ORCID Profile
0000-0002-9540-458X
Current Organisations
Flinders University
,
Stellenbosch University
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Aged Health Care | Aboriginal and Torres Strait Islander Health | Public Health and Health Services | Health and Community Services
Behaviour and Health | Disability and Functional Capacity | Health Related to Ageing | Health Status (e.g. Indicators of Well-Being) |
Publisher: Springer Science and Business Media LLC
Date: 30-04-2011
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.JSE.2010.10.024
Abstract: This systematic review explored the midterm effectiveness of extracorporeal shockwave therapy (ESWT) in reducing pain and improving shoulder function. Calcified rotator cuff tendinitis is a common cause of chronic shoulder pain that leads to significant pain and functional limitations. ESWT is an alternative to surgery when conservative treatments such as nonsteroidal antiinflammatory drugs, steroidal injections, and physiotherapy fail to relieve symptoms. It is hypothesised that ESWT is effective in the midterm for reducing pain and improving function for patients with chronic calcific tendinitis and that a dose-response relationship exists in the treatment parameters for effectiveness. Articles were electronically searched from the Cochrane Controlled Trials Register, MEDLINE, CINAHL, PUBMED, EMBASE, SPORTSDiscus and PEDro using a comprehensive search strategy. Studies were included if they were randomized controlled trials testing the midterm effectiveness of ESWT for chronic calcific tendonitis. Methodologic quality was assessed by PEDro (total score = 10). The strength of the evidence was reported using the National Health and Medical Research Council body of evidence framework. Six of the nine included studies scored 7 or more for methodologic quality. All studies had follow-up periods of at least 6 months. Common methodologic flaws were insufficient blinding of clinicians and assessors. There was consistent evidence of midterm effectiveness of ESWT in reducing pain and improving shoulder function for patients with chronic calcified tendinitis. ESWT is a potential alternative to surgery with good mid-term effectiveness and minimal side effects. This review noted several limitations with the current body of evidence. Studies were mainly from a few European countries involving medical doctors, with a lack of erse perspectives and effectiveness evaluation from other health professionals who might use this treatment option for patients with chronic calcific tendinitis. Further, the different outcome measures used and inadequate reporting details in the included studies did not permit a quantitative synthesis of the effectiveness of this treatment. A lack of follow up period beyond one year in the studies also precluded conclusion to be made on the longer term effectiveness of ESWT. Due to variable treatment parameters (eg dosage), this review was unable to provide clear guidance of the dose-effect of the midterm effectiveness of ESWT. Studies of better methodologic design using standardized treatment protocols and studies with longer follow-up are required.
Publisher: SAGE Publications
Date: 03-11-2010
DOI: 10.1111/J.1747-4949.2010.00488.X
Abstract: Adherence to recommended clinical practices improves stroke outcomes. As a result, stroke clinicians are increasingly expected to evaluate the quality of the care they provide so that areas for improvement can be targeted. Finding the best method to evaluate the quality of dysphagia management can be challenging. To systematically review process indicators used to assess the quality of care provided to patients with dysphagia following acute stroke and examine the level of evidence underpinning these indicators. Databases were systematically searched to identify publications (January 2006–April 2009) that describe process indicators relating to the clinical management of acute stroke-related dysphagia. Relevant process indicators were extracted from the reviewed publications for detailed post hoc analysis including supporting evidence and alignment to the current Australian and English stroke guidelines. Title and abstract review found 150 potential studies. Full-text review resulted in 25 publications that met the study's inclusion criteria. Thirteen process indicators were identified in the literature that related to the initial assessment, clinical management, rehabilitation and discharge planning for patients with acute stroke-related dysphagia. These processes were supported by levels of evidence ranging from high ‘level 1’ (8%) down to ‘expert opinion’ evidence (46%). Two process indicators did not align to recommendations in the clinical guidelines. This systematic review underpins informed selection of process indicators for evaluating the quality of dysphagia management following stroke. The selection of quality indicators is complicated by equivocal supporting evidence however, indicators should reflect expected local practices, align with national stroke guidelines and be feasible for clinical auditing.
Publisher: Informa UK Limited
Date: 23-03-2011
Publisher: Elsevier BV
Date: 08-2003
DOI: 10.1016/S0749-0712(02)00148-8
Abstract: The development of outcome instruments has been reported to be a long process, often taking years to complete. In a previous article, we reported on the rationale behind the construction of a new wrist outcome instrument that assesses, from the wrist-injured in idual's perspective, their ability to perform activities of daily living following a wrist disorder. Content validity and test-retest reliability of the wrist outcome instrument also was demonstrated. Here we report on the results of the assessment of other aspects of validity, specifically construct validity of the wrist outcome instrument and the ability of the instrument to detect change over time. We evaluated these psychometric properties against frequently used clinical tests that assess impairments and thus report on the relationship between the ability to perform activities of daily living and impairment measures.
Publisher: Informa UK Limited
Date: 23-03-2011
Publisher: Elsevier BV
Date: 08-2007
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.APERGO.2012.09.008
Abstract: Descriptive study. The objective of this study was to present anthropometric data from high school students in Cape Metropole area, Western Cape, South Africa that are relevant for chair design and whether the dimensions of computer laboratory chairs currently used in high schools match linear anthropometrics of high-school students. Summary of Background Data. Learner-chair mismatch is proposed as a cause of poor postural alignment and spinal pain in adolescents. A learner-chair mismatch is defined as the incompatibility between the dimensions of a chair and the anthropometric dimensions of the learner. Currently, there is no published research to ascertain whether the furniture dimensions in school computer laboratories match the anthropometrics of the students. This may contribute to the high prevalence of adolescent spinal pain. The s le consisted of 689 learners, 13-18 years old. The following body dimensions were measured: stature, popliteal height, buttock-to-popliteal length and hip width. These measurements were matched with the corresponding chair seat dimensions: height, depth and width. Popliteal and seat height mismatch was defined when the seat height is either >95% or 95% or <80% of the buttock-popliteal length. Seat width mismatch is defined where the seat width should be at least 10% and at the most 30% larger than hip width. An 89% of learners did not match the seat. Five percent of learners matched the chair depth, the majority was found to be too big. In contrast, 65% of the learners matched the chair width dimension. A substantial mismatch was found. The school chairs failed standard ergonomics recommendations for the design of furniture to fit the user. This study supports the conclusion that there is no one-size-fits-all solution. There is an urgent need for chairs that are of different sizes or that are adjustable.
Publisher: IEEE
Date: 2005
DOI: 10.1109/ISWC.2005.20
Publisher: Medical Journals Sweden AB
Date: 2012
Abstract: Whilst prognostic factors for recovery from whiplash associated disorders have been documented, factors related to high physiotherapy use are not well recognized. This study profiles predictors for high use of physiotherapy services from a large dataset from an Australian state insurer for motor vehicle accidents. A dataset of Motor Accident Commission claims in South Australia for whiplash associated disorders (2006-2009) was interrogated. The median number of physiotherapy services per claimant was 15 (range: 1-194). The typical high user of physiotherapy was female, aged 25-59 years, living in a high socio-economic area, with legal representation, who delayed obtaining physiotherapy for at least 28 days after the accident. The largest mean number of days between treatments (5.4 days) in the first 5 treatments related to the lowest subsequent use of physiotherapy services. This represents the first review of physio-therapy service use based on an insurance dataset. A range of factors were related to high use of physiotherapy services. It is hoped that identifying the mean number and spread of physiotherapy interventions for whiplash associated disorders, and the profile of high users of physiotherapy will help gauge the success of strategies to maximize the efficacy of physiotherapy management of whiplash associated disorders.
Publisher: AOSIS
Date: 08-02-2021
Publisher: Informa UK Limited
Date: 08-2011
DOI: 10.2147/JMDH.S23028
Publisher: African Journals Online (AJOL)
Date: 03-09-2014
DOI: 10.4314/AHS.V14I3.28
Publisher: Wiley
Date: 2004
DOI: 10.1002/NAU.20064
Abstract: To investigate the repeatability of a short stress test of coughing and jumping (the expanded Paper Towel Test (PTT)) to quantify urine loss in stress incontinent adult women. In the laboratory, the reliability of two methods of measuring the size of the wet area, produced by a typical volume of water titrated onto paper towel was investigated and some absorbency properties of the brand of towel used were quantified. Thirty one women performed a provocative coughing and jumping test on consecutive days using a "perineal pad" of paper towel. The repeatability coefficient was calculated. The provocative test was repeatable to within 2.8 ml of urine loss, but with the exclusion of one anomalous result, the repeatability improved to lie within 1 ml. The coefficient of variation (CV) for the between-method differences (computer scanning and graph paper) was 1.27%. A volume of 1 ml of water produced a wet area of 25.7 cm2. The range of measurable areas corresponded to volumes of 0.005-8 ml. Standardization of method is required because the size of the wet area differed by manufacturer of paper towel (P < 0.01, two products compared) and with time elapsed since titration (P < 0.01). The "expanded PTT" is a simple tool for quantification of urine loss (0.005-8 ml) in women to 72 years with stress incontinence. With a suggested modification, it should prove reliable for detection of between-visit differences of 1 ml. The reliability of the test is dependent upon the use of standard protocol and paper towel with known volume-area ratio. To improve clinical diagnosis, it can also be used with any brand of paper towel to confirm the sign of stress incontinence on exertion.
Publisher: SAGE Publications
Date: 10-2014
DOI: 10.4276/030802214X14122630932557
Abstract: Many occupational therapists administer sensory interventions to address the needs of children with autism spectrum disorder. However, the current evidence regarding the effectiveness of sensory interventions is inconclusive, resulting in calls for more robust testing through randomized controlled trials. Our initial research plan was to conduct a randomized controlled trial that had real-world applications for occupational therapists and children diagnosed with autism spectrum disorder. However, as we conceptualized this study, we identified many uncertainties regarding the criteria required for a robust trial. In this opinion piece we describe and discuss the challenges we encountered when designing a community-clinic-based effectiveness study in an Australian context.
Publisher: Springer Science and Business Media LLC
Date: 20-08-2013
Abstract: Functional decline (FD) is a largely preventable feature of aging, characterized as gradual erosion of functional autonomy. This reduces an older person’s capacity for safe, independent community living. The healthcare needs of an unprecedented aging population places pressure on health systems to develop innovative approaches to ensuring older people live healthy and independent lives for as long as possible. TRIIFL aims to demonstrate that: Incipient FD in older people can be identified using a simple telephone-screening process within four weeks of discharge from an emergency department presentation for a minor health event and Early engagement into a person-centered in idualized intervention arrests or reduces the rate of FD over the next 12 months. A randomized controlled trial (RCT) nested within a 13-month longitudinal cohort study. The RCT (conducted over 12 months) tests the effectiveness of a novel, early, home-based, personalized program (compared with no intervention) in arresting or slowing FD. TRIIFL focuses on older adults living independently in the community, who have not yet had a serious health event, yet are potentially on the cusp of FD. Participants in the longitudinal cohort study will be recruited as they present to one large tertiary hospital Emergency Department, providing they are not subsequently admitted to a ward. S le size calculations indicate that 570 participants need to be recruited into the longitudinal study, with 100 participants randomized into the trial arms. Measures from all subjects will be taken face-to-face at baseline (recruitment), then subsequently by telephone at one, four, seven and thirteen months later. Measures include functional abilities, quality of life, recent falls, mobility dependence, community supports and health service usage. Specific to the nested RCT, the quality of life tool (SF12) applied at one month, will identify in iduals with low mental component quality of life scores, who will be invited to enter the RCT. Assessors will be blinded to RCT arm allocation, and subjects in the RCT will be blinded to the intervention being received by other subjects. Australian & New Zealand Clinical Trials Registry: ACTRN12613000234718
Publisher: Elsevier BV
Date: 06-2021
Publisher: Springer Science and Business Media LLC
Date: 29-06-2005
Publisher: Elsevier BV
Date: 08-2000
DOI: 10.1016/S0003-6870(00)00002-8
Abstract: This paper describes adolescent low back pain and tests its associations with environmental features of backpack load, time spent carrying loads, time sitting, and time playing sport, using data from 1269 adolescents in twelve volunteer high schools in Adelaide, South Australia. Backpacks were the preferred method of load carrying, two-thirds of wearers preferring to carry the load over two shoulders. The average load weighed 5.3 kg (approximating 10% of body weight). The youngest students carried approximately the same amount as the oldest students. Girls were more likely than boys to report recent low back pain, and there were gender- and age-specific associations between recent low back pain, the amount of time spent sitting, the backpack load and time spent carrying it, and time playing sport. Body mass was not a confounder of any association. These findings support ongoing concerns regarding environmental contributions to adolescent low back pain.
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.AMEPRE.2009.07.012
Abstract: Over the past decade, childhood obesity has been recognized as an increasing health problem worldwide. It is a predictor of obesity during adulthood, which is strongly linked to chronic lifestyle diseases. This paper aims to evaluate the effectiveness of school-based programs in the prevention and management of childhood obesity. A comprehensive literature search was undertaken for RCTs and clinical controlled trials on school-based interventions that addressed childhood obesity, published between 1995 and 2007. The papers included for the meta-analysis were those in which ORs or standardized mean differences and their 95% CIs were reported or could be calculated from available data. Meta-analysis showed that the odds of participants' being overweight and obese in the school-based intervention programs compared with the control arm were significantly protective in the short term (OR=0.74, 95% CI=0.60, 0.92). Interventions that were conducted for more than 1 year had a higher OR of decreasing the prevalence of obesity. However, intervention programs were not effective in decreasing BMI compared with control treatments, with a weighted mean difference of -0.62 (95% CI=-1.39, 0.14). This meta-analysis showed that there was convincing evidence that school-based interventions are effective, at least short-term, in reducing the prevalence of childhood obesity. Longer-running programs were more effective than shorter programs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-1999
DOI: 10.1097/00007632-199911010-00015
Abstract: A Cross-sectional, observational study, examining the effects of backpack weight on adolescent posture. To investigate the response of the craniovertebral angle to backpack load. There is a widely held belief that repeated carrying of heavy loads, such as school backpacks, places additional stress on rapidly growing adolescent spinal structures, making them prone to postural change. Ten volunteer state high schools in metropolitan Adelaide, South Australia, provided 985 students, aged 12 to 18 years and from five different high school years, for this study. Students' posture was measured with and without their school backpack. All data analyses were undertaken per school year level to account for specific load-carrying requirements and spinal development associated with the age group. A significant change in craniovertebral angle was found at every year level, when comparing standing posture with no backpack with posture when carrying a backpack. The change was greatest for the youngest students. Incremental change in craniovertebral angle was not strongly associated with backpack loads. The association became stronger for the oldest girls when controlled for body mass index and for weight. The results support a differential postural response per gender and per level of spinal development but also suggest that the craniovertebral angle may not be the most sensitive measure of head-on-neck postural change for adolescents.
