bluuebunny/crossref_metadata_2025_split huggingface dataset:
Internet research and informed consent: An ethical model for using archived emails
Authors: Watson Mohinder , Jones Derek , Burns Lindsey 
Published: May 2014

Ethical conduct involving research participants rests on the Belmont principles of autonomy, beneficence and justice. Novel methods present new challenges in safeguarding these principles. The increasing use of data obtained from the internet in health research raises important questions regarding obligations to people posting personal information online. Ethical issues warrant special consideration since guidelines are only beginning to emerge, placing greater onus on the researcher’s discretion. This paper presents a model (a synthesis of the work of Eysenbach and Till (2001) and Kraut et al (2004)) to assist in decision-making regarding obtaining or waiving informed consent when using archived emails from websites. For illustrative purposes, the application of the model to a PhD project is described.
An audit of botulinum toxin therapy services for adult spasticity
Authors: Sakel Mohamed 
Published: May 2014

Audit is a core component of the clinical governance programme, the mechanism to improve the quality of the service and the performance of clinicians in the NHS. The Royal College of Physicians (RCP), UK, has produced national guidelines setting standards for botulinum toxin therapy in adult spasticity. Such therapy is an essential element in treating spasticity. This article critically explores the experience of the first 3 years of a new service at one acute trust. This is the first reported audit on spasticity or botulinum toxin therapy. The results highlighted areas for improvement and consequent specific action plans have been drawn up for implementation. The data, together with other quality indicators, will support the team to engage with the service commissioners for improvement and further investments in this adult spasticity service. Future audit data from other services can potentially contribute to benchmarking of spasticity services. The article also considers and explores the potential role of physiotherapist or nurse injectors of botulinum toxin therapy for spasticity treatment; and future research ideas are generated.
Treatment across cultures: Is there a model?
Authors: Core Ludmila 
Published: May 2014

Aims: The increase of cultural diversity in countries worldwide impacts on health-care providers, who are required to provide culturally-appropriate care to patients from culturally and linguistically diverse (CALD) backgrounds. Cultural differences may impact both on treatment processes and patient responses to treatment. This article aimed to explore how cultural issues and cultural sensitivity uniquely infl uence the rehabilitation process of individuals from various ethnic and cultural backgrounds; and give an insight into cross-cultural issues pertaining to health-care delivery from an American physical therapy perspective. Content: A literature review on issues facing health-care providers—;specifi cally physical therapists—;in delivery of culturally-appropriate care was undertaken. Key areas are discussed and a culturally sensitive treatment model for health-care providers to use when working with CALD patients is proposed. Discussion and conclusions: A review of the literature revealed limited research in this area from physical rehabilitation disciplines; although there was an encouraging proportion of articles on the culture-oriented trend in professional education. It is suggested that professional education of physical therapists should include a cultural component; focusing on particular cultures, culturally sensitive behaviour based on knowledge of cultures, and assistance with return to work or pre-morbid activities. Piloting of the proposed model is suggested to add to the literature in this area.
Disciplinary developments in New Zealand
Authors: Diesfeld Kate , Godbold Rosemary 
Published: May 2014

Background New Zealand's disciplinary regimen has particular significance because victims of personal injury are almost entirely barred from suing for common law damages in civil proceedings. Contents This article examines the New Zealand legal system, and considers how it attempts to maintain the accountability of medical professionals, while preventing the rising tide of litigation seen in other jurisdictions. Generally, New Zealanders do not have recourse to traditional malpractice litigation. One aim of tort litigation is to hold the responsible individuals accountable for their actions. In the absence of malpractice litigation, New Zealand's approach to maintain accountability by health professionals includes a code of consumers' rights, competence assurance legislation, and a disciplinary tribunal. This disciplinary body offers a valuable international comparator because it applies across the health professions. Case studies from select health professions (occupational therapy, osteopathy and physiotherapy) reveal the types of misconduct that qualify for discipline and the corresponding penalties. Conclusions New Zealand's disciplinary regimen functions as a form of preventive law on behalf of health providers and their patients. All therapists need to be aware of the relevant rules and regulations in their own jurisdiction, but it is important to consider those of others.
Assessment of back and abdominal pressure, sexual frequency and quality of life
Authors: Kumar Suraj , Sharma Vijai P , Shikla Rakesh , Dev Ravi , Pal Singh Negi Mahendra 
Published: May 2014

