ORCID Profile
0000-0002-2668-4856
Current Organisation
University of South Australia
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Publisher: Elsevier BV
Date: 03-2020
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15044
Abstract: Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the ‘maximum value for spend’ of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to minimise inappropriate and costly care and maximise highly appropriate and less expensive care. These strategies were developed based on clinical experiences and with supporting evidence from scientific studies. What does this paper add? Major changes to the health system are required to slow down the growth in healthcare expenditure. This paper describes opportunities in which allied health practitioners can implement similar strategies not only to improve the quality of patient outcomes, but also to offer cost-effective solutions for a sustainable healthcare. What are the implications for practitioners? Allied health practitioners can provide solutions to healthcare challenges and assist in the transformation of healthcare in Australia. However, for this to happen, there should be concerted efforts to increase recognition of and support for the use of allied health services.
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.PHYSIO.2021.08.004
Abstract: Complex physical interventions are widely used in physiotherapy, despite doubts over the validity of clinical trial results due to lack of credible shams. Credible shams are critically needed, so too, therefore, is a process by which they can be developed. The authors used a novel methodology to develop and test blinding protocols for dry needling, a complex physical intervention for which blinding is particularly difficult. The research design was a practical three-day workshop influenced by Participatory Action Research, which uses iteration and reflection to solve a problem. Five multidisciplinary experts (researchers, clinicians, technician, magician) were invited. Healthy volunteers ('recipients', n=17) and accredited physiotherapists (n=6) were recruited to enable testing of blinding strategies. Primary outcomes were expert opinion on the potential to blind recipients/therapists for (1) in idual blinding strategies, and (2) entire blinding protocols. Secondary outcomes included recipient/therapist blinding effectiveness and acceptability. Experts iteratively developed 11 blinding protocols involving 22 blinding strategies. Experts rated 18 of the blinding strategies to 'definitely have potential' and identified four categories: knowledge of the sham, clinical interaction, disinformation, and sensation. Recipient and therapist blinding became more successful as the protocols evolved. Credible shams capable of simultaneous recipient and therapist blinding have been regarded to be impossible in dry needling. The preliminary success of the devised protocols suggest that our novel approach may be a crucial step in sham development. Improvements in expert rankings and blinding effectiveness as the protocols progressed support the value of this workshop approach.
Publisher: Elsevier BV
Date: 12-2005
DOI: 10.1016/S1440-2440(05)80051-9
Abstract: Pelvic rotation during cycling is important because it influences aerodynamics, cycling efficiency and the occurrence of overuse injuries. The aim of this study was to determine whether or not pelvic position in long sitting influences pelvic position during cycling. An observational, cross sectional, within-subjects study design was used. Thirty elite international track and road cyclists participated as subjects and two measures were undertaken. In long sitting, a digital inclinometer was positioned on the lumbosacral junction to give a static measure in degrees of sacral inclination (SI) relative to the horizontal. During active cycling, video analysis of reflective surface markers over the anterior superior iliac spine and posterior superior iliac spine was used to give a measure in degrees of anterior pelvic rotation (APR), by the angle between these two landmarks and the horizontal. No significant linear relationship was found between the two testing positions (r = 0.23, p = 0.22).
