bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the reliability and validity of two balance measures in adults with stroke
Authors: Pal J , Hale LA , Skinner MA
Published: May 2014

This study investigated the concurrent and construct validity and the test–retest reliability of the Activities-specific Balance Confidence Scale (ABCS) and the Falls Efficacy Scale (FES) in 24 adults who had had a stroke. Participants' balance was assessed at baseline using the Berg Balance Scale (BBS) and they were stratified into two groups based on their ability to walk independently. All completed an ABCS and a FES questionnaire at baseline, and 1 week and 5 months later. The numbers of falls experienced by each participant was recorded over the 5-month period.

Moderate correlations were found between the BBS and both the ABCS and FES. The ABCS and the FES demonstrated high reliability over a 1-week period. The ABCS scores of the low mobility group were significantly different to those of the high mobility group (P=0.002), which was not the case for the FES scores. There was a poor correlation between the baseline scores of the ABCS and the FES and the number of fall events experienced in the subsequent 5 months.

Both the ABCS and the FES demonstrated high test–retest reliability and moderate properties of validity. It is suggested that these scales be included in the assessment of balance in adults after stroke. Key words: stroke, balance, reliability, validity, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Berg Balance Scale
Continuing professional development: A survey of Irish staff grade physiotherapists
Authors: French Helen P
Published: May 2014

Continuing professional development (CPD) in physiotherapy incorporates a broad range of activities that provides personal and professional development. There is a responsibility on both the individual and workplace to ensure that the employee is up to date and competent.

A questionnaire survey of staff grade physiotherapists in five acute hospitals was conducted to determine the current CPD activities they were undertaking and their perceived CPD needs. Seventy one physiotherapists completed the questionnaire. Respondents were asked to prioritize CPD activities and the top five activities identified were: clinical supervision, intensive clinical training, in-service education, short courses and performance appraisal. The effective components and perceived benefit of these activities are presented and discussed. The results of this survey can be used to develop a CPD framework in the workplace.
A balance screening tool for older people: Reliability and validity
Authors: Mackintosh Shylie , Datson Nicolle , Fryer Caroline
Published: May 2014

Balance screening within therapy assessments for older clients is an efficient method to assess a client's need for further balance assessment and intervention. The ‘Balance Screening Tool’ (BST), a six-task functional standing balance test, is a simple and quickly administered method of screening balance in older adults. This study aimed to determine the intra- and inter-rater reliability of the BST and to establish its concurrent validity with the Berg Balance Scale (BBS).

A group of 14 falls risk assessment community care clients and a group of 16 community dwelling older adults were screened for balance impairment using both the BST and BBS. The Spearman rank correlation coefficient for intra-rater reliability was 0.90, and for inter-rater reliability was 0.89 with no significant difference between the test scores (Wilcoxon sign rank, p = 0.16). For individual items of the BST, kappa coefficients ranged from 0.64–1.00 for intra-rater reliability and 0.58–0.71 for interrater reliability. Correlation between the total BST and BBS scores were rs = -0.87 and rs = -0.92.

The results suggest excellent intra-and inter-rater reliability for the BST, and excellent concurrent validity of the tool with the BBS. The BST is a valid and reliable method to quickly screen older adults for balance problems in a home or clinical setting.
Copyright and the allied health professional: Rights and responsibilities
Authors: Jones Diana , Raine Sue , Hanlon Susannah
Published: May 2014

Throughout the varied roles allied health professionals undertake in the course of their careers, in increasingly different settings, they will be both users and producers of information. Copyright rules and regulations govern the use of information and are changing all the time so that written advice rapidly becomes outdated.

This article aims to help allied health professionals to practise legally and ethically by providing a framework for thinking about copyright that is illustrated in the context of two familiar practice scenarios. Copyright management is complex and lack of awareness leads to risk of infringement.
Apparatus for enhancing sensory processing in children
Authors: Wheble Jane , Swee Hong Chia
Published: May 2014

The process of the brain organizing and interpreting information from the environment is called sensory integration. The occupational therapy team in Peterborough, UK, has used a sensory integration approach for pre-school and school-aged children with motor, sensory and/or attentional difficulties for over 10 years. Sensory integration provides a crucial foundation for later, more complex learning and behaviour. The children are seen individually or in groups in schools, nurseries and specialist units. Advice is given to parents for strategies to support children's behaviour regulation at home. Under direction from paediatric occupational therapists, many primary schools run sensory circuits, which involve the use of some sensory integration equipment as well as physical education equipment normally found in mainstream schools.

