A global initiative in evidence-based research for allied health practitioners
The University of South Australia is home to the International Centre for Allied Health Evidence (iCAHE). iCAHE was launched in August 2003 and is a member of the Sansom Institute. iCAHE provides essential resources for allied health workers, researchers, educators, clinicians, policy makers, administrators and patients across the world.
iCAHE provides education, research, guidance and support to inform evidence-based allied and scientific health practice, policy and education. iCAHE focusses on production, synthesis, implementation and dissemination of evidence and in collaboration with key stakeholders closes the evidence-practice gaps through evidence-based practice, policy and educational strategies.
People
Director
Professor Karen Grimmer
Deputy Director
Dr Saravana Kumar
Research assistants
Kate Beaton
Zuzana Machotka
Khushnum Pastakia
Olivia Thorpe
Lucylynn Lizarondo
Jessica Stanhope
Research Fellows
Julie Luker
PhD students
John Arnold
Helen Banwell
Ryan Causby
Michelle Guerin
Debbie Howson
Val Dones
Lucylynn Lizarondo
Max Martin
Ashley Pedler
Liz Pridham
TRIP Fellows
Dr. Kylie Johnston
Dr. Susie Thomas
Visitors and valued colleagues
Associate Professor Erica Bell
Deputy Director, A/Director and Coordinator PHCRED, University of Tasmania, Australia
Associate Professor Leigh Blizzard
Menzies Research Institute, University of Tasmania, Australia
Ms. Ivis Chung
Advanced Institute of Allied Health Sciences, Hong Kong Hospital Authority, Hong Kong
Ms. Wendy Dolejs
Central North Adelaide Health Service
Mr. John Forward
Central North Adelaide Health Service
Dr. Consuelo Gonzalez-Suarez
Janine Dizon
University of Santo Tomas, Philippines
Ms. Louise Gordge
Clinical service co-ordinator, Royal Adelaide Hospital
Ms. Julie Falco
Department of Health, South Australia
Professor Quinette Louw
Stellenbosch University, South Africa
Associate Professor John Moss
The University of Adelaide
Ms. Karen Murphy
ACT Allied Health Advisor
Dr. Guy Nehrenz
Professor of Health Science, Nova Southeastern University, U.S.A
Dr. Patricia Neumann
The Pelvic Floor Clinic, Norwood SA
Dr. David Worth
Rankin Occupational Safety & Health
Dr. Kristiaan Schreve
University of Stellenbosch, Department of Mechanical Engineering
Ms. Sally Sobels
Manager, Health Reform Planning, SA Health
Ms. Michele Sutherland
Falls Prevention Project Manager, Department of Health
Ms. Catherine Turnbull
South Australian Department of Health, Principal Allied Health Advisor
Mr. Jimmy Wu
Advanced Institute of Allied Health Sciences, Hong Kong Hospital Authority, Hong Kong
University staff affiliated with iCAHE
Ms. Helen Banwell
Mrs. Angela Berndt
Dr. Kobie Boshoff
Dr. Rose Boucaut
Mr. Ryan Causby
Dr. Ian Edwards
Dr. Coralie English
Dr. Angela Evans
Dr. Maarten Immink
Mr. Mark Jones
Dr. Sara Jones
Dr. Shylie Mackintosh
Dr. Nicola Massy-Westropp
Mrs. Maureen McEvoy
Dr. Michelle McDonnell
Mrs. Carolyn Murray
Dr. Mary Russell
Dr. Rolf Scharfbillig
Assoc. Prof. Lorraine Sheppard
Dr. Simon Spedding
Dr. Mandy Stanley
Mr. Hugh Stewart
Dr. Kerry Thoirs
Miss Hayley Uden
Ms. Gisela van Kessel
Dr. Julie Walters
Ms. Prue Welsh
Associate Proffessor Susan Hillier
Dr. Kylie Johnston
Dr Steve Milanese
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Affiliated Research Groups
Since its inception in 2003 the International Centre for Allied Health Evidence has been focused on taking the message of Evidence-Based Practice (EBP) in Allied Health to the world. As the first centre of its kind, iCAHE has been a leader in providing mentorship for international groups looking to further their work in the areas of evidence-based allied health. A part of this significant process has been the establishment and mentoring of iCAHE affiliated research groups.
