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The dissemination of evidence-based practice in German physiotherapy is limited by several barriers. However, a recent study shows that some German physiotherapists are already successfully implementing such a practice. Based on Everett M. Rogers’ diffusion of innovations theory, this study defined evidence-based practice as an innovation in German physiotherapy to gain insight into therapists’ strategies to overcome these barriers.

For many centuries and in many cultures, jesters recited tales of heroic exploits, but they did more than simply recount past events--they amused, cajoled, and spun tales that transported listeners to the edge of mysterious, unmapped territories. Through the transformative power of play and the imagination, they reworked what was already understood and created from it new realities that transcended the established order. The author maintains that such imaginative play is vital to creativity in any medium and is fundamental for optimal human development. She explores possibilities for cultivating creativity through the playful, paradoxical stance of the jester--a serendipitous and purposeful, strange and familiar, disruptive and productive figure. Her discussion, grounded in a visual-arts practice that leverages uncertainty and randomness, considers the role of play in light of its wider implications for knowledge and creativity. (Contains 17 notes.)

Dr. Diane Rosen is a principal at Compass Consultants, a business consultancy. In this article, she discusses how nonprofit leadership is different from the for‐profit sector and how to optimize impact through authentic leadership. [ABSTRACT FROM AUTHOR]

Dr. Diane Rosen is a principal at Compass Consultants, a business consultancy. In this article, she leads a discussion on the pros and cons of mission/vision/values exercises. [ABSTRACT FROM AUTHOR]

To determine how obstetricians and gynecologists (OB/GYNs) perceive the gynecologic health effects of obesity and to identify perceived obstacles to counseling. OB/GYNs with 3 St. Louis health systems were emailed a 46-question survey regarding physicians' role in counseling women on the health risks of obesity and barriers faced in achieving this counseling. Differences between respondents' gender, age, practice type, years in practice, and body mass index were assessed using Chi-square or Fisher's exact tests as appropriate. Of 318 OB/GYNs emailed, 134 completed surveys, including 82 generalists and 52 subspecialists. 93% of respondents believed it was necessary to educate patients on health risks of obesity. 90% and 75%, respectively, cited diagnoses of endometrial hyperplasia and cancer as teachable moments for counseling. The most frequently cited barriers to successful counseling were lack of time, referral services, and patient tools/information. Most did not believe they had adequate reimbursement (65%), training (53%) or educational resources (50%) to counsel patients. Survey answers differed by practice setting, gender, and provider age. Although most OB/GYN providers consider obesity counseling important, execution is hindered by perceived barriers that differ by provider gender, age, and practice type. For OB/GYNs, more effective weight management counseling will require better training and practice-specific strategies. Based on survey responses, better reimbursement combined with increased resources for appropriate referrals and cancer prevention counseling are needed in order to improve weight management implementation in OB/GYN. •The majority of OB/GYNs believe obesity counseling is important•Perceptions of obesity counseling differ based on provider/practice characteristics.•Lack of time, referral services, and patient tools are the biggest cited barriers to counseling.•Improved obesity counseling could improve downstream OB/GYN morbidities.