scholarly journals Status of Consultation and Local Collaboration Regarding Ankle-Foot Orthosis in the Life Period: A Cross-sectional Study of Care Managers

2018 ◽  
Vol 33 (6) ◽  
pp. 941-945
Author(s):  
Noriyuki ABE ◽  
Takahiro HOSOYA ◽  
Tadamitsu MATSUDA
BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035629
Author(s):  
Pia Augustsson ◽  
Anna Holst ◽  
Irene Svenningsson ◽  
Eva-Lisa Petersson ◽  
Cecilia Björkelund ◽  
...  

ObjectivesTo perform an analysis of collaborative care with a care manager implementation in a primary healthcare setting. The study has a twofold aim: (1) to examine clinicians’ and directors’ perceptions of implementing collaborative care with a care manager for patients with depression at the primary care centre (PCC), and (2) to identify barriers and facilitators that influenced this implementation.DesignA cross-sectional study was performed in 2016–2017 in parallel with a cluster-randomised controlled trial.Setting36 PCCs in south-west Sweden.ParticipantsPCCs’ directors and clinicians.OutcomeData regarding the study’s aims were collected by two web-based questionnaires (directors, clinicians). Descriptive statistics and qualitative content analysis were used for analysis.ResultsAmong the 36 PCCs, 461 (59%) clinicians and 36 (100%) directors participated. Fifty-two per cent of clinicians could cooperate with the care manager without problems. Forty per cent regarded to their knowledge of the care manager assignment as insufficient. Around two-thirds perceived that collaborating with the care manager was part of their duty as PCC staff. Almost 90% of the PCCs’ directors considered that the assignment of the care manager was clearly designed, around 70% considered the priority of the implementation to be high and around 90% were positive to the implementation. Facilitators consisted of support from colleagues and directors, cooperative skills and positive attitudes. Barriers were high workload, shortage of staff and extensive requirements and demands from healthcare management.ConclusionsOur study confirms that the care manager puts collaborative care into practice. Facilitators and barriers of the implementation, such as time, information, soft values and attitudes, financial structure need to be considered when implementing care managers at PCCs.


2012 ◽  
Vol 37 (3) ◽  
pp. 212-221 ◽  
Author(s):  
Sumiko Yamamoto ◽  
Naoki Tomokiyo ◽  
Tadashi Yasui ◽  
Toshikazu Kawaguchi

Background: An ankle-foot orthosis with an oil damper was previously developed to assist the first rocker function during gait, but the effects of the amount of resistive moment generated on gait have not been clarified. Objectives: To measure the amount of resistive moment generated by the ankle-foot orthosis with an oil damper during gait and determine its effect on the gait of patients with stroke. Study Design: Preliminary cross-sectional study. Methods: The gait of four patients with stroke in the chronic phase was measured in four conditions: without an ankle-foot orthosis and with the ankle-foot orthosis with an oil damper generating three different amounts of resistive moment. Measurements were taken with a three-dimensional motion analysis system and a specially designed device to determine the resistive moment. Results: The resistive moment was observed in the former half in stance of the paretic limb, and its magnitude was less than 10 N m. Some gait parameters related to terminal stance and preswing were affected by the amount of resistive moment. The forward component of floor reaction force and the shank vertical angle showed peak values when the patients reported feeling most comfortable during gait. Conclusion: Although the resistive moment generated by the ankle-foot orthosis with an oil damper was small, it was sufficient to alter gait. Clinical relevance To maximize the effectiveness of ankle-foot orthoses, it is necessary to know the effects of resistive moment on the gait of patients with stroke. The ankle-foot orthosis with an oil damper assists the first rocker function in gait and also affects the gait in a later phase in stance. The peak values of some gait parameters coincided with patients reporting gait to be most comfortable. It is important to know that ankle-foot orthosis with an oil damper assistance in the first rocker alters the weight acceptance on the paretic limb and affects the gait parameters related to propulsion ability in stance.


2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Maiko Watanabe ◽  
Noriko Yamamoto-Mitani ◽  
Masakazu Nishigaki ◽  
Yuko Okamoto ◽  
Ayumi Igarashi ◽  
...  

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Tripković ◽  
M Odalović ◽  
S Mladenović Janković ◽  
A Nešković ◽  
M Jakovljević

Abstract Background Growing evidence has suggested that job satisfaction in the health-care system can affect productivity, the quality of service, and patient safety. Knowledge regarding job satisfaction of health workers and its determinants is valuable to health-care managers for decision making in the field of personnel policy. This study was aimed to assess job satisfaction among health workers in public hospitals in Belgrade, Serbia and identify its associated factors. Methods This was a cross-sectional study, carried out within 24 hours, in December 2018, as a part of a national survey, which is conducted annually in all health care institutions in Serbia. Data were collected by self-administered structured questionnaire, which was distributed to all health workers who were at work at the time of the survey (11,588 health workers in 26 public hospitals in Belgrade). The completed questionnaires were returned by 9,203 health workers, which constituted the response rate of 79.4%. Multivariable logistic regression was applied to identify factors significantly and independently associated with a higher level of job satisfaction. Results Overall, 31.4% of the respondents were satisfied with their job. Age less than 35 years [AOR = 1.40; 95% CI (1.18-1.67)], no work stress [AOR = 2.66; 95% CI (1.94-3.65)], satisfaction with time for accomplishment of tasks [AOR = 1.92; 95% CI (1.64-2.26)], satisfaction with recognition and value of health workers’ engagement [AOR = 1.79; 95% CI (1.51-2.13)], and satisfaction with leadership style and work organization [AOR = 1.90; 95% CI (1.60-2.26)] were identified as determinants with highest influence at job satisfaction. Conclusions Less than third of health workers in Belgrade’s hospitals were satisfied with their job, while satisfaction with various aspects of the job, age, and work stress, were identified as predictors. The results of this study could be useful in proposing strategies to improve job satisfaction of health workers. Key messages The job satisfaction of health workers in Belgrade’s hospitals is low. Health-care managers should pay attention to create an environment that promotes job satisfaction and reduces work stress.


2021 ◽  
Vol 19 (3) ◽  
pp. 307-314
Author(s):  
Parisa Aslani ◽  
◽  
Alireza Khaghani ◽  
Taher Babaee ◽  
◽  
...  

Objectives: Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system that is the second leading cause of nerve failure in young adults. One of the clinical manifestations of MS is impaired balance and gait. Ankle-foot Orthosis (AFO) and Functional Electrical Stimulation (FES) are the most common rehabilitation interventions to improve the patients’ gait and balance. This study aimed to evaluate and compare the effect of using an FES system and an AFO equipped with FES on the gait and balance of patients with MS. Methods: This research was a cross-sectional study. The patients were included in the study who were diagnosed with MS, had a score of lower than five on the expanded disability status scale, had a history of drop foot for at least three months, aged 20-50 years, and prescribed an AFO or FES, or both. The participants were asked to wear the FES system to evaluate their balance and ability to walk using the Balance Evaluation Systems Test (BESTest). Then, the participants were asked to wear an AFO equipped with FES, and their balance and ability to walk were assessed again. Results: The AFO equipped with FES provides more gait stability than FES alone condition (P <0.05). The ability of patients to use the FES alone was greater than using the AFO equipped with FES (P<0.05). Discussion: The study results showed that the walking ability of MS patients using an FES system is greater than that of AFO equipped with FES. This outcome can be due to the difficulty and limiting effect of using an orthosis on their performance. However, the patient’s postural response during stepping back and forth in the condition of AFO equipped with the FES system was better than the FES system alone.


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.


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