Publisher: Informa UK Limited
Date: 02-2023
DOI: 10.2147/JMDH.S392375
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.PHYSIO.2021.08.007
Abstract: Dry needling is widely used in physiotherapy. Lack of blinding in clinical trials means that dry needling effects and mechanisms remain unclear, with blinding issues accepted as an unavoidable barrier to better evidence. The authors aimed to overcome this barrier by designing a protocol to double-blind dry needling trials. A prospectively registered randomised experiment tested a novel blinding protocol for blinding effectiveness. University physiotherapy clinic. Therapists (n=15) and asymptomatic volunteers ('recipients') (n=45) were randomly allocated to real and/or sham interventions. The protocol involved custom-made needles and cognitive and multisensory blinding techniques. The primary outcome was guesses about allocation. The a priori criterion for successful blinding was ≤50% correct guesses (random chance). Secondary analyses explored blinding patterns using blinding indices. Correct guesses were not different from 50% for therapists [41% (95%CI 30 to 50), n=120 guesses] or recipients [49% (95%CI 38 to 60), n=90 guesses]. Blinding indices supported the primary result but revealed that recipients were better at detecting real dry needling than sham. Both therapists and recipients were successfully blinded, which contrasts with the widely held assumption that double-blinding is impossible for needling interventions. The authors recommend that any future trials can, and therefore should, blind therapists. However, secondary analyses revealed that recipients receiving real dry needling were less blinded than sham recipients, which may still create bias in clinical trials and suggests further work is needed to improve recipient blinding. Nonetheless, the current findings offer an opportunity to gain better evidence concerning the effects and mechanisms of dry needling. osf.io/rkzeb/.
Publisher: Wiley
Date: 14-06-2017
DOI: 10.1002/SONO.12113
Publisher: Public Library of Science (PLoS)
Date: 19-08-2021
DOI: 10.1371/JOURNAL.PONE.0256425
Abstract: Telehealth has become a necessity within the medical and allied health professions since the COVID-19 Pandemic generated a rapid uptake worldwide. It is now evident that this health delivery format will remain in use well into the future. However, health education training, most particularly allied health, has been slow to ‘catch up’ and adapt curriculum to ensure graduates are equipped with the knowledge and skills to implement telehealth in the workplace. The aim of this study was to gain a comprehensive understanding of current telehealth curricula in undergraduate and postgraduate allied health education training programs, with a focus on the aims, objectives, content, format, delivery, timeline and assessments. A systematic search of Medline, Embase, PsychINFO, Scopus, ERIC and relevant grey literature was conducted. Students studying allied health degrees through formal education at either postgraduate or undergraduate level were included, while nursing, dentistry and medical students were excluded. The data from the included studies was extracted and tabulated by country, participants, program and content. Of the 4484 studies screened, eleven met the eligibility criteria. All studies were published after 2012, highlighting the recency of research in this area. The studies were conducted in four countries (Australia, United Sates of America, United Kingdom, Norway) and participants were from various allied health professions. Of the included studies, four related to undergraduate programs, four to postgraduate programs and for the remaining three, this was not specified. Curricula were delivered through a combination of online and face-to-face delivery, with assessment tasks, where reported, comprising mainly multiple-choice and written tests. Published reporting of telehealth curricula within allied health programs is limited. Even the minority of programs that do include a telehealth component lack a systematic approach. This indicates that further primary research would be beneficial in this area.
Publisher: Public Library of Science (PLoS)
Date: 21-12-2020
DOI: 10.1371/JOURNAL.PONE.0244190
Abstract: Few studies have explored evidence-based practice (EBP) knowledge, attitudes and behaviours of health professional graduates transitioning into the workforce. This study evaluated changes in these EBP domains in physiotherapists after one year of working. A mixed methods design was used. Participants completed two psychometrically-tested EBP questionnaires at two timepoints. The Evidence-Based Practice Profile questionnaire collected self-report EBP data (Terminology, Relevance, Confidence, Practice, Sympathy) and the Knowledge of Research Evidence Competencies collected objective data (Actual Knowledge). Changes were calculated using descriptive statistics (paired t-tests, 95% CI, effect sizes). Qualitative interview data collected at one timepoint were analysed using a descriptive approach and thematic analysis, to examine the lived experience of participants in the context of their first employment. The aim of the mixed methods approach was a broader and deeper understanding of participants’ first year of employment and using EBP. Data were analysed from 50 participants who completed both questionnaires at the two timepoints. After one year in the workforce, there was a significant decrease in participants’ perceptions of Relevance (p .001) and Confidence with EBP (p .001) and non-significant decreases in the other domains. Effect sizes showed medium decreases for Relevance (0.69) and Confidence (0.57), small decreases in Terminology (0.28) and Practice (0.23), and very small decreases in Sympathy (0.08) and Actual Knowledge (0.11). Seven themes described participants experience of using EBP in their first working year. After a year in the workplace, confidence and perceptions of relevance of EBP were significantly reduced. A subtle interplay of features related to workplace culture, competing demands to develop clinical skills, internal and external motivators to use EBP and patient expectations, together with availability of resources and time, may impact early graduates’ perceptions of EBP. Workplace role models who immersed themselves in evidence discussion and experience were inspiring to early graduates.
