OBJECTIVES:Although back pain is common among horticulture workers, effective prevention and management strategies are lacking. The first phase of a study using the Exploration, Preparation, Implementation, and Sustainment Framework is described with aims to characterize stakeholder perceptions of: 1) the need to address back pain, 2) attitudes towards pain medication including opioids, 3) contextual factors, and 4) preferences for training related to musculoskeletal injury prevention. METHODS:In-depth interviews were completed in English or Spanish (n = 14) with consultants, owners, supervisors, and workers and in English or Spanish. Transcripts were recorded, transcribed, and coded, followed by qualitative inductive-deductive thematic analysis. RESULTS:While back pain is widespread, productivity requirements and working through pain may lead to de-emphasizing awareness and practices to prevent and manage back pain. Nursery and landscape workers tend to work regardless of pain, often using over-the-counter pain relievers to get through the day. Use of pain medication is seldom discussed, including risks of opioids and owners and consultants were hesitant to provide Naloxone in the workplace. Non-modifiable but variable contextual factors to consider when designing training are seasons and weather, type of horticulture, business models, productivity goals, and income needs. Training, policies, administrative controls, and worker knowledge and attitudes towards pain are potentially modifiable. Most current training is informal and on-the-job, and supervisors play a critical intermediary role. Integrating training into current work practices could minimize reductions in work time. CONCLUSIONS:Proactive interventions to limit and manage back pain and increase awareness of medication risks are needed for horticulture workers. Themes will be useful to design horticulture-specific training: 1) variability in contextual factors (weather, seasons, business models) requires training options that can be used at down-times and in different locations, 2) productivity drivers and worker tendencies to work through pain to protect their income require short, practical strategies and training without disrupting workflow, and appropriate messaging, 3) need for a supportive workplace culture, and 4) importance of involving supervisors. The non-modifiable and modifiable contextual findings from this study will be helpful for designing prevention training in the horticulture industry and could potentially apply to other outdoor physically challenging occupations.

Introduction: The Scholarship of Teaching and Learning (SoTL) is the practice of critically examining student learning to improve teaching and then disseminating insights from this work for others to build on. SoTL often justifies faculty members’ careers in health professions education (HPE); however, SoTL is not universally understood or acknowledged in promotion and tenure (P&T) decisions across HPE institutions. We conducted a scoping review of the published literature to map how SoTL has been conceptualized, realized, and described as institutionally recognized by P&T committees. Methods: In July 2024 (updated in July 2025 and April 2026), the authors searched 7 databases for peer-reviewed publications referring to any scholarship relating to education, teaching, and/or learning in HPE in the United States. We followed Arksey & O’Malley’s scoping review methodology and incorporated stakeholder feedback. Articles were grouped by discipline: medicine and other health professions. Results: Of the 4,588 articles identified, 130 were included for full review, with 52 reporting on SoTL activities in medical education (40%) and 78 in other HPE domains (60%). While articles shared core SoTL concepts, SoTL was operationalized in a variety of ways, many blurring the distinction between scholarly teaching and SoTL. The articles demonstrated that SoTL has been inconsistently recognized by P&T committees. Conclusion: Using Institutional Logics to support analysis, we found that the recognition of SoTL in HPE organizations varies with the degree of alignment between the logics of research and teaching. We propose strategies for increasing this alignment and provide literature-based distinctions between scholarly teaching, SoTL and educational research to support this goal.

BackgroundBack pain is extremely common in agriculture, horticulture, and seafood workers. There is a gap in studies for horticulture and seafood sectors and a scoping review with a wide lens could help inform research within, and across sectors.ObjectiveThis scoping review aimed to establish available evidence for intervention strategies in agricultural, horticulture, and seafood workers to minimize, prevent, or address back pain.MethodsA scoping review was conducted using 15 bibliographic databases encompassing health, business, and agricultural interventions without study type or publication date limits. Articles were screened and extracted by two independent reviewers, with a third resolving discrepancies. Data was synthesized and studies categorized to help inform future research.ResultsData were extracted from 74 studies; agriculture interventions were most common (82%), with few agriculture and horticulture (4%), horticulture (5%), and seafood studies (7%). Interventions were mostly ergonomic (72%; engineering 65%, administrative 3%, engineering and administrative 3%), with fewer self-management (16%; education, exercise, education and exercise 5% each), or both ergonomic and self-management (12%) studies.ConclusionsThere is a major gap in studies in horticulture and seafood sectors, and future research could build from existing evidence in agriculture and across sectors. There is a need for field studies for participants who have pain across all sectors, and rigorous research designs including larger sample sizes and longer follow-up. Future studies focusing on administrative controls, exercise, education, and multimodal approaches are needed, especially if the results translate to multiple sectors.RegistrationThe scoping review protocol was registered through the Open Science Framework on March 26, 2024. https://doi.org/10.17605/OSF.IO/FB3ST.

