bluuebunny/crossref_metadata_2025_split huggingface dataset:
The analysis of interaction in online focus groups
Authors: Watson Mohinder , Peacock Susi , Jones Derek 
Published: May 2014

Computer mediated communication has enabled researchers to transfer the focus group method to the online environment. This has important practical, ethical and theoretical implications including the challenge of maximizing and analysing focus group interaction in a faceless medium, devoid of visual and vocal cues. In the online setting where written communication is the only means of understanding data, interaction offers the researcher a critical window to interpret meaning and to understand better what is happening in the social context of the group. A schema of questions has been used in this study to draw attention to this interaction and to examine the transcripts of online focus groups, which sought to investigate the lived experiences of sufferers of repetitive strain injury. Five asynchronous online focus groups were conducted on a closed website specifically created for the study. Online focus group interaction was found to generate rich qualitative data. More studies are required to explore what is potentially an innovative tool for qualitative researchers.
Development and evaluation of a communication clinic for patients' relatives
Authors: Gupta Romesh , McCann Peter , Rawcliffe Colette , Brigden David 
Published: May 2014

This article describes a new, successful concept of providing a service within rehabilitation, which to the authors' knowledge has not been described before in the literature. The ‘relatives communication clinic’ is a dedicated clinic solely for the purpose of communicating to patients' relatives in a formal environment. The weekly relatives communication clinic is attended by the consultant physician, members of nursing staff, members of the multidisciplinary team, the patient and the patient's relatives and/or carers. The clinic was formally audited to evaluate its effectiveness. In the period studied (May–December 2003), 47 separate families were seen. A retrospective audit analysed the notes of the patients involved. Complaints were reduced by 25% and concordance with the management plan was 100%. Feedback showed that the multidisciplinary team and trainee health-care professionals benefited greatly from the clinics: for example, it reduced fragmented care plans, helped timely discharge planning and empowered junior staff. The relatives' communication clinic should be an integral part of modern hospital rehabilitation, especially when dealing with elderly, complex patients.
An investigation of day hospital outcome measures
Authors: Palmer Síobhán , Kneebone Ian 
Published: May 2014

It is important to evaluate services in order to establish best practice, allocate limited resources, and strive towards clinical excellence. This study explored outcome measures for medical rehabilitation day hospitals for older people, where a broad range of needs are addressed. The aim was to identify alternatives to the current measure in use across four day hospitals, as it was considered by staff that this measure was not consistently reflecting observed and clinically significant changes. Consultation with day hospital staff clarified the outcomes they hoped to capture in a measure, nd their concerns about current measures. Literature review identified potential alternatives, one of which was piloted; the CANE-S (Camberwell Assessment of Need-Short Form). The CANE-S was selected for pilot owing to it being specifically designed for use within services for older people, with established reliability and validity. Pilot results indicated that the CANE-S was not a suitable measure for all of the four day hospitals because it did not offer the brevity and distinctiveness required by all. Recommendations for further evaluation are discussed.
Using confidence intervals to assess clinical relevance of research findings
Authors: Wright CC 
Published: May 2014

Background: There is a need for reporting of statistics that convey information about the clinical importance of findings. Estimation is a method that is used to produce such statistics and confidence interval estimates, in particular, are frequently reported in research studies. Contents: This article introduces the concept of estimation by focusing on key features of confidence intervals and how they are related to precision of findings from a research study. It illustrates how to interpret confidence intervals through a simple hypothetical study on recurrent low back pain, with the Visual Analogue Scale for pain and the Oswestry Disability Index as the two outcomes. Use of confidence intervals to assess clinical importance of research findings is demonstrated. Key properties of confidence intervals are discussed and illustrated graphically, and consideration is given to aspects at the design stage that influence the precision of results in a research study. Conclusions: An understanding of the concept of confidence intervals will enable researchers to report results that might be used to judge clinical importance of findings from their research, and consumers of research to critique clinical importance of results presented in published studies.
Preventing avoidable admissions for disabled people of working age: An exploratory study
Authors: Hanley Laura Jane , Triskel Natty , Cozens Phillipa 
Published: May 2014

