bluuebunny/crossref_metadata_2025_split huggingface dataset:
An analysis of the East Kent Outcome System for use in intermediate care
Authors: Murphy Annette , Logan Philippa 
Published: May 2014

Aims Intermediate care is a multiprofessional rehabilitation service aimed at helping people to remain in their own homes and to avoid hospital admission. Historically, however, each profession of the rehabilitation team has set their own goals with the client. This study aimed to identify and test the feasibility of using a goal attainment outcome measure that the whole intermediate care team could adopt; if successful, this would enable combined goals and thus a more efficient service. Methods A literature review was carried out to identify a suitable and appropriate goal attainment outcome measure. The East Kent Outcome System (EKOS) was chosen and adopted by four intermediate care teams in Nottingham City Primary Care Trust, UK. An audit of EKOS record forms was then conducted in 2008, which looked at EKOS goal summary records completed by all members of the multidisciplinary team. Findings EKOS goal summary records were completed for 334 service users who were receiving rehabilitation either at home or in a residential care setting over this 1-year period. The total number of goals set for this population was 1061, with an average of three goals per service user. Of these goals, 79% were fully achieved and 13% were not achieved. Of the goals not achieved, the most common reason was that people's health had deteriorated. Conclusions The EKOS can be used with success by intermediate care services to quantify the goal setting process and provide a consistent, systematic method of writing and recording goals.
Is circuit class physiotherapy possible during inpatient spinal cord injury rehabilitation? A feasibility trial
Authors: Lynch Elizabeth A , Watson Sarah C 
Published: May 2014

Elizabeth A Lynch, Sarah C Watson Aims: This article describes a feasibility study to determine whether circuit classes could be successfully provided to patients with recently acquired spinal cord injury (SCI) undergoing inpatient rehabilitation. Methods: Eleven patients with SCI participated in a physiotherapy circuit class run in addition to regular inpatient rehabilitation, over a two month period. All patients chose to attend the circuit classes for the duration of their availability. On completion of the trial, a purpose-designed questionnaire was administered to investigate patient satisfaction. Feedback was also collected from staff regarding their experience of the circuit class. Findings: No adverse events occurred during any circuit classes. Patients reported high levels of satisfaction with the class, reporting that classes were challenging, motivating, confidence building and a source of peer-support. Staff reported that circuit classes helped build clinical skills and confidence, and allowed the provision of effective therapy to SCI patients. All patients and staff recommended that circuit classes continue. Conclusions: This small feasibility study demonstrated that it is both possible and desirable to implement circuit class physiotherapy to a cohort of people with recently acquired SCI undergoing inpatient rehabilitation.
Psychoneuroimmunology of infection: implications for occupational therapy
Authors: Mailoo Venthan J , Chow Gary , Wilkins Amy J , Kennish Sophie 
Published: May 2014

Background: Psychoneuroimmunology is the study of the interactive relationships between the mind and immune system. This article looks at psychological factors influencing infection susceptibility. A thorough review of the research evidence on this topic is beyond the scope of this article. Recent infection-specific psychoneuroimmunology literature is therefore highlighted and possible underlying mechanisms are summarized. Content: Current evidence shows that susceptibility to infections and allergies can be increased by chronic stress through suppression of the T-helper 1 immune response in favour of a T-helper 2 immune response. Conclusions: Holistic interventions such as stress management, lifestyle changes, and career management could be considered to reduce susceptibility to infection. Further research however is required in this area to contribute to an evidence base underpinning psychosocial interventions for preventative health care.
Influences on women's completion of a cardiac rehabilitation programme
Authors: Sherwood Sarah A , Povey Rachel C 
Published: May 2014

Aims: This article describes a study investigating patient and programme factors influencing women's completion of a cardiac rehabilitation (CR) programme. Methods: A qualitative cross-sectional design was adopted. Semi-structured interviews were conducted with five women who had completed and five women who did not complete the CR programme. An interpretative phenomenological analysis was conducted on the reviews; both individually and within the two groups (‘completers’ and ‘non-completers’). This entire process was also undertaken by a second researcher, and led to the emergence of a list of both individual themes and master themes for each group. Findings: Positive influences on completion included a correct medical understanding, successful behavioural changes in terms of lifestyle control, approach-focused coping, addressing support needs and positive recognition for the role of CR. Negative influences on completion included incorrect medical understanding, limited lifestyle changes, emotion focused coping, high degree of concern on the impact of significant others and lack of perceived consistent value of CR. Conclusions: In order to improve completion rates for CR programmes among women with heart disease, it is important to clarify their initial medical understanding and beliefs, and to continually reassess their perceptions during programme delivery. Incorporating individual support, flexibility, and bespoke programmes for different age groups may enhance attendance at cardiac rehabilitation programmes.
Visual methods in practice and research: a review of empirical support
Authors: Pain Helen 
Published: May 2014

