The Effect of Aquatic Physiotherapy on Low Back Pain in Pregnant Women

This study evaluated the effect of antenatal aquatic physiotherapy sessions on low back pain in pregnant women. Thirty-three subjects (31.8 + 4.8 years) participated in a prospective, quantitative, repeated measures within subjects design. Low back pain was measured using a Numerical Rating Scale immediately before and after each session. The subjects significantly improved their post session pain scores by an average of 44 percent. Pain did not increase significantly from the beginning to the end of the course of sessions as is normally expected in this population and the number of sessions made no significant difference. Conclusions: This finding suggests that attending once a week will effectively manage low back pain for pregnant women

Effectiveness of Training in Changing Allied Health Students’ Cultural Competency Skills

Purpose: Allied health students require cultural competence training to help them act as caring, ethical, and socially responsible health professionals. There is a lack of evidence for the effectiveness of cultural competence training changing the cultural skill level of allied health students or their behaviour in clinical practice. Method: We conducted a systematic search of the literature to examine the effectiveness of cultural competence training in changing allied health student cultural competency skills. CINAHL, Embase, ERIC, Medline and Scopus databases were searched from inception until August 2017. Search terms represented the population (e.g. allied health students), and cultural competence training. Two reviewers independently screened all retrieved studies and abstracts, then full text papers against inclusion criteria. All included studies were critically appraised, and data was extracted for analysis. Results: Of the initial 9,076 database hits, 15 intervention studies met the inclusion criteria; indicating this is a nascent area of research. Fourteen of the 15 studies demonstrated that cultural competence training provided to allied health students could significantly increase their perceived cultural competence skills, with effect sizes ranging from small to very large. Training was predominately conducted using traditional classroom teaching activities. The review identified that this field of research is dominated by the model and survey tool devised by Campinha-Bacote with a focus on skills required for patient assessment, rather than patient outcomes. Conclusions and possibly recommendations: Cultural competence training can improve allied health students’ perceived level of cultural competence skills for clinical practice. To ensure an effective translation of skill development to clinical practice, tertiary institutions seeking to develop and evaluate cultural competency training programs should focus on teaching cultural competency skills that lead to improved patient outcomes

Exercising choice and control: A qualitative meta-synthesis of perspectives of people with a spinal cord injury

OBJECTIVE: To systematically search the literature and construct a meta-synthesis of how choice and control are perceived by people with spinal cord injury (SCI). DATA SOURCES: Medline, Academic Search Premier, CINAHL, Cochrane, EMBASE, HealthSource, ProQuest, PsychInfo, SAGE, and SCOPUS were searched from 1980 until September 2018 including all languages. Reference lists of selected studies were also reviewed. STUDY SELECTION: Eligible qualitative studies included perspectives about choice of control as reported by people with an SCI. Studies were excluded if they included perspectives from other stakeholder groups. A total of 6706 studies were screened for title and abstract and full text of 127 studies were reviewed resulting in a final selection of 29. DATA EXTRACTION: Characteristics of the studies were extracted along with any data (author interpretations and quotes) relating to perspectives on choice and control. DATA SYNTHESIS: First-order analysis involved coding the data in each study and second-order analysis involved translating each segment of coded data into broader categories with third-order analysis condensing categories to 2 broad overarching themes. These themes were experiencing vulnerability or security and adapting to bounded abilities. CONCLUSIONS: Perspectives of choice and control are influenced by interrelated environmental, interpersonal, and personal contexts. From a personal perspective, participants reported a readiness for adaptation that included turning points where emotional and cognitive capacity to make choices and take control changed. Health professionals need to be responsive to this readiness, promote empowerment and foster, rather than remove, hope

Perspectives of choice and control in daily life for people following brain injury: A qualitative systematic review and meta-synthesis

Background and Objective: Acquired brain injury (ABI) can result in considerable life changes. Having choice and control over daily life is valued by people following ABI. This meta-synthesis will analyse and integrate international research exploring perspectives of choice and control in daily life following ABI. Methods: Databases were searched from 1980 to 13 January 2022 for eligible qualitative studies. After duplicates were removed, 22,768 studies were screened by title and abstract, and 241 studies received full-text assessment with 56 studies included after pearling. Study characteristics and findings were extracted that related to personal perspectives on choice and control by people with an ABI (including author interpretation and quotes). Data from each study were coded and then segments of coded data across the studies were compared to create multiple broad categories. Findings: Findings were then reduced from categories into 3 overarching themes with 12 subthemes. These themes were: (1) feeling like a second-class citizen; (2) reordering life and (3) choosing a path. Participants with an ABI tussled between their feelings of loss following brain injury and their thinking about how they start to regain control and become agents of their own choices. The themes describe their sense of self, their changed self and their empowered self in relation to ‘choice and control’. Conclusions: Re-engaging with choice and control after ABI is dynamic and can be challenging. Health professionals and supporters need to facilitate a gradual and negotiated return to agency for people following ABI. A sensitive and person-centred approach is needed that considers the readiness of the person with ABI to reclaim choice and control at each stage of their recovery. Clear service or process indicators that are built on lived experience research are needed to facilitate changes in service delivery that are collaborative and inclusive. Patient or Public Contribution: This review included the voices of 765 people living with ABI and was conducted by a diverse team of allied health professionals with practice knowledge and research experience with people following ABI. Twenty-nine of the 56 included studies had participants contributing to their design or analysis

The Implementation of Evidence to Improve Falls Prevention: Lessons from a Case Study in Aged Care

