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https://www.readbyqxmd.com/read/28691694/context-dependent-adaptation-improves-robustness-of-myoelectric-control-for-upper-limb-prostheses
#1
Gauravkumar K Patel, Janne Mathias Hahne, Claudio Castellini, Dario Farina, Strahinja Dosen
OBJECTIVE: Dexterous upper-limb prostheses are available today to restore grasping, but an effective and reliable feed-forward control is still missing. The aim of this work was to improve the robustness and reliability of myoelectric control by using context information from sensors embedded within the prosthesis. APPROACH: We developed a context-driven myoelectric control scheme (cxMYO) that incorporates the inference of context information from proprioception (inertial measurement unit) and exteroception (force and grip aperture) sensors to modulate the outputs of myoelectric control...
July 10, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28679679/protocol-for-a-mixed-methods-realist-evaluation-of-a-health-service-user-feedback-system-in-bangladesh
#2
Bassey Ebenso, Rumana Huque, Zunayed Azdi, Helen Elsey, Shammi Nasreen, Tolib Mirzoev
INTRODUCTION: Responsiveness to service users' views is a widely recognised objective of health systems. A key component of responsive health systems is effective interaction between users and service providers. Despite a growing literature on patient feedback from high-income settings, less is known about effectiveness of such systems in low-income and middle-income countries. METHODOLOGY AND ANALYSIS: This paper disseminates the protocol for an 18-month 'RESPOND' project that aims to evaluate the system of collecting and responding to user feedback in Bangladesh...
July 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28672013/realist-evaluation-of-an-enhanced-health-visiting-programme
#3
Lawrence Doi, Ruth Jepson, Samantha Hardie
BACKGROUND: The health visitors' role in many countries is changing. In Scotland, the role has undergone substantial changes through the introduction of an enhanced health visiting programme, which includes increased, structured home visits. This evaluation was conducted within NHS Ayrshire and Arran, one of the 14 Scottish Health Boards. Our aim was to understand and explain how, and why, the programme could contribute to improving health and wellbeing outcomes for children and families...
2017: PloS One
https://www.readbyqxmd.com/read/28662782/danish-perioperative-nurses-documentation-a-complex-multifaceted-practice-connected-with%C3%A2-unit-culture-and-nursing-leadership
#4
Susanne F Søndergaard, Vibeke Lorentzen, Erik E Sørensen, Kirsten Frederiksen
Researchers have described the documentation practices of perioperative nurses as flawed and characterized by subjectivity and poor quality, which is often related to both the documentation tool and the nurses' level of commitment. Studies suggest that documentation of nursing care in the OR places special demands on electronic health records (EHRs). The purpose of this study was to explore how the use of an EHR tailored to perioperative practice affects Danish perioperative nurses' documentation practices...
July 2017: AORN Journal
https://www.readbyqxmd.com/read/28662674/evaluation-of-a-knowledge-transfer-scheme-to-improve-policy-making-and-practices-in-health-promotion-and-disease-prevention-setting-in-french-regions-a-realist-study-protocol
#5
Linda Cambon, Audrey Petit, Valery Ridde, Christian Dagenais, Marion Porcherie, Jeanine Pommier, Chrisine Ferron, Laetitia Minary, François Alla
BACKGROUND: Evidence-based decision-making and practice are pivotal in public health. However, barriers do persist and they relate to evidence properties, organisations and contexts. To address these major knowledge transfer (KT) issues, we need to rethink how knowledge is produced and used, to enhance our understanding of decision-making processes, logics and mechanisms and to examine the ability of public health services to integrate research findings into their decisions and operations...
June 29, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28637090/early-warning-systems-and-rapid-response-to-the-deteriorating-patient-in-hospital-a-realist-evaluation
#6
Jennifer Mcgaughey, Peter O'Halloran, Sam Porter, John Trinder, Bronagh Blackwood
AIM: To identify those contexts and mechanisms that enable or constrain the implementation of Rapid Response Systems on acute general hospital wards to recognise and respond to patient deterioration. BACKGROUND: Rapid Response Systems allow deteriorating patients to be recognised using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. DESIGN: Realist Evaluation. METHODS: The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation...
June 21, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28619459/reflections-on-experiential-learning-in-evaluation-capacity-building-with-a-community-organization-dancing-with-parkinson-s
#7
April Nakaima, Sanjeev Sridharan
This paper discusses what was learned about evaluation capacity building with community organizations who deliver services to individuals with neurological disorders. Evaluation specialists engaged by the Ontario Brain Institute Evaluation Support Program were paired with community organizations, such as Dancing With Parkinson's. Some of the learning included: relationship building is key for this model of capacity building; community organizations often have had negative experiences with evaluation and the idea that evaluations can be friendly tools in implementing meaningful programs is one key mechanism by which such an initiative can work; community organizations often need evaluation most to be able to demonstrate their value; a strength of this initiative was that the focus was not just on creating products but mostly on developing a learning process in which capacities would remain; evaluation tools and skills that organizations found useful were developing a theory of change and the concept of heterogeneous mechanisms (informed by a realist evaluation lens)...
