bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative efficacy of methyl salicylate iontophoresis and moist heat pack in the management of knee osteoarthritis
Authors: Wani Surendra K , Gaikwad Pallavi 
Published: May 2014

Objective: To investigate the effectiveness of methyl salicylate iontophoresis in reducing pain and disability in patients with knee osteoarthritis (OA). Materials and methods: A total of 40 patients with knee OA patients who were admitted at the outpatient physiotherapy clinic participated in this study. The patients were randomly assigned into two groups. Group A received methyl salicylate iontophoresis while group B received moist packs daily for a period of two weeks. Patients were evaluated for pain and functional capacity using numerical pain rating scale (NPRS), walking speed test (WST), modified get up and go test (MGUGT), total single limb standing test (TSLST) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) before therapy and after 2 weeks of intervention. Results: The mean age and duration of symptoms were 56.45±6.30, and 2.27±1.05 years respectively for individuals treated with methyl salicylate iontophoresis and 56.8±5.47, 2.12±0.86 years for individuals treated with moist pack. After 2 weeks of intervention, significant differences were observed in all outcome parameters for both groups when compared to baseline values (P<0.01). Also, significant difference was found in most of the parameters except MGUGT in both groups post interventionally (P<0.001, P=0.103). Conclusion: Methyl salicylate iontophoresis can be included in the treatment of knee osteoarthritis to enhance pain relief and functional activity.
Intra-rater reliability of timed ‘up and go’ test for children diagnosed with cerebral palsy
Authors: Sanjivani N Dhote , Prema A Khatri 
Published: May 2014

Background: The ‘timed up and go’ (TUG) test is a quick test, used in clinical practice as an outcome measure to assess functional mobility in adults. However, little information is available for TUG test use in people with cerebral palsy (CP). Aim: To assess within-session and test-retest reliability of TUG test and to find the mean score of it with respect to the Gross Motor Function Classification System (GMFCS) in children diagnosed with CP. Methodology: An observational study of 30 children with CP of 4-12 years, those within GMFCS level I, II, and III, and an IQ>50. The sampling technique used was purposive sampling excluding children with cognitive deficit. The documented data was analyzed by using intraclass correlation coefficient (ICC). Subjects performed TUG on three occasions—at initial assessment; 30 min after initial assessment; 1 week after initial assessment. On each of these three occassions three TUG tests were performed. A mean score of the three trials was documented as a final score. Within session and test-retest reliability was analyzed using scores of trial 1 and 2; and trials 1 and 3 respectively. To find the mean score of the TUG test with respect to GMFCS level, a mean of all scores from all TUG tests performed within the particular GMFCS levels was calculated. Result: Reliability of TUG test was high, with ICC of 0.99 within session, and 0.99 was test-retest relibility. Significant variation was seen in the TUG score for the three levels of GMFCS. Conclusion: Intra-rater reliability of TUG test in children with CP was found to be highly reliable.
Effectiveness of a patient/carer empowerment programme for people with hip fractures
Authors: Louie Stephanie Wai-Shan , Poon Mei-yee , Yu Shuk-yiu , Chan Wai-ling , Au Kai-ming , Wong Kam-man 
Published: May 2014

Aims: The study compared the effects of a patient and carer empowerment programme and conventional hip fracture protocol on hip fractures related knowledge, activity of daily living (ADL) independence, fall efficacy on ADL; and application frequency of adapted ADL skills in individuals with hip fracture.Methodology: 134 participants were recruited with 63 and 71 participants allocated to Patient and Carer Empowerment Programme (PCEP) and conventional hip fracture protocol respectively. Paired t-test was used to compare the pre-post scores of hip fracture knowledge test, Functional Independence Measures-motor scores, Lawton Instrumental ADL scales and Chinese version of Fall Efficacy Scales within groups. Independent t-test was used to compare the outcome measures and application frequency of adapted ADL skills between groups.Results: It showed that both groups have improvement on hip fracture related knowledge, ADL, instrumental ADL independence and fall efficacy on ADL (P<0.05). However, the participants who underwent the PCEP were found to apply adapted ADL skills more frequently.Conclusion: It appears that participants who underwent the PCEP were more ready to build up habit on adapted ADL skills use. Further studies to investigate carers’ stress and hands-on caregiving skills after the programme were recommended.
Mental health vocational rehabilitation–occupational therapists’ perceptions of individual placement and support
Authors: Baxter Claire , Prior Susan , Forsyth Kirsty , Maciver Donald , Meiklejohn Alison , Irvine Linda , Walsh Mike 
Published: May 2014