Aims: Many therapists and health researchers use visual objects or activities in the course of their work, but may make assumptions regarding the perception and understanding of them. The purpose of this article is to examine some of the assumptions made in the literature when visual methods are used, and to draw together evidence that supports or challenges their use. Methods: The literature was searched across a number of academic disciplines, and 285 papers and books were reviewed for empirical support of visual methods, including the development of perceptual skills and how images are understood. These were compiled into a narrative summary. Findings: Empirical and theoretical support was found for the development of perception and conceptual understanding of visual images. Many authors have reported fruitful use of visual and verbal communication together. Use of visual methods when verbal communication is impaired or absent, and whether they facilitate the expression of emotion, are discussed. Conclusions: Using visual methods, whether in interventions or research, require an informed choice of medium, method and interpretation, but also offer a sound basis for enriched understanding when applied in a sensitive and reflective manner.
Neuropsychological sequelae in motor neurone disease: outcomes of a peer support programme
Authors: Ng Louisa , Talman Paul , Khan Fary 
Published: May 2014

Aims: Motor neurone disease (MND) is an incurable, progressive and fatal neurodegenerative disease. The focus of management is on achieving the best quality of life for patients and their families. Peer support has been proposed as an effective means of coping with a stressful life experience although data on efficacy are mixed. Methods: The first (preliminary) study on the effectiveness of six-week face-to-face peer support program (n = 7) in MND was studied through a pre-post design. Findings: Results showed that despite high participant satisfaction and a trend towards reduced psychological distress (depression, anxiety and stress) six-weeks post programme, psychological distress had worsened again at 12 months, while quality of life, coping strategies and caregiver burden remained unchanged. Conclusions: Although participant numbers were too small to be conclusive, it is suggested that group face-to-face peer support is a feasible form of support in MND and should be considered even in patients who are severely disabled and/or have severe verbal communication (dysarthria).
Supporting practice-based learning with video-mediated technologies: an overview
Authors: Taylor Teri , Nichol David 
Published: May 2014

Aims: The primary aim of this article is to present a an overview of the use of technologies and in particular, video-mediated technologies, in the one-to-one support of students. Contents: Historically, limited research into the use of video communications to support practice-placed learning, highlighted a number of difficulties but suggested the potential for more widespread use in the future. However, despite dramatic improvements in hardware, software and infrastructure, video-mediated communications remain limited in their practice-based application. This article explores in brief, the historical issues associated with the technology and potential reasons for a lack of more comprehensive use in current education. Raising questions relating to consumer demands, the article explores how the development of infrastructure has failed to keep pace with technologies, thus, potentially contributing to a slower uptake within education than envisaged a decade ago. Conclusions: With reference to new, emerging technologies and the development of national and global infrastructures, suggestions are made as to how future, health-related higher education may alter from traditional models of learning.
Handwriting in healthy adults aged 20-24 years: informing handwriting rehabilitation
Authors: Gozzard Megan , McCluskey Annie , Lannin Natasha , Drempt Nadege van 
Published: May 2014

Aims: To describe the handwriting of healthy young adults by exploring the types of handwriting activities performed and characteristics of handwriting such as speed, style, and legibility. Findings will help to inform the practice of rehabilitation therapists who assess and treat adults with impaired handwriting. Methods: Descriptive cross-sectional study. Sixteen healthy Australian adults aged 20-24 years were recruited using quota sampling methods. Both observational and survey methods were used. Participants used a digital pen and kept a log of handwriting occasions over three consecutive days. Findings: The mean age of participants was 21.6 years (SD=1.3). Participants wrote on few occasions each day (mean=2.4, SD=1.9), with a large variation in the number of words written per day (median=52.8, IQR=129.5). Notes, messages, and lists were most commonly written. Most occasions (78%) involved self-generated text. Many participants (31% when self-generating text) wrote at least a few illegible words, but the overall meaning of text could be understood. Conclusions: The quantity of text written per occasion/per day by these young adults was small, but similar to that collected from older adults in an earlier study. Findings may help rehabilitation therapists to determine when handwriting is ‘impaired’, and whether their assessments are relevant for today's young adults.
Rehabilitation for Patients After Stroke in a Tertiary Hospital: is it early and Intensive Enough?
Authors: Mohd Nordin Nor Azlin , Aziz Noor Azah , Alkaff Sharifa Ezat , Sulong Saperi , Aljunid Syed 
Published: May 2014

