bluuebunny/crossref_metadata_2025 huggingface dataset:
Devoting time for continuing professional development
Authors: White Elizabeth
Published: May 2014

In recent weeks, nursing and some allied health professions (AHP) organizations have been lobbying hard for protected time within the work schedule for their members to undertake continuing professional development (CPD) activities (Rickerby, 2006). For AHPs, undertaking and recording evidence of CPD activities has, from 1 July 2006, become mandatory (Health Professionals Council, 2006) in order to retain the registration with the Health Professions Council (HPC), which is a pre-requisite to practice for the professions regulated by this organization.
Evaluating wellbeing in people with aphasia using speech therapy and clinical psychology
Authors: Brumfitt Shelagh , Barton Jane
Published: May 2014

Mood disorders are very common after stroke. Although there is some variation in reports, up to 50% of stroke patients will suffer with depression at some point following their stroke and this will include aphasic speakers. However, there are well recognized difficulties in evaluating wellbeing in the aphasic speaker because of problems in making test items comprehensible.

The aim of this article is to examine ways to evaluate emotional wellbeing in aphasic speakers from a multidisciplinary perspective, using knowledge and practice from the professions of clinical psychology and speech and language therapy. The accessibility of these approaches for the aphasic speaker will be discussed, taking into account such factors as item comprehensibility, visual presentation of material and behavioural characteristics of aphasic speakers with low mood.
Integrating medical humanities into physiotherapy and occupational therapy education
Authors: Smith Sue , Molineux Matthew , Rowe Nick , Larkinson Louise
Published: May 2014

This paper outlines an innovative curricular development at Leeds Metropolitan University. Two new programmes the MSc occupational therapy (OT) and MSc physiotherapy (PT) (preregistration) which have a strong element of shared learning in their curricula are running for their first year post approval.

Medical humanities (MH) is frequently used as method of education with preregistration OT students and medical students (Hurwirz, 2003) but is much less commonly used in PT preregistration education. The OT and PT students jointly took part in a week of MH involving workshops, discussion and a ‘performance’ of work in progress. The week focused on the use of literature and the arts as a channel for exploration and discussion of human issues that are pertinent to health professionals. The aim was to help foster empathy, compassion and skills which the students would need to use on an everyday basis when dealing with a wide spectrum of service users and colleagues at the University and on practice placement.

The paper is sectioned chronologically. There is a review of the background literature and rationale for the development of MH in PT and OT cirricula. The external specialist tutors, the course leaders and the OT and PT students' views and input are outlined.

The MH week was evaluated through written evaluation forms, a student focus group, email comments from students to course leaders and a staff debriefing. Learning points for staff and students are addressed. Recommendations relating to the format, content and development ideas for implementation of MH education for future cohorts are proposed.
Widening participation: Accessing careers in the allied health professions
Authors: Greenwood Nan , May Steve , Lissouba Pascale , Bithell Christine
Published: May 2014

Access students represent a significant proportion of those entering higher education. This questionnaire-based study investigated the potential usefulness of targeting students on Access to higher education (Access) programmes, for recruitment into the allied health professions (AHPs).

There were marked differences in the extent to which mature students on Access courses had previously considered studying the AHPs. However, among students claiming to know nothing about individual AHPs, receiving minimal information about the AHPs signifi cantly increased the proportions who would consider careers in occupational therapy, podiatry and diagnostic and therapeutic radiography.

These findings suggest that Access students are a worthwhile recruitment target and have important implications for policy makers.
Encouraging children with disabilities to explore their surroundings
Authors: Fernandes Tanya
Published: May 2014

Cognitive and physical stimulation is essential for the growth and development of all children, especially those with functional impairments. Children should be encouraged to partake in day-to-day activities, to carry out functional tasks and to enjoy the freedom of play, wherever and whenever possible.

Independence is key to growth and this article will look at assistive equipment and play equipment, which can be used to encourage children to explore their environment as independently as possible, preventing 'learned helplessness' and encouraging individuals to reach their full potential.
Research and development capacity building in allied health: Rhetoric and reality
Authors: Atkin Helen , Jones Diana , Dawson Pam , Smith Kathleen , Welch Amanda , Hargreaves Gerard
Published: May 2014

Allied health professional (AHP) research and development (R&D) locality groups were formed as part of a Northern and Yorkshire Regional R&D initiative in 1998 to provide infrastructure support for R&D, however, their sustainability has proved problematic. This paper charts the journey of one locality group and uses the research cycle model to illustrate an attempt to make interdisciplinary research capacity building in practice a reality.

