The Experts below are selected from a list of 3357 Experts worldwide ranked by ideXlab platform
Regina Kulier - One of the best experts on this subject based on the ideXlab platform.
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cephalic version by Postural Management for breech presentation
Cochrane Database of Systematic Reviews, 2012Co-Authors: Justus G Hofmeyr, Regina KulierAbstract:Background Babies with breech presentation (bottom first) are at increased risk of complications during birth, and are often delivered by caesarean section. The chance of breech presentation persisting at the time of delivery, and the risk of caesarean section, can be reduced by external cephalic version (ECV - turning the baby by manual manipulation through the mother's abdomen). It is also possible that maternal posture may influence fetal position. Many Postural techniques have been used to promote cephalic version. Objectives The objective of this review was to assess the effects of Postural Management of breech presentation on measures of pregnancy outcome. We evaluated procedures in which the mother rests with her pelvis elevated. These include the knee-chest position, and a supine position with the pelvis elevated with a wedge-shaped cushion. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (22 August 2012). Selection criteria Randomised and quasi-randomised trials comparing Postural Management with pelvic elevation for breech presentation, with a control group. Data collection and analysis One or both review authors assessed eligibility and trial quality. Main results We have included six studies involving a total of 417 women. The rates for non-cephalic births, Cesarean section and Apgar scores below 7 at one minute, regardless of whether ECV was attempted or not, were similar between the intervention and control groups (risk ratio (RR) 0.98; 95% confidence interval (CI) 0.84 to 1.15; RR 1.10; 95% CI 0.89 to 1.37; RR 0.88; 95% CI 0.50 to 1.55). Authors' conclusions There is insufficient evidence from well-controlled trials to support the use of Postural Management for breech presentation. The numbers of women studied to date remain relatively small. Further research is needed.
Justus G Hofmeyr - One of the best experts on this subject based on the ideXlab platform.
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cephalic version by Postural Management for breech presentation
Cochrane Database of Systematic Reviews, 2012Co-Authors: Justus G Hofmeyr, Regina KulierAbstract:Background Babies with breech presentation (bottom first) are at increased risk of complications during birth, and are often delivered by caesarean section. The chance of breech presentation persisting at the time of delivery, and the risk of caesarean section, can be reduced by external cephalic version (ECV - turning the baby by manual manipulation through the mother's abdomen). It is also possible that maternal posture may influence fetal position. Many Postural techniques have been used to promote cephalic version. Objectives The objective of this review was to assess the effects of Postural Management of breech presentation on measures of pregnancy outcome. We evaluated procedures in which the mother rests with her pelvis elevated. These include the knee-chest position, and a supine position with the pelvis elevated with a wedge-shaped cushion. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (22 August 2012). Selection criteria Randomised and quasi-randomised trials comparing Postural Management with pelvic elevation for breech presentation, with a control group. Data collection and analysis One or both review authors assessed eligibility and trial quality. Main results We have included six studies involving a total of 417 women. The rates for non-cephalic births, Cesarean section and Apgar scores below 7 at one minute, regardless of whether ECV was attempted or not, were similar between the intervention and control groups (risk ratio (RR) 0.98; 95% confidence interval (CI) 0.84 to 1.15; RR 1.10; 95% CI 0.89 to 1.37; RR 0.88; 95% CI 0.50 to 1.55). Authors' conclusions There is insufficient evidence from well-controlled trials to support the use of Postural Management for breech presentation. The numbers of women studied to date remain relatively small. Further research is needed.
Terry Pountney - One of the best experts on this subject based on the ideXlab platform.
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the development and implementation of an integrated care pathway for 24 hour Postural Management a study of the views of staff and carers
Physiotherapy, 2006Co-Authors: Ginny Humphreys, Terry PountneyAbstract:Objectives Children and young adults with moderate or severe motor impairment are at risk of developing contractures and deformities. In North Devon, an integrated care pathway (ICP) was written by a multidisciplinary group from within the paediatric and adult learning disability services to improve the provision of 24-hour Postural Management for this client group. Staff and carers’ views were sought to investigate the effects of being involved in developing an ICP, and to explore perceptions of the difference that the ICP has made to practice. Design A qualitative methodology using focus groups. Results There has been significant learning, closer team working and an increase in clinical reasoning skills and staff confidence. The rich data collected revealed the extent of the feelings of ownership, sense of achievement and pride in the project. Producing a written ICP has been more helpful than simply meeting to discuss how to improve service delivery. The changes in practice are thought to be beneficial and may improve outcomes. Conclusions The process of developing an ICP has had a positive effect on staff in terms of their clinical practice and team working. The perception of staff and carers is that the service to this client group has been improved. © 2006 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Hull K - One of the best experts on this subject based on the ideXlab platform.
