bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pilot evaluation of an inpatient neurological rehabilitation programme
Authors: Guerrier Sue , Kneebone Ian 
Published: May 2014

Evaluation systems for rehabilitation services are required so that financial providers, service users and those involved in service delivery can assess their efficacy. This article reports on a pilot study to assess a community hospital inpatient rehabilitation unit service, in terms of client change from admission to discharge, using routinely administered measures: the Functional Assessment Measure and the Northwick Park Dependency Scale. Cases considered were acute admissions, predominantly clients with neurological diagnoses. The measurements taken demonstrated a positive change in all areas assessed for the majority of clients. A minority of clients showed no change. It is recommended that future evaluations incorporate goal-achievement measures, in order to assess whether the unit's services have helped clients to reach their specific goals, and consider clients' views of the service. It is also suggested that the financial impact of the service should receive attention and that variation coding might help to identify the reasons why some clients might not benefit from the programme.
An audit of an evidence-based assessment tool for the blue badge disabled parking scheme
Authors: Morrissey N , Guyan P , Alexander CM 
Published: May 2014

Those who have difficulty walking are eligible for a ‘blue badge’, which gives extra parking rights. An evidence-based assessment was introduced to assess applicants' eligibility for this badge. The assessment consisted of an interview, symptom scaling, falls risk assessment (including functional reach) and a walk test. In total, 226 assessments were carried out in a 6-month period. The discriminant analysis using all parts of the assessment gave 95% compliance and a cross validation value of 88%. Post-assessment, awards of badges decreased by 12% and appeals decreased by 25%. All parts of the assessment were found to be useful in helping to make a decision. Answers from the assessment could predict the eligibility for 88% of the time. Consequently, therapists' knowledge and experience is still necessary. Using a face-to-face evidence-based assessment reduced the potential for abuse, decreased the amount of appeals and made the decision-making process more transparent.
Hypermobility syndrome and developmental coordination disorder: Similarities and features
Authors: Kirby Amanda , Davies Rhys , Bryant Amy 
Published: May 2014

Children with movement difficulties can follow a number of different pathways to reach a diagnosis. They may receive a diagnosis of developmental coordination disorder (DCD) after being referred to an occupational therapist or paediatrician via school or parents, because of functional difficulties that impact on activities of daily living, such as dressing and feeding, or because of an impact on education, such as writing and ball skills. In contrast, children may present to rheumatologists or physiotherapists for joint pain, dislocation or late developmental milestones. These children may subsequently be diagnosed as having benign joint hypermobility syndrome (BJHS). This article contrasts and compares functional difficulties between these two groups and considers whether BJHS could be associated with DCD. In addition, the article considers whether there is the potential for not diagnosing or misdiagnosing these children through lack of awareness by professionals and because of differing assessment routes. The data from this survey show that children with BJHS do have a range of functional difficulties similar to those with DCD, and discusses the implications of this for management by the different professionals involved, and the potential for further research.
Improving hospital compliance with the Disability Discrimination Act through use of an audit
Authors: Singh Rajiv , Pentland Brian 
Published: May 2014

The 1995 Disability Discrimination Act protects disabled people from discrimination in access to services, facilities and goods, as well as in education and employment. All hospitals have an inherent duty to enable access to services, but this will now be enshrined in law. As the health sector has most contact with disability, it may be expected that most hospitals would already be in a good position to comply with the Act, especially one treating many patients with disability. However, the authors of this article identified many problems in a rehabilitation hospital setting by means of a simple access audit in March 2004. Recommendations were made and by March 2005, considerable improvements had been made, costing £100 000. This article details the results of the survey and the measures taken to improve compliance. It also discusses the constraints and opportunities to improve facilities for people with disability. Although many necessary changes will be expensive, not all problems identified require costly correction. Many simply involve a change in staff attitudes and practices. The authors recommend that all hospitals start to identify the changes needed under the Act by means of a simple access audit that can be carried out by hospital staff with no specialist equipment.
Increasing practitioner knowledge of falls in older people: Role of higher education
Authors: Newman Ann , Jensen Jan 
Published: May 2014

This article sets the context and justifies the need for post-registration interprofessional education on the prevention and management of falls in the older person. It describes the collaboration involved in the development of an interprofessional module entitled ‘Assessment, management and reduction of falls in the older person’ at Canterbury Christ Church University College. The module content was based on evolving evidence from the National Institute of Clinical Excellence. The module was delivered for the first time in the academic year 2004–2005. It is proposed to evaluate the effect of this module on practitioner knowledge, understanding and contribution to the delivery of an integrated falls service in 2006.
Does taping control the foot during walking for people who have had a stroke?
Authors: Hillier Susan L , Masters R 
Published: May 2014