Publisher: Informa UK Limited
Date: 2009
DOI: 10.3109/09593980802665023
Abstract: Novel, short-lived upper limb tasks performed by young adults have been used to investigate the role of transversus abdominis (TrA) in maintaining postural stability. Little information exists concerning the behaviour of TrA in older adults during protracted postural challenges. The primary aim of this study was to describe the change in thickness of TrA during an incremental upper limb exercise test in older adults. A secondary analysis was undertaken to compare the results between younger and older subjects. Healthy subjects aged between 40 and 70 years performed the Unsupported Upper Limb Exercise Test (UULEX) while activity of TrA was continuously monitored by using rehabilitative ultrasound imaging. Changes in muscle dimensions were measured every minute during the test. The thickness of TrA increased significantly and exponentially between minutes 8 and 13 of the UULEX. Although there was a significant difference between older and younger subjects in absolute measures of TrA thickness, the change in TrA thickness as a percentage of resting thickness during the UULEX demonstrated an identical pattern between younger and older subjects. This study suggests that TrA is continually and increasingly active during an upper limb task in both younger and older asymptomatic subjects.
Publisher: Springer Science and Business Media LLC
Date: 24-08-2020
DOI: 10.1186/S12909-020-02189-Z
Abstract: Evidence-based practice (EBP) education or training are considered fundamental to building and strengthening an EBP culture, as well as to encouraging evidence-based academic and clinical practice in the nursing community. However, few valid and reliable instruments are available for the assessment of EBP teaching and learning in clinical nurses in China. Translation, reliability, and validity testing of the English Evidence-Based Practice Profile Questionnaire (EBP 2 Q), which has strong psychometric properties, may encourage evaluation and promote the implementation of EBP in Mainland China. Based on established guidelines for the development of questionnaires, the English EBP 2 Q was translated and cross-culturally adapted. The Chinese version of the EBP 2 Q (EBP 2 Q-C) was validated using a s le of 543 nurses. Structural validity was evaluated through exploratory factor analysis and confirmatory factor analysis, and the questionnaire was tested for convergent and criterion validity. The internal consistency and test-retest reliability were also evaluated. The content validity index demonstrated good content validity (≥0.98). An eight-factor structure was obtained in the exploratory factor analysis, and verified by a three-order factor model from the confirmatory factor analysis ( χ 2 /df = 2.001 RMSEA = 0.065 SRMR = 0.077 and CFI = 0.884). The Spearman’s rank correlation analysis of the EBP 2 Q-C with the Evidence-Based Practice Questionnaire showed moderate correlations for Practice (0.58) and Confidence (0.68) and a low correlation for Sympathy (0.32). Criterion validity was demonstrated by significant differences in terms of nurses’ highest education, present position, EBP training, involvement in research programs, and level of understanding of English. Both the overall Cronbach’s α and the Cronbach’s α for the domains exceeded 0.70. The intraclass correlation coefficients for the domains ranged between 0.75 and 0.96, indicating satisfactory repeatability. Except for the convergent validity of the Sympathy domain, the EBP 2 Q-C provided evidence of validity and reliability. Therefore, it can be applied in EBP education or training assessment in Mainland China.