Publisher: Wiley
Date: 10-10-2015
DOI: 10.1111/GGI.12379
Abstract: Functional decline is an insidious-onset manifestation of aging, which can be overlooked in its early stages. Current screening measures for incipient functional decline are generally applied at one point-in-time, in hospital wards or emergency departments when older people are in health crisis. This potentially provides an imprecise estimate of the situation. In line with internationally recognized challenges of dealing with the needs of aging populations, it is essential that sensitive screening for incipient functional decline occurs much earlier, in familiar community settings. The present review presents an evidence-based synthesis of features, measures and/or manifestations of early functional decline in community-dwelling older in iduals. A systematic search was carried out to collate indicators of early functional decline. These were then organized into constructs, which reflected the principal measurement intent as identified by the author of each article. A total of 146 articles (reporting 195 psychometrically sound measurement tools, representing 107 constructs) were included in the review. The constructs were then clustered into six broad health domains: medical status, performance capacity, participation, demographics, anthropometry and relationships with health providers. These domains were developed after consultation with a range of allied health professionals and a consumer representative. The present review provides the first known evidence-based synthesis of indicators of early functional decline in older community-dwelling people, and shows the range of constructs that need to be considered in assessment for early functional decline.
Publisher: Informa UK Limited
Date: 07-2011
DOI: 10.2147/JMDH.S23144
Publisher: CSIRO Publishing
Date: 2009
DOI: 10.1071/AH090423
Abstract: Background: Osteoporosis contributes significantly to fractures, subsequent disability and premature mortality in Australia. Better detection and management of osteoporosis will reduce unnecessary health expenditure. Objective: To evaluate, in one large tertiary metropolitan hospital, the orthopaedic health care team?s approach to osteoporosis guideline implementation to improve early identification and management of osteoporosis. Methods: This paper describes the implementation of multifaceted strategies to improve healthpromoting behaviours and the uptake of osteoporosis guidelines by staff in the orthopaedic outpatient clinic at one metropolitan hospital, reflecting organisational and in idual commitment to embedding guideline recommendations into routine practice. Implementation strategies were aimed at the requirements and perspectives of different stakeholder groups. Five audit datasets were compared: 62 patient records in two baseline audits, and three post-implementation audits of 31 patient records, collected over the following 3-month periods (August 2006 to April 2007). All audits used the same criteria to assess compliance with clinical guidelines, and outcomes of implementation strategies. Results: There was consistent improvement in compliance with osteoporosis guidelines over the audit periods. Comparing baseline and immediate post-implementation data, there was a significant improvement (P 0.05) in the percentage of patients with likely fragility fractures who were identified with an osteoporotic fracture. The percentage of patients who had a likely fragility fracture, with whom staff communicated about their problems and how to deal with them, increased consistently over all post-implementation audit periods. For patients with established osteoporosis who presented with fragility fractures, there was sustained improvement over the audit periods in the percentage provided with guideline-based care. Conclusion: This study highlights that appropriate and targeted intervention strategies can be effective if modelled on best practice guideline implementation approaches with the use of a coordinated post-fracture management approach to osteoporosis.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
DOI: 10.1111/J.1744-1609.2012.00295.X
Abstract: It is essential that allied health practice decisions are underpinned by the best available evidence. Therefore, effective training needs to be provided for allied health professionals to do this. However, little is known about how evidence-based practice training programs for allied health professionals are delivered, the elements contained within them, how learning outcomes are measured or the effectiveness of training components in improving learning outcomes. We conducted a systematic literature review to identify effectiveness of evidence-based practice training programs and their components for allied health professionals. Key words of evidence-based practice programs OR journal clubs OR critical appraisal AND allied health OR physiotherapists OR occupational therapists OR speech pathologists AND knowledge OR skills OR attitudes OR behaviour were applied to all available databases. Papers were critically appraised using the Joanna Briggs Institute and McMaster tools and the checklist of recommendations for educational interventions. Data were extracted on participants, training program components and underpinning theories, methods of delivery and learning outcomes. Data were synthesised using a combination of narrative and realist synthesis approaches. Six relevant studies (four randomised controlled trials and two before-and-after studies) reported on the effectiveness of evidence-based practice training programs for evidence-based practice for groups of health professionals. Specifically, only three of these studies (one randomised controlled trial and two before-and-after studies) reported on allied health professionals (physiotherapists, occupational therapists and social workers). Among these three studies on allied health, outcomes were variably measured, largely reporting on knowledge, skills, attitudes and/or behaviours. Significant changes in knowledge and skills were reported in all studies. Only the social work study, which reassessed outcomes after 3 months, reported significant changes in attitudes and behaviours. Training took from 3 hours to 2 days. While there was information on training program components, there was no evidence of effectiveness related to learning outcomes. Overall, there is limited research regarding training of allied health professionals in evidence-based practice and learning outcomes. From the limited evidence base, there was consistent evidence that any training significantly influenced knowledge, skills and attitudes, irrespective of the allied health discipline. There was little information, however, regarding how to change or measure behaviours. This review cannot recommend components of training for allied health professionals in evidence-based practice, which significantly improve learning outcomes.
Publisher: Informa UK Limited
Date: 06-2014
DOI: 10.2147/JMDH.S59473
Publisher: Springer Science and Business Media LLC
Date: 20-08-2008
Abstract: All the reported measures of sitting posture, as well as photographs, have one flaw, as these measures are external to the body. These measures use calculations from external bony landmarks to estimate spinal posture, on the understanding that what is being measured externally reflects the shape, health and performance of structures of the underlying spine. Without a comparative measure of the relative position of the structures of the spine, the validity of any external spinal posture measure cannot be established. This paper reports on a study which tests the validity of photographs to measure adolescent sitting posture. The study was conducted in a laboratory at the Department of Human Biology, University of Cape Town. A random s le of 40 adolescents were recruited from the Cape metropolitan schools, to detect differences of three degrees or more between the repeated measures of upright, normal or slouched posture (photographs) and between the posture photographs and LODOX measures. Eligible participants were healthy male and female subjects aged 15 or 16 years old, in Grade 10, and who were undertaking Computer or Computype studies at their schools. Two posture measurement tools were used in the study, namely: Photographs were taken using the Photographic Posture Analysis Method (PPAM) and Radiograph s were taken using the LODOX (LODOX (Pty) Ltd) system. Subjects' posture was assessed in simulated computer workstations. The following angles were measured: the sagittal head angle, cervical angle, protraction/retraction angle, arm angle and the thoracic angle. Data from 39 subjects (19 males, 20 females) was used for analysis (17 15-year-olds (7 boys and 10 girls), 22 16-year-olds (12 boys and 10 girls)). All but one photographic angle showed moderate to good correlation with the LODOX angles (Pearson r values 0.67–0.95) with the exception being the shoulder protraction/retraction angle Pearson r values. Bland Altman limits of agreement illustrated a slight bias for all angles. The reliability study findings from repeated photographs demonstrated moderate to good correlation of all angles (ICC values 0.78–0.99). The findings of this study suggest that photographs provide valid and reliable indicators of the position of the underlying spine in sitting. Clinically it is important to know whether a patient is showing true progression in relation to a postural intervention. Based on the results of this study, the PPAM can be used in practice as a valid measure of sitting posture.
Publisher: Wiley
Date: 18-05-2005
Publisher: Wiley
Date: 10-04-2013
DOI: 10.1111/BJET.12042
Publisher: Springer Science and Business Media LLC
Date: 13-05-2011
Publisher: SAGE Publications
Date: 2019
Abstract: There are no agreed comprehensive tests for age-related changes to physical, emotional, mental and social functioning. Research into declining function focuses on those 75 years and older and little is known about age-related changes in younger people. The aims of this project were (1) to ascertain a comprehensive test battery that could underpin community-based health screening programmes for people aged 40–75 years and pilot both (2) community-based recruitment and (3) the utility, acceptability, response burden and logistics. A total of 11 databases were searched using a broad range of relevant terms. An identified comprehensive, recent, high-quality systematic review of screening instruments for detection of early functional decline for community-dwelling older people identified many relevant tools however, not all body systems were addressed. Therefore, lower hierarchy papers identified in the rapid review were included and expert panel consultation was conducted before the final test battery was agreed. Broad networks were developed in one Australian city to aid pilot recruitment of community-dwellers 40–75 years. Recruitment and testing processes were validated using feasibility testing with 12 volunteers. The test battery captured (1) online self-reports of demographics, health status, sleep quality, distress, diet, physical activity, oral health, frailty and continence and (2) objective tests of anthropometry mobility lung function dexterity flexibility, strength and stability hearing balance cognition and memory foot sensation and reaction time. Recruitment and testing processes were found to be feasible. This screening approach may provide new knowledge on healthy ageing in younger people.
Publisher: Wiley
Date: 05-07-2014
DOI: 10.1111/JEP.12213
Abstract: Declining capacity to function safely and independently in the community is a manifestation of ageing. Multiple measures are used to define and predict functional decline. This paper explores the use of partial least squares (PLS) analysis to understand the interaction between overtime measures of functional decline. Comprehensive information was captured on in iduals aged 65+ who presented at a large metropolitan Australian hospital Emergency Department (ED) for a complaint, which did not result in a hospital admission. They were followed-up by telephone 1 and 3 months, post-ED discharge. Information was collected each time on home situations (living alone, using community services, using a gait aid and having a formal carer), recent falls, hospitalizations and instrumental activities of daily living (IADLs). PLS analysis was applied to identify overtime relationships between measures. Valid information was provided by 147 in iduals at all three time points. The eight in idual IADL items clustered clearly around physical, mental or combined mental and physical IADLs. These clusters were strongly related to increased use of community supports, gait aid and carer, and living alone. The relationship was less convincingly for hospitalizations, and falls were not explained well. PLS analysis offers a novel and comprehensive way of analysing complex health data, which allows sense to be made of relationships over a 3-month period. This analysis provides a better understanding of declining function over time, than could be provided by current health modelling methods.
Publisher: Informa UK Limited
Date: 04-2014
DOI: 10.1080/00140139.2014.884247
Abstract: Dynamic movement whilst sitting is advocated as a way to reduce musculoskeletal symptoms from seated activities. Conventionally, in ergonomics research, only a 'snapshot' of static sitting posture is captured, which does not provide information on the number or type of movements over a period of time. A novel approach to analyse the number of postural changes whist sitting was employed in order to describe the sitting behaviour of adolescents whilst undertaking computing activities. A repeated-measures observational study was conducted. A total of 12 high school students were randomly selected from a conveniently selected school. Fifteen minutes of 3D posture measurements were recorded to determine the number of postural changes whilst using computers. Data of 11 students were able to be analysed. Large intra-subject variation of the median and IQR was observed, indicating frequent postural changes whilst sitting. Better understanding of usual dynamic postural movements whilst sitting will provide new insights into causes of musculoskeletal symptoms experienced by computer users.
Publisher: BMJ
Date: 05-06-2007
Abstract: Youth sports injury is a public health concern, as it has detrimental effects on the health and well-being of young athletes. The knee joint is reported to be the most common joint injured by young sports participants. The potential loss of ability to participate in regular physical activity after injury is alarming, because physical inactivity is one of the major risk factors associated with systemic disease, disability and/or death worldwide. This paper presents a systematic review of the epidemiological research reporting on the prevalence of knee injuries among active adolescents to ascertain the global scope of the problem. The 19 eligible studies for this review were mostly (90%) conducted in developed countries. Global adolescent knee injury prevalence ranges between 10% and 25%, with more recent studies reporting higher percentages. The average methodological appraisal score of the 19 studies was 56%. Females and adolescents appear to be more at an increased risk of sustaining a knee injury compared with males. Developing standard injury definitions as well as descriptions of injury causes must be taken into consideration in future injury surveillance research in order to appropriately inform effective knee injury preventative programmes for youth.
Publisher: Springer Science and Business Media LLC
Date: 28-02-2011
Publisher: Springer Science and Business Media LLC
Date: 04-11-2015
Publisher: Springer Science and Business Media LLC
Date: 14-07-2015
Publisher: IEEE
Date: 11-2014
Publisher: Informa UK Limited
Date: 12-2011
DOI: 10.2147/COPD.S26581
Publisher: Wiley
Date: 18-08-2020
DOI: 10.1111/JEP.13265
Abstract: Most frailty assessments have been developed for people aged over 65 years. However, there is growing evidence that frailty is detectable in younger people. This paper tests the hypothesis that the Fried frailty phenotype and the CFS categories identify the same people in age-gender subgroups in community-dwelling 40 to 75-year-olds. Participants were recruited via comprehensive community-s ling strategies. They self-reported frailty using the Clinical Frailty Scale (CFS), and frailty was also estimated using the Fried phenotype (self-reported unintended weight loss, exhaustion and low regular exercise observed slow gait speed and poor grip strength). CFS and Fried scores were compared overall, and for age-gender subgroups (40-49 years, 50-59 years, 60-69 years, and 70-75 years). Spearman rho and differences in mean integer Fried scores were calculated across CFS categories using ANOVA. Correlations were determined between Fried categories of not-frail, pre-frail, and frail and ranked CFS categories, using ranked scores (tau-c) and Cochran-Mantel-Haenszel (C-M-H) tests. Of 656 participants (67% female mean age 59.9 years, SD 10.6), Fried phenotype classified 59.2% not frail, 39.0% pre-frail, and 1.8% frail, with no gender or age differences. CFS data were missing for 25 participants, with N = 631 reporting categories of very well (24.6%), well (44.6%), managing well (21.9%), vulnerable (6.3%), mildly frail (0.5%), and moderately frail (0.2%). Overall, the mean Fried frailty scores increased incrementally and significantly across ranked CFS categories (P < .01), with weak linear correlation (rho = 0.09). There were variable correlations in age-gender groups, with the best correlation found for women aged 50 years or older, and men aged 60 to 69 years. Frailty assessments using the two assessments became more consistent, as age increased. Pre-frailty was identified by both assessments in all age-gender groups. The validity of self-reported CFS, and of pre-frailty criteria relevant to people younger than 65 years, needs investigation.
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/01421590802512870
Abstract: The attainment of clinical competence is a key outcome of physiotherapy programmes worldwide. Clinical education forms a core component of the training of physiotherapy students. The study on which this article is based aimed to investigate what physiotherapy students and clinical teachers at one physiotherapy training institution perceive as effective opportunities to facilitate learning in a clinical context. A survey of staff and students at the physiotherapy ision at Stellenbosch University was undertaken as one element of a situational case study. All enrolled physiotherapy students with clinical education experience and all clinical teachers involved in the clinical education of these students were invited to participate. A purpose-built questionnaire was developed and validated before being administered. The response rate was 80%. The clinical teaching and learning opportunities deemed most valuable for learning by students and teachers were demonstrations of patient management, feedback, discussions and assessment. Teachers and students varied in their perceptions of the learning value of peer assessment, self-assessment and reflection. The study provided indications for teachers on the valuable learning opportunities as perceived by students and teachers in a physiotherapy clinical setting. The activities perceived as most effective in facilitating learning in the clinical milieu were demonstrations of patient management, discussion, feedback and assessment. Participants indicated that they valued in idual contact with teachers and that they learnt productively from discussions with the teachers. It was reported that immediate and verbal feedback improved the learning experience. Both formative assessment in the form of a mock assessment and summative assessment in the form of an end-of-block test were identified as important in facilitating learning. Further research is required on peer assessment, self-assessment and reflection to establish the role of these aspects of learning.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2007
Publisher: JMIR Publications Inc.