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PATCH: Posture and mobility training for care staff versus usual care in care homes: Study protocol for a randomised controlled trial
'Springer Science and Business Media LLC', 2019Co-Authors: Graham L, Cicero R, Clarke D, Cundill B, Ellwood A, Farrin A, Fisher J, Goodwin M, Hawkins R, Hull KAbstract:This is the final published version, also available from BMC via the DOI in this record.Background: Residents of care homes have high levels of disability and poor mobility, but the promotion of health and wellbeing within care homes is poorly realised. Residents spend the majority of their time sedentary which leads to increased dependency and, coupled with poor Postural Management, can have many adverse outcomes including pressure sores, pain and reduced social interaction. The intervention being tested in this project (the Skilful Care Training Package) aims to increase the awareness and skills of care staff in relation to poor posture in the older, less mobile adult and highlight the benefits of activity, and how to skilfully assist activity, in this group to enable mobility and reduce falls risk. Feasibility work will be undertaken to inform the design of a definitive cluster randomised controlled trial. Methods: This is a cluster randomised controlled feasibility trial, aiming to recruit at least 12-15 residents at each of 10 care homes across Yorkshire. Care homes will be randomly allocated on a 1:1 basis to receive either the Skilful Care Training Package alongside usual care or to continue to provide usual care alone. Assessments will be undertaken by blinded researchers with participating residents at baseline (before care home randomisation) and at three and six months post randomisation. Data relating to changes in physical activity, mobility, posture, mood and quality of life will be collected. Data at the level of the home will also be collected and will include staff experience of care and changes in the numbers and types of adverse events residents experience (for example, hospital admissions, falls). Details of NHS service usage will be collected to inform the economic analysis. An embedded process evaluation will explore intervention delivery and its acceptability to staff and residents. Discussion: Participant uptake, engagement and retention are key feasibility outcomes. Exploration of barriers and facilitators to intervention delivery will inform intervention optimisation. Study results will inform progression to a definitive trial and add to the body of evidence for good practice in care home research. Trial registration: ISRCTN Registry, ISRCTN50080330. Registered on 27 March 2017.Chartered Society of Physiotherapy (CSP) Charitable Trus
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PATCH: posture and mobility training for care staff versus usual care in care homes: study protocol for a randomised controlled trial
'Springer Science and Business Media LLC', 2018Co-Authors: Graham L, Cicero R, Clarke D, Cundill B, Ellwood A, Farrin A, Fisher J, Goodwin M, Hawkins R, Hull KAbstract:Background: Residents of care homes have high levels of disability and poor mobility, but the promotion of health and wellbeing within care homes is poorly realised. Residents spend the majority of their time sedentary which leads to increased dependency and, coupled with poor Postural Management, can have many adverse outcomes including pressure sores, pain and reduced social interaction. The intervention being tested in this project (the Skilful Care Training Package) aims to increase the awareness and skills of care staff in relation to poor posture in the older, less mobile adult and highlight the benefits of activity, and how to skilfully assist activity, in this group to enable mobility and reduce falls risk. Feasibility work will be undertaken to inform the design of a definitive cluster randomised controlled trial. Methods: This is a cluster randomised controlled feasibility trial, aiming to recruit at least 12–15 residents at each of 10 care homes across Yorkshire. Care homes will be randomly allocated on a 1:1 basis to receive either the Skilful Care Training Package alongside usual care or to continue to provide usual care alone. Assessments will be undertaken by blinded researchers with participating residents at baseline (before care home randomisation) and at three and six months post randomisation. Data relating to changes in physical activity, mobility, posture, mood and quality of life will be collected. Data at the level of the home will also be collected and will include staff experience of care and changes in the numbers and types of adverse events residents experience (for example, hospital admissions, falls). Details of NHS service usage will be collected to inform the economic analysis. An embedded process evaluation will explore intervention delivery and its acceptability to staff and residents. Discussion: Participant uptake, engagement and retention are key feasibility outcomes. Exploration of barriers and facilitators to intervention delivery will inform intervention optimisation. Study results will inform progression to a definitive trial and add to the body of evidence for good practice in care home research. Trial registration: ISRCTN Registry, ISRCTN50080330. Registered on 27 March 2017
Ginny Humphreys - One of the best experts on this subject based on the ideXlab platform.
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the development and implementation of an integrated care pathway for 24 hour Postural Management a study of the views of staff and carers
Physiotherapy, 2006Co-Authors: Ginny Humphreys, Terry PountneyAbstract:Objectives Children and young adults with moderate or severe motor impairment are at risk of developing contractures and deformities. In North Devon, an integrated care pathway (ICP) was written by a multidisciplinary group from within the paediatric and adult learning disability services to improve the provision of 24-hour Postural Management for this client group. Staff and carers’ views were sought to investigate the effects of being involved in developing an ICP, and to explore perceptions of the difference that the ICP has made to practice. Design A qualitative methodology using focus groups. Results There has been significant learning, closer team working and an increase in clinical reasoning skills and staff confidence. The rich data collected revealed the extent of the feelings of ownership, sense of achievement and pride in the project. Producing a written ICP has been more helpful than simply meeting to discuss how to improve service delivery. The changes in practice are thought to be beneficial and may improve outcomes. Conclusions The process of developing an ICP has had a positive effect on staff in terms of their clinical practice and team working. The perception of staff and carers is that the service to this client group has been improved. © 2006 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.