Aishwarya Joshi

Background: Wearable sensor systems maximize visual and clinical feedback for physical therapists to enhance patient outcomes in rehabilitation medicine. However, physical therapists must adopt and accept new technologies for full integration into routine care to advance the use of technology in clinical care. Their role in technology design is critical in adopting and implementing technology. Interprofessional collaboration should be supported in the design of rehabilitation-assisted technologies. Objective: We used the established tenets of the Technology Acceptance Model to describe physical therapists’ expectations and experiences before and after using a novel wearable system in outpatient physical therapy. Methods: This multiple methods pilot study used a comparative pre-post survey and a qualitative semistructured focus group study design. Using purposive sampling, we recruited outpatient physical therapists to pilot the novel wearable technology, describe their expectations and experiences, and participate in a semistructured focus group discussion conducted to gather training and user experience information. Results: The study sample consisted of 5 physical therapists with an average age of 38.8 (SD 6.9) years and a work experience average of 12 (SD 7.7) years. Presurvey data show favorable expectations for usefulness and ease of use; however, favorability in both factors decreased after use. For perceived usefulness, all responses moved in the less favorable direction; mean difference −4.4 (SD 3.21); P=.04. All but 2 responses moved in the less favorable direction for overall perceived ease of use; mean difference −4.8 (SD 1.79); P=.04. Themed responses to open-ended questions in the postsurvey were feedback, setup time, accuracy, performance, and enhanced functional activities. Inductive content analysis of the focus group responses resulted in the following themes: system training, system benefits, system challenges, physical therapist perception of patients, and suggestions for improvement. The expectation for frequency of use decreased pre- to postexperience by 53% (mean −22, SD 14.40; P=.04). Conclusions: The Technology Acceptance Model–based survey responses and focus group themes outcomes demonstrated that physical therapists’ expectations for using new technology were not met. Engaging physical therapists in piloting novel wearable technology highlights the importance of physical therapist engagement in developing, refining, and implementing wearable devices for rehabilitation.

This study describes trends in the number of administrators in Pennsylvania hospitals from 1991 to 2020, and in the proportion of administrators to other hospital staff. Data are from the Pennsylvania Department of Health and the American Hospital Association. We find that between 1991 and 2020, the average number of administrators increased by 102% (60% when adjusted for patient volume). RNs, all nurses, and total hospital staff did not increase to the same extent, so the proportion of administrators to these staff increased by 24%, 33%, and 70% respectively. Common policies for reducing administrative costs may or may not apply to reducing administrator growth. Other policies should be explored as we discover specifics about this growth. Future studies should include data from other states and lower-level administrative staff. Studies should also examine the relationship between the number and proportion of administrators and nurse staffing, costs and quality of care.

The study examines the association between social determinants of health, tooth loss, and cognitive decline. Using regression models, the 2020 Behavioral Risk Factor Surveillance data examined the study objective; it included 32,663 older adults who reported on cognitive status. Results suggested that older adults missing more than five teeth or unable to work are 1.61 times and 6.84 times more likely to report cognitive decline, respectively. Older adults with higher education and higher household incomes are less likely to report cognitive decline. Results suggested that older adults with no diabetes or who never smoked are 31% and 39% less likely to report a cognitive decline. The results suggested a significant association between tooth loss and cognitive decline among social determinants of health. A comprehensive approach to affect cognitive decline should include oral and social health strategies.

The most common cause of suboptimal X-rays cited by radiologists is human error, specifically positioning error. Positioning errors are most commonly encountered in dental offices while using panoramic X-rays. The purpose of this research is to develop a method of reducing positioning error in panoramic X-rays that is low-cost and easy to implement in existing dental settings. To obtain the study objective, we took photos of the model biting on a bite block in various incorrect positions, including head rotation and head tilt. We then developed a prompt using a histogram of gradients and linear support vector machines, which identify facial landmarks, to guide the model in correcting the head positioning for a panoramic X-ray. The results indicated that the predicted prompts matched the actual prompts, and the program was able to successfully guide the patient. The quality of panoramic radiographs can be improved by paying close attention to the patient’s head positioning.

The study aimed to comprehensively review and assess evidence-based outcomes of the Greenhouse model. We systematically reviewed, assessed, and reported on relevant literature using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines for the scoping review. We identified qualitative or quantitative studies that met our inclusion criteria from PubMed, Medline, CINAHL, and EBSCOhost. The review yielded 41,515 articles published between January 2015 and December 2022; eleven articles met the inclusion criteria and were included in the analysis. The emerging themes were organizational culture, clinical outcomes, and business effects. The Greenhouse model offers a favorable organizational culture with opportunities to enhance clinical and business outcomes. The scoping review was registered in Prospero: CRD42023389048.