This article describes some of the common sensory integration pieces of equipment that are used for enhancing children's sensory processing.
Exploring social and leisure participation among stroke survivors: Part two
Authors: Amarshi Farah , Artero Lisa , Reid Denise
Published: May 2014

Older adults who live in the community often report decreased levels of social and leisure participation following stroke. A qualitative study using open-ended, focused interviews was conducted with a sample of 12 older adult stroke survivors. This study aimed to explore how often older adult stroke survivors participate in social and leisure activities, the meaning(s) associated with this participation and the factors felt to hinder or contribute to this participation. Background information and the methodology are described in part one.

In this second part, the findings and discussion of the interviews are provided. Using a modified grounded theory approach to analysis, four main themes emerged from the data: ‘it's a completely different life’; ‘what limits me from participating’; ‘what I need to participate’; and ‘continuing on with my life’. A model was developed to describe the potential relationships between the themes generated.

This study highlights the re-establishment of continuity in social and leisure participation following stroke. The findings provide implications for health-care providers, who can help in developing programmes that support social and leisure participation among stroke survivors in the community
Do exercises improve outcome following fixation of ankle fractures? A systematic review
Authors: Smith Toby O , Davies Leigh
Published: May 2014

The aim of this review was to evaluate the literature that assessed whether postoperative ankle mobilization exercises improve outcome following open reduction and internal fixation of ankle fractures. An electronic search was undertaken of the databases AMED, Cinahl, Embase, Medline (via Ovid), PEDro and PubMed, from their inception to December 2005. Controlled clinical trials comparing the effects of postoperative ankle exercises with subjects who were not prescribed exercises following open reduction and internal fixation of ankle fractures were included. Two reviewers independently assessed the methodological quality of the literature using the PEDro (Physiotherapy Evidence Database) scoring system. In total, 15 articles of 870 ankle fractures were reviewed.

Overall, postoperative ankle exercises neither improved nor jeopardized short- or longer-term outcomes following open reduction and internal fixation of ankle fractures. However, owing to the plethora of methodological limitations and limited evidence, it is not possible to firmly establish this conclusion. Further large, well-designed randomized controlled trials are required to evaluate this topic.
The effective use of e-learning in postgraduate health-care students
Authors: Kale Swati , Richardson Barbara
Published: May 2014

Recent trends show increasing numbers of mature students in health care reflecting the growing importance of lifelong learning and continuing professional development (CPD) within health and social care. This article reports an evaluation of effective use of e-learning, defined as any learning that uses information and communication technology. This was used in a small cohort of multidisciplinary postgraduate health students over a period of two successive years. Evaluation carried out by questionnaire, informal feedback from students and electronically recorded activity statistics led to the conclusion that mature health-care students find it difficult to adapt to and use the facilities of e-learning. A purposeful approach is suggested in planning integration of e-learning facilities into traditional study and to establish a common level of skills in order to enable all students to use e-learning in furthering their professional development.
When the jokes are funny but nobody laughs
Authors: Mott Sarah
Published: May 2014

Communication of knowledge, ideas and concerns is important to all of us. The ability to communicate generally relies on voice, speech, and facial and bodily expressiveness. Getting our message across to another person is a complex business as people see and hear what they wish. When we tell a joke, we hope that the listener will laugh, or at the very least smile. If we are sharing a sad story, we expect the listener to reflect our sadness in their face and tone of voice. When delivering a speech we hope that the audience will look attentive and interested.
Can pinch grip strength be used as a valid indicator of manual dexterity?
Authors: Harwin Simon , Adams Jo
Published: May 2014

Outcome measurement is important in clinical practice. Manual dexterity is a relevant component of hand function and improvement in dexterity can often be a treatment aim following hand injury. However, standardized dexterity tests can be costly and time consuming to complete in busy clinical practice. Valid, quick and practical clinical indicators of broader functional performance can be a useful adjunct to outcome measurement. This study examined whether tripod pinch grip strength was a valid indicator of manual dexterity.

Thirty healthy volunteers were recruited and their tripod pinch strength was measured using the B+L pinch gauge (B and L Engineering). Manual dexterity was assessed using the Purdue Pegboard.

There were strong, statistically signifi cant correlations between pinch strength and manual dexterity for males but not for females in this healthy sample. Tripod pinch grip could be used as a valid indicator for manual dexterity for males but the relationship between dexterity and pinch grip differs between sexes.
Vocational rehabilitation programmes
Authors: Thurgood Judy
Published: May 2014

It is good to see an increasing number of reports on British vocational rehabilitation programmes (Hills L and Cullen (2007) A study into the employment trends of individuals treated at a spinal cord injury centre 14(8) pp350–355). From my experience of running a return to work programme I would like to make the following comments:
Patellofemoral pain syndrome provides a challenge to evidence-based practice
Authors: Robertson Claire
Published: May 2014

