Development of a Digital Health Capability Framework for Allied Health Practitioners: An Australian First

Background: The value of digital health technologies and their contribution to high-quality and safe clinical care and enhanced health patient experience and outcomes is well established. Digital health technologies are increasingly being used by Victorian allied health professionals (AHPs) in routine service delivery, the uptake of which has been significantly accelerated by the impact of the coronavirus (COVID-19) pandemic. Objectives: This case study outlines the development of a capability framework to support Victorian AHPs, health services, other employers, and university training partners to measure and expand digital health capability at individual practitioner and workforce levels. Methods: A mixed-methods approach to the development of digital health and clinical informatics capabilities and the resultant framework is described, consisting of five phases: (i) a literature/scoping review to identify existing frameworks (ii) expert panel interviews, (iii) thematic analysis of interview themes, (iv) user testing and feedback and, (v) revision based on feedback. Results: This approach proved successful in managing key challenges that emerged during the project, as well as identifying potential barriers and enablers to longer term framework adoption, implementation, and maintenance. Conclusion: This study describes a mixed-methods approach to the development of an Australian-first, Allied health digital health capability framework to address knowledge and skills development at individual practitioner and workforce levels. This case study highlights the need for targeted education and training resources to support the health workforce to build capability in the application and use of digital health technologies. In developing a digital capability framework specific to the allied health workforce, the importance of stakeholder consultation in the early identification of barriers and enablers to potential uptake and implementation is also reinforced

Guidance and standard operating procedures for functional exercise testing in cystic fibrosis

Regular exercise testing is recommended for all people with cystic fibrosis (PwCF). A range of validated tests, which integrate both strength and aerobic function, are available and increasingly being used. Together, these tests offer the ability for comprehensive exercise evaluation. Extensive research and expert consensus over recent years has enabled the adaptation and standardisation of a range of exercise tests to aid the understanding of the pathophysiology related to exercise limitation in PwCF and has led to the development of novel exercise tests which may be applied to PwCF. This article provides expert, opinion-based clinical practice guidance, along with test instructions, for a selection of commonly used valid tests which have documented clinimetric properties for PwCF. Importantly, this document also highlights previously used tests that are no longer suggested for PwCF and areas where research is mandated. This collaboration, on behalf of the European Cystic Fibrosis Society Exercise Working Group, represents expert consensus by a multidisciplinary panel of physiotherapists, exercise scientists and clinicians and aims to improve global standardisation of functional exercise testing of PwCF. In short, the standardised use of a small selection of tests performed to a high standard is advocated

Exploring Approaches to Exercise Testing and Training in Adults with Cystic Fibrosis

This research involved a: (i) narrative review exploring the effects of high intensity interval training (HIIT) in people with chronic respiratory disease; (ii) survey of exercise testing and training procedures; (iii) randomised controlled trial (RCT) evaluating the effects of HIIT on exercise capacity in people with CF; (iv) systematic review mapping behaviour change techniques (BCTs) optimising participation in physical activity in young people with chronic cardiorespiratory conditions and; (v) evaluation of BCTs employed within the RCT

The digital motor output: a conceptual framework for a meaningful clinical performance metric for a motor neuroprosthesis

In recent years, the majority of the population has become increasingly reliant on continuous and independent control of smart devices to conduct activities of daily living. Upper extremity movement is typically required to generate the motor outputs that control these interfaces, such as rapidly and accurately navigating and clicking a mouse, or activating a touch screen. For people living with tetraplegia, these abilities are lost, significantly compromising their ability to interact with their environment. Implantable brain computer interfaces (BCIs) hold promise for restoring lost neurologic function, including motor neuroprostheses (MNPs). An implantable MNP can directly infer motor intent by detecting brain signals and transmitting the motor signal out of the brain to generate a motor output and subsequently control computer actions. This physiological function is typically performed by the motor neurons in the human body. To evaluate the use of these implanted technologies, there is a need for an objective measurement of the effectiveness of MNPs in restoring motor outputs. Here, we propose the concept of digital motor outputs (DMOs) to address this: a motor output decoded directly from a neural recording during an attempted limb or orofacial movement is transformed into a command that controls an electronic device. Digital motor outputs are diverse and can be categorized as discrete or continuous representations of motor control, and the clinical utility of the control of a single, discrete DMO has been reported in multiple studies. This sets the stage for the DMO to emerge as a quantitative measure of MNP performance