May 8, 2017: Evaluation and Program Planning
https://www.readbyqxmd.com/read/28600370/substituting-physicians-with-nurse-practitioners-physician-assistants-or-nurses-in-nursing-homes-protocol-for-a-realist-evaluation-case-study
#8
Marleen Hermien Lovink, Anke Persoon, Anneke Jah van Vught, Lisette Schoonhoven, Raymond Tcm Koopmans, Miranda Gh Laurant
INTRODUCTION: In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare...
June 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28582260/a-personalized-self-management-rehabilitation-system-for-stroke-survivors-a-quantitative-gait-analysis-using-a-smart-insole
#9
Richard John Davies, Jack Parker, Paul McCullagh, Huiru Zheng, Chris Nugent, Norman David Black, Susan Mawson
BACKGROUND: In the United Kingdom, stroke is the single largest cause of adult disability and results in a cost to the economy of £8.9 billion per annum. Service needs are currently not being met; therefore, initiatives that focus on patient-centered care that promote long-term self-management for chronic conditions should be at the forefront of service redesign. The use of innovative technologies and the ability to apply these effectively to promote behavior change are paramount in meeting the current challenges...
November 8, 2016: JMIR Rehabil Assist Technol
https://www.readbyqxmd.com/read/28569395/co-located-welfare-advice-in-general-practice-a-realist-qualitative-study
#10
Charlotte Woodhead, Hillliary Collins, Robin Lomas, Rosalind Raine
General practitioners (GPs) engage with patients about a variety of social issues distinct from direct clinical work ("non-health" issues), such as health-related benefits and debt. Co-located welfare advice services could provide support to practices but have usually been considered in terms of patient rather than practice outcomes. We aimed to develop an initial programme theory for how the provision of co-located advice supports specific practice outcomes, and to identify salient barriers and enabling factors...
June 1, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28559153/valuing-and-embracing-complexity-how-an-understanding-of-complex-interventions-needs-to-shape-our-evaluation-capacities-building-initiatives
#11
Sanjeev Sridharan, April Nakaima
This paper describes some of the main challenges of evaluating complex interventions, as well as the implications of such challenges for evaluation capacity building. It discusses lessons learned from a case study of an evaluation of Dancing with Parkinson's, an organization that provides dance classes to people with Parkinson's disease in Toronto, Canada. These implications are developed from a realist evaluation lens. Key lessons include the need to develop skills to understand program mechanisms and contexts, recognize multiple models of causality, apply mixed method designs, and ensure the successful scaling up and spread of an intervention...
May 10, 2017: Evaluation and Program Planning
https://www.readbyqxmd.com/read/28544273/use-of-clinical-guidelines-in-remote-australia-a-realist-evaluation
#12
Sandeep Reddy, Victoria Orpin, Sally Herring, Stephanie Mackie-Schneider, Janet Struber
AIM: The aim of this evaluation was to assess the acceptability, accessibility, and compliance with the 2014 editions of the Remote Primary Health Care Manuals (RPHCM) in health care centres across remote areas of Northern and Central Australia. METHOD: To undertake a comprehensive evaluation that considered context, the evaluation used a realist evaluation framework. The evaluation used a variety of methods including interviews and survey to develop and test a programme theory...
May 24, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28489608/simulation-study-comparing-the-helmet-chin-pet-with-a-cylindrical-pet-of-the-same-number-of-detectors
#13
Abdella M Ahmed, Hideaki Tashima, Eiji Yoshida, Fumihiko Nishikido, Taiga Yamaya
There is a growing interest in developing brain PET scanners with high sensitivity and high spatial resolution for early diagnosis of neurodegenerative diseases and studies of brain functions. Sensitivity of the PET scanner can be improved by increasing the solid angle. However, conventional PET scanners are designed based on a cylindrical geometry, which may not be the most efficient design for brain imaging in terms of the balance between sensitivity and cost. We proposed a dedicated brain PET scanner based on a hemispheric shape detector and a chin detector (referred to as the helmet-chin PET), which is designed to maximize the solid angle by increasing the number of lines-of-response in the hemisphere...