Aims The present study was undertaken to determine the extent to which back pressure changes and abdominal pressure changes, sexual frequency and quality of life in patients with lower back pain differ from normal, and recover after a physiotherapy intervention. Methods Thirty nine lower back pain patients and 31 without lower back pain (control) were enrolled for this study. Patients were treated with dynamic muscular stabilization technique (DMST), which is an active approach of physical therapy. Pain, back pressure changes, abdominal pressure changes, sexual frequency and quality of life of normal subjects and patients were assessed at baseline and after 180 days of DMST intervention in patients. Data were analysed by Student's t-test, Pearson correlation coefficient (r) and analysis of variance with α=0.05. The control and study groups were age matched (P>0.05). Findings The DMST improved all the variables significantly (P<0.01) and the improvement was observed more in females than males. Conclusions DMST is an effective intervention for reducing pain, and restoring back pressure changes, abdominal pressure changes, sexual frequency and quality of life to normal levels in patients with lower back pain. Its success, however, does seem to depend on the sex of the patient, which suggests an area for further research.
The interplay of evidence and knowledge for social work practice in a health setting
Authors: Fielding Angela , Crawford Frances , Leitmann Sabina , Anderson Judi 
Published: May 2014

AimsThere is a growing body of research and scholarly literature addressing, from a range of philosophical views, the nature and effectiveness of evidence-based practice across health and human services. Influenced by developments in the USA and UK, there is an increasing requirement in Australia for evidence-based accountability from professional practitioners. Following Clifford Geertz's dictum that to understand a practice it is necessary to study what it is that practitioners do, this interpretive study explores how experienced and reputedly effective social workers use knowledge in practice.MethodsThe study was conducted in 2007/08 at a West Australian tertiary hospital. A purposive sample of four social workers, identified by their manager as experienced and effective practitioners, were interviewed on their practice in a case study of their choice. Interview data were transcribed and analysed thematically alongside official case notes to explore the ways in which evidence and knowledge interplay in shaping effective practice and the ways this is recorded for agency purposes.FindingsPractitioner thick descriptions on two cases revealed mediation and interaction with both empirical and reflective types of knowledge, with a dynamic interplay of evidence, knowledge and knowledge making, and practice wisdom.ConclusionsThe authors argue that social workers are active agents who use and generate knowledge while they are making practice decisions based on their assessment of empirical knowledge, values, principles, and tacit knowledge. In this research project, researchers and practitioners examined and articulated effective social work practice to illustrate the ways in which multiple forms of knowledge are incorporated.
Using Rasch analysis to establish the construct validity of rehabilitation assessment tools
Authors: Mui Lim Sok , Rodger Sylvia , Brown Ted 
Published: May 2014

Background Rasch analysis is a statistical model that can be used in the development of new assessment tools and the evaluation of already existing ones. Rasch analysis can also be used to provide various forms of construct validity evidence. In the revised conceptualization of validity, validity is operationalized as a unitary concept with five types of evidence. This article aims to inform rehabilitation practitioners of the different forms of validity evidence that can be demonstrated using Rasch analysis. Content The history and the more recently accepted conceptualization of validity is briefly outlined. Examples of studies in the field of rehabilitation and health care are given to illustrate the varying forms of Rasch-generated validity evidence. Conclusions An understanding of Rasch analysis application in the validation of assessment tools will equip rehabilitation practitioners with better skills in interpreting the measurement properties of instruments developed using Rasch analysis. Rehabilitation practitioners are also encouraged to use Rasch analysis to evaluate existing instruments, with the aim of generating equivalent measures of underlying constructs.
Effects of visible vs concealed alphabet cues on speech intelligibility in dysarthria
Authors: Kentner Jenny , Miller Nick 
Published: May 2014

Aims Alphabet cues are often applied to improve communication with people with speech impairment. Uncertainty remains regarding which factors associated with the individual participant applying the technique (e.g. type and severity of dysarthria) or with the technique itself (e.g. visual letter information or altered speech output) impact on outcome. This study examined intelligibility of dysarthric speech with and without visible and concealed cues, and investigated the effects of word frequency, length and complexity on word recognition. Methods Twenty-two listeners transcribed words (n=120) of varying length (monosyllabic n=66, disyllabic n=54) and varying complexity (simple onset n=60, complex onset n=60) from an audiorecording of an adult with severe dysarthria associated with amyotrophic lateral sclerosis. Words were spoken with habitual speech, and with simultaneous pointing to the initial letter on an alphabet board (cueing). Intelligibility was tested in three listening conditions: habitual speech (with no cues), cued speech with alphabet cues visible to listeners and cued speech without alphabet cues visible to listeners. Findings In total, 46.6% of all the 120 words were correctly identified. Considering all items, visible cues increased intelligibility while concealed cues decreased intelligibility compared to the no cues condition. When examining word subsets, 30% of items with complex onsets and 38% of two-syllable items were correctly recognized. Higher word frequency facilitated recognition. Conclusions Visible cues significantly improved intelligibility however, not all words were equally facilitated. The possible issues around the implementation of cues associated with some neurological aetiologies are highlighted.
An overview of case-control study designs and their advantages and disadvantage
Authors: Morrow Brenda 
Published: May 2014

