From the Director
iCAHE has had a busy time in the last three months. The increasing focus nationally and internationally on evidence translation into practice, and patient/ consumer engagement in healthcare decisions makes iCAHE’s research even more important. We recently welcomed Janine Dizon into iCAHE. She is a UniSA PhD graduate, who has the specific brief of formalising professional development and delivering EBP training for policy-makers, managers and clinicians. She has already developed a process by which CPD courses in a range of topics can be offered in a way which articulates with UniSA postgraduate degrees. Check the iCAHE website for more information.
There are now ten Research Area Teams (RATs) whose leaders presented their team’s work to the iCAHE Executive Management committee in July. This highlighted the breadth of research being undertaken under the iCAHE umbrella. The iCAHE Methods RAT has completed five Rapid Reviews since December for government and industry. This brings the total number of Rapid Reviews undertaken in iCAHE in the last three years to 11. Rapid Reviews are becoming an increasingly common way of identifying the best available evidence for a range of questions. Our learnings are that every Rapid Review is different, and this learning has been incorporated into our evidence-based practice teaching programs. The Methods RAT is planning to write a methods handbook to guide future Rapid Reviews. There have been changes in the last 6 months iCAHE staff, with Kate Kennedy, Deb Kay, Jeric Uy and Julie Luker all moving to greener pastures. We have since welcomed Heath Pillen (nutrition and public health background), and Holly Bowen (psychology background). Our editor Maura McInerney, and health economist Asterie Twizeyemariya have increased their hours. We are proud to announce recent PhD completions for iCAHE students Helen Banwell, Ryan Causby and Yasmin Lai, and we welcome new iCAHE HDR students Innes Serrada, Paul Reid, Troy Morrison and Brooke Osborne.
Many common assumptions and perceptions about older people are based on outdated stereotypes. Indeed there is no typical older person, there is great diversity in older adults and older age does not mean dependence is inevitable. Healthy ageing is the process of developing and maintaining the functional ability that enables well-being in older age (World Health Organisation 2015). Internationally healthy active ageing is being supported by the adoption of enablement and reablement strategies and policies. Enablement is directed at identifying subtle, covert changes that occur with ageing in community dwelling adults. By addressing these changes with known evidenced interventions further decline and critical thresholds for injury and chronic conditions can be avoided. Reablement is required when a person has reached a critical threshold and loss of function secondary to a health condition or injury has occurred. Interventions are aimed at maximising function and may include improving or maintaining function or adapting to the consequences of declining function. Both enablement and reablement should be person-centred and goal directed, allowing for self-determination and consumer involvement in the decision-making. This requires great change so that the health system aligns with the needs and wants of the older populations they now serve – a population that has quite different expectations from the older populations of the 80’s and 90’s.
Adoption of healthy active ageing approaches is resulting in the development of age-friendly environments with changes to housing design, community spaces and technological advances that support ageing in the home. Much work is needed to ensure health policies, funding models, service delivery, workforce training, community opinion and cultural change allow us all to benefit from adoption of enablement and reablement for healthy active ageing.
Sue Gordon PhD, BaAppSc(Physio), GCEd
Strategic Professor, Chair of Restorative Care in Ageing
A partnership position funded by ACH group and Flinders University
How and why Australians access health information and perceptions of the usage and storage of personal health data
The University of SA’s International Centre for Allied Health Evidence (iCAHE) is conducting research into how Australians access health information and what they understand about the use of their health records. They are seeking adults to complete a 15-minute survey. If you’d like to take part, you can complete the survey online (www.unisa.edu.au/cahe) or ask for a paper copy to be sent to you - contact iCAHE by email (iCAHE@unisa.edu.au ) or phone 1800 126 334. For further information about the project, please contact the Project Director, Dr Steve Milanese (firstname.lastname@example.org) on 83021053.
This project has been approved by the University of South Australia’s Human Research Ethics Committee (Protocol number 35745). If you have any questions about your rights as a participant, please contact the Executive Officer of the UniSA Human Research Ethics Committee, Vicki Allen. (Vicki.email@example.com; tel 8302 3118)
Collaborative translational research with ASHO, Dept Health SA
The International Centre for Allied Health Evidence (iCAHE) was asked by SA Health to estimate budget impacts related to podiatric interventions for people with diabetes. Diabetic foot disease, often leading to infection and/or limb amputation, consumes a large proportion of the diabetes health-care budget. The project, led by iCAHE’s Dr Asterie Twizeyemariya, involved the scoping of a cross-sector pathway of intervention, and the cost-modelling of different scenarios with, and without, intervention.
