scholarly journals Evaluating the impact of a training program to support transitioning from the hospital to the community for people after stroke: a community case study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Michelle Lui ◽  
Katherine McKellar ◽  
Shari Cooper ◽  
Janice J. Eng ◽  
Marie-Louise Bird
Keyword(s):  
Health Authority ◽  
Exercise Program ◽  
Stroke Recovery ◽  
Evidence Based ◽  
Group Exercise ◽  
Physiotherapy Service ◽  
Transitions In Care ◽  
The Impact ◽  
Community Centre

Abstract Background The transitions in care along the stroke recovery path are challenging, particularly in finding mechanisms to continue one’s recovery once at home. We aim to evaluate the impact of training physiotherapists and fitness instructors from one regional community together to deliver an evidence-based group exercise program starting in the hospital and transitioning to the community using an implementation approach. Methods The evidenced based exercise program Fitness and Mobility Exercise (FAME) for stroke was chosen as the intervention. Data from interviews with stakeholders (community centre and health authority hospital staff including a physiotherapy navigator) was transcribed and themes evaluated using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. These data were supplemented by information collected as a quality assurance project within the health authority. Results Two programs were established; one in the community centre (run over 15 months by fitness instructors) and one in the regional hospital (run over 12 months by a rehabilitation assistant under the direction from a physiotherapist). Transitions in care were facilitated by implementing the same evidence-based group exercise class in both the hospital and community setting, so people living with stroke could seamlessly move from one to another. An existing physiotherapist navigator service also was valued as a support for the transitions between the two centres for people with stroke. The hospital group accessed group-based physiotherapy service on average 31 days earlier than they were able to in a one-to-one format. Conclusions This case study described the implementation of the Fitness and Mobility Exercise (FAME) program in one community and the use of a physiotherapist navigator to assist transition between them. After a community training workshop, FAME programs were established within the health authority and the community centre. FAME program participants within the health authority benefited from reduced wait times to access hospital outpatient physiotherapy service. Improvements in function were measured in and reported by the people after stroke attending either the health authority or community centre FAME groups.

scholarly journals Corporations’ use and misuse of evidence to influence health policy: a case study of sugar-sweetened beverage taxation

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Gary Jonas Fooks ◽  
Simon Williams ◽  
Graham Box ◽  
Gary Sacks
Keyword(s):  
South African ◽  
Evidence Base ◽  
Evidence Based ◽  
Economic Modelling ◽  
Complex Interplay ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
Sweetened Beverages ◽  
The Impact

Abstract Background Sugar sweetened beverages (SSB) are a major source of sugar in the diet. Although trends in consumption vary across regions, in many countries, particularly LMICs, their consumption continues to increase. In response, a growing number of governments have introduced a tax on SSBs. SSB manufacturers have opposed such taxes, disputing the role that SSBs play in diet-related diseases and the effectiveness of SSB taxation, and alleging major economic impacts. Given the importance of evidence to effective regulation of products harmful to human health, we scrutinised industry submissions to the South African government’s consultation on a proposed SSB tax and examined their use of evidence. Results Corporate submissions were underpinned by several strategies involving the misrepresentation of evidence. First, references were used in a misleading way, providing false support for key claims. Second, raw data, which represented a pliable, alternative evidence base to peer reviewed studies, was misused to dispute both the premise of targeting sugar for special attention and the impact of SSB taxes on SSB consumption. Third, purposively selected evidence was used in conjunction with other techniques, such as selective quoting from studies and omitting important qualifying information, to promote an alternative evidential narrative to that supported by the weight of peer-reviewed research. Fourth, a range of mutually enforcing techniques that inflated the effects of SSB taxation on jobs, public revenue generation, and gross domestic product, was used to exaggerate the economic impact of the tax. This “hyperbolic accounting” included rounding up figures in original sources, double counting, and skipping steps in economic modelling. Conclusions Our research raises fundamental questions concerning the bona fides of industry information in the context of government efforts to combat diet-related diseases. The beverage industry’s claims against SSB taxation rest on a complex interplay of techniques, that appear to be grounded in evidence, but which do not observe widely accepted approaches to the use of either scientific or economic evidence. These techniques are similar, but not identical, to those used by tobacco companies and highlight the problems of introducing evidence-based policies aimed at managing the market environment for unhealthful commodities.

