2,088 research outputs found
Exercise and progressive supranuclear palsy : the need for explicit exercise reporting
Background
Progressive Supranuclear Palsy (PSP) is the most frequent form of atypical Parkinsonism. Although there is preliminary evidence for the benefits of gait rehabilitation, balance training and oculomotor exercises in PSP, the quality of reporting of exercise therapies appears mixed. The current investigation aims to evaluate the comprehensiveness of reporting of exercise and physical activity interventions in the PSP literature.
Methods
Two independent reviewers used the Consensus on Exercise Reporting Template (CERT) to extract all exercise intervention data from 11 studies included in a systematic review. CERT items covered: âwhatâ (materials), âwhoâ (instructor qualifications), âhowâ (delivery), âwhereâ (location), âwhenâ, âhow muchâ (dosage), âtailoringâ (what, how), and âhow wellâ (fidelity) exercise delivery complied with the protocol. Each exercise item was scored â1â (adequately reported) or â0â (not adequately reported or unclear). The CERT score was calculated, as well as the percentage of studies that reported each CERT item.
Results
The CERT scores ranged from 3 to 12 out of 19. No PSP studies adequately described exercise elements that would allow exact replication of the interventions. Well-described items included exercise equipment, exercise settings, exercise therapy scheduling, frequency and duration. Poorly described items included decision rules for exercise progression, instructor qualifications, exercise adherence, motivation strategies, safety and adverse events associated with exercise therapies.
Discussion
The results revealed variability in the reporting of physical therapies for people living with PSP. Future exercise trials need to more comprehensively describe equipment, instructor qualifications, exercise and physical activity type, dosage, setting, individual tailoring of exercises, supervision, adherence, motivation strategies, progression decisions, safety and adverse events.
Conclusion
Although beneficial for people living with PSP, exercise and physical therapy interventions have been inadequately reported. It is recommended that evidence-based reporting templates be utilised to comprehensively document therapeutic exercise design, delivery and evaluation
Confidence amongst multidisciplinary professionals in managing paediatric rheumatic disease in Australia
Objective. Interprofessional collaboration is a crucial component of care for children with rheumatic disease. Interprofessional care, when delivered appropriately, prevents disability and improves long-term prognosis in this vulnerable group. Methods. The aim of this survey was to explore allied health professionalsâ and nursesâ confidence in treating paediatric rheumatology patients. Results. Overall, 117 participants were recruited, 77.9% of participants reported being ânot confident at all,â ânot confident,â or âneutralâ in treating children with rheumatic diseases (RD) despite 65.1% of participants reporting having treated >1 paediatric rheumatology case in the past month. Furthermore, 67.2% of participants felt their undergraduate education in paediatric rheumatology was inadequate. âJournalsâ or âtexts booksâ were used by 49.3% of participants as their primary source of continuing professional development (CPD) and 39.3% of participants indicated that they did not undertake any CPD related to paediatric rheumatology. Small group and online education were perceived to be potentially of âgreat benefitâ for CPD. Conclusion. This paper highlights allied health professionalsâ and nursesâ perceived inadequacy of their undergraduate education in paediatric RD and their low confidence in recognising and treating RD. Undergraduate and postgraduate education opportunities focusing on interprofessional collaboration should be developed to address this workforce deficiency
Critical-Thinking Skills of First-Year Athletic Training Students Enrolled in Professional Programs
Context: The Examination of Professional Degree Level document presented to the National Athletic Trainersâ Association Board of Directors states that research in athletic training education has not investigated differences in the critical-thinking skills of professional athletic training students.
Objective: Investigate the differences in critical thinking and other demographic variables across first-year athletic training students enrolled in professional bachelorâs- and masterâs-degree programs.
Design: Quantitative study.
Setting: District 10 athletic training programs.
Patients or Other Participants: Students (N ÂŒ 40) enrolled within their first 6 months of a professional athletic training program were asked to complete the California Critical Thinking Skills Test (CCTST). Twelve first-year masterâs-degree students (8 female, 4 male) and 28 bachelorâs-degree students (18 female, 10 male) completed the CCTST (age ÂŒ 20.73 6 3.09 years).
Main Outcome Measure(s): Athletic training students in District 10 were asked to complete the CCTST during the first 6 months of their respective programs. Independent t tests were used to evaluate the difference in critical-thinking scores between professional masterâs- and bachelorâs-degree athletic training students. A 1-way analysis of variance was conducted to determine differences in critical-thinking skills with regard to gender, age, and parental educational level.
Results: There were no statistically significant differences in critical-thinking skills between bachelorâs- and masterâs-degree athletic training students enrolled in a professional athletic training program (P ÂŒ .991). Additionally, there were no statistically significant differences in critical-thinking skills with regard to gender (P ÂŒ .156), age (P ÂŒ .410), or parental education level (P ÂŒ .156).
