Exploring the use of ultrasound imaging by physiotherapists: An international survey

Background: National surveys in New Zealand, Australia and the United Kingdom suggest ultrasound imaging (USI) use by physiotherapists is increasing. However, concerns exist regarding clarity for scopes of practice, and availability and standardisation of training. Objectives: To investigate physiotherapists' understanding of scopes of practice for the use of USI; clarify the professional contexts, clinical uses and levels of training; and identify barriers preventing physiotherapists' USI use. Design: A cross-sectional, observational survey. Methods: An Internet-based survey, offered in 20 different languages, was used including items covering five domains: (1) demographic and professional characteristics; (2) knowledge of scope of practice; (3) USI use; (4) USI training content and duration; and (5) perceived barriers to physiotherapists' use of USI. Results: 1307 registered physiotherapists from 49 countries responded; 30% were unsure of the scope of practice for physiotherapists' USI use. 38% of participants were users of USI, reporting varied contexts and clinical uses, reflected in the broader categories of: (i) biofeedback; (ii) diagnosis; (iii) assessment; (iv) injection guidance; (v) research; (vi) and teaching. The training users received varied, with formal training more comprehensive. 62% were non-users, the most common barrier was lack of training (76%). Conclusion: These findings suggest physiotherapists' USI use is increasing in various contexts; however, there is uncertainty regarding scopes of practice. There are discrepancies in training offered, with a lack of training the most common barrier to physiotherapists' use of USI. International guidelines, including a USI training framework, are needed to support the consistent and sustainable use of USI in physiotherapy

Addressing the climate challenge

In 2021, colleagues from across the University of Birmingham community were invited to write articles about topics relevant to the COP26 climate change summit. In this series of articles, experts from across many different disciplines provide new insight and evidence on how we might all understand and tackle climate change

'A chequered scene': Female agency and queer choices in the late eighteenth century

This is a creative writing thesis comprising of novel and critical commentary. The overall aim of both parts is to engage with the dual topics of female agency and queer choices in the late eighteenth century. The novel, A Chequered Scene, transplants a sixteen-year-old girl from the twenty-first century to 1790 Hampshire, thereby highlighting the contrasts and similarities experienced by women and queer people in the two time periods. The novel aims to deliver an authentic portrait of eighteenth-century life through its style and language, as well as capture the sense of the eighteenth-century novel through its split narrative, epistolary structure. A Chequered Scene explores and illuminates the liminal spaces within which women and queer people exercised their agency. This is done through the narrative itself and in the creation of specific characters whose lives are representative of the potential opportunities or strictures their historical equivalents may have faced: the young heiress with a mercenary suitor; the rich widow who relishes her liberty; the ‘fallen woman’ with an implacable devotion to the one she loves; one born to the wrong sex who dons the clothes of their chosen identity. Part two, the critical commentary, offers a series of demarcations on the core aspects of female strictures in the late eighteenth century, including marital prospects and potential careers. Claims for originality lie in the production of an original novel and in employing the extended metaphor of life as ‘a chequered scene’ in the commentary. Queer and female lives navigate the board of society, either staying within the light of patriarchal strictures, or straying onto the dark of impermissible proclivities. Research into the collection at Chawton House, particularly educational works, conduct literature, memoirs, and diaries, as well as building on recent criticism, has informed the creative aspect in an original way

Widening the educational capabilities of socio‐economically disadvantaged students through a model of social and cultural capital development

Widening participation programmes aim to increase the progression of students from low socio‐economic status (SES) groups to higher education. This research proposes that the human capabilities approach is a good justice‐based framework within which to consider the social and cultural capital processes that impact upon the educational capabilities of young people from low SES groups. It presents a case study which examines the developing capability set of Irish students from a representative sample of schools participating in a university‐based widening participation outreach programme aimed at increasing social and cultural capital constructs. Qualitative analysis is presented from four schools; four student focus groups with 22 student participants, and 15 individual student interviews. Findings focus on the developing capabilities of autonomy, hope, voice and identity, as well as on the relationship between specific widening participation activities and the developing capability set. The findings highlight the development of college‐focused knowledge and how this impacts upon students’ aspiration to participate in higher education. The idea of ‘widening capability’ is discussed in relation to the potential of the capability approach to contribute an additional dimension to a mainly neoliberal policy rhetoric, which emphasises the market value of higher‐education participation. In doing so, it explores how widening participation activities can influence the widening capability set of low SES students, and its relationship with what the students deem to be ‘a life of value’

The validity of Rehabilitative Ultrasound Imaging for measurement of trapezius muscle thickness

The purpose of the study was to establish the validity of Rehabilitative Ultrasound Imaging (RUSI) against Magnetic Resonance Imaging (MRI) for measuring trapezius muscle thickness. Participants were asymptomatic subjects recruited from Trinity College Dublin and associated teaching hospitals. Four MRI axial slices were made through each of the C6, T1, T5 and T8 spinous processes, with the subject supine. RUSI was performed immediately after MRI at the same vertebral levels, with the subject prone. Linear measurements of trapezius muscle thickness were made off-line on both the MRI and Ultrasound scans, in three regions: lower, middle and upper trapezius. Bland and Altman limits of agreement and Pearson's correlation coefficient were used to analyse the relationship between thickness measures taken from MRI and RUSI. Eighteen subjects (9 women) participated, (age-range 21–42 years). Results demonstrated good agreement between MRI and RUSI measurements of the lower trapezius muscle at T8 (r = 0.77) and moderate agreement at T5, (r = 0.62). Results were poor for the middle (T1) and upper (C6) trapezius muscles, (r = ?0.22 to 0.52) but may be explained by differences in both positioning and imaging planes between the 2 modalities. It was concluded that RUSI is a valid method of measuring lower trapezius muscle thickness

Ways to improve surgical outcomes in low- and middle-income countries

Global surgery initiatives such as the Lancet Commission on Global Surgery have highlighted the need for increased investment to enhance surgical capacity in low- and middle-income countries. A neglected issue, however, is surgery-related rehabilitation, which is known to optimize functional outcomes after surgery. Increased investment to enhance surgical capacity therefore needs to be complemented by promotion of rehabilitation interventions. We make the case for strengthening surgery-related rehabilitation in lower-resource countries, outlining the challenges but also potential solutions and policy directions. Proposed solutions include greater leadership and awareness, augmented by recent global efforts around the World Health Organization's Rehabilitation 2030 initiative, and professionalization of the rehabilitation workforce. More research on rehabilitation is needed in low- and middle-income countries, along with support for system approaches, notably on strengthening and integrating rehabilitation within the health systems. Finally, we outline a set of policy implications and recommendations, aligned to the components of the national surgical plan proposed by the Lancet Commission: infrastructure, workforce, service delivery, financing, and information management. Collaboration and sustained efforts to embed rehabilitation within national surgical plans is key to optimize health outcomes for patients with surgical conditions and ensure progress towards sustainable development goal 3: health and well-being for all