bluuebunny/crossref_metadata_2025 huggingface dataset:
Attention deficit hyperactivity disorder: Current status and future perspectives
Authors: Saadah MA , Saadah LM
Published: May 2014

Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioural syndrome of childhood onset. It can be diagnosed by a competent paediatric neuropsychiatrist, although a multidisciplinary team approach is preferable. As yet, there is no single treatment strategy proven to cure this syndrome and no long-lasting documented effects once the adopted line of treatment is withdrawn.

A combined therapeutic approach that includes pharmaceutical and nonpharmaceutical treatments is used in the management of ADHD in the developed countries – an approach that cannot be used in the developing countries, which do not have well structured health services. The need for further research is paramount, as a deeper understanding of the complex neural network is an important preliminary step.

This article argues that multiple paradoxes found within the concept of ADHD will open new horizons in the aetiopathogenesis, molecular basis and treatment approaches of this syndrome.
A decade of development for the health-care professional
Authors: Rushton Alison
Published: May 2014

The 10 years since the inception of the British Journal of Therapy and Rehabilitation in 1994 have seen a period of considerable development in the UK and the international context of health care. Rapid advances in knowledge and technology have contributed to a demand for healthcare professionals to develop expertise in managing more complex problems.
In search of evidence for occupational therapy: A new tool
Authors: Bennett S , McKenna K , Hoffmann T , McCluskey A , Tooth L , Strong J
Published: May 2014

Where is the evidence that occupational therapy intervention can make a difference? In short, it may be found somewhere among thousands of articles, spread over hundreds of journals. It is not surprising that surveys show that a major difficulty facing occupational therapists implementing evidence-based practice is the limited time they have to locate relevant research (Humphris et al, 2000; Bennett et al, 2003).
The integration of acupuncture into physiotherapy practice
Authors: McDonough Suzanne
Published: May 2014

Complementary and alternative medicine (CAM) use in the UK is increasing. There could be more than 60000 CAM practitioners and possibly 20000 statutory health professionals regularly practising CAM in the UK (Mills and Budd, 2000). Acupuncture has been estimated to be the fourth most popular form of CAM in the UK (Ernst and White, 2000), used in both private and NHS settings.
Bowel care for people with established spinal cord lesions
Authors: Parker Joanna
Published: May 2014

Matthew, a paraplegic for over 20 years, could have died during a recent admission to his local general hospital. This was not because of the medical reason for his admission, but because of the staff's lack of knowledge and understanding about one of his fundamental care needs. Matthew depends on manual evacuation (or digital removal of faeces) as his established, routine method of bowel management.
Professional practice placements and disabled students: How prepared are you?
Authors: Awang Darren , Taylor Clare
Published: May 2014

It is likely that all allied health professionals are aware of the duties of the Disability Discrimination Act (DDA) (1995), which provides basic rights to disabled people in the key areas of employment, accessing goods and services and land or property management. Within education, the Special Educational Needs and Disability Act (2001) provides further rights for disabled students, including the requirements of higher education institutions (HEIs) to not only make reasonable adjustments to accommodate additional needs, but also to anticipate these needs. This has represented a significant change in way that education should be provided for disabled people in the UK.
Measuring outcomes of care in older people following a comprehensive assessment
Authors: Nancarrow Susan A
Published: May 2014

The Australian Capital Territory (ACT) community health service successfully introduced a single point of entry and single assessment process for its community health services at the same time as the ACT government moved to outcomes-based funding. This article discusses an attempt to measure the outcomes of the single assessment process, which was part of a larger study to explore the practicalities of routine outcomes measurement in clinical practice. The aim was to investigate whether it is possible to introduce routine outcome measures for an assessment and complex intervention.

A quasi-experimental design was developed, which involved the 3-month follow-up of all patients who underwent an assessment during a single month. Outcome measures included the Dartmouth Primary Care Cooperative Information Project (COOP) charts and achievement of patient goals. While the quantifiable outcomes improved slightly across some domains, one third of the participants developed new needs over the 3-month follow-up period.

While the Dartmouth COOP charts were easy to use in this setting, rates of adherence to the tool were low, and the tool provided less valuable information than simply asking the clients whether they had achieved their goals. As a result of the project, the service introduced routine 3-month telephone follow-up to ascertain changes in health-care needs and the achievement of client goals. This study highlights the dynamic nature of older people’s needs and the need for ongoing monitoring and care, rather than a snap-shot assessment of outcomes, and makes recommendations for services attempting to introduce a comprehensive assessment process.
Clinical reasoning processes in physiotherapists' assessment of unilateral neglect: Part two
Authors: Plummer Prudence , Morris Meg E , Denisenko Sonia , Dunai Judith
Published: May 2014

Physiotherapists do not always differentiate between the different types of unilateral neglect (ULN) when performing neurological assessments. This study explored the clinical decision-making processes used by 14 Australian neurological physiotherapists when assessing ULN after stroke. The method and background to this study was detailed in part one. Briefly, participants observed a videotape of an experienced therapist assessing a stroke patient with left ULN. The videotape was paused at intervals and participants recorded their thoughts pertaining to the patient at that time. Afterwards, physiotherapists were asked questions in relation to their clinical decisions and were instructed to classify the behaviour of the patient using a glossary of diagnoses.