Physiotherapists in musculoskeletal out-patients' will be wellaccustomed to the large number of patients with patellofemoral pain syndrome (PFPS). The need for effective, evidence-based treatment with this patient group is vital, and it is the chasm between the plethora of literature and the reality of clinical practice that this editorial will explore.
Meeting the mental health challenge
Authors: Ashurst Adrian
Published: May 2014

Today one in four people may suffer from some form of mental illness during their lifetime. Sufferers may be affected by conditions such as eating disorders, anxiety disorders and depression through to paranoid schizophrenia.
A new biomechanical method for objective measurement of spasticity: A preliminary study
Authors: Nakhostin Ansari Noureddin , Karimi Hosein , Farahmand Farzam , Naghdi Soofia , Faghihzadeh Soghrat
Published: May 2014

The assessment of the various impairments in brain damage including spasticity is important. The purpose of this study was to develop a new biomechanical method based on quantification of velocity reduction (VR) suitable for clinical use.

A highly reliable system was developed to apply a constant torque perturbation at the elbow. This system was used to measure the VR in 30 healthy adults and 10 hemiplegic patients. In healthy subjects, the mean VR was 3.02% (SE (standard error) = 0.29). In hemiplegic patients, the mean VR in the impaired arm (81.47%, SE= 2.87) was significantly higher than the VR (%) either in the nonimpaired arm (9.86%, SE= 0.92) (WSRT (Wilcoxon Signed Ranks Test) : Z = -12.74; p<0.001), or the normal (3.02%) p < 0.001). The interaction between the associated reaction (AR) and the asymmetrical tonic neck reflex (ATNR) with head away from the impaired arm made a significant higher VR (90.41%, SE=3.43) (p < 0.001). The correlation between the VR (%) and the Modified Ashworth Scale scores was significant (Spearman's rho = 0.77, p < 0.001).

It is concluded that the quantification of velocity reduction may be used as an objective method of measuring spasticity in neurological conditions.
Development of a manual handling programme for allied health
Authors: Brusco Natasha K , Taylor Nicholas , Stevens Julie A , Butler Michael , Searle Aidan
Published: May 2014

In line with current legislation relating to occupational health and safety, a package was developed and implemented to guide patient manual handling for the allied health team. The ‘Allied Health Smart Moves’ (AHSM) package was based on a risk assessment model, incorporating therapists' clinical judgment to minimize manual handling risks, while maximizing the therapeutic benefits for the patient.

A working party developed and implemented the package for physiotherapists, occupational therapists and allied health assistants in a large metropolitan Health Network. Eighty eight per cent of all relevant staff completed training in the package and demonstrated improved knowledge of related legislation as well as safe manual handling procedures after training.

The number of musculoskeletal disorders reported by the possible 227relevant allied health staff in the 6-month period before implementation of the AHSM package was three, and in the 6-month follow up period was none. The AHSM package was successfully developed and implemented within a large metropolitan health network.
The role of ‘rehab’ in therapy: Is it opting out?
Authors: Scullion Philip
Published: May 2014

The term ‘rehab’ may immediately evoke images of head injury or stroke. Lay perceptions however are more likely to relate to alcohol or drug rehab and expensive clinics set in beautifully landscaped private grounds, serviced by the finest chefs and an orchestral array of therapists offering a personalized treatment plan.
The health-care climate: Managing the change
Authors: Ritchie Julia
Published: May 2014

It is not new to face challenges; as therapists it is part of working in a big organization, it is part of the culture. Governments set the agenda and are instrumental in aiming to improve health care. If we, as therapy leaders, are to influence the agenda, we need to understand this strategic direction, read the health-care forecasts and position our services at the cutting edge of new developments. We need to be at the forefront of change and not stragglers picking up the ‘leftovers’. In the past we have fallen between the didactic relationship of doctors and nurses. For the future we need to be confident and strong in our own identity as therapists. There is a need to be united, a conglomerate, rather than therapy islands of professional isolationism. We are in a strong position to pioneer patient pathways across the traditional clinical specialty boundaries. It is now conference season and we have the opportunity to discuss these issues and consider how to steer the way forward.
Foreign accent syndrome: Not such a funny turn
Authors: Miller Nick
Published: May 2014

In foreign accent syndrome (FAS) it appears as if someone who previously spoke with one accent has suddenly started speaking with a different one; usually foreign, but sometimes another accent of the same language. This can occur in people who have never spoken with a different accent, never lived abroad and have no psychological reasons for speaking differently, although these are all factors to consider in differential diagnosis.
Internationalizing the curriculum: What does it mean?
Authors: Roed Jannie
Published: May 2014

Recently there has been an increasing demand on UK universities to internationalize their curricula. This is part of a wider internationalization agenda initiated by the government and promoted by the Higher Education Academy (HEA), the independent UK body which helps institutions, discipline groups and staff to provide the optimum learning experience for their students.
Trends in post-stroke functional independence over a 5-year period: A pilot study
Authors: White Jennifer H , Pollack Michael , Nair Balakrishnan R , D'Este Catherine
Published: May 2014

The aim of this pilot study was to identify trends in functional independence over time in community-dwelling stroke survivors. This community-based, follow-up study examined 75 community-dwelling, ischaemic stroke survivors in Newcastle, Australia. Post-stroke functioning was assessed using the Modified Rankin Scale (MRS) in stroke sub-type categories using the Oxfordshire Community Stroke Project Classification.

