bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational therapy in the modern adult acute mental health setting: a review of current practice
Authors: Lloyd Chris , Lee Williams Philip 
Published: May 2014

Background Health care systems are changing and with them, the role and scope of occupational therapy. The inpatient mental health setting is one area where change has been rapid and expansive, directly impacting on the role of occupational therapy. Literature pertaining to the current practice of occupational therapy in this setting is currently overshadowed by a focus on community-based care. This article aims to describe and summarize the recently published literature regarding current practices of occupational therapy in this important setting. Methods Current practices were identified with reference to policy documents, text books and journal articles dating from 1990 to the present day. Findings There was found to be a paucity of current literature relating to occupational therapy practice in acute mental health. From the literature that was available, four core elements of occupational therapy practice in acute mental health were identified: individual assessment, individual treatment, therapeutic groups, and discharge planning. Conclusions It is suggested that the development and communication of the occupational therapy role focusing on the four core elements of practice will provide a sound base for the development of the clinical role of occupational therapy in acute mental health. Occupational therapists working in the acute mental health setting are encouraged to be aware of the available literature pertaining to this area and establish a renewed focus on clinical research to evaluate current practice and to guide debate on emerging occupational therapy roles.
Issues experienced by service users with an eating disorder: a qualitative investigation
Authors: Walker Sarah , Lloyd Chris 
Published: May 2014

Aims: This study examined the perceptions of treatment by service users who had been diagnosed with an eating disorder Methods: A qualitative research design using Consensual Qualitative Research (CQR) was used. A focus group was held where the discussion was guided by a semi-structured interview schedule. Three key domains were identified using the CQR procedure: therapeutic relationship, response of others, and treatment experiences. Conclusions: The pervasive theme that appeared to emerge throughout the session was the lack of understanding by others including family, friends and health professionals.
A smarter future: technology to enhance an independent lifestyle for our future selves
Authors: Evans Nina , Harris Nigel , Kuppuswamy Annapoorna 
Published: May 2014

Background: Technology plays an increasing role in our everyday lives, but we have yet to explore its full potential for supporting independent living. Content: This article gives an overview of the range of new telecare technology that is available and looks at some of the current challenges and future opportunities this presents. The evidence base for the effectiveness still needs to be established and more work is needed to quantify the benefits for carers. There are opportunities around the application of the technology to support independent living for people with dementia. We discuss our experiences and the potential for assistive technology. Conclusion: Although technology has great potential for supporting independent living, we are currently utilizing a fraction of this capacity. To fully realize its benefits, a systematic and cohesive approach across various sectors needs to be adopted.
The Longer Term Functional Impact of a Traumatic Hand Injury on People Living in a Regional Metropolitan Australian Location
Authors: Bell Joanna , Gray Marion , Kingston Gail 
Published: May 2014

Aims: This article describes a study exploring the longer term functional impact of a traumatic hand injury on people residing in a regional metropolitan Australian location. Methods: A descriptive cross sectional retrospective survey was sent to adult patients who received treatment for a traumatic hand injury from the occupational therapy clinic at a regional Australian hospital, 1-4 years post injury (n=498). The Upper Extremity Functional Index was included in the survey. Findings: Over 90% of respondents reported having ongoing residual difficulties. Participants indicated that the most affected areas were work and leisure. Almost half the respondents agreed or strongly agreed that the exercises ‘hurt too much to do’ (46%) and that they ‘did not have enough time’ to do exercises (34.5%). Conclusions: This study emphasized notable longer term impact of a traumatic hand injury on people residing in a metropolitan Australian location; especially in the areas of work and leisure. Findings indicate the need for some change in the delivery of rehabilitation programmes in an Australian regional metropolitan context. Holistic consideration of factors which may influence outcomes will improve rehabilitation programmes and, in turn, overall quality of life for individuals who sustain a traumatic hand injury.
The value of an inter-agency pathway for Attention Deficit Hyperactivity Disorder (ADHD)
Authors: Russell Lucy , Forbes Fiona , Forsyth Kirsty , Maciver Donald , Mulvanny Amanda , Whitehead Jacqueline 
Published: May 2014

Introduction: This article, co-authored by experts in research, child and adolescent mental health, occupational therapy and education services, considers service provision in Attention Deficit Hyperactivity Disorder (ADHD). Contents: This article outlines the roles of those who are involved in service provision for children and young people with ADHD, and identifies the challenges faced by ADHD services. Care pathways are then described, with details of factors that need to be considered in the mapping of potential local pathways. Conclusions: The development of local care pathways for the diagnosis and management of ADHD is suggested as a method of meeting the challenges identified.
Perceptions of physiotherapy students of a person-centred approach in rehabilitation
Authors: Schmitt Janet , Akroyd Karen , Akroyd Linda 
Published: May 2014