The findings revealed that physiotherapists used both hypothetico-deductive and pattern recognition models of clinical reasoning. Hypotheses concerning neglect were generated early in the assessment. Only a small number of physiotherapists were able to refine their neglect-related hypotheses in light of new information. Types of neglect were rarely considered in the decision-making process. Neglect behaviour was more precisely characterized when therapists were provided with the glossary.

Although relevant cues were obtained for neglect-related hypothesis formation, a lack of specialized knowledge may limit the ability of physiotherapists to make detailed characterizations of neglect behaviour. A glossary comprising definitions of the different types of neglect improved the ability of clinicians to accurately characterize neglect behaviour, suggesting that education may enhance diagnostic reasoning ability of physiotherapists in the assessment of ULN.
Key considerations before disclosing information to a patient's family
Authors: Duckett Stéphane
Published: May 2014

While there has been a welcome shift towards full disclosure to families of a patient's medical status, this may present significant challenges to the rehabilitation team. This article attempts to summarize key recommendations in considering disclosure to family members.
Choice, consent and therapy services
Authors: Lloyd-Smith Walter
Published: May 2014

Last summer there was a flurry of political activity about expanding role for choice in the delivery and development of public services. Although the notion of informed consent is closely linked to this objective, the political pronouncements did not discuss this in any meaningful way.
A new national service framework for rehabilitation
Authors: Scullion Philip
Published: May 2014

Announced in 2001 and expected in December 2004, the National Service Framework (NSF) for Long-term Conditions (Department of Health, 2005) was published in March, promising widespread improvements by 2015. Over the past decade, the UK Department of Health has published a series of NSFs setting out standards that the public can expect from the NHS in relation to specified conditions such as coronary heart disease, diabetes and mental health.
Thinking outside the bed: Managing interface pressure
Authors: Norton Linda , Rappl Laurie , Sibbald Gary
Published: May 2014

Bed rest has often been prescribed as a treatment for pressure ulcers. However, clients have expressed difficulty complying with this. It is clear that bed rest can cause a number of complications, including muscle atrophy, urinary tract infections, pulmonary emboli and decreased cardiac reserve, while there is no compelling evidence that bed rest is effective in the treatment of pressure ulcers. The long list of potential complications has highlighted a number of issues, including whether or not bed rest is an effective treatment and the difference between compliance, adherence and coherence. A comprehensive assessment will guide the choice of managing interface pressure.

To address these issues, this article will provide an overview of the wound healing paradigm, explore whether or not bed rest is an effective treatment for pressure ulcers and examine alternatives for managing pressure throughout the client’s activities of daily living.
Horsemastership part 3: International perspectives of its therapeutic value
Authors: Young Rhona Lee , Bracher Maggie
Published: May 2014

In previous opinion articles written by the authors, it has been proposed that horsemastership is an effective medium for therapy and education for young adults with additional needs. However, the existing research to support this proposal is informal and limited. Therefore, the first author carried out an international piece of research into the value of horsemastership to this group of people. A questionnaire using both quantitative and qualitative methods was completed by 21 professionals of various disciplines and countries who used horsemastership for therapeutic and educational purposes.

This article gives a brief description of the methodology, including justification for the design selected, and discusses the relevance and implications of the results of this study. To pull together the three articles written by the authors, a final conclusion on the value of horsemastership to people with additional needs is drawn.
Finding the right words: The significance of professional terminology
Authors: Creek Jennifer
Published: May 2014

One of the important ways that therapists express their raison d'être is through action: action with and action on behalf of their clients (Creek, 2003). Schön (1983) suggested that all practice professions have difficulty in expressing what they do in words because so much of their knowledge is tacit, i.e. ‘a kind of knowing in practice’. Yet, there are times when we need both to think and to communicate verbally.
Assisting people with disabilities to bathe and shower
Authors: Swann Julie
Published: May 2014

Some people with disabilities require advice, assisitive equipment or adaptations to their homes in order to be able to wash their bodies. A wide range of bathing and showering aids and specialist baths and showers is available to help with this personal care activity and it is important for occupational therapists to know what equipment is available so they can help service users to make an informed choice.