Ischaemic stroke survivors who were discharged with a dependent level of functioning after first-ever stroke were shown to have a 54% chance of achieving independence if they survived up to 5 years in the community. Survivors with lacunar infarction and posterior circulation infarction stroke sub-types were the most likely to achieve independence.
Occupational therapy awareness: Where are we now?
Authors: Kingsland Nancy , Wilson Angela
Published: May 2014

Each year second year occupational therapy students from two campuses at Canterbury Christ Church University in the UK take responsibility for planning, organizing and implementing their contribution to the annual National Occupational Therapy week (5–11 November 2007) promoted by the College of Occupational Therapy in the UK. The theme for 2007 was ‘promoting personal health and well being for the people within the communities in which you work’.
Exercise your mind: Physical activity as a therapeutic technique for depression
Authors: Cripps Faith
Published: May 2014

Aims: Depression has been predicted to become the most prevalent cause of disability in the world. Limitations in current pharmacological and psychological interventions have led researchers to identify other interventions that can be used for its treatment. This article will explore the role of physical activity as an intervention and, more specifically, the role of physiotherapists in its delivery.

Content: The growing evidence base to support the relationship between physical activity and depression—together with its underlying mechanisms—is discussed. Key research exploring the efficacy of physical activity interventions is highlighted and briefl y appraised.

Conclusions: Here the author argues that health professionals should acknowledge the growing evidence base in this area to a greater extent, and begin to clinically employ the concept of the fiercely debated ‘evidence-based practice’. Furthermore, it is suggested that the physiotherapy profession is ideally placed to deliver such a service and that physiotherapists should recognize that this is part of their practice, their scope and thus their responsibility.
Maintaining independence: A therapy pathway of a person with multiple sclerosis
Authors: Engin Lucy , Pretorius Carolina
Published: May 2014

Aims: The aim of this case report is to give an insight into the community rehabilitation of a client with primary progressive multiple sclerosis (MS) in the UK. The authors aimed to highlight the importance of interdisciplinary working in meeting the client's changing needs.

Contents: The therapy pathway of one patient with MS seen by a long-term conditions rehabilitation team is described, with an emphasis on occupational therapy and physiotherapy input and the reflections of these therapists. Therapy progress was measured by the achievement of goals; and this case report describes how these goals were met. The report focuses on goal setting, building a good rapport with the client and effective joint working with other professions.

Conclusions: This case report gives an overview of the therapy pathway and the reflection processes of one community rehabilitation service in providing care for a client with MS. In writing this report the therapists reflected on their input; and gained an understanding of their own professional boundaries and how blurring these boundaries can benefit the client.
Focus group methodology Part 2: Considerations for analysis
Authors: Plummer-D'Amato Prudence
Published: May 2014

Qualitative research is often criticized for its lack of scientific rigour. In particular, the criticisms of qualitative research relate to issues of representativeness and generalizability of the findings, reliability and validity.

This article will discuss these concepts in the context of focus group data and explain how trustworthiness has been proposed as a more suitable criterion for evaluating qualitative research. Strategies for enhancing trustworthiness of focus group data will also be presented.

Further issues pertinent to the recording and analysis of focus group data will be highlighted, and unique ethical considerations for focus groups will be presented. Considerations for the effective planning and design of focus group research were discussed in Part 1.
Exercise intervention in acquired brain injury rehabilitation: A discussion
Authors: Blake Holly , Batson Mindi
Published: May 2014

Physical activity is essential for health and well-being. The importance of an active lifestyle is increasingly being recognized in rehabilitation for its benefits to quality of life and the prevention and management of secondary disease resulting from disability.

However, there is a paucity of published evidence for lifestyle exercise intervention in traumatic brain injury. Most studies evaluate the impact of specific physical rehabilitation therapies or exercise intervention, with physical fitness or body composition as outcomes. Few studies also consider the psychosocial benefits of exercise.

