Determine the feasibility of allied health assistant (AHA) management of people with hip fracture an acute hospital.
Assessor-blind, parallel, feasibility randomised controlled trial with qualitative component.
Acute orthopaedic ward.
People with surgically-managed hip fracture, who walked independently pre-fracture and had no cognitive impairment.
Rehabilitation from an AHA, under the supervision of a physiotherapist, compared with rehabilitation from a physiotherapist.
Feasibility was evaluated according to focus areas of demand, acceptability, practicality and implementation. Secondary outcomes included estimates of effect of adherence to hip fracture mobilisation guidelines, discharge destination, 30-day readmission, functional activity, and length of stay.
Fifty people were allocated to receive rehabilitation from an AHA (n = 25) or physiotherapist (n = 25). AHA rehabilitation had high demand with 60% of eligible participants recruited. Satisfaction with AHA rehabilitation was comparable with physiotherapy rehabilitation (acceptability). The AHA group received an average of 11 min (95% CI 4 to 19) more therapy per day than the physiotherapy group (implementation). The AHA group may have had lower cost of acute care (MD -$3 808 95% CI -7 651 to 35) and adverse events were comparable between groups (practicality). The AHA group may have been 22% (HR 1.22, 95% CI 0.92 to 1.61) more likely to walk on any day and may have had a shorter length of stay (MD -0.8 days, 95% CI -2.3 to 0.7).
AHA management of patients with hip fracture was feasible and may improve adherence to mobilisation guidelines and reduce cost of care and length of stay.
ACTRN12620000877987. CONTRIBUTION OF THE PAPER.

The main objective of this work was to develop a tool to assist the activation of a helicopter emergency medical service (HEMS) for the SAMU 14. We opted for a methodology based on \"guidelines of good professional practice.\" Simple consensus was used. A multidisciplinary working group (pilots, medical regulation assistants, doctors) was created. Subgroup meetings (pilots, medical regulation assistants, doctors) developed subparts of the tool. The assembly of the tool\'s subparts was reviewed by the working group and then by an independent reading group. This work enabled the consensual creation of a tool to support the use of the helicopter emergency medical service (HEMS) for the SAMU 14. It is composed of maps, a protocol, and a written procedure of activation. This methodology by \"simple consensus\" allowed the development of a tool rationalizing the activation of the helicopter emergency medical service (HEMS) for the SAMU 14. It was the first work of this type within the SAMU 14. This simple and transposable methodology could be used in other emergency centers or for other multidisciplinary protocols.

The main objective of this work was to develop a tool to assist the activation of a helicopter emergency medical service (HEMS) for the SAMU 14. We opted for a methodology based on “guidelines of good professional practice.” Simple consensus was used. A multidisciplinary working group (pilots, medical regulation assistants, doctors) was created. Subgroup meetings (pilots, medical regulation assistants, doctors) developed subparts of the tool. The assembly of the tool’s subparts was reviewed by the working group and then by an independent reading group. This work enabled the consensual creation of a tool to support the use of the helicopter emergency medical service (HEMS) for the SAMU 14. It is composed of maps, a protocol, and a written procedure of activation. This methodology by “simple consensus” allowed the development of a tool rationalizing the activation of the helicopter emergency medical service (HEMS) for the SAMU 14. It was the first work of this type within the SAMU 14. This simple and transposable methodology could be used in other emergency centers or for other multidisciplinary protocols.
L’objectif principal de ce travail était la création d’un outil d’aide au déclenchement d’un SMUR héliporté au SAMU 14. Nous avons opté pour une méthodologie type « recommandations de bonnes pratiques professionnelles » (RBPP). Le consensus simple a été utilisé. Un groupe de travail multidisciplinaire (pilotes, assistant de régulation médicale [ARM], médecins) a été créé. Des réunions en sous-groupe (pilote, ARM et médecins) ont permis d’élaborer des sous-parties de l’outil. L’assemblage des sous-parties de l’outil a été relu par le groupe de travail puis par un groupe de lecture autonome et validé en réunion de service. Ce travail a permis la création consensuelle d’un outil d’aide à l’emploi du vecteur héliporté en SMUR primaire au sein du SAMU 14. Il est composé de cartes, d’une fiche réflexe et d’une procédure écrite de déclenchement. Cette méthodologie par consensus simple a permis la création d’un outil rationalisant le déclenchement du vecteur héliporté pour le SAMU 14. Il s’agissait du premier travail de ce type au SAMU 14. Cette méthodologie simple et transposable pourrait être utilisée dans d’autres centres 15 ou pour d’autres protocoles multidisciplinaires.

UNASSIGNED: Hippotherapy, an equine-assisted service, uses the movement of the horse as a treatment tool. Hippotherapy is often used by occupational therapists, physiotherapists, and speech and language pathologists. To optimise hippotherapy and facilitate the development of transdisciplinary hippotherapy practise guidelines, this scoping review identified novel hippotherapy concepts used during hippotherapy interventions for clients with spastic cerebral palsy.
UNASSIGNED: To explore, identify, and describe concepts that constitute hippotherapy practices for clients with spastic cerebral palsy.
UNASSIGNED: An exploratory descriptive qualitative research design, using Arksey and O\'Malley\'s five stages of scoping review.
UNASSIGNED: We identified and tabulated 19 hippotherapy concepts.
UNASSIGNED: Hippotherapy is a complex intervention with multiple concepts. This review contributed to the development of hippotherapy practice guidelines for clients with spastic cerebral palsy.
UNASSIGNED: Including hippotherapy concepts into hippotherapy practice will inform therapists, benefit clients, and contribute to future research.