This pilot study investigated the potential effects of inversion-control ankle taping on the timing and distribution of plantar pressures in the hemiplegic foot during the stance phase of gait. Five subjects with residual left hemiplegia after stroke and equinovarus foot posture participated in the single-case design study. The Emed-AT-2 force plate system was used to measure and analyse specific plantar pressure variables, including time to heel strike, contact area and maximum mean pressure under the total surface of the foot. Subjective reports of functional gait were also recorded. Descriptive statistics were calculated for the analysis of results. All subjects achieved earlier heel-strike under the taped condition. Changes in other gait parameters appeared to depend on the individual subject characteristics. This study has identified beneficial effects and further research is warranted to confirm the use of ankle taping as a quick and affordable gait re-education tool after stroke.
Implementing evidence-based practice: A model for change
Authors: Plastow Nicola Ann 
Published: May 2014

Evidence-based practice is a crucial part of professional conduct for practicing allied health professionals. Rosenberg and Donald (1995) identified the well-recognized four steps to evidence-based practice, which include identifying the clinical question, finding and critically evaluating the evidence and finally implementing the evidence. To date there is a wide variety of literature available describing evidence-based practice and methods of critically evaluating the literature, however, there are few articles describing how to promote change on the basis of evidence found. This article aims to outline a model for changing practice for health professionals at all levels of practice. The model uses broad organizational development and project management principles. It is applicable for managing change both within organizations and at an individual level and will be useful to a range of allied health professionals.
Psychoneuroimmunology and occupational therapy for inflammatory disorders
Authors: Mailoo Venthan J 
Published: May 2014

The occupational therapy profession was founded in 1917 on the notion that occupations contribute to psychological well being and physical adaptation. The credibility of occupational therapy has been threatened because the scientific basis of this notion is not always evident. The focus of occupational therapy in many physical settings has therefore shifted away from its original ethos towards one of physical problem solving and discharge facilitation. Psychoneuroimmunology (PNI) is a developing branch of science that provides a theoretical framework to support the profession’s return to its original ethos of using occupations to promote health. This paper is an analysis of psychoneuroimmunological evidence to support occupational therapy for inflammatory disorders. A broad literature search revealed mind-body inflammatory pathways including anatomical links, nerve growth factor, adrenocorticotrophin, cortisol, somatostatin and substance-P.
Tools for daily living: An equipment guide
Authors: Fernandes Tanya 
Published: May 2014

Assistive equipment and devices should enable those with disabilities to engage in, and carry out every day tasks. There are many different types of tools available that can be employed within the home to make tasks such as, eating, drinking, getting up and down the stairs, in and out of the bath and bed much easier This article will focus on the different areas of the home, looking at the most suitable types of equipment available that can be used to solve mobility issues and general impairments of function.
The aptitudes of allied health professionals working in remote communities
Authors: Thomas Yvonne , Clark Michele 
Published: May 2014

This study aimed to identify the aptitudes required in allied health professionals working in three different service delivery models serving remote locations in Northern tropical Australia. Eighteen allied health professionals including; dietetics, diabetes educators, occupational therapy, physiotherapy, psychology, podiatry, social work and speech pathology participated in this exploratory study using a narrative approach. A range of aptitudes were identified and themed under the following headings: (1) being organized but flexible, (2) cooperation and mediation, (3) culturally aware and accepting communicators, (4) knowing the community, (5) resourcefulness and resilience and (6) reflectivity. Limiting factors were also deduced. Three of the themes are discussed in this paper. The study found that allied health professionals working in remote settings identified as important personal attributes not necessarily valued in metropolitan settings. Recruitment processes and education programs need to recognize the importance of personal attributes as well as professional skills.
Working with Asian individuals: Advancing the New Zealand mental health workforce
Authors: Nayar Shoba , Tse Samson , Woh Wong Sai , Wali Renuka , Thapliyal Anil , Bhui Kamaldeep 
Published: May 2014

In 2005, the Asian Mental Health Workforce Development Feasibility Project was published in New Zealand. A key recommendation from the report was for the development of an education programme to increase the workforce’s cultural responsiveness to address Asian individuals' mental health needs at a national level. Drawing on models of teaching and learning and literature identifying cultural capability, and in consultation with service users and workshop participants, a two-day education programme was developed and implemented in four cities. Demand for the workshops was high and initial evaluations showed a positive response in terms of mental health professionals gaining knowledge and enhanced understanding of best practices when working with Asian individuals. However, this project has to be seen as a beginning towards implementing a training programme at a nation wide level. The aim of this paper is to present the education programme and evaluation results as delivered across New Zealand.
Can the type of walking stick issued effect mobility, confidence or fear of falling?
Authors: Marston Adrian 
Published: May 2014