This article discusses the limited literature on lifestyle exercise interventions for people with traumatic brain injury together with future directions for intervention. Further research which investigates the impact of exercise intervention on health and well-being of brain injured individuals and their families is clearly needed.
On the ball with emergency on-call?
Authors: Reeve Julie
Published: May 2014

Emergency on-call physiotherapy has been defined by Gough and Doherty (2007) as:
College of Occupational Therapists' annual conference and exhibition
Authors: White Elizabeth
Published: May 2014

The College of Occupational Therapists' (COT) annual conference took place in early June in the attractive setting of the Harrogate International Centre, UK, and the nearby town enjoyed an influx of some 700 delegates, presenters and exhibitors. For the first time, the College's conference was run in conjunction with one of its clinical Specialist Sections, and occupational therapists (OTs) with an interest in HIV/AIDS, Oncology and Palliative Care were able to add their conference themes to the overall programme.
User participation and involvement in mental health rehabilitation: A literature review
Authors: Petersen Kirsten , Hounsgaard Lise , Nielsen Claus Vinther
Published: May 2014

Aim

This review aimed to identify and evaluate research on user participation and involvement in mental health rehabilitation; how it is viewed from the users and the professionals perspectives, how it affects the processes and outcome of rehabilitation, and which theories and research methods are used.

Method

Empirical research papers from 1997–2007 were reviewed. A systematic search of international electronic databases was performed, using the Matrix Method.

Findings

Thirteen papers based on quantitative and qualitative methods were included. Differing perspectives on user involvement, barriers and factors furthering rehabilitation were key themes highlighted. User participation and involvement has a positive effect on development of social skills, on outcome of rehabilitation and assists the prevention of helplessness.

Conclusions

Although sparse, existing research suggests that user participation and involvement has a positive effect on the process and outcome of rehabilitation in mental health. Exploration of this area would benefit from greater clarity of theoretical concepts around user participation, and further research should explore barriers to user involvement.
Interprofessional education: Does it deliver on the claims?
Authors: Burge Tracey
Published: May 2014

Within the last 20 years the terms interprofessional working and collaborative care have become embedded within health-care vocabulary. The modern health-care student, while being socialized into their chosen profession, is constantly primed for team-working and interprofessional practice. Health policies (Department of Health, 2000) and reports (Laming, 2003; World Health Organization, 2006) have driven forward the concept that collaborative interprofessional care is the most effective way of meeting patients' needs and it is now widely accepted that a collaborative approach ensures both patient safety and the quality of care (Nisbet et al, 2008).
The impact of workforce flexibility on older people's services
Authors: Nancarrow Susan , Moran Anna , Enderby Pamela , Parker Stuart , Dixon Simon , Mitchell Caroline , Bradburn Michael , McClimens Alex , Gibson Clare , John Alex , Borthwick Alan , Buchan Jim
Published: May 2014

The health workforce has undergone unprecedented change over the past decade. Several countries have introduced substantial workforce changes to address staffi ng shortages in medicine, nursing and the allied health professions, and in some cases, to improve the productivity and effi ciency of health services. This raft of changes, with various labels, including workforce redesign and re-engineering, has facilitated possibly the largest transformation in professional role boundaries in the history of the development of the professions. The result has been the introduction of new types of workers and new roles for several existing staff. The impact of these changes on service effectiveness and effi ciency remains largely unknown.
Skilled transfer training in stroke rehabilitation: A review of use and safety
Authors: Mehan Robert , Mackenzie Meaghan , Brock Kim
Published: May 2014

Aims

This study reviews the use of a competency-based training tool, which was developed to teach staff on a stroke rehabilitation unit specifi c, skilled transfers based on the Bobath concept. The tool aims to minimize risk of injury to staff while maximizing the patient's opportunity to actively participate in transfers.

Methods

A retrospective audit was undertaken to assess the safety of the transfers for staff and use of the transfers in patients with moderate to severe stroke at one rehabilitation unit at a hospital in Melbourne, Australia. Incident reports from a 7-year period were reviewed. Use of transfers was investigated over 1 year by auditing records for mode of transfer used for each week of rehabilitation stay. Six incident reports relating to staff injury were identifi ed, with no days of work lost. The skilled transfers taught on the training programme were used for 46% of the cumulative length of rehabilitation stay.

Discussion and conclusions

These results indicate that the competency-based skilled transfers potentially provide opportunities for the patient to actively participate in transfers with minimal risk of injury to staff. This competency-based training tool should be further explored, and research should also investigate the ability of skilled transfers to enhance outcomes and/or the rate of recovery for stroke patients.
Reintegration and rehabilitation after spinal cord injury: a small-scale pilot study
Authors: Suddick Kitty , O'Neill Aoife
Published: May 2014

Aims

Despite the fact that community reintegration is rapidly becoming a significant area of clinical, policy and research concern, research into reintegration after spinal cord injury (SCI) within the UK is sparse. This small-scale pilot study aimed to explore the experiences of reintegration for people living with SCI in the UK, and how rehabilitation was perceived to have helped or hindered this reintegration.