This study is arguably the first to develop an economic model that compares best evidence practice podiatry care with usual care for people with diabetes in outpatient settings, and calculates the impact on the health care budget over one year. Study results suggest that best evidence practice podiatry care for every person with diabetes would lead to cost-savings for the South Australian health care system.
Resources for You
Outcomes Calculator Update
Our beloved outcomes calculator software has been unavailable for the past few months because it had difficulty operating on the latest Windows environment. It has done pretty well since it was first developed in 2001, with only minimal upgrades needed to keep it running. We apologise to the people who have been using it and are waiting for its rehabilitation. We have found a wonderful local programmer, and the outcomes calculator is now in the recovery room, post-surgery, and we hope it will be available within the month. We will let all current users know by email when it is available, and we will supply an updated version for minimal cost, to cover what has been a massive software rewrite and upgrade. Rest assured that all your existing data will transport across to the new calculator without loss, this has been a priority for our programmer. We will send out specific instructions for installation, and we will provide a helpline for the first month to ensure that everything goes smoothly. People who have not considered using the outcomes calculator might like to visit The Outcomes Calculator section of our website for more information, and consider trialling the new version. The iCAHE Outcomes Calculator is a unique tool that supports throughout-episode outcome data collection (drawing from over 200 freely available, psychometrically-sound outcome measures). The Outcomes Calculator provides a graph at the closure of the episode that demonstrates patient progress over time, as well as metrics on change in the outcome measure from baseline. This has been found to be an invaluable tool for quality improvement, and discussion between patients, clinicians, referrers and funders regarding the need for ongoing treatment.
PROMS (Patient Reported Outcome MeasureS)
The use of PROMS (or Patient Reported Outcome MeasureS) in everyday clinical practice has the potential to narrow the gap between clinicians’ and patients’ views of clinical and functional reality, and assist in tailoring treatment plans to meet the patient’s preferences and needs (Nelson et al 2015 - click here). Many outcome measures developed over the last 30 years reflect only what clinicians and/ or the health system percieve as important to measure in terms of treatment effectiveness. Uptake of PROMS offers a way of formally hearing what patients/ consumers value, and this can increase the quality of dialogue between clinicians, patients, funders, managers and policy-makers. The following links lead to excellent material on the use of PROMs in the UK by the Private Health Insurance Network (PHIN). An introductory page can be found here. At the bottom of that page is a link to a site that allows you to download the following PDF, or for a direct link click here (PDF Download).
Actions in Allied Health
27th - 29th October 2016, Port Lincoln, South Australia.
“It takes a village to raise a child” is a traditional African proverb and the theme for the 2016 SARRAH National Conference for Rural and Remote Allied Health Professionals.
What if our “child” is rural and remote health outcomes and thriving communities?
In rural and remote life and work, our “village” has never been more important than it is today. We live in a rapidly evolving environment and we are faced with a myriad of both challenges and opportunities each day. Navigating these changes can be daunting – collaboration, innovation, partnerships and supports are necessary to prepare our communities for a vibrant, sustainable future.
A village approach implies that there is shared responsibility and that people work together and contribute in ways that are consistent with their strengths, skills and abilities.
It takes a village to have necessary tough conversations, to disagree and to problem solve in ways that are inclusive.
At the 2016 SARRAH National Conference, delegates will have the opportunity to explore how this village approach can be applied to rural and remote health outcomes.
International Association for Public Participation Australasia iap2 2016 Conference: The Future Of Engagement and Democracy, People, Power, Practice
17th – 19th October 2016, Adelaide, South Australia.
Public participation has evolved significantly in the past two decades and we are on the cusp of an exciting new era in community and stakeholder engagement. This conference will provide delegates an opportunity to share the lessons learned and how to improve practice for future engagement.
Each speaker and presentation is handpicked to address the theme of ‘The Future of Democracy- People, Power, Practice’, and each will offer a unique tool to pack in your tool box and take home to build capacity in your organisation. Whether you’re in the public, private or not-for-profit sector, this event is not to be missed.