Date: 13-07-2021
DOI: 10.2196/23174
Abstract: People with stroke and their caregivers experience numerous information needs internet-based resources may offer cost-effective ways to improve access to information about this condition and its management, including the availability of resources and support. The quality of online health information is, therefore, an important consideration for both developers and consumers of these online resources. This study aims to map and evaluate the content, readability, understandability, design, and quality characteristics of freely available online information resources (ie, websites) that empower people with stroke and their caregivers with information and self-help strategies poststroke. This descriptive review will follow the five systematic and rigorous methodological steps that are recommended for scoping reviews, which include the following: (1) identifying the research question, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarizing, and reporting the results. Data will then be synthesized and analyzed thematically. As of February 2021, the scoping review is in the data extraction stage. Data will be synthesized, and the first results are expected to be submitted for publication in an open-access peer-reviewed journal in August 2021. In addition, we will develop an accessible summary of the results for stakeholder meetings. Ethical approval is not required for this review, as it will only include publicly available information. This study is novel and will evaluate the typology, content, and design-related criteria, including accessibility, aesthetics, navigability, interactivity, privacy, and data protection, of online information resources for stroke. The review will be limited to online resources published in English. DERR1-10.2196/23174
Publisher: Wiley
Date: 10-2008
DOI: 10.1111/J.1365-2753.2008.01050.X
Abstract: Health-based journal clubs have been in place for over 100 years. Participants meet regularly to critique research articles, to improve their understanding of research design, statistics and critical appraisal. However, there is no standard process of conducting an effective journal club. We conducted a systematic literature review to identify core processes of a successful health journal club. We searched a range of library databases using established keywords. All research designs were initially considered to establish the body of evidence. Experimental or comparative papers were then critically appraised for methodological quality and information was extracted on effective journal club processes. We identified 101 articles, of which 21 comprised the body of evidence. Of these, 12 described journal club effectiveness. Methodological quality was moderate. The papers described many processes of effective journal clubs. Over 80% papers reported that journal club intervention was effective in improving knowledge and critical appraisal skills. Few papers reported on the psychometric properties of their outcome instruments. No paper reported on the translation of evidence from journal club into clinical practice. Characteristics of successful journal clubs included regular and anticipated meetings, mandatory attendance, clear long- and short-term purpose, appropriate meeting timing and incentives, a trained journal club leader to choose papers and lead discussion, circulating papers prior to the meeting, using the internet for wider dissemination and data storage, using established critical appraisal processes and summarizing journal club findings.
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/AH09619
Abstract: Background.The Australian Government Medicare Enhanced Primary Care (EPC) initiative for chronic disease management (CDM) supports integrated allied health (AH) and general medical practitioner (GP) care. There are limited ex les of how to operationalise this initiative in private practice, and minimal evidence of expected service utilisation or acceptability to patients. This paper reports on a 2007 Australian integrated GP rivate sector AH pilot program, based on Medicare EPC guidelines for Type II diabetes. Objectives.Describe how the pilot program was put in place (operationalised). Report on service utilisation and patient perspectives of the pilot program. Methods.Pilot program: patients with Type II diabetes were referred to credentialed diabetes educators (CDEs), dietitians or podiatrists by their GP, via a Medicare-approved team care arrangement (TCA). Dietitians and CDEs operated on a sessional basis from GPs’ rooms, and podiatrists operated from their own clinics. All AH providers accepted the Medicare Plus rebate only, and provided guidelines-based care (focussed on patient education, disease ownership and self-management). Service utilisation was measured by the number and type of AH attendances per patient. Patient perspectives of the pilot program, and what they perceived they had gained from participation in it, were measured by semi-structured telephone interviews. Results.An average of 2.3 AH consultations were consumed by 588 patients, of whom 59 were interviewed. Interviewed patients appreciated the ready and timely access to AH services at no additional cost, the integration of GP/AH care, and being actively involved in managing their disease. Approximately 60% of patients had never previously consulted an AH provider regarding diabetes. Interviewees perceived that collocated, integrated GP–AH care heightened their disease awareness, improved their knowledge of their disease and encouraged them to better self-manage. Most interviewees indicated that they did not require further AH assistance in the short term (having gained what assistance they needed), and ~60% interviewees indicated they would pay a gap fee for similar AH services in the future. Conclusion.Integrated AH/GP guidelines-based care provided in GP clinics appears to be cost efficient. It has the potential to improve patient access to AH care, promote the role of integrated care in the management of Type II diabetes, and improve patient education and self-management. What is known about the topic?There is a growing body of research on the effectiveness of multidisciplinary teams in the management of patients with chronic disease, in terms of promoting better health and self-management education. However little is known in Australia about the operationalisation of the Enhanced Primary Care (EPC) program by general medical practitioners (GPs) and private allied health (AH) providers, to manage any chronic disease. Service utilisation and patient perspectives of integrated GP/AH care under the EPC program are also largely unreported. What does this paper add?This paper describes how the pilot program was put in place (operationalised) within the Australian context using the Medicare EPC initiative, for the management of Type II diabetes. It describes service utilisation, and patient perspectives of integrated private AH and GP care in terms of the process, and what they gained from participating in it. What are the implications for practitioners?Integrating private AH and GP care in GPs’ rooms in Australia, under the EPC program, appears to be cost effective and readily accessible, and provides advantages for patients with Type II diabetes.
Publisher: Springer Science and Business Media LLC
Date: 11-06-2010
Publisher: Elsevier BV
Date: 2000
Publisher: Springer Science and Business Media LLC
Date: 17-07-2014
Publisher: Springer Science and Business Media LLC
Date: 26-02-2014
Publisher: Elsevier BV
Date: 10-2000
DOI: 10.1016/S1054-139X(00)00119-1
Abstract: To assess the reliability of adolescents' self-report of recent recreational injury. Identical written questionnaires were administered twice in a 3-week period to 75 randomly selected adolescents (aged 11-12 years and 15-16 years) in state primary and secondary schools in South Australia, Australia. The questionnaires sought information on injury sustained in the previous week. Parents of 60 of the adolescents were contacted in the same week as one of the questionnaire administrations, to verify their adolescent's most recent injury self-report. Intraclass and Pearson correlation coefficients provided evidence of agreement between responses, and stability of measure. There was high stability and good agreement between the parent and adolescent responses provided in the same week, suggesting that adolescents accurately reported recent recreational injury. The poor stability and low agreement between repeated adolescent responses over the 3-week period indicated not poor recall, but the changing nature of mostly minor recreational injury. These findings suggest that the nature of the injury reported in the first questionnaire had changed by the time of the second questionnaire administration, and that this was accurately reported. Confidence can be placed in adolescents' self-reports of recreational injury in the preceding week.
Publisher: Oxford University Press (OUP)
Date: 04-1999
Abstract: To compare stakeholder expectations of outcome of physiotherapy management of acute low back pain. Observational design using interviews and questionnaires. Practice/workplace. The study s le was from South Australia. It comprised 74 physiotherapists randomly selected from professional association listings (49.3% response rate), 121 physiotherapy patients (recruited by participating physiotherapists when attending their first physiotherapy treatment for acute low back pain), 21 general practitioners randomly selected from medical practitioner listings in the metropolitan telephone book (36.2% response rate) and 13 third party payers of a total of 16 available insurers in the metropolitan area (82% response rate). Stakeholders reported expectations of outcome at the end of the first treatment session and at the completion of the episode of care. There were differences in expectations between stakeholders, as well as between naive and experienced patients. Overall, patients expected symptom relief at the end of the first treatment. Naive patients decided to return for further treatment based on the relationship established with the therapist, whereas experienced patients also expected some advice on their condition during the first contact. Physiotherapists and referrers expected symptom relief and then long-term management strategies to be provided, and third party payers expected cost-efficient management of the condition and patient satisfaction. Physiotherapists need to address potential imbalance of consumer knowledge and foster a quality partnership with their patients on the first visit to physiotherapy. Patients who are in pain may not derive full value from information provided in an untimely manner.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.MATH.2013.04.003
Abstract: Physiotherapists should be proactive in preparing themselves to participate in innovative models of health care, which are emerging from the healthcare workforce reforms in Australia. One challenging outcome of workforce change is physiotherapy (non-medical) prescribing (NMP), which is part of the extension of scope of physiotherapy practice. This paper summarises the current evidence base for Australian physiotherapists seeking to obtain prescribing rights. A targeted literature review was undertaken through EBSCO Host, Cochrane, Medline, SportsDiscus, Cinahl, Healthsource and Google.com using broad search terms to identify peer-reviewed and grey literature pertaining to NMP by physiotherapists, nationally and internationally. No critical appraisal was undertaken however literature was structured into the NHMRC hierarchy of evidence. Themes raised in the included literature were reported descriptively. There were six relevant peer-reviewed articles, of hierarchy levels III_3 and IV. There was however, comprehensive and recent grey literature to inform Australian physiotherapy NMP initiatives. Themes included the need for standard National action in relation to legislative and regulatory/registration issues, appropriate education, credentialing and supervisory requirements for physiotherapy prescribing. Many lessons can be learnt from the literature, including the importance of planned, uniform National action (rather than piecemeal state-by-state initiatives). Essential elements include appropriate training and skills-based recognition within the discipline and the broader health team, and the need to overtly demonstrate effectiveness and safety. Regularly-evaluated service-delivery models which support NMP by physiotherapists are further required, to demonstrate efficiency, timeliness, patient centredness and equity.
Publisher: Wiley
Date: 11-2008
DOI: 10.1002/JHM.371
Abstract: Adverse events occur when patients transition from hospital to outpatient care. For quality improvement and research purposes, clinicians need appropriate, reliable, and valid survey instruments to measure and improve discharge processes. The objective of this study was to validate the Modified Physician-PREPARED scale to measure qualities of hospital discharge from the outpatient physician perspective. Descriptions include item development and psychometric properties. The design was a postal survey of outpatient physicians ractitioners who followed 403 patients who were discharged from hospital to home. We mailed questionnaires 10 days after discharge. Questionnaire items assessed perceptions of quality and outcome of discharge planning and communication. Analysis yielded the Modified Physician-PREPARED scale value: the sum of scores from 8 items. Internal consistency and construct validity were assessed. Survey response rate was 76%. Mean Modified Physician-PREPARED scale value was 16.6 +/- 4.0 with range 8 to 24. High scores reflected high perceptions of discharge quality. Analysis identified 2 principal components: timeliness of communication, and adequacy of discharge plan/transmission. The scale had acceptable internal consistency (Cronbach's alpha 0.86) and construct validity. When considering the discharge planning and communication for a specific patient, outpatient primary care physicians reported higher scores when they were involved in the discharge planning (P < 0.001) and when they were aware of community support services (P = 0.002). The Modified Physician-PREPARED scale measured outpatient physician perceptions of quality of hospital discharge to home. Clinicians and researchers may find the scale useful to evaluate discharge processes.
Publisher: Springer Science and Business Media LLC
Date: 12-2013
Publisher: South African Medical Association NPC
Date: 14-09-2015
DOI: 10.7196/SAMJNEW.7697
Publisher: Informa UK Limited
Date: 03-2014
DOI: 10.2147/JPR.S49620
Publisher: Wiley
Date: 06-2007
DOI: 10.1002/PRI.374
Publisher: University of Toronto Press Inc. (UTPress)
Date: 04-2013
DOI: 10.3138/PTC.2012-15
Abstract: Purpose: The Adapted Fresno Test (AFT) is a seven-item instrument for assessing knowledge and skills in the major domains of evidence-based practice (EBP), including formulating clinical questions and searching for and critically appraising research evidence. This study examined the interrater reliability of the AFT using several raters with different levels of professional experience. Method: The AFT was completed by physiotherapists and occupational therapists, and a random s le of 12 tests was scored by four raters with different levels of professional experience. Interrater reliability was calculated using intra-class correlation coefficients (ICC [2, 1]) for the in idual AFT items and the total AFT score. Results: Interrater reliability was moderate to excellent for items 1 and 7 (ICC=0.63–0.95). Questionable levels of reliability among raters were found for other items and for the total score. For these items, the raters were clustered into two groups—“experienced” and “inexperienced”—and then examined for reliability. The reliability estimates for rater 1 and rater 2 (“inexperienced”) increased slightly for items 2 and 5 and for the total score, but not for other items. For raters 3 and 4 (“experienced”), ICCs increased considerably, indicating excellent reliability for all items and for the total score (0.80–0.99), except for item 4, which showed a further decrease in ICC. Conclusion: Use of the AFT to assess knowledge and skills in EBP may be problematic unless raters are carefully selected and trained.
Publisher: Wiley
Date: 18-07-2020
DOI: 10.1111/JEP.13232
Abstract: Chemical restraint (CR) (also known as rapid tranquilisation) is the forced (non-consenting) administration of medications to manage uncontrolled aggression, anxiety, or violence in people who are likely to cause harm to themselves or others. Our population of interest was adults with mental health disorders (with/without substance abuse). There has been a growing international movement over the past 22 years towards reducing/eliminating restrictive practices such as CR. It is appropriate to summarise the research that has been published over this time, identify trends and gaps in knowledge, and highlight areas for new research to inform practice. To undertake a comprehensive systematic search to identify, and describe, the volume and nature of primary international research into CR published since 1995. This paper reports the processes and overall findings of a systematic search for all available primary research on CR published between 1 January 1996 and 31 July 2018. It describes the current evidence base by hierarchy of evidence, country (ies) producing the research, CR definitions, study purpose, and outcome measures. This review identified 311 relevant primary studies (21 RCTs 46 non-controlled experimental or prospective observational studies 77 cross-sectional studies 69 retrospective studies 67 opinion pieces, position or policy statements and 31 qualitative studies). The USA, UK, and Australia contributed over half the research, whilst cross-country collaborations comprised 6% of it. The most common research settings comprised acute psychiatric wards (23.3%), general psychiatric wards (21.6%), and general hospital emergency departments (19.0%). A key lesson learnt whilst compiling this database of research into CR was to ensure that all papers described non-consenting administration of medications to manage adults with uncontrolled aggression, anxiety, or violence. There were tensions in the literature between using effective CR without producing adverse events, and how to decide when CR was needed (compared with choosing non-chemical intervention for behavioural emergencies), respecting patients' dignity whilst safeguarding their safety, and preserving safe workplaces for staff, and care environments for other patients. The range of outcome measures suggests opportunities to standardise future research.