This article explores some of the bathing and showering equipment currently available. It emphasizes the importance of empowering individuals to make the right choice for themselves. The key to providing a good service is to ensure that advice provided follows an appropriate assessment that takes into account individual needs.
The use of assessments in occupational therapy in Malta
Authors: Micallef Theresien , Hong Chia Swee
Published: May 2014

Assessment forms an integral component in the occupational therapy process.
Treating lower limb vascular claudication using community-based exercise rehabilitation
Authors: Abbassian Ali , Khan Aamir Z , Poulter Edward , Ransome Roseann , Thomas Paul R
Published: May 2014

‘Claudication’ refers to pain experienced in the legs that is brought on by exertion, caused by relative ischaemia of the muscle. Exercise is effective in improving vascular claudication pain and walking distance. Despite this, community-based exercise rehabilitation programmes that are directly available to GPs are almost unknown in the UK. In this pilot study, the authors assess the practicalities of setting up such a programme and evaluate its efficacy.

Patients with stable claudication for whom exercise was not contraindicated were enrolled into a twice-weekly exercise programme for up to 8 months (n=20). This was supervised by one of the authors with experience in exercise rehabilitation. Outcome measures included the Six-Minute Walk Test (6MWT) and the Short-Form-36 (SF-36) questionnaire. The average walking distance as measured by the 6MWT increased by 16.3% (P=0.001). There was also a 23.5% increase in the average score of the physical functioning domain of the SF-36 (P=0.007).

Community-based exercise rehabilitation for lower limb claudication is safe and effective, with high compliance and attendance rates. Walking distances increase both objectively and subjectively. Patients also become more able to cope with claudication pain and show improvements in their physical function. If these programmes are available to primary care groups, the majority of patients can be managed in the community, reducing the workload of consultant-based hospital services.
The development of a web-based tool for training referral prioritization skills
Authors: Harries Priscilla
Published: May 2014

Over the past 10years, I have become fascinated by research that has explored experts' decision-making strategies. I have followed the methods used in clinical decision making but also in fields such as air traffic control, weather forecasting, wine tasting, farming, music, firefighting and sports.
Independence, wellbeing and choice: What about people with dementia?
Authors: Burton Lin
Published: May 2014

The Green paper Independence, Wellbeing and Choice (Department of Health, 2005) advocated moving to a proactive and preventative model of care where users and carers are put at the centre of service planning and delivery. It acknowledges that users and carers should be recognized as partners in assessing their own needs and choosing how those needs are met through a combination of statutory, voluntary or independent provision.
Availability and use of patient handling sliding devices
Authors: Gallagher Paula , Flynn Claire , Dockrell Sara
Published: May 2014

Although some research has been carried out on patient handling aids, there is a lack of studies focusing on sliding devices. This questionnaire survey investigated the availability, use and criteria for use of sliding devices, along with training received.

Sliding devices were available to the majority of respondents (88%) and 81% of these respondents who had these devices available for use actually used them. Only 26% of respondents had specific criteria on which their decision to use a sliding device was based. Most (92%) respondents had received training in the use of sliding devices. Safety in the use of this equipment gives rise to some concern, as some respondents had never received training but were using the sliding devices. Because of their wide availability, further research into the use of sliding devices by nurses and other health professionals is required.
Expert physiotherapists' clinical decision-making in acute care. Part two
Authors: Prentice CE , Chipchase L
Published: May 2014

The evaluation of patients' functional outcome and mobility status is of critical importance to all physiotherapists, including those practising in acute care. However, the difficulty in attributing aspects of improvement to physiotherapy intervention has made outcome measurement a complex process. Furthermore, a general literature search failed to identify an immediately appropriate evaluative outcome measure to guide physiotherapists' reasoning or monitor patients' in the acute care setting. Without adequate instruments to measure intervention efficacy for clinical and research purposes, it is difficult to implement evidence-based practice.

Part two of this article series presents findings on outcome measurement derived from the focused ethnography in-depth interview methodology described in part one. Recommendations to improve physiotherapists' functional outcome evaluation in acute care are discussed. The use of individualized/patient-specific measures of either items of impairment or activity limitation are suggested, as scored from the physiotherapists' perspective.
Bathing and showering equipment: A product guide
Authors: Fernandes Tanya
Published: May 2014

Bathing should be seen as a pleasant and relaxing experience for all those concerned. This should not be any different for a child with a disability. Bathing and showering equipment tailored to meet the specific need of the child and the extent of the disability can ease the burden on the carer and encourage the independence of the child.