This paper reports on a study investigating the construction of falls prevention evidence within an aged care organization. It describes how the structure and culture of an aged care organization influences the construction of falls prevention evidence by staff. Method: An instrumental single case study design grounded in an interpretive, constructivist paradigm drew on data collected in 2010 from a document review, observations, and informal interviews with nursing and allied health staff. An iterative analysis used a model of diffusion determinants. Results: The aged care organization which served as the case for this study linked its cultural strengths of vision, leadership, and innovativeness with its decision making structures to resources from its external environment to implement falls prevention strategies that were both best practice and innovative. The case study demonstrated that in addition to known individual and organizational barriers to the use of evidence, the nature of evidence itself can act as a barrier when it is constructed into a norm which directs practice in a particular direction thus obscuring alternatives. Conclusion: Organizations can reflect on how their culture and structure can influence the effective use of evidence, the contribution to creating a social norm that inhibits the creative research, and the management required to address complex health issues

A Qualitative Study to Examine Feasibility and Design of an Online Social Networking Intervention to Increase Physical Activity in Teenage Girls.

BACKGROUND:Online social networks present wide-reaching and flexible platforms through which to deliver health interventions to targeted populations. This study used a social marketing approach to explore teenage girls' perceptions of physical activity and the potential use of online social networks to receive a physical activity intervention. METHODS:Six focus groups were conducted with 19 Australian teenage girls (ages 13 to 18 years) with varying levels of physical activity and socioeconomic status. A semi-structured format was used, with groups discussion transcribed verbatim. Content analysis identified emergent themes, with triangulation and memos used to ensure accuracy. RESULTS:Physical activity was most appealing when it emphasised sport, exercise and fitness, along with opportunities for socialisation with friends and self-improvement. Participants were receptive to delivery of a physical activity intervention via online social networks, with Facebook the most widely reported site. Participants commonly accessed online social networks via mobile devices and particularly smartphones. Undesirable features included promotion of physical activity in terms of walking; use of cartoon imagery; use of humour; and promotion of the intervention via schools, each of which were considered "uncool". Participants noted that their parents were likely to be supportive of them using an online social networking physical activity intervention, particularly if not promoted as a weight loss intervention. CONCLUSION:This study identified key features likely to increase the feasibility and retention of an online social networking physical activity intervention for teenage girls. Guidelines for the design of interventions for teenage girls are provided for future applications

The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women

Abstract Background Approximately 50% of Australian women experience low back pain in pregnancy, with somewhere between 8 and 36% of women suffering from pregnancy related depression/anxiety. Both low back and pelvic pain and depression and anxiety are associated with poor maternal health outcomes, including increased sick leave, higher rates of functional disability, and increased access to healthcare. It also impacts upon time and mode of delivery with an increase in inductions and elective caesarean sections. For babies of women with depression and anxiety preterm birth, low birth weight and intrauterine growth restriction are all common complications. Given these poor health outcomes, it is important to determine the co-morbidity of low back and pelvic pain and depression/anxiety in pregnancy. Methods A cross sectional study of a hospital based sample of 96 nulliparous women were assessed at 28 weeks as part of their routine antenatal appointment. Data was collected via interview and clinical records and included the Edinburgh Depression Scale (EDS), the Numerical Rating Scale (NRS) and the Modified Oswestry Low Back Pain Disability Questionnaire (MODQ). Spearman’s correlation co-efficients, prevalence ratios and ANOVA were used to determine comorbidity. Results 96 women consented to participation in the study. All study outcomes were moderately correlated. There were three main findings: One, there was a positive correlation between low back and pelvic girdle pain (LBPP) and depression/anxiety was rho = 0.39, p < 0.001, between LBPP and functional disability was rho = 0.51, p < 0.001 and between risk of depression/anxiety and functional disability was rho = 0.54, p < 0.001. Two, a woman with LBPP was 13 times more likely to have increased risk of depression/anxiety, whilst a woman with increased risk of depression/anxiety was 2.2 times more likely to have LBPP and finally three, amongst women who reported LBPP, the level of disability experienced was significantly higher in women who had concurrent increased risk of depression/anxiety (p = 0.003). This occurred even though the severity of pain did not differ between groups (NRS score mean p = 0.38). Conclusions This study found a high level of co-occurrence of LBPP, functional disability and depression/anxiety in women in their third trimester of pregnancy. Importantly women who reported higher depression/anxiety symptoms appeared to experience higher levels of functional disability in relation to their LBPP, than women with lower depression/anxiety symptoms and LBPP

The effect of aquatic physiotherapy on low back pain in pregnant women

This study evaluated the effect of antenatal aquatic physiotherapy sessions on low back pain in pregnant women. Thirty-three subjects (31.8 ± 4.8 years) participated in a prospective, quantitative, repeated measures, within subjects design. Low back pain was measured using a Numerical Rating Scale immediately before and after each session. The subjects significantly improved their post session pain scores by an average of 44%. Pain did not increase significantly from the beginning to the end of the course of sessions as is normally expected in this population, and the number of sessions made no significant difference. This finding suggests that attending once a week may contribute to the management of low back pain for pregnant women.

A principle-based approach to the design of a graduate resilience curriculum framework

This article describes the principles and structure used to create the Graduate Resilience Curriculum Framework intended to support academics to develop higher education students’ resilience as an important graduate attribute. Enhancing student resilience requires a structured approach to learning that articulates the factors that are important for the building of resilience, in a format that reflects incremental development across the student journey. This paper describes the principles used to inform the design and development of the curriculum framework including the adoption of a systemic program approach that is strengths-based, learner-centred and viewed through an ecological lens to support students’ resilience over time. The three learning domains of knowledge, skills and application guide students to develop a sense of themselves as resilient. The Graduate Resilience Curriculum Framework provides an evidence-based guide for university staff to embed strategies that develop student resilience in a planned, supportive and scaffolded way