Publisher: PeerJ
Date: 31-07-2018
DOI: 10.7717/PEERJ.5318
Abstract: Blinding is critical to clinical trials because it allows for separation of specific intervention effects from bias, by equalising all factors between groups except for the proposed mechanism of action. Absent or inadequate blinding in clinical trials has consistently been shown in large meta-analyses to result in overestimation of intervention effects. Blinding in dry needling trials, particularly blinding of participants and therapists, is a practical challenge therefore, specific effects of dry needling have yet to be determined. Despite this, dry needling is widely used by health practitioners internationally for the treatment of pain. This review presents the first empirical account of the influence of blinding on intervention effect estimates in dry needling trials. The aim of this systematic review was to determine whether participant beliefs about group allocation relative to actual allocation (blinding effectiveness), and/or adequacy of blinding procedures, moderated pain outcomes in dry needling trials. Twelve databases (MEDLINE, EMBASE, AMED, Scopus, CINAHL, PEDro, The Cochrane Library, Trove, ProQuest, trial registries) were searched from inception to February 2016. Trials that compared active dry needling with a sham that simulated dry needling were included. Two independent reviewers performed screening, data extraction, and critical appraisal. Available blinding effectiveness data were converted to a blinding index, a quantitative measurement of blinding, and meta-regression was used to investigate the influence of the blinding index on pain. Adequacy of blinding procedures was based on critical appraisal, and subgroup meta-analyses were used to investigate the influence of blinding adequacy on pain. Meta-analytical techniques used inverse-variance random-effects models. The search identified 4,894 in idual publications with 24 eligible for inclusion in the quantitative syntheses. In 19 trials risk of methodological bias was high or unclear. Five trials were adequately blinded, and blinding was assessed and sufficiently reported to compute the blinding index in 10 trials. There was no evidence of a moderating effect of blinding index on pain. For short-term and long-term pain assessments pooled effects for inadequately blinded trials were statistically significant in favour of active dry needling, whereas there was no evidence of a difference between active and sham groups for adequately blinded trials. The small number and size of included trials meant there was insufficient evidence to conclusively determine if a moderating effect of blinding effectiveness or adequacy existed. However, with the caveats of small s le size, generally unclear risk of bias, statistical heterogeneity, potential publication bias, and the limitations of subgroup analyses, the available evidence suggests that inadequate blinding procedures could lead to exaggerated intervention effects in dry needling trials.
Publisher: Springer Science and Business Media LLC
Date: 29-06-2005
Publisher: Springer Science and Business Media LLC
Date: 29-11-2011
Publisher: Springer Science and Business Media LLC
Date: 25-01-2013
Publisher: Informa UK Limited
Date: 26-08-2010
Publisher: World Scientific Pub Co Pte Lt
Date: 2004
Publisher: International Journal of Medical Education
Date: 06-06-2013
Publisher: University of Toronto Press Inc. (UTPress)
Date: 02-2016
DOI: 10.3138/PTC.2015-10E
Abstract: Purpose: To investigate the magnitude of change in outcomes after repeated exposure to evidence-based practice (EBP) training in entry-level health professional students. Method: Using an observational cross-sectional analytic design, the study tracked 78 students in physiotherapy, podiatry, health science, medical radiations, and human movement before and after two sequential EBP courses. The first EBP course was aimed at developing foundational knowledge of and skills in the five steps of EBP the second was designed to teach students to apply these steps. Two EBP instruments were used to collect objective (actual knowledge) and self-reported (terminology, confidence, practice, relevance, sympathy) data. Participants completed both instruments before and after each course. Results: Effect sizes were larger after the first course than after the second for relevance (0.72 and 0.26, respectively), practice (1.23 and 0.43), terminology (2.73 and 0.84), and actual knowledge (1.92 and 1.45) effect sizes were larger after the second course for sympathy (0.03 and 0.14) and confidence (0.81 and 1.12). Conclusions: Knowledge and relevance changed most meaningfully (i.e., showed the largest effect size) for participants with minimal prior exposure to training. Changes in participants' confidence and attitudes may require a longer time frame and repeated training exposure.