Centre for Evidence Translation, University of Stellenbosch
The University of Stellenbosch's Centre for Evidence Translation has been working with iCAHE since 2006 as an affiliated group, and has made significant achievements in the area of evidence-based allied health.
Affiliated Group Convenor: Professor Quinette Louw
Mail Address: PO Box 19063
Tygerberg 7505
South Africa
Telephone Number: 2721 938 9300
Email: qalouw@sun.ac.za
Affiliated group members:
Proffessor Quinette Louw
Dawn Ernsten
Lynette Crous
Linzette Morris
Sjan-Mari van Niekerk
Collaborators
iCAHE specialises in the production of clinical guidelines, systematic reviews and the synthesis of research evidence.
iCAHE has collaborated with a range of industry groups.
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Projects
Ryan Causby
Student Home Page
Recent Findings
Information coming soon.
Project Overview
Manual skills are of significant importance amongst many health professions. Dentistry, Surgery, Nursing and Podiatry are all professions which require a high level of psychomotor capability in addition to cognitive abilities in order to succeed. A large part of the required skill set can be attributed directly to dexterity.
Dexterity is defined as “manual ability that requires rapid coordination of gross or fine voluntary movements, based on a certain number of capacities, which are developed through learning, training and experience” (Poirier 1988, p71).
Teaching manual skills across disciplines and across programs is inconsistent and may lack an evidence-based approach. To date there is very little literature on clinical teaching and assessment of manual skills in the Podiatry profession. It seems pertinent in the age of evidence-based practice to investigate the teaching of manual clinical skills and the psychomotor elements which relate to them. Consequently the overall aim of Ryan’s project is:
- To establish how manual clinical skills, particularly scalpel skills, are taught in Podiatry schools throughout Australia and New Zealand
- Determine appropriate objective psychomotor tests of dexterity, and establish a correlation with manual clinical skills in novice, intermediate and experienced Podiatry practitioners
- Determine if specific manual training improves dexterity and subsequent skill acquisition in Podiatry students
By doing this it is hoped that we can establish a method to objectively identify struggling students and implement techniques to improve their dexterity and subsequent performance without putting the public at risk. Furthermore, in the future we may use the findings from this project to investigate and evaluate further teaching tools.
Poirier, F 1988, 'Dexterity as a Valid Measure of Hand Function', Occupational Therapy in Health Care, vol. 4, no. 3-4, pp. 69-83.
Helen Banwell
Student home page
Recent Findings
Information coming soon.
Project Overview
Investigations of individually prescribed custom made foot orthoses by podiatrists in adults with symptomatic pes planus (flat feet).
Flexible pes planus (flat feet) is a descriptive term for feet that have a visually lowered medial longitudinal arch often in association with rearfoot eversion1. Reported to affect approximately 15% of the adult population2 pes planus can be categorised as either symptomatic (painful, non-functional) or non-symptomatic (non-painful, functional) with the literature purporting that flexible non-symptomatic pes planus is a predominantly benign condition with no justification for intervention3. When pes planus is symptomatic however, functional foot orthoses (FO) are often prescribed and remain the most commonly quoted intervention within the literature4. However, currently there is little evidence to support this use of FO for symptomatic pes planus nor a demonstrative understanding of their mechanism of action. Underlying this is also the ongoing concern that, as a profession, podiatrists have not established practice guidelines or alike for the prescription of FO for pes planus.
The proposed PhD studies will investigate a number of clinical issues for orthosis prescription for symptomatic pes planus by podiatrists.
Stage one will establish the current prescription habits and use of foot orthosis by a retrospective clinical note audit of the largest prescription clinic in South Australia (UniSA’s podiatry biomechanics clinic). Stage two will be a systematic review of evidence for the use of foot orthosis in the pes planus population. Stage three will involve a Delphi consensus (three or four round survey) to determine best practice prescription methods for customising the foot orthoses and stage four will investigate if the use of ‘best practice’ prescribed foot orthosis has an influence on the commonly reported symptoms of pes planus around pain, fatigue and function.