Conference Reflections (2016 ASSMIRT)
The 11th Annual Scientific Meeting of Medical Imaging and Radiation Therapy (ASSMIRT) was held in Brisbane (22-24th April). The conference was divided into sessions dedicated to the two medical professions with accompanying student conference sessions and motivation speeches. I attended both the radiation therapy student and general conference which covered a variety of topics with current studies and future directions. The sessions were all relevant on a clinical level, particularly sessions on the implementation of new protocols that improved patient safety, quality of care and efficiency. For example there was a study conducted on the implementation of cone bream computer tomography in breast cancer patient set up, allowing rotational errors to be identified and corrected before treatment. Also increasing the imaging frequency amongst patients undergoing treatment for their supraclavicular fossa to a daily routine to compensate for the high intrafraction movement in the region. This made me reflect on the current protocols I have seen during my placement time, and why these are in place and how they can be improved. Future directions include patient education, with an interesting study highlighting the use of video based programs as a way to improve patient; knowledge, satisfaction and reduce anxiety. This presentation particularly stuck out to me as the profession has such a large patient focus, and this is definitely an area of continual improvement. Other presentations shed light on new aspects of patient care such as the link between cognitive decline and radiotherapy treatment which was unbeknown to me. This impacted on my outlook of quality of life for patients. Further expansion on the long term effects of radiotherapy amongst patients will impact my clinical care and reiterate the importance for quality assurance. General knowledge was explored also through large trial groups on topics ranging from set up to advanced planning and delivery techniques which are considered more gold standard Overall the information gained was invaluable and has left me asking more questions on the future of my chosen profession and my role within the community.
Grimmer K., Machingaidze S., Dizon J., Kredo T., Louw Q., Young T. 2016 South African clinical practice guidelines quality measured with complex and rapid appraisal instruments. BMC Research Notes 2016 9:244.
Dizon JMR, Machingaidze S, Grimmer K (accepted September 2016): To adopt, to adapt, or to contextualise? The big question in Clinical Practice Guideline Development. BMC Research Notes
Bernhardsson, S., Lynch, E., Dizon, J. M., Fernandes, J., Gonzalez-Suarez, C., Lizarondo, L., Luker, J., Wiles, L., & Grimmer, K. (2016). Advancing Evidence-Based Practice in Physical Therapy Settings: International Perspectives on Implementation Strategies and Interventions. Physical Therapy.
Mine K., Nakayama T., Milanese S., Grimmer K. 2016. The effectiveness of braces and orthoses for patients with knee osteoarthritis: A systematic review of Japanese-language randomised controlled trial. Prosthetics and Orthotics International. (In Press)
Barry K., Kumar S., Linke R., Dawes E. 2016. A clinical audit of anatomical side marker use in a paediatric medical imaging department. Journal of Medical Radiation Sciences.
Ormsby R., Staudacher A., Blyth J., Bezak E., Sykes P. 2016. Temporal Responses to X-Radiation Exposure in Spleen in the pKZ1 Mouse Recombination Assay. Radiation Research 185,000-000.
Harriss-Phillips W., Bezak E., Potter A. 2016. Stochastic Predictions of Cell Kill During Stereotactic Ablative Radiation Therapy: Do Hypoxia and Reoxygenation Really Matter?
Luker J., Craig L., Bennett L., Ellery F., Langhome P., Wu O., Bernhardt J. 2016. Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT. BMC Medical Research Methodology. 16:52
McCaul M., Grimmer K., 2016. Pre-hospital clinical practice guidelines – Where are new now? African Journal of Emergency Medicine.
Grimmer K., Dizon J., Louw Q. 2016. Editorial. South African Guidelines Excellence (SAGE): Efficient, effective and unbiased clinical practice guideline teams. SAMJ Editorial.