Publisher: Springer Science and Business Media LLC
Date: 24-07-2014
Publisher: Springer Science and Business Media LLC
Date: 12-10-2010
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2018
Publisher: Informa UK Limited
Date: 2008
DOI: 10.1080/09593980701773340
Abstract: The aim of this study was to measure transversus abdominis (TrA) during an incremental fatiguing task. Using real-time ultrasound, TrA thickness was measured in 26 healthy subjects (18-25 years, 9 male) during an unsupported upper limb exercise test (UULEX). Repeatability of changes in TrA thickness during the UULEX was established by using a test-retest process (n=9, intraclass correlation coefficient=0.62 (95% CI 0.38-0.82), standard error of measurement approximately 1 (95% CI 0.87-1.08)). Using mixed model analysis with time as an independent variable, TrA thickness changed significantly throughout the UULEX (p < 0.05). Measures of TrA thickness at minutes 10, 11, and 12 were significantly greater than at baseline (p=0.006 (95% CI 0.23-1.35), 0.001 (95% CI 0.45-1.61), and <0.0001 (95% CI 0.77-2.03), respectively). Transversus abdominis was shown to be continuously and increasingly active over the 12 minutes of an incremental bilateral upper limb test in young healthy adults. As increases in TrA thickness occurred at the points of greatest postural and ventilatory demands, these findings may have implications for subjects with musculoskeletal or respiratory impairments who are often challenged by upper limb tasks.
Publisher: Elsevier BV
Date: 02-2007
Publisher: Springer Science and Business Media LLC
Date: 31-07-2014
Publisher: Oxford University Press (OUP)
Date: 02-08-2019
DOI: 10.1093/PTJ/PZZ111
Abstract: Blinding of participants and therapists in trials of physical interventions is a significant and ongoing challenge. There is no widely accepted sham protocol for dry needling. The purpose of this review was to summarize the effectiveness and limitations of blinding strategies and types of shams that have been used in dry needling trials. Twelve databases were searched from inception to February 2016. Trials that compared active dry needling with a sham that simulated dry needling were included. The main domains of data extraction were participant/therapist details, intervention details, blinding strategies, blinding assessment outcomes, and key conclusions of authors. Reported blinding strategies and sham types were synthesized descriptively, with available blinding effectiveness data synthesized using a chance-corrected measurement of blinding (blinding index). The search identified 4894 in idual publications with 27 trials eligible for inclusion. In 22 trials, risk of methodological bias was high or unclear. Across trials, blinding strategies and sham types were heterogeneous. Notably, no trials attempted therapist blinding. Sham protocols have focused on participant blinding using strategies related to group standardization and simulation of tactile sensations. There has been little attention given to the other senses or cognitive strategies to enhance intervention credibility. Nonpenetrating sham types may provide effective participant blinding. Trials were clinically and methodologically erse, which limited the comparability of blinding effectiveness across trials. Reported blinding evaluations had a high risk of chance findings with power clearly achieved in only 1 trial. Evidence-based consensus on a sham protocol for dry needling is required. Recommendations provided in this review may be used to develop sham protocols so that future protocols are more consistent and potentially more effective.