A previous qualitative pilot study found that using a moulded handle stick (Fischer stick) compared to conventional sticks could improve mobility through increased confidence and reduced fear of falling in the elderly patient. However, this was not statistically significant to refer to the general population. The aim of this study was to provide the missing statistical data concerning increased confidence and reduced fear of falling when issuing sticks to elderly patients with ‘non arthritic hands’. An inferential study of experimental design by randomized control trial, allocating participants (n=47 aged 60–90years mean 80years) into one of two groups – moulded stick or conventional stick. An objective measure ‘Timed Up and Go’ (TUG) detected changes in mobility, with the Likert Scale detecting the changes in confidence and fear of falling over a 6-week evaluation period. The moulded stick group showed a significant increase in mobility, confidence and a marginally reduced fear of falling (P<0.001), compared to the conventional stick group that showed little or no change in all tests. This study infers statistical significance to the findings of the pilot study validating that there are substantial benefits in using a moulded handle stick over a conventional stick for the general elderly population.
Making disability equipment ordinary: Choice, control and the retail model
Authors: Winchcombe Maggie 
Published: May 2014

Research into the experiences of disabled people who use charitable funds to get the equipment they need for health or social reasons has brought the shortcomings of public services and professional practice into sharp relief. Findings have been substantiated by a government report on wheelchair services and have fed into government plans for major re-organization of community equipment services, within planned reforms to adult social care. The retail model, proposed by the Department of Health, is currently only being implemented in England and is not mandatory. Exploration of developments internationally would enlighten practitioners who are engaged in developing service delivery models. This article discusses the implications of the issues raised by the reports and the proposed changes in social care, in relation to practice for therapists and other providers of community equipment in England. Wider availability via mainstream retail outlets will, far from diminishing the roles of health professionals, create greater awareness and take-up of this equipment and will allow professionals to work to their strengths as therapists and be truer to their codes of professional ethics, rather than ‘gatekeepers’ of the state purse. Current practice will need to change in order for clients (patients) to achieve the outcomes they require from the intervention rather than those bound by organizational or professional concerns. This will require a shift in focus towards a partnership approach in which the experience and skills of the client are given equal weight with those of the practitioner.
Physiotherapy as a profession: Where are we now?
Authors: Kell Clare , Owen Gwyn 
Published: May 2014

In the early 21st century physiotherapy the UK is experiencing unprecedented challenges to its practice and professional project as it responds to both changes in health-care design and delivery and developments in science and technology. This article analyses a wide range of discipline-specifi c and generic literature addressing the sociology of ‘profession’ to explore the impact of the changing contexts and demands of practice on the identity and professional claim of physiotherapy. The article aims to frame a discussion about 21st century professionalism in the historical and theoretical context of the profession. While the article explicitly explores physiotherapy in the UK context, the issues addressed will be of interest and relevance to all health-care professionals exploring their role in relation to the state and wider society.
Patient satisfaction with circuit class therapy and individual physiotherapy
Authors: Lynch Elizabeth , Harling Rachel , English Coralie , Stiller Kathy 
Published: May 2014

The purpose of this observational study was to determine patients' levels of satisfaction with circuit class therapy and individual physiotherapy sessions on a stroke rehabilitation unit. Forty-nine persons participated in both circuit class therapy and individual physiotherapy sessions as part of standard inpatient rehabilitation following stroke. A purpose-designed questionnaire was administered to investigate patient satisfaction. High degrees of satisfaction were reported with both methods of physiotherapy service delivery. Individual sessions were perceived as being more tailored to participants' goals, whereas participants reported that circuit classes offered a more supportive environment than the individual therapy sessions. Participants were satisfied with the amount of supervision and assistance provided in both forms of physiotherapy service delivery. No distinct advantage was seen for one form of therapy over the other in terms of patient satisfaction.
Randomized controlled trials: Fundamental concepts
Authors: M Morrow Brenda 
Published: May 2014

A clinical randomized controlled trial (RCT) is an experimental research study in which subjects are randomly allocated to receive or not receive an experimental preventative, therapeutic or diagnostic procedure, and then are followed to determine the effect of the intervention. RCTs are considered the gold standard for clinical research design. However, in order for valid conclusions and appropriate recommendations to be made for clinical practice, the research needs to be methodologically sound and reported on in sufficient detail to allow reproducibility and critical appraisal. This article will review the fundamental components of a RCT for the prospective investigator as well as for those attempting to implement evidence-based therapy and rehabilitation practice based on reports of RCTs.
Engaging women from South Asian communities in cardiac rehabilitation
Authors: Visram Shelina , Crosland Ann , Unsworth John , Long Sue 
Published: May 2014

