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 search process: Integrating the investigation and identification of missing and unidentified persons

The effective search for the missing and identification of persons, alive or dead, are core components in the prevention and in resolving the issue of Missing Persons. Despite the growing literature on this topic, there is still a lack of publications describing the Search as a process that includes different phases inherently composed of forensic investigative and identification principles for both living and deceased missing persons. This paper is the result of discussions between the Forensic Unit of the International Committee of the Red Cross (ICRC) and members of its external Forensic Advisory Board. It aims to present the Search process as an overarching concept that includes the investigation and identification phases of the missing in any state (dead or alive), in any scenario (with or without bodies), with an integrated, multidisciplinary, and multiagency approach for implementation by all actors involved in the investigation and identification phases of missing persons. [Abstract copyright: © 2021 The Authors.

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

Decolonising occupational science education through learning activities based on a study from the Global South

If occupational science education is to become more globally relevant, it must highlight more voices and practices from diverse communities. Learning about occupational justice from the perspectives of Global South communities addresses cognitive injustice and the need to decolonise occupational science education. This paper offers some critical reflections concerning the author’s pedagogic approach, and the ways his research about olive growing in Palestine (Simaan, 2018) informed students’ learning about occupational justice. It focuses on the processes in which students and lecturers engaged within a decolonising approach to occupational science education. A learning activity based on pedagogical processes of ‘conscientization’ (Freire, 1996), critical reflexivity (Whiteford & Townsend, 2011) and intercultural translation (Santos, 2014) is discussed, and lessons learnt by lecturer and students about themselves, their communities, and occupational science are reflected upon. Selected students’ reflections, which illustrate how they positioned themselves in relation to the community studied, and how they interrogated their own reactions to learning about daily lives in Palestine, are discussed. These processes demonstrate the benefits of highlighting local knowledge on occupational justice produced by Global South groups, and how this knowledge might begin to address cognitive injustice and the need to decolonise occupational science pedagogy. More empirical and theoretical work is needed in occupational science education regarding intercultural translations concerning occupational justice, and means of doing and knowing from diverse Global South perspectives

Nonhuman humanitarianism: when ‘AI for good’ can be harmful

Artificial intelligence (AI) applications have been introduced in humanitarian operations in order to help with the significant challenges the sector is facing. This article focuses on chatbots which have been proposed as an efficient method to improve communication with, and accountability to affected communities. Chatbots, together with other humanitarian AI applications such as biometrics, satellite imaging, predictive modelling and data visualisations, are often understood as part of the wider phenomenon of ‘AI for social good’. The article develops a decolonial critique of humanitarianism and critical algorithm studies which focuses on the power asymmetries underpinning both humanitarianism and AI. The article asks whether chatbots, as exemplars of ‘AI for good’, reproduce inequalities in the global context. Drawing on a mixed methods study that includes interviews with seven groups of stakeholders, the analysis observes that humanitarian chatbots do not fulfil claims such as ‘intelligence’. Yet AI applications still have powerful consequences. Apart from the risks associated with misinformation and data safeguarding, chatbots reduce communication to its barest instrumental forms which creates disconnects between affected communities and aid agencies. This disconnect is compounded by the extraction of value from data and experimentation with untested technologies. By reflecting the values of their designers and by asserting Eurocentric values in their programmed interactions, chatbots reproduce the coloniality of power. The article concludes that ‘AI for good’ is an ‘enchantment of technology’ that reworks the colonial legacies of humanitarianism whilst also occluding the power dynamics at play

Sanitation, human rights, and disaster management

Purpose The purpose of this paper is to link debates around the international law on human rights and disaster management with the evolving debate around the human right to sanitation, in order to explore the extent to which states are obliged to account for sanitation in their disaster management efforts. Design/methodology/approach The paper is based on analysis of existing laws and policy relating to human rights, sanitation and disaster management. It further draws upon relevant academic literature. Findings The paper concludes that, while limitations exist, states have legal obligations to provide sanitation to persons affected by a disaster. It is further argued that a human rights-based approach to sanitation, if respected, can assist in strengthening disaster management efforts, while focusing on the persons who need it the most. Research limitations/implications The analysis in this paper focuses on the obligations of states for people on their territory. Due to space limitations, it does not examine the complex issues relating to enforcement mechanisms available to disaster victims. Originality/value This is the first scholarly work directly linking the debates around international human rights law and disaster management, with human rights obligations in relation to sanitation. The clarification of obligation in relation to sanitation can assist in advocacy and planning, as well as in ensuring accountability and responsibility for human rights breaches in the disaster context