Val Dones
Student Home Page
Recent Findings
2011 is an exciting year for collecting data. Recruitment of participants, scouting for adroit and committed research assistants, systematising a flurry of paper work, dealing with red tape, and keeping the line-up of participants full are amongst the challenges I dealt with. Data collection is not as simple as it sounds. It involved lots of critical thinking to solve surging concerns during implementation of the study so as to ensure accrual of unbiased data. As on off shoot of this exercise, it strengthened professional ties among physical therapy professors, alumni and rehabilitation doctors of the University of Santo Tomas who were part of this data collection.
The diagnostic examination of patients with pain on the outer aspect of the elbow (lateral epicondylar pain) and the cadaver dissection had put in variety in my PhD. The 6-day intensive cadaver dissection workshop by Gil Hedley which I attended in the United States of America helped put in perspective the approach that I would take in systematically dissecting the elbow. The 20 elbows which I had dissected in the University of Santo Tomas, Philippines unfolded the intricate connections that are inherent in the human fasciae of the elbow. The pictures taken during the cadaver dissection and the imprint it created on my mind had provided important anatomical and biomechanical insights as I stressed the elbow joints of the participants with lateral epicondylar pain during their diagnostic examination.
Of course, writing was always a part of my PhD no matter how busy the data collection was. With the guidance of Karen Grimmer-Somers, Kerry Thoirs and Consuelo Suarez, we were able to publish a paper entitled, ‘Inter-Tester Reliability of Sonographers in Detecting Pathological Lesions in the Elbow of Individuals with Lateral Epicondylar Pain’ which is available in this link http://www.worldscinet.com/jmr/00/0002/S0218957712500017.html.
2011 was definitely a challenging and an enjoyable part of my PhD. I am looking forward to an enriching writing experience in 2012.
Project Overview
Val's current study is on the diagnosis and upper extremity biomechanics of patients suffering from lateral epicondylitis.
Michelle Guerin
Student Home Page
Recent Findings
Michelle has a webpage devoted to her project, go here for more details.
Project Overview
Michelle's PhD is looking at community services involvement in discharge planning. The overall purpose of this study was to develop a set of guiding principles to improve the discharge process of older adults from hospital into the community through concerted and planned involvement of local community services.
The aged and community care industry is increasing in importance, with demand for services expected to double in Australia over the next 20 years (ACSA, 2001).This increase in demand is driven by the ageing population in Australia, particularly in the very old age group (>85 years) (ACSA, 2001).As a result of this ageing demographic, services to address the health, well-being and quality of life of older Australians are currently of paramount importance, and this will continue to be into the future. As people age they are at increased risk of developing diseases and disabilities, and as a result older people are disproportionately high users of health and community services (ASCA, 2001).With increasing usage of these services there is a strong emphasis in Australia for community services to play a larger role in optimising older peoples' health and wellbeing in the community (ASCA, 2001; NCOSS, 2010).In doing so, and assisting in managing older people discharged from hospital, community services can help to alleviate some of the demand for acute care services by older people. My research highlights that community services in South Australia play a vital role in assisting to manage older peoples' health and wellbeing after discharge from hospital. One of the factors influencing this role (as identified by the community service providers who were interviewed) was the different models under which the hospital and community services operate.The community service providers identified that the hospital and the community operate under different health models. With the hospital operating predominately under a Biomedical Model (NCOSS, 2010; Wade & Halligan, 2004) and community services under a Social Model (ASCA, 2001; NCOSS, 2010).
References:
Aged and Community Services Australia (ACSA) 2001, Submission to the Inquiry into the Definition of Charities and Related Organisations, Australia.
Council of Social Services NSW (NCOSS), NCOSS Response to the NSW Government's discussion paper on A National Health and Hospitals Network for Australia's Future, NSW, Australia.
Wade, DT & Halligan, PW 2004 Do biomedical models of illness make for good healthcare systems? British Medical Journal, vol 329, pp.1398-1401.
World Health Organisation (1986). Ottawa charter for health promotion: an International Conference on Health Promotion, the move toward a new public health, November 17-21, 1986, Ottawa, Ontario, Canada. Ottawa, World Health Organisation:4.