May 10, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28486991/exploring-the-utility-and-scalability-of-a-telehomecare-intervention-for-patients-with-chronic-kidney-disease-undergoing-peritoneal-dialysis-a-study-protocol
#14
Lianne Jeffs, Arsh Kumar Jain, Rachel HiuTung Man, Nike Onabajo, Laura Desveaux, James Shaw, Jennifer Hensel, Payal Agarwal, Marianne Saragosa, Trevor Jamieson, Ivy Wong, Maria Maione, R Sacha Bhatia
BACKGROUND: Chronic Kidney Disease (CKD) is a pressing global health concern that is placing increased strain on health care resources. CKD patients regularly receive peritoneal dialysis as a common CKD treatment. An emerging technological solution is telehomecare as way to support patients receiving PD in their homes. This study protocol outlines a mixed methods evaluation exploring a telehomecare developed to enhance CKD patients' outcomes and experiences. The study aims to assess the usability, acceptability and scalability of this virtual care application...
May 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28473524/a-realist-evaluation-of-patients-decisions-to-deprescribe-in-the-empower-trial
#15
Philippe Martin, Cara Tannenbaum
BACKGROUND AND OBJECTIVES: Successful mechanisms for engaging patients in the deprescribing process remain unknown but may include: (1) triggering motivation to deprescribe by increasing patients' knowledge and concern about medications; (2) building capacity to taper by augmenting self-efficacy and (3) creating opportunities to discuss and receive support for deprescribing from a healthcare provider. We tested these mechanisms during theEliminating Medications through Patient Ownership of End Results (EMPOWER) () trial and investigated the contexts that led to positive and negative deprescribing outcomes...
May 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28472938/exploring-generative-mechanisms-of-the-antiretroviral-adherence-club-intervention-using-the-realist-approach-a-scoping-review-of-research-based-antiretroviral-treatment-adherence-theories
#16
Ferdinand C Mukumbang, Sara Van Belle, Bruno Marchal, Brian van Wyk
BACKGROUND: Poor retention in care and non-adherence to antiretroviral therapy (ART) continue to undermine the success of HIV treatment and care programmes across the world. There is a growing recognition that multifaceted interventions - application of two or more adherence-enhancing strategies - may be useful to improve ART adherence and retention in care among people living with HIV/AIDS. Empirical evidence shows that multifaceted interventions produce better results than interventions based on a singular perspective...
May 4, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28462767/public-private-partnerships-to-improve-primary-healthcare-surgeries-clarifying-assumptions-about-the-role-of-private-provider-activities
#17
Oliver Mudyarabikwa, Patrick Tobi, Krishna Regmi
Aim To examine assumptions about public-private partnership (PPP) activities and their role in improving public procurement of primary healthcare surgeries. BACKGROUND: PPPs were developed to improve the quality of care and patient satisfaction. However, evidence of their effectiveness in delivering health benefits is limited. METHODS: A qualitative study design was employed. A total of 25 interviews with public sector staff (n=23) and private sector managers (n=2) were conducted to understand their interpretations of assumptions in the activities of private investors and service contractors participating in Local Improvement Finance Trust (LIFT) partnerships...
May 2, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28417517/evaluating-clinical-ethics-support-a-participatory-approach
#18
Suzanne Metselaar, Guy Widdershoven, Rouven Porz, Bert Molewijk
The current process towards formalization within evaluation research, in particular the use of pre-set standards and the focus on predefined outcomes, implies a shift of ownership from the people who are actually involved in real clinical ethics support services (CESS) in a specific context to external stakeholders who increasingly gain a say in what 'good CESS' should look like. The question is whether this does justice to the insights and needs of those who are directly involved in actual CESS practices, be it as receivers or providers...
May 2017: Bioethics
https://www.readbyqxmd.com/read/28411668/-realist-evaluation-for-implementation-research
#19
Cécile Marie Dupin
The realist approach to evaluation can be useful faced with the complexity of health interventions in populations. Implementation is the process by which these interventions are put into practice. Scientific realism can provide an important contribution to the development of programme theories through implementation research, and help to reveal the distal and proximal mechanisms of programmes aimed at combatting social inequalities in healthcare.
April 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/28394187/using-critical-realistic-evaluation-to-support-translation-of-research-into-clinical-practice
#20
Michelle C Swift, Marilyn Langevin, Alexander M Clark
A challenge that speech-language pathologists (SLPs) face is the translation of research into clinical practice. While randomised controlled trials (RCTs) are often touted as the "gold standard" of efficacy research, much valuable information is lost through the process; RCTs by nature are designed to wash out individual client factors and contexts that might influence the outcome in order to present the "true" impact of the intervention. However, in the area of behavioural interventions, the interaction of client factors and contexts with the treatment agent can substantially influence the outcome...
April 10, 2017: International Journal of Speech-language Pathology
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