A scoping review of clinical practice improvement methodology use in rehabilitation

CONTEXT: The Clinical Practice Improvement (CPI) approach is a methodological and quality improvement approach that has emerged and is gaining in popularity. However, there is no systematic description of its use or the determinants of its practice in rehabilitation settings. METHOD: We performed a scoping review of the use of CPI methodology in rehabilitation settings. RESULTS: A total of 103 articles were reviewed. We found evidence of 13 initiatives involving CPI with six different populations. A total of 335 citations of determinants were found, with 68.7% related to CPI itself. Little information was found about what type of external and internal environment, individual characteristics and implementation process might facilitate or hinder the use of CPI. CONCLUSION: Given the growing popularity of this methodological approach, CPI initiatives would gain from increasing knowledge of the determinants of its success and incorporating them in future implementation

Effect of rehabilitation length of stay on outcomes in individuals with traumatic brain injury or spinal cord injury : a systematic review protocol

Background: Rehabilitation interventions are a key component of the services required by individuals with neurotrauma to recover or compensate for altered abilities and achieve optimal social participation. Primary studies have produced evidence of the effect of rehabilitation length of stay on individuals with neurotrauma. However, to date no systematic review of this evidence has been performed. This makes it difficult for managers and clinicians to base their rehabilitation practices upon evidence. Method: Supported by a committee of stakeholders, we will search electronic databases for research articles examining the association between length of stay or intensity of inpatient rehabilitation services and outcomes or the determinants of inpatient rehabilitation length of stay in adults with neurotrauma published after January 1990. Two researchers will independently screen the article titles and abstracts for inclusion. Two reviewers will independently extract the data. Primary outcomes of interest will be level of function, participation and return to work. If the data allow it, a meta-analysis of the studies will be performed. Discussion: The results of this systematic review will clarify the factors that influence length of stay and intensity of rehabilitation services for individuals with TBI and SCI. They will give clinicians indications for optimal length of stay in these patient populations, contributing to better quality of care and better functional results

The Disability Creation Process Model: A Comprehensive Explanation of Disabling Situations as a Guide to Developing Policy and Service Programs

Understanding disability remains a challenge. Although the international community has largely embraced the idea that disability is the product of social and environmental practices, society still lacks good conceptual frameworks. In an era when the rights of persons with disabilities have been enshrined in international and national laws, such frameworks have become a necessity. Within the province of Quebec, Canada, the Disability Creation Process (DCP) model has served such a role. Furthermore, recent efforts to enrich the model enhance the applicability of this powerful tool to a broader range of contexts. As a result, the DCP model could be used more widely than it is today. In this paper we provide the foundations of the approach encapsulated by the model and explain how its usage guides policy development and service delivery within the province of Quebec. We also highlight its forward-looking capacities

COMPARING THE VALIDITY OF FIVE PARTICIPATION INSTRUMENTS IN PERSONS WITH SPINAL CONDITIONS

Objective: To evaluate and compare the construct validity of 5 participation instruments developed using the International Classification of Functioning, Disability and Health (ICF). Methods: A total of 545 subjects diagnosed and treated for a spinal condition at an acute hospital were followed-up and consented to complete a questionnaire. Subjects completed 5 participation instruments (Impact on Participation and Autonomy (IPA), Keele Assessment of Participation (KAP), Participation Measure-Post Acute Care (PM-PAC), Participation Objective Participation Subjective (POPS), World Health Organization Disability Assessment Schedule II (WHODAS II)). In addition, each subject completed a health status instrument and a quality of life instrument. The dimensionality, convergent/discriminant validity and known-group validity of the participation instruments were assessed. Results: A confirmatory factor analysis of the facture structure for the IPA and PM-PAC demonstrated adequate model fit. For convergent/discriminant validity, correlations were generally higher among similar domains of the WHODAS II, IPA, KAP and PM-PAC, and as expected the lowest correlations were observed with the objective domains of the POPS. Most instruments demonstrated known-group validity. Conclusion: Differences in the construct validity evidence of the POPS compared with the other 4 instruments were noted. To date, there is no gold standard for measuring participation, and clinicians and researchers should consider the type of information required prior to selecting an instrument