To disinvest or invest? The role of programme budgeting and marginal analysis (PBMA) for economic evaluation and prioritization between public health interventions

2019 ◽  
pp. 312-340
Author(s):  
Joanna M. Charles ◽  
Rhiannon T. Edwards
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Local Population ◽  
Health Improvement ◽  
Evidence Based ◽  
Marginal Analysis ◽  
The Impact ◽  
Allocation Decisions

This chapter describes the application of programme budgeting and marginal analysis (PBMA) as an evidence-based framework to make resource allocation decisions such as whether to invest or disinvest in certain services, products, or interventions. This evidence-based eight-step decision-making process can help decision-makers to maximize the impact of healthcare resources on the health needs of a local population. Programme budgeting is an appraisal of past resource allocation in specified programmes or services with a view to tracking future resource allocation in those same programmes or services. Marginal analysis is the appraisal of the added benefits and added costs of a proposed investment or the lost benefits and lower costs of a proposed disinvestment. This chapter pays particular attention to the use of the PBMA framework to appraise a national health improvement budget as a case study to illustrate the methods practical application in public health.

scholarly journals One Step at a Time: A Journey of Hope, Inspiration, and Determination

2014 ◽  
Author(s):  
Melinda Hermanns ◽  
Barbara Haas
Keyword(s):  
Quality Of Life ◽  
Functional Ability ◽  
Single Case ◽  
Exercise Program ◽  
The United States ◽  
Surgical Interventions ◽  
Field Notes ◽  
The Impact

Approximately three million persons in the United States face the challenge of living with Parkinson's Disease (PD). In spite of medical and surgical interventions, the disease progresses, resulting in bradykinesia, rigidity and postural instability that impair functional ability and quality of life. The purpose of this case study is to illuminate the impact an exercise program may have on an individual with PD. A single case study design was used to explore the effect of exercise on the quality of life of a 73-year old gentleman with advanced PD. Interviews and field observations of the client, wife, and staff at a community based exercise facility were conducted. Analyses were based on coding of verbatim transcripts and field notes. Three themes emerged from the study: hope, inspiration, and determination. This case study is an exemplar of the impact exercise conducted in a supportive environment may have on improving the functional ability and quality of life for persons with PD.

Crisis and Transition in Jerusalem under Rome, Byzantium, Islam and the Crusades

2018 ◽  
pp. 63-98
Author(s):  
Kay Prag
Keyword(s):  
Cultural Transmission ◽  
Central Place ◽  
Evidence Based ◽  
Demographic Changes ◽  
Archaeological Evidence ◽  
The Impact

Comparing historical and archaeological evidence based on findings from the Kenyon excavations provides some information on the impact of ‘hard’ and ‘soft’ transitions on the contemporary populations. An overview of the archaeological evidence illustrates both the processes and results of crisis, transition and aftermath. Jerusalem provides a case study of four major and several lesser episodes affecting ethnicity, politics, economy and religion over less than 1,500 years, from the Roman destruction in AD 70 and the establishment of Aelia Capitolina. There were major demographic changes resulting from the ‘hard’ transitions, but for all there is clear archaeological evidence of material and cultural transmission and survivals, visible not just in elite structures such as the major shrines, but widespread through a city with an ancient role as a central place of burial.

scholarly journals A qualitative examination of the perceived impact of bureaucratic managerialism on evidence-based practice implementation in Nigeria: a collective case study

2019 ◽  
Vol 24 (8) ◽  
pp. 635-646
Author(s):  
Jude N Ominyi ◽  
David A Agom ◽  
Chidiebere Valentine Ekuma
Keyword(s):  
Acute Care ◽  
Nurse Managers ◽  
Evidence Based Practice ◽  
Care Quality ◽  
Healthcare Management ◽  
Successful Implementation ◽  
Evidence Based ◽  
Case Study Methodology ◽  
The Impact