Publisher: SAGE Publications
Date: 2004
Abstract: Although work-related musculoskeletal disorders (MSDs) are now well recognized and documented, tests to diagnose and quantify these disorders are not well developed. Late presentation of MSDs is believed to equate to poor outcomes, and lack of reliable monitoring of treatment may lead to an inappropriate return to work. The authors report on a study to quantify “normal” muscle activity in volunteers. Subjects were randomly ided into control and intervention (exercise) groups. Using sonography, the authors measured the diameters of the selected soft tissue twice daily over a period of a week, with an extra measurement after exercise in the intervention group. Results indicated that there was no statistically significant difference between the intervention and control groups over any of the time frames or in dominant and nondominant sides. However, results indicated there was a day-to-day and diurnal difference in muscle size, indicating that muscles do not remain static in size.
Publisher: AOSIS
Date: 08-02-2021
Publisher: Wiley
Date: 24-08-2010
DOI: 10.1111/J.1365-2753.2009.01331.X
Abstract: There are no standard criteria for an occupational therapy (OT) home assessment for patients about to be discharged from an acute rehabilitation facility. This has implications for benchmarking, quality improvement and research. The aim of this paper is to establish 'core/essential' and 'ideal world' elements of OT home assessments for patients about to be discharged from acute rehabilitation settings. A piloted open-ended questionnaire initiated a Delphi study involving knowledgeable OTs working in Australian public and private acute rehabilitation settings. 'Core/essential' and 'ideal world' elements of OT home assessments were confirmed when 70% agreement was reached. Of 242 facilities in two Australian states, 110 were invited to participate, and 81 OTs from 84 facilities did so. Four Delphi rounds were required to reach consensus on 30 'core/essential' and 25 'ideal world' elements. Standard use of 'core/essential' pre-discharge home assessment elements should improve standards of care and the quality of discharge planning. OTs should consider including 'ideal world' criteria in pre-discharge assessments to optimize recently ill patients' community independence.
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.BURNS.2009.06.215
Abstract: Paediatric burns are a significant international public health problem. Developing and developed countries report similar challenges regarding paediatric burn prevention programs. Paediatric burns requiring healthcare often incur significant health and opportunity costs, death or long-term disability. This paper reviews international burn prevention strategies, and considers implementation of effective prevention strategies in South Africa. REVIEW QUESTION: Are there differences between developed and developing countries regarding causes and prevalence of paediatric burns, prevention strategies, and evidence of effectiveness? REVIEW FRAMEWORK: Implementing effective burn prevention strategies in South Africa. This systematic literature review identified, and narratively synthesized information from studies reporting population-based initiatives to prevent paediatric burns. Strategies from developing and developed countries were compared. Common strategies were identified, and evidence of effectiveness described. 30 studies were included from 16 developed/developing countries, reporting similar prevention strategies. Multi-pronged community-based interventions were most effective. Common elements comprised raising awareness of how burns occur, how burns can be prevented, the speed of sustaining significant injuries, and the short- and long-term effects of burns. Burn prevention strategies relevant to South Africa were provision of education in different formats (written, pictorial and verbal) in places frequented by children and parents, monitoring children more closely in hazardous areas (e.g. kitchens), and better planning of homes to reduce hazards. More work is required to establish effective, sustainable community-wide prevention programs in developed and developing countries. Effective paediatric burn prevention programs for South Africa should acknowledge parent and child literacy, how and where information is best accessed, the need to adapt effective hazard reduction programs to informal settlements, and the importance of legislated minimum safe housing standards. This requires significant commitment from Government, communities and in iduals.
Publisher: SAGE Publications
Date: 15-07-2013
Abstract: The study aimed to assess the association between childhood obesity and snacking. A total of 396 students in grades 4 to 6 enrolled in an elementary school in the Philippines were the participants in this study. Demographic profile anthropometric measures of height, weight, body mass index and information about snacking were gathered. Obese group had statistically more servings of sweetened drinks and low-quality snacks. Female obese subjects have statistically more servings at nighttime and greater total snack servings. For the whole cohort, the odds ratio of being overweight with high total snack servings was 2.12 (95% confidence interval = 1.25-3.62) whereas the odds ratio of being obese with calories obtained from snacking was 2.08 (95% confidence interval = 1.01-4.26). Nighttime snacks and bad-quality foods should be minimized. Moreover, reducing food portions at any snack time will protect children from being overweight.
Publisher: Springer Science and Business Media LLC
Date: 13-04-2011
Publisher: AOSIS
Date: 20-02-2020
Abstract: Background: Clinical practice guidelines (CPGs) provide conveniently packaged evidence-based recommendations to inform clinical decisions. However, intended end-users often do not know how to source, appraise, interpret or choose among CPGs. Moreover, it can be confusing when recommendations on the same topic differ among CPGs, in wording, intent and underpinning evidence.Objectives: This article reports on the processes of: (1) identifying current CPGs for acute and subacute low back pain (LBP) to fit the needs of South African physiotherapists, (2) collating and summarising CPG recommendations to produce a user-friendly end-user product and (3) testing the utility of the summary CPG document on South African physiotherapy clinicians to efficiently determine acceptability, appropriateness and feasibility to inform clinical decision-making.Method: An adapted approach was followed by systematically searching online CPG repositories and online databases for LBP CPGs screening and critically appraising identified CPGs summarising recommendations from relevant CPGs and organising them into clinical practice activities. Feedback on utility was obtained from 11 physiotherapists.Results: Three high-quality, international CPGs provided 25 recommendations on the assessment and management of acute and subacute LBP relevant to South African physiotherapy practice. They were organised into 10 headings. Physiotherapy user feedback suggested that this document would assist in clinical decision-making.Conclusion: Organised recommendations extracted from multiple, relevant CPGs provide an end-user-friendly resource for physiotherapists treating LBP.Clinical implications: Collated and organised CPG recommendations may effectively assist South African physiotherapists’ clinical decision-making in assessing and managing patients with acute and subacute LBP.
Publisher: Elsevier BV
Date: 05-2002
DOI: 10.1016/S0895-6111(02)00006-X
Abstract: A single, complete, ovine knee was imaged using conventional MRI then dissected allowing comprehensive dimensional measurement of the intra-articular structures. A three-dimensional (3-D) computer model of the knee was generated from the MR sections. Thirty-two in idual structural measures were recorded from the image output for which there was an available surgical measure for direct comparison. The results of Pearson's correlation testing show a rounded score of 1.00, suggesting an exceptional linear correlation between direct anatomical measurement and the 3-D image output. Further analysis of the data revealed an average error of measurement of 0.2mm across the 32 measures. The findings of this preliminary study suggest that 3-D reconstruction from MR data may be an appropriate, and accurate, means for making dimensional measurements of the bony and soft tissue structures of the ovine knee. It is unlikely that the measurement error would be of any great clinical significance. There is evidence in the literature to suggest that an ovine knee may be considered an acceptable model for substitution for the human knee in diagnostic assessment studies. Therefore, such findings may be considered clinically relevant in the field of human knee assessment.
Publisher: Science Alert
Date: 15-08-2009
Publisher: Informa UK Limited
Date: 02-2014
DOI: 10.2147/JMDH.S58603
Publisher: Elsevier BV
Date: 05-2006
DOI: 10.1016/J.JSAMS.2006.02.006
Abstract: There is scant guidance in the literature on the most appropriate Australian measures of, and thresholds for, extreme heat regarding giving advice on safe sports participation in hot weather. The purpose of this paper is to present a process for investigating two common measures of heat (air temperature, wet bulb globe temperature (WGBT)) in one state in Australia (South Australia), regarding their usefulness in making decisions regarding sports participation in the heat. Commonly reported measures and thresholds of extreme heat were identified from a systematic review of guidelines regarding sports participation in hot weather. Dry air temperature (threshold of 35 degrees C), and WBGT index (threshold of 28 degrees C) were highlighted. Repeated daily measures of dry air temperature by the Bureau of Meteorology (BoM) and WBGT index from 12 meteorological recording sites in South Australia (SA) for four consecutive summer periods (2000-2004) were analysed using these thresholds to investigate the prevalence of extremely hot temperatures in SA during these periods. The extremely hot hours-per-day data were standardised using a denominator of per-day-month across the 12 SA recording regions. Across the four summer seasons of data in SA, there were similar standardised numbers of hours-per-day of extremely hot dry air temperature and WBGT index. There was a high correlation between these hours of hot weather measures, highlighting the congruence between hot air and humidity measures. Three distinct regional site groupings were identified, in which there was a different prevalence of extremely hot weather conditions. In SA, dry air temperature is an appropriate and robust measure of extreme heat related to sports participation, this measure providing as much information as WBGT in identifying extremely hot periods of weather. Dry air temperature can be readily measured by sports participants or officials irrespective of the geographical location in SA. Three SA regions demonstrated distinct differences in prevalence of extremely hot conditions, suggesting the need for site-specific interpretation of heat participation guidelines to ensure sports safety in hot weather. Other states in Australia could use the approach outlined in this paper to identify the most appropriate measure of extreme heat relevant to local conditions, and to assist in interpreting heat limit guidelines in a local context.
Publisher: Wiley
Date: 24-08-2010
DOI: 10.1111/J.1365-2753.2009.01339.X
Abstract: Pre-discharge occupational therapy home assessments are common practice, and considered important for falls prevention in older people. This prospective, observational cohort study describes the association between pre-discharge home assessment and falls in the first month post-discharge from a rehabilitation hospital. 342 inpatients were recruited and followed up 1 month post-discharge. Patients were classified into diagnostic groups (cardiac, orthopaedic trauma, spinal, peripheral joint surgery, neurological and deconditioned). Age, gender, falls risk [Falls Risk Assessment Scoring System (FRASS)], functional independence scores (FIM™) and receipt (or not) of a home assessment were recorded. Patients completed a diary to document post-discharge falls. Logistic regression analysis tested the effect on falling of receiving a home assessment, age, gender, diagnostic group, FRASS and FIM™. Considering all subjects, not receiving a home assessment increased the risk of falling 1 month post-discharge [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4-4.7, P=0.003]. Neurological and orthopaedic trauma patients had significantly elevated risks of falling [OR (95% CI), respectively, 12.5 (4.7-33.2), 3.4 (1.4-8.4)] relative to the orthopaedic joint group. For all diagnostic groups except neurological, falls risk was mitigated by a home assessment. In non-neurological patients, adjusting for the effect of diagnostic group, FRASS and FIM™ scores indicated a significant association between not receiving a home assessment and falling (OR 4.2, 95% CI 2.1-8.2, P<0.001). Pre-discharge occupational therapy home assessments are sound post-discharge falls-prevention strategies in non-neurological patients. The decision to conduct a home assessment should consider diagnosis, falls risk and functional independence.
Publisher: Elsevier BV
Date: 05-2003
Publisher: SAGE Publications
Date: 07-2006
DOI: 10.1111/J.1468-2982.2006.01120.X
Abstract: The epidemiological and clinical literature identifies strong associations between adult headache, cervical and thoracic spine dysfunction and spinal posture. This paper reports on the prevalence and incidence of headache, neck and upper back pain which occurred in the previous week, in urban Australians aged 13–17 years. Commencing in 1999, we followed a cohort of South Australian students through 5 years of secondary schooling. Of our commencing cohort of students, 132 (30±) provided data on bodily pain every year. For both girls and boys, there was a significantly decreasing prevalence of headache over the study period, while neck pain and upper back pain increased. There was a significantly increasing trend over time for boys with upper back pain. Twenty percent of girls and boys consistently reported headache, neck pain or upper back pain over 5 years. The progression of early adolescent headaches to mid-adolescent neck and upper back pain potentially reflects the adolescents’ biomechanical responses to intrinsic and extrinsic imposts. This requires further investigation to understand the causes of adolescent headache, neck and upper thoracic pain.
Publisher: Informa UK Limited
Date: 04-2015
DOI: 10.2147/CIA.S74613
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.JMPT.2008.08.005
Abstract: This article provides a historical perspective and an overview of different ways of measuring sagittal plane cervical posture in clinical and research settings. Measures of cervical posture are considered, in terms of their purpose, their reliability and validity, and their capacity to provide knowledge about cervical posture. Despite technological advances in measurement techniques, there is still much to learn about cervical posture in terms of understanding how the neck balances the head against the force of gravity. The in idual spinal segments of the neck assume different relative positions, depending on the in idual's genetics anatomical construction occupational demands muscle strength and endurance as well as mental state, personality, and culture. Valid measures which can capture this objectively and reliably continue to challenge clinicians and researchers.
Publisher: Elsevier BV
Date: 05-2004
Publisher: Informa UK Limited
Date: 07-2011
DOI: 10.2147/JMDH.S22569
Publisher: Informa UK Limited
Date: 2014
DOI: 10.2147/CIA.S56086
Publisher: Informa UK Limited
Date: 04-2013
DOI: 10.2147/CIA.S42528
Publisher: Informa UK Limited
Date: 2010
DOI: 10.3109/09638280903514754
Abstract: This paper reports on a 3-month post-discharge falls profile of a cohort of patients discharged home from an acute rehabilitation setting. A consecutively-s led cohort of consenting patients was prospectively followed for 3 months after discharge from a large Australian metropolitan acute rehabilitation facility. Patients were diagnostically classified by the reason for admission. All patients completed a monthly falls diary. Each month, falls were described by severity, location, frequency and outcome. Patients also completed the World Health Organisation's quality of life (QoL-BREF) at Months 1 and 3. Almost a third of the study participants fell during the study [105 fallers of 342 total (31%)]. Of these, 21 fell more than once (20%). There were significant differences in falls reported per diagnostic group, including frequency, impact, severity and ability to get up. Irrespective of diagnostic group, fallers had lower QoL scores compared to non-fallers. Both the neurological and orthopaedic trauma groups were most at risk of falling in Months 1 and 3, whereas in Month 2, only the neurological group was most at risk of falling. Falls are a fact of life for some patients during their community rehabilitation phase. Patients from different diagnostic groups have different over-time risk profiles for falling. Thus, there is no 'one-size fits all' solution for falls prevention. This study provides useful data to assist in formulating appropriate falls prevention strategies for recently ill people.