Publisher: Springer Science and Business Media LLC
Date: 11-05-2018
Publisher: Informa UK Limited
Date: 02-01-2016
DOI: 10.1080/10401334.2015.1107490
Abstract: PHENONENON: In many developed countries, accreditation documents, which reflect the practice standards of health professions, form the basis for evaluation of education programs for meeting the requirements for registration. The 2005 Sicily statement proposed a 5-step model of training in evidence-based practice (ask, access, appraise, apply, and assess). A key recommendation was that evidence-based practice should be incorporated into entry-level health professional training and registration. No previous research has assessed the extent to which this has occurred. We undertook a systematic audit of the accreditation documents for the registered health professions in Australia. The 11 health professional disciplines included in the audit were medicine, nursing and midwifery, pharmacy, physiotherapy, dentistry, psychology, occupational therapy, optometry, podiatry, osteopathy, and chiropractic. Two investigators independently identified the occurrence of the term evidence that related to "evidence-based practice" and the occurrences of terms related to the 5 steps in the accreditation documents. Occurrence of the term evidence as it relates specifically to "evidence-based practice" ranged from 0 (pharmacy, dentistry and occupational therapy) to 8 (physiotherapy) in the accreditation documents. Overall, there were 77 occasions when terms relating to any of the 5 steps of evidence-based practice were used across all 11 accreditation documents. All 5 steps were included in the physiotherapy and psychology documents 4 steps in medicine and optometry 3 steps in pharmacy 2 steps each in documents for chiropractic, osteopathy, and podiatry and 1 step for nursing. There was no inclusion of terms relating to any of the 5 steps in the dentistry and occupational therapy documents. Insights: Terminology relating explicitly to evidence-based practice and to the 5 steps of evidence-based practice appears to be lacking in the accreditation documents for health professions registered in Australia. This is not necessarily reflective of the curricular content or quality, or dedication to evidence-based practice teaching. However, recognition and demand by accreditation bodies for skills in evidence-based practice may act as a driver for education providers to give greater priority to embedding this training in entry-level programs. Consequently, accreditation bodies are powerfully positioned to shape future directions, focus, and boundaries within and across professions. Future international audits of accreditation documents could provide insight into the global breadth of this phenomenon and contribute to closer scrutiny of the representation of evidence-based practice in future iterations of accreditation documents.
Publisher: SAGE Publications
Date: 07-2001
DOI: 10.1177/87564790122250453
Abstract: Various sonography studies have evaluated the normal flexor tendons of the fingers by reporting the echogenicity of these structures. Due to the descriptive nature of these studies, little information is available concerning the reproducibility of sonographic measures of the finger flexor tendons. The aim of this study was to determine whether sonography measurement of finger flexor tendons can provide reproducible information. The study used a test-retest, same-subject experimental design. In iduals who had no history of injury or surgery to the fingers had the right and left middle fingers of both hands assessed on two different occasions (test 1 and test 2) separated by at least 4 hours. The flexor tendons were assessed for continuity and measured for thickness at three points along the finger: the heads of the metacarpal, proximal phalanx, and middle phalanx. Reliability was assessed using Pearson's Correlation Coefficient ( r), t test (paired two-tail), and the intraclass correlation coefficient (ICC 1,1 ). The majority of measures had an excellent linear correlation ( r 0.75). The t tests indicated that there were no significant differences between the two tests ( P [.lessequal] .05). High ICC 1,1 values suggested that there were excellent relationships between the measures on the two occasions of testing. No significant differences were found between measures of the left and right hands. The synovial sheath-pulley systems were evident as an echogenic specular reflection situated anteriorly to the flexor tendons in all in iduals. Using this measurement protocol, sonography was found to be a reliable method of measuring and assessing the flexor tendons of the fingers.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.APMR.2012.11.030
Abstract: To review the literature for the criterion validity of pedometers for use in child and adult populations with physical disabilities. Academic Search Premier, ERIC, SPORTDiscus, MEDLINE, AMED, Scopus, CINAHL, Web of Science, and EMBASE databases, searched from inception to September 7, 2011. Studies were included if they were peer-reviewed articles, included populations with physical disabilities, and reported primary data for pedometer validity in comparison with direct observation. A consensus approach was used to apply the inclusion and exclusion criteria. Of the 163 articles identified in the database searches (excluding duplicates), 7 studies met the inclusion criteria. The quality of the studies was assessed independently by 2 reviewers, using a purpose-designed appraisal tool, with a consensus approach used to settle disagreement. A single reviewer extracted data relating to s le size, participant characteristics, pedometer model, main variables tested, duration of tests, and method of direct observation. The methodologic quality of the studies was generally high however, there was a wide variation of population and methodology between studies. The correlation between pedometer step counts and directly observed step counts was moderate to excellent (intraclass correlation coefficient, .52-.87), and percent errors ranged from 0.5% to 24.7%. Secondary variables reported included the effect of speed of movement, pedometer placement, comparison of pedometer makes/models, and test-retest reliability. Available evidence suggests that pedometers are valid for use in clinical and research settings in people with physical disabilities. Further research examining the validity of pedometers in less heterogeneous populations of people with disabilities is warranted to determine validity for specific disability populations and to determine optimal pedometer placement.