Methods

Seven participants between 5–12 years, post-SCI, and who lived in the community were recruited from local sport and activity groups. All participants took part in a single semi-structured interview. Interviews were transcribed verbatim and sent to each respondent for validation. Transcripts were then analysed.

Findings

Themes that emerged regarding the individuals' experiences of reintegration and rehabilitation were: restoring independence, regaining life roles, understanding and redefining, individuals' and family and friends' attitudes, professionals' attitude and approach, dissatisfaction and unmet needs, transition to home, and lack of community rehabilitation and follow-up services.

Conclusions

Although only a small-scale study, the findings suggest potential areas for improving SCI rehabilitation. They also support further research that will establish whether current rehabilitation services are successful in meeting the needs of those with SCI.
Population health surveys: An introduction to basic concepts
Authors: Waghorn Geoffrey , Lloyd Chris
Published: May 2014

Background

Population health surveys are a subset of general survey research methods that overlap with epidemiology, a research domain that has been defined as the study of the distribution of disease in populations, rather than the study of disease processes in affected individuals. Population based surveys in health, therapy or rehabilitation differ in fundamental ways from other research methods which may involve interventions, experimental designs or non-representative surveys.

Content

This article introduces some basic concepts in population survey design so that health professionals can better assess and use information from this source. The different types of population-based survey designs are described, and an overview of sampling methods is provided. The concepts of prevalence and incidence are examined, and methods of diagnostic assessment, reliability estimation, and of survey and data set evaluation are described.

Conclusions

Population surveys need to be methodologically sound and reported in sufficient detail for close replication. The strengths and limitations of the design need to be critically discussed with reference to the population in scope and the aims of the study. This article can be used by health professionals to classify the potential strength of a particular population survey with respect to its intended purpose and population in scope.
Supporting allied health practitioners in evidence-based practice: A case report
Authors: Lizarondo Lucylynn M , Kumar Saravana , Grimmer-Somers Karen
Published: May 2014

Aims

The Centre for Allied Health Evidence in collaboration with the Department of Health, South Australia, initiated structured journal clubs across selected metropolitan and country allied health-care sites. The aim was to provide a sustainable model of journal club to keep allied health practitioners informed of the current best evidence. This case report describes the development of the journal club, and its evaluation to date.

Methods

The journal club development and its component processes are described. Evaluation of the journal club was conducted using a survey to ascertain participants knowledge and attitude towards evidence-based practice and their expectations of journal clubs. Semi-structured interviews were used to explore reasons for interest in journal clubs, local barriers to implementation and sustainability, and members perspectives of journal clubs.

Findings

The processes involved in the journal club comprised six distinct steps, from development of a clinical scenario to reflect issues in current clinical practice, to dissemination of the research publication and its critical appraisal at the health service site. Evaluation of participants attitudes revealed a lack of confidence in research interpretation, positive expectations of the journal club (in applying research to practice), and a reliance on peers for research information. The journal club model was found to be effective in addressing the significant barriers of access and evaluation of research evidence.

Conclusions

The case report demonstrates how this unique model of collaborative partnership between researchers and allied health practitioners can address the barriers in evidence-based practice, which could potentially impact on overall health service quality. Further evaluation of this model is needed.
The contribution of Communities of Practice to the global health agenda
Authors: Lunday Jacqui
Published: May 2014

In the context of everyday work pressures and priorities, frontline health professionals may find it hard to see the relevance of the wider global health agenda. These issues and challenges may seem remote and matters closer to home more pressing (Hume, 2002). Yet, there is an everincreasing need for practitioners to share solutions; to connect with and learn from colleagues across the international community. Sharing learning and knowledge could potentially transform practice at a local level, and in turn redress imbalances and inequalities in health-care and rehabilitation provision globally. It is the collective action of individuals locally which will result in tangible results towards the delivery of the Millennium Development Goals for poverty reduction and health improvement (United Nations, 2008).
Australia's health workforce: implications of change
Authors: McMeeken Joan
Published: May 2014

Australia has long been a popular destination for international health professionals; both for short-term travel and opportunities for professional work experience, and for migration. As is occurring in many countries, the Australian health workforce is currently undergoing reform. In 2005 a Productivity Commission report into the workforce highlighted the ongoing shortage of health professionals across Australia and the critical limitations in the availability of clinical education as universities increased enrolments (Productivity Commission, 2005). The report encouraged governments to further examine health policy nationally and develop new models of care. The ageing population, the decreasing availability of health professionals and the particular difficulties in providing suitable health care in rural and remote areas and for members of the indigenous population are additional drivers for change (National Health Workforce, 2009).
The importance of exercise training for cardiorespiratory fitness post-stroke
Authors: Billinger Sandra A
Published: May 2014