This article explores the range of assistive products available on the market and the factors that need to be taken into consideration before purchasing such equipment.
A dynamic and comprehensive practice model of paediatric feeding practice
Authors: Fayed Nora , Berall Glenn , Dix Louise , Judd Peter
Published: May 2014

Feeding impairment is a complex problem impacting the health, development, and the nutritional status of many individuals in the paediatric population. Prevalence rates of feeding impairment span a wide range between 30–80% of children with neurological diagnoses (Field et al, 2003; Schwartz, 2003). Conversely there is sparse practice information available to guide professionals working on feeding teams on how to function effectively to deal with the problem.

This report will provide a procedural example of a practice model that incorporates a dynamic team approach and comprehensive service delivery. The model is based on an innovative practice-driven feeding assessment procedure that integrates medical and rehabilitative perspectives. Discussion of the advantages, disadvantages, and future directions for the model will also be presented.
The role of the occupational therapist in attention deficit hyperactivity disorder:
Authors: Young Rhona Lee
Published: May 2014

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that can significantly interfere with all aspects of occupational performance, i.e. the interaction of the individual's mental, physical, sociocultural and spiritual skill components within an environment (Hagedorn, 2000). Given that ADHD can have a significant impact on individuals' overall function, occupational therapy (OT) input should have a primary role in the assessment and intervention for ADHD.

This article gives a descriptive account of the author's experience of undertaking a specialist OT post for the Scottish Borders ADHD service. The benefits gained from having specialist OT input in the service are highlighted and approaches used by the OT in the assessment and intervention for ADHD are discussed.
Telecare: New fad or the key to the delivery of new services?
Authors: Fisk Malcolm J.
Published: May 2014

No one concerned with changes to service frameworks can have failed to notice the attention now increasingly given to telecare, i.e. the provision of care and support at a distance and mediated by communications technologies. The notion of telecare is relatively new although most will be familiar with its component parts; drawing on social alarms (personal response systems), smart home technologies, telemedicine and telehealth (Fisk, 2003). The context is also familiar; one where cash-strapped service providers have little alternative but to find better means of supporting people in situ rather than face the prospect of more people being admitted, staying for longer or living in institutions.
Telecare: Looking to the future
Authors: Swann Julie I
Published: May 2014

A new age is emerging with regard to the type and range of care services being delivered. An explosion of technological advances, creatively applied to health and social care provision, can enhance the lives of people of all ages. With an increasing ageing population, the benefits of these developments could lead to better outcomes for people as well as being more affordable than the traditional models of care. These advances, however, do open up new ethical challenges that must be addressed.

This article will explore the opportunities and challenges involved in using telecare in today's health-care climate and provide examples of the types of products available.
Stretch for the management of contractures: Evidence does not support it
Authors: Harvey Lisa
Published: May 2014

Contractures are a common complication of neurological disability. They are undesirable for many reasons but in particular because they are unsightly and limit a person's ability to move and perform purposeful tasks. Even minor contractures can have profound implications for some patients. For example, a minor contracture around the elbow in a person with C6 tetraplegia can make the difference between a life of dependence and independence. Elbow contractures in these patients prevent them from lifting their body weight through their upper limbs, a prerequisite for transferring independently in and out of bed each day.
Rehabilitation in mental health: A context for health professionals
Authors: Kennard Jerry
Published: May 2014

The factors that cause or generate social exclusion are complex and multi-faceted. Research into social xclusion does not include rigorously controlled studies, but embraces qualitative, quantitative and mostly descriptive methods from the best quality material available to provide a narrative review that is both systematic and transparent.

As part of their Breaking the Cycle series, a review of literature confi ned to the last decade was commissioned by the Social Exclusion Unit (SEU) via the Offi ce of the Deputy Prime Minister. Nine domains of social exclusion were included in the subsequent report, one of which was health. The health domain was itself sub-categorized into six areas, one of which was mental health.

This article reflects further on details submitted to the SEU, relating mental health to healthy living. The focus is on mental health promotion and the relationship between physical exercise and mental health. The article looks at public perception of mental health and its impact, and the evidence for physical activity in improving mental health outcomes. Health professionals may interpret the issues within their own remit for rehabilitation and research. The key point summary aims to provide a platform for further discussion and possible action.
The HydroTilt Armchair: Meeting complex seating requirements
Authors: Collins Fiona
Published: May 2014

This article explores the difficulties encountered by people with seating needs, whose requirements cannot be met by more conventional armchairs. Such people often have limited ability to remain independently seated within the chair and also are at high risk of developing pressure damage.

This paper discusses the features of the HydroTilt armchair and provides case examples which demonstrate the different situations in which the chair may be used.
Make yourself at home in the Naidex family house
Authors: Drury Paul
Published: May 2014

A fascinating family house featuring the latest independent living products to support life across the generations is set to be a major feature at Naidex 2007.
A survey to e xplore the negative social evaluation of patients by physiotherapists
Authors: Housley Georgie , Thomson Diane
Published: May 2014

There is a paucity in the physiotherapy literature about the specific characteristics and circumstances which lead to the negative social evaluation of patients as 'problems'. The aim of this survey was to explore further the 'problem patient' categories defined by Thomson (2000) in a group of physiotherapists in four London NHS hospitals.

