bluuebunny/crossref_metadata_2025_split huggingface dataset:
Allied health professional's views on palliative care for people with advanced Parkinson's disease
Authors: Waldron Mary , Kernohan W George , Hasson Felicity , Foster Susan , Cochrane Barbara , Payne Cathy 
Published: May 2014

Mary Waldron, W George Kernohan, Felicity Hasson, Susan Foster, Barbara Cochrane, Cathy Payne Aims: Allied health professionals (AHPs) have a key role in the delivery of palliative care through rehabilitation. However, evidence suggests that rehabilitation remains an area of neglect in palliative care. This study explores the views of allied health professionals in delivering rehabilitation in palliative care to people with Parkinson's disease. Methods: Twelve allied health professionals, from both generalist and specialist settings, who had experience of working with people with advanced Parkinson's disease and/or palliative care took part in interviews and/or focus groups. Findings: Participants viewed palliative care as holistic care, however, the rehabilitation care they provided was impeded by a number of personal and organisational barriers, and negative perceptions. Misconceptions as to the value of rehabilitation in the palliative stage and a lack of training resulted in uncertainty as to when and how it could be introduced. While the importance of early referral to AHP rehabilitation services was highlighted, organisational and administrative barriers prevented many people from accessing such care. Conclusions: Many health professionals have a role in palliative rehabilitation, but barriers prevent early referral and ongoing access to such services. There is a need to educate professionals in the principles of palliative rehabilitation, combined with providing targeted resources to promote shared care and responsibility.
A clinical pathway for management of fractured ankles can be used to identify course of recovery and resource use
Authors: Page Carolyn , Brock Kim , Black Susan 
Published: May 2014

Carolyn Page, Kim Brock, Susan Black Aims: This article describes a study investigating the use of a clinical pathway for the management of fractured ankles and seeking to identify the usual course of recovery for patients treated according to the pathway for both conservative and surgical management. Methods: The study was a prospective, observational cohort study The participants were 63 patients who had sustained a fractured ankle and could weight bear The outcome measures were the Ankle Lunge Test (ALT), Lower Extremity Functional Scale, swelling, and 10m walk test. Findings: Compliance in documenting key items of assessment on the pathway ranged between 52% and 91%. Adherence to recommended interventions was above 60% for most recommendations. The number of weeks attending physiotherapy had a mean of 6.6 (SD 3.3). There was a correlation of r = 0.44 between ALT at week 1 and week of discharge (p > 0.01), with those having poor ALT results more likely to have prolonged treatment. The surgically treated group had a significantly poorer ALT at week one (p < 0.01), continued to make slower recovery at week three (p < 0.001) and, overall, had a significantly longer period of physiotherapy. Conclusions: A structured clinical pathway for fractured ankles is an effective and efficient way to collect data on this population and has the capacity to detect patients that fail to progress as normal.
How Students with Low Level Subjective Wellbeing Perceive the Impact of the Environment on Occupational Behaviour
Authors: Yazdani Farzaneh 
Published: May 2014

Aims: This article describes a study exploring what students with a low level of subjective wellbeing and satisfaction with life perceive as the impact of the environment on their occupational behaviour in the Arabic Muslim context in Jordan. The study explored the way students explain their occupational adaptation - their dissatisfaction with environmental demands and supports and its relation to their occupational behaviour.Methods: A qualitative approach was used with a purposive sample of ten students who had been assigned as having a low level of subjective wellbeing and satisfaction with life. An in-depth interview, guided by the concepts of the Model of Human Occupation (MOHO), was carried out with these students to explore the cultural specifics of their environment.Findings: Many students perceive their problems to be mostly related to the discrepancy between their own established values, and the new demands of a less traditional lifestyle. A student's environment has a significant impact on the way they identify with values.Conclusions: The outcomes of the study will help counsellors understand the atmosphere of student life in the Arab Muslim context, as well as contexts with a similar perspective. It also emphasizes the importance of validating environmental elements which impact on students’ occupational behaviour in different cultures.
Effect of physical exercise-movement strategies programme on mobility, falls, and quality of life in Parkinson's disease
Authors: Georgy Ehab , Barsnley Susan , Chellappa Rajesh 
Published: May 2014