Research purpose:Vocational rehabilitation (VR) has been the focus of recent UK government policy, which outlines objectives to support individuals with mental illness into work. To provide such support, individual placement and support (IPS) as one approach, is frequently referred to. This has ignited both discussion and research within the occupational therapy (OT) profession to re-examine its contribution to VR and consider IPS as part of its practice.Aim:To explore occupational therapists’ (OTs) perceptions about their role within mental health (MH) VR and IPS.Method:Semi-structured interviews were used to generate data in this qualitative study. The interview transcripts were subject to thematic framework analysis.Findings:The findings revealed similarities and compatibility with OT and IPS. Participants acknowledged the value of IPS for clients who wish to obtain paid employment but also recognized the value of all worker roles which is in keeping with the professions values.Conclusion:The findings are congruent with discursive literature regarding OT and VR. Consideration given by OTs to the uniqueness and complexities of work as an occupation reinforces their distinct contribution to VR and could extend to IPS. Further research is needed to verify and extend this study's findings.
Contemporary splinting practice in the UK for adults with neurological dysfunction: A cross-sectional survey
Authors: Kilbride Cherry , Hoffman Karen , Baird Tess , Tuckey Joanne , Marston Louise , Souza Lorraine De 
Published: May 2014

Aim: To explore the contemporary splinting practice of UK occupational therapists and physiotherapists for adults with neurological dysfunction. Method: Cross-sectional online survey of members of the Association of Chartered Physiotherapists in Neurology and College of Occupational Therapists Specialist Section Neurological Practice. Results: Four hundred and twenty therapists completed the survey. Contracture management is the most common rationale for therapists splinting adults with neurological dysfunction. Other shared therapeutic goals of splinting include maintaining muscle and joint alignment, spasticity management, function, pain management and control of oedema. Considerable clinical uncertainty was uncovered in practice particularly around wearing regimens of splints. Most therapists have access to locally-derived splinting guidelines, which may contribute to this diversity of practice. Conclusions: This study provides a unique insight into aspects of contemporary splinting practice among UK therapists, who belong to a specialist neurological professional network and work in a number of different health-care settings with adults who have a neurological condition. Study findings show a wide variation in splinting practice, thereby indicating a potential need for national guidance to assist therapists in this area of clinical uncertainty. Further research is required to establish best practice parameters for splinting in neurological rehabilitation.
The impact of spinal cord stimulation for upper extremity complex regional pain syndrome on level of function
Authors: Haynes Louise , Goebel Andreas , Flynn Maria 
Published: May 2014

Background/aimsSpinal cord stimulation (SCS) is able to provide significant pain relief in individuals with complex regional pain syndrome (CRPS). Less is known about how this treatment impacts on function, particularly from the patients' perspective. This qualitative exploratory study was part of a larger service evaluation into current and future management of this patient group. This evaluation aimed to gain insight into the influence of SCS on daily activity and work and to explore the patients' journey from symptoms to diagnosis, SCS implant and afterwards.MethodsA purposive sample of three patients took part in semi-structured interviews. Thematic content analysis of the data was then used to extract themes and subthemes.ResultsThematic content analysis identified two emerging concepts: freedom and conflict. Within these two concepts, seven subthemes were apparent. Although participants described feelings of independence due to the effect of SCS on activity levels, other less encouraging issues were identified. These include a dependence on the stimulator, a lack of control over the future, and a perceived lack of understanding of their condition by others.ConclusionHow these concepts relate to patients' ability to return to work is explored and areas for further research are identified.
Subjective experiences of occupational performance of activities of daily living in patients with mild stroke
Authors: Kristensen Hanne , Postat Annemette , Poulsen Trine , Jones Dorrie , Minet Lisbeth Rosenbek 
Published: May 2014