Results showed that the majority of problem patient categories were generalizable to a wider population of therapists although the agreement was relatively weak. Patients with multiple healthcare and psychosocial needs were seen the most often and 15 out of the 17 categories were seen regularly.

The lack of extremes of opinion suggests these physiotherapists are reluctant to label patients negatively. The differences between the junior grades (juniors and senior IIs) and senior grades (senior I and above) suggested that inexperience and lack of time management skills underpinned the juniors' understanding of problem patients. The context, daily practice and the type of patients seen reflected the disparity between the clinical settings. A biopsychosocial approach in which patients are enabled to contribute their perspective to increase and possibly change the therapists' understanding are crucial to the management of problem patients.
The importance of using outcome measures in elderly care
Authors: Hibberd Jane , Hong Chia Swee
Published: May 2014

Outcome measurement is the measure of any meaningful change in a client that has occurred as a result of interventions (Clarke et al, 2001).
Investigating joint kinematics during a hoist-assisted sit-to-stand activity
Authors: Bilboe Jade , Healey Kathryn , Busse Monica E
Published: May 2014

Assisting individuals to stand up from a chair, or sit-to-stand (STS), is a physically demanding task restricted by manual handling regulations. If a hoist was able to produce a normal STS movement pattern this would offer a safe option for both therapist and patient, satisfying both therapeutic and manual handling criteria.

Twenty-two healthy subjects participated in the study. Each subject completed STS with and without hoist assistance. Two hoists were used: the Sara 3000 and the Encore. The STS movements were captured on digital camera and the knee and trunk angles were calculated at point of seat-off for unassisted STS, Sara 3000 STS and Encore STS. Data were analysed using a repeated measures ANOVA.

Trunk angles during STS using both hoists were found to be different (P < 0.001) from that seen during normal STS. Knee angles measured when using the Sara 3000 hoist were different to those seen during unassisted (or normal) STS; however, knee angles at seat-off for the Encore hoist were similar to those seen during normal STS.

This study analysed the movement patterns re-created by two hoists used in the clinical setting. Results showed that the Encore hoist is effective at re-creating normal knee angles at seat-off during the STS transfer, however, neither hoist is able to encourage the required normal trunk angle for independent STS.
How fair is Fair Access to Care Services? A survey of occupational therapy teams
Authors: Sackley Cath , Lett Karen
Published: May 2014

Statutory legislation dictates that local authorities in the UK provide equipment and minor works for vulnerable and disabled people. The service is financed through central government and local council taxes. The authorities employ occupational therapists to assess and make recommendations for equipment and adaptations. This represents a substantial financial commitment; for example in 2003/4, over 2 000 occupational therapists were employed to provide this service and 483 000 people received equipment and adaptations (Department of Health (DH), 2005).
Case study evaluation of body weight-supported treadmill training for parkinsonian gait
Authors: Evans Elizabeth , Cook David
Published: May 2014

Parkinsonian gait is characterized by kinetic and kinematic anomalies such as reduced push-off and reduced walking velocity. It is evident that any improvement to gait is likely to result in concomitant improvement in aspects of everyday life that require whole body ambulation. Consequently, the aim of this study was to quantify, biomechanically, the potential of body weight-supported treadmill training (BWSTT) in eliciting a shift toward a more normal pattern of gait for individuals with Parkinson's disease.

A single-subject intervention-based research design was adopted. Kinetic, kinematic and spatiotemporal data were captured via the simultaneous use of a Kistler force platform and an automated video-based motion analysis system. The emphasis of the BWSTT intervention was to provide stimulus to the extensor load receptors of the lower extremities through the unloading and reloading of body weight, characterized through kinetic and kinematic profiles (Dietz, 1997).

The findings of the study revealed significant enhancement—relative to ‘normal’ gait—of parkinsonian gait following BWSTT, which was reflected in observed normalization across measured spatiotemporal, kinematic, and kinetic parameters. As such, BWSTT may be a viable method of implementing sustained improvement to parkinsonian gait, although further large-scale research is needed.
A survey of dysphagia screening practices across England and Wales
Authors: Head Kathryn , Weeks Keith , Stroud Alison , Coll Anne Marie
Published: May 2014

Screening of acute stroke patients for signs of dysphagia (swallowing impairment) is recommended within 24hours of hospitalization owing to increased risk of morbidity and mortality. Speech and language therapists (SLTs) are the lead health professionals responsible for assessment of dysphagia. However, increasing demand for assessment and the relative dearth of SLTs in the NHS has resulted in delays in assessment of up to 6days. Subsequently there is a drive for nurses to perform this screening process using a validated screening method and tool.

