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WCPT report : the role of physical therapists in disaster management

SKELTON, Peter
SYKES, Catherine
et al
March 2016

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This report has two main aims: to highlight the need for physical therapist involvement in disaster management and particularly in Emergency Medical Teams (EMTs); and to brief physical therapists who want to work in the field, and national and international agencies who are already working in the field. Following an introduction to the topic of disasters, the paper outlines in separate sections the three phases of disaster management most relevant to physical therapists: preparedness; response; and recovery. Each section includes information on the role of physical therapists and details guidelines and resources to support practice in disaster management. Case studies include: Nepal, 2015 April earthquake; 2011- great East Japan earthquake; integration of rehabilitation professionals into the UK Emergency Medical Team; Nepal, 2011 onwards; Phillipines, typhoon Sendong, 2011;  Phillipines, typhoon Haiyan, November 2013; Haiti, 2011- physical therapy in post-earthquake recovery and reconstruction; Pakistan, earthquake Oct 2005; Phillipines, typhoon Bopha 2012-2013.

Living in hell : how people with mental health conditions in Indonesia are treated

HUMAN RIGHTS WATCH (HRW)
March 2016

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This report examines the abuses—including pasung—that persons with psychosocial disabilities face in the community, mental hospitals, and various other institutions in Indonesia, including stigma, arbitrary and prolonged detention, involuntary treatment, and physical and sexual violence. It also examines the government’s shortcomings in addressing these problems.

Based on research across the Indonesian islands of Java and Sumatra, Human Rights Watch documented 175 cases of persons with psychosocial disabilities in pasung or who were recently rescued from pasung. 

 

Living in hell : abuses against people with psychosocial disabilities in Indonesia

HUMAN RIGHTS WATCH (HRW)
March 2016

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This article with a video is related to a report examining the abuses—including pasung—that persons with psychosocial disabilities face in the community, mental hospitals, and various other institutions in Indonesia, including stigma, arbitrary and prolonged detention, involuntary treatment, and physical and sexual violence. It also examines the government’s shortcomings in addressing these problems.

Based on research across the Indonesian islands of Java and Sumatra, Human Rights Watch documented 175 cases of persons with psychosocial disabilities in pasung or who were recently rescued from pasung. 

 

Evaluation of the feasibility and acceptability of the ‘Care for Stroke’ intervention in India, a smartphone-enabled, carer-supported, educational intervention for management of disability following stroke

SURESHKUMAR, K
MURTHY, G V S
NATARAJAN, S
GOENKA, S
KUPER, H
February 2016

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This study aimed to identify operational issues encountered by study participants in using the ‘Care for Stroke’ intervention and to evaluate the feasibility and acceptability of the intervention. ‘Care for Stroke’ is a smartphone-enabled, educational intervention for management of physical disabilities following stroke. It is delivered through a web-based, smartphone enabled application (app). It includes inputs from stroke rehabilitation experts in a digitised format. Sixty stroke survivors discharged from hospital in Chennai, South India, and their caregivers participated in the study. The preliminary intervention was field-tested with 30 stroke survivors for 2 weeks. The finalised intervention was provided to a further 30 stroke survivors to be used in their homes with support from their carers for 4 weeks. Field-testing identified operational difficulties related to connectivity, video-streaming, picture clarity, quality of videos, and functionality of the application. Assessment was carried out by direct observation and short interview questionnaires. 

 

 

Dengue fever

PACIFIC MEDICAL TRAINING
2016

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Symptoms of dengue fever, dengue hemorrhagic fever and dengue hemorrhagic shock are listed. The epidemiology of dengue is outlined and a map shows countries where there is risk of dengue infection worldwide. Precautions to prevent dengue and what to do if you contract dengue whilst travelling are outlined.    

Community-based rehabilitation in a post-soviet environment in Azerbaijan : where society meets ideology

BURCHELL, Gwen
2015

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This paper explores UAFA’s experience, since 2002, in working with Azerbaijani stakeholders to move from the medical approach to disability, propagated by the Soviet model of planning and implementation, to a social, community-based approach. The paper highlights the common misconceptions and how these can be overcome, including the policy gaps that challenge effective implementation.

 

The importance of creating and maintaining a core team is discussed, alongside the process that UAFA has developed for building up teams of CBR workers. Finally, the paper raises the issue of introducing outcomes-based evaluation in a society that has no such prior experience, followed by an account of the continual challenge faced by most programmes–namely, how to achieve sustainable funding.

