The influence of standards and clinical guidelines on prosthetic and orthotic service quality : a scoping review

OBJECTIVES: Standards and guidelines are an integral part of prosthetic and orthotic service delivery in the developed world underpinned by an assumption that they lead to improved services. Implementing them has a cost, however, and that cost needs to be justified, particularly in resource-limited environments. This scoping review thus asks the question, "What is the evidence of the impact of standards and guidelines on service delivery outcomes in prosthetics and orthotics?" MATERIALS AND METHODS: A structured search of three electronic databases (Medline, Scopus and Web of Science) followed by manual searching of title, abstract and full text, yielded 29 articles. RESULTS: Four categories of papers were identified: Descriptions and Commentaries (17 papers), Guideline Development (7), Guideline Testing (2) and Standards implementation (3). No articles were explicitly designed to assess the impact of standards and guidelines on service delivery outcomes in prosthetics and orthotics. DISCUSSION AND CONCLUSION: Studies tended to be commentaries on or descriptions of guideline development, testing or implementation of standards. The literature is not sufficiently well developed to warrant the cost and effort of a systematic review. Future primary research should seek to demonstrate whether and how guidelines and standards improve the outcomes for people that require prostheses, orthoses and other assistive devices. Implications for Rehabilitation International Standards and Clinical Guidelines are now an integral part of clinical service provision in prosthetics and orthotics in the developed world. Complying with standards and guidelines has a cost and, particularly in resource-limited environments, it should be possible to justify this in terms of the resulting benefits. This scoping review concludes that there have been no previous studies designed to directly quantify the effects of implementing standards and guidelines on service delivery

The Future of U.S. Detention under International Law: Workshop Report

The International Committee of the Red Cross Regional Delegation for the United States and Canada, the Harvard Law School Program on International Law and Armed Conflict, and the Stockton Center for the Study of International Law at the U.S. Naval War College recently hosted a workshop titled Global Battlefields: The Future of U.S. Detention under International Law. The workshop was designed to facilitate discussion on international law issues pertaining to U.S. detention practices and policies in armed conflict. Workshop participants included members of government, legal experts, practitioners and scholars from a variety of countries. This report attempts to capture the main debates that arose in each session

Regulating disasters? The role of international law in disaster prevention and management

Purpose – This article explores the role of international law in disaster prevention and management, with a particular focus on the emerging field of international disaster law, and its relationship with international human rights law. It further introduces the four articles of the special column of this journal issue, dedicated to disasters and international law. Design/methodology/approach – The analysis is based upon primary sources of legislation and policy, as well as academic literature on disasters and international law. Findings – Although the field of international disaster law is at its infancy, we argue that this emergent area does have the potential to gain widespread recognition as a distinct field of law, and that this could be of benefit for the wider disaster management community. Originality/value – The article introduces key legal features and themes relating to international law and disasters, highlighting their relevance for disaster management. The added value is to widen the discussion on aspects of disasters regulated by international law, thus facilitating the future exchange with other academic subjects and operational fields. Keywords – disasters; international law; disaster management; treaties; human rights; international disaster law; international human rights law. Paper type – Research pape

The analytical framework of water and armed conflict: a focus on the 2006 Summer War between Israel and Lebanon

This paper develops an analytical framework to investigate the relationship between water and armed conflict, and applies it to the ‘Summer War’ of 2006 between Israel and Lebanon (Hezbollah). The framework broadens and deepens existing classifications by assessing the impact of acts of war as indiscriminate or targeted, and evaluating them in terms of international norms and law, in particular International Humanitarian Law (IHL). In the case at hand, the relationship is characterised by extensive damage in Lebanon to drinking water infrastructure and resources. This is seen as a clear violation of the letter and the spirit of IHL, while the partial destruction of more than 50 public water towers compromises water rights and national development goals. The absence of pre-war environmental baselines makes it difficult to gauge the impact on water resources, suggesting a role for those with first-hand knowledge of the hostilities to develop a more effective response before, during, and after armed conflict

The Shadows of the Past

We examined associations between two orientations based on historical group trauma, a form of enduring group victimhood (Perpetual Ingroup Victimhood Orientation [PIVO]) and the belief that one’s group might itself become a victimizer (Fear of Victimizing [FOV]), and attitudes, cognitions, and emotions related to intergroup conflicts. PIVO was positively and FOV was negatively related to aggressive attitudes and emotions toward the outgroup (Studies 1a-1c, Israeli–Palestinian conflict), and to the attribution of responsibility for a series of hostilities to the outgroup (Study 3, Israeli–Palestinian conflict). PIVO was negatively and FOV positively related to support for forgiveness and reconciliation (Study 2, Northern Ireland conflict). In Experimental Study 4, FOV predicted greater accuracy in remembering harm, regardless of victims’ group identity, whereas PIVO was associated with reduced accuracy only when victims were Palestinians (outgroup members). Taken together, these findings indicate that both orientations have a significant impact on intergroup conflicts and their resolution

Psychosocial Capacity Building in Response to Cascading Disasters: A Culturally Informed Approach

The dominant paradigm guiding mental health professionals responding to major disasters is the field of \u27disaster mental health\u27, which historically focused more on psychological factors than social factors, privileging individual over collective interventions. However, resilience to complex events is a result of multiple drivers, such as social networks and local culture, that must be considered together in the assessment and planning process. This paper adopts a multi-disciplinary perspective for disaster response, applying a social-ecological approach to disaster risk reduction which has been developed through practice and a review of the literature. In particular, we investigated how psychosocial healing, collective efficacy and social justice as intertwined aspects of the recovery process may inhibit the escalation of cascading disasters. The article argues that psychosocial capacity building can be used in disaster preparation as well as to respond to cascading events, as the escalation of secondary emergencies caused by the loss of vital services can heavily influence collective behaviors, and hinder the response capacity of emergency services. Our research suggests that adopting a multi-systemic approach, drawing on local cultural practices, can deepen the capacity of local people to take control over their own process of healing and psychosocial restoration, enhancing a sustainable recovery process. The conclusions suggest some possible applications for responders, utilizing groups and activities, and raise questions for researchers in the field

Public health, conflict and human rights: toward a collaborative research agenda

Although epidemiology is increasingly contributing to policy debates on issues of conflict and human rights, its potential is still underutilized. As a result, this article calls for greater collaboration between public health researchers, conflict analysts and human rights monitors, with special emphasis on retrospective, population-based surveys. The article surveys relevant recent public health research, explains why collaboration is useful, and outlines possible future research scenarios, including those pertaining to the indirect and long-term consequences of conflict; human rights and security in conflict prone areas; and the link between human rights, conflict, and International Humanitarian Law