News
As part of the School of Health Science's Research Week, PhD students were required to submit a poster. iCAHE PhD student Michelle Guerin's poster was listed as a finalist in the top three posters. Michelle's poster portrays older individuals' experiences of leaving hospital and returning home, and provides important insights in the development of discharge policies. To view the poster click here
Debbie Howson
Student Home Page
Recent Findings
Information coming soon.
Project Overview
Information coming soon.
Lucylynn Lizarondo
Student Home Page
Recent Findings
Now in the third year of my PhD candidature, I have collected all data for the third and final study of my research. As previously reported in the PhD corner, my study aims to explore the determinants of individual allied health practitioners’ uptake of EBP using the iCAHE journal club as a medium. I would like to find out the characteristics of practitioners who are likely or not likely to benefit from a journal club approach. Baseline measurements of knowledge, skills, behaviour relevant to EBP were collected between March and May 2011. Journal club meetings then ran for six months, after which, post measurements were gathered using the same questionnaires. The next months will be devoted to the statistical analysis of my data and writing of a manuscript based on findings from this study.
My journey has been very challenging but equally rewarding and enjoyable. In the past year, I was able to present my research findings from the first two studies in local as well as international conferences. I was fortunate to listen and speak with people who are as passionate as I am in promoting evidence-based practice in allied health. Not meaning to show off, I am also very pleased with the two publications that came out from my first two studies. To provide useful resources to researchers who work in the same area, here are the links to the papers:
Lizarondo L, Grimmer-Somers K, Kumar S (2011): Exploring the perspectives of allied health practitioners regarding the use of journal clubs as a medium for promoting evidence-based practice: a qualitative study. BMC Medical Education 11: 66.
Lizarondo L, Grimmer-Somers K, Kumar S (2011): A systematic review of the individual determinants of research evidence use in allied health. Journal of Multidisciplinary Health Care 4: 261-272.
Project Overview
Since working in iCAHE in 2008, I have been assisting allied health practitioners in South Australia organise their journal clubs using the iCAHE model (http://www.unisa.edu.au/cahe/Resources/JC/journalclub.asp). This journal club initiative is part of iCAHE's commitment to promote the use of research evidence in making decisions about health care. Because of my exposure to this project, I have developed a strong interest in evidence-based practice (EBP), specifically the role of journal club in bridging the gap between research and practice.
Liz Pridham
Student Home Page
Recent Findings
Information coming soon.
Project Overview
Information coming soon.
Jess Stanhope (Honours Student)
Student Home Page
Recent Findings
There were significant differences between the participants in terms of their LPE and EMG results, which indicates that a case series is the most appropriate study design for future research. LPE ratings appear to be a valid measure of strain as they correlate positively with playing duration for most flautists, however they did not correlate well with tempo for any of the participants. EMG measures did not correlate well with playing duration for any of the participants, and only correlated well with tempo in the forearm extensors. LPE and EMG measures did not correlate well with one another. In conclusion, LPE ratings appear to be a valid measure of strain in some flautists, but they are not a valid measure of muscle activity specifically.
Project Overview
The aim of this project was to examine the validity of local perceived exertion (LPE) ratings made using Borg’s CR10 scale in adult, high-level flute players. We looked specifically at the forearm extensor and upper trapezius regions. This was done by examining the correlation between these ratings and playing duration and the tempo (speed) at which they played a set exercise. Electromyography (EMG) was also used to measure muscle activity in the same regions. The correlation between this and tempo and playing duration was also examined, as was the correlation with the LPE ratings. This forms the first stage of developing a project to investigate the risk factors for playing-related musculoskeletal disorders in flautists, and strategies for prevention.
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Publications
For details on iCAHE research and publications, visit the iCAHE staff home pages by clicking their names above.
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Contact
iCAHE
International Centre for Allied Health Evidence
Member of Sansom Institute
University of South Australia
Division of Health Sciences
GPO Box 2471
Adelaide SA Australia 5000
Telephone: +61 8 8302 2099
International: +61 8 8302 2853
Email: iCAHE@unisa.edu.au
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