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Background: Motor coordination concerns are estimated to affect 5%–6% of school‐aged children. Motor coordination concerns have variable impact on children's lives, with gait and balance often affected. Textured insoles have demonstrated positive impact on balance and gait in adults with motor coordination disorders related to disease or the ageing process. The efficacy of textured insoles in children is unknown. Our primary aim was to identify the feasibility of conducting a randomised controlled trial involving children with motor control issues. The secondary aim was to identify the limited efficacy of textured insoles on gross motor assessment balance domains and endurance in children with movement difficulties. Methods: An assessor‐blinded, randomised feasibility study. We advertised for children between the ages of 5–12 years, with an existing diagnosis or developmental coordination disorder or gross motor skill levels assessed as 15th percentile or below on a norm‐referenced, reliable and validated scale across two cities within Australia. We randomly allocated children to shoes only or shoes and textured insoles. We collected data across six feasibility domains; demand (recruitment), acceptability (via interview) implementation (adherence), practicality (via interview and adverse events), adaptation (via interview) and limited efficacy testing (6‐min walk test and balance domain of Movement ABC‐2 at baseline and 4 weeks). Results: There were 15 children randomised into two groups (eight received shoes alone, seven received shoes and textured insoles). We experienced moderate demand, with 46 potential participants. The insoles were acceptable, however, some parents reported footwear fixture issues requiring modification. The 6‐min walk test was described as problematic for children, despite all but one child completing. Social factors impacted adherence and footwear wear time in both groups. Families reported appointment locations and parking impacting practicality. Underpowered, non‐significant small to moderate effect sizes were observed for different outcome measures. Improvement in balance measures favoured the shoe and insole group, while gait velocity increase favoured the shoe only group. Conclusion: Our research indicates that this trial design is feasible with modifications such as recruiting with a larger multi‐disciplinary organisation, providing velcro shoe fixtures and using a shorter timed walk test. Furthermore, progressing to a larger well‐powered randomised control trial is justified considering our preliminary, albeit underpowered, efficacy findings. Trial Registration: This trial was retrospectively registered with the Australian and New Zealand Clinical Trial Registration: ACTRN12624000160538. [ABSTRACT FROM AUTHOR]

Objective: To explore consultation patterns, management practices, and costs of foot, ankle, and leg problems in Australian primary care.Study Design: We analyzed data from the Bettering the Evaluation and Care of Health program, April 2000 to March 2016. Foot, ankle, and leg problems were identified using the International Classification of Primary Care, Version 2 PLUS terminology. Data were summarized using descriptive statistics examining general practitioner (GP) and patient characteristics associated with a foot, ankle, or leg problem being managed. Cost to government was estimated by extracting fees for GP consultations, diagnostic imaging, and pathology services from the Medicare Benefits Schedule (MBS) database. Costs for prescription-only medicines were extracted from the Pharmaceutical Benefits Schedule and for nonprescribed medications, large banner discount pharmacy prices were used.Results: GPs recorded 1,568,100 patient encounters, at which 50,877 foot, ankle, or leg problems were managed at a rate of 3.24 (95% confidence intervals [CIs] 3.21-3.28) per 100 encounters. The management rate of foot, ankle, or leg problems was higher for certain patient characteristics (older, having a health care card, socioeconomically disadvantaged, non-Indigenous, and being English speaking) and GP characteristics (male sex, older age, and Australian graduate). The most frequently used management practice was the use of medications. The average cost (Australian dollars) per encounter was A$52, with the total annual cost estimated at A$256m.Conclusions: Foot, ankle, and leg problems are frequently managed by GPs, and the costs associated with their management represent a substantial economic impact in Australian primary care. [ABSTRACT FROM AUTHOR]