Background Low back pain (LBP) is highly prevalent and disabling, especially in agriculture sectors. However, there is a gap in LBP prevention and intervention studies in these physically demanding occupations, and to date, no studies have focused on horticulture workers. Given the challenges of implementing interventions for those working in small businesses, self-management offers an attractive and feasible option to address work-related risk factors and manage LBP. Objective This study will (1) investigate the effectiveness of self-management strategies for nursery and landscape workers by comparing within-subject control and intervention periods and (2) determine if adoption and effectiveness differs between participants randomly assigned to review self-management videos only and those who also receive multimodal implementation support. We will also identify contextual factors impacting effectiveness and implementation. Methods A pragmatic, mixed methods, hybrid effectiveness and implementation design will be used to compare back pain with work tasks, disability, medication and substance use, and psychological factors between a baseline control and intervention periods. We aim to recruit 122 English- and Spanish-speaking horticulture workers with back pain, 30 supervisors, and 12 focus group participants. Participants will review short video modules designed to increase awareness of opioid risk and introduce self-management and ergonomic choices and use 1 self-management and 1 ergonomic strategy for 10 weeks. They will be randomly assigned to 2 implementation groups: video modules only or video + multimodal personalized support (checklist guidance, review of video feedback for ergonomic problem-solving, and text message reminders). Questionnaires will be administered at 3-month time points: baseline, pre- and postintervention, and at 3 and 6 months. Qualitative analysis of field notes, open-ended comments, and focus groups will expand understanding of results with comprehensive documentation of the context, barriers and facilitators, and reasons for adoption. Results The project was funded on September 29, 2023 (Centers for Disease Control and Prevention National Institute of Occupational Health and Safety, CDC NIOSH; U54OH011230-07S1), as a core research grant for the Southeast Coastal Center for Agricultural Health and Safety. The design, creation, and editing of English and Spanish videos was completed in June 2024 after comprehensive formative evaluation. Enrollment began in June 2024 with anticipated completion in 2027. Conclusions We hypothesize that both self-management interventions will result in reductions in work task pain and disability and that the video enhanced with multimodal personalized support will result in greater reductions than the video alone. If self-management is effective, mitigating pain positively impacts quality of life, productivity, and retention, while increasing the use of nonpharmacological alternatives to opioids addresses an important public health issue. Implementation aims will help inform reasons for results, barriers and facilitators, and potential for similar interventions in these and similar industries with physically challenging outdoor work. Trial Registration ClinicalTrials.gov NCT06153199; http://clinicaltrials.gov/study/NCT06153199 International Registered Report Identifier (IRRID) DERR1-10.2196/64817

Abstract Date Presented 03/21/24 Therapy students in an early childhood training program demonstrated improved self-ratings of teaming competencies and use of teaming strategies and approaches. Entry-level training on collaborative practice enhances the quality of early intervention/early childhood programs. Primary Author and Speaker: Christine T. Myers Additional Authors and Speakers: Kristen Lewandowski, Claudia Senesac, Kim Dunleavy

Background Ergonomic development and awareness are critical to the long-term health and well-being of surgeons. Work-related musculoskeletal disorders affect an overwhelming majority of surgeons, and various operative modalities (open, laparoscopic, and robotic surgery) differentially affect the musculoskeletal system. Previous reviews have addressed various aspects of surgical ergonomic history or methods of ergonomic assessment, but the purpose of this study is to synthesize ergonomic analysis by surgical modality while discussing future directions of the field based on current perioperative interventions. Methods pubmed was queried for "ergonomics," "work-related musculoskeletal disorders," and "surgery," which returned 124 results. From the 122 English-language papers, a further search was conducted via the articles' sources for relevant literature. Results Ninety-nine sources were ultimately included. Work-related musculoskeletal disorders culminate in detrimental effects ranging from chronic pain and paresthesias to reduced operative time and consideration for early retirement. Underreporting symptoms and a lack of awareness of proper ergonomic principles substantially hinder the widespread utilization of ergonomic techniques in the operating room, reducing the quality of life and career longevity. Therapeutic interventions exist at some institutions but require further research and development for necessary widespread implementation. Conclusion Awareness of proper ergonomic principles and the detrimental effects of musculoskeletal disorders is the first step in protecting against this universal problem. Implementing ergonomic practices in the operating room is at a crossroads, and incorporating these principles into everyday life must be a priority for all surgeons.

