University of Western States is a private health science-focused university in Portland, Oregon. Founded in 1904, UWS is the second oldest chiropractic university in the world. The university has just under 1,000 students enrolled in both online and on campus.
PURPOSE:Heuristic effect size benchmarks for Cohen's d, Hedges' g, and p-values lack statistical and clinical grounding, producing misleading interpretations of within-subject occupational therapy (OT) research outcomes. This study aimed to recalibrate d, g, and p-value thresholds for paired samples t-tests using Bayesian posterior probabilities representing evidential support for a clinical effect. MATERIALS AND METHODS:Using JASP's Bayesian Paired Samples t-test module, Bayes Factors (BF10) were iteratively derived across 67 sample sizes (N = 5-500) and converted to d/g thresholds corresponding to posterior probabilities of 50%, 75%, 90%, 95%, and 99%. Sensitivity analyses evaluated threshold stability across Cauchy prior scales. Two generalized additive models compared BF10 and p-values for predicting effect sizes using 100 published OT studies from the American Journal of Occupational Therapy. RESULTS:Recalibrated thresholds corrected small- and large-sample bias. BF10 predicted effect sizes more accurately than p-values (R2 = 0.992 vs. 0.966; ΔAIC = 154.81). Thresholds were robust to prior specification. p-values near .05 consistently failed to achieve posterior probabilities of 75% or greater. CONCLUSIONS:These recalibrated thresholds provide occupational therapists a principled, sample size-sensitive tool for interpreting within-subject outcomes probabilistically, offering a practical alternative to conventional heuristic benchmarks.
BACKGROUND:Federally Qualified Health Centers (FQHCs) deliver comprehensive primary care and supportive services to underserved populations. However, current care models have been unable to meet demand for spinal and musculoskeletal (MSK) care, a leading cause of disability and driver of opioid prescribing. PURPOSE:Chiropractors are well positioned to help FQHCs manage the burden of acute and chronic spinal and MSK pain, supporting primary care providers while expanding access to nonpharmacologic treatment. Yet integration of chiropractic services into FQHCs remains limited. DISCUSSION:Although chiropractors are eligible to provide qualifying Medicare Prospective Payment System visits in FQHCs, chiropractic adoption appears to be enabled primarily by Medicaid coverage, with integration concentrated in states that reimburse chiropractic services and where approximately 50% of chiropractic FQHC patients have Medicaid coverage. This article examines the financing and policy environment shaping chiropractic integration in FQHCs, compares fee-for-service and value-based payment models, and explores alternative pathways, including shared savings, capitation, and grant funding. Drawing on parallels to successful integration from dentistry, podiatry, and optometry, we describe how chiropractors can function as embedded spinal and MSK specialists contributing to quality and cost outcomes. CONCLUSION:We argue that with supportive Medicaid and Medicare policies, chiropractic services can improve pain outcomes for spinal and MSK disorders while reducing downstream health care utilization in safety-net settings.
Rape is often considered traumatizing for those who have experienced it and also for those who hear about it. We explore how a content-based semester-long study of sexualized violence and harm incorporates the language arts of close readings, critical thinking, low stakes writing in journals, film and theater analyses, and playwrighting in order to bring sexualized violence and harm into the discourse of the class we call Seeing Rape, and then into student-written theater performance by the same name for our college community. By examining how we study rape in the course, we explore how the class practices and models speaking about rape and sex to be able to give voice to rape trauma and its public secrecy. This paper is written as an auto-ethnographic collaborative effort undertaken by two professors and two former undergraduates who reflect on their processes in a course and then later in the theater. The professors will discuss how students are encouraged in the class to confront, critique, and contest how cultures define rape and/or silence rape stories as well as how instruction can challenge the ways in which rape is manipulated as a concept in culture. The former students' auto-ethnographic reflections about their linguistic choices from among their communicative repertoires in the creation of their theatrical representations of rape comprise the main findings of the study.