Aim To investigate the subjective experiences of occupational performance of activities of daily living (ADL) in patients with mild stroke. Methodology Data was generated from January – December 2011 and consisted of 41 individual ADL-I interviews with patients in hospital and another 41 interviews with the same patients 1 month after discharge. The last eight interviews were extended with semi-structured interviews. Results The study participants consisted of 16 women and 25 men with a mean age of 69 years. The majority of the participants were independent in the PADL- and IADL-activities included in the ADL-I interviews. However, a minority of participants experienced difficulties in performing normal daily activities without the help of alternative strategies or assistive devices. This resulted in them having to spend more time on these activities, and this increased their fatigue and risk of accidents. Conclusion It is important to view the patients with mild stroke as heterogeneous, and consider post-stroke fatigue and emotional reactions when evaluating rehabilitation needs. Therefore, it is important to look further into structured tools, which examine how well the participant performs daily activities and how this is perceived, to understand fully the patient's rehabilitation needs.
Eureka! A reliable, home-made water volumetry device
Authors: Kimmel Lara A , Prescott Jonathan G , Holland Anne E , Bedi Harvinder S 
Published: May 2014

BackgroundWater displacement is considered to be the gold standard for measuring foot volume; however, it is time-consuming and infrequently used in clinical practice. The objectives of this study were to determine whether a home-made water displacement device is a reliable and time-efficient method for determining foot volume.MethodsThirty participants with no foot pathologies were enrolled and had their foot volume measured in two home-made water volumetry devices (Preski and PreskiLite). The participants' foot volumes were measured on two occasions on each of two different days.ResultsAll measurements were achieved in less than 90 seconds. Within-day reliability was high (intraclass correlation [ICC]=0.997–0.999) with the minimal detectable change (MDC) at the 90% confidence level (MDC90) of less than 25 ml for both devices. Mean differences in volume displaced between days were small (range 0.6– -5.4 mls). For between-day measures on the same leg, the mean coefficient of variation ranged from 0.65–1 with associated ICCs of 0.989–0.997. The MDC90for between-day measures was 46 ml for the PreskiLite and 23 ml for the Preski. The difference in volume displaced between right and left legs was less than the MDC90for both devices.ConclusionsA novel, home-made water volumetry device provides reliable measures of foot volume both within and between days. Measurements taken on the contralateral leg provide an adequate control. These portable devices provide rapid measurements and only one measurement is needed per day.
Effect of low dose high frequency training on paramedic cognitive skills
Authors: Kardong-Edgren Suzan , Brouhard Rod , Bourn Scott , Oermann Marilyn , Odom-Maryonuzan Tamara 
Published: May 2014

Background: Paramedics in many parts of the US are required to obtain advanced cardiac life support (ACLS) recertification every two years. However, like other healthcare providers, they may experience problems with retention of this knowledge. Study objectives: This year-long study examined the difference in ACLS cognitive performance, measured by a modified Megacode, between two groups of paramedics: those who practiced for 10 minutes monthly over 10 months using brief computer-based ACLS scenarios, and those who did not refresh. Methods: Participants were randomised into the experimental group using computer gaming for a minimum of 10 minutes a month, and a control group that did not. In month 12, all participants took a post-test Megacode. Results: 27 (79%) of the experimental and 18 (95%) of the control group successfully completed the pre-test Megacode. 38 (72%) of all participants passed both the pre- and post-test Megacodes; three (6%) failed both Megacodes, five (9%) of the experimental group who failed the pretest passed the post-test at month 12. Four participants in the experimental group and three in the control group failed the post-test at month 12. Conclusions: paramedics recalled ACLS algorithms with or without practice.
Community paramedics: a scoping review of their emergence and potential impact
Authors: O'Meara Peter 
Published: May 2014