Background: Parkinson's disease (PD) is an incurable, progressive neurodegenerative disorder that gradually results in accumulating disability. Evidence suggests that specific interventions, for example, physical exercise and movement strategy training, can improve some of the PD-associated problems and enhance quality of life. The aim of this paper is to demonstrate the effect of a tailored rehabilitation programme, comprising of a combination of exercise therapy and movement strategy training, on falls risk, mobility, and quality of life in people with PD. Methods: A prospective longitudinal design, with 1- and 2-year follow-up, was conducted, where fifteen people with idiopathic PD and average age of 76.1 years attended weekly, then biweekly 90-minute rehabilitation sessions that focused on exercise therapy and movement strategy training. Outcome measures were assessed at baseline and at 1- and 2-year, which included self-reported number of falls, Freezing of Gait Questionnaire, Tinetti falls assessment tool, and Parkinson's Disease Questionnaire (PDQ-39). Results: At 1-year, a significant improvement was identified in gait freezing and Tinetti scores, as well as a statistically significant reduction in the number of falls and falls risk. Several aspects of the PDQ-39 have also improved. Some of the effects continued to exist through year two, but the improvement has not been consistent compared to year one. Conclusion: A combination of regular exercise and movement strategy training has the potential for reducing falls risk, and improving mobility (less gait freezing) and quality of life of people with PD.
The lived experience of freezing in people with Parkinson's: an interpretive phenomenological approach
Authors: Redmond Lucy , Suddick Kitty 
Published: May 2014

Background/Aims: The aim of this study was to explore the experience of freezing for people with Parkinson's where there is currently limited understanding. Methods: An interpretive phenomenological approach was used. Semi-structured interviews were undertaken with a purposive sample of 6 participants from the UK in 2009. The first interview was undertaken in person and the next five by telephone. The interviews were transcribed verbatim and thematically analysed. Findings: The experience, triggers, and methods used to overcome or cope with freezing were individual and varied. Freezing was experienced as an entity, which was unpredictable and uncontrollable. Its impact was a heightened physical awareness, and a feeling of separation and alienation from one's body. This affected the person's emotions and heightened the link between their emotional and physical self. Conclusions: The findings of this small scale study highlight the need for further research into the lived experience of people with Parkinson's. They have provided a starting point for generating greater understanding of freezing, by those who experience it. Further work may be needed to explore and broaden this concept. The implementation of coping and supportive strategies that emphasize the emotional consequences, impact on daily life, and relationships may be warranted.
Alcohol disorders and older people: a preliminary exploration of healthcare professionals’ knowledge, in Ireland
Authors: Waldron Ashleigh , McGrath Margaret 
Published: May 2014

Aims: To explore knowledge of alcohol disorders in older adults among healthcare professionals in Ireland. Methods: A cross sectional postal survey of 480 healthcare professionals was conducted. Knowledge was explored using 25 true/false statements which focused on four key areas relating to alcohol disorders among older people: (i) general knowledge of alcohol disorders among older people (ii) impacts of alcohol disorders on health outcomes for older people (iii) management of alcohol disorders among older people and (iv) treatment of alcohol disorders in older people. Demographic data was gathered using a short form designed for the study. Findings: 157 usable surveys were returned giving a response rate of 33%. The majority of respondents had not undertaken specialist training in alcohol disorders among older people. However despite this, overall knowledge of the topic was high. The mean score was 17.9 (SD 2.6) out of a possible 25. The study identified gaps in participants’ knowledge of intervention strategies for alcohol disorders among older people. A statistically significant difference in knowledge was found between professional groups with psychologists having significantly higher scores than occupational therapists. Professionals who spent less than 50% of their clinical time working with older adults had significantly higher knowledge scores than those who spent 100% of their time working with older people. Conclusions: The findings suggest that healthcare professionals in Ireland would benefit from further education which focuses on intervention strategies in order to ensure that the need of older people with alcohol disorders are appropriately addressed.
Applications of whole body vibration therapy in the clinical setting: a brief review
Authors: Kessler Nathan , Kim Sylvia , McGeehan Michael , Hong Junggi 
Published: May 2014

Introduction: Whole body vibration therapy (WBV) is an emerging treatment modality that is currently being applied to many age-related chronic conditions including balance and gait deficiencies, fibromyalgia, multiple sclerosis, cystic fibrosis, Parkinson's disease, and peripheral neuropathy. However, while many preliminary studies have demonstrated intriguing results for WBV as a therapy for several chronic conditions, WBV remains an enigma in the medical community, partially due to a lack of any comprehensive reviews of the literature. The purpose of this study is to provide a concise review of the theoretical basis for whole body vibration as well as its experimental clinical applications. Methods: 38 studies were included, which examined the application of WBV for six known conditions. Since few trials have been conducted, specific inclusion criteria based on study methodology were deemed to be inappropriate for this review. Results: This review shows conclusive results supporting the use of WBV therapy for improving balance and gait deficiencies as well as reducing pain symptoms associated with fibromyalgia, Parkinson's disease, and peripheral neuropathy. Inconclusive results were found for the effects of WBV therapy on cystic fibrosis and multiple sclerosis. Conclusions: WBV therapy appears to be an effective non-pharmaceutical treatment alternative for improving balance and gait deficiencies as well as symptoms associated with fibromyalgia, Parkinson's disease, and peripheral neuropathy. It may also be a good complimentary aspect of physical therapy protocols for some of these conditions. However, the effectiveness of WBV for treatment of cystic fibrosis and multiple sclerosis remains unknown.
Managing widowhood in later life: The challenges encountered
Authors: Collins Tracy 
Published: May 2014

