Browsing by Author "Grimmer-Somers, Karen"

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    Assessment for incipient hospital-acquired deconditioning in acute hospital settings : a systematic literature review
    (Medical Journals Sweden AB, 2019) Gordon, Susan; Grimmer-Somers, Karen; Barras, Sarah
    Objectives: To systematically identify literature reporting on assessment instruments relevant for incipient hospital-acquired deconditioning during acute hospital admissions; evaluate their psychometric properties; and identify individual assessment items to form the basis of a comprehensive acute hospital test battery for hospital-acquired deconditioning. Design and data sources: Systematic evidence scan of MEDLINE, CINAHL, PubMed and Google Scholar from database inception to January 2018. Study selection: Papers reporting psychometric properties of assessment instruments to detect change in body function and structure, relevant to hospital-acquired deconditioning were selected. Included instruments should assess one or more elements of hospital-acquired deconditioning, reflect the short time-frame constraints of acute hospital admissions, and be able to be applied by any healthcare provider. Quality evaluation: Evidence of psychometric properties and utility were assessed using a validated instrument. Data extraction: Hospital-acquired deconditioning assessment items. Results: Eight potentially-relevant instruments were identified, with moderate-to-good validity and utility, but limited evidence of reliability. These instruments reported a total of 53 hospital-acquired deconditioning assessment items. Seventeen items with measurement periods greater than 3 days were excluded. The remaining items measured anthropometrics, gait, balance, mobility, activities of daily living, and skin integrity. Conclusion: These assessment items provide the basis of a multifaceted evidence-based test battery to comprehensively and repeatedly assess acute hospital inpatient function for incipient hospital-acquired deconditioning.
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    The prevalence of low back pain in Africa : a systematic review
    (BioMed Central, 2007-11) Louw, Quinette A.; Morris, Linzette D.; Grimmer-Somers, Karen
    Background: Low back pain (LBP) is the most prevalent musculoskeletal condition and one of the most common causes of disability in the developed nations. Anecdotally, there is a general assumption that LBP prevalence in Africa is comparatively lower than in developed countries. The aim of this review was to systematically appraise the published prevalence studies conducted on the African continent to establish the prevalence of LBP in Africa. Methods: A comprehensive search was conducted in April 2006. The following databases PEDro, Psychinfo, Science Direct, SportsDiscus, PubMed, CINAHL, Biblioline Pro-African Wide NiPAD and SA ePublications were individually searched using specifically developed search strategies for epidemiological research conducted on LBP amongst the African population. Two reviewers independently evaluated the methodological quality of the studies reviewed. Results: A total of 27 eligible epidemiological studies were included in this review. The majority of the studies (63%) were conducted in South Africa (37%) and Nigeria (26%). The most common population group involved workers (48%), while scholars comprised 15% of the population. 67% of the studies were found to be methodologically sound, and the LBP prevalence of these were analyzed. The mean LBP point prevalence among the adolescents was 12% and among adults was 32%. The average one year prevalence of LBP among adolescents was 33% and among adults was 50%. The average lifetime prevalence of LBP among the adolescents was 36% and among adults was 62%. Conclusion: The findings support the global burden of disease of LBP, in addition to suggesting that LBP prevalence among Africans is rising and is of concern. Further research into the most effective strategies to prevent and manage LBP in Africa is warranted.
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    A profile of hospital-admitted paediatric burns patients in South Africa
    (BMC Research Notes, 2010-06) Parbhoo, Asha; Louw, Quinette A.; Grimmer-Somers, Karen
    Background: Injuries and deaths from burns are a serious, yet preventable health problem globally. This paper describes burns in a cohort of children admitted to the Red Cross Children's Hospital, in Cape Town, South Africa. This six month retrospective case note review looked at a sample of consecutively admitted patients from the 1 st April 2007 to the 30 th September 2007. Information was collected using a project-specific data capture sheet. Descriptive statistics (percentages, medians, means and standard deviations) were calculated, and data was compared between age groups. Spearman's correlation co-efficient was employed to look at the association between the total body surface area and the length of stay in hospital. Findings: During the study period, 294 children were admitted (f= 115 (39.1%), m= 179 (60.9%)). Hot liquids caused 83.0% of the burns and 36.0% of these occurred in children aged two years or younger. Children over the age of five were equally susceptible to hot liquid burns, but the mechanism differed from that which caused burns in the younger child. Conclusion: In South Africa, most hospitalised burnt children came from informal settlements where home safety is a low priority. Black babies and toddlers are most at risk for sustaining severe burns when their environment is disorganized with respect to safety. Burns injuries can be prevented by improving the home environment and socioeconomic living conditions through the health, social welfare, education and housing departments.