Background: This study aimed to evaluate the provision of rehabilitation to and the functional recovery of stroke survivors receiving acute care in a tertiary hospital. Methods: Analyses of medical records of stroke patients who were admitted to a main teaching hospital between the years 2006-2009. Variables studied were the demographics, clinical profiles, rehabilitation profiles and the patients' functional recovery at discharge, as measured on a modified Rankin Scale (mRS). Findings: Records of 557 patients; mean age 64 years, 53.7% females were analysed. Mean length of stay was 6.8 days SD=5.8 during which, 62.7% received daily rehabilitation. Mean time from stroke diagnosis to rehabilitation was 3.0 days SD=2.0; 51.0% of cases were seen after 48 hours of hospital admission. Rehabilitation was provided mainly by physiotherapy services to 71.6%, 64.7% and 52.5% of severe, moderate and mild cases, respectively. Mean mRS was 3.5, SD=0.9 and 53.0% had not regained any level of walking ability prior to discharge. Age and severity level significantly predicted mRS at discharge (F6,536=12.26, P<0.001). Conclusions: Provision of rehabilitation to acute stroke survivors in a tertiary hospital was sub-optimal. Establishment of dedicated stroke rehabilitation services is recommended to enable better functional gain in post-stroke survivors.
Return to work services rendered for patients at stroke rehabilitation facilities in Gauteng Province, South Africa
Authors: Ntsiea Mokgobadibe Veronica , Van Aswegen Helena , Lord Sue , Olorunju Steve 
Published: May 2014

Background: Stroke survivors have lower quality of life than their apparently healthy counterparts and returning to work may contribute to their life satisfaction. The potential for people to return to work following stroke may be enhanced by targeted programmes or directed input, however little is known about the availability of such programmes in South Africa. The aim of this study was to establish current practice in return to work (RTW) intervention programmes for patients with stroke. Method: A cross sectional survey was performed using a self administered questionnaire which was posted with an information document to 53 stroke rehabilitation facilities within the Gauteng province in South Africa and 36 facilities responded. Results: Seventeen of the 36 clinical settings referred patients to facilities offering RTW services; 12 facilities did not refer patients for RTW and did not offer RTW services and seven facilities offered RTW services. Of the seven facilities that rendered post stroke RTW services five communicated with the employer to discuss reasonable accommodation and four did assessments for potential to return to work. The most common reason given by the 29 facilities for not offering RTW services was that they referred patients to other therapists who offered these services. The second most common reason was the unemployment status of the patient at the time of having stroke. Conclusion: A small number of clinical facilities in the Gauteng province of South Africa assess their patients in order to establish potential for return to work after stroke and a small number of clinical facilities render RTW intervention for patients with stroke.
How does cognitive ability affect stroke rehabilitation outcomes?
Authors: Gurr Birgit , Ibbitson Joseph 
Published: May 2014

Background: This paper discusses literature findings on the impact of pre-stroke degenerative cognitive impairments (pre-stroke dementia) on post-stroke rehabilitation outcomes. This association has practical implications for stroke rehabilitation services which are faced with the dilemma that pre-stroke cognitive impairment may be a cause of stroke and, on the other hand, stroke may cause cognitive deficits. Content: The link between pre-stroke dementia and stroke is described by explaining how vascular and neurodegenerative pathology contribute to stroke occurrence and to stroke related impairment. Stroke seems to be more closely related to dementia than previously thought and vascular factors appear to be at the core of a wide range of dementing disorders. The literature reviewed emphasises how cognitive performance at stroke onset can give indications about the anticipated level of post-stroke functional independence. Conclusion: The importance of assessing and monitoring cognitive performance of stroke survivors using reliable neuropsychological procedures is emphasised. The assessment results help to estimate rehabilitation potential, to plan the most effective interventions and to optimise post-hospital discharge arrangements. This helps clinicians on stroke units to make rehabilitation decisions addressing both cognitive variables and professional standards.
Which calculations do child branch student nurses find most difficult in the classroom setting?
Authors: Barrett Gary 
Published: May 2014

The purpose of this study was to attempt to identify the types of calculations that cause most concern for student nurses. A Solomon Four Group Testing system, using the pre-test, intervention and post-test experimental design was used. Student nurses studying on the child branch programme were recruited. Each participant was part of a cohort of students who were exposed to a variety of calculation tests in the classroom setting, without the use of a calculator, and were allocated to receive an intervention in the form of an interactive lecture or a calculation workbook, or assigned to the control cohort who received no intervention. The cohorts then received a post-intervention calculation test. The data collected was analysed and revealed that certain identified themed questions resulted in a significant and worrying failure rate. Also emerging from the data, it was clear that identified interventions resulted in substantial improvements in subsequent scores of the students.
Using intravenous paracetamol in children following surgery: a literature review
Authors: Clarke Sonya , Richardson Olga 
Published: May 2014