Background/aim Widowhood in later life is a transition experienced by many older people, particularly older women. This paper explores the challenges encountered by a group of older women experiencing the loss of a spouse or partner. Methods The data is drawn from a longitudinal study exploring the significance of personal communities in managing the transition of later life widowhood. A series of qualitative interviews were conducted with 26 older widows (62–90 years of age) over a period of 18 months. Interview transcripts were subjected to thematic analysis. Results This paper presents a number of themes from the women's accounts of their Christmas celebrations and their Christmas cards, which illustrate the challenges to managing widowhood in later life. Themes included: family friction, dependence, additional losses, over commitment, passivity and feeling different. Conclusion The findings reveal that Christmas can be an isolating and excluding experience for some older women, and that widowhood can be compounded by age-related illness, and the loss of social relationships and roles in later life. The research has a number of implications for practice with older women who are widows.
Convergent validity of a newly developed occupational performance assessment: A pilot study
Authors: Ikiugu Moses N 
Published: May 2014

Aim: This pilot study aimed to investigate the validity of an assessment for instrumental use of the mind: the Assessment and Intervention Instrument for Instrumentalism in Occupational Therapy (AIIIOT). The AIIIOT is used to guide individuals being assessed in developing personal mission statements to guide their lives. The individuals then assess themselves on perceived frequency, adequacy, satisfaction, and belief in ability to perform occupations that would help them achieve the stated missions. Method: The validity of the AIIIOT in evaluating occupational performance was investigated by comparing it with the Canadian Occupational Performance Measure (COPM). Eleven people, aged 19–58 years, comprising of nine women and two men, participated in this convergent validity study. Data were gathered using the AIIIOT and the COPM. Pearson moment correlation and linear regression analyses were conducted to determine the convergent and predictive validities. Results: The participants' AIIIOT belief scores were correlated with the COPM performance and satisfaction scores, indicating that the AIIIOT belief scale had convergent validity. The AIIIOT belief scores were good predictors for the performance and satisfaction with performance of prioritised occupations as measured on the COPM. The AIIIOT adequacy scores were good predictors for the AIIIOT Frequency scores. Adequacy scores were also good predictors of the AIIIOT satisfaction scores. Conclusion: The above findings suggested that the AIIIOT had reasonable convergent and predictive validities. Further research with larger, more representative samples is indicated to confirm these findings.
Assessing functional ability in older patients
Authors: Nielsen Louise Møeldrup , Maribo Thomas , Nielsen Hanne Grethe , Jensen Jonna , Petersen Kirsten 
Published: May 2014

Aim:This study aimed to develop an understanding of how primary and secondary care health professionals perceive current practice and challenges in assessing older patients' functional abilities. A secondary aim was to gain insight into how these professionals perceive the need for generic tools for assessing functional ability among older patients.Method:A qualitative design was used to explore health professionals' perspectives on the assessment of older patients' functional ability. Two groups of health professionals participated in focus group interviews, with one group for each of the two different settings: the local hospital and the municipality.Results:Focus group interviews showed that health professionals in the hospital and the municipality expressed the need for an observation-based tool to predict and guide decisions about the rehabilitation needs of older patients. Participants from the hospital expressed a need for a fast and simple screening tool to identify those in need of further rehabilitation and care after discharge. Participants from the municipality expressed a need for a more detailed assessment tool to capture information about patients' ability to perform daily activities, any need for food delivery, and information about social relationships and home environment.Conclusion:The health professionals at the hospital and in the municipality had different expectations when it comes to assessment tools. All participants would like a simple tool that is quick to administer, to assess the quality of functional ability and predict the need for rehabilitation. The different context (hospital or primary care) seems to influence the way health professionals perceive the need for assessment of functional ability in older patients.
Managing hypoglycaemia
Authors: Holt Paula 
Published: May 2014

Overall key pointsHypoglycaemia is a life-threatening side effect of insulin and oral insulin secretagogue therapy. Many lifestyle issues contribute to the development of hypoglycaemia. Common causes include injection technique, insulin errors and mistiming of medication. All healthcare professionals who care for people with diabetes must have a thorough understanding of the causes and effective treatment of hypoglycaemia.
Work readiness in paramedic graduates: what are employers looking for?
Authors: O'Brien Kylie , Hartley Peter , Dawson David , Quick Jason , Moore Amber 
Published: May 2014

