Exploring the perspectives of allied health practitioners toward the use of journal clubs as a medium for promoting evidence-based practice: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Research evidence suggests that journal clubs (JCs) are one approach which can be used to bridge the gap between research and clinical practice. However, there are issues which potentially threaten their viability such as on-going participation or compliance with attendance, which require further exploration. The objectives of this study are: to explore the views and perspectives of allied health practitioners (AHPs) regarding the use of any type of JC in promoting evidence-based practice (EBP); to identify ways in which an innovative model of JC developed by the International Centre for Allied Health Evidence (<it>i</it>CAHE) might be refined.</p> <p>Methods</p> <p>A qualitative descriptive study utilising focus group interviews with various groups of AHP was undertaken-- those who have been exposed to the <it>i</it>CAHE JC model and those who have no experience of the <it>i</it>CAHE model (although they may have had exposure to other forms of JC). Maximum variation sampling was used to recruit participants for the study. Transcripts of focus groups were coded and distilled into content-related categories.</p> <p>Results</p> <p>Six focus groups with 39 AHPs were facilitated. Allied health practitioners perspectives' on JCs were classified in five broad categories: utility and benefits of a JC, elements of an effective and sustainable JC, barriers to participation, incentives for participation, and opportunities for improvement in the current <it>i</it>CAHE JC model. Overall, JCs were seen as a forum for reflective practice and keeping up-to-date with research evidence, and a venue for learning the processes involved in critical appraisal. Limited knowledge of statistics and heavy clinical workload were reported as barriers to participation in a JC. Strategies such as mentoring, strong support from managers, and providing CPD (continuing professional development) points can potentially address these barriers. Opportunities for refinement of the current <it>i</it>CAHE model were raised.</p> <p>Conclusions</p> <p>This study suggests that a structured model of JC such as <it>i</it>CAHE's model is acceptable, and likely to be used with enthusiasm by AHP to achieve EBP. Future research should explore the impact of <it>i</it>CAHE JC compared with no JC exposure, and other forms of exposure to JCs, in influencing change in allied health practitioners behaviours and evidence implementation.</p

Multiple planar coincidences with N-fold symmetry

Planar coincidence site lattices and modules with N-fold symmetry are well understood in a formulation based on cyclotomic fields, in particular for the class number one case, where they appear as certain principal ideals in the corresponding ring of integers. We extend this approach to multiple coincidences, which apply to triple or multiple junctions. In particular, we give explicit results for spectral, combinatorial and asymptotic properties in terms of Dirichlet series generating functions.Comment: 13 pages, two figures. For previous related work see math.MG/0511147 and math.CO/0301021. Minor changes and references update

Doppler Radar for the Extraction of Biomechanical Parameters in Gait Analysis

The applicability of Doppler radar for gait analysis is investigated by quantitatively comparing the measured biomechanical parameters to those obtained using motion capturing and ground reaction forces. Nineteen individuals walked on a treadmill at two different speeds, where a radar system was positioned in front of or behind the subject. The right knee angle was confined by an adjustable orthosis in five different degrees. Eleven gait parameters are extracted from radar micro-Doppler signatures. Here, new methods for obtaining the velocities of individual lower limb joints are proposed. Further, a new method to extract individual leg flight times from radar data is introduced. Based on radar data, five spatiotemporal parameters related to rhythm and pace could reliably be extracted. Further, for most of the considered conditions, three kinematic parameters could accurately be measured. The radar-based stance and flight time measurements rely on the correct detection of the time instant of maximal knee velocity during the gait cycle. This time instant is reliably detected when the radar has a back view, but is underestimated when the radar is positioned in front of the subject. The results validate the applicability of Doppler radar to accurately measure a variety of medically relevant gait parameters. Radar has the potential to unobtrusively diagnose changes in gait, e.g., to design training in prevention and rehabilitation. As contact-less and privacy-preserving sensor, radar presents a viable technology to supplement existing gait analysis tools for long-term in-home examinations.Comment: 13 pages, 9 figures, 2 tables, accepted for publication in the IEEE Journal of Biomedical and Health Informatics (J-BHI

The prevalence of underweight, overweight and obesity in a multiracial group of urban adolescent schoolchildren in the Cape Metropole area of Cape Town