OBJECTIVE:The goals of this study are to establish whether mechanical pressure pain, short-term memory recall of a painful stimulus, or long-term memory of a previous painful lower limb injury alters isometric muscle strength and whether there was a difference in responses between participants with and without a previous history of injury.DESIGN:Fifty-nine pain-free participants (29 with previous injury and 30 without) participated in this study. Tibialis anterior isometric muscle strength was compared pre- and post-noxious mechanical stimulus with instructions to recall pain (short- and long-term).RESULTS:Short- and long-term pain recall produced a significant reduction in muscle strength (short-term: F (1,57) = 160.472, P < 0.001; long-term: F (1,57) = 128.899, P < 0.001). A greater decrease was experienced with short- and long-term pain memory than exposure to mechanical pain (mechanical pain: -14.8% or -32.98 kg, 95% confidence interval [CI], -41.57 to -24.19; short-term: -24.1% or -52.70 kg, 95% CI = -60.98 to -44.34; long-term: -20.3% or -44.63 kg, 95% CI = -52.77 to -36.95). There was no significant difference in responses associated with an injury history.CONCLUSIONS:Findings suggest that recalled pain memory can impact motor responses and calls attention to the role of past injury history in the rehabilitation process.

Increasing demands placed on the current healthcare system has resulted in evolving interprofessional models of care. An evidence-informed approach to staffing needs should be used to identify the appropriate skill mix necessary for healthcare settings. Though patient care needs assessment tools exist, few particularly focus solely on health disciplines in a real-time, systematic manner that can be applied at the unit level. The Interprofessional Patient Care Needs Assessment Tool (IPPCNAT) was designed to characterize unit level needs of patients from a collective health discipline lens. Conceptualization, development, and refinement of the IPCCNAT occurred over three phases. The final version of the IPCCNAT is comprised of six broad domains of practice, each with 3–10 specific patient care needs. Data gathered from implementing this tool provides insight for managers and administrators on patient care needs, at the unit level. This insight facilitates the optimization of overlapping scopes and existing resources. provide a means for healthcare managers and administrators to be continuously responsive to patient care needs. The tool development process can provide a guideline for other organizations in their efforts to optimize a professional model of care within a healthcare context, rather than determining the appropriate staffing mix output based on the skill level of each profession.

Objectives. Lower back pain (LBP) is extremely prevalent in seafood harvesters who often have limited or no access to ergonomic consultation, occupational health support and rehabilitation services. This pilot study aimed to describe a participatory ergonomic approach and determine the feasibility and extent of adoption of self-management strategies in clam farmers with LBP. Methods. A rapid prototype participatory ergonomic approach was used to develop context-specific self-management strategies. Options to adjust lifting and repetitive stress were introduced using video clips, demonstrations and discussions in the workplace. Workers chose and implemented three strategies for 8 weeks with weekly reminders. Survey and qualitative data from focus groups were analyzed. Results. Team strategies were the most popular, but individual options were used more often. Strategies were considered feasible, acceptable and relatively easy to use. Strategies were implemented relatively consistently, and most improved productivity with decreased pain. Challenges for uptake included changing habit, culture and team dynamics. Conclusions. Participatory rapid prototyping provided a feasible and efficient option to introduce strategies for clam farmers with small teams, variable work processes and workloads, and time restrictions. Strategies were considered acceptable and easy to use, and most increased productivity. These methods show potential for future research.

Purpose: Memory has been identified as an important protective feature to prevent future injury, but its role has yet to be ascertained.The current study aimed to determine whether there was a difference in pressure pain threshold (PPT) responses between participants with a prior history of injury of lower extremity injury (PSI) and those without (NPSI) when exposed to 1) experimental mechanical pain, 2) short-term memory recall of a painful stimulus, or 3) long-term memory of the pain associated with a prior injury.Subjects and Methods: The study used a pretest-posttest quasi-experimental design.A convenience sample of 59 pain-free participants was recruited from an urban university.Twenty-nine PSI and 30 NPSI were stratified into two groups based on their injury history with PPT values measured at baseline and immediately following each of the three experimental conditions.A repeated measure ANCOVA analysis was conducted for each condition to determine whether there was a difference in PPT responses between the two groups.Results: There was a statistically significant difference in PPT values between the two groups when exposed to experimental pain, F(1,57) = 6.010, p = 0.017, partial η 2 = 0.095 and with long-term pain memory, F(1,57) = 4.886, p = 0.031, partial η 2 = 0.079.There was no statistically significant difference between groups with short-term pain memory, F(1,57) = 3.925, p = 0.052,