This paper presents an extended critical review of primary papers related to the efficacy and safety of intravenous (IV) paracetamol in children following surgery. The primary focus is a critical evaluation of the methods, effects, experiences and outcomes of using IV paracetamol in children following surgery. Search strategies, inclusion/exclusion criteria, and methods were replicated as for Clarke and Richardson (2007a,b). Duplicate systems were also used to categorize the research papers into respective levels of evidence (Atkins et al, 2004; Petrisor et al, 2006) and Detsky et al’s (1992) scales were used to assess the quality of randomized trials which score randomization, statistical analysis and blinding. IV paracetamol permeates readily into the central nervous system (CNS) of children and is detected in the cerebrospinal fluid within five minutes. The transfer is fast and enables central analgesic and antipyretic action of IV paracetamol. CNS penetration of IV paracetamol was reported as five times greater in girls than boys. A single dose of IV paracetamol 15mg/kg produced analgesia similar to a single infusion of propacetomol 30mg/kg. No serious adverse effects were reported, however, a very small number fo subjects reported vomiting, and burning sensation at the injection site. However, paracetamol 15mg/kg was better tolerated at the injection site than propacetamol. This literary evidence provides a modest source of empirical research that supports the health care professional when using IV paracetamol in children post-surgery, therefore ensuring their practice reflects the best available evidence.
A non-comparative multi-centre clinical evaluation of a new hydropolymer adhesive dressing
Authors: Taylor A. , Lane C. , Walsh J. , Whittaker S. , Ballard K. , Young S.R. 
Published: May 2014

This study evaluates the performance of a new hydropolymer adhesive dressing in the treatment of chronic or acute wounds, in the presence of blood and/or low levels of exudate, in 74 patients, in a five-site multi-centre non-comparative clinical trial of four weeks' duration. The primary efficacy variable was defined as the incidence of central island dressing adherence to the wound bed in the final stages of healing The hydropolymer dressing performed extremely well with 98.4% (240 out of 244) of the dressings not adhering to the wound bed.
Effects of adhesive dressings on the stratum corneum of the skin
Authors: Dykes P.J. , Heggie R. , Hill S.A. 
Published: May 2014

Two human models were developed to quantify the stratum corneum removed by different adhesive dressings and to measure the peel force of dressing removal and relate this to stratum corneum removal. The first was an open study designed to compare the effects of applying Mepiform Safetac, Tielle and Duoderm Extra Thin to the skin of 12 normal volunteers aged 19–53 years. Treatments were applied once (one 24-hour application) or three times (three × 24-hour applications) to forearm skin which had been prestained with methylene blue. After dressing removal the dye left on the skin was sampled using the skin surface biopsy method and measured spectrophotometrically. The results show that, after one and three applications, the Mepiform Safetac sites had a higher level of dye than those on which the other dressings had been applied (p<0.05, after three applications). Based on the assumption that the more dye is left on the skin, the less damage is caused, this suggests that Mepiform Safetac is less damaging to the skin surface than the other products tested. In the second study the peel force needed to remove adhesive dressings from prestained skin was measured and related to the amount of stratum corneum removed. Mepilex Border Safetac, Duoderm Extra Thin, Allevyn Adhesive, Biatain Adhesive and Tielle Hydropolymer Dressing were compared in 20 normal volunteers aged 23–64 years. Three consecutive 24-hour applications of each product were made, with measurements of peel force at 24, 48 and 72 hours. The amount of dye remaining on the skin at 72 hours was assessed by the surface biopsy method. Statistically significant differences between products were observed in terms of both peak force and steady state force of removal. Differences in the level of damage to the superficial stratum corneum were also detected. However, low levels of peel force were not always associated with low damage and, therefore, other factors must contribute to stratum corneum removal in this model.
Evaluation of a new composite dressing for the management of chronic leg ulcer wounds
Authors: Daniels S. , Sibbald R.G. , Ennis W. , Eager C.A. 
Published: May 2014

Objectives: A new composite dressing (Versiva, ConvaTec) combines three technologies: hydrocolloid, hydrofibre and a foam-film layer. This study aimed to assess the safety of the dressing in the management of patients with venous leg ulcers. Clinical performance was also assessed. Method: This multicentre, non-randomised, open-label, phase II study assessed the safety (via adverse-effect reporting) and performance, including weartime, absorption, dressing integrity, ease of use and wound progression, of Versiva. Up to 10 dressing changes were assessed within a five-week study period. Results: In 75 dressing changes of 11 ulcers, the mean wear time was approximately five days. No or minimal leakage was observed in 81% of changes. In 93%, the dressing was ‘very easy’ to remove, with no trauma to surrounding skin. Most changes (77%) were painless. Conclusion: Versiva met or exceeded the investigators' expectations for exudate absorption, protection of peri-wound skin and reduction in wound pain and ulcer area. Healing or marked improvement was observed in 82% of leg ulcers within the five-week study. The relatively long wear-time of five days represents a cost-effective advantage for this dressing compared with other available adhesive foams for the management of chronic wounds. Declaration of interest: This study was sponsored by ConvaTec.