This paper centres on the exploratory phase of a three-stage programme of research, designed to develop and evaluate a bedside dysphagia screening tool for use by registered nurses. Here the authors focus on a review of the salient professional literature and the findings of a survey of current dysphagia screening practices employed by nurses across 52 NHS trusts in England and Wales.
An occupational therapy income-generation group for HIV-positive women in Uganda: Part 1
Authors: Kamba Moses , Rugg Sue
Published: May 2014

Little is known of the occupational therapy interventions available to occupational therapy clients living with the human immunodeficiency virus (HIV) in the developing world. This two-part series explores one group of female clients’ views of taking part in such an intervention; an occupational therapy income-generation group. In this, the first part of the article, the authors outline the relevant background literature, exploring research on support group attendance, social support for HIV-positive people and the value of income-generation activities for women in developing countries.

This material shows that people with chronic health conditions, especially those from potentially stigmatised groups, can obtain much-valued practical, psychological, social and economic support from therapeutic group attendance. This suggests that occupational therapy has much to offer this potential client group. The authors used this material to underpin a small qualitative study of ten HIV-positive Ugandan women taking part in an occupational therapy income-generation group. The methods used in this study, its findings and implications are detailed in part two of this article.
Slings and things: The importance of assessment
Authors: Alexander Pat
Published: May 2014

This article explores the use of slings in hoists in clinical settings and the rise of injuries in the UK resulting from user error. The findings of a questionnaire survey which sought to identify which staff were involved with the prescription of hoist slings, and how much training they receive to help with this task, are presented. The findings are discussed in the context of rises in user-related accidents, and recommendations are made for future research.
Books
Authors: Allen John
Published: May 2014

Dr. Robert Donatelli is a physical therapist with a significant number of accomplishments and titles, particularly in sports medicine. He is the clinical director of an outpatient facility, providing sports and orthopaedic rehabilitation, and national director of a sports rehabilitation organisation. He is the editor of Physical Therapy of the Shoulder and Orthopaedic Physical Therapy and has lectured extensively throughout the United States, Canada, England, Romania, Sweden and Australia. Alongside academic achievement he is also a physical therapist for the ATP and PGA tennis tours and personal physical therapist to Andy Roddick. Dr Donatelli has rehabilitated many professional athletes and was the physical therapist for the Champions Tour of Tennis, which included tennis legends such as Jimmy Connors and John McEnroe. He is particularly well known for his work on shoulder and foot rehabilitation, which is evident in detailed chapters in the book on upper and lower limb pathology, biomechanics and evaluation; with an appropriate intermediary linkage of ‘core’ and kinetic chain theory and practice.
The compulsory competency road to assured public safety: A view from New Zealand
Authors: Bradshaw Terence W
Published: May 2014

The New Zealand (NZ) Health Practitioners Competence Assurance Act 2003 (HPCAA) charged the Podiatrists’ Board of NZ (along with the other regulatory authorities for most of the other NZ health professions) with the overarching responsibility of assuring public safety (NZ Ministry of Health, 2003). The podiatry profession in NZ is relatively small in number and currently has approximately 270 practising podiatrists (Podiatrists’ Board of NZ, 2007a). Approximately 80% of those podiatrists are employed in private practice (NZ Health Information Service, 2006). A registered podiatrist wishing to practise in NZ is required by the Podiatrists’ Board to hold an Annual Practising Certifi cate (APC).
Stepping Out: A programme focusing on self-management after stroke
Authors: Jones Fiona
Published: May 2014

A person having a stroke in the UK now has a good chance of receiving some care in an acute stroke unit, which is a vast improvement on 10 years ago. However, stroke survivors can rarely access any specialist rehabilitation beyond the fi rst few months after stroke and many still believe they are ill-equipped to manage in the longer term (Department of Health, 2005). The last national stroke audit found that the number of specialist community stroke rehabilitation teams had actually declined over the last 5 years (Intercollegiate Working Party for Stroke, 2004). It seems that the attention of the stroke world has chiefl y focused on primary prevention and acute care, possibly to the detriment of developing better programmes to support individuals living with the consequences of stroke.
Home-based rehabilitation for people with stroke: An evaluation of efficacy
Authors: Bader Tara
Published: May 2014

Stroke affects approximately 150,000 people each year in England and approximately 15 million people each year worldwide. Post-stroke rehabilitation aims to reduce morbidity and improve quality of life for affected individuals. It can be provided in both the hospital and home setting, as patients can be discharged early on home-based rehabilitation schemes. This article evaluates the current evidence for the effectiveness of home-based rehabilitation and discusses how further research should guide practice in this area.