Background Evidence-based practice (EBP) is widely recognised as an essential aspect of contemporary healthcare delivery. However, the rise in cost containment and quest for profitability in healthcare management is found to be compromising implementation of evidence-based initiatives aimed at improving care quality. Aims The aim of this work was to examine perspectives of nurses regarding the impact of bureaucratic managerialism on EBP implementation in the Nigerian acute care setting. Methods A qualitative case study methodology was utilised to gather data from two large acute care settings. Drawing on semi-structured interviews, 12 staff nurses, 21 ward managers and 2 nurse managers were interviewed. Data were inductively analysed and themes generated. Results The managerial practice in this context is founded on bureaucratic managerialism, which in turn generated hierarchical constraints that denied nurses the opportunity to self-govern. Implementation of evidence-based initiatives was consequently opposed by the managerial desire to maximise throughput. Conclusions There is need for nurse managers to have greater managerial influence, which would allow opportunities for implementing EBPs to be created. Managerial autonomy for nurse managers would allow them to create enabling environments capable of facilitating successful implementation.

Champions of an Older Adult Exercise Program: Believers, Promoters, and Recruiters

2016 ◽  
Vol 37 (6) ◽  
pp. 728-744 ◽  
Author(s):  
Christina E. Miyawaki ◽  
Basia Belza ◽  
Marlana J. Kohn ◽  
Miruna Petrescu-Prahova
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Exercise Program ◽  
Evidence Based ◽  
Group Exercise ◽  
Program Delivery ◽  
Vital Part ◽  
Successful Program ◽  
Program Adoption ◽  
Evidence Based Programs

Champions, who support, market, and promote programs, are a vital part of successful program adoption, implementation, and maintenance. Enhance®Fitness (EF) is an evidence-based, community-delivered group exercise program for older adults. Using semistructured phone interviews with 20 participants, 17 instructors, and 15 staff, we explored the roles of champions in adopting, implementing, and maintaining EF at YMCA-affiliated sites. Interviews revealed EF champions play critical roles in program dissemination. Champions are outgoing, passionate, and enthusiastic about EF. They believe in the program and its benefits (believers), are “walking advertisements” (promoters), and have magnetic personalities, persuading newcomers to join (recruiters). EF champions were not purposefully selected but naturally arose during the course of program delivery. Community sites adopting evidence-based programs can foster and support champions by engaging with them, and capitalizing on their energy as an emerging resource throughout the adoption, implementation, and maintenance of programs.

scholarly journals Exploring Impact of Requirements Engineering on Other IT Project Areas – Case Study

2020 ◽  
Vol 21 (3) ◽  
Author(s):  
Aleksander Jarzębowicz ◽  
Katarzyna Poniatowska
Keyword(s):  
Pilot Study ◽  
Requirements Engineering ◽  
Empirical Studies ◽  
Evidence Based ◽  
Great Effort ◽  
It Projects ◽  
Industrial Projects ◽  
Extensive Effort ◽  
The Impact

Requirements Engineering (RE) is recognized as one of the most important (yet difficult) areas of software engineering that has a significant impact on other areas of IT projects and their final outcomes. Empirical studies investigating this impact are hard to conduct, mainly due to the great effort required. It is thus difficult for both researchers and industry practitioners to make evidence-based evaluations about how decisions about RE practices translate into requirement quality and influence other project areas. We propose an idea of a lightweight approach utilizing widely-used tools to enable such an evaluation without extensive effort. This is illustrated with a pilot study where the data from six industrial projects from a single organization were analyzed and three metrics regarding the requirement quality, rework effort, and testing were used to demonstrate the impact of different RE techniques. We also discuss the factors that are important for enabling the broader adoption of the proposed approach.

Abstract TP402: Developing Evidenced Based Practice: A Proposal for an Impairment-Based Rehabilitation Program Using Computerized Therapy

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Ericka Brice Smith
Keyword(s):  
Meta Analysis ◽  
Community Setting ◽  
Communication Disorders ◽  
Rehabilitation Program ◽  
Practice Change ◽  
Stroke Recovery ◽  
Evidence Based ◽  
Star Model ◽  
Home Setting