Aims: A person-centred approach is a core component of health care policy and professional standards in the UK. The aims of this study were to explore perceptions of final year physiotherapy students of a person-centred approach in rehabilitation and compare students' views of person-centred to service users' views as found in the literature. Methodology: A qualitative cross-sectional study was undertaken using elements of grounded theory. Data were collected from semi-structured focus group interviews and then analyzed using iterative content analysis. Results: The principles of a person-centred approach raised by participants included: patient empowerment and choice; information and education for patients; holistic approach; individualization of interventions; and family/carers'/providers' roles. Results indicate that there are key distinctions between the principles of a person-centred approach in rehabilitation considered important by service users in the literature and those perceived as important by final year physiotherapy students. Conclusions: Evidence suggests that the perceptions of the physiotherapy students are more closely aligned to the principles of a person-centred approach as defined by health care professionals, as compared to those defined by service users. Further research is required to ascertain the nature and prevalence of the power dynamic within the therapeutic relationship and its potential impact upon a person-centred approach to rehabilitation.
Occupational therapists' involvement views, and training needs of evidence-based practice: a rural perspective
Authors: Hu Dai 
Published: May 2014

Aim: To date, a number of studies on occupational therapists’ views and perceptions of evidence-based practice (EBP) have been published; however there has been little research with the same purposes focusing on therapists who work in rural areas in the UK. This study aims at exploring the perception, involvement and participation of EBP of occupational therapists in rural areas, and the indication of future improvements. Methods: A questionnaire reflecting practitioner's attitudes, involvement in EBP activities and training needs was mailed to 73 therapists who practice in one rural area in England. All of the 64 (response rate 87.7%) respondents were from one NHS trust, and the majority work in mental health/learning disability settings. Results: The results showed no significant difference between the sample and those who work in urban areas. Most participants were positive to EBP, but generally had a low involvement in EBP related activities due to various barriers. Postgraduate education demonstrated significant positive influence on perception and skills of EBP in the sample. Conclusion: How to integrate research findings into practice is the priority in future training, and a focus on multifaceted and innovative approaches, including their effectiveness, is important in promoting EBP.
Effect of The Back Book on fear-avoidance beliefs, disability, and pain levels in subjects with low back pain
Authors: Sparkes Valerie , Chidwick Nathan , Coales Philippa 
Published: May 2014

Background/Aim: The Back Book was designed as an evidenced-based booklet to change patients’ beliefs and behaviours regarding back pain. This information focused on encouragement of normal activity, avoiding too much rest and maintaining a positive attitude. Previous studies have shown that The Back Book, when combined with other management strategies, appears to have a positive effect on patients’ beliefs about back pain and clinical outcomes. This study aimed to determine the effect of The Back Book on attitudes towards back pain, function, and pain when given to patients on a waiting list to see a physiotherapist in a spinal pain clinic (SPC). Method: Subjects were recruited from a SPC waiting list and randomized into experimental and control groups. All subjects completed the Back Beliefs, Fear Avoidance Beliefs, and Roland Morris Disability questionnaires, and Visual Analogue Scale for pain before and after reading The Back Book or no intervention. Results: No statistical or clinical differences were seen in any of the outcome measures. Conclusion: This preliminary data suggests that The Back Book may not be suitable to be used in isolation. Further research should establish the most appropriate point and mode of delivery of this information.
The realist approach to evaluation research: an introduction
Authors: Hewitt Gillian , Sims Sarah , Harris Ruth 
Published: May 2014

Background: The realist approach is a form of theory-driven evaluation developed to strengthen the explanatory power of evaluation studies and contribute to evidence-based policy and practice. It is a generic approach that can be applied to many fields of research, including health and social care. Content: This article introduces the reader to the realist approach and outlines its application in empirical evaluation studies and literature syntheses. It describes how the realist researcher evaluates complex social interventions not by asking whether a particular programme or intervention ‘works’, but, recognising that all interventions only ever work for certain people in certain circumstances, by asking instead ‘what works for whom in what circumstances’? Realist researchers then try to articulate the theories (termed ‘mechanisms’) that underpin the programme and explore how contexts influence the mechanisms to produce different programme outcomes. Conclusions: Realist evaluation and realist synthesis are an advanced approach to evaluation research, but they offer an innovative and insightful means by which to further our understanding of complex social interventions.
Speech and language therapists’ understanding and adoption of evidence-based practice
Authors: Stephens Danielle , Upton Dominic 
Published: May 2014