Evidence suggests that home-based rehabilitation can not only improve quality of life for the patient, including physical and emotional outcomes, but it also has the potential to offer better support for the carer than hospital-based rehabilitation. Home-based rehabilitation also has the benefit of reducing length of time spent in hospital which may be a preferable option for patients. However, the cost-effectiveness of home-based rehabilitation remains unclear. Future research should investigate specific types of home-based rehabilitation, assessing outcomes of quality of life, impact on the carer, length of hospital stay and cost.
Measuring the impact of bariatric patients in acute care
Authors: Christie Heather J
Published: May 2014

The World Health Organization (2007) states that there are now over 1 billion overweight adults globally and there has been a three-fold increase in obesity rates since 1980. Similarly, a steady increase in the number of patients with morbid obesity requiring physiotherapy intervention during acute care admissions has been noted. Health Canada (2006) defines a patient as obese when their body mass index (BMI) is 30 kg/m2 or more. Dresel (2004) further defines a patient as morbidly or severely obese when their BMI is greater than 40 kg/m2.
Books
Authors: Jackson Jo
Published: May 2014

The author of this book identified the need for a text that will provide information for the nonresearcher to understand and appraise studies but would also facilitate the routine application of evidence within clinical practice. In order to do this she has produced a detailed book presented in four distinct parts: Principles of Evidence-based Physical Therapy Practice; Elements of Evidence; Appraising the Evidence and; Evidence in Practice.
Assistive technology provision in Australia: Needs and priorities
Authors: Barbara Anita
Published: May 2014

Important discussion, such as that provided by Winchcombe in ‘Making disabilty equipment ordinary: Choice, control and the retail model' (Vol 15(3), 2008, p.115) on the provision of assistive technologies for disabled people brings about a range of ideas, options and hopes for a better future. However, as demonstrated by the example of Australia, the core challenge with this issue is the simple fact that governments often do not commit the money needed to meet the ‘needs’ and often valid ‘wants’ of disabled people.
Mental health issues in the spotlight
Authors: Akhurst Jacqui
Published: May 2014

On 15 May 2008, a debate in the House of Lords highlighted the economic costs of what was termed ‘mental ill health’ in the workplace. Drawing from reports by the Sainsbury Centre for Mental Health, Baroness Neuberger highlighted the total per annum costs of employee mental ill health as nearly £26 billion (equivalent to £1 000 per employee in the UK). This fi gure is computed from sickness absence, the costs of staff replacement and the substantive impact of reduced productivity of those present, but unwell, at work. Particular reference was made to people employed by the NHS, where the Baroness spoke of numerous people who had confided in her that they had mental health difficulties but were unable to speak of these to their managers. Furthermore she noted that ‘mental ill health among staff costs the NHS over £1 billion, which is equivalent to a quarter of the entire mental health budget for England’ (House of Lords, 2008).
Assessing outcomes in an Australian rehabilitation service: Using an ICF-based approach
Authors: Graham Susan K , Cameron Ian D
Published: May 2014

Aims

Rehabilitation services provide multidisciplinary management of complex clients and therefore require a multifactorial assessment tool to assess standards, discriminate between services and clients, and suggest areas requiring improvement. The World Health Organization International Classifi cation of Functioning Disability and Health (ICF) provides a structure based on impairment, activity, participation and environment that may be a useful basis for assessing rehabilitation outcomes. The authors developed a set of clinical indicators including the Australian Faculty of Rehabilitation Medicine (AFRM) clinical indicators (which largely concern the rehabilitation process) and additional outcome measures based on the ICF domains, and undertook this pilot study to assess its usefulness.

Method

In July and August 2004 a clinical reviewer assessed 30 client records from an inpatient and a community-based rehabilitation service respectively, using a proforma which included the AFRM clinical indicators and additional indicators relating to goal attainment and the ICF domains. The reviewer ascertained which ICF domains were relevant for each client and if the relevant domains were addressed in the records.

Findings

After practice, the pro forma was easy to use but time consuming. Items based on the AFRM clinical indicators tended to be complied with 100% (i.e. for most clients, all of the AFRM clinical indicators were fulfi lled). Scores based on improvement in activity and participation, and goal attainment had means of 0.23-0.43 (medians 0.0-0.6) with a range between clients of 0 (improvement in all areas assessed) and 1 (no improvement), suggesting that these scores are potentially more discriminatory than the AFRM clinical indicators.