High-intensity interval training is effective at increasing exercise endurance capacity and is well tolerated by adults with cystic fibrosis

Background: To optimize outcomes in people with cystic fibrosis (CF), guidelines recommend 30 to 60 min of moderate-intensity aerobic exercise on most days. Accumulating this volume of exercise contributes importantly to the substantial treatment burden associated with CF. Therefore, the main aim of this study was to investigate the effects of low-volume high-intensity interval training (HIIT) on exercise capacity in people with CF. Methods: This randomized controlled trial included people with CF aged ≥15 years, who were allocated to either eight weeks of thrice-weekly 10-min sessions of HIIT (experimental group) or eight weeks of weekly contact (control group). Before and after the intervention period, participants completed measurements of time to symptom limitation (Tlim) during a constant work rate cycle ergometry test (primary outcome), and maximal work rate (Wmax) during a ramp-based cycle ergometry test and health-related quality of life (HRQoL). Results: Fourteen participants (median (IQR) age 31 (28, 35) years, forced expiratory volume in 1 second (FEV1) 61 (45, 80) % predicted) were included (seven in each group). Compared to the control group, participants in the experimental group demonstrated a greater magnitude of change in Tlim, Wmax (p = 0.017 for both) and in the physical function domain of HRQoL (p = 0.03). No other between-group differences were demonstrated. Mild post-exercise muscle soreness was reported on a single occasion by four participants. Overall, participants attended 93% of all HIIT sessions. Discussion: Eight weeks of low-volume (i.e., 30-min/week) HIIT produced gains in exercise capacity and self-reported physical function and was well tolerated by people with C

Guidance and standard operating procedures for functional exercise testing in cystic fibrosis

Regular exercise testing is recommended for all people with cystic fibrosis (pwCF). A range of validated tests, which integrate both strength and aerobic function, are available and increasingly being used. Together, these tests offer the ability for comprehensive exercise evaluation. Extensive research and expert consensus over recent years has enabled the adaptation and standardisation of a range of exercise tests to aid the understanding of the pathophysiology related to exercise limitation in pwCF, and has led to the development of novel exercise tests which may be applied to pwCF. This article provides expert, opinion-based clinical practice guidance, along with test instructions, for a selection of commonly used valid tests which have documented clinimetric properties for pwCF. Importantly, this document also highlights previously used tests that are no longer suggested for pwCF and areas where research is mandated. This collaboration, on behalf of the European CF Society Exercise Working Group, represents expert consensus by a multidisciplinary panel of physiotherapists, exercise scientists and clinicians and aims to improve global standardisation of functional exercise testing of pwCF. In short, the standardised use of a small selection of tests performed to a high standard is advocated

Community responsibility for preventing sexual violence: A pilot study with campus greeks and intercollegiate athletes

Previous research has noted higher incidences of sexual violence on campus among members of campus Greeks and athletes and the need to do prevention programs with them. This article presents the results of an exploratory pilot study of a sexual violence prevention program with members of one fraternity, sorority, men\u27s and women\u27s intercollegiate athletic team. The program, experimentally evaluated and found to be effective with a general sample of undergraduates, was used to determine its efficacy specifically with Greeks and athletes. The model on which the program is based calls for prevention efforts that take a wider community approach rather than simply targeting individuals as potential perpetrators or victims. Results from repeated-measures analysis of variance indicate that the program worked overall. Future directions are discussed