Background: According to the National Aphasic Association (n.d.), about 25-45% of stroke survivors experience aphasia. Treatments for aphasia have several forms focusing on restoring impaired spoken language, written expression, or reading comprehension (American Speech Language Hearing Association, n.d.). Impairment-based therapy (IBT) has demonstrated to be an approach focusing on in-home training using specific linguistic forms which utilize technology (Galletta & Barrett, 2014). Clinical Question/PICOT: In adult patients over 18 years of age, who recently experienced a stroke and diagnosed with aphasia, will the use of impairment- based therapy compared to standard treatment provide shorter recovery times from aphasia? Summary of Evidence: Eight studies included in the review of the evidence. Six randomized control trials, one meta-analysis, and one case study. Five articles supported evidence reflecting that impairment-based therapy can be useful in stroke recovery for aphasic patients. Two studies focused on the magnitude of impairment-based treatment in the community setting is clinically significant in the promotion of continuous therapy with a clinician. The case study investigated the effects of language therapy in first four months with aphasia. The evidence identified supports the proposal of using IBT with aphasic patients rehabilitation through computerized sessions in the community or home setting. Results: When incorporating the ACE Star Model, identifying issues relevant to the language and speech competence of aphasic patients as well as filling gaps in their existing communication therapy is essential. By developing an evidence-based practice (EBP) team comprised of clinicians , executive leaders and healthcare facilities, an evaluation of practice issues relevant to aphasic patients can occur. A pilot for practice change focusing on language and cognitive therapy tasks, a structured, personalized therapy will be provided using the digital application platform, Constant Therapy. Conclusion: By assessing preliminary results from the evidence-based project, this can be a benefit to patients with lifestyle intentions to improve cognitive, language and communication disorders associated with aphasia.

scholarly journals The Satisfaction of Older Adults About Online Group Exercise Program: An alternative option to maintain physical and mental wellbeing during COVID 19 pandemic

2021 ◽  
Vol 16 (3) ◽  
pp. 42-48
Author(s):  
Mayur Revadkar ◽  
Riddhi Goradia
Keyword(s):  
Older Adults ◽  
New Technologies ◽  
Exercise Program ◽  
Well Being ◽  
Group Exercise ◽  
Online Platforms ◽  
Alternative Option ◽  
The Impact ◽  
Mental Well Being ◽  
Online Group

Background: Considering the impact of lockdown on older adults, there is a need for some online option to maintain the physical and mental well-being of this vulnerable population in the current pandemic situation. Generally, In the Indian context, elderly are not well acquainted with online platforms for different purposes of shopping, health or for being socially active. However with adequate training they are willing to learn new technologies and adapt to online platforms. Objectives: To find the satisfaction of Online group exercise program for older adult’s population to maintain their physical and mental well-being. Methodology: It was a web-based intervention study where 40 participants were invited to fill the patient satisfaction questionnaire and feedback form using Google Forms. Participants who have attended the online group exercise class at least for a period of 1 month (20 Sessions) were included in the study. Out of 40, 34 participants responded to the questionnaire.  Results: As per descriptive statistical analysis, results showed that 100% of study population was satisfied in all aspects of online exercise program. Conclusion: With adequate training and constant technical support; elderly population can be encouraged to participate in online group exercise program which is well appreciated by this population as an alternative option in changing health care delivery models.

scholarly journals Assessing the Impact of Community Centre’s on Roma Integration: A Study of Eastwood

2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Olga Fuseini
Keyword(s):  
Vital Role ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Budget Cuts ◽  
The Government ◽  
The Uk ◽  
The Impact ◽  
Community Centre

During the last 10 years, Roma have become the second largest and the most deprived ethnic minority in Rotherham and thus, the local authority has put Roma integration as a priority in terms of community planning and development. Due to the complexities around Roma integration and the government budget cuts to public spending, the local authorities rely on community centres to fill gaps in improving the Roma integration and their quality of life in the UK. This article aims to assess the impact of a community centre on Roma integration, specifically, focusing on the Eastwood area of Rotherham. The research methods included semi-structured interviews of professionals that regularly engage with Roma community and the Roma residents of Eastwood. The case study findings show that the Eastwood community centre plays a vital role in the Roma integration. Some of the main contributing factors include their expertise and the ability to effectively engage with the Roma community. However, this paper only touches upon the issue of Roma integration in the UK, which means that more comprehensive and a larger scale of research is needed to improve the processes of Roma integration and the integration of other communities in similar settings

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