Collaborative development of a research proposal proved valuable, despite not gaining funding. An initiative to build research capacity in both qualified AHP staff and pre-registration Masters’ students in the context of research project supervision is being promoted as part of pre-registration Masters programmes at Northumbria University. Locality group members have formed a collaborative learning group to support research-minded practitioners.

For those individuals who want to make the move from research consumer to researcher in practice, infrastructure support remains inadequate. Innovative intra- and inter-organizational models need to be explored.
Availability and use of electrotherapy devices: A survey
Authors: Ghulam Sarwar Shah Syed , Farrow Alexandra , Esnouf Alan
Published: May 2014

Electrophysical agents such as radiofrequency electromagnetic fields (shortwave and microwave), ultrasound, laser and electrical stimulation are used for therapeutic purpose in physiotherapy departments. They are primarily used for treating a wide range of musculoskeletal injuries.

This study investigated the availability and use of therapeutic diathermy, ultrasound, laser, transcutaneous electrical nerve stimulation (TENS) and interferential equipment in 46physiotherapy departments in NHS hospitals in the south of England, using a self-administered questionnaire.

Results indicated that therapeutic ultrasound was the most commonly available and most often used modality by surveyed departments. Pulsed shortwave diathermy, interferential, and laser were available to a lesser degree and also used less often. Continuous shortwave diathermy was used rarely and only in larger departments. Microwave diathermy was not available in any of the surveyed departments. The level of non-use of equipment despite availability was highest for continuous shortwave diathermy followed by pulsed shortwave diathermy and then laser.

The rare use and total non-use of some of the modalities, despite availability of equipment, may have implications for purchasers of this expensive equipment. While the findings of this study show a regional trend in NHS physiotherapy departments, this may not be generalizable to a national level.
Bariatric furniture: Considerations for use
Authors: Bakewell Joanna
Published: May 2014

Given the increasing prevalence of obesity throughout the world, it is important that health-care providers are able to meet the needs of this service-user group. One area that is necessary to consider in bariatric care is the suitability of furniture, both in the hospital and in a patient's own home. If these patients have suitable chairs and beds, transfer in to standing or mobility equipment will be facilitated, allowing users to be both more mobile and able to participate in therapy.

Prescribing and advising bariatric patients on furniture should take into account all aspects of individual need. Given the amount of time a patient spends in bed and in sitting (both in the hospital and home) a patient's bed or chair will be their most frequently used piece of equipment. By choosing the most appropriate furniture, not only will the quality of life of these patients be improved, but the manual handling risks to both carers and therapists will be reduced.

This article will highlight the range of furniture available to this patient group and discuss considerations for use.
What is spasticity? The discussion continues
Authors: Ibuki Aileen , Bernhardt Julie
Published: May 2014

Spasticity is a term that has been used by clinicians and researcher for decades, yet there is little agreement about what it actually means. Numerous definitions for spasticity have been proposed and as knowledge of the phenomenon builds, definitions that were accepted in the past may no longer be valid.

This paper does not attempt to define spasticity but instead explores how the definitions for spasticity have evolved over time and illustrates the need for authors to be cautious when using the term.
Measurement error and reliability testing: Application to rehabilitation
Authors: Bialocerkowski Andrea E , Bragge Peter
Published: May 2014

Aims: Effective measurement of clinical outcomes is dependent on reliable outcome instruments. Measurement error and reliability testing are fundamental underpinnings of reliability. This article defi nes and illustrates sources of measurement error, outlines strategies for error minimization, and gives an overview of the types of reliability studies.

Content: The two main sources of measurement error: systematic bias and random error, are discussed. The three major types of reliability evaluation are then illustrated: test-retest; intra-rater and inter-rater reliability, and the relationship between reliability and validity is explained.

Discussion and conclusions: Quantifi cation of measurement error is integral to determining the true effect of therapy, as quantifi ed by outcome measurement. Interpretation of reliability data involves consideration of many factors including demographic, diagnostic and clinical characteristics of the study sample.
The impact of intermediate care: The carer's perspective
Authors: Reid Gaynor Ann , Hulme Claire
Published: May 2014

Aims: The worldwide phenomenon of an ageing population has considerable consequences for health and health care; leading to greater demand for long-term care and support from families for older relatives. In the UK this, together with the preference for dependent older people to be cared for in the community, has led to the growth of intermediate care services (ICS) that bridge hospital and home offering rehabilitation and care. However, there has been limited in-depth exploration of carer perspectives of these services. This study therefore aimed to explore the impact of ICS on informal carers.