The COVID-19 pandemic amplified the egregious disproportionate burden of disease based on race, ethnicity, and failure of organizations to address structural racism. This paper describes a journey by members of the National Academies of Practice (NAP) who came together to address diversity, equity, and inclusion (DEI). Through collaborative efforts, a virtual, interactive workshop was designed and delivered at NAP's 2021 Virtual Forum to facilitate discussions about DEI priorities across professions and to initiate a sustainable action plan toward achieving inclusive excellence. Resulting discoveries and reflections led us to the essential question: can we truly become an anti-racist interprofessional healthcare organization?

The future of health care professional education is moving from a focus on the individual to embrace the health of the larger society. The COVID-19 pandemic has further highlighted the connection between social determinants and the health of populations. There are frameworks and competencies to support the delivery of population health content in the entry-level Doctor of Physical Therapy (DPT) curriculum. Three options for integrating population health content into the DPT curriculum are presented: (1) threading the content throughout the curriculum, (2) concentrating the content in 1 or 2 identified courses, and (3) offering elective courses. Each of these strategies has benefits and challenges, but threading the content throughout the curriculum provides the best opportunity to reinforce population health competencies across populations and practice settings. Experiential learning using authentic scenarios provides an ideal opportunity for students to understand population health concepts in a real-world context. Activities that incorporate interaction with other health professions broaden students' perspectives of the role of different professions for achieving population health goals. Examples of learning activities are included in 3 competency areas, Foundations of Population Health, Prevention and Health Promotion, and Health Policy. Current societal issues provide an opportunity to enhance population health education from a meaningful perspective for students. The topic of health equity presents an opportunity to tie social and political factors of population health to social justice and health outcomes. Similarly, the COVID-19 pandemic puts issues of mental health, health disparities, and health systems front and center in our understanding of population health.IMPACT:Health care practitioners are looking at health through the lens of health equity and acknowledging the impact of social and political determinants on health to address health disparities, decrease health care expenditures, and respond to changes necessitated by pandemics such as COVID-19. As health care systems and practices are rethought and reconstructed, the intentional integration of population health principles woven into the fabric of professional education is a critical component of preparing future providers. This article describes how population health concepts can be meaningfully embedded into the DPT curriculum along with providing realistic examples and activities.

Background: To identify and classify methods for assessing professionalism across health profes-sion degree programs and identify gaps in the literature regarding types of assessments. Methods: The authors conducted a scoping review of articles published from database inception through 24 January 2020. Included articles described an assessment approach for professionalism in health profession degree programs available in full-text in the English language. Articles were classified based on profession, timing of assessment, feedback type, assessment type, professional -ism dimension, and Barr's modified Kirkpatrick hierarchy. Results: Authors classified 277 articles meeting inclusion criteria. Most articles were from medical ed-ucation (62.5%) conducted during didactic (62.1%) or experiential/clinical curriculum (49.8%). Few articles (15.5%) described longitudinal assessment. Feedback type was formative (32.2%) or summative (35%), with only 8.3% using both. Assessment types frequently reported included self-administered rating scales (30%), reflections (18.8%), observed clinical encounters (17.3%), and knowledge-based tests (13.4%). Ethical practice principles (65%) and effective interactions with patients (48.4%) were the most frequently assessed dimensions of professionalism. Authors observed balanced distribution among Barr's modified Kirkpatrick model at levels of reaction (38.3%), modification of perceptions and attitudes (33.6%), acquisition of knowledge and skills (39%), and behavioral change (36.1%). (C) 2021 Published by Elsevier Inc.

