scholarly journals Relationship between models of care and key rehabilitation milestones following unilateral transtibial amputation: a national cross-sectional study

Physiotherapy ◽  
2019 ◽  
Vol 105 (4) ◽  
pp. 476-482 ◽  
Author(s):  
J. Hebenton ◽  
H. Scott ◽  
C. Seenan ◽  
F. Davie-Smith
CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S94-S95
Author(s):  
R. Hossain ◽  
Z. Ma ◽  
J. Dai ◽  
S. Jamani ◽  
R. Hossain ◽  
...  

Introduction: Administrative data can aid in study and intervention design, incorporating hard-to-reach individuals who may otherwise be poorly represented. We aim to use administrative health data to examine emergency department visits by people experiencing homelessness and explore the application of this data for planning interventions. Methods: We conducted a serial cross-sectional study examining emergency department use by people experiencing homelessness and non-homeless individuals in the Niagara region of Ontario, Canada. The study period included administrative health data from April 1st, 2010 to March 31st, 2018. Outcomes included number of visits, number of unique patients; group proportions of Canadian Triage and Acuity Scale (CTAS) scores; time spent in emergency; and time to see an MD. Descriptive statistics were generated, and t-tests were performed for point estimates and a Mann-Whitney U test for distributional measures. Results: Our data included 1,486,699 emergency department visits. The number of unique people experiencing homelessness ranged from 91 in 2010 to 344 in 2017, trending higher over the study period compared to non-homeless patients. The rate of visits increased from 1.7 to 2.8 per person. People experiencing homelessness tend to present later in the day and with higher overall acuity as compared to the general population. Time in emergency department and time to see an MD were greater among people experiencing homelessness. Conclusion: Administrative health data allows researchers to enhance interventions and models of care to improve services for vulnerable populations. Given the challenging fiscal realities of research, our study provides insights to more effectively target interventions for vulnerable populations.


2014 ◽  
Vol 26 (3) ◽  
pp. 128-133 ◽  
Author(s):  
Carol Pierce Dionne ◽  
William J.J. Ertl ◽  
Jonathan D. Day ◽  
Brenda J. Smith ◽  
Sesh Commuri ◽  
...  

2021 ◽  
Author(s):  
◽  
Nakimuli Jackline ◽  
Ihudiebube Splendor Chikaodili N

Background: Midwives are principal professionals providing woman-centered continuity of care for childbearing women worldwide. Perhaps there is inadequate evidence to infer whether there are differences in illness and deaths, usefulness, and psychosocial results between models of care that is midwife-led and other care models. Methodology: A descriptive cross-sectional study was used where a Self-administered and semi-structured questionnaire with both closed and open-ended questions was used to collect data. Results: The level of confidence in perineal management and managing vaginal deliveries is directly influenced by the level of education attained by the midwife. From the study findings, midwives who had attained a degree in midwifery expressed more confidence at perineal management and vaginal deliveries than those with a diploma and certificate in midwifery. Study findings also showed that midwives with the least time of exposure (work experience, those with fewer than a year of working experience expressed low levels of confidence towards perineal management and vaginal deliveries. Conclusions: The findings from this study demonstrate= that midwives crave for additional educational opportunities in perineal management, especially, in prevention strategies. They demanded the up-to-date evidence and best practice recommendations to provide guidance to midwifery perineal management. This shows that the midwives’ were enthusiastic about the continuous evaluation of their practices and commitments to life-long learning. It is therefore anticipated that midwives tailored educational program that will not only improve clinical skills and perineal protection techniques but also confidence in decision making be established to meet midwifery needs Recommendations: Midwives should embark on a ‘back to basics approach, they should continuously review the Anatomy and physiology, including the perineum and pelvic floor and mechanism of labor. This paucity of knowledge may be as a consequence of previously limited focus on the anatomy of the perineum in earlier pre-registration midwifery curricula and existing perineal management workshops.


2019 ◽  
Vol 43 (4) ◽  
pp. 363 ◽  
Author(s):  
Anthony Bell ◽  
Ghasem-Sam Toloo ◽  
Julia Crilly ◽  
John Burke ◽  
Ged Williams ◽  
...  