Aim: This review aimed to explore the knowledge, understanding and attitudes held by speech and language therapists (SLTs) to evidence-based practice (EBP). Furthermore, it addresses the adoption of such a framework and how it could be increased within SLTs professional practice. Method: The review included research conducted between 1998 and 2011. Academic Search Complete, CINAHL Plus, Psyc Articles, Medline, Ingenta, Science Direct, JSTOR and Google Scholar, were searched using the terms ‘Evidence-Based Practice’, ‘Speech and Language Therapists’ and ‘Clinical Practice'0. Results: Research predominantly reports limited engagement with EBP. Findings continuously demonstrate how SLTs lack the skills required in order to conduct literature searches and assess relevant research evidence. Furthermore, the research base available to SLTs is of low level quality due to focusing principally on efficacy rather than effectiveness. Additionally, many barriers are evident, including lack of time, resources, skills and understanding, which prevent both conducting research and the implementation of EBP. Conclusion: Although SLTs tend to display high positive regard for EBP, these attitudes are rarely translated into practice. Due to the inadequacy of the current research base available to SLTs it is essential for SLT researchers and practitioners to combine efforts in order to ensure the reliability of future research. This will enable the expansion of relevant research whilst continually promoting EBP and SLT as a discipline.
Developing patient-centred care in health professionals: reflections on introducing service-learning into the curriculum
Authors: Roskell Carolyn , White Deborah , Bonner Cathy 
Published: May 2014

Background: This paper examines how professionalism is fostered to promote ‘patient-centred care’ in UK healthcare education and identifies challenges reported by educators. It reports a pilot study which introduced ‘service-learning’ into the dental and physiotherapy curricula as a strategy for promoting pertinent professional values and skills. Content: Undergraduate dental, and pre-registration postgraduate physiotherapy, students experienced service-learning via attendance at non-professional community placements, such as organising social events with homeless people, as part of their programme of study. Pre-placement preparation and post-placement debrief were offered. Evaluation data were obtained through focus groups, questionnaires, and interviews from students, placement providers and academic staff. Although the intervention was generally well received, important limitations emerged revealing new insights into difficulties with this type of learning for students, placement providers and institutions. Conclusion: Service-learning shows potential for enhancing capability to deliver patient-centre care. Lessons learnt from this project may usefully inform curriculum development in healthcare education and open up further avenues for research.
Are we missing any patients with serious spinal pathology?
Authors: Keillar Eden 
Published: May 2014

Background: Due to its rarity, serious spinal pathology (SSP) is often missed or misdiagnosed. The consequence of missing the vital signs and symptoms can be devastating for patients, their families and clinicians. At present, there appear to be no available NHS statistics on the prevalence rates of missed or misdiagnosed conditions in the UK. Aim: To identify whether a specialist physiotherapy-led back pain service misdiagnosed any patients with SSP between 2004–2008. Methods: Subject data was extracted from a back pain service database and International Classification of Disease (ICD) codes were used to identify patients diagnosed with SSP. The two data sources were cross matched to identify patients assessed by the specialist service and later diagnosed with SSP. Results: The database search identified 25 patients (0.2% of the total number of patient records) who had been diagnosed with SSP. Four patients had been misdiagnosed. Clinicians should be aware that there appears to be a small cohort of patients in which it is almost impossible to differentiate between simple mechanical lower back pain (LBP) and SSP early in its evolution. Conclusion: SSP continues to be rare; however, the risk of misdiagnosis remains. The emergence of new red flags and a growing body of evidence emphasising the importance of combinations of red flags raises the question over whether an up-to-date review of the red flag recommendation list is warranted.
Arm Activity measure (ArmA) application for recording functional gain following focal spasticity treatment
Authors: Ashford Stephen , Slade Mike , Nair Ajoy , Turner-Stokes Lynne 
Published: May 2014