Objectives: A previous systematic literature review (SLR) evaluated 501 experiments on reducing patient anxiety across medical and dental environments. This integrative review examines those interventions and explores possible mechanisms leading to relative success or failure within those environments, in the interest of interprofessional education and communication. Methods: Reviewers evaluated 501 experiments testing interventions for reducing patient anxiety in a variety of medical and dental health care settings. Methodology for the SLR, largely following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, is briefly reviewed. Results: A total of 501 experiments (from 408 articles) met review criteria. One hundred and forty-three Music experiments were included, and Music interventions were largely effective, except in the case of colonoscopy. Education is the only intervention that occasionally (5 times of 130 experiments) raised patient anxiety in the face of a procedure; the discussion focuses on the wisdom of assessing patient need for information. Thirty-seven Cognitive Behavioral Therapy (CBT) experiments of various types are included, with a success rate of 89%, with a particularly high rate of success (12 of 12 experiments) in dentistry. Massage has a success rate that is similar to that of CBT, but Massage has been tested in far fewer specialty areas. Relaxation has been tested in every specialty area, except mechanical ventilation, with promising results. Acupuncture and Acupressure have not been widely tested, but their effectiveness rate is 100% when it comes to reducing patient anxiety in various procedural settings. Similarly, experiments show Hypnosis to be successful in 90% of trials. In contrast, Distraction was successful in only 40% of the experiments summarized, although it was more effective in dentistry. A variety of Nature-based Interventions (Aromatherapy, Nature Sounds, and Visual Stimuli) were highly successful across a variety of settings. Discussion: Possible mechanisms are discussed, along with commentary on feasibility. Limitations include publication bias, small sample sizes, and the lack of placebo controls. Future areas of research are pointed out.

ABSTRACT Purpose: Participatory ergonomics engages workers in the development of strategies to reduce workplace-related pain, offering a flexible and practical option to create individualized context-specific strategies. This paper describes the outcomes of a feasibility study using a participatory approach for self-management of low back pain in clam farmers. Methods: A within-subject time-control design with repeated baseline and post-intervention assessment was used. After refining individual and team-based strategies, stakeholder interviews, and rapid prototyping, workers selected three strategies to use for 8 weeks. Frequency and ease of use for strategies are described. Pre-post paired t-tests were used for analysis of pain-related disability, difficulty and pain with work tasks, pain-related fear, self-efficacy, and coping. Analysis of improvements exceeding published and individual variability was calculated. Results: Participants chose both team and individual strategies, most using strategies 5 days a week >50% of the time. Significant improvements in pain-related disability, pain during specific tasks, pain-related anxiety, and coping were seen after 8 weeks of implementing strategies. No changes in task difficulty, fear, self-efficacy and average resting pain were reported. Pain improvements > MDC95 were reported by 74% with 56–64% > personalized MDC95 for lifting tasks. Conclusions: Pain-related disability, work activity pain ratings and related pain anxiety and coping improved beyond individual variability in this feasibility study. Multiple strategies allowed workers to choose relevant self-management options. Introduction of work-related changes in the workplace, visual demonstration, review of team videos and reminders were helpful. Further studies of this approach are needed.

BACKGROUND:Soccer players incur injuries that typically affect their performance. Injuries are caused by intrinsic and extrinsic factors that call for multifactorial preventive interventions. The study examines the impact of the FIFA 11+ warm up programme on the incidence and severity of injuries in second division soccer players in Rwanda.METHODS:Twelve teams (309 players) were randomised in the intervention group and 12 teams (317 players) in the control group using a cluster randomized controlled trial with teams as the unit of randomization. Intervention group teams implemented the FIFA 11+ soccer specific warm-up programme during training and matches at least three times a week over seven months of the Rwandan soccer season. Control group teams continued with usual warm up exercises. The primary outcome of this study was the overall incidence of training and match injuries. Injuries, training and match exposure as well as severity categories were recorded per the F-MARC guidelines.RESULTS:A lower proportion of players sustained injuries in the intervention group (52%) compared to the control group (63%) (Odd ratio: 0.7; 95%CI: 0.5-0.9). A significantly lower rate ratio was observed in the intervention group for overall (RR = 0.6; 95%CI: 0.5-0.8) and match (RR = 0.6; 95%CI: 0.5-0.8) injuries. Compliance to the injury prevention programme was 77%. In the intervention group, the incidence of injury was similar across all teams and across the medium and highly compliant teams. There was a statistically significant 55% and 71% reduction of the rate of moderate and severe injuries in the intervention group respectively.CONCLUSION:The 11+ warm up injury prevention programme resulted in a significant reduction in the odds of sustaining injuries. In addition, injuries sustained were less severe. The programme should be rolled out to all teams in Rwanda and may well result in a decrease in the incidence and severity of injury in similar contexts.TRIAL REGISTRATION:Pan African Clinical Trial Registry (PACTR201505001045388).