Wiles L., Murray C., Baker A., Berndt A., Boshoff K. 2016. Ethics Education in Allied Health: A systematic Review of Learning Outcomes for Entry-Level Students. Humanities and Social Sciences. Special Issue: Ethical Sensitivity: A Multidisciplinary Approach. Vol. 4, No. 2-1, 2016, pp. 13-24. doi: 10.11648/j.hss.s.2016040201.13
Adams R., Jones A., Lefmann S., Sheppard L. 2016. Towards understanding the availability of physiotherapy services in rural Australia. Rural and Remote Health. 2016. 16:3686
Murdoch K, Buckley JD, McDonnell MN (2016). The effect of aerobic exercise on neuroplasticity within the motor cortex following stroke. PLOS ONE 11(3):e0152377. doi:10.1371/journal.pone.0152377
Snow NJ, Mang CS, Roig M, McDonnell MN, Campbell KL, Boyd LA (2016). The Effect of an Acute Bout of Moderate-intensity Aerobic Exercise on Motor Learning of a Continuous Tracking Task. PLOS ONE 11(2): e0150039. doi:10.1371/journal.pone0150039
Wolf SL, Kwakkel G, Bayley M, McDonnell MN, for the Upper Extremity Stroke Algorithm Working Group (2016). Best practice for arm recovery post stroke: an international application. Physiotherapy 2016 Mar; 102 (1):1-4. doi: 10.1016/j.physio.2015.08.007.
Childs, JT, Esterman, AJ, Thoirs, K A, Turner, R C 2016 Ultrasound in the assessment of hepatomegaly: a simple technique to determine an enlarged liver using reliable and valid measurements. Sonography, online, pp. 1-6. DOI: 10.1002/sono.12051
Santos A., Marcu L., Wong C. Bezak E. 2016. Risk estimation of second primary cancers after breast radiotherapy. Acta Oncologica. DOI:10.1080/0284186X.2016.1185150
Lynch E., Luker J., Cadilhac D., Fryer C., Hillier S. 2016. A qualitative study in using the Theoretical Domains Framework to investigate why patients were or were not assessed for rehabilitation after stroke. Clinical Rehabilitation. July 2016
Murray C., Gilbert-Hunt S., Berndt A., Perrelle L. 2016. Promoting participation and engagement for people with dementia through a cognitive stimulation therapy programme delivered by students: A descriptive qualitative study. British Journal of Occupational Therapy. 1-9.
Boshoff K., Gibbs D., Phillips R., Wiles L., Porter L. 2016. Parents' voices: ‘why and how we advocate’. A meta-synthesis of parents' experiences of advocating for their child with autism spectrum disorder. Child: care, health and development.
Beard M., Orlando J, Kumar S. 2016. Overcoming the tyranny of distance: An audit of process and outcomes from a pilot telehealth spinal assessment clinic. Journal of Telemedicine and Telecare.
Martin P., Newby M., Moran M., Browne M., Kumar s. Interprofessional Scenario-Based Learning for New Graduates in a Regional Setting: A Pilot Study. 2016. Internet Journal of Allied Health Sciences and Practice. Vol. 14. No 3.
Martin P., Kumar S., Lizarondo L., Tyack Z. 2016. Factors influencing the perceived quality of clinical supervision of occupational therapists in a large Australia state. Australian Occupational Therapy Journal.
Wiese C., Simpson R., Kumar S. The Effectiveness of Equine-Based Therapy in the Treatment of Social and Behavioural Aspects of Children with Autism Spectrum Disorder: A Systematic Review. Internet Journal of Allied Health Sciences and Practice. 2016. Vol. 14. No. 3.
Lawrence-Wood E., Kumar S., Crompvoets S., Fosh B., Rahmanian H., Jones L., Neuhaus S. 2016. A Systematic Review of the Impacts of Active Military Service on Sexual and Reproductive Health Outcomes among Servicewomen and Female Veterans of Armed Forces. Journal of Military and Veterans’ Health. Vol. 24 Issue 3 (Jul 2016)
Thayabaranathan, T., Andrew, N., Immink, M.A., Hillier, S., Stevens, P., Stolwyk, R., Kilkenny, M., & Cadilhac, D. (2016) Benefits of mindfulness-based interventions for stroke care: A systematic review. International Journal of Stroke, 10(S3):38.
BOOK CHAPTER: Cardiorespiratory Physiotherapy: Adults and Paediatrics, 5th Edition. Chapter 6. Outcome Measurement In Cardiorespiratory Physiotherapy Practice. Parry S., Denehy, L., With contributions from Baldwin C., Connolly B., Skinner E., Singh S., Rand S., Williams C.
BOOK CHAPTER: Advances in Medical Physics Volume 6. Chapter 9. Targeted Alpha Therapy for Cancer. Allen B., Marcu L., Bezak E. Medical Physics Publishing.