Methods: An overview of UK Government policy on carers is provided to set the context. Qualitative semi-structured interviews, which explored participants’ lives as carers, their daily routine and what caring meant to them, were conducted with 19 informal carers within one ICS in north-west England.

Findings: The ICS was not viewed in isolation; the impact of the ICS on the carer depended on previous experience and quality of health care, involvement in the decision making process, expectations and communication.

Conclusions: A whole systems approach should be encouraged to increase awareness of carers’ experiences and the lasting impact negative experiences can have.
The assistant practitioner: A professional project
Authors: Adams Caroline
Published: May 2014

Background: Since the beginning of the 20th century, there has been much academic interest in the subject of the professional. Newly emerging professions or those belonging to emerging tiers of professional status—;such as the assistant practitioner—;may be unaware of the current rhetoric concerning de-professionalization or re-professionalization of health-care practitioners. In the case of radiography, the additional project of professionalizing the assistant practitioner has been troublesome in regard to its scope of practice. The supervising practitioners (radiographers) may have regarded their emergence only as a labour market strategy, which in turn would have caused assistant practitioners to feel disempowered.

Content: This article takes the role of the assistant practitioner as a case study to highlight issues of hegemony within the profession of radiography in the UK. The history of radiography, through which the role of the assistant practitioner and its scope of practice evolved, is fi rst examined. Concepts of professionalization, and issues of knowledge, control and division of labour are then explored.

Conclusions: It is suggested that the protected title of Radiographer may need to be explored in light of the reconsideration of values and movement of tasks. The author suggests that the title should be subdivided to incorporate both Practitioner and Assistant Practitioner in Radiography; in order to empower the assistant practitioner in their role.
Motivational interviewing in vocational rehabilitation for people living with mental ill health
Authors: Lloyd Chris , Tse Samson , Waghorn Geoff , Hennessy Nicole
Published: May 2014

Background: People living with mental ill health are among the most socially and economically marginalized members of the community. Unemployment rates are high and suitable support to return to work may not always be available. Motivational interviewing (MI) is a focused method of communication that was originally developed to assist counsellors in the treatment of problem drinking. However, more recent applications have demonstrated success with a variety of health conditions and problem behaviours. MI helps clients identify and change behaviours that may be preventing them from achieving optimal life goals, for instance, returning to paid employment.

Content: This article gives an overview of the MI approach and highlights key research to date in the field. The vocational expectations of mental health service users and barriers to achieving them are examined. The potential for using MI in vocational rehabilitation with people living with mental ill health is then explored.

Conclusions: A successful return to work can help people regain a lost sense of purpose and identity, which is crucial to achieving optimal life goals. It is proposed that motivation for work can be clarified and enhanced by the skilled application of a MI technique. Further work and research in this area is needed.
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.
Disability equality and human rights: Are clients being empowered or impaired?
Authors: Scullion Philip
Published: May 2014

The pattern of disability across the globe varies considerably. This is partly owing to economic conditions but also results from the prevailing ideology and resultant common understanding of ‘disability’. Disabled People International (2005), a global organization aimed at promoting rights, reports that :
The evolution of a state-wide continuing education programme for allied health professionals
Authors: MM Schoo Adrian , E Stagnitti Karen , P McNamara Kevin
Published: May 2014

Allied health professionals require continuing education (CE) to maintain and improve competencies and standards of care. Research suggests that professional access to CE in rural areas can be difficult.

This article uses an action research framework to describe the development and implementation of a CE programme for allied health professionals in a rural area in Australia, and its subsequent evolution into a state-wide programme. To evaluate programme relevance, attendance and perceived clinical relevance, physiotherapists (n = 75) in southwest Victoria were surveyed 1 year after commencement of a CE programme. A secondary outcome was the perceived effect on clinical practice.

More than two-thirds (68.6%) of physiotherapists attended at least one workshop, 57.2% attended four or more sessions and 22.9% attended at least one of the two conducted courses over the period. In addition, 20% of the physiotherapists perceived that attending the programme had a large positive effect on their therapeutic skills, whereas 68.6% reported some effect. From a regional CE programme for physiotherapists the programme evolved into a state-wide programme for 22 allied health professions.
Talking about stroke rehabilitation can improve team processes
Authors: Clarke David J
Published: May 2014

Stroke is an international health concern. The World Health Organization (WHO, 2004) estimates that 15 million people will suffer a stroke every year. Thus stroke represents one of the most common causes of death and disability throughout the world. However, as numerous risk factors for stroke are modifiable, many countries have developed national strategies to prevent strokes, e.g. through better recognition and control of hypertension. In Canada, the United States, Australia and the United Kingdom (UK) these strategies also focus on early intervention and treatment in reducing death and disability, and recognize the key role played by rehabilitation professionals in assisting individuals to adjust and adapt their lives following a stroke.
Information provision during stroke rehabilitation: The health professional's perspective
Authors: Gustafsson Louise
Published: May 2014

Education in chronic conditions such as stroke aims to improve self-management skills. Previous research has informed health professionals about the information needs of clients with stroke and their carers, and suggested methods for information provision. This article will briefly review the evidence in this area and present findings from a study which investigated the clinical practice and views on information provision of stroke rehabilitation team members.