Conclusions: The results suggest masterâs students do not have greater critical-thinking skills than professional bachelorâs students before engaging in athletic training education. Therefore, as the professional degree of athletic training transitions to the graduate level, athletic training educators may need to investigate and use pedagogical practices that will graduate critically thinking athletic trainers
Using audit and feedback to increase clinician adherence to clinical practice guidelines in brain injury rehabilitation: v
ObjectiveThis study evaluated whether frequent (fortnightly) audit and feedback cycles over a sustained period of time (>12 months) increased clinician adherence to recommended guidelines in acquired brain injury rehabilitation.DesignA before and after study design.SettingA metropolitan inpatient brain injury rehabilitation unit.ParticipantsClinicians; medical, nursing and allied health staff.InterventionsFortnightly cycles of audit and feedback for 14 months. Each fortnight, medical file and observational audits were completed against 114 clinical indicators.Main outcome measureAdherence to guideline indicators before and after intervention, calculated by proportions, Mann-Whitney U and Chi square analysis.ResultsClinical and statistical significant improvements in median clinical indicator adherence were found immediately following the audit and feedback program from 38.8% (95% CI 34.3 to 44.4) to 83.6% (95% CI 81.8 to 88.5). Three months after cessation of the intervention, median adherence had decreased from 82.3% to 76.6% (95% CI 72.7 to 83.3, pConclusionA fortnightly audit and feedback program increased cliniciansâ adherence to guideline recommendations in an inpatient acquired brain injury rehabilitation setting. We propose future studies build on the evidence-based method used in the present study to determine effectiveness and develop an implementation toolkit for scale-up.</div
Vol. 19 no. 2 Semester 2 (2008)
https://researchonline.nd.edu.au/in_principio2000s/1001/thumbnail.jp
Implementation of evidence-based weekend service recommendations for allied health managers : a cluster randomised controlled trial protocol
Background: It is widely acknowledged that health policy and practice do not always reflect current research evidence. Whether knowledge transfer from research to practice is more successful when specific implementation approaches are used remains unclear. A model to assist engagement of allied health managers and clinicians with research implementation could involve disseminating evidence-based policy recommendations, along with the use of knowledge brokers. We developed such a model to aid decision-making for the provision of weekend allied health services. This protocol outlines the design and methods for a multi-centre cluster randomised controlled trial to evaluate the success of research implementation strategies to promote evidence-informed weekend allied health resource allocation decisions, especially in hospital managers. Methods: This multi-centre study will be a three-group parallel cluster randomised controlled trial. Allied health managers from Australian and New Zealand hospitals will be randomised to receive either (1) an evidence-based policy recommendation document to guide weekend allied health resource allocation decisions, (2) the same policy recommendation document with support from a knowledge broker to help implement weekend allied health policy recommendations, or (3) a usual practice control group. The primary outcome will be alignment of weekend allied health service provision with policy recommendations. This will be measured by the number of allied health service events (occasions of service) occurring on weekends as a proportion of total allied health service events for the relevant hospital wards at baseline and 12-month follow-up. Discussion: Evidence-based policy recommendation documents communicate key research findings in an accessible format. This comparatively low-cost research implementation strategy could be combined with using a knowledge broker to work collaboratively with decision-makers to promote knowledge transfer. The results will assist managers to make decisions on resource allocation, based on evidence. More generally, the findings will inform the development of an allied health model for translating research into practice. © 2018 The Author(s). **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate âJennifer Martinâ is provided in this record*
Factors that influence the sustainability of structured allied health journal clubs: a qualitative study
Background: Structured journal clubs are a widely used tool to promote evidence-based practice in health professionals, however some journal clubs (JC) are more effectively sustained than others. To date, little research has provided insights into factors which may influence sustainability of JCs within health care settings. As part of a larger randomised controlled study, this research aimed to gain understanding of clinicians' experiences of sustaining a structured JC format (TREAT- Tailoring Research Evidence and Theory) within their clinical context. The study also aimed to identify which strategies may assist longer term sustainability and future implementation of the TREAT format. Methods: We employed a qualitative methodology, informed by behaviour change theory. Clinicians (n=19) from five different JCs participated in focus groups to explore their experience in sustaining the JC format six months after the formal trial period had completed. Clinicians were asked to describe factors which they perceived helped or hindered sustaining components of the JC format within their local context. Following a descriptive summary of the data, barriers and enablers were thematically analysed according to behaviour change theory domains: capability, motivation and opportunity and further mapped to targeted implementation strategies. Results: Participants reported perceived benefits of maintaining the TREAT format and described several components that promoted its sustainability. Sustaining factors linked to individuals' capability included building research knowledge and skills and having access to research experts. Sustaining factors that enhanced opportunities for behaviour change included management expectation to attend and a team culture which values evidence based practice, while factors found to enhance individuals' motivation included the JC having close application to practice and clinicians sensing ownership of the JC. Several implementation strategies to enhance these factors are described including graduated support to clinicians in facilitation of JCs and greater engagement with managers. Conclusions: Long-term sustainability of a structured JC is dependent on both individual and service level factors and a balance of implementation strategies that enhance capability, opportunity and motivation. Consideration of how clinicians can be engaged to take ownership and build their own capability from the commencement of the JC is important. Trial registration: ACTRN12616000811404
Virginia\u27s Money Follows the Person Demonstration
Educational Objectives
1. Describe Virginia\u27s Money Follows the Person Demonstration project, including the new services available to individuals through Virginia\u27s Medicaid-funded home and community-based waiver program.
2. Explain how Virginia\u27s Money Follows the Person Demonstration project, being administered by the Virginia Department of Medical Assistance Services (DMAS), would assist an individual in transitioning from a long-term care facility to the community.
3. Illustrate how someone might experience the MFP processes from pre-transition through post-transition
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