Research group in focus - Early Childhood Intervention Research Group
The Early Childhood Intervention Research Group work with families, early childhood services, therapists and other professionals to conduct and disseminate research on early intervention to enable children to optimise their learning, growth and development. The group leader is Dr Kobie Boshoff, and includes Hugh Stewart, Scott Weeks, Emily Ward, Sophie Leffman, Olivia Thorpe and Alvin Atlas as group members. We have the following honours students in the group: Nancy McPharlin, Holly Bowen and Jake Monaco.
The group has a focus on evidence- based practice, practice-based, multi-disciplinary research at both service planning and intervention technique levels. This past six months, we have been focussing on the following projects:
- Designing the evaluation of the Responsive Relationship Program in Children’s Centres. This project focusses on both an outcome and process evaluation of the training program for Early Childhood Educators. Holly Bowen and Jake Monaco are implementing the evaluation during school terms 4 (2016) and terms 1,2, and 3 in 2017. This project will provide preliminary results, with further expansion of the training program and evaluation in the future.
- Nancy McPharlin has been conducting a systematic review on the occupational therapy role in NICUs as part of her honours studies.
- Scott Weeks has been implementing his audit tool for documenting services provided by occupational therapists as part of validating the tool for use.
- Kobie has been working with Deanna Gibbs (UK), Louise Wiles, Rebecca Taylor (Canberra) on their 2nd publication arising from their qualitative meta-analysis into the parent experience of advocacy for their child with autism. Kobie has also been working with PhD students from the University of Pretoria in South Africa on their systematic reviews.
- Hugh has been working on the evaluation of the DCSI Assistive Technology Equipment Provision Package, with others in the Occupational Therapy Program.
- Sophie has submitted a review for publication with Ray Russo and Susan Hillier: The effectiveness of Robotic-Assisted Gait Training for paediatric gait disorders: systematic review
The past few months has also been a month of building relationships with industry, with Kobie having discussions with potential partners such as Novita and Autism SA, with the aim of dual funding applications. The group members have a number of grant applications in process.
Researcher in focus: Dr Janine Margarita Dizon
Dr Janine Margarita Dizon has recently joined iCAHE to lead iCAHE’s professional development and training arm. Janine completed her PhD in UniSA under iCAHE in 2012 and her PhD work was on the development and evaluation of an evidence-based practice (EBP) course for physiotherapists using the concepts of complex interventions with ‘core’ (essential) and ‘variable’ (depending on local context needs) training components. Janine has been developing and teaching undergraduate and post-graduate courses for medical and allied health-professionals in the last 10 years particularly in the line of evidence-based healthcare, clinical guidelines and health research methods in the Philippines, Hong Kong and South Africa.
iCAHE’s new professional development and training arm which Janine leads was established in order to:
- Provide continuing education to health professionals (clinicians and academics) nationally and internationally
- Provide pathways for higher degree opportunities (Post-graduate courses for clinicians and academics)
- Provide opportunities for research mentoring
Out and about
Karen Grimmer meeting with Capital Markets Collaborative Research Centre (CMCRC) staff in Sydney in July. CMCRC fund an iCAHE PhD scholarship, and current research on consumer views on uses and storage of their health data.
(from Left Uma Srinivasan, David Jonas, Karen Grimmer and Steve Clark)
A team of researchers from Occupational Therapy were awarded the Best Paper prize at the inaugural Australian Assistive Technology Association Conference in the Gold Coast on July 26. The conference is dedicated to technology innovations for people with disabilities and has a multidisciplinary and international following. The team comprised Susan Gilbert-Hunt, Dr Mandy Stanley, Dr Angela Berndt, Dr Carolyn Murray, Kirsty Jewell and Hugh Stewart. Hugh presented the paper and is seen here accepting the award from the CEO of Occupational Therapy Australia Ms Rachel Norris.
(from left Hugh Stewart and Rachel Norris)
Congratulations to Ines Serrada, PhD candidate in iCAHE for being awarded the Physiotherapy Research Foundation prize at the Australian Physiotherapy Association New Graduate Awards night on April 6. She was recognised for having the highest grade for her Honours thesis, which was completed concurrently with the 3rd and 4th years of the Physiotherapy degree. Ines is destined for a successful research career, and has commenced a PhD with the Stroke and Rehabilitation Research Group with a very happy supervisor, as shown in the photo.
(from Left Michelle McDonnell and Ines Serrada)