Sixty-seven health professionals working in the inpatient or outpatient stroke rehabilitation settings of six major hospitals completed a questionnaire on information provision. Information topics that were conveyed by the majority of participants to both clients and their carers included what to expect in rehabilitation, recovery after stroke, treatment after stroke, and community services. Participant responses were similar for clients with stroke and their carers during both inpatient and outpatient rehabilitation. The participants were aware of the ideal methods of information provision but cited factors relevant to the team and organization as barriers to effective practice.

Health professionals are finding it difficult to achieve ideal practice for information provision in stroke rehabilitation. The identification of key team members who are responsible for identifying individual information needs and coordinating delivery of the education programme may be beneficial and requires further evaluation.
Qualitative research: Part two - Methodologies
Authors: Nicholls David
Published: May 2014

Background

There are still many practitioners, academics and researchers who are bemused by the principles and practices of qualitative research. The second paper in this three part series on qualitative research explores the important question of research methodologies.

Content

Focusing on four of the more common methodologies – phenomenology, grounded theory, ethnography and discourse analysis – the article shows how each represents a distinctively different view of reality (a feature of qualitative research that was unpacked in the first article in the series).

Conclusions

These methodologies are then used to highlight some of the fundamental methodological differences between quantitative and qualitative research. Having set down these principles, I move on, in the third article, to discuss qualitative methods of data collection and analysis.
Pilot study evaluating fear of falling and falls among older rolling walker users
Authors: Liu Hao , Grando Victoria , Zabel Reta , Nolen Jeff
Published: May 2014

Aims

Fear of falling is considered a risk factor for falls. Walkers are commonly used by older adults for enhancing mobility. This study aimed to investigate the level of fear of falling in terms of the Falls Efficacy Scale, how that level is associated with fall frequency, and how walkers were used among older walker users.

Methods

Forty two qualified older adults completed the Falls Efficacy Scale and a questionnaire concerning walker use and history of falls in the last 12 months. Their walkers were assessed for appropriate use and maintenance.

Findings

Fifteen subjects (36%) fell at least once after beginning to use a walker, but the number of falls did not correlate to the duration of walker use. A moderate positive correlation existed between Falls Efficacy Scale scores and the number of falls. Assessments of the walkers showed that the most common misuse was lack of medical consultation in obtaining a walker, followed by incorrect walker height, forward-leaning posture during ambulation. However, the most significant difference (P<0.05) between the fallers and the non-fallers was only identified in poor posture problems.

Conclusions

Inappropriate use of a walker, especially the forward-leaning posture, may be associated with the falls. Falls may increase the fear of falling in older walker users. Clinicians including physicians, therapists, and nurses should possess knowledge to instruct older adults on appropriate walker use.
Upfront and enabling: Delivering specialist multidisciplinary neurological rehabilitation
Authors: Ross Denise , Heward Kate , Salawu Yomi , Chamberlain M Anne , Bhakta Bipin
Published: May 2014

Aims

In the acute hospital setting, rehabilitation issues arising from neurological complications in patients on the medical and surgical wards are common. This article describes the work of one multidisciplinary, highly expert neurological rehabilitation team, which is available to advise and treat patients in a large teaching hospital in the UK, during one calendar year.

Methods

The development of the service, its staff and the interventions that the team employs are described. A review of the data from medical records of all patients referred to the team in the period 1st January to 31st December 2006 is then presented. These data were anonymised and extracted from patient notes using a standardized proforma, and include information on referral, initial diagnosis, rehabilitation interventions and subsequent discharge/transfer.

Findings

Sixty-one patients were seen. Their age ranged from 15 to 87 years with equal gender distribution. The dominant users of the team were surgery, respiratory medicine, intensive care and infectious diseases. Fifteen patients presented with new neurological conditions and 17 patients developed neurological conditions during their inpatient stay (stroke, critical care illness and other rare diagnoses). Twenty-nine patients had established neurological disabilities, and the enforced inactivity of admission threatened their precarious independence.