Landmine injuries at the Emergency Management Center in Erbil, Iraq

<p>Abstract</p> <p>Background</p> <p>Landmines can cause death, injury and disability in addition to many indirect public health consequences. This study aimed at understanding the trends, demography and other epidemiological characteristics of hospitalized landmine injured patients in Erbil governorate.</p> <p>Methods</p> <p>The case records of landmine injured patients who had been admitted to the Emergency Management Centre in Erbil city from July 1998 to July 2007 were reviewed and descriptively analyzed.</p> <p>Results</p> <p>Two hundred eighty five landmine injured patients were admitted to the center, their mean ± SD age was 26.5 ± 13.2 years (range 6-71 years), 95.1% were males, nearly 50% were between 19 to 35 years of age and 96.8% were civilians. Around 72% of victims sustained limb amputations; 58.6% lower limb and 13.3% upper limb out of the total. The hospital mortality rate was 2.1%. The number of admissions for landmine injury was steadily decreasing between July 1998 and July 2001, followed by prominent increase between July 2002 and July 2003. The highest proportion of admissions occurred in summer (35.4%) and majority of incidents occurred along the borders with Iran and Turkey (61.8%).</p> <p>Conclusion</p> <p>Civilian male adolescents and young adults constituted the majority of hospitalized landmine victims in Erbil governorate. While a high proportion of victims sustained lower limb amputations, upper limb amputations particularly among children and injury to head and face were relatively common which might be attributed to handling explosives. This emphasizes the need to examine the reasons behind handling explosives.</p

Short‐ and longer‐term impacts of Child Friendly Space Interventions in Rwamwanja Refugee Settlement, Uganda

Alastair Ager - ORCID 0000-0002-9474-3563 https://orcid.org/0000-0002-9474-3563Karin Diaconu - ORCID 0000-0002-5810-9725 https://orcid.org/0000-0002-5810-9725Background The establishment of Child Friendly Spaces (CFSs) has become a widespread intervention targeting protection and support for displaced children in humanitarian contexts. There is a lack of evidence of impact of these interventions with respect to both short‐term outcomes and longer‐term developmental trajectories.Methods We collected data from caregivers of Congolese refugee children residing in Rwamwanja Refugee Settlement at three timepoints. To assess short‐term impact of CFSs, we compared indicators assessed shortly after refugees’ arrival (baseline, T1) and endline (T2, three to six months after CFS implementation) amongst 430 CFS attenders and 161 nonattenders. Follow‐up assessments after the end of CFS programming were conducted 18 months post‐baseline (T3) with caregivers of 249 previous CFS attenders and 77 CFS nonattenders.Results In the short‐term, attendance at CFSs was associated with better maintenance of psychosocial well‐being (PSWB; β = 2.093, p < .001, Cohen's d = .347) and greater increases in developmental assets (β = 2.517, p < .001, Cohen's d = .231), with significantly stronger impacts for girls. CFS interventions meeting higher programing quality criteria were associated with greater impact on both PSWB and development assets (β = 2.603 vs. β = 1.793 and β = 2.942 vs. β = 2.337 for attenders at higher and lower‐quality CFSs c.f. nonattenders, respectively). Amongst boys, benefits of program attendance were only indicated for those attending higher‐quality CFS (β = 2.084, p = .006 for PSWB). At follow‐up, however, there were no discernable impacts of prior CFS attendance on any measures. Age and school attendance were the only characteristics that predicted an outcome – developmental assets – at follow‐up.Conclusions Attendance at CFSs – particularly involving higher‐quality programming – supported children's well‐being and development. However, sustained impact beyond active CFS programming was not demonstrated. Intervention goals and strategies in humanitarian contexts need to address the challenge of connecting children to other resources to facilitate developmental progress in conditions of protracted displacement.This research was funded by World Vision International and Elrha's Research for Health in Humanitarian Crises (R2HC) Programme (elrha.org/r2hc), which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. At the time of the award supporting this study, the R2HC program was funded equally by the Wellcome Trust and the UK Department for International Development.https://doi.org/10.1111/jcpp.1306960pubpub1