Science-Based and Practice-Based Innovativeness and Performance of Substance Abuse Treatment Facilities.

Science-based and practice-based innovativeness and performance of substance abuse treatment facilities.

Filed under: Rehab Centers

Health Care Manage Rev. 2013 Jan 25;
Nayar P, Yu F, Apenteng B

BACKGROUND:: The fields of mental health and substance abuse treatment lag significantly behind other health care organizational fields in the adoption, implementation, and dissemination of evidence-based practices. Innovative organizational practices may be science based or practice based. The implementation of innovative practices requires considerable organizational resources. Whether this organizational investment actually pays off in terms of superior performance is unclear. This issue in the context of substance abuse treatment facilities (SATFs) in the United States is examined in this study. PURPOSE:: The purpose of this study is to examine the influence of the use of innovative organizational practices, both science based (psychosocial interventions) and practice based, on the organizational performance of SATFs. METHODOLOGY/APPROACH:: The study uses cross-sectional data on 13,513 SATFs in the United States, obtained from the National Survey of Substance Abuse Treatment Services 2009 database. FINDINGS:: Multinomial logistic regression models find a positive association between the use of science-based innovations and practice-based innovations and organizational performance, that is, the provision of comprehensive (core and wraparound) services. SATFs that were located in metropolitan areas, those accredited by the Commission on Accreditation of Rehabilitation Facilities and Joint Commission, that had a mixed (Substance Abuse and Mental Health) focus or were recipients of earmark funds also had higher organizational performance. PRACTICE IMPLICATIONS:: The results signify that substance abuse facilities that are high innovators in terms of implementing science based and practice-based innovative practices have higher organizational performance. Organizations that have institutionalized these practices have invested considerable resources in innovation. The shown higher organizational performance provides justification for the organizational investment in innovation.
HubMed – rehab

 

Detrusor botulinum toxin A injection significantly decreased urinary tract infection in patients with traumatic spinal cord injury.

Filed under: Rehab Centers

Spinal Cord. 2013 Jan 29;
Jia C, Liao LM, Chen G, Sui Y

Study design:The study was designed as a single-arm clinical trial.Objectives:To investigate the effect of detrusor botulinum toxin A (BoNTA) injection on urinary tract infection (UTI) in patients with spinal cord injury (SCI).Setting:The study was performed in a national rehabilitation research center of China.Methods:Between September 2010 and May 2012, 41 male inpatients with neurogenic detrusor overactivity (NDO) caused by traumatic SCI, mean age 36.0±8.8 years, duration of SCI since inclusion 21.5±17.3 months, received an injection of 300?U BoNTA into detrusor. Before and 3 months after injection, each patient kept a bladder diary, underwent video-urodynamic investigation and urine culture. All UTIs occurring in the 6 months before and the 6 months after injection were recorded.Results:Before injection, the mean number of UTI over 6 months was 1.39±1.36. After injection, the mean significantly decreased to 0.78±0.96 (P=0.023). The mean maximum detrusor pressure during filling decreased significantly in the patients of detrusor overactivity (n=24) compared with patients of normo-active detrusor (n=17) after injection (35.4±12.2 vs 20.9±7.9?cmH(2)O, P=0.000), meantime, the decrease of UTI was significant in the former (1.29±1.21 vs 0.41±0.62?cmH(2)O, P=0.015) while no significant in the latter (1.46±1.47 vs 1.04±1.08, P=0.319).Conclusion:Detrusor BoNTA injection significantly decreased UTI in SCI patients with NDO. This effect seems to be related to the decrease of detrusor pressure.Spinal Cord advance online publication, 29 January 2013; doi:10.1038/sc.2012.180.
HubMed – rehab

 

Determinants and consequences for standing balance of spontaneous weight-bearing on the paretic side among individuals with chronic stroke.

Filed under: Rehab Centers

Gait Posture. 2013 Jan 25;
Mansfield A, Danells CJ, Zettel JL, Black SE, McIlroy WE

Hemiparetic stroke patients commonly bear more weight on the non-paretic side which seems intuitively linked to unilateral control deficits. However, there is evidence that some post-stroke favour weighting the paretic side, which may be problematic given altered capacity of the paretic limb to contribute to the control of upright posture. This study explores the prevalence and clinical determinants of stance asymmetry, and the relationship between stance asymmetry and postural control among chronic stroke patients. Subjects (n=147; >6 months post-stroke) stood on two force plates in eyes-open and eyes-closed conditions; 59 were symmetric, 18 had paretic asymmetry (PA), and 70 had non-paretic asymmetry (NPA). Root mean square (RMS) of antero-posterior and medio-lateral centre-of-pressure under each limb and both limbs combined were compared. RMS of total medio-lateral centre-of-pressure was greater for both asymmetric groups compared with the symmetric group. PA subjects relied less on the loaded limb for control than NPA subjects and relied more on visual information for postural control than those who were symmetric. There were no differences in the characteristics of individuals between the PA and NPA groups. The loading of the paretic limb was not related to impaired postural control during stationary standing which was attributable, in part, to individuals relying on control from the non-paretic limb, in spite of lower vertical load, and a greater dependence on visual contributions. There was no evidence that greater loading on the paretic limb was related to persisting dyscontrol but may rather reflect a learned strategy.
HubMed – rehab

 

Reliability of principal components and discrete parameters of knee angle and moment gait waveforms in individuals with moderate knee osteoarthritis.

Filed under: Rehab Centers

Gait Posture. 2013 Jan 25;
Robbins SM, Astephen Wilson JL, Rutherford DJ, Hubley-Kozey CL

Gait measures are used to evaluate change in patients with knee osteoarthritis (OA), but reliability has not been fully established in this population. This study examined test-retest reliability of knee angle and moment gait waveform characteristics captured using discrete parameters and principal component analysis (PCA) in individuals with moderate knee OA. Participants (n=20) underwent three-dimensional gait analysis on two occasions. Motion and force data were captured using two camera banks, infrared light emitting diodes and force plate during self-selected walking. Knee angle and moment waveforms were calculated and analyzed using discrete parameters and by identifying waveform characteristics using PCA. Intraclass correlation coefficients (ICC(2,k)) examined test-retest reliability of discrete parameters and PCA derived scores (PC-scores). ICC(2,k) values ranged from 0.57 to 0.93 for discrete parameters, 0.52-0.86 for knee angle PC-scores and 0.30-0.94 for the knee moment PC-scores. However, 10 of 13 discrete parameters, six of nine knee angle PC-scores and seven of nine knee moment PC-scores had ICC(2,k) values greater than or equal to 0.70. Discrete parameters and PC-scores from flexion angles and adduction moments had the highest ICC(2,k) values while adduction angles, rotation angles, and rotation moments had the lowest. Most knee angle and moment waveform characteristics demonstrated ICC(2,k) values that could be interpreted as acceptable. Caution should be used when examining adduction and rotation angle magnitudes and early/mid-stance rotation moment magnitudes due to lower ICC(2,k) values.
HubMed – rehab

 

More Rehab Centers Information…