Publisher: SAGE Publications
Date: 15-08-2018
Abstract: While perceived as safe, diagnostic ultrasound has the potential to cause biological effects on the body tissues. The aim of this study was to evaluate knowledge, attitudes, and practices of Australasian sonographers on bioeffects and safety of ultrasound scanning. Focus groups were used to develop a questionnaire to explore knowledge, attitudes, and practices of ultrasound safety, which was then distributed to Australasian sonographers. Thematic (focus groups) and descriptive (questionnaires) analyses were undertaken. A 37-item questionnaire addressed knowledge, attitudes, and practices of ultrasound safety. In 47 collected responses, sonographers demonstrated good familiarity of thermal index (TI) (79%), mechanical index (MI) (68%), and “as low as reasonably achievable” (ALARA) principle (85%). However, most sonographers could not accurately define TI (13%) and had poor knowledge of safety guidelines relating to TI (19%) and MI (14%). Over 30% were uncertain about their attitudes to ultrasound safety issues. While 52% always and 30% most of the time adhere to ALARA, 37% of sonographers reported never monitoring TI and MI. While familiar with safety terms, knowledge of safety guidelines was lacking. Many sonographers were uncertain about their attitudes to the safety of scans, and safety practices involving monitoring for bioeffects were not a high priority.
Publisher: Informa UK Limited
Date: 11-10-2022
DOI: 10.1080/00140139.2021.1979253
Abstract: Sit-stand workstations are growing in popularity, however limited guidelines exist regarding optimal schedules of sitting and standing. This was the first known study to observe sit-stand workstation schedules when postural change is based on maintaining musculoskeletal discomfort within 'acceptable' levels. Fourteen healthy adults new to sit-stand workstations completed computer-based work at a sit-stand desk for half a workday. Participants changed between standing and sitting postures each time discomfort reached the maximum acceptable threshold. On average, the amount of standing and sitting was greatest in the first standing (median 40 minutes, interquartile range 40 minutes) and sitting (median 30 minutes, interquartile range 115 minutes) bouts. Average durations spent standing and sitting were lower in all consecutive bouts. Stand-sit ratios indicated an equal amount of standing to sitting or somewhat less standing. The schedules had substantial inter-participant variability. Future studies should consider that optimal schedules may vary with regard to time and be in idual-specific.
Publisher: Elsevier BV
Date: 12-2002
DOI: 10.1016/S1440-2440(02)80017-2
Abstract: Current practices regarding in-patient strengthening exercise prescription following anterior cruclate ligament (ACL) reconstruction are scarcely addressed in the literature and remain unreported for Australian hospitals. An observational, questionnaire-based study was used to Investigate in-patient quadriceps strengthening practices in Australian hospitals after ACL reconstruction. Questionnaires were returned by 248 hospitals (76% response rate) and of these 88 hospitals reported performing ACL reconstructions. These hospitals were surveyed to determine the types of quadriceps strengthening exercises prescribed during the in-patient period. Information was sought regarding routine management strengthening practices. A variety of quadriceps exercises such as static quadriceps contractions (SQC), straight leg raises (SLR) and inner range quadriceps (IRQ) were frequently prescribed, although no standard practice currently exists. Static quadriceps exercises were prescribed by 91% of hospitals surveyed, IRQ exercises were used by 30%, and 49% reported using SLR exercises. Current literature tends to support the performance of SQC and SLR exercises during the early postoperative period following ACL reconstruction. Conversely, current clinical practice is incongruent with regard to the scientific recommendations for IRQ performance.