Aims This study sought to describe experiences and perceptions of cardiac rehabilitation among a sample of women from South Asian communities in an inner-city area of Newcastle-upon-Tyne, UK. Methods Data were collected via eight semi-structured interviews with staff and a focus group discussion with nine clients from a community-based, culturally sensitive cardiac rehabilitation service. Findings A number of individual, cultural and practical barriers to participation were identified. Facilitators centred on whether the format and content of the sessions could be considered ‘appropriate’. For example, a women’s dance group proved to be successful through the selection of a familiar local venue, supportive session leader, and an activity that was felt to be both enjoyable and beneficial. Conclusions This study has shown that it is possible to engage hard-to-reach groups in cardiac rehabilitation and physical activity. Further work is needed to explore whether this research is applicable in other ethnic groups and whether the lessons learned could be successfully incorporated into mainstream health services.
Residential pain management programmes: Participants' hopes and expectations
Authors: Bustin BM , Hughes OG 
Published: May 2014

Aims The authors sought to identify the initial expectations held by potential participants of a residential pain management programme. Drawing on existing placebo literature, it was anticipated that such insight would provide greater opportunities to secure positive outcomes for participants. Methods Focus groups and questionnaires were undertaken with 17 potential participants of the programme, to explore their pre-programme expectations. Data were thematically summarized. Findings Participants provided a wealth of information about their hopes from the programme. Thematic analysis revealed that participants were not, however, describing their expectations of their own potential achievements from participating in the programme. Conclusions The data provided by the participants highlighted the relevance of self-efficacy in interpreting their current potential for change. It is recommended that researchers should exercise caution when selecting the methods and language for qualitative approaches, particularly around ‘hopes’ and ‘expectations’. These findings may have clinical implications for the evaluation of patients' preparedness for engaging in treatment in this area.
The working alliance in supported employment for people with severe mental health problems
Authors: Waghorn Geoff , De Souza Tara , Rampton Nicole , Lloyd Chris 
Published: May 2014

Aims This study examined the utility of the Working Alliance Inventory Short form (WAI-S) for measuring the working alliance between supported employment service providers and service users with severe mental health problems. Methods Service users (n=32) and their respective service providers (n=17, 32 pairs) from five supported employment services independently rated their working alliance using the WAI-S. Findings There was little correlation at item, factor, and total score levels, and low agreement between service users and service providers on 11 of 12 working alliance items of the WAI-S. Conclusions These findings challenge the validity of the working alliance construct in this context, suggesting that both the WAI and the WAI-S may not be optimal measures of the working alliance in supported employment. The contextual differences between psychotherapy and supported employment, and the greater divergence of user-provider perceptions, imply that the working alliance in supported employment may differ from the alliance in psychotherapy. Researchers are encouraged to investigate the nature of the working alliance in supported employment rather than project characteristics identified in other settings.
Determinants of physical activity participation following traumatic brain injury
Authors: Reavenall Sarah , Blake Holly 
Published: May 2014

Aims The objective of the study described in this article was to establish the environmental, social, or personal determinants associated with physical activity participation in people with traumatic brain injury (TBI). Methods A multi-centre cross-sectional questionnaire survey using a convenience sample was used at eight community day centres for brain injured populations. The participants were 63 individuals with traumatic brain injury (51 male, 12 female). Physical activity participation was based on the proportion of participants achieving the level of physical activity recommended for health (30 mins moderate activity, most days of the week). Standardized measures were used to assess activities of daily living (Extended Activities of Daily Living Scale), self-efficacy (Self-Efficacy for Exercise Scale), social support (Social Support for Exercise Scale) and mood (General Health Questionnaire-12). Findings Over half the participants were not active enough for health benefit. Active participants were more independent in activities of daily living (t = -2.21, P < 0.05), had greater self-efficacy for exercise (t = -3.02, P < 0.05) and were more educated (χ2=5.61, P<0.05) than inactive participants. Logistic Regression showed self-efficacy for exercise to be the only significant predictor of physical activity participation (β = 0.32, OR 1.03, P < 0.05). Conclusions Self-efficacy predicted physical activity participation. Efforts to increase self-efficacy among brain injured participants may encourage activity participation in those who are able and this warrants further investigation.