Conclusions

The team was instrumental in addressing key quality requirements of the UK National Service Framework for people with Long Term Neurological Conditions. Their contribution to better discharges, earlier discharges and the patients' ‘quality of life’ was viewed by staff involved with the patients as significant. Further rigorous research is required to quantify these improvements further.
Improving practice through involvement in action research
Authors: Spalding Nicola J
Published: May 2014

Background

This article presents an action research project as a case study to highlight the attributes of this approach in evaluating a health-care intervention, for the purpose of improving it. The action research was undertaken with a group of health-care professionals who wanted to improve a preoperative education programme for patients awaiting a total hip replacement.

Content

Descriptive detail is provided on the process and justification for action research in this context. The findings and discussion focus on the author's reflections on using action research, rather than the findings in respect of preoperative education. Integral to the action research was the involvement of the health-care professionals. Challenges arose during the research planning which had the potential to undermine the research purpose, but these were addressed to ensure the healthcare professionals were fully involved. Being involved in the action research enabled the health-care professionals to work together for a collective goal of improving their service. Significantly, the action research facilitated their reflections as a means of evaluating and improving their practice.

Conclusions

Many improvements were made as a result of the action research. These improvements were seen to have three dimensions: improvement in the health-care professionals' theoretical understanding, improvement in their own teaching practices, and improvement in their service outcomes.
A celebration of disability culture: Autonomia Expo 2009
Authors: Balakatounis Konstantine
Published: May 2014

Autonomia EXPO is the largest annual event for people with disabilities in Greece. It is held at the Peace and Friendship Stadium in Athens and is organized by Disability NOW, a nonprofit organization managed chiefly by people with severe disabilities. The event constitutes the largest exhibition of products and services for disability, health, rehabilitation, special education, technology and independent living in Greece. It brings people together from throughout Greece and Southern Europe to share information to improve the lives of people with disabilities and to assist the caregivers and the healthcare professionals working with them. Nikos Voulgaropoulos, the man behind Disability NOW, described the EXPO in a talk given at this year's event:
The Society for Research in Rehabilitation summer meeting
Authors: Bakewell Joanna
Published: May 2014

The Society for Research in Rehabilitation—a multidisciplinary rehabilitation research society in the UK—held its summer meeting in Bath on the 1–2 July. The meeting was jointly held with the Institute of Physics and Engineering in Medicine, Rehabilitation and Bioengineering Special Interest Group, and delegates attended from a range of professions to present research and discuss current issues in rehabilitation.
Moving and handling rehabilitation patients: A survey of nurses' views
Authors: Kneafsey Rosie , Haigh Carol
Published: May 2014

Aims

This article reports on a UK national questionnaire survey to explore nurses' views in relation to the handling of rehabilitation patients.

Methods

3205 questionnaires were distributed via the Royal College of Nursing Rehabilitation and Intermediate Care Nurses Forum and the UK Stroke Nurses Network national conference.

Findings

Questionnaires were returned by 501 nurses (a response rate of 15.6%); 83.6% of respondents were confident in their patient handling skills. Respondents valued physiotherapy knowledge and were committed to teamwork in relation to patient handling. ‘No lifting’ policies were reported to be in use in the workplaces of 77.6% of respondents, and 33.4% of these respondents felt the policies interfered with rehabilitation. There was an equal number of respondents who agreed that manually helping patients to stand or transfer helps them to regain more mobility than if an aid were used (40.2%), and who disagreed (40.2%). The majority of nurses (64.9%) stated that manual handling was more physically tiring than using a mechanical aid, and 60.9% of nurses reported that they had put themselves at risk to promote rehabilitation.

Conclusions

Nurses in this study valued their role in supporting patients with mobility and movement problems and were positive about teamworking as a way to facilitate this. However, further observational research is needed to explore the actual nature of multiprofessional teamworking in relation to patient handling. Nurses should view all patient handling activities as a rehabilitation opportunity and managers should ensure that nurses have access to the full range of patient handling equipment needed to facilitate rehabilitation.
Guillain-Barré syndrome: An update in rehabilitation
Authors: Khan Fary , Ng Louisa
Published: May 2014

Background

Guillain-Barré syndrome (GBS) is an autoimmune mediated polyradiculoneuropathy which causes acute neuromuscular paralysis and ventilatory failure. It mainly affects young adults, and most patients (80%) make a good recovery; being ambulant again at 6 months post-onset. However, residual deficits can cause significant long-term disability, which impacts on activities of daily living, work, social activities, and health-related quality of life.