Про один підхід до ідентифікації особи за контуром профілю носа

У статті розглядається підхід для ідентифікації особи за контуром профілю носа. Для знаходження простору ознак пропонується використовувати апроксимацію за допомогою B-сплайнів. Алгоритмічна реалізація підходу використовує моделювання структури бази даних у вигляді n- вимірного куба.В статье рассматривается подход для идентификации личности по контуру носа. Для нахождения пространства признаков предлагается использовать аппроксимацию с помощью B-сплайнов. Алгоритмическая реализация подхода использует моделирование структуры базы данных в виде n-мерного куба.An approach of human identification by the nose contour profile is researched in the paper. B-splines approximation is suggested for determining the feature space. Algorithmic implementation of the approach uses database structure in the form of n-dimensional cube

Embedded Systems and Assistive Technology for Last Mile Mobility

International audienc

Using Geospatial Technologies for Assessing Accessibility of Urban Spaces for People with Motor Disabilities: Theoretical Framework of an Approach Centered on Users’ Perception

The quality of life of people with disabilities strongly depends on their ability to access urban spaces and conduct their daily activities without any restriction. Unfortunately, there is a significant gap between traditional urban design and the way people with disabilities live in urban environments, which significantly limits their mobility and hence their social participation. In recent years, several governments and administrations have issued norms and guidelines that aim to ensure the construction of environments that are accessible and barrier-free in order to facilitate the mobility of these people. However, the goal and the means to improve mobility and quality of access to urban environments are still misunderstood by the public authorities and the actors involved. In order to help people with disabilities overcome the existing environmental barriers, we need to better understand how they perceive the accessibility of an urban environment while taking into account the heterogeneity of their profiles. In this paper, we present a theoretical framework of a new approach to assess accessibility of urban environments centered on users’ perception. To take into consideration the diversity of users’ profiles, the proposed framework combines the principles of the Disability Creation Process model and ‘Cognitive Design’. These two paradigms provide a solid background for the definition of experimental protocols for assessing the level of accessibility of urban spaces that may contain diverse obstacles and facilitators. In addition, this paper illustrates the importance of geospatial technologies for the implementation of such protocols.La qualité de vie des personnes en situation de handicap dépend en grande partie de leur capacité à accéder aux espaces urbains et à mener leurs activités quotidiennes sans restriction. Malheureusement, il existe un écart considerable entre la planification urbaine traditionnelle et la manière dont les personnes en situation de handicap vivent en milieu urbain, ce qui limite significativement leur mobilité et leur participation sociale. Au cours des dernières années, plusieurs gouvernements et administrations ont publié des normes et des directives visant à garantir la création d'environnements accessibles pour faciliter la mobilité pour toutes les categories de la population. Toutefois, l'objectif et les moyens d'améliorer la mobilité des personnes en situation de handicap et l’accessibilité des espaces urbains demeurent peu compris par les autorités publiques et les acteurs impliqués. Afin d'aider les personnes en situation de handicap à surmonter les barrières environnementales qu’elles rencontrent, nous devons mieux comprendre comment elles perçoivent l'accessibilité d'un environnement urbain en tenant compte de l'hétérogénéité de leurs profils. Dans cet article, nous présentons le cadre théorique d’une nouvelle approche pour évaluer l’accessibilité des environnements urbains centrée sur la perception des usagers. Pour prendre en compte la diversité des profils des usagers, le cadre théorique proposé combine les principes du modèle du Processus de production du handicap (PPH) et le Design Cognitif. Ces deux paradigmes fournissent une base solide pour définir des protocoles expérimentaux permettant d'évaluer le niveau d'accessibilité d’espaces urbains contenant divers obstacles et facilitateurs. En outre, cet article illustre l’importance des technologies géospatiales pour la mise en oeuvre de tels protocoles