Publisher: University of Toronto Press Inc. (UTPress)
Date: 10-2009
Publisher: AOSIS
Date: 08-02-2021
Publisher: Mary Ann Liebert Inc
Date: 02-2007
Abstract: The construction of stable engineered tissue depends on the formation of a functional connective tissue produced by cells locally. A major component of connective tissue is collagen. Its deposition into a stable matrix depends on the enzymatic extracellular conversion of procollagen to collagen. This step is very slow in vitro and we hypothesized that this is due to a lack of crowdedness and insufficient excluded volume effect (EVE) in culture media. We used neutral (670 kDa) and negatively charged dextran sulfate (DxS, 500 kDa) to create EVE in cell cultures and to enhance in vitro matrix formation by accelerating procollagen conversion. Biochemical analyses in 2 human fibroblast lines revealed mostly unprocessed procollagen in uncrowded culture medium, whereas in the presence of DxS, procollagen conversion occurred and most of the collagen was associated with the cell layer. Immunocytochemistry confirmed DxS-related collagen deposition that colocalized with fibronectin. The large neutral dextran showed, in identical concentration ranges, no effects that correlated well with its smaller hydrodynamic radius as determined by dynamic light scattering. This predicted a 10 times bigger crowding power of DxS and benchmarks it as a potentially promising crowding agent facilitating the formation of extracellular matrix in vitro.
Publisher: Elsevier BV
Date: 12-2002
DOI: 10.1016/S1440-2440(02)80016-0
Abstract: This study examined the order effect of a hamstring muscle stretch and resisted hamstring exercises on straight leg raise range of movement (SLR-ROM), in a group of twenty females aged 20-34 years. The stretch was applied either immediately before or Immediately after a resisted hamstring exercise. Exercise significantly decreased SLR-ROM (p < 0.05) and stretching significantly increased SLR-ROM (p < 0.05). The overall change in SLR-ROM for the two groups showed that a significant increase in SLR-ROM was detected (at a low force level) in Group 1 subjects who performed exercise and then stretched. A non-significant increase in SLR-ROM was detected by the higher force level in Group 1 subjects. In contrast, Group 2 subjects (stretch then exercise) showed a non-significant reduction in SLR-ROM at both levels of force.
Publisher: Mark Allen Group
Date: 04-2009
DOI: 10.12968/IJTR.2009.16.4.41196
Abstract: The Centre for Allied Health Evidence in collaboration with the Department of Health, South Australia, initiated structured journal clubs across selected metropolitan and country allied health-care sites. The aim was to provide a sustainable model of journal club to keep allied health practitioners informed of the current best evidence. This case report describes the development of the journal club, and its evaluation to date. The journal club development and its component processes are described. Evaluation of the journal club was conducted using a survey to ascertain participants knowledge and attitude towards evidence-based practice and their expectations of journal clubs. Semi-structured interviews were used to explore reasons for interest in journal clubs, local barriers to implementation and sustainability, and members perspectives of journal clubs. The processes involved in the journal club comprised six distinct steps, from development of a clinical scenario to reflect issues in current clinical practice, to dissemination of the research publication and its critical appraisal at the health service site. Evaluation of participants attitudes revealed a lack of confidence in research interpretation, positive expectations of the journal club (in applying research to practice), and a reliance on peers for research information. The journal club model was found to be effective in addressing the significant barriers of access and evaluation of research evidence. The case report demonstrates how this unique model of collaborative partnership between researchers and allied health practitioners can address the barriers in evidence-based practice, which could potentially impact on overall health service quality. Further evaluation of this model is needed.
Publisher: Wiley
Date: 14-02-2020
DOI: 10.1111/JEP.13363
Publisher: Elsevier BV
Date: 11-2004
Publisher: Wiley
Date: 21-03-2007
DOI: 10.1002/PRI.363
Abstract: Physiotherapists' use of research evidence with clinical decision-making has interested researchers world-wide since 1980 however, little is known about such practices in Australia. The present survey sought information on Australian physiotherapists' perceptions of the importance of research, and barriers to uptake of evidence in clinical practice, when compared with an international cohort from 2001. An Australian-relevant version of an English (UK) National Health Service (NHS) survey instrument was used to canvass 453 physiotherapists, randomly selected from the South Australian Physiotherapy Registration Board 2004-2005 records. The first survey was mailed in August 2005, a reminder was sent two weeks later to non-responders and a follow-up survey was sent in April 2006 to non-responders whose addresses had changed since 2005. There was a 51% response rate. Of the non-responders, 12% were not contactable at their listed address, highlighting the mobility of Australian physiotherapists. Most respondents had undertaken research as students (59.5%) or as students and clinicians (11.5%). Of these, 37.1% were encouraged to embark on more research, and 20.5% were discouraged. The significant predictors of positive perceived importance of research were: previous research experience being positive about undertaking further research working in hospitals and holding a postgraduate degree. Clinicians working privately were significantly less likely than managers to be positive about research importance. The only significant predictor for not perceiving barriers to uptake of evidence was being positive about undertaking future research. The study identified constraints on uptake of evidence into practice that were related to accessing, reading and interpreting published research, and implementing findings. Found consistently across employment categories were barriers relating to lack of time, uncertainty about what the research reported, scepticism about the value of research and being isolated from peer support and literature sources. The responses indicated a positive shift towards evidence uptake since the 2001 NHS survey, suggesting an influence of increased exposure to information on evidence-based practice. A greater focus on research whilst training, the application of educational strategies for empowerment, better knowledge transfer and upskilling within the workplace, and ensuring dedicated time and organizational support for research activities are indicated.
Publisher: Springer Science and Business Media LLC
Date: 19-09-2011
Publisher: Informa UK Limited
Date: 06-2011
DOI: 10.2147/JMDH.S20265
Publisher: Springer Science and Business Media LLC
Date: 03-03-2005
Publisher: Informa UK Limited
Date: 09-2011
DOI: 10.2147/JPR.S21821
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2009
Publisher: Wiley
Date: 06-2010
DOI: 10.1002/PRI.479
Abstract: Evidence based practice is increasingly mandated by all stakeholders as an integral process of ensuring safe and quality health care. It is recognised that evidence based practice can contribute to minimising misuse, overuse and underuse of health care. Operationalising evidence based practice requires physiotherapists to access relevant evidence, appraise the evidence for its methodological quality, extract information relevant to their practice, and implement it as part of health care service delivery. The final step in this process is to evaluate evidence implementation and reflect what, if any, changes to health care processes and outcomes was achieved. From a theoretical perspective, these steps seem logical and readily achievable. However, practical application in clinical practice settings has encountered numerous barriers. One such barrier, which is commonly encountered and is a contentious area, is the issue of ethics in evidence implementation. Using two hypothetical case studies, we aim to highlight common frustrations encountered by physiotherapists when implementing evidence into practice, ethical ambiguity underpinning evidence implementation and discuss implications in terms of clinical practice and research.
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/PY10042
Abstract: Glaucoma is an insidious eye disease, potentially putting 4% of older Australians at risk of blindness, unless detected sufficiently early for initiation of effective treatment. This paper reports on the strengths of evidence and glaucoma risk factors that can be identified by primary health care providers from a patient’s history. A comprehensive search of peer-reviewed databases identified relevant secondary evidence published between 2002 and 2007. Risk factors that could be determined from a patient’s history were identified. A novel glaucoma risk factor reference guide was constructed according to evidence strength and level of concern regarding risk of developing glaucoma. The evidence is strong and consistent regarding the risk of developing glaucoma, and elevated intraocular pressure, advancing age, non-Caucasian ethnicity and family history of glaucoma. There is moderate evidence of association with glaucoma, and migraine, eye injury, myopia and long-term use of corticosteroids. There is conflicting evidence for living in a rural location, high blood pressure, diabetes and smoking. Early detection of people at risk of developing glaucoma can be initiated using our risk factor guide coupled with a comprehensive patient history. Timely future assessment and subsequent management strategies for at-risk in iduals can then be effectively and efficiently actioned.
Publisher: Informa UK Limited
Date: 11-2015
DOI: 10.2147/CIA.S90672
Publisher: Wiley
Date: 23-09-2013
DOI: 10.1111/RESP.12128
Abstract: Pulmonary rehabilitation (PR) is recommended in the management of people with chronic obstructive pulmonary disease (COPD), but implementation appears to be low. The aim of this study was to determine the frequency of referral to, and attendance at, PR programmes in a s le of patients with COPD. A cross-sectional study of patients admitted to a tertiary hospital in South Australia, with a primary diagnosis of COPD between March and November 2011 was conducted. Data were collected from medical records and patient interview. From 235 admissions with preliminary coding as COPD, 88 patients had COPD as the primary reason for admission and were potentially eligible for rehabilitation. While 57% had been referred to rehabilitation during their disease course, only 18% had attended and completed at least half the programme. Seven patients had attended in the previous 2 years. Mean percentage predicted forced expiratory volume in 1 s was 42% at the time of referral. During the index admission, discussion of rehabilitation resulting in a referral occurred in 14 cases (16%). No demographic or disease characteristics were associated with referral/no referral being reviewed by a COPD nurse coordinator during admission increased the likelihood of referral (odds ratio = 18.7, 95% confidence interval: 3.8-91.4). PR had been implemented in a small proportion of patients admitted to hospital with an exacerbation of COPD due to gaps in both referral to and subsequent attendance at a programme. Strategies to improve referral to and participation in PR are required.
Publisher: Springer Science and Business Media LLC
Date: 06-07-2011
Publisher: Elsevier BV
Date: 09-2003
DOI: 10.1016/S1440-2440(03)80026-9
Abstract: This paper reports on injuries sustained by Australian Rules footballers aged seven to 17 years, who played a full season of junior South Australia National Football League (SANFL) affiliated school or club competition in 2000. 697 boys provided information on injuries sustained throughout the season. 136 players (19.5% of the total) reported 234 injuries (1.7 injuries per injured player). The leg, the head and face, and hands were the most commonly injured areas, with 43.2% of injuries related to a collision. The majority of injuries were minor, involving soft tissue contusions. The 12-14 year olds playing club competition had the highest risk of injuries, and the most common occurrence of head and hand injuries. Over 60% of injuries occurred in the last two quarters of the game, and 21% of the reported injuries occurred at training. This study identified the need to review rule modification in the young adolescent age groups playing club competition to ensure that growing bodies are not exposed to unsafe playing practices.
Publisher: SAGE Publications
Date: 11-2003
DOI: 10.1191/0269215503CR667OA
Abstract: Background: Isometric strength of the wrist musculature is frequently used in the clinical setting as a primary outcome measure following a wrist disorder. Objective: A systematic search of the literature was undertaken to review published starting positions and test protocols used in assessing isometric strength of the wrist musculature. Methods: AMED, CINAHL, Current Contents, EMBASE and MEDLINE computerized databases were searched for literature published between January 1980 and September 2002 that described the methodologies used to assess isometric wrist muscle strength. Papers were excluded if they explored motor unit recruitment, strength was assessed via manual muscle testing or no information regarding starting position or test protocol was included. Results: A total of 15 papers met the inclusion criteria. Starting position varied between papers, with little justification for the positions assumed. Test protocols used also were variably described, with some not meeting accepted standards for the assessment of isometric strength. Many of the reports lacked information regarding starting position and test protocol used, which precluded replication of the methodology. Conclusions: Further research is required to determine the optimum starting position and test protocol for the assessment of isometric wrist muscle strength. These should subsequently be assessed for reliability, to ensure that consistent results are produced over different occasions of testing.
Publisher: Oxford University Press (OUP)
Date: 04-2000
Abstract: To assess the content and quality of published wrist outcome instruments using standardized criteria. An analytical study that examined 32 wrist outcome instruments sourced from textbooks, Medline (1951 to present) and Current Contents. The content of each instrument was classified into four categories: traditional measures (such as range of movement and strength), measures of the ability to perform daily activities, compensatory mechanisms used, and 'other'. Analysis included the frequency of assessment per category and the method of assessment. In addition, each instrument was graded using 13 quality criteria. Three criteria (scientific justification of the content and scoring system used, demographic utility) were considered to be essential. Eighty-two per cent of instruments reviewed for this paper contained traditional measures, of which most were assessed objectively. The ability to perform specific daily activities was assessed in 31% of the instruments whereas compensatory mechanisms were evaluated in only one instrument. These variables were not assessed in a consistent manner. Using the quality scoring system derived for this study, the quality of the instruments was generally poor. Only one instrument fulfilled all of the essential criteria. Only four instruments completely satisfied more than 50% of the criteria. Most wrist outcome instruments neglected to assess the impact of the disorder on the in idual. Outcome was generally not expressed in functional terms or in terms that were relevant to each in idual. The majority of the reviewed articles had poor quality. Thus use of these instruments may preclude sensitive evaluation of the efficacy of any intervention.
Publisher: Springer Science and Business Media LLC
Date: 28-06-2006
Abstract: Stress urinary incontinence (SUI) is a prevalent and costly condition which may be treated surgically or by physical therapy. The aim of this review was to systematically assess the literature and present the best available evidence for the efficacy and effectiveness of pelvic floor muscle training (PFMT) performed alone and together with adjunctive therapies (eg biofeedback, electrical stimulation, vaginal cones) for the treatment of female SUI. All major electronic sources of relevant information were systematically searched to identify peer-reviewed English language abstracts or papers published between 1995 and 2005. Randomised controlled trials (RCTs) and other study designs eg non-randomised trials, cohort studies, case series, were considered for this review in order to source all the available evidence relevant to clinical practice. Studies of adult women with a urodynamic or clinical diagnosis of SUI were eligible for inclusion. Excluded were studies of women who were pregnant, immediately post-partum or with a diagnosis of mixed or urge incontinence. Studies with a PFMT protocol alone and in combination with adjunctive physical therapies were considered. Two independent reviewers assessed the eligibility of each study, its level of evidence and the methodological quality. Due to the heterogeneity of study designs, the results are presented in narrative format. Twenty four studies, including 17 RCTs and seven non-RCTs, met the inclusion criteria. The methodological quality of the studies varied but lower quality scores did not necessarily indicate studies from lower levels of evidence. This review found consistent evidence from a number of high quality RCTs that PFMT alone and in combination with adjunctive therapies is effective treatment for women with SUI with rates of 'cure' and 'cure/improvement' up to 73% and 97% respectively. The contribution of adjunctive therapies is unclear and there is limited evidence about treatment outcomes in primary care settings. There is strong evidence for the efficacy of physical therapy for the treatment for SUI in women but further high quality studies are needed to evaluate the optimal treatment programs and training protocols in subgroups of women and their effectiveness in clinical practice.