Background Case-control studies are analytical observational research studies which identify cases of subjects with an outcome or disease of interest, match these with appropriate controls without the condition, and then obtain a history of exposure for both groups. Contents This article provides an overview of the design, analysis, interpretation, advantages and disadvantages of case-controlled studies. Readers should appreciate the strengths, weaknesses and potential pitfalls of case-control studies when interpreting results and applying them to clinical practice. Conclusions Although lower in the research hierarchy than cohort studies and randomized controlled trials, case-control studies may be the only viable research design for investigating rare conditions within a short time period
Participation in physical activity among inpatients with severe mental illness: a pilot study
Authors: Bonsaksen Tore 
Published: May 2014

Tore Bonsaksen Aims: Severe mental illness is associated with low levels of physical activity. This study explored participation in a physical activity programme among patients with severe mental illness and its relationships to other variables. Methods: Eighteen hospitalized patients participated in the study. Their level of participation in a physical activity programme was explored and their age and anxiety and depression levels were used to predict participation. Findings: The patients had low levels of participation. Seventy-eight percent attended 50 percent or less of the activities, while the sample mean level was 28 percent participation. Participation in the programme increased with age. Conclusions: This pilot study has several limitations, most importantly the limited sample size. A greater variety in activities offered and better inclusion of personal activity preferences may increase motivation to participate among younger patients. Adequate social support may counteract barriers related to anxiety and depression symptoms, and thus increase participation. Recommendations for future research include undertaking larger scale studies exploring the relationships between physical activity and other variables, and to investigate processes of motivation for physical activity among patients in this group.
User evaluation of the Neater Uni-wheelchair in the home environment: an exploratory pilot study
Authors: Mandy Anne , Stew Graham , Michaelis Jon 
Published: May 2014

Anne Mandy, Graham Stew, Jon Michaelis Background: The Neater Uni-wheelchair was designed as an alternative to powered wheelchairs, lever drive and dual handrim wheelchairs for hemiplegic users. It is a standard Action 3 chair to which a kit has been attached which enables users to self-propel and steer independently of attendants. The aim of this pilot study was to explore users’ experiences of the Neater Uni-wheelchair in the home environment. Methods: Six users from a previous study, carried out in 2009, agreed to evaluate the Neater Uni-wheelchair in their home environments. The methodological approach was micro-ethnography ( Holloway and Wheeler, 2010 ) and data were transcribed and analysed using Framework Analysis ( Ritchie and Spencer, 1994 ). Findings: Key themes identified were independence and freedom, ease of use and manoeuvrability, usefulness and change in activity. This pilot study would support the notion that the Neater Uni-wheelchair is a viable alternative to those that are currently available to hemiplegic users. Conclusions: The results from this exploratory study would support the need for a larger study. There are no storage issues, it is a cheaper option than a powered wheelchair and it would appear to increase independence, activity and participation in the short term.
Learning from experience: shared constructs in virtual reality and occupational therapy
Authors: Foran Amanda C 
Published: May 2014

Background:Rehabilitation professionals have long accepted the belief that engagement in meaningful activity contributes to human development and can enhance health and wellbeing. More recently, theorists have begun to discuss the importance not only of engagement in such activities, but the experience one has while engaging in them. With this shift, it is important for scholars of rehabilitation, in particular occupational therapy theorists and clinicians, to develop better ways to describe and measure occupational experience.Contents:This article considers how an understanding of occupational experience can be enhanced by taking up constructs in virtual reality theory that are similar to those in occupational therapy and occupational science, such as immersion, presence, flow, and embodiment. Correspondingly, the growing field of virtual reality can benefit from occupational therapists' and occupational scientists' work on occupational presence, therapeutic occupation, and the adaptation of contexts (including virtual contexts) to fit individual needs.Conclusions:As both virtual reality and occupational therapy continue to evolve, it is critical that scholars in each field look outside current paradigms to seek knowledge that is mutually beneficial to advancing understandings of human experience.
Stress of caring and nurses' beliefs in the stroke rehabilitation environment: a cross-sectional study
Authors: Joice Sara , Jones Martyn , Johnston Marie 
Published: May 2014