 

 

Disability, CBR and Inclusive Development, Vol 26, No 3

Towards a Core Set of Clinical Skills for Health-Related Community Based Rehabilitation in Low and Middle Income Countries

O’Dowd, Jessica
MacLachlan, Malcolm
Khasnabis, Chapal
Geiser, Priscille
2015

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Purpose: This research aims to identify a core set of clinical skills for working in a Community Based Rehabilitation (CBR) setting, and to discuss whether they are appropriate for task shifting to a new or an alternative cadre of rehabilitation workers.

 

Methods: The study focussed on work activities relating to the health component of the CBR Matrix. 40 health professionals working in CBR in Low and Middle Income Countries (LMIC) were surveyed to discover the clinical skills that were used most frequently during the past 3 months and to determine which of these skills were deemed most important in a CBR setting.

 

Results: A core set of clinical skills for health-related CBR work in LMIC were identified: advocacy and sensitisation; assessment, monitoring and reporting; behavioural and cognitive interventions; collaboration and referral; communication; continuing professional development; education; gait training; group work; home-based rehabilitation; manual therapy; neurofacilitation techniques; positioning; prescription of strengthening exercises; prescription of stretching programmes; provision of aids, assistive devices and technologies; psychosocial support; recreational therapy; self-care; sensory interventions; supervision; upper body rehabilitation; vocational rehabilitation and working with families.

 

Conclusions: It is possible to identify a core set of health-related CBR skills. These may be considered in the development of training programmes for new or alternative cadres of CBR workers, using a task-shifting model including appropriate support, supervision and referral mechanisms.

Implications: Further research is required to establish the generalisability of the skills sets identified here, both across contexts and different client groups and their needs. The identification of core sets of skills for other areas of the CBR Matrix - livelihood, social, empowerment and education – could similarly facilitate access to these domains for people with disabilities.

Rehabilitation in sudden onset disasters

SKELTON, Pete
HARVEY, Alice
September 2015

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The role of rehabilitation professionals in responding to Sudden Onset Disasters (SODs) is evolving rapidly, and our professions increasingly find themselves at the forefront of emergency response teams. At the same time, there is a movement towards the professionalisation of the humanitarian response sector, in particular Emergency Medical Teams, and a recognition that specialist training is required to prepare professionals for work in an austere humanitarian environment. The intended audience of the manual are physiotherapists and occupational therapists who may deploy to provide rehabilitation in the immediate aftermath of a sudden onset disaster. It was developed to support volunteers on the UK International Emergency Trauma Register (UKIETR), but with the aim of being relevant to all rehabilitation professionals interested in rapid deployment to austere environments. The content is restricted to the context of sudden onset disasters such as an earthquake or tsunami, and has been developed to support work in an austere environment, where the type of equipment and support that is normally available has been disrupted. UKIETR professionals are UK based volunteers who receive specialist training to prepare them for international deployment as part of team in response to emergencies. They may be deployed within a multi-disciplinary foreign medical team in a field hospital scenario, or as part of a more specialist ‘cell’ offering niche medical, surgical or rehabilitation services. The manual is designed to complement the three day core rehabilitation training run by Handicap International which all UKIETR members must attend. It is a clinical manual, and the contents are directly linked to modules taught on the core training course. In addition there are a number of ‘cheat sheets’ and patient education resources at the back of the manual which are designed to be used in the field. Chapters include: rehabilitation and the UKIETR; introduction to rehabilitation following sudden onset disasters; amputee rehabilitation; spinal cord injury; peripheral nerve injury; fractures; burns and soft tissue injury; and acquired brain injury

Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq : a randomized household cluster survey

LAFTA, Riyadh
et al
August 2015

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“The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad.” The quantitative study shows the methodology used in the collection of data, the findings discovered through evaluation of the data gathered, and interpretation of how to best use those findings to serve specific populations”

 

 PLOS ONE, 10(8)

The need for a rehabilitation model to address the disparities of public healthcare for people living with HIV in South Africa

CHETTY, Verusia
HANASS-HANCOCK, Jill
June 2015

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This article advocates for the development and implementation of a model of care to guide rehabilitation of people living with HIV in South Africa. The paper begins by presenting the emerging evidence of rehabilitation in the context of HIV, and goes on to identify appropriate steps to develop a model of care based on this that would be applicable to South Africa

African Journal of Disability 4(1), Art. #137

Effects of Motor Imagery on Upper Extremity Functional Task Performance and Quality of Life among Stroke Survivors

RAJESH, T
2015

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Purpose: To assess the effects of Motor Imagery programme on upper extremity functional task performance and quality of life among stroke survivors.

