scholarly journals Development of a Best Practice Statement on the Use of Ankle-Foot Orthoses Following Stroke in Scotland

2010 ◽  
Vol 34 (3) ◽  
pp. 245-253 ◽  
Author(s):  
Roy Bowers ◽  
Karyn Ross

A National Health Service Quality Improvement Scotland (NHS QIS) scoping exercise in 2007 identified the use of ankle-foot orthoses (AFOs) following stroke as a clinical improvement priority, leading to the development of a best practice statement (BPS) on AFO use after stroke. This paper outlines the development process of the BPS which is available from NHS QIS. The authors were involved as part of a working group that included practitioners from the fields of orthotics, physiotherapy, stroke nursing and bioengineering, staff of NHS QIS and a patient representative. In consultation with an NHS QIS health services researcher, the authors undertook a systematic literature review to evidence where possible the recommendations made in the BPS. Where evidence was unavailable, consensus was reached by the expert working group. As the BPS was designed for the non-specialist and non-orthotic practitioner the authors also developed educational resources which were included within the BPS to aid the understanding of the principles underpinning orthotic design and prescription. The BPS has been widely distributed throughout the health service in Scotland and is available electronically at no cost via the NHS QIS website. As part of an ongoing evaluation of the impact of the BPS on the quality of orthotic provision, NHS QIS has invited feedback regarding successes and challenges to implementation.

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 903
Author(s):  
Diogo Ricardo ◽  
Maria Raposo ◽  
Eduardo Cruz ◽  
Raul Oliveira ◽  
Filomena Carnide ◽  
...  

Background: Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of pathological gait in the sagittal plane. Methods: A systematic search of the literature was conducted to identify randomized controlled trials (RCT) and controlled clinical trials (CCT) which measured the effect of ankle foot orthoses (AFO) on the gait of children with spastic bilateral CP, with kinetic, kinematic, and functional outcomes. Five databases (Pubmed, Scopus, ISI Web of SCIENCE, SciELO, and Cochrane Library) were searched before February 2020. The PEDro Score was used to assess the methodological quality of the selected studies and alignment with the Cochrane approach was also reviewed. Prospero registration number: CRD42018102670. Results: We included 10 studies considering a total of 285 children with spastic bilateral CP. None of the studies had a PEDro score below 4/10, including five RCTs. We identified five different types of AFO (solid; dynamic; hinged; ground reaction; posterior leaf spring) used across all studies. Only two studies referred to a classification for gait patterns. Across the different outcomes, significant differences were found in walking speed, stride length and cadence, range of motion, ground force reaction and joint moments, as well as functional scores, while wearing AFO. Conclusions: Overall, the use of AFO in children with spastic bilateral CP minimizes the impact of pathological gait, consistently improving some kinematic, kinetic, and spatial-temporal parameters, and making their gait closer to that of typically developing children. Creating a standardized protocol for future studies involving AFO would facilitate the reporting of new scientific data and help clinicians use their clinical reasoning skills to recommend the best AFO for their patients.


2017 ◽  
Vol 12 (10) ◽  
pp. 185
Author(s):  
Abdullah Abbas Al-khrabsheh ◽  
Omar Rabeea Mahdi ◽  
Ahmed Kh. Muttar

The study aimed at identifying the dimensions of the quality of health service and its impact on strategic success. In order to achieve the objectives of the study, the analytical descriptive method was used. The population of the study represented all private Jordanian hospitals. Due to the difficulty of reaching the whole study population, the researcher took a random sample. The number of questionnaires distributed was (220) questionnaires, of which (200) were returned. The study also concluded that the importance of quality of service in private hospitals was medium. The study recommended that the importance of quality of service should be enhanced as a part of the strategic vision when constructing the strategy in private hospitals as it received the weakest degree and the same applies to the importance of strategic success and achievement of hospital goals.