Content

This article provides an overview of the aetiology, pathogenesis and clinical presentation of GBS. Current evidence regarding use of outcome measures and the symptomatic and rehabilitation treatment for adult GBS survivors is outlined. Issues impacting on rehabilitation are also discussed, including complications as a result of immobility, autonomic dysfunction and deafferent pain syndromes.

Conclusions

GBS is a complex and challenging condition that requires integrated and coordinated health-care delivery and services. Rehabilitation is aimed at improving a person's functional ability in daily living tasks and social reintegration. However, evidence for many rehabilitation treatments is currently lacking. Outcome measurement for disability in this group is also limited and not well quantified. The longer term impact of disability in GBS survivors and ‘aging’ effects are not well understood. Further research in these areas is therefore required.
The Society of Research in Rehabilitation: Summer Meeting 2010
Authors: Gibson Ali
Published: May 2014

The Society of Research in Rehabilitation (SRR) is the major multidisciplinary rehabilitation research society in the UK. Its aims are to advance education and research into all aspects of the rehabilitation of people with disability, and to disseminate the useful results of such research for the public benefit.
An overview of cohort study designs and their advantages and disadvantages
Authors: Morrow Brenda
Published: May 2014

Background

Cohort studies are analytical observational research studies which follow groups (cohorts) of subjects forward in time from an exposure to an outcome/s. Rigorous cohort studies provide the best scientific evidence of all the observational research designs.

Contents

This paper provides an overview of the definition, design, analysis, interpretation, advantages and disadvantages of cohort studies. Readers should appreciate the strengths, weaknesses and potential pitfalls of cohort studies when interpreting and applying results to clinical practice.

Conclusions

Cohort study designs should be considered when RCT are not possible or practical for ethical, logistical, or financial reasons. When properly designed and interpreted, links between exposures and outcomes (including an indication of causality) can be made.
The allied health profession role in work with people with Parkinson's disease
Authors: Heisters Daiga
Published: May 2014

Parkinson's UK – the support and research charity – is committed to improving life for everyone affected by Parkinson's. Occupational, physio and speech and language therapies can greatly improve quality of life for people with Parkinson's and help them maintain their independence, as can be seen from comments such as:
The use of interactive formative assessments with first-year occupational therapy students
Authors: Mui Lim Sok , Rodger Sylvia
Published: May 2014

Aims

The literature suggests that the effective use of formative assessments enables timely and constructive feedback to be provided to students, leading to enhanced learning. In this article, the effect of the combined use of different interactive formative assessments during large group tutorials was investigated.

Methods

This study was carried out in 2009, and involved 115 first-year occupational therapy university students. Game-show quizzes involving the use of audience response system took place during the tutorials to enhance student engagement. Collaborative group testing where quizzes were presented individually, then in groups, was also used. Each student involved was asked to generate questions and answers that contributed to the quizzes and their exam. To examine the influence of interactive formative assessments, two methods of data analysis were used. First, a comparison of the 2009 cohort's exam results with those of the previous year's equivalent students and second, a qualitative analysis of students' completed evaluation questionnaires.

Findings

When compared to the previous year's cohort, there was a significant difference in the students' exam results (p<0.001). Qualitative descriptive analysis of evaluation questionnaires suggested that students perceived the interactive formative assessments as engaging, and assisted them in identifying knowledge gaps and focusing their exam revision.

Conclusions

Interactive formative assessments presented in this study led to enhanced learning and were viewed by the students as being fun and engaging, as well as providing immediate feedback.
Training characteristics important for growing consciousness of joystick-use in people with profound cognitive disabilities
Authors: Nilsson Lisbeth , Nyberg Per , Eklund Mona
Published: May 2014

Aim

The Driving to Learn project focused on people with profound cognitive disabilities and their possible achievements from practicing joystick-use in a powered wheelchair. The aim of this study within the project was to statistically analyse the participants' outcomes, and to explore factors, in terms of participant and training characteristics, associated with a favourable outcome of training joystick-use.

Methods

In this study, previously collected and analysed data and findings from 45 participants (aged 12 months to 52 years) were used to extract participant and training characteristics. Associations between participant and training characteristics and the participant's outcome of joystick-use were calculated.

Results

The results showed that training characteristics were decisive for reaching steering control, whereas participant characteristics were not. Factors significantly associated with participant's reaching ‘control of steering’ were: taking part in more than 30 training sessions (p=0.004), training at two or more training venues (p=0.007), undergoing a training period longer than two years (p=0.016), and a high degree of training with professional trainers (p=0.045).