 

Method: Thirty people who were diagnosed with stroke, were selected from the Department of Occupational Therapy, SVNIRTAR, Odisha, India, and consecutively assigned to control (n=15) and experimental (n=15) groups. The control group received conventional occupational therapy only, and the experimental group received conventional occupational therapy combined with Motor Imagery programme. Upper Extremity Motor Activity Log (UE-MAL) and Stroke Specific Quality Of Life Questionnaire (SSQOL) were used for assessment, before and after the intervention.

 

Results: The experimental group showed significant improvement compared to the control group (P<.004 & P<.001). The implication is that there is a good relationship between upper extremity functional task performance and quality of life (r= 0.928).

 

Conclusions: The Motor Imagery programme is a simple and very cost-effective treatment used in Occupational Therapy practice. It can be easily taught and learnt. The study concludes that Motor Imagery programme is effective in improving upper extremity functional task performance and quality of life among stroke survivors.

How rehabilitation can help people living with HIV in Sub-Saharan Africa : an evidence-informed tool for rehab providers

Canadian Working Group on HIV and Rehabilitation
University of Toronto
University of Zambia
March 2015

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The aim of this e-module (or pdf) is to enhance knowledge about HIV care among rehabilitation providers in Sub-Saharan Africa (SSA) to help address the needs of people living with HIV. The resource is divided into 5 sections: the role of rehabilitation in the context of HIV in SSA; what rehabilitation providers need to know about HIV in SSA; rehabilitation interventions that can help people living with HIV in SSA; what rehabilitation providers need to know about caring for children and youth living with HIV in SSA; concepts and tools for measuring rehabilitation outcomes in HIV in SSA. This current resource is a comprehensive adaptation of the 2014 Canadian e-Module for rehabilitation providers in Sub-Saharan Africa which was developed from "A Comprehensive Guide for the Care of Persons with HIV Disease (Module 7)", published by Health Canada and the Wellesley Central Hospital, Toronto, Canada, published in 1998.

Physiotherapy exercises for people with spinal cord injuries and other neurological conditions

MESSENGER, Peter
2015

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This website allows users to search for exercises appropriate for people with spinal cord injuries and other neurological conditions. Users can select exercises, save exercises into booklets and can access previously created booklets. This website is useful for physiotherapists, occupational therapists and other rehabilitation professionals
Note: users must be logged on to the website to save exercises into booklets and to access previously created booklets. Recommend that first time users review first time user information prior to logging on

Why should rehabilitation be integrated into health systems?

HANDICAP INTERNATIONAL
2015

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This advocacy briefing paper presents information about the importance of rehabilitation being integrated into health systems. It highlights a brief overview and definition of rehabilitation, and related key health facts and issues such as lack of access to rehabilitation, the value of rehabilitation and legal frameworks. It provides recommendations for stakeholders and suggests ways to measure progress

Advocacy briefing paper

A home-based rehabilitation intervention for people living with HIV and disability in a resource-poor community, KwaZulu-Natal : study protocol for a randomized controlled trial

COBBING, Saul
HANASS-HANCOCK, Jill
MYEZWA, Hellen
2015

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In this paper, the researchers develop a needs-based home-based rehabilitation programme for people living with HIV in order to improve their quality of life and functional ability. The study aims to  provide rehabilitation professionals and researchers with evidence that can be utilised to improve existing rehabilitation interventions for people living with HIV.