Aims There is a significant number of disabled people of working age who are at risk of experiencing an unplanned and potentially avoidable hospital admission. However, despite the huge cost of these admissions for both the NHS and the individual involved, there is very little research into health-care strategies that would enable disabled people of working age to avoid unplanned admissions. The authors aimed to investigate experiences of, and problems linked to, potentially avoidable admissions experienced by disabled people of working age in the UK, and propose ways of addressing problems identified. Methods Focus groups and interviews with health professionals (n=10) and service users (n=3) from similar services in South West England were conducted to explore issues around avoidable admissions. Thematic analysis of the date was then conducted. Findings Analysis revealed that the needs and expectations of disabled people of working age are different to those of older people, that there is a lack of information and specialist equipment available to service users and a shortage of age-appropriate services for disabled people of working age. Conclusions Disabled people of working age who experience unplanned admissions experience double discrimination: as disabled people their impairment-related needs can be poorly understood and met, and as younger people they can be excluded by services designed to meet the needs of older people. Short and long-term recommendations for further research and strategies which may help to reduce the number and impact of potentially avoidable admissions by disabled people of working age are suggested.
Verbal mediation as a treatment strategy for children with non-verbal learning difficulties
Authors: Fox Tania , Lincoln Nadina 
Published: May 2014

Aim The aim of this case study was to investigate the effectiveness of verbal mediation training in children with non-verbal learning difficulties. Methods Two A-B-A single case experimental design studies were conducted. In the intervention phase each child was asked to complete non-verbal construction tasks using verbal mediation. Children also completed a digit span task, as a control measure of overall development. During the training and follow-up phases they completed a jigsaw, as a measure of generalization of training to a related task. Findings: The results suggested that the children improved in their ability to complete non-verbal construction tasks, unrelated to changes in their overall developmental level. Conclusions Findings suggest that verbal mediation training was beneficial for two children with non-verbal learning difficulties but further research, in the form of randomized controlled trials is needed.
The Delphi technique: A review
Authors: Vernon Wesley 
Published: May 2014

Background The Delphi technique is an approach with much to offer health-care research. It was first devised by the RAND corporation in the 1950s and later, in the 1970s, was rediscovered by the nursing profession. Delphi is one of a range of consensus techniques, all of which fall under the broad classification of action research approaches. The purpose of the Delphi technique is to test opinion consensus amongst a group of experts. Content A brief overview of the various consensus methods is given. The development and operation of the Delphi technique is then considered and a critical assessment of the technique is offered. Conclusions Delphi is potentially useful across a wide range of applications, however, it is important to appreciate the strengths, weaknesses and pitfalls to avoid in its application.
Grip strength and functional balance in community-dwelling older women
Authors: Barron Joan , Guidon Marie 
Published: May 2014

Background: Effective detection and treatment of balance impairment in older people is a matter of clinical urgency. 4 screening tool for impaired balance is required, as is clarity regarding the role of muscle strength in balance control. Methods: This observational study examined the relationship between grip strength and balance in 40 community-dwelling women aged 65-95 years. Measures included grip strength, Functional Reach test, Single Leg Stance Test, Timed Up and Go test and the Berg Balance Scale. Correlation analyses were used to investigate relationships between the variables. Findings: Significant correlations were found between grip strength and each of the balance measures. The strongest correlation (r=0.55, P<0.001) was found between right grip strength and the Berg Balance Scale. The weakest correlation (r=-0.36, P=0.012) was between left grip strength and the Timed Up and Go test. Grip strength accounted for only 14%-31% of the variance in balance test scores Conclusions: The association between grip strength and balance was not sufficiently robust for grip strength to be recommended as a screening tool for balance impairment in older people.
Developing clinician expertise in paediatric dysphagia: what is an effective learning model?
Authors: Duivestein Janice , Gerlach Alison 
Published: May 2014

Background: Developing and maintaining clinician expertise in specialized rehabilitation practice areas can be challenging, and requires effective education and learning strategies. To widen the scope of this series, this article looks at education and learning models, how to develop and assess them, and their value in practice. This article provides an example relevant to any specialized learning. Content: The authors use the example of paediatric feeding and swallowing difficulties (dysphagia) to describe the evaluation and exploration of the education and learning models at two paediatric agencies in British Columbia, Canada. These models are designed to support occupational therapists and speech language pathologists in developing expertise for performing videofuoroscopic swallow studies (VFSS), a component of a comprehensive paediatric dysphagia evaluation. Clinicians involved in providing specialized paediatric dysphagia services, including VFSS, were engaged in this study through a participatory action research approach. Data on current education and learning models and clinicians’ experiences were collected through questionnaires and a focus group. Results identified three interconnected themes: ‘dynamic and interactive learning is necessary to refect the complex and changing practice environment’; ‘supports and resources provide infrastructure to enhance learning’; and ‘personal characteristics influence learning.’ Conclusions: Findings from this preliminary participatory action research study suggest that education and learning models to facilitate the development of clinician expertise in paediatric VFSS should consider employing a multi-faceted approach in which the necessary supports, resources and interactive learning environments are available for both new and experienced clinicians.
Interventions for post-stroke disturbances of mood and emotional behaviour: recommendations from SIGN 118
Authors: Gillespie David C , Joice Sara , Lawrence Maggie , Whittick Janice 
Published: May 2014