Publisher: Wiley
Date: 18-05-2011
DOI: 10.1002/PRI.511
Publisher: University of Toronto Press Inc. (UTPress)
Date: 04-2011
DOI: 10.3138/PTC.2010-13
Abstract: Purpose: To describe the performance of the pillow that participants usually slept on with respect to retiring and waking cervico-thoracic symptoms, pillow comfort, and sleep quality. Methods: Participants (n=106) were systematically recruited for a field trial comparing their own pillow and five trial pillows. Participants provided daily retiring and waking symptom reports and sleep-quality and pillow-comfort ratings prospectively for 1 week on each pillow. Linear and logistic regression models were used to investigate the relationship between pillow use, age, gender, sleep quality, pillow comfort, and waking and temporal (overnight) symptom reports. Results: No waking symptoms were reported by 42.5% of participants on their own pillow. Regular waking symptoms, failure to relieve retiring symptoms, uncomfortable pillows, and/or poor-quality sleep were reported by over 50% of participants. All participants who reported poor sleep quality also reported poor pillow comfort. Pillow-comfort reports were not related to any waking symptom report however, reports of poor sleep quality were significantly related to waking cervical stiffness (adjusted odds ratio [AOR]=4.3 [Confidence Interval (CI): 1.3–15.6]) and scapula pain (AOR=6.1 [CI: 1.1–31.6]). Feather pillow users provided consistently low reports of pillow comfort and sleep quality. Conclusion: Many participants appear to have made poor pillow choices, as poor sleep quality, low pillow comfort, and waking symptoms were common. Further research is required to understand why people choose particular pillows to sleep on, as well as to identify the best fit between person and pillow to optimize sleep quality and reduce waking symptoms.
Publisher: Springer Science and Business Media LLC
Date: 03-03-2014
Publisher: Springer Science and Business Media LLC
Date: 2000
Abstract: Discharge planning endeavours to assist the transition of patients from the acute hospital setting into the community. We examined the quality of discharge planning from the perspective of the carer. Spouses were the most common carers for the elderly patients in our study. Many carers were also elderly, with their own health problems. Using a new instrument (entitled PREPARED) (K. Grimmer and J. Moss, Int J Qual Health Care (in press)), carers rated the quality of planning for discharge much lower than did the patient, indicating that their needs were often not met when discharge was being planned. In free text responses, carers expressed their dissatisfaction over communication about how the family would cope once the patient went home. Carers generally had lower summary mental quality of life scores than the Australian norms (as measured by the SF-36 health survey (J. Ware and R. Sherbourne, Med Care 1992 30: 473-483)), suggesting that the caring role may have impacted upon their emotional wellbeing. The rate of use of community services in the first week post-discharge was low, suggesting that carers and patients carried the majority of the burden immediately after discharge. We suggest that planning for hospital discharge requires more consideration of the carer.
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.WOMBI.2014.10.008
Abstract: This paper provides an overview of the history of child protection, the associated law and the 2008 amendments to the Child and Young Persons (Care and Protection) Act 1998 in relation to the Assumption of Care at birth practice. To explore the current practice of an Assumption of Care (AOC) where a newborn baby is removed from his/her mother at the time of birth, particularly focussing on the impact of the AOC on midwives. Assumption of Care practices in NSW raise significant issues for midwives in relation to the midwifery codes of ethics and conduct and importantly, to their ability to work in ways that honour a "woman-centred care" philosophy. When midwives are exposed to conflict between workplace and personal or professional values such as the practice of AOC cognitive dissonance can occur. Further research is required to understand the impact of current Assumption of Care. Broader research to not only look at effect on the midwife but also on other health professionals involved and the women who personally experience the removal of their baby at the time of birth. Consideration must also be given to ways of working with vulnerable families to enhance the acceptability and efficacy of maternity services and with associated agencies will decrease the need for Assumption of Care at birth.
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.MATH.2009.02.005
Abstract: Prolonged sitting and psychosocial factors have been associated with musculoskeletal symptoms among adolescents. However, the impact of prolonged static sitting on musculoskeletal pain among South African high school students is uncertain. A prospective observational study was performed to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain (UQMP) in grade ten high school students working on desktop computers. The sitting postural alignment, depression, anxiety and computer use of 104 asymptomatic students were measured at baseline. At three and six months post baseline, the prevalence of UQMP was determined. Twenty-seven students developed UQMP due to seated or computer-related activities. An extreme cervical angle ( 43.95 degrees OR 2.8 95% CI: 1.1-7.3) and a combination of extreme cervical and thoracic angles ( 71.1 degrees OR 2.2 95% CI: 1.1-5.6) were significant postural risk factors for the development of UQMP. Boys with any extreme angle were more likely to suffer pain compared with boys with all middle range angles (OR 4.9 95% CI: 1.0-24.5). No similar effect was found for girls. There was no strong relationship between depression, anxiety, computer exposure and UQMP among South African high school students.
Publisher: Wiley
Date: 06-2009
DOI: 10.1111/J.1746-1561.2009.00414.X
Abstract: Little is known about pre-pubescent Filipino children's involvement in moderate-to-vigorous physical activity (MVPA). There are international guidelines regarding required levels of MVPA for healthy children. This study describes participation of 11- to 12-year-olds in randomly selected public and private schools in San Juan, Metromanila, in MVPA and sports during a school day. The Filipino-modified Physical Activity Questionnaire for Older Children (F_PAQ_C) was administered in English and Filipino. Additional data was collected on sex, age, type of school, and amount of time spent using television and computers. Children's self-assessment of physical activities (1 question in the F_PAQ_C) was correlated with their cumulative F_PAQ_C score. Three hundred eighty subjects (167 boys, 213 girls) participated. Participation in MVPA varied between sex and age groups, from 56.1% to 65.0%. Fewer than 10% of participants were very active. The children were more active during physical education classes than at recess or lunch, after class, or in the evening. Walking for exercise, jumping, jogging and running, free play, and dance were most common. Boys, younger children, and private school students most commonly engaged in MVPA. Self-assessed physical activity had modest correlation (r(2)= 0.21) with cumulative F_PAQ_C score, after adjusting for sex, age, and school type. Most children were not physically active during the school day, except in physical education classes. To reduce the gap between recommended and current activity levels, more opportunities should be provided for preteen Filipino children to engage in MVPA during and after school.
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.MATH.2009.02.006
Abstract: A random allocation single blind block design pillow field study was undertaken to investigate the behaviour of cervico-thoracic spine pain in relation to pillow use. Participants (N=106) who reported preference for side sleep position with one pillow were recruited via a telephone survey and newspaper advertisement. They recorded sleep quality and pillow comfort ratings, frequency of retiring and waking cervical pain and duration of waking cervical pain while sleeping for a week on their usual pillow, polyester, foam, feather and rubber pillows of regular shape and a foam contour pillow. Analysis was undertaken comparing sleep quality, pillow comfort, waking and temporal cervical pain reports, between the usual pillow and the trial pillows, between pillows of differing content and foam pillows of differing shape. This study provides evidence to support recommendation of rubber pillows in the management of waking cervical pain, and to improve sleep quality and pillow comfort. The rubber pillow performed better than subjects' own pillow in most instances. Subjects' own pillow performed similarly to foam and polyester pillows, and there is no evidence that the use of a foam contour pillow has advantages over the regular shaped pillows. Feather pillows should not be recommended.
Publisher: Springer Science and Business Media LLC
Date: 29-10-2012
Publisher: Informa UK Limited
Date: 2012
DOI: 10.2147/RRU.S27801
Publisher: Elsevier BV
Date: 12-2004
Publisher: Springer Science and Business Media LLC
Date: 11-2007
Publisher: Wiley
Date: 28-10-2020
DOI: 10.1002/PRI.1883
Publisher: Informa UK Limited
Date: 15-03-2004
Publisher: Springer Science and Business Media LLC
Date: 07-2010
Publisher: Springer Science and Business Media LLC
Date: 04-2002
Publisher: Elsevier BV
Date: 09-2000
Abstract: To test the validity of a questionnaire to measure frequency of headaches related to the neck. A secondary goal was to test the reliability of field measurement of associated cervical spine anthropometric and muscle performance factors. Intermethod and test-retest comparisons. Two municipalities in a rural area of Tasmania, Australia. One hundred subjects were selected as a representative s le of never-injured adults from a comprehensive listing of the source population, and 93 participated. Subjects distinguished headaches matching three criteria for overt neck involvement, reported past-month frequency by questionnaire, and recorded in a diary occurrences during the next month. Measurements of height, weight, neck column length and circumference, lateral flexion and extension range of movement, cervical short flexor muscle endurance, and cervical long flexor and extensor strength were taken at the start and end of the month. Headache frequency was associated with neck stiffness and neck ache. There was moderate agreement (weighted K = .66) between questionnaire and diary, but better agreement (K = .72) for subjects who maintained their usual patterns of recreational sport. For this group, the correlation with "true" frequency was r(u) = .87. The anthropometric and muscle performance factors were reliably measured (intraclass correlations .96 to 1.00, kappa .78 to .86) despite minor improvement in muscle performance on retest. The questionnaire measure has construct validity. Neck-related headaches are a temporally stable presentation in never-injured subjects who maintain customary sporting activity. Measurement error was consequential, but less so for this group than for the study subjects generally. The anthropometric and muscle performance measurements were reliable, but slight improvements on retest suggest the need for multiple measurements.
Publisher: Wiley
Date: 19-03-2009
DOI: 10.1111/J.1365-2753.2008.01023.X
Abstract: Rationale, aim and objective The use of stroke clinical guidelines is widely encouraged yet variably operationalized. The factors which support, or hinder guideline compliance are poorly understood, and there is little research which pertains to the unique roles of Allied Health (AH) staff when operationalizing stroke clinical guidelines. This study identifies factors influencing AH staff compliance with guideline recommendations in an acute stoke unit. Method A retrospective audit was conducted of hospital records of stroke patients admitted to an Australian tertiary metropolitan hospital in 2005. The recorded clinical care provided by an AH team was audited against the 38 recommendations in the Australian acute stroke guidelines relevant to allied health. Results Compliance with guideline recommendations was variable, with better care compliance found for younger patients, patients admitted on weekdays, and patients with poorer functional ability on admission, longer lengths of stay and better functional improvements during admission. Compliance also reflected the congruence of guideline recommendations with 'usual practice'. Conclusions A number of factors influenced AH staff compliance with acute stroke guidelines. These findings are a platform upon which further implementation research can be launched for AH professionals.
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/PY10045
Abstract: The effects of osteoporosis (OP) can be significantly slowed if disease is detected early. We report on a clinical risk prediction rule developed from patient histories taken in an orthopaedic outpatient clinic, before confirmatory testing for OP. Data were extracted from routine audits of consecutive records of patients with recent wrist fracture, comprising demographic details, medications, past and current disease, and fracture details. Clinical prediction rule elements were tested against clinical suspicion of OP. The clinical prediction elements comprised sex and age risk, medications that predispose patients to OP and/or falls, previous fractures and disease/medical conditions that are known OP risks. The best cut point (6.5) demonstrated 100% sensitivity with clinical suspicion of OP. Patient history information is often available before OP is clinically suspected or a definitive diagnosis is made. Our clinical prediction rule will be useful in primary care settings where objective measures of bone health are not readily available. It will raise OP awareness amongst health care providers and patients, particularly those not previously suspected of having OP. It will assist in identifying at-risk patients early and commencing them on appropriate management, without waiting for definitive bone health tests.
Publisher: Springer Science and Business Media LLC
Date: 16-06-2011
Publisher: Elsevier BV
Date: 08-2011
Publisher: Springer Science and Business Media LLC
Date: 05-02-2003
Abstract: The current practice of the Swedish Knee Register is not to take into consideration if one or both knees in a patient are subject to surgery when evaluating risk of revision after arthroplasty. Risk calculations are typically done by statistical methods, such as Kaplan-Meier analyses and Cox's proportional hazards models, that are based on the assumption that observed events are independent, and this is rarely appreciated. The purpose of this study was to investigate if ignoring bilateral operations when using these methods biases the results. The bias of not taking bilateral operations into account was investigated by statistically analysing 55 298 prostheses in 44 590 patients, undergoing knee arthroplasty surgery in Sweden during 1985-1999, using traditional proportional hazards analysis, which assumes that all observations are independent, and a shared gamma frailty model, which allows patients to contribute repeated observations. The effect of neglecting bilateral prostheses is minute, possibly because bilateral prosthesis failure is a rare event. We conclude that the revision risk of knee prostheses in general can be analysed without consideration for subject dependency, at least in study populations with a relatively low proportion of subjects having experienced bilateral revisions.
Publisher: Springer Science and Business Media LLC
Date: 29-04-2014
Publisher: Elsevier BV
Date: 02-2007
DOI: 10.1016/J.JSAMS.2006.07.008
Abstract: This paper presents the findings of a systematic review of guidelines on preventing heat illness in sports participants and officials. University library databases and Internet sources were searched for guidelines pertaining to community-based sports, and occupational health and safety, using a comprehensive list of search terms. Guidelines were included if they met the criteria of English language, full text and fully referenced, and dealt specifically with, or could be extrapolated to, prevention of heat illness in sports participants and officials. Guideline inclusion was evaluated by two independent reviewers, who also independently assessed guideline quality using the AGREE instrument. Common guideline themes were identified by synthesis and recommendations for each theme were extracted. A synthesis of recommendations for common themes was then undertaken. Thirteen eligible guidelines were included. Thirty-two guidelines were excluded, as they did not provide sufficient information on construction or references. The methodological quality of the included guidelines was variable. The evidence-base of the guidelines varied, reflecting primary and secondary research. While five common heat-illness prevention themes were identified (fluid intake, heat limits, clothing, acclimatisation, precautionary interventions), variable recommendations were made pertaining to these themes. This potentially reflected the variable underpinning evidence of the guidelines. This review highlighted the need for better quality guideline construction related to defensible and transparent evidence sources regarding sports participation in hot weather. The synthesised recommendations cautiously provide a framework of current best evidence upon which sporting organisations internationally can base strategies for safe participation in the heat.
Publisher: Wiley
Date: 2006
DOI: 10.1002/PRI.340
Abstract: Adolescent spinal pain is a worldwide concern, with few longitudinal studies to validate concerns that an increasing number of adolescents report pain with age. The aim of the present study was to track reports of low back pain (LBP) in adolescents each year over a five-year period (between the ages of 13 and 17 years). A longitudinal, observational, repeated-measures study, commencing in 1999. We followed a group of South Australian students throughout five years of high schooling, reporting on prevalence of recent low back pain each year. In 1999, data were collected from 434 13-year-olds (82.5% eligible students). In the subsequent four years, the response rate from the 1999 s le was, respectively, 72.2%, 69.1%, 56.2% and 40.1%. A significant increasing prevalence of recent LBP was reported for girls and boys. The odds of girls reporting recent LBP in the final study year (fifth year) compared with the first year was 4.4 (95% CI 1.9-10.1),for boys 1.6 (95% CI 0.7-3.7). New cases of girls' recent LBP decreased consistently over the study (90% in 2000, 46.1% in 2001, 42.1% in 2002 and 33% in 2003). New boys' cases decreased in the second and third study years (85% in 2000, 45% in 2001) then increased (45.8% in 2002, 63.6% in 2003), suggesting less established patterns of occurrence. New cases of LBP reflected a decreasing percentage of total LBP reports over each study year for girls (suggesting increasing consistency of LBP occurrence with age). A different pattern was observed for boys, with a reversal of the downward trend after age 15 years, showing an increased percentage of LBP reports that reflected new cases in the final two study years.