Cardiorespiratory (CR) fitness, or aerobic fitness, is a term used to describe the ability of the circulatory and respiratory systems to supply oxygen to the working muscles during activity. CR fitness is an important assessment to use in the post-stroke population due to the risk of a sedentary lifestyle. For healthcare professionals working in rehabilitation of people post-stroke, it is important to understand the methodology and exercise protocols used to assess CR fitness to guide exercise prescription and enhance cardiovascular health.
A specialized exercise programme for a patient suffering from eosinophilic meningitis
Authors: Sealey Rebecca , Newman Rosemarie
Published: May 2014

Aims

The aim of this study was to determine whether a specialized exercise program, including vibration training, resistance exercise and stretching, improved health, fitness and quality of life in a patient suffering from chronic pain due to skin hypersensitivity, insomnia, irritability and depression, all associated with eosinophilic meningitis, with pain exacerbated during exercise.

Methods

The 20-–30-minute program incorporated stretching, lower-body exercises performed on a vibration platform and upper-body resistance exercises, which were performed three times a week within an air-conditioned environment. The patient wore a tight-fitting long-sleeve shirt to minimize skin pain. Pre- and post-assessments included body mass index, girth, cholesterol, resting heart rate and blood pressure, mobility, strength, endurance and flexibility.

Findings

The patient completed all 36 exercise sessions, resulting in an average 14% (2–25%) improvement in health, 42% (19–103%) improvement in functional fitness, and improved quality of life measures as stated by the patient. Despite experiencing chest skin pain during vibration training, the combination of the air-conditioned environment, as well as the short duration of the sessions, the use of a long-sleeved shirt and the proximity of the patient's house to the clinic, helped him control his pain.

Conclusions

The set programme with pain-control measures was a successful exercise combination for the patient who was previously unable to undertake regular exercise due to pain associated with skin hypersensitivity from meningitis.
Legal rehabilitation of health professionals in New Zealand
Authors: Diesfeld Kate , Godbold Rosemary
Published: May 2014

Aims

A common understanding of ‘rehabilitation’ is the restoration of physical or mental functioning. However, sometimes the concept is applied by professional disciplinary bodies to restore poorly performing health practitioners to their former level of professional functioning. This article aims to research what ‘rehabilitation’ means, in the context of New Zealand law.

Methods

A range of cases were considered to assess what rehabilitation consists of, and when disciplinary boards choose to use it. Where discrepancies between decisions gave rise to questions, further analysis was carried out.

Findings

It can be seen that the New Zealand's disciplinary decisions do not appear consistent, particularly differing by profession. Nevertheless, a clearer approach is beginning to emerge, one which should become more so in the future.

Conclusions

Analysis of New Zealand's disciplinary decisions may contribute to the rich international research on professional regulation.
Systematic review: interventions intended to reduce admission to hospital of older people
Authors: Batty Christine
Published: May 2014

Aims

To reduce costly acute hospital admissions of a growing elderly population, a number of complex interventions have been developed, but evidence of the effectiveness of these is inconclusive. What is it about these models that make them effective or ineffective? The aim of this study was to examine the research underpinning these models; analyse treatment components and identify what is and is not effective.

Method

Thirteen international studies of complex interventions that reported hospital admission data as an outcome, published between 2000 and 2009, were examined.

Findings

What works in reducing admissions is not one, but a combination of components, underpinned by the delivery of interventions by established, integrated health and social care teams.

Conclusions

the most effective models in preventing older people being admitted to hospital are provided by established, integrated teams in the patient's home. However, cost effectiveness must be considered if effective interventions are to be delivered to a growing population of older people.
New standard – PAS 150 – aims to ensure consistently high quality care
Authors: Playford E Diane , Baylis Mark
Published: May 2014

A standard newly published by BSI (The British Standards Institution) aims to ensure a consistently high quality of care from providers of vocational and clinical rehabilitation. The publication of the new standard PAS 150 Providing Rehabilitation Services. Code of Practice stems directly from the dramatic growth in the number of providers of rehabilitation. Although it applies equally to the National Health Service, PAS 150 addresses the lack of regulation or quality control in the private sector.
The role of an Australian homeless health outreach team. Part 2: a case study
Authors: Murtagh Laura , Lloyd Chris , Bassett Hazel
Published: May 2014

Background

Throughout the western world, the issue of homelessness has been receiving increasing attention. As a government response to homelessness in Australia, the Queensland State Government developed a strategic plan to address this issue, establishing Homeless Health Outreach Teams.

Contents

This article follows on from the previous issue, where the background to a team's formation is discussed. This article continues this discussion by describing a case study of a homeless service user. The areas that are addressed include the team involvement, recommendations for continuing treatment, and the practical ways in which the service user was assisted.