Objectives: This paper reports on the extent of the peer-reviewed literature relating to community paramedics since the inaugural meeting of the International Roundtable on Community Paramedicine in 2005. A scoping review was undertaken to: examine the extent, range and nature of research activity; determine the value of undertaking a full systematic review; summarise and disseminate research findings; and identify research gaps in the existing literature. Methods: This scoping study systematically searched and located literature on community paramedics from 2005 to 2012 irrespective of study design. It mapped the key concepts underpinning the emergence of community paramedics and the main sources and types of evidence available. In this review the concept of community paramedics as defined by the International Roundtable on Community Paramedicine was used as the key reference point. Results: The community paramedicine literature fell into three broad categories: theoretical studies; empirical studies measuring outcomes; and reviews. While there are few peer-reviewed articles, a growing number of empirical studies are beginning to emerge as a result of programme evaluations in various regions of the world. At this time there are a handful of relevant reviews in the literature that are focused on innovations in paramedic practice. One Australian research team has published all of the peer-reviewed theoretical papers underpinning this innovation in paramedic practice. Conclusions: There is growing evidence of community paramedicine research in the literature, including some links with related studies, such as that of the extended care paramedic programmes in the United Kingdom. There remains a strong focus on commentaries and opinion papers in both peer-reviewed and trade publications. Nonetheless, there is an emerging research literature that is contributing to the development of community paramedicine programme models and the evaluation tools that will contribute toward the future evolution of the model.
Pain assessment and management in cognitively impaired children
Authors: Thompson Karen 
Published: May 2014

This article identifies primary themes in the literature regarding the assessment and management of pain in children with cognitive impairment (CI). The principal focus is an evaluation of methods, effects and outcomes of assessment and pain management. The review entailed a systematic and rigorous search of appropriate health-care databases using appropriate search terms in conjunction with preset inclusion and exclusion criteria. The review divided the harvested papers into four key themes:(1) The prevalence and severity of pain in children with CI (2) The reliability and validity of available assessment tools (3) Parental ratings of their child’s pain and its reliability (4) Pharmacological management of pain in children with CI versus that of children without CI.It was generally acknowledged that children with CI were more vulnerable to experiencing pain, not only owing to condition-associated and surgical reasons, but also because of a lack of adequate pain assessment caused by their inability to adequately communicate their pain. Pain assessment tools found in the literature were all based on the assessment of altered behaviours and other non-verbal cues and suggested parents provide a realistic approximation of pain, especially when pain tools are employed. Some debate exists regarding the management of pain in children with CI; however little research has been carried out in this area and therefore much more is required to ensure that children with CI are not being under-medicated and allowed to endure unnecessary pain. Health professionals need to review their practice in relation to the assessment and management of pain in children with CI and ensure their practice reflects the best available evidence.
The effects of supplementation of creatine on total homocysteine
Authors: D Shelmadine Brian , M Hudson Geoffrey , W Buford Thomas , Grothe Ann , J Moreillon Jen , L Gutierrez Jean , G Bowden Rodney , L Wilson Ronald , W Willoughby Darryn 
Published: May 2014

BackgroundSmall increases in homocysteine are associated with increased risk for cardiovascular events patients with end-stage renal disease (ESRD). Endogenous creatine intake may decrease homocysteine via negative feedback inhibition, as creatine is a by-product of methionine and homocysteine metabolism. Therefore, this study was conducted to examine whether oral supplementation of creatine would affect levels of plasma homocysteine in ESRD patients. Methods: 16 ESRD patients with hyperhomocysteinemia completed the study. Patients supplemented 5 g/day of creatine monohydrate for 30 days. Results: Homocysteine levels significantly increased (t=-2.315, p=0.035) in ESRD patients (pre-test 18.9±14.0 mg/dlitre, 139.80±103.56 μmol/litre; post-test 28.8±11.2 mg/dlitre, 213.03±82.85 μmol/litre). Conclusions: The current study suggests that ingestion of 5 g/day of creatine monohydrate in ESRD patients results in an increase in homocysteine. Combined with previous studies it appears that dosages ≥ 5 g/day of creatine increase homocysteine in patients with decreased renal function.
Comparative cost-effectiveness of four-layer bandaging in the treatment of venous leg ulceration
Authors: Carr L. , Phillips Z. , Posnett J. 
Published: May 2014