Publisher: Springer Science and Business Media LLC
Date: 28-02-2012
Abstract: Lumbar spinal stenosis (LSS) is prevalent in those over the age of 65 years and the leading cause of spinal surgery in this population. Recent systematic reviews have examined the effectiveness of conservative management for LSS, but not relative to surgical interventions. The aim of this review was to systematically examine the effectiveness of land based exercise compared with decompressive surgery in the management of patients with LSS. A systematic review of randomised controlled trials and clinical trials was undertaken. The databases MEDLINE, Embase, CINAHL, PEDro and Cochrane Library Register of Controlled Trials were searched from January 2000 to June 2011. Only studies that included subjects with lumbar spinal canal stenosis were considered in this review. Studies also had to use a patient reported functional outcome measure for a land based exercise intervention or lumbar decompressive surgery. Only one study compared the effectiveness of exercise and decompressive surgery for LSS. Surgery demonstrated statistically significant improvements in patient reported functional outcome scores at 6, 12 and 24-months post-intervention ( p 0.01). To facilitate further analysis, the results from 12 exercise and 10 surgical intervention arms were compared using percentage change in patient reported functional outcome measure scores. Exercise interventions showed initial improvements, ranging from 16 to 29% above baseline. All decompressive surgical interventions demonstrated greater and sustained improvements over 2-years (range 38-67% improvement) with moderate to large effect sizes. The most commonly reported complications associated with surgery were dural tears, while details of adverse effects were lacking in exercise interventions. This systematic review of the recent literature demonstrates that decompressive surgery is more effective than land based exercise in the management of LSS. However, given the condition's slowly progressive nature and the potential for known surgical complications, it is recommended that a trial of conservative management with land based exercise be considered prior to consideration of surgical intervention.
Publisher: Elsevier BV
Date: 12-2010
DOI: 10.1111/J.1753-6405.2010.00616.X
Abstract: A small percentage of Australians frequently attend hospital emergency departments (ED) with potentially avoidable health crises. These in iduals are termed 'vulnerable' due to their complex health and social needs. When these needs are unmanaged, unnecessary ED and hospital-admission costs are incurred. A holistic community-based program was developed to engage a cohort of vulnerable in iduals in strategies to improve their health and health behaviours, and health service use. A purposive s le of frequent ED attendees was identified in one Australian metropolitan health region. Core program elements included working with clients within their environment, problem solving, empowerment, education, goal setting and mentoring. Evaluation data included services provided for, and time spent with, clients hospital admission and emergency department attendances and related costs client engagement data mental health measures client stories and participant interviews. Data was analysed from 37 clients. On average, staff spent 34 hours with each client, costing approximately $1,700 each. Significant improvements resulted in client health and health behaviours. Crisis emergency department and inpatient admissions decreased, and planned outpatient clinic use increased. Low-cost community-based intervention for frequent ED attendees has the potential for significant tertiary hospital savings.
Publisher: Informa UK Limited
Date: 12-10-2022
DOI: 10.1080/09593985.2021.1983909
Abstract: Near falls, such as stumbles or slips without falling to the ground, are more common than falls and often lead to a fall. The objective of this study was to investigate which balance tests differentiate near fallers from fallers and non-fallers. This cross-sectional, observational study assessed balance in healthy community dwelling adults aged 40-75 years. Participants reported falls and near falls in the previous 6 months. Balance testing was completed in the local community for static (i.e. feet together and single-leg stance) and dynamic balance (i.e. tandem walk, Functional Movement Screen hurdle step and lunge). Between-group comparative analysis of pass-fail for each balance test was undertaken. Of 627 participants, there were 99 fallers (15.8%), 121 near fallers (19.3%) and 407 non-fallers (64.9%). Near fallers were twice as likely as non-fallers to fail single-leg stance eyes (OR 2.7, 95% CI 1.5-4.9), five tandem steps (OR 2.5, 95% CI 1.5-5.7), hurdle step (OR 2.9, 95% CI 1.4-5.8), and lunge (OR 2.5. 95% CI 1.5-4.1). The predictive capacity differentiates near fallers with a sensitivity of 73.3%. A new battery of tests assessing static and dynamic balance identifies near fallers in seemingly healthy, community dwelling middle- and young-older-aged adults.
Publisher: Elsevier BV
Date: 05-1999
DOI: 10.1016/S0003-9993(99)90191-0
Abstract: To investigate headache specifically associated with the cervical spine, and factors associated with it. Cross-sectional, population-based observational study. Two agriculturally based municipalities in southern Tasmania, Australia. Four hundred fifty adults were randomly selected from electoral rolls after refusals and exclusions, 427 subjects participated. For analysis, subjects were ided into three groups: those who did not have a particular type of headache in the previous month, those reporting fewer than two headaches of this type for the month (occasional headache), and those reporting two or more (frequent) headaches of this type in the month. Information collected by questionnaire and by objective measurement on anthropometric and functional measurements, wearing glasses or dentures, usual occupation, and usual recreational activities. The monthly prevalence of frequent headaches associated with the cervical spine was 28.3% (95% confidence interval [CI], 24.2-32.9), and another 35.4% (30.9-40.1) of subjects had these headaches occasionally. The frequency of headache occurrence was associated with a difference between front and back neck length of 2 cm or more. Occasional participation in recreational sport by men and wearing glasses by women were significant predictors of headache. Headaches of this type were more frequent in subjects with a long anterior neck length relative to their posterior neck length, particularly if they occasionally participated in recreational sports (men) or wore glasses (women).
Publisher: Springer Science and Business Media LLC
Date: 16-09-2004
Publisher: IEEE
Date: 10-2007
Publisher: SAGE Publications
Date: 2009
Abstract: Hamstring strain injury is a common problem within sport. Despite research interest, knowledge of risks for and management of hamstring strain is limited, as evidenced by high injury rates. To present the current best evidence for hamstring strain injury risk factors and the management of hamstring strain injury. MEDLINE, AMED, SportDiscus, and AUSPORT databases were searched (key terms “hamstring” and “strain,” “injury,” “pull,” or “tear”) to identify relevant literature published between 1982 and 2007 in the English language. Studies of adult athlete populations (older than 18 years) pertaining to hamstring strain incidence, prevalence, and/or intervening management of hamstring strain injury were included. Articles were limited to full-text randomized, controlled studies or cohort studies. Twenty-four articles were included. Articles were critically appraised using the McMaster Quantitative Review Guidelines instrument. Data pertaining to injury rates and return to sport outcomes were extracted. Each author undertook independent appraisal of a random selection of articles after establishing inter-rater agreement of appraisal. Previous strain, older age, and ethnicity were consistently reported as significant risks for injury, as was competing in higher levels of competition. Associations with strength and flexibility were conflicting. Functional rehabilitation interventions had preventive effects and resulted in significantly earlier return to sport. Additionally, weak evidence existed for other interventions. Current evidence is inconclusive regarding most interventions for hamstring strain injury, while the effect of potentially modifiable risks is unclear. Further high-quality prospective studies into potential risks and management are required to provide a better framework within which to target interventions.
Publisher: Science Alert
Date: 15-06-2012
Publisher: Hindawi Limited
Date: 11-11-2008
DOI: 10.1111/J.1742-1241.2008.01930.X
Abstract: The elderly patient admitted to the emergency department (ED) of an acute care hospital is at risk of declining functionally, both during the stay at the hospital as an inpatient and postdischarge. Accurate and early identification of this population may lead to improved outcomes through targeted early interventions. To identify, critically appraise and characterise available screening tools to screen for elderly patients at risk of functional decline presenting to the ED of acute care hospitals. Screening tools administered in the ED to identify elderly patients at risk of functional decline during hospital stay and/or postdischarge. All primary quantitative and qualitative study types were included. Population included age > 65 years presenting to the ED of an acute care hospital. Six studies reporting on five screening tools were identified. Two instruments reported acceptable discriminative ability however, one of these has not been prospectively validated. No studies that validated any of the instruments in a setting other than the development setting were identified. A single study reported good test-retest reliability data for one instrument, the Identification of Seniors at Risk. This review was unable to identify a 'gold standard' tool to screen for risk of functional decline for the elderly patient admitted to the ED. Further research should be carried out to determine adjunctive processes to increase the accuracy of the identification of elderly patients at risk of functional decline. Further research should also be carried out to determine the appropriateness, or generalisability of these tools in different healthcare settings.
Publisher: Elsevier BV
Date: 05-2006
Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: Wiley
Date: 25-05-2010
DOI: 10.1111/J.1365-2753.2009.01174.X
Abstract: This paper summarizes evidence of long-term effectiveness of physiotherapy exercise therapy for chronic low back pain (LBP). A literature search was undertaken for experimental studies (2001-2007), which reported any post-intervention (follow-up) outcomes. Studies were critically appraised using the PEDro instrument. Comparative statistics were calculated, relative to the type of follow-up outcome data. Fifteen moderate quality trials were included [mean PEDro score 7.7, SD 1.3 (range 5-10)]. Nine trials reported pain scales, and six reported LBP reoccurrence. Trials which reported on pain scales at 6-month follow-up found significant differences in favour of exercise [standardized mean differences -0.57, 95%CI -0.75 to -0.39 (555 participants)]. At 12-month follow-up, a small pain scale benefit from exercise persisted [standardized mean differences -0.25, 95%CI -0.44 to 0.06 (434 participants)]. There was unconvincing evidence of exercise effectiveness on pain scales after this time. Three of the four trials which reported dichotomous outcomes at 6-month follow-up demonstrated large clinical benefits of exercise (relative risk reduction of reoccurrence 45-246%, absolute risk reduction of reoccurrence 36-42 for every 100 patients and number needed to treat approximating 3, to prevent one patient suffering a LBP recurrence). The effect of exercise on LBP reoccurrence was variably reported beyond 6 months. Exercise programmes are effective for chronic LBP up to 6 months after treatment cessation, evidenced by pain score reduction and reoccurrence rates. The way in which follow-up data are reported assists clinical interpretation of research findings.
Publisher: Springer Science and Business Media LLC
Date: 23-11-2012
Publisher: Springer Science and Business Media LLC
Date: 07-03-2006
Abstract: A common knee injury mechanism sustained during basketball is landing badly from a jump. Landing is a complex task and requires good coordination, dynamic muscle control and flexibility. For adolescents whose coordination and motor control has not fully matured, landing badly from a jump can present a significant risk for injury. There is currently limited biomechanical information regarding the lower limb kinetics of adolescents when jumping, specifically regarding jump kinematics comparing injured with uninjured adolescents. This study reports on an investigation of biomechanical differences in landing patterns of uninjured and injured adolescent basketball players. A matched case-control study design was employed. Twenty-two basketball players aged 14–16 years participated in the study: eleven previously knee-injured and eleven uninjured players matched with cases for age, gender, weight, height and years of play, and playing for the same club. Six high-speed, three-dimensional Vicon 370 cameras (120 Hz), Vicon biomechanical software and SAS Version 8 software were employed to analyse landing patterns when subjects performed a "jump shot". Linear correlations determined functional relationships between the biomechanical performance of lower limb joints, and paired t-tests determined differences between the normalised peak biomechanical parameters. The average peak vertical ground reaction forces between the cases and controls were similar. The average peak ground reaction forces between the cases and controls were moderately correlated (r = -0.47). The control (uninjured) players had significantly greater hip and knee flexion angles and significantly greater eccentric activity on landing than the uninjured cases ( p 0.01). The findings of the study indicate that players with a history of knee injuries had biomechanically compromised landing techniques when compared with uninjured players matched for gender, age and club. Descriptions (norms) of expected levels of knee control, proprioceptive acuity and eccentric strength relative to landing from a jump, at different ages and physical developmental stages, would assist clinicians and coaches to identify players with inappropriate knee performance comparable to their age or developmental stage.
Publisher: Wiley
Date: 10-2008
DOI: 10.1111/J.1365-2753.2008.01014.X
Abstract: To establish the effectiveness of clinical guideline implementation strategies. Data sources/study setting Systematic reviews in full text, English language, 1987-2007, reporting any measure of clinical process change or cost-benefit analysis. Overview of secondary evidence Independent critical appraisal using AMSTAR, primary author undertaking all data extraction using a purpose-built form. Principal findings We identified 144 potential papers, from which 33 systematic reviews were included. These reflected 714 primary studies involving 22 512 clinicians, in a range of health care settings. Implementation strategies were varied, rarely comparable, with variable outcomes. Effective implementation strategies included multifaceted interventions, interactive education and clinical reminder systems. Didactic education and passive dissemination strategies were ineffective. Cost-effectiveness studies were rare. Successful guideline implementation strategies should be multifaceted, and actively engage clinicians throughout the process.
Publisher: SAGE Publications
Date: 02-2009
DOI: 10.1111/J.1468-2982.2008.01714.X
Abstract: Headaches and neck pain are reported to be among the most prevalent musculoskeletal complaints in the general population. A significant body of research has reported a high prevalence of headaches and neck pain among adolescents. Sitting for lengthy periods in fixed postures such as at computer terminals may result in adolescent neck pain and headaches. The aim of this paper was to report the association between computer use (exposure) and headaches and neck pain (outcome) among adolescent school students in a developing country. A cross-sectional study was conducted and comprehensive description of the data collection instrument was used to collect the data from 1073 high-school students. Headaches were associated with high psychosocial scores and were more common among girls. We found a concerning association between neck pain and high hours of computing for school students, and have confirmed the need to educate new computer users (school students) about appropriate ergonomics and postural health.
Publisher: Public Library of Science (PLoS)
Date: 30-03-2018
Publisher: Wiley
Date: 30-06-2015
DOI: 10.1002/MUS.24574
Abstract: Despite reports on the association of radial nerve (RN) size and lateral epicondylalgia (LE), Filipino normative values on RN size in healthy elbows are not established. An association with upper extremity anthropometric measurements is likewise not reported. Musculoskeletal ultrasound measurements of the RN at the level of the lateral epicondyle (RN-LE), posterior interosseous nerve at the level of the radial head and supinator (PIN-RH and PIN-sup), and superficial RN (SRN) in the elbows of healthy Filipinos were made in Manila from January-September 2011. A total of 198 elbows of 99 healthy participants aged 43 years (range, 33-48 years) [median(IQR)] were investigated. Men have larger PIN-RH, PIN-sup, and SRN compared with women. Arm length was associated with PIN-RH, PIN-sup, and SRN (P < 0.05). Activities and elbow circumference measurements (at 2 levels) were associated with PIN-RH. RN reference values can now be used for comparison in elbows with LE.