David C Gillespie, Sara Joice, Maggie Lawrence, Janice Whittick Background: Stroke is a leading cause of death and disability. A high proportion of those who survive participate in programmes of rehabilitation. Clinical practice guidelines have come to play an increasingly important role in stroke rehabilitation, providing accessible summaries of the evidence for the management of specific consequences of the condition. Among the most common - and disabling - consequences of stroke are disorders of mood and emotional behaviour. Content: This article reports the development of clinical practice recommendations for post-stroke emotional disturbance for the Scottish Intercollegiate Guidelines Network (SIGN). SIGN 118 Management of Patients with Stroke: Rehabilitation, Prevention and Management of Complications and Discharge Planning was published in June 2010. Suggestions are made for ways in which the SIGN 118 recommendations for disorders of mood and emotional behaviour can be implemented in routine clinical practice. Limitations of the guidelines are also discussed. Conclusions: Although gaps in the evidence base exist, SIGN guideline 118 has an important role to play in closing the gap between what stroke multi-disciplinary teams do to promote good psychological outcomes, and which aspects of practice are supported by a robust evidence base.
Evaluation of a radiographic technique: one dimension of critical thinking
Authors: Castle Alan 
Published: May 2014

Background: Previous articles in this series (July 2010 and April 2011) have looked at examples of how undergraduate students can demonstrate their ability to interpret data and generate new ideas as part of developing their critical thinking skills. As a final example, the evaluation component of critical thinking is explored that requires students to recognize arguments, separate fact from opinion and verify the value of evidence. In this way they can fully engage with evidence-based practice. Contents: The evaluation component of critical thinking encourages students to ask the right questions when considering research data and dig deeper into the motives, expertise and assumptions underlying the evidence presented. The worked example is for an evaluation of the effectiveness of X-ray imaging of the lumbar spine in patients presenting with persistent nonspecific low back pain (LBP). The structure of the evaluation includes clinical indications, diagnostic yield, effectiveness of current practice and comparison with other diagnostic imaging options. Conclusions: Since critical thinking is not a single entity, understanding the key components that contribute to the whole is important if undergraduate students are to be encouraged and supported in developing their critical thinking skills. The example of an evaluation of a radiographic technique illustrates how students are expected to go about demonstrating their understanding of the intentions and motivations behind judgements, protocols and guidelines that are aimed at improving the delivery of health care.
Active exercise in critically ill adults affected by thrombocytopaenia
Authors: Polastri Massimiliano , Vianelli Nicola 
Published: May 2014

Introduction Thrombocytopaenia (TCP), or low platelet count, is a haematological disorder that commonly occurs in critically ill patients and is defined as a platelet count below 100 000/μL. Patients are at higher risk of muscular atrophy and other complications after prolonged bed rest. This literature review aims to clarify the appropriateness of active exercise in critically ill adult patients with TCP. Methods A review of the literature was conducted using the following key words that are PubMed medical subheading (MeSH) terms: ‘critical illness’, ‘exercise therapy’, ‘manual therapy’, ‘physical therapy’, ‘physiotherapy’, ‘postoperative care’, ‘rehabilitation’, ‘thrombocytopenia’, and ‘thrombopenia’. The search was limited by publication date (2000 to 2013) and language (English only) in three main databases: PubMed, SCOPUS, and CINAHL. Results The key word searches found a total of 78 citations. Of these, only those meeting the inclusion criteria were selected after reading the title and abstract. Two studies were included after reading the full-texts. Exercise is used to treat muscular atrophy in critically ill adult patients, and rehabilitation plays an important role in the care pathway. Results of our analysis do not support evidence for or against exercise in critically ill adult patients with TCP; therefore, health professionals must pay close attention to the presence of signs of bleeding in these patients when proposing exercise. Discussion Surprisingly, no study was found that directly covered this issue. Aggressive exercise may not be appropriate in patients with very low platelet counts. On the other hand, critically ill patients are at high risk of muscular atrophy due to the forced bed rest, especially after complex surgery or in prolonged hospitalisation. Physiotherapists and those providing care must share their observations with the rest of the multidisciplinary team before treatment starts. Conclusions Active exercise in critically ill adult patients with severe TCP must be personalised and platelet count carefully monitored before proposing physical activity. Physical recovery can be challenging in critically ill adult patients, and it can be limited by severe TCP, mostly when bleeding is present.
A pilot thoracic exercise programme reduces early (0–6 weeks) sternal pain following open heart surgery
Authors: Sturgess Tamica , Denehy Linda , Tully Elizabeth , El-Ansary Doa 
Published: May 2014