Objective: The objective was to determine the prevalence of underweight, overweight and obesity in high school learners in the Cape Town area.Design: A cross-sectional study was conducted.Setting: High schools in the Cape Metropole Area of the Western Cape.Subjects: A complex cluster sampling procedure was followed. Thirty-six students per school were selected from each randomly selected school. Thirteen- to 18-year-old pupils were eligible for inclusion.Outcome measures: Height and weight measurements.Results: The sample comprised 689 students. There were considerably  more underweight adolescent boys than adolescent girls (17.3% boys to 9.9% girls), and double the frequency of overweight adolescent girls than adolescent boys (7.7% girls to 3.5% boys). The 14-year-old boys had the highest prevalence of underweight (55.2%), and the 17-year-old girls the highest prevalence of overweight (22%). The highest prevalence of obesity was found in 15-year-old boys (11.1%), who also demonstrated a relatively high prevalence of underweight (30.2%).Conclusion: This study reported on a substantial percentage of underweight adolescents (27.1%). Noteworthy levels of overweight and obesity in  adolescent girls added to the substantial prevalence of underweight in adolescent boys. Africa has enough to contend with in respect of transmissible diseases, without additional lifestyle-based health burdens

Adolescent standing postural response to backpack loads: a randomised controlled experimental study

BACKGROUND: Backpack loads produce changes in standing posture when compared with unloaded posture. Although 'poor' unloaded standing posture has been related to spinal pain, there is little evidence of whether, and how much, exposure to posterior load produces injurious effects on spinal tissue. The objective of this study was to describe the effect on adolescent sagittal plane standing posture of different loads and positions of a common design of school backpack. The underlying study aim was to test the appropriateness of two adult 'rules-of-thumb'-that for postural efficiency, backpacks should be worn high on the spine, and loads should be limited to 10% of body weight. METHOD: A randomised controlled experimental study was conducted on 250 adolescents (12–18 years), randomly selected from five South Australian metropolitan high schools. Sagittal view anatomical points were marked on head, neck, shoulder, hip, thigh, knee and ankle. There were nine experimental conditions: combinations of backpack loads (3, 5 or 10% of body weight) and positions (backpack centred at T7, T12 or L3). Sagittal plane photographs were taken of unloaded standing posture (baseline), and standing posture under the experimental conditions. Posture was quantified from the x (horizontal) coordinate of each anatomical point under each experimental condition. Differences in postural response were described, and differences between conditions were determined using Analysis of Variance models. RESULTS: Neither age nor gender was a significant factor when comparing postural response to backpack loads or conditions. Backpacks positioned at T7 produced the largest forward (horizontal) displacement at all the anatomical points. The horizontal position of all anatomical points increased linearly with load. CONCLUSION: There is evidence refuting the 'rule-of-thumb' to carry the backpack high on the back. Typical school backpacks should be positioned with the centre at waist or hip level. There is no evidence for the 10% body weight limit

Testing the stability of behavioural coping style across stress contexts in the Trinidadian guppy

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.1. Within-populations, individuals can vary in stress response, a multivariate phenomenon comprising neuroendocrine, physiological and behavioural traits. 2. Verbal models of individual stress ‘coping style’ have proposed that the behavioural component of this variation can be described as a single axis, with each individual’s coping style being consistent across time and stress contexts. 3. Focusing on this behavioural component of stress response, and combining repeated measures of multiple traits with a novel multivariate modelling framework, we test for the existence of coping style variation and assess its stability across contexts in the Trinidadian guppy (Poecilia reticulata). 4. Specifically, we test the following hypotheses: (i) there exists repeatable among-individual behavioural (co)variation (‘personality’) within a mild stress context consistent with a risk-averse—risk-prone continuum of behavioural coping style, (ii) there is population-level plasticity in behaviour as a function of stressor severity, (iii) there is among-individual variation in plasticity (i.e., IxE), and (iv) the presence of IxE reduces cross-context stability of behavioural coping style. 5. We found significant repeatable among-individual behavioural (co)variation in the mild stress context (open field trial), represented as an I matrix. However, I was not readily described by a simple risk-averse—risk-prone continuum as posited by the original coping style model. We also found strong evidence for population-level changes in mean behaviour with increasing stressor severity (simulated avian and piscine predation risks). 6. Single-trait analyses did show the presence of individual-by-environment interactions (IxE), as among-individual cross-context correlations were significantly less than +1. However, multi-trait analysis revealed the consequences of this plasticity variation were minimal. Specifically, we found little evidence for changes in the structure of I between mild and moderate stress contexts overall, and only minor changes between the two moderate contexts (avian versus piscine predator). 7. We show that a multivariate approach to assessing changes in among individual (co)variance across contexts can prevent the over-interpretation of statistically significant, but small, individual-by-environment effects. While behavioural flexibility enables populations (and individuals) to respond rapidly to changes in the environment, multivariate personality structure can be conserved strongly across such contexts.Funding was provided by a grant from the Biotechnology and Biological Sciences Research Council (BBSRC, grant BB/L022656/1). A.J.Y. is supported by a BBSRC David Phillips Fellowship