Publisher: Springer Science and Business Media LLC
Date: 23-09-2011
Publisher: World Scientific Pub Co Pte Lt
Date: 09-2011
DOI: 10.1142/S0218957712500017
Abstract: Purpose: This research aims to determine the inter-tester reliability of sonographers in detecting presence of lesions in the elbows of participants with Lateral Epicondylar Pain (LEP) using the Musculoskeletal Ultrasound (MSUS) and in measuring the internal dimensions of the Radial Nerve at various points in the upper extremities. Methods: Two healthcare professionals who are experienced in MSUS and a musculoskeletal researcher agreed on the diagnostic sonographic features of LEP. Evidence of lesions was sought on the common extensor tendon (CET), lateral epicondyle, lateral collateral ligament, and distal biceps tendon. Measurements on the internal widest dimensions of the radial nerve at specified points were gathered. Results: There was perfect agreement between the two healthcare professionals in detecting bony irregularities on the lateral epicondyle and strong agreement on the presence of neovascularity in CET. The inter-tester reliability in assessing the internal architecture of the common extensor tendon ranged from poor (CET's margin and fibrillar pattern) to fair (for adjacent fluid and intratendinous calcifications). There were no significant differences between sonographers in measuring the Radial Nerve except for the Posterior Interosseous Nerve. Conclusions: Differences in MSUS assessment on CET's tendon margin and fibrillar pattern and the measurement of PIN between experienced healthcare professionals in MSUS scanning and interpretation highlight the need for standardized protocol.
Publisher: JMIR Publications Inc.
Date: 03-08-2020
Abstract: eople with stroke and their caregivers experience numerous information needs internet-based resources may offer cost-effective ways to improve access to information about this condition and its management, including the availability of resources and support. The quality of online health information is, therefore, an important consideration for both developers and consumers of these online resources. his study aims to map and evaluate the content, readability, understandability, design, and quality characteristics of freely available online information resources (ie, websites) that empower people with stroke and their caregivers with information and self-help strategies poststroke. his descriptive review will follow the five systematic and rigorous methodological steps that are recommended for scoping reviews, which include the following: (1) identifying the research question, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarizing, and reporting the results. Data will then be synthesized and analyzed thematically. s of February 2021, the scoping review is in the data extraction stage. Data will be synthesized, and the first results are expected to be submitted for publication in an open-access peer-reviewed journal in August 2021. In addition, we will develop an accessible summary of the results for stakeholder meetings. Ethical approval is not required for this review, as it will only include publicly available information. his study is novel and will evaluate the typology, content, and design-related criteria, including accessibility, aesthetics, navigability, interactivity, privacy, and data protection, of online information resources for stroke. The review will be limited to online resources published in English. ERR1-10.2196/23174
Publisher: Springer Science and Business Media LLC
Date: 20-06-2014
Publisher: Oxford University Press (OUP)
Date: 12-2004
Abstract: To describe the reported experiences of elderly patients regarding their transition from an acute hospital to independent community living. Observational longitudinal study based on semi-structured interviews conducted monthly for 6 months following discharge from hospital. Four South Australian acute hospitals. Patients. One hundred elderly patients who faced a long-term change in health status and/or in their ability to manage practical aspects of daily living. Experiences in managing change in health status, social circumstances and independent community living. Few patients believed that discharge plans made in hospital had assisted their return to independent community living. Discharge planning addressed mainly formal health services rather than practical aspects of daily living. Many patients implemented innovative solutions when formal services were unavailable or inadequate. Pain, tiredness, loss of mobility, and grief over loss of previous abilities were frequent, long lasting sequelae to illness, and few discharge plans prepared patients to deal with this. Elderly patients who have left hospital to face a permanent change in health status often regret that they have not been better prepared for what lies ahead in terms of more specific information about their condition, linked with practical discharge plans that prepare them for their period of convalescence. We suggest that the underlying problem is a disjunction between the multiple systems involved in hospital discharge planning, primary medical care, disability-oriented community health services, and informal community services.
Publisher: Informa UK Limited
Date: 07-2011
DOI: 10.2147/JMDH.S21559
Publisher: Elsevier BV
Date: 1996
Publisher: Oxford University Press (OUP)
Date: 04-2001
Abstract: To describe the development, validity and application of a new instrument (PREPARED) for obtaining feedback from community consumers of discharge planning activities. Iterative qualitative and quantitative investigations. The community catchment area of a metropolitan Australian tertiary public hospital. Patients aged over 65 years, with a range of conditions, recently discharged from hospital, their carers, and hospital nursing staff. PREPARED was constructed from interviews with patients, carers and hospital staff. It was trialed and modified to ensure sensitive measurement of key attributes of discharge planning process and outcome. This paper explores the patient and carer versions of PREPARED. Data items were reduced to domains of key questions by factor analysis. Instrument performance was assessed by correlation of process and outcome measures, by comparing PREPARED responses with subsequent unstructured interview data, and by testing whether PREPARED responses were independent of health-related quality of life at the time of survey. Four key process domains were identified: information exchange (community services and equipment), medication management, preparation for coping after discharge and control of discharge circumstances. Outcome was measured as overall satisfaction with discharge, whether equipment and community service needs had been met, use of health services and health related costs post-discharge. The instrument performed well when compared with interview data, the process and outcome domains were largely independent of each other, as were responses to PREPARED and SF-36. PREPARED offers a comprehensive way of closing the quality improvement loop, by providing information from the community perspective on the quality of planning for discharge from the acute hospital setting.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2009
Publisher: Wiley
Date: 12-2001
Publisher: Oxford University Press (OUP)
Date: 16-05-2008
Publisher: Springer Science and Business Media LLC
Date: 24-06-2013
Publisher: Elsevier BV
Date: 10-2000
DOI: 10.1016/S1054-139X(00)00120-8
Abstract: To report the prevalence of recent adolescent recreational and sporting activities and associated injury. Data were collected during three school terms in 1997 using a validated questionnaire administered once only to 3538 girls and boys aged 11-12 years and 15-16 years. These students comprised 97.5% of the students in these age ranges in randomly selected state and private schools in the Adelaide metropolitan area (South Australia). Participants identified up to three recreational and/or sporting activities in which they had participated in the previous week. Data were collected on the nature and extent of participation, and on associated injuries. Participation and injury reports were summarized descriptively in gender strata in the two adolescent age groups and stratum specific odds ratios were used to explore injury risk. Subjects reported participating in 8997 sporting and/or recreational activities in the preceding week (an average of 2.5 participations per student). Over 140 sports and recreational pursuits were represented, incorporating organized and nonorganized activities undertaken in teams, social groups, or alone. Approximately 25% of adolescents reported at least one recreational injury. Injuries were mostly minor, reflecting soft tissue trauma and skin abrasions. Organized group sport incurred the highest risk of injury. There were marked gender and year level differences in injury risk in a number of common activities. These findings support the need for ongoing education regarding injury prevention and management.
Publisher: Mary Ann Liebert Inc
Date: 12-2003
DOI: 10.1089/109493103322725405
Abstract: Post-surgical pain has been consistently reported in pediatrics as being difficult to manage and limiting to surgical outcomes. Pain management of children is not ideal, and some children unable to tolerate traditional pharmacological agents. Virtual reality (VR) is a new and promising form of non-pharmacologic analgesia. This case study explored the use of VR analgesia with a 16-year-old patient with cerebral palsy participating in a twice-daily physiotherapy program following Single Event Multi-Level Surgery. Over 6 days, the patient spent half of his physiotherapy sessions using VR and the other half without (order randomized). Traditional pharmacological pain management was administered throughout the trial. Using a subjective pain scale (five faces denoting levels of pain), the patient's overall pain ratings whilst in the VR (experimental) condition were 41.2% less than those in the no-VR (control) condition. This case report provides the first evidence that VR may serve as a powerful non-pharmacologic analgesic for children following surgery.
Publisher: Springer Science and Business Media LLC
Date: 14-11-2014
Publisher: Elsevier BV
Date: 07-2001
Abstract: The purpose of this study was to determine whether a standardized hand activity would produce changes in the cross-sectional diameter of the median nerve. Ultrasound measures of proven reliability of the cross-sectional diameter of the median nerve in the wrist were taken. These measures were taken before activity and immediately after the activity, after 5 minutes, and after 10 minutes. The median nerves of 40 normal subjects showed an increase in cross-sectional diameter immediately after hand activity then returned to a size close to the preactivity size within 10 minutes. The cross-sectional area of the carpal canal did not change significantly after the hand activity was performed. Female gender and body mass index over 25 were associated with significantly larger size increases in the median nerve. This preliminary study suggests that ultrasound is sensitive to the effects of activity upon the hand.
Publisher: Springer Science and Business Media LLC
Date: 06-06-2019
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/AH12034
Abstract: Objective. To estimate the risk of functional decline after discharge for older people presenting to, and discharged from, a large emergency department (ED) of a tertiary hospital. Methods. The cohort was generated by consecutive s ling of non-Indigenous males and females aged 65 years or over or Aboriginal and Torres Strait Islander males and females aged 45 years or more, without diagnosed dementia, who were living independently in the community before presenting at ED and who were not admitted to hospital as an inpatient after presenting to ED. The hospital assessment risk profile (HARP) was administered to all eligible participants. Sociodemographic information was collected. Results. Approximately 40 patients per day over two 14-week data collection periods were potentially eligible for inclusion in the study. In total, 597 (17.6% of in iduals who presented to ED) were eligible, agreed to participate and continued to be eligible on discharge from ED. Their HARP scores suggested that ~52% were at-risk of functional decline (14.1% high risk, 38.5% intermediate risk). Conclusions. Elderly patients present to and are discharged from ED every day. The routinely administered HARP instrument scores suggested that approximately half these in iduals were at-risk of functional decline in one large hospital ED. Given this instrument’s moderate diagnostic accuracy, the true figure may be higher. We suggest that all over-65 year olds presenting at ED without being admitted as an inpatient should be considered for routine screening for potential downstream functional decline, and for intervention if indicated. What is known about the topic? Older in iduals often present to ED in lieu of consulting a general medical practitioner, and are not admitted to a hospital bed. Patient demographics, functional and mental capacity and reasons for presentation may be flags for functional decline in the coming months. These could be used by ED staff to implement targeted assessment and intervention. What does this paper add? This paper highlights the high percentage of older in iduals who, at time of ED presentation, are at-risk of downstream functional decline. What are the implications for practitioners? Older people who are discharged from ED without a hospital admission may ‘slip through the net’, as an ED presentation presents a limited window of opportunity for ED staff to undertake targeted assessment, and intervention, to address the potential for downstream functional decline. The busy nature of ED, resource implications and the range of presenting conditions of older people may preclude this. This research suggests a reality that a large percentage of older people who present at ED but do not require a subsequent hospital admission have the potential for functional decline after discharge. Addressing this, in terms of specific screening processes and interventions, requires a rethink of hospital and community resources, and relationships.
Publisher: Springer Science and Business Media LLC
Date: 04-01-2002
Abstract: Open dislocations are infrequent, often associated with damage to the neuro vascular structures. We present an unusual case of an open antero-lateral dislocation of the elbow, which was not associated with any vascular or neural injury. A 34 year female dance instructor sustained an open dislocation of her elbow. Surgical exploration was undertaken. No major neurovascular injury was present. There was almost complete disruption of all the muscular and ligamentous attachments to the distal humerus and the proximal radius and ulna, which were not formally repaired during surgery. The elbow was found to be very unstable, and was placed in a back slab. The functional recovery was complete in about six months, the patient regaining full range of elbow movement. Elbow dislocations without associate fractures are adequately treated by manipulation and reduction, in spite of the almost complete disruption of the soft tissues around the joint.
Publisher: Elsevier BV
Date: 08-2003
DOI: 10.1016/S0749-0712(02)00149-X
Abstract: Many types of wrist outcome instruments are used in the clinical setting to determine the effectiveness of treatment. The authors have previously identified that the in idual's perspective and the use of compensatory mechanisms are important factors to consider in the measurement of outcome following a wrist disorder. No published wrist outcome instrument currently addresses these factors, however. Therefore, the aim of this study was to develop a wrist outcome instrument that assessed, from the wrist-injured in idual's perspective, their actual ability to perform activities of daily living following a wrist disorder. This article reports on the rationale and procedures used to construct the new instrument and presents the results of preliminary psychometric testing of the wrist outcome instrument.
Publisher: University of Toronto Press Inc. (UTPress)
Date: 10-2010
Abstract: Purpose: This report highlights the current international gap between the availability of high-quality evidence for pulmonary rehabilitation (PR) and its low level of implementation. Key barriers are outlined, and potentially effective strategies to improve implementation are presented. Summary of key points: Although pulmonary rehabilitation (PR) is recommended by international guidelines as part of the management of patients with chronic obstructive pulmonary disease (COPD), participation in PR remains low. Physician referral to PR ranges from 3% to 16% of suitable patients. Barriers to participation include limited availability of suitable programmes and interrelated issues of referral and access. In idual patient barriers, including factors relating to comorbidities and exacerbations, perceptions of benefit, and ease of access, contribute less overall to low participation rates. Chronic care programmes that incorporate self-management support have some benefit in patients with COPD. However, the demonstrated cost-effectiveness of PR is substantial, and efforts to improve its implementation are urgently indicated. Conclusion: To improve implementation, a holistic examination of the key issues influencing a patient's participation in PR is needed. Such an examination should consider the relative influences of environmental (e.g., health-service-related) factors, organizational factors (e.g., referral and intake procedures), and in idual factors (e.g., patient barriers) for all participants. On the basis of these findings, policy, funding, service delivery, and other interventions to improve participation in PR can be developed and evaluated.
Publisher: Wiley
Date: 10-09-2019
DOI: 10.1111/JEP.13287
Abstract: This paper explores the economic value of rehabilitation to South Africa, using a costed ex le of cerebrovascular accident (CVA) (stroke) rehabilitation. We report an economic modelling approach using a worked cost-effectiveness to validate the argument for the cost-saving benefits of stroke rehabilitation. South African health care, employing analysis of available secondary data from South African research and government reports. In line with international trends in stroke epidemiology, we focused on people who were employed prior to having their stroke, with return-to-work as the desired rehabilitation outcome. Not applicable. We used information on stroke rehabilitation and secondary data derived from grey and published literature, to determine if early stroke rehabilitation represents value for money from the government perspective. For our worked ex le, we used return-to-work rates, intervention costs, and the cost of rehabilitation services to estimate cost-savings as a result of an in idualized workplace intervention. The cost of delivering the in idualized intervention was estimated at R5633 atient. Combining survivor rates, return-to-work rate, and costs of the programme, a work intervention programme could result in a net saving of R133.1 million over 5 years (or about R26.6 per year (discount 3%). The value of rehabilitation should not be considered in terms of cost-effectiveness alone, but also as an investment for the country. A staged, prioritized approach should be considered in future South African national health budget.
Start Date: 2011
End Date: 12-2012
Amount: $116,546.00
Funder: Australian Research Council
View Funded Activity