Conclusions

Appropriate training characteristics assisted growing consciousness of joystick-use in people with profound cognitive disabilities. Findings from the project also include the identification of an eight-phase process of growing consciousness of joystick-use and the development of a tool for assessment of phases, which were used to measure the participants outcome.
The process of transformation in rehabilitation: what does it look like?
Authors: Jehanne Dubouloz Claire , King Judy , Ashe Brenda , Paterson Barbara , Chevrier Jacques , Moldoveanu Mirela
Published: May 2014

Introduction

Educators and proponents of adult learning theory understand that adults can experience significant events in their lives that can lead to a process of transformation that challenges or changes pre-existing values, beliefs and behaviours. This process of transformation can occur at any point in an adult's life, including when learning to live with a chronic illness and disability. The purpose of this article is to introduce health care providers to the possible process of transformation during rehabilitation.

Content

The authors present a suggested model of the process of transformation in rehabilitation, one developed as part of a larger metasynthesis qualitative research project related to rehabilitation, physical health, chronic illness, and disability. The article proposes how this model could be helpful for health care providers when interacting with adults learning to live with chronic health conditions.

Conclusions

The process of transformation provides insight regarding the complexity of patients' experiences learning to live with chronic health conditions. The article concludes by identifying future directions for practice and research.
The effect of fear of movement on the lives of people with chronic low back pain
Authors: Ashby Samantha , Richards Kailee , James Carole
Published: May 2014

Aims

This article looks at the effect that fear of movement can have on the lives of people with chronic low back pain. It describes the experiences of people who were attending a six week work hardening programme as part of their vocational rehabilitation in Sydney, Australia.

Method

A thematic content analysis of data collected during an ethnographic study of eleven unemployed participants with chronic low back pain who attended the work hardening programme took place. The analysis focused on the effects of fear of movement on the participants' lives.

Findings

The fear of movement impacted on all aspects of the participants' daily occupations and restricted their occupational roles. These changes involved loss of occupational roles, relationship changes, loss of participation in leisure and encountering barriers to returning to paid employment.

Conclusions

The fear of movement impacted on all aspects of the participants' daily occupations and restricted their occupational roles. These changes involved loss of occupational roles, relationship changes, loss of participation in leisure and encountering barriers to returning to paid employment.
Developing a competent and flexible workforce using the Calderdale Framework
Authors: Smith Rachael , Duffy Jayne
Published: May 2014

Background

Successive UK Governments have sought to reform the NHS by putting the patient at the centre of service design. There is also a drive to modernize the NHS workforce.

Contents

The Calderdale Framework provides a tool to facilitate the development of a competent and flexible workforce, and engages clinicians throughout the process. This review uses a case study to illustrate the implementation of the Calderdale Framework in practice, leading to the development of competency based training and new ways of working for support staff.

Conclusions

Use of the Calderdale Framework within the Clinical Therapy and Rehabilitation Directorate of the Calderdale NHS Trust, led to a competency trained support staff workforce. It is a useful tool for clinicians and managers wishing to review service design and workforce development.
DotComUnity.org.uk – A valuable resource for all rehabilitation workers
Authors: Piper Steve
Published: May 2014

DotComUnity.org.uk is a not-for-profit website aiming both to help to improve lives of adults and children with learning and physical disabilities, and to shape the future of care services. This online resource is designed to provide a ‘one stop shop’, where all manner of services and facilities suitable for people with a physical or learning disability can be located. This is provided along with forthcoming appropriate local events. Everyone involved in the care of people living with learning difficulties or other disabilities can benefit from the facilities offered by the website. With all the relevant services, facilities and events listed in one place, anyone in the circle of care will find it a useful tool. Membership is free and is available to anyone.
Single case experimental design: an overview
Authors: Rassafiani Mehdi , Sahaf Robab
Published: May 2014

Background

In health related research, it is critical not only to demonstrate the efficacy of intervention, but to show that this is not due to chance or confounding variables.

Content

Single case experimental design is a useful quasi-experimental design and method used to achieve these goals when there are limited participants and funds for research. This type of design has various advantages compared to group experimental designs. One such advantage is the capacity to focus on individual performance outcomes compared to group performance outcomes.

Conclusions

This comprehensive review demonstrates the benefits and limitations of using single case experimental design, its various design methods, and data collection and analysis for research purposes.
Continuing professional development – time for a different experience?
Authors: Newberry Karen
Published: May 2014

When did you last undertake a Continuing Professional Development (CPD) activity that made you laugh until you nearly cried, made you realise you had muscles in places you had forgotten existed, and, most importantly, challenged you to reflect on the very essence of therapy and rehabilitation? If you have not had such experiences for some time, it might be worth contacting your local wheelchair basketball team and booking into a training session.
Applied research: building the evidence base for health sector development
Authors: Thunhurst Colin , Randall Sue
Published: May 2014

Background

Over recent years there has been a growth of interest in applied research. With the continuing explosion in academically focused peer reviewed publishing, researchers have been forced to reconsider the relevance of their work and its relationship to key health sector developments.