2013 ◽  
Vol 5 (4) ◽  
pp. 134-166 ◽  
Author(s):  
Martin Gaynor ◽  
Rodrigo Moreno-Serra ◽  
Carol Propper

The effect of competition on the quality of health care remains a contested issue. Most empirical estimates rely on inference from nonexperimental data. In contrast, this paper exploits a procompetitive policy reform to provide estimates of the impact of competition on hospital outcomes. The English government introduced a policy in 2006 to promote competition between hospitals. Using this policy to implement a difference-in-differences research design, we estimate the impact of the introduction of competition on not only clinical outcomes but also productivity and expenditure. We find that the effect of competition is to save lives without raising costs. (JEL H51, I11, I18, L32, L33)


Dermatology ◽  
2010 ◽  
Vol 221 (1) ◽  
pp. 34-42 ◽  
Author(s):  
M. Lapidoth ◽  
C. Dierickx ◽  
S. Lanigan ◽  
U. Paasch ◽  
A. Campo-Voegeli ◽  
...  

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Virginia Minogue ◽  
Karen Matvienko-Sikar ◽  
Catherine Hayes ◽  
Mary Morrissey ◽  
Gregory Gorman ◽  
...  

Abstract Background Translating research findings into service improvements for patients and/or policy changes is a key challenge for health service organizations. The Health Service Executive (HSE) in Ireland launched the Action Plan for Health Research 2019–2029, as reported by Terrés (HSE, Dublin, 2019), one of the goals of which is to maximize the impact of the research that takes place within the service to achieve improvements in patient care, services, or policy change. The purpose of this research is to review the literature on knowledge translation theories, models, and frameworks (TMFs) and to assess the suitability of the TMFs for HSE use, selecting one or more for this purpose. The aim is to produce guidance for HSE researchers and other health services staff, validate the usability of the framework(s) with researchers, and review and implement the guidance. It was hoped that identifying a suitable methodology would provide the means to increase the uptake and application of research findings, and reduce research wastage. This paper reports on the first part of the study: the review, assessment, and selection of knowledge translation TMFs for a national health service. Methods An interdisciplinary working group of academic experts in implementation science, research wastage, and knowledge translation, along with key representatives from research funders (Health Research Board) and HSE personnel with expertise in quality improvement and research management, undertook a three-stage review and selection process to identify a knowledge translation TMF that would be suitable and usable for HSE purposes. The process included a literature review, consensus exercise, and a final consensus workshop. The review group adopted the Theory Comparison and Selection Tool (T-CaST) developed by Birken et al. (Implement Sci 13: 143, 2018) to review knowledge translation theories, models, and frameworks. Results From 247 knowledge translation TMFs initially identified, the first stage of the review identified 18 that met the criteria of validity, applicability, relevance, usability, and ability to be operationalized in the local context. A further review by a subgroup of the working group reduced this number to 11. A whole-group review selected six of these to be reviewed at a facilitated consensus workshop, which identified three that were suitable and applicable for HSE use. These were able to be mapped onto the four components of the HSE knowledge translation process: knowledge creation, knowledge into action, transfer and exchange of knowledge, and implementation and sustainability. Conclusion The multiplicity of knowledge translation TMFs presents a challenge for health service researchers in making decisions about the appropriate methods for disseminating their research. Building a culture that uses research knowledge and evidence is important for organizations seeking to maximize the benefits from research. Supporting researchers with guidance on how to disseminate and translate their research can increase the uptake and application of research findings. The use of robust selection criteria enabled the HSE to select relevant TMFs and develop a process for increasing the dissemination and translation of research knowledge. The guidance developed to inform and educate researchers and knowledge users is expected to increase organizational capacity to promote a culture of research knowledge and evidence use within the HSE.


Rheumatology ◽  
2014 ◽  
Vol 53 (suppl_1) ◽  
pp. i40-i40
Author(s):  
Chandrika Gordon ◽  
Rebecca J. Stack ◽  
Marilyn Robinson ◽  
Karim Raza ◽  
Ishraga Awad ◽  
...  

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