Background and Aims: The Arm Activity measure (ArmA) is a new measure for recording the pattern of change in passive function after focal spasticity intervention. This study aimed to demonstrate the application of the ArmA for measuring passive and active functional movement. Methods An open-label prospective cohort study was conducted within a two-centre specialist spasticity management program. Outcome measures used were the ArmA, the Modified Ashworth Scale (MAS) and the Leeds Adult Spasticity Impact Scale (LASIS). Measurement was undertaken at baseline, at 8 weeks and at 16 weeks. Participants (n=58) presenting for treatment of upper limb spasticity were included and comprised of 32 men and 26 women, with a mean age of 47 years (SD=17.5). Participants received a single administration of BoNT (Dysport®, Ipsen, Slough, UK; or BOTOX®, Allergan, Irvine, CA, USA) following baseline assessment as part of routine clinical practice. Results Significant changes were demonstrated over the 16-week period in both the MAS (Xr2=66.6; P<0.005) and the ArmA passive function subscale (Xr2=11.9; P<0.005) (e.g. improved ease of dressing and hygiene). No change was identified in the ArmA active function subscale. Comparison of change at individual time-points showed the gain in passive function to be maintained at 16 weeks (Z=-2.6; P<0.01). Conclusion Significant gains in passive function were recorded by ArmA at 8 weeks, and maintained at 16 weeks post-injection in the context of on-going physical intervention.
A pilot study to investigate the muscle strength of children infected with HIV
Authors: Humphries Carolyn , Potterton Joanne , Mudzi Witness 
Published: May 2014

Background/aimsPaediatric HIV remains a significant challenge to children and caregivers in South Africa. Little is known about the effect of HIV infection on muscle strength in children, however potential decrease in muscle strength has been inferred to affect functional ability in these children. The aim of this pilot study was to compare the muscle strength of children infected with HIV who had been receiving highly active antiretroviral therapy (HAART) to that of children infected with HIV not receiving HAART.MethodsThe study population included a group of 16 children receiving HAART and 16 children not receiving HAART. A one-off test of muscle strength was undertaken using a hand-held dynamometer for the child, and a demographic questionnaire and social status index to their primary caregiver. Two-sample student t tests, Pearson correlation analyses, and backward regression analyses were used to analyse data.ResultsThe cluster of differentiation (CD4) count of the group on HAART was significantly higher than the group not receiving HAART. The group not receiving HAART was stronger than the HAART group. No significant correlation was shown between length of time having received HAART and muscle strength, or between CD4 count and muscle strength in the group receiving HAART. A significant negative correlation was shown between CD4 count and muscle strength in the group not receiving HAART.ConclusionFurther research is needed to establish the impact of earlier administration of HAART on muscle strength in children infected with HIV.
Evaluation and conservative treatment for Osgood-Schlatter disease: A critical review of the literature
Authors: Kabiri Laura , Tapley Howell , Tapley Stasia 
Published: May 2014

Background Osgood-Schlatter disease (OSD) is a tibial tubercle traction apophysitis resulting from repetitive strain on the patellar tendon insertion. OSD can lead to significant functional limitations and disability that can persist into adulthood. Methods The authors of this review systematically searched PubMed, CINAHL, TWUniversal, and The Cochrane Library for articles dated from January 1980 to December 2013 that related to the evaluation and conservative treatment of Osgood-Schlatter disease. Search phrases included ‘Osgood-Schlatter disease AND diagnosis’ and ‘Osgood-Schlatter disease AND treatment’. Articles were assessed for evidence strength based upon modified criteria from the evidence-based medicine pyramid and the diagnosis and treatment sections of the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Table. Findings There is a wealth of evidence to support a clinical diagnosis of Osgood-Schlatter disease. There is also fair evidence to employ functional outcome measures during evaluation. Evidence concerning conservative treatments for Osgood-Schlatter disease ranges from poor to strong based upon the intervention. Conclusion While strong evidence for clinical diagnosis is supported by the literature, further research is required to establish definitive functional outcome measures and effective interventions in the management of Osgood-Schlatter disease.
A review of nasogastric tube management in children 1: Enteral feeding
Authors: Clarke Sonya , Richardson Olga 
Published: May 2014

This first article of two identifies the primary themes in the literature regarding nasogastric tube management in children. The principal focus is a critical evaluation of the methods, effects, experiences and outcomes of the primary theme, nasogastric tube feeding in children. This article concludes with the implications and recommendations for future nursing practice. The in-depth critical review encompassed a systematic and rigorous search of appropriate healthcare databases using appropriate search terms in conjunction with preset inclusion and exclusion criteria. The review divided the harvested primary papers into three key themes: enteral feeding via the nasogastric tube (considered here); confirmation of tube position and associated incidence of tube placement error; hydration via the nasogastric tube for acute gastroenteritis in children. Valid and reliable methods were used to grade and appraise the culled papers so that conclusions could be drawn and recommendations made. Three primary literary themes are identified from this investigation. The primary theme, enteral feeding using the nasogastric tube is contraindicated for a selection of children. In spite of these findings empirical evidence suggests the nasogastric tube as a safe and effective method for short term feeding in children with a variety of chronic conditions that can be regularly used at home and in hospital. Health professionals need to review their practice in relation to nasogastric tube management in children, and ensure their practice reflects the best available evidence.