Publisher: Wiley
Date: 13-06-2013
DOI: 10.1111/DMCN.12181
Abstract: The aim of this study was to determine the reliability, validity, and optimal placement of pedometers in children with cerebral palsy (CP) who ambulate without aids. Seventeen participants aged 7 to 17 years with CP (eight males, nine females mean age 12y 4mo SD 3y 2mo), who could ambulate without aids, wore four New Lifestyles pedometers (NL-1000) on an elasticized waist belt. Fourteen participants had hemiplegia, two diplegia, and one triplegia all were classified in Gross Motor Function Classification System (GMFCS) level I (n=8) or II (n=9). Participants completed 3-minute walking and running trials around an indoor course and were videotaped to verify the actual number of steps taken during each trial. Inter-pedometer reliability was determined by comparing pedometer readings using intraclass correlation coefficients (ICCs). Validity was determined by comparing pedometer step counts with video step counts using ICC, t-tests, and Bland-Altman plots. Optimal pedometer placement was determined using Wilcoxon signed-rank tests to compare the percentage error for pedometers positioned on the dominant and non-dominant hips. Excellent reliability (ICC 0.88-0.99) and validity (ICC 0.78-0.95) were demonstrated with no significant difference between the video step counts and pedometer step counts. There was no significant difference between the step counts recorded by pedometers on the dominant and non-dominant hips. This study showed that NL-1000 pedometers have a high degree of reliability and validity in ambulant children with CP in controlled conditions.
Publisher: Springer Science and Business Media LLC
Date: 06-09-2016
Publisher: SAGE Publications
Date: 10-03-2020
Abstract: In clinical trials of physical interventions, participant blinding is often poorly addressed and therapist blinding routinely omitted. This situation presents a substantial barrier to moving the field forward. Improving the success of blinding will be a vital step towards determining the true mechanisms of physical interventions. We used a Delphi approach to identify important elements of shams for physical interventions to maximise the likelihood of participant and therapist blinding in clinical trials. Two expert groups were recruited: (1) experts in research methodology and (2) experts in deceptive and/or hypnotic techniques including magic. Magicians were included because they were considered a potentially rich source of innovation for developing credible shams due to their unique skills in altering perceptions and beliefs. Three rounds of survey were conducted, commencing with an open-ended question. Responses were converted to single ‘items’, which participants rated in the following two rounds using a 9-point Likert scale, categorised as ‘Not important’ (0–3), ‘Depends’ (4–6) and ‘Essential’ (7–9). Consensus was pre-defined as ≥80% agreement within a 3-point category. Thirty-eight experts agreed to participate (research methodology: n = 22 deceptive and/or hypnotic techniques: n = 16), and 30 experts responded to at least one round (research methodology: n = 19 deceptive and/or hypnotic techniques: n = 11). Of 79 items, five reached consensus in the ‘Essential’ category in both groups, which related to beliefs of participants ( n = 3 items), interactions with researchers ( n = 1 item) and standardisation of clinical assessments ( n = 1 item). Thirteen additional items reached consensus in the ‘Essential’ category in one group. Experts in research methodology had one additional item reach consensus, related to authentic delivery of study information. The remaining 12 additional items that reached consensus in the deceptive and/or hypnotic techniques group related mainly to therapist attitude and behaviour and the clinical interaction. Experts agreed that, for shams to be believable, consideration of cognitive influences is essential. Contrary to the focus of previous shams for physical interventions, replicating the tactile sensation of the active treatment was not considered an essential part of sham development. Therefore, when designing sham-controlled clinical trials, researchers should carefully consider the cognitive credibility of the entire intervention experience, and not just the indistinguishability of the sham intervention itself. The findings provide new guidance to researchers on important contributors to blinding in physical intervention trials.
No related grants have been discovered for Maureen McEvoy.