Contents

In this article we consider the nature of applied research – how does it differ from pure research, translational research, action research and/or monitoring and evaluation? We present a case study example drawn from a currently active area of applied research. We consider the fundamental questions that have to be considered by applied researchers – How can they retain methodological rigour?; Does he who pays the piper unduly call the tune?; Is the ‘opportunism’ of applied research compatible with ethical considerations? Is an academic environment the most appropriate one in which to undertake applied research?

Conclusions

The need for applied research has never been more pressing; yet executing it has never been more problematic. Notwithstanding the methodological and practical problems encountered, we argue that it plays a vital role in the development of health systems and of health systems researchers.
Development of a clinical screening tool to differentiate levels of challenging patient behaviour
Authors: Royle Jane , Whitehill Yvonne
Published: May 2014

Aims

This article describes the design of a systematic interdisciplinary clinical tool developed to differentiate levels of challenging behaviour (CB) in patients following a traumatic or acquired brain injury in order to facilitate decisions regarding rehabilitation and management needs.

Methods

A ‘top-down and bottom-up’ approach was used, based on clinical case examples and adaptations from the Overt Aggression Scale – Modified for Neurorehabilitation (OAS-MNR) (Alderman et al, 1997). Inter-rater reliability, face and content validity were tested through opportunistic sampling and blind re-screening of 20 patients on a post-acute neurorehabilitation ward.

Findings

Inter-rater reliability for overall decision on suitability for inpatient neurorehabilitation referral was significant (V = 0.84; P = 0.03); with significant inter-rater reliability within CB ratings. Ninety-three percent of staff were able to make an agreed decision regarding overall level of CB; there was a 95% concordance between staff using the tool; 90% of expert neurorehabilitation staff agreed with the decision from the tool, indicating a high degree of feasibility and clinical utility.

Conclusions

Changes were made to improve the tool's overall clinical usefulness. Findings indicate it is accessible for ward staff, and appropriate for use as a decision and management aid for patients presenting with a range of CBs. Further exploration of psychometric properties across settings and aetiology of CB is recommended.
Evaluation of trunk acceleration in healthy individuals and those with low back pain
Authors: Aluko Augustine , DeSouza Lorraine , Peacock Janet
Published: May 2014

Augustine Aluko, Lorraine DeSouza, Janet Peacock

Aims: The aim of this study was to investigate trunk acceleration as a measure of performance in both healthy individuals and those with low back pain (LBP). The study explored the difference in behaviour of trunk acceleration during flexion-extension movements between these two groups. This study investigated the test-retest reliability of the Lumbar Motion Monitor (LMM) using a single task protocol.

Methods: Trunk acceleration of a group of healthy participants (M = 5, F = 5) and a group of participants with LBP (M = 4, F = 6) was evaluated using the LMM. Two sets of measurements were obtained from participants performing trunk flexion-extension movements for 8 seconds. Each participant had a 10 minute rest period between measures. Data were analysed using a two-way mixed model for an intra-class correlation (ICC) analysis to investigate the reliability of the measure, and a Bland-Altman graph was used to demonstrate the levels of agreement between those repeated measures.

Results: The LBP group of participants demonstrated a slower three dimensional performance than the healthy group. The ICC for average sagittal acceleration (0.96, 95% confidence interval (CI) 0.90-0.98) and peak sagittal acceleration (0.89, 95% CI 0.75-0.96) with a 95% limit of agreement for the repeated measures of between -100.64 and +59.84 degrees/s2 demonstrates the reliability of the measure. The higher ICC and its narrow confidence interval suggest that average rather than peak acceleration is more reliable. Within group measures for both the healthy and LBP groups demonstrated similar reliability for average acceleration (ICC 0.98, 95% CI 0.92-0.99) and for peak acceleration (healthy group ICC 0.94, CI 0.76-0.99; LBP group ICC 0.92, 95% CI 0.67-0.98).

Conclusions: Low back pain may reduce trunk acceleration. The LMM may be used to measure trunk acceleration as a descriptor of trunk performance in response to an onset of LBP. However, the Bland-Altman limits suggest that its reliability is dependent upon the harness upon which the LMM is secured remaining in a fixed position.