The COVID-19 pandemic caused a rapid shift to remote consultations. United Kingdom (UK) NHS Allied Health Professional (AHP) services may have been unprepared for telehealth implementation. This study explored these services\' organisational readiness regarding telehealth guidelines implementation and staff training.
A cross-sectional online survey exploring available telehealth guidelines and staff training was distributed among UK AHPs and AHP service managers between May and June 2021.
658 participants answered the survey (119 managers and 539 clinicians). Most services, in which telehealth was in place, had implemented telehealth guidelines (clinicians, 64%; managers, 82%), with most guidelines produced by the NHS staff who use them for their consultations. Most clinicians reported that guidelines had ambiguous areas (e.g., regarding protection from litigation and dealing with emergencies), whereas most managers reported the opposite opinion. Guidelines most frequently reported on appropriate telehealth technology and environment for staff and patients, while recommended consultation length and how to conduct telehealth with certain population groups were least reported. Clinicians lacked training in most telehealth aspects, while managers reported that staff training focused on telehealth software and hardware. For both clinicians and managers, training is needed on how to deal with emergencies during telehealth.
UK NHS AHP services are not fully equipped with clear and comprehensive guidelines and the skills to deliver telehealth. Vulnerable people are excluded from current guidelines, which may widen health inequalities and hinder the success of the NHS digital transformation. The absence of national guidelines highlights the need for uniform AHP telehealth guidelines.

BACKGROUND: When a new guideline is published  there is a need to understand how its recommendations can best be implemented in real-world practice. Yet, guidelines are often published with little to no roadmap for organizations to follow to promote adherence to their recommendations. The purpose of this study was to evaluate the impact of using a common process model to implement a single clinical practice guideline across multiple physical therapy clinical settings.
METHODS: Five organizationally distinct sites with physical therapy services for patients with peripheral vestibular hypofunction participated. The Knowledge to Action model served as the foundation for implementation of a newly published guideline. Site leaders conducted preliminary gap surveys and face-to-face meetings to guide physical therapist stakeholders\' identification of target-behaviors for improved guideline adherence. A 6-month multimodal implementation intervention included local opinion leaders, audit and feedback, fatigue-resistant reminders, and communities of practice. Therapist adherence to target-behaviors for the 6 months before and after the intervention was the primary outcome for behavior change.
RESULTS: Therapist participants at all sites indicated readiness for change and commitment to the project. Four sites with more experienced therapists selected similar target behaviors while the fifth, with more inexperienced therapists, identified different goals. Adherence to target behaviors was mixed. Among four sites with similar target behaviors, three had multiple areas of statistically significantly improved adherence and one site had limited improvement. Success was most common with behaviors related to documentation and offering patients low technology resources to support home exercise. A fifth site showed a trend toward improved therapist self-efficacy and therapist behavior change in one provider location.
CONCLUSIONS: The Knowledge to Action model provided a common process model for sites with diverse structures and needs to implement a guideline in practice. Multimodal, active interventions, with a focus on auditing adherence to therapist-selected target behaviors, feedback in collaborative monthly meetings, fatigue-resistant reminders, and developing communities of practice was associated with long-term improvement in adherence. Local rather than external opinion leaders, therapist availability for community building meetings, and rate of provider turnover likely impacted success in this model.
BACKGROUND: This study does not report the results of a health care intervention on human participants.

暂无摘要。

BACKGROUND: Back pain is one of the most common reasons for a person to call an ambulance service, yet how ambulance services manage back pain has not been described.
METHODS: Australian-state and New Zealand ambulance service jurisdiction websites were searched between 25th January to 3rd February 2022. Pain management guidelines were included where no specific back pain guideline was found. Identified guidelines were screened, appraised using AGREE II tool and recommendations on pharmacological and non-pharmacological management of back pain, ambulance transport and alerting features were extracted, summarised, and compared to two primary care guidelines.
RESULTS: Nine guidelines were identified including four back pain and 5 pain management guidelines. All four back pain guidelines recommend paracetamol or ibuprofen as analgesic options to manage back pain. These guidelines recommend transport to the emergency department when there are alerting features for serious disease, lack of pain control or where the patient is unable to ambulate. 2 out of 9 ambulance guidelines were recommended for use in their existing format following quality appraisal using AGREE II tool. Ambulance guidelines scored significantly lower than primary care guidelines for back pain.
CONCLUSIONS: Ambulance service guidelines for back pain recommend advice, reassurance, paracetamol and referral to primary care.

A clinical practice guideline on Parkinson disease was developed by an American Physical Therapy Association volunteer guideline development group that consisted of physical therapists and a neurologist. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches for management of Parkinson disease. The Spanish version of this clinical practice guideline is available as a supplement (Suppl. Appendix 1).

This study developed guidelines for psychological first aid. This guideline promotes core response and disaster capabilities for disaster mental-health professionals, such as mental-health nurses and counseling psychologists at disaster sites. A research team composed of a first-aid professor and counseling psychology professor developed this psychological first-aid guideline to promote the psychological response required at disaster sites. The team verified each question\'s content adequacy at each guideline-development stage to determine the appropriateness of response to a disaster. The PFA performance stage and achievement objectives were moved to the next stage only when the research team fully agreed upon them. This guideline revised and supplemented the six steps suggested in the handbook to five steps through expert meetings. The modified part was made into one step, without separating the first rapport formation and safety check. The checklist for evaluation was developed after verification by a total of four people, including one emergency-rescue-department professor, one counseling psychology professor, one paramedic, and one health educator. Based on previous studies, the cutting point is 24 points. The final completed psychological first aid consists of five stages: rapport formation and safety verification, psychological stabilization, information collection, problem resolution, and recovery, with details to be carried out at each step. These guidelines contribute to the promotion of disaster-response capabilities of disaster psychologists. Continuous training and practical exercises based on the five stages will provide fundamental data for a disaster-simulation psychological-first-aid educational development.