multicomponent sepsis transition and recovery (STAR) program using nurse navigators to deliver best practice care to sepsis survivors reduced 30-day readmission or mortality. B Results: b Of 317 patients randomized to receive STAR, 228 (72%) received >=1 intervention component via STAR while 91 (29%) received >=4; 9 (3%) refused participation, 17 (5%) had no care needs that required specific intervention, and 63 (20%) were unable to be reached post discharge. [Extracted from the article]

To investigate the diagnostic accuracy of patient history associated with hip pain. A systematic, computerized search of electronic databases (PubMed, MEDLINE, Cumulative Index of Nursing and Allied Health Literature, and Web of Science), a search of the gray literature, and review of the primary author's personal library was performed. Hip-specific search terms were combined with diagnostic accuracy and subjective or self-report history-based search terms using the Boolean operator "AND." This systematic review was conducted and reported according to the protocol outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were: (1) patients with hip pain; (2) the statistical association of at least 1 patient history item was reported; (3) study designs appropriate for diagnostic accuracy; (4) adults aged ≥18 years; (5) written in English; and (6) used an acceptable reference standard for diagnosed hip pathology. Titles and abstracts of all database-captured citations were independently screened by at least 2 reviewers. Two reviewers independently extracted information and data regarding author, year, study population, study design, criterion standard, and strength of association statistics associated with the subjective findings. For hip osteoarthritis (OA), a family history of OA (positive likelihood ratio [+LR], 2.13), history of knee OA (+LR, 2.06), report of groin or anterior thigh pain (+LR, 2.51-3.86), self-reported limitation in range of motion of 1 or both hips (+LR, 2.87), constant low back pain or buttock pain (+LR, 6.50), groin pain on the same side (+LR, 3.63), and a screening questionnaire (+LR, 3.87-13.29) were the most significant findings. For intra-articular hip pathology, crepitus (+LR, 3.56) was the most significant finding. Patient history plays a key role in differential diagnosis of hip pain and in some cases can be superior to objective tests and measures. [ABSTRACT FROM AUTHOR]