This paper reports the results of an analysis designed to estimate the expected annual cost per patient of treating venous leg ulcers, and to evaluate the relative cost-effectiveness of a systematic treatment regimen using a four-layer compression bandaging system (Profore) compared with usual care. A Markov model has been developed which simulates the transition of patients between health states (healed and unhealed) over a 52-week period. Healing rates used in the model are derived from those reported in the literature. By running the model for a cohort of 100 patients over 52 weeks it is possible to estimate expected outcomes and annual budgetary costs for alternative treatment regimens. Results suggest that, when compared with usual care, a systematic treatment regimen using Profore is unambiguously more cost-effective. Patient outcomes are improved and annual treatment costs reduced. An important implication is that failure to co-ordinate treatment policies and to use the most cost-effective treatments may result in substantial inefficiency in the use of NHS resources. This inefficiency could represent the equivalent of between £350,000 and £1.08 million annually for a typical health authority.
Cost-effectiveness of treating deep diabetic foot ulcers with Promogran in four European countries
Authors: Ghatnekar O. , Willis M. , Persson U. 
Published: May 2014

Objective: This study aimed to estimate the cost-effectiveness of treating non-superficial diabetic foot ulcers with Promogran plus good wound care (GWC) compared with GWC alone in four European countries (France, Germany, Switzerland and UK). Methods: An existing Markov-based health economic model of non-superficial diabetic foot ulcers was adapted to incorporate the relative efficacy of Promogran compared with GWC alone as demonstrated in a randomised controlled trial. Treatment with Promogran was modelled for a maximum of three months. Country-specific treatment costs were used to estimate the incremental cost per ulcer-free day gained over 12 months. Some parameter assumptions were changed to assess the sensitivity of the results. Results: Within the first three months of treatment, 26% of ulcers in the Promogran cohort healed compared with 20.7% in the GWC cohort. Over the 12 months, the average number of months spent in the healed state was 3.41 (GWC) and 3.75 (Promogran). Promogran treatment was found to be cost-saving in all four countries, using year 2000 Euro values. Conclusion: Promogran with GWC may be cost-effective, perhaps even cost-saving, under a wide variety of assumptions for the treatment of neuropathic foot ulcers. Declaration of interest: This study was funded by Ethicon Gmbh (Johnson and Johnson), Germany.
Digital imaging versus conventional contact tracing for the objective measurement of venous leg ulcers
Authors: Samad A. , Hayes S. , French L. , Dodds S. 
Published: May 2014

Objective: This study aimed to compare the accuracy and inter-observer reproducibility of leg ulcer measurements made using digital images and conventional contact tracing. Method: The accuracy of measurements made with these two methods by four observers of 11 shapes with a known area was assessed. The time taken to do this was also measured. Following this, the accuracy and inter-observer reproducibility of the two methods was measured for patients with leg ulcers presenting to the vascular clinic, with contact tracing as the reference. Results: For the reference shapes, both methods had a mean error of less than 5%. Contact tracing significantly underestimated the area by 3.9% (p<0.05), while digital tracing showed no significant error. Digital tracing was quicker than contact tracing, especially for larger shapes (p<0.05). For leg ulcers, there was no significant difference between area measurements made by the two methods. Inter-observer variation of digital tracing was greater for the ulcers than the reference shapes. This was due to differences in subjective interpretation and technical problems in recording some images. Conclusion: Measurement of leg ulcer area using computer-aided tracing of digital camera images is more accurate and quicker than contact tracing provided that appropriate care is taken when taking the pictures. Digital images offer considerable advantages in the shared hospital-community care of patients with leg ulcers. Declaration of interest: None.