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    The quality of evidence of psychometric properties of three-dimensional spinal posture-measuring instruments
    (BioMed Central, 2011-05-13) Brink, Yolandi; Louw, Quinette; Grimmer-Somers, Karen
    Abstract. Background. Psychometric properties include validity, reliability and sensitivity to change. Establishing the psychometric properties of an instrument which measures three-dimensional human posture are essential prior to applying it in clinical practice or research. Methods. This paper reports the findings of a systematic literature review which aimed to 1) identify non-invasive three-dimensional (3D) human posture-measuring instruments; and 2) assess the quality of reporting of the methodological procedures undertaken to establish their psychometric properties, using a purpose-build critical appraisal tool. Results Seventeen instruments were identified, of which nine were supported by research into psychometric properties. Eleven and six papers respectively, reported on validity and reliability testing. Rater qualification and reference standards were generally poorly addressed, and there was variable quality reporting of rater blinding and statistical analysis. Conclusions. There is a lack of current research to establish the psychometric properties of non-invasive 3D human posture-measuring instruments.
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    Towards a needs-based design of the physical rehabilitation workforce in South Africa : trend analysis [1990–2017] and a 5-year forecasting for the most impactful health conditions based on global burden of disease estimates
    (Springer Nature, 2021-05-13) Louw, Quinette A.; Grimmer-Somers, Karen; Berner, K.; Conradie, T.; Bedada, D. T.; Jesus, T. S.
    Background: Rehabilitation can improve function in many people with chronic health conditions. It is important to consider priority conditions requiring rehabilitation, so it can be realistically positioned and costed in national health financing systems like South Africa (SA)‘s proposed National Health Insurance (NHI). This paper describes temporal trends of top-ranked conditions on years lived with disability (YLDs) rates in SA, for which physical rehabilitation can ameliorate associated disability. Methods: This study is a systematic synthesis of publicly available Global Burden of Disease (GBD) 2017 estimates. The top 11 conditions contributing most to YLDs and for which evidence-based rehabilitation interventions exist were identified. Age-standardized rates per 100,000 and YLDs counts were extracted from 1990 to 2017. Significance of changes in temporal trends was determined using Mann-Kendall trend tests. Best-fit rates of yearly changes were calculated per condition, using GBD estimates (2012–2017), and extrapolated (by imposing the bestfit regression line onto results for each subsequent predicted year) as forecasts (2018–2022). Results: Trends for YLDs counts per condition year (1990–2017) and forecasted values (2018–2022) showed an overall steady increase for all conditions, except HIV and respiratory conditions. YLDs counts almost doubled from 1990 to 2017, with a 17% predicted increase from 2017 to 2022. The proportionate contribution to YLDs counts reduced over time for all conditions, except HIV. Although age-standardized YLDs rates appear relatively stable over the analyzed periods for all conditions (except HIV, respiratory conditions and type 2 diabetes), trend changes in YLDs rates over 28 years were significant for all conditions, except neonatal (p = 0.855), hearing loss (p = 0.100) and musculoskeletal conditions (p = 0.300). Significant trend decreases were apparent for 4/9 conditions, implying that another 5/9 conditions showed trend increases over 28 years. Predicted all-age prevalence in 2022 suggests relatively large increases for cardiovascular disease and heart failure, and burns, while relative decreases are predicted for fractures and dislocations, stroke, and musculoskeletal conditions. Conclusion: Rehabilitation needs in SA are potentially massive and unmet, highlighting the need for innovative and context-specific rehabilitation that considers current local needs and projected changes. These findings should be considered when designing the NHI and other schemes in SA to ensure human and financial resources are deployed efficiently.
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    Usability testing of a multimedia e-learning resource for electrolyte and acid-base disorders
    (Wiley Online Open, 2013-04) Davids, M. R.; Chikte, Usuf M. E.; Grimmer-Somers, Karen; Halperin, Mitchell L.
    The usability of computer interfaces may have a major influence on learning. Design approaches that optimize usability are commonplace in the software development industry but are seldom used in the development of e-learning resources, especially in medical education. We conducted a usability evaluation of a multimedia resource for teaching electrolyte and acid-base disorders by studying the interaction of 15 medical doctors with the application. Most of the usability problems occurred in an interactive treatment simulation, which was completed successfully by only 20% of participants. A total of 27 distinct usability problems were detected, with 15 categorized as serious. No differences were observed with respect to usability problems detected by junior doctors as compared with more experienced colleagues. Problems were related to user information and feedback, the visual layout, match with the real world, error prevention and management, and consistency and standards. The resource was therefore unusable for many participants; this is in contrast to good scores previously reported for subjective user satisfaction. The findings suggest that the development of e-learning materials should follow an iterative design-and-test process that includes routine usability evaluation. User testing should include the study of objective measures and not rely only on self-reported measures of satisfaction.