The paper outlines a randomised control trial to test the programme, to be conducted at a public hospital in KwaZulu-Natal, South Africa. The trial will assess the participants’ quality of life, perceived level of disability, functional ability and endurance

Trials 16:491

Human Rights

www.macao-tz.org
December 2014

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Malezi AIDS Care Awareness Organization (MACAO) is a non-profit organization reaching out to neglected Indigenous people in Ngorongoro District, Arusha Region of Northern Tanzania.  Macao founded in 2003, Macao is a humanitarian organization that provides assistance to approximately 200,000 Indigenous Maasai community in Ngorongoro district for addressing needs of water and sanitation, food security, health Care Research, Education, Research environment, Maasai Traditional Research, Human Rights and sustainable economic development by strengthening their livelihoods.  In addition to responding to major relief situations, MACAO focuses on long-term community development through over 4 Area Development Project. We welcome the donors and volunteers to join us in this programs, we are wolking in ruro villages.

Access to services for women with disabilities who experienced violence

MANDL, Sabine
et al
October 2014

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This final short report summary encompasses the main findings of the Daphne III project “Access to Specialised Victim Support Services for Women with Disabilities who have experienced Violence.” The project aimed to assess the range of different experiences of violence against disabled women and their use of support structures. In addition specialised victim support services were interviewed about their experiences and capabilities in terms of counselling and accommodating disabled women. The project focused on three components: (1) Assessing the legal and policy framework (2) Generating extensive empirical data by surveying disabled or Deaf women (focus group discussions, in-depth-interviews) and service providers (online survey, interviews with staff members) and (3) Developing good practice examples and recommendations. For each component national reports and an associated comparative report was prepared, identifying the most prominent issues including the commonalities and differences between the four countries issues.

 

 

Predictors of voluntary HIV counselling and testing services utilization among people with disabilities in Addis Ababa, Ethiopia

ADEREMI, Toyin Janet
et al
June 2014

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“The study investigated HIV testing prevalence and factors associated with the utilization of voluntary HIV counselling and testing (VCT) services among individuals with disabilities in Addis Ababa. The analysis was based on a survey of 209 men and 203 women with disabilities, aged 15–49, who had ever heard about HIV and AIDS in four sub-cities in Addis Ababa. HIV testing prevalence was 53.2%, with no significant difference between males and females. Comprehensive HIV knowledge, living with spouse, and religious affiliations positively predicted utilization of VCT services among participants. Living with both parents and having physical or mental/intellectual disabilities were negative predictors of VCT services utilization. More research on the predictors of utilization of VCT services by gender and urban/rural divides are needed among people with disabilities”

AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, Vol 26, Issue 10

Generation and Content Validation of Mobility Domains and Item Pool for Community-dwelling Individuals

MANIKANDAN, N
KUMAR, K B
RAJASHEKHAR, B
2014

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Mobility disability can affect a wide range of activities, from difficulty in turning in bed to problems of riding a vehicle. The existing scales do not include all the relevant items for mobility within the community. There is therefore a strong need to develop a scale with items which are comprehensive and culturally relevant to community-dwelling individuals.

 

Purpose: This study was conducted to generate the mobility domains and item pool for community-dwelling individuals, and to validate the content.

 

Method: The method includedextensive research into literature on existing mobility scales, and direct interviews with 20 persons with chronic mobility disability who livewithin their community. The generated items were grouped under the relevant domains and subjected to content validation by 10 experts. Items were judged on the basis of relevance, and acceptance of the item or domain was conditional on a 70% minimum level of agreement between the experts.

 

Results: Ninety-nine items and 14 domains were generated by the literature search and direct interviews. The items were grouped under the 14 domains, according to their relevance and purpose. Content validation resulted in the elimination of 44 items and 5 domains as per the criteria for agreement. Items and domains were also modified to improve relevance and reduce ambiguity.

 

Conclusion: A comprehensive mobility item pool for community-dwelling individuals, with items ranging from simple to the most challenging tasks under the proposed domains, has been generated and content validated. The development of a new mobility disability scale which uses these items, and evaluation of its psychometric properties is recommended.

Evolution of community physiotherapy in India

RAJAN, Pavithra
2014

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Despite the urgent need for physiotherapy services for underprivileged communities, Community Physiotherapy is not a sought-after specialisation in India. Physiotherapists tend to serve in institutions rather than at community level, as a result of which this field of healthcare has stagnated. This article, based on an interview with one of the country’s eminent community physiotherapists, gives a first person account of the evolution of community physiotherapy in India and provides qualitative inputs to deal with the prevalent issues. While the need for services has increased, there has been no matching growth in the pool of physiotherapists willing to work in the community. Several recommendations have been made, including changes in approach to community physiotherapy by both physiotherapists as well as community organisations in India.

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