AimsTo investigate whether thoracic exercises result in improved pain, range of movement and health-related quality of life (HRQOL) following open heart surgery (OHS), and to evaluate patient perception of the role of thoracic exercises in recovery.MethodsA single-blinded pilot trial was conducted in a tertiary public hospital in Australia. Thirty-eight participants who underwent OHS were randomly allocated to an experimental (Group 1, n=23), or control (Group 2, n=15) group. All participants were prescribed a twice-daily walking programme postoperatively. The experimental group also completed a progressive, individualised thoracic exercise programme. Baseline pre-operative measures of shoulder and thoracic range of movement, pain and HRQOL were repeated at 4 weeks following discharge and 3 months postoperatively. Participants also rated their perceptions of the role of exercise and its contribution to physical recovery.FindingsAt 4 weeks following discharge, the experimental group reported 1.7 cm on the visual analogue scale (VAS) less sternal pain (95% CI of median 2.8–0.0, P=0.03) than the control group. The experimental group reported a trend toward greater perception of the contribution of their physiotherapy programme than the control group (median difference 1.2 cm, 95% CI -2.1–-0.0, P=0.04). There were no other differences between the two groups.ConclusionsThoracic exercises following OHS may be effective in reducing sternal pain and warrant further investigation.
An evaluation of high fidelity simulation training for paramedics in Ireland
Authors: Power David , Henn Patrick , O'Driscoll Paul , Power Theresa , McAdoo John , Hynes Helen , Cusack Stephen 
Published: May 2014

• Introduction: The requirement for pre-hospital practitioners to perform additional interventions is ever increasing. In Ireland the training of pre-hospital practitioners is currently developing and evolving to meet this demand. This requires the use of simulators with the capability to simulate more advanced interventions. • Objectives: We wished to explore the views of pre-hospital care practitioners post participation in a pilot high fidelity simulation in emergency care, to gauge its acceptability, relevance and application. • Method: Pre-hospital care practitioners’ participated in 12 full immersion high-fidelity simulated scenarios, over three consecutive days. Live video recording was during the scenarios and replayed during debriefing sessions. The participants completed a voluntary and anonymous evaluation of the training using six statements on a five point Likert scale and free text written comments to three open-ended questions. • Results: The overall response to the training was overwhelming positive with 94.4 % of the participants either strongly agreed or agreed that the course met their learning needs. All agreed that they found the course relevant to their stage of training and that the course will impact beneficially on their clinical practice. • Conclusion: This pilot study has shown that high-fidelity simulation is both applicable and relevant to pre-hospital practitioner.
Measurement of breast skin viscoelasticity and a pilot study on the potential radioprotective effect of a zinc-based cream
Authors: Gorodetsky R. , Andriessen A. , Poliansky I. , Vexter A. 
Published: May 2014

Radiation-induced late skin effects were studied in patients with breast cancer in relation to different protocols of fractionated radiotherapy in three different medical centres, in Israel, the UK and the USA. The mechanical properties of skin were evaluated in breasts of healthy volunteers, and non-irradiated and irradiated breasts of patients, using a newly developed viscoelasticity skin analyser (VESA). The increase of the dose of radiation per fraction was found to have more impact on the development of radiation-induced late skin effects than the elevation of the total dose given. In addition, a pilot study on the possible radioprotective effect of external application of a cream containing zinc oxide on radiation-induced early skin changes in patients with breast cancer was initiated. Non-invasive measurement of trace elements and zinc pharmacokinetics in the skin of healthy controls following the application of the zinc oxide cream were performed by unique diagnostic X-ray spectrometry (DXS). Application of the cream, followed by thorough skin cleansing, significantly increased the amount of residual zinc in the skin, but continuous daily treatment did not cause further build-up of the dermal zinc level. The radioprotective effect of the zinc oxide cream on the skin is now being studied.
The supply of dressings by hospital pharmacy departments in Wales
Authors: Thomas S. 
Published: May 2014

A research project to examine the dressings and wound management materials supplied by pharmacy departments in Wales was carried out. Data were collected from the NHS computer database, which contains information on 17 hospitals, servicing 80-90% of the Welsh population. Over a 12-month period, hospital pharmacy departments throughout Wales issued dressings and related materials costing £2.1m. As not all pharmacy departments supply the full range of dressings used in hospitals, and only one issues surgical sutures, this sum probably represents less than half of the total expenditure in Wales on this commodity group. Existing methods for recording the issue of dressings do not provide reliable information either on the range of products used or the total quantities issued throughout Wales. Despite expectations to the contrary, hospital use of dressings did not appear to have a major influence over prescribing patterns in the primary sector. The amount of cavity wound dressings that are supplied on an outpatient basis suggests a real need for these items to be available in the community. (Since completion of this study, cavity wound dressings have been added to the Drug Tariff.)