Background: This study investigated the perceptions of employers on workplace readiness of paramedic graduates from Australian paramedic education programmes. Objective: The investigators sought an understanding of what skills and knowledge are required by employers from a graduate paramedic in order to inform educators and improve the work preparedness capabilities of graduates of Australia paramedic education programmes. Design: In-depth, one-on-one, semi-structured, qualitative interviews were carried out in person or by telephone. Study participants: Senior operational and educational personnel representatives from Australian employers of paramedic degree graduates. Analysis and main outcome measures: Interview data from 11 interviews was analysed using thematic analysis. Results: Employers perceived new graduates to be work ready for supervised practice, but not independent practice. Employers understood work readiness along a continuum of skill development, and that this was developed in partnership with universities. Graduate attributes were highly desired by employers, and were seen to align well with organisational values. Employers reported that university graduates often lacked significant life experience and clinical experiences relevant to the work environment; however, they understood that it was the employers role to adapt to this and to provide and support the integration of these developing experiences in the clinical setting. Conclusions: This study provides new insight into the expectations and observations of paramedic employers within Australia. The results from this study may inform further educational and professional development opportunities resulting in improvements within the field of paramedicine.
Evidence-based practice: non-invasive blood pressure measurement in children
Authors: Summers Kathryn 
Published: May 2014

Blood pressure (BP) reflects a person’s cardiovascular status. BP alterations may indicate particular diseases, response to illness, and outcomes of treatment. Systolic and diastolic BPs rose substantially in children and teenagers between 1988 and 2004 (Muntner et al, 2004). In children, hypertension is most often associated with coarctation of the aorta or renal disease; more recently it has been linked to obesity (National High Blood Pressure Education Program Working Group, 2004). For premature neonates, rapid recognition of hypotension is crucial in preventing cerebral complications (Strebor, 2005). For these reasons, BP measurement is a skill frequently performed by nurses and healthcare workers in a variety of paediatric settings.However, the variety of devices used for measuring BP and the advent of automated BP measurement has resulted in many nurses losing this valuable skill. Few nurses are aware of the potential inaccuracy of automated machines (Schell et al, 2006) and there are studies indicate a disturbing lack of clarity among practitioners about the basic recommendations for accurate BP measurement. This often results in children receiving sub-optimal care. This review aims to demonstrate the complexities of measuring BP in children, highlighting an awareness of the limitations of automated machines and provide recommendations for good practice when measuring BP in children.
Understanding participation in activities and quality of life in children with cerebral palsy
Authors: McManus Vicki 
Published: May 2014

Cerebral palsy (CP) is the most common cause of physical disability in children. The impact of CP on quality of life is not well understood. This paper explores the literature to understand what participation in everyday activities and quality of life means for children living with CP and their families.Quality of life and participation in disability, namely CP, are starting to be researched but the longitudinal element of QOL has not yet been done.Further studies based on longitudinal designs should be carried out to determine the quality of life and activity levels of these children long into adult life.
The K Wire Project: removal of percutaneous kirschner wires from children without general anaesthetic
Authors: Moreton Mary Lucy , Proctor Ishbel , Henderson Annette , Robb JE 
Published: May 2014

Percutaneous Kirschner (K) wires are used to hold the position of a fracture of a bone following manipulation under anaesthetic. The K wire is left protruding through the skin so that the wire can be removed as the fracture heals. This audit reviews a change in practice in the removal of K wires without a general anaesthetic (GA), which resulted in ‘The K Wire Project’, which set a standard of treatment and a clinical pathway for these children. The change in practice proposal offered a less invasive procedure for the children and their families and reduced the time the child had to spend in hospital. This was a collaborative project which involved developing the skills of the paediatric orthopaedic practitioner combined with preparation and distraction techniques facilitated by the hospital play specialist. The project set a standard of treatment and a clinical pathway for these children. Before June 2001 children attending the Royal Hospital for Sick Children in Edinburgh (RHSC), who required having K wires removed, were admitted to the Day Care Unit (DCU) to have the procedure carried out under GA. Occasionally, the orthopaedic surgeon would consider the child ‘old enough’ to have the wire removed in the Fracture Clinic. This was not usually planned and children who had the procedure carried out in the fracture clinic received very little, if any, preparation and distraction for the procedure. However, orthopaedic surgeons and anaesthetists felt that in many cases this short procedure could be undertaken in a controlled environment, with the child awake.