Background: Part of the multidisciplinary stroke unit team nurses report their role as complex and demanding. Aims: To explore stress of caring in nursing nurses'and its relationship with perception of the work environment and beliefs about stroke. Methods: This cross sectional study recruited a convenience sample of nursing staff from stroke units (n=44), 99% female; mean age 39 years (s.d. 9.6). The Stress of Caring Scale (SCS) and an adapted Illness Perception Questionnaire (IPQ-R: HP) were completed. The responses on the IPQ-R: HP were compared to stroke survivors (n=106) responses to the original IPQ-R completed in an earlier study. Results: Nurses' stress was positively correlated with perceptions of demand, strain and effort, and reward imbalance (P<.001) and negatively correlated with decisional control and helpfulness of support (P<05). Nurses believed stroke to incur greater symptoms, consequences, emotional impact, and a longer duration (P<.01) and that the patient's role and their treatment (P<.05) to be less salient than stroke survivors. Stress of caring was associated with the nurses’ beliefs about stroke (P<.05). Conclusions: Work environment and discrepancies between patients' and nurses’ beliefs may account for perceived stress and possibly impact on the nurse's role in rehabilitation.
Validity of individual test items of the Addenbrooke's Cognitive Examination-Revised (ACE-R) in stroke
Authors: Ferguson Heather , Lincoln Nadina B 
Published: May 2014

Aims: The Mini-Mental State Examination (MMSE) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) have poor validity for detecting cognitive impairment in stroke patients. The aim was to determine whether a combination of individual items could identify stroke patients with overall cognitive impairment or domain specific impairment as well as the full test. Method: Data was analysed from 34 stroke patients who completed the ACE-R and a neuropsychological test battery. Results: No individual items were found to reliably identify overall cognitive impairment. A combination of nine items from the ACE-R were as effective at identifying overall cognitive impairment and domain specific impairment as the MMSE and the full ACE-R. However these items were not an effective screening measure when compared to the results of the neuropsychological test battery. Conclusion: The ACE-R can be reduced to a nine item test with no loss of information but this is still not an adequate cognitive screening measure for detecting cognitive impairment in stroke patients.
Reliability of physiotherapists using the Pirani scoring system for clubfoot
Authors: Harvey Nicole , Daley Deborah , Mudge Anita , Sims Susan , Adams Roger 
Published: May 2014

Aim: The purpose of this study was to examine the intra-rater and inter-rater reliability of physiotherapists using the Pirani scoring system for clubfoot to score digital photographs of infants’ feet. Methods: Twelve infant feet were photographed to reflect variations in the six clinical signs of clubfoot. Physiotherapists viewed the photographs and scored the feet using the Pirani scoring system on two separate occasions. Results: Intra-rater reliability was excellent when scoring photographs, while inter-rater reliability was found to be fair to good for most subscales. Experienced therapists demonstrated higher reliability than novice therapists but not significantly so. Reliability was equivalent between the Pirani scoring system and a modified five-point scoring system created for this study. Scoring the rigidity of equinus subscale was found to be more reliable than the other subscales (P<0.01), which did not differ significantly from each other.
The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) for post-stroke cognitive impairment screening
Authors: Green Steven , Sinclair Emma , Rodgers Emma , Birks Emily , Lincoln Nadina 
Published: May 2014

Aims:Clinical guidelines recommend stroke patients are routinely screened for cognitive impairment. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was evaluated for screening for post-stroke cognitive impairment.Methods:The RBANS and a neuropsychological test battery were administered to 60 participants recruited from acute stroke wards.Results:Using a cut-off of < 70 points, the RBANS Total Index demonstrated 50% sensitivity and 100% specificity for detecting any cognitive impairment. ROC curve analysis identified an optimum total index cut-off score of < 84 points (sensitivity 84%; specificity 90%). The RBANS Indices did not have acceptable sensitivity and specificity using a cut-off of < 70 points. ROC curve analysis identified higher optimum cut-offs (sensitivity 79–89%; specificity 48–96%).Conclusion:The RBANS was an acceptable measure for detecting post-stroke cognitive impairment but does not include assessment of executive ability.