Conclusions

A key feature of team's work was the close working relationships established with both the non-government and government sectors in order to address the service user's complex needs. The work was challenging, but the potential of working in this way with a population experiencing homelessness is only limited by the creativity of the team.
Disability Studies in India: The Kerala Experience
Authors: Karna GN
Published: May 2014

The study of disability as difference is not new. Disability theory is currently divided between those who insist it reflects a physical fact affecting life quality, and those who believe disability is defined by social prejudice. Notwithstanding a dialogue spanning bioethical, medical and social scientific literatures, the differences between opposing views remains persistent.  Moreover, the issue of disability is dogged by the controversy of ‘normality’ and ‘abnormality’. Disability as ‘difference’, is often used in this context.
Living with chronic obstructive pulmonary disease: experiences in northern regional Australia
Authors: Sossai Kate , Gray Marion , Tanner Bronwyn
Published: May 2014

Objectives: This study aims to explore in depth the experience of living with chronic obstructive pulmonary disease (COPD) from the perspective of people with the condition in northern regional Australia.

Methods: Qualitative research design was employed. Data was obtained from eight participants from a health service for chronic illness using semi-structured interviews to capture participants' diverse experiences. The interviews were audio-taped, transcribed and analyzed using a computer software programme. Data was coded and analyzed thematically.

Results: Participant narratives illustrated the severe functional impairments and subsequent psychosocial consequences of this disease. In relation to the participants' experience of COPD, six major themes were identified. These were: emotional wellbeing, physical experience, knowledge and understanding, social relationships, external factors, and experience of intervention in relation to their COPD.

Conclusions: This study provides a depth of insight into the day to day experience of people with COPD in a northern Australian location. Findings highlight the importance of the effect that climate, anxiety, and patient education have on participation in daily life and indicate a need for further research into these factors.
Positive clinical placements: perspectives of students and clinical educators in rehabilitation medicine
Authors: Hall Mark , McFarlane Lu-Anne , Mulholland Susan
Published: May 2014

Background: Clinical education is a critical component of health science training programmes; however, clinical placement offers are often difficult to obtain. Although most placements are successful, a negative experience can have a significant impact on students, clinicians and clinical sites and may result in an agency's reluctance to supervise students. This study identified elements in rehabilitation medicine student clinical placements that facilitate a positive placement outcome.

Methods: 152 first year rehabilitation medicine (Occupational and Physical Therapy & Speech-Language Pathology) students and 120 of their clinical educators completed a survey after their first (4-12 week) clinical placement. Students and educators rated items in 10 sections addressing demographics, general perceptions regarding a positive placement experience, physical space and resources, orientation to site, clinical educator-student relationship, relationship with the interprofessional team, location, area of practice, and financial and social supports.

Findings: Ninety-eight percent of students and 97% of clinicians stated that the placement experience had been positive. Qualitative findings highlight student and clinical educator attitudes towards teaching and learning, and the team at the placement site as key factors contributing to a positive outcome.

Conclusion: Despite external pressures and a lack of physical space to accommodate students, placement experiences were overwhelmingly positive. The factors contributing to this positive outcome can assist sites and university programmes in planning for future experiences.
Do occupational therapy pre-discharge home visits affect the longer term outcomes of the discharge process?
Authors: Wilson Lesley , Atwal Anita , Richards Chris , McIntyre Anne
Published: May 2014

Background:

Pre-discharge occupational therapy home assessments are routinely performed with older adults in Europe, Australia, and North America. Their primary aim is to facilitate a timely and safe discharge. There has been remarkably little research on the impact of pre-discharge occupational therapy home visits upon the subsequent discharge outcomes.

Aim:

The purpose of this study was to determine whether pre-discharge home visits from an acute care National Health Service hospital enable an older person to remain at home, whether pre-discharge home visit prevents re-admission to hospital and whether occupational therapy recommendations made on the pre-discharge visit were still complied with two years after discharge.

Method:

Medical notes of 7 older adults were retrospectively analysed in May 2007 two years after their pre-discharge home visits carried out in 2005. A non-standardised pre-designed data collection tool was used in the medical note analysis.

Results:

The findings from this exploratory study suggest that occupational therapy pre-discharge home visits may have a positive effect in enabling frail older adults to remain living at home, that re-admissions following home visits in the current sample were for medical rather than functional reasons and that not all the recommendations made by occupational therapists were complied with.

Conclusion:

It is suggested that further research needs to be done to determine whether occupational therapists in acute care services have a wider role in the management of more frail older adults with long term and deteriorating conditions. There needs to be an acknowledgement that the compensatory approach used within pre-discharge home visits may be of benefit to many older clients.