Objective The acuity and number of presentations being made to emergency departments (EDs) is increasing. In an effort to safely and efficiently manage this increase and optimise patient outcomes, innovative models of care (MOC) have been implemented. What is not clear is how these MOC reflect the needs of patients or relate to each other or to ED performance. The aim of this study was to describe ED MOC in Queensland, Australia. Methods Situated within a larger mixed-methods study, the present study was a cross-sectional study. In early 2015, leaders (medical directors and nurse managers) from public hospital EDs in Queensland were invited to complete a survey detailing ED activity, staffing profiles, treatment space, MOC and National Emergency Access Target (NEAT) performance. Routinely collected ED information system data was also used. Results Twenty of the 27 EDs invited participated in the study (response rate 74%). An extensive array of MOC were identified that were categorised into those that facilitate input, throughput and output from the ED. There was no consistent evidence as to the relative effectiveness of these MOC in achieving ED performance benchmarks, such as NEAT performance. Conclusion There is considerable variability in the MOC used throughout EDs in Queensland. A more complete analysis of the relative effectiveness of different MOC either in isolation or as part of a comprehensive approach would help inform more consistent MOC in Queensland EDs. What is known about the topic? MOC in any given ED are implemented in response to factors such as the geographical location of the hospital, hospital-specific characteristics and service profile, staffing profile and patient demographic profile. In the era of time-based targets, they may also serve to address a particular aspect of flow in the face of rising ED demand. Although many of the MOC attempt to deal with flow in a linear fashion, target specific phases of the ED journey or address particular patient cohorts, what is clear is that not all EDs are shaped and formed the same. What does this paper add? The study provides a comprehensive description of the varied models of care operating within Queensland public hospital EDs and how they relate to ED performance. A basic taxonomy of contemporary ED MOC is necessary to allow comparison between departments and inform decisions regarding safety, efficiency and cost-effectiveness. What are the implications to practitioners? A contemporary understanding of the presence and profile of ED MOC that currently exist within a network of hospitals and health services is important for managers, clinicians and patients to inform decision-making regarding the safety, clinical effectiveness and cost-effectiveness of these models. This understanding can also inform where and how further improvements in care delivery can progress.


2010 ◽  
Vol 20 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Evelyn R. Klein ◽  
Barbara J. Amster

Abstract A study by Yaruss and Quesal (2002), based on responses from 134 of 239 ASHA accredited graduate programs, indicated that approximately 25% of graduate programs in the United States allow students to earn their degree without having coursework in fluency disorders and 66% of programs allow students to graduate without clinical experience treating people who stutter (PWS). It is not surprising that many clinicians report discomfort in treating PWS. This cross-sectional study compares differences in beliefs about the cause of stuttering between freshman undergraduate students enrolled in an introductory course in communicative disorders and graduate students enrolled and in the final weeks of a graduate course in fluency disorders.


Vacunas ◽  
2020 ◽  
Vol 21 (2) ◽  
pp. 95-104 ◽  
Author(s):  
Y.M. AlGoraini ◽  
N.N. AlDujayn ◽  
M.A. AlRasheed ◽  
Y.E. Bashawri ◽  
S.S. Alsubaie ◽  
...  

GeroPsych ◽  
2017 ◽  
Vol 30 (2) ◽  
pp. 61-70 ◽  
Author(s):  
Lia Oberhauser ◽  
Andreas B. Neubauer ◽  
Eva-Marie Kessler

Abstract. Conflict avoidance increases across the adult lifespan. This cross-sectional study looks at conflict avoidance as part of a mechanism to regulate belongingness needs ( Sheldon, 2011 ). We assumed that older adults perceive more threats to their belongingness when they contemplate their future, and that they preventively react with avoidance coping. We set up a model predicting conflict avoidance that included perceptions of future nonbelonging, termed anticipated loneliness, and other predictors including sociodemographics, indicators of subjective well-being and perceived social support (N = 331, aged 40–87). Anticipated loneliness predicted conflict avoidance above all other predictors and partially mediated the age-association of conflict avoidance. Results suggest that belongingness regulation accounts may deepen our understanding of conflict avoidance in the second half of life.


2010 ◽  
Vol 26 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Marc Vierhaus ◽  
Arnold Lohaus ◽  
Indra Shah

This investigation focuses on the question whether assessments of the development of internalizing behavior from childhood to adolescence are affected by the kind of research design (longitudinal versus cross-sectional). Two longitudinal samples of 432 second-graders and 366 fourth graders participated in a longitudinal study with subsequent measurements taken 1, 2, and 3 years later. A third sample consisting of 849 children covering the same range of grades participated in a cross-sectional study. The results show that the development of internalizing symptoms in girls – but not in boys – varies systematically with the research design. In girls, there is a decrease of internalizing symptoms (especially between the first two timepoints) in the longitudinal assessment, which may reflect, for example, the influence of strain during the first testing situation. Both longitudinal trajectories converge to a common trajectory from grade 2 to grade 7 when controlling for this “novelty-distress effect.” Moreover, when we control this effect, the slight but significant decrease characterizing the common trajectory becomes similar to the one obtained in the cross-sectional study. Therefore, trajectories based on longitudinal assessments may suggest more changes with regard to internalizing symptoms over time than actually take place, while trajectories based on cross-sectional data may be characterized by an increased level of internalizing symptoms. Theoretical and practical implications of these results are discussed.


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