Conclusions

The high level of compliance with the AFRM clinical indicators suggests that these indicators may not be useful for discriminating between services, but are likely to provide a useful measure of minimum standards. Items based on activity, participation and goal attainment, or a previously published instrument such as the Goal Attainment Scaling Tool, may be more appropriate methods for assessing outcomes in different settings. Further work is needed to appropriately assess potential confounding factors via use of the ICF concept of environmental facilitators and barriers.
Helping health professional students develop their critical thinking skills
Authors: Castle Alan
Published: May 2014

Critical thinking is a high-order intellectual activity that goes beyond the simple acquisition of knowledge. It is a key skill for all health professionals to master in an age where they are expected to base their practice on sound evidence (Quality Assurance Agency for Higher Education, 2001; Health Professions Council, 2008).
Restraint reduction and person-centred care
Authors: Hughes Rhidian
Published: May 2014

Restraint refers to the restriction of someone's freedom and liberties. Restraint is a topic in health and social care that tends to grab the media spotlight. Coverage tends to focus on the abuse of individuals or groups, particularly older people, people with learning disabilities, and young people. In recent months, it is a topic that has attracted a great deal of attention, for example:
Review of upper limb ability assessments in acute stroke care, from a practice perspective
Authors: Rowland Tennille J , Gustafsson Louise , Henderson Robert D , Turpin Merrill , Read Stephen J
Published: May 2014

Aims

The purpose of this study was to compare three upper limb ability assessments – the Action Research Arm Test (ARAT), Arm Motor Ability Test (AMAT), and Chedoke Arm and Hand Activity Inventory (CAHAI) – in acute stroke occupational therapy practice during a 6-month period, to identify whether any or all were appropriate for use in acute stroke care.

Methods

Medical records of clients with stroke admitted to an acute stroke unit were reviewed retrospectively. Inclusion criteria were: (a) admission between March and August 2006, (b) new diagnosis of stroke, (c) upper limb involvement, and (d) assessed by an occupational therapist with ARAT, AMAT or CAHAI. Included records were reviewed and the following noted: diagnosis, upper limb weakness, gender, age, assessment score, when assessed, time to administer, test items completed, and qualitative notations.

Findings

Thirty three records satisfied the inclusion criteria. A range of stroke subtypes were assessed. The mean ARAT score was 21.4/45, CAHAI was 66.5/91 and AMAT was 3.0/5. The median number of days post-stroke when assessed was 9 days.

Conclusions

Overall, ARAT, CAHAI and AMAT were useful for assessment of upper limb ability. The results cannot specifically identify which assessment is most suited to the acute stroke setting. The findings do support the inclusion of ARAT, CAHAI and AMAT in standard clinical care.
Using qualitative observational methods in rehabilitation research: Part one
Authors: Clarke David J
Published: May 2014

Background

Research in rehabilitation practice commonly aims to evaluate the effectiveness of complex interventions, and qualitative research—often as part of a mixed methods approach—is being increasingly employed to address important research questions in rehabilitation. Such questions often focus on the activities, experiences and perceptions of patients, carers and practitioners, as well as on the outcomes of rehabilitation. Qualitative observational methods can provide detailed accounts of social processes, which are often hidden or taken for granted, but which constitute the day-to-day reality of rehabilitation practice.

Content

This two-part article examines the characteristics of systematic qualitative observational methods in the context of rehabilitation research. The first article will introduce this methodology, discuss its merits, philosophical and methodological influences, and then illustrate how qualitative observational research should be planned and conducted. The next article will discuss participant observation, and explore the approaches to recording fieldnotes and working with qualitative observational data.

Conclusions

Increasingly researchers and practitioners are recognizing that reliance on traditional quantitative approaches alone cannot fully account for the all of the individual, social and organizational factors which may have a bearing on the outcomes of rehabilitation interventions. Qualitative observation is an approach available to researchers to understand the impact of these complex factors.
Case report of multidisciplinary management of a unilateral transhumeral amputee
Authors: Wang Joy Phang Yuen , Wa Ho Kam , Yin Frank Lai Ho , Wai Law Sheung , Kit Eddy Siu Hon , Cheung Herman Lau Mun , Ming Cavor Chan Kai
Published: May 2014

Background

After the 12 May 2008 Sichuan disaster, thousands of injured survivors required intensive rehabilitation. Stand Tall project volunteered to help the earthquake victims with state-ofthe-art prosthesis and rehabilitation technology.

Content

This case report highlights the multidisciplinary rehabilitation module for a 9-year-old girl with unilateral transhumeral amputee. Early intervention for rehabilitation and multidisciplinary approach were the keys to her successful pathway. In pre-prosthetic phase, physical and activities of daily livings training, prosthesis fitting and motor training for myoelectric hand were essential.

Conclusions

Despite her young age, functional training for usage of prosthesis was successful and her rehabilitation outcome was satisfactory. The ultimate goal of rehabilitation in her case would be use of bilateral hands, psychological adjustment and social reintegration.