This study aims to determine if children follow the same cortical activation patterns as adults when responding to two‐point discrimination sensory stimuli during functional magnetic resonance imaging (fMRI). We recruited 15 children with typical development, aged between 8 and 16 years. These participants were asked to complete a two‐point discrimination test (task block) while undergoing an fMRI scan. In the two‐point stimulus test, strong activation compared to baseline was observed in the left and right frontal orbital cortex. The inferior parietal lobe also exhibited activity, particularly on the right side, with activation in both the supramarginal and angular gyri. Further activity was evident in the left supramarginal gyrus and the left paracingulate gyrus. This novel study on fMRI two‐point discrimination testing in children shows the activation patterns in key brain regions involved in somatosensory discrimination and decision making. Practical Applications: This study provides crucial normative data on cortical activation patterns during two‐point discrimination testing in typically developing children. Such data serve as a valuable reference point for future research investigating sensory processing and cognitive function in pediatric populations. Researchers can use these findings to establish benchmarks and compare cortical activation patterns in children with neurodevelopmental conditions. This information is essential for exploring pathology, which may affect tactile sensation techniques and developing targeted interventions tailored to individual needs in pediatric treatment. Additionally, it lays the groundwork for further exploration into the neural mechanisms underpinning somatosensory discrimination, potentially leading to advancements in understanding and treating sensory‐related disorders in children. [ABSTRACT FROM AUTHOR]

Background Implementing evidence into clinical practice is a key focus of healthcare improvements to reduce unwarranted variation. Dissemination of evidence-based recommendations and knowledge brokering have emerged as potential strategies to achieve evidence implementation by influencing resource allocation decisions. The aim of this study was to determine the effectiveness of these 2 research implementation strategies to facilitate evidence-informed healthcare management decisions for the provision of inpatient weekend allied health services. Methods and findings This multicentre, single-blinded (data collection and analysis), 3-group parallel cluster randomised controlled trial with concealed allocation was conducted in Australian and New Zealand hospitals between February 2018 and January 2020. Clustering and randomisation took place at the organisation level where weekend allied health staffing decisions were made (e.g., network of hospitals or single hospital). Hospital wards were nested within these decision-making structures. Three conditions were compared over a 12-month period: (1) usual practice waitlist control; (2) dissemination of written evidence-based practice recommendations; and (3) access to a webinar-based knowledge broker in addition to the recommendations. The primary outcome was the alignment of weekend allied health provision with practice recommendations at the cluster and ward levels, addressing the adoption, penetration, and fidelity to the recommendations. The secondary outcome was mean hospital length of stay at the ward level. Outcomes were collected at baseline and 12 months later. A total of 45 clusters (n = 833 wards) were randomised to either control (n = 15), recommendation (n = 16), or knowledge broker (n = 14) conditions. Four (9%) did not provide follow-up data, and no adverse events were recorded. No significant effect was found with either implementation strategy for the primary outcome at the cluster level (recommendation versus control [beta] 18.11 [95% CI -8,721.81 to 8,758.02] p = 0.997; knowledge broker versus control [beta] 1.24 [95% CI -6,992.60 to 6,995.07] p = 1.000; recommendation versus knowledge broker [beta] -9.12 [95% CI -3,878.39 to 3,860.16] p = 0.996) or ward level (recommendation versus control [beta] 0.01 [95% CI 0.74 to 0.75] p = 0.983; knowledge broker versus control [beta] -0.12 [95% CI -0.54 to 0.30] p = 0.581; recommendation versus knowledge broker [beta] -0.19 [-1.04 to 0.65] p = 0.651). There was no significant effect between strategies for the secondary outcome at ward level (recommendation versus control [beta] 2.19 [95% CI -1.36 to 5.74] p = 0.219; knowledge broker versus control [beta] -0.55 [95% CI -1.16 to 0.06] p = 0.075; recommendation versus knowledge broker [beta] -3.75 [95% CI -8.33 to 0.82] p = 0.102). None of the control or knowledge broker clusters transitioned to partial or full alignment with the recommendations. Three (20%) of the clusters who only received the written recommendations transitioned from nonalignment to partial alignment. Limitations include underpowering at the cluster level sample due to the grouping of multiple geographically distinct hospitals to avoid contamination. Conclusions Owing to a lack of power at the cluster level, this trial was unable to identify a difference between the knowledge broker strategy and dissemination of recommendations compared with usual practice for the promotion of evidence-informed resource allocation to inpatient weekend allied health services. Future research is needed to determine the interactions between different implementation strategies and healthcare contexts when translating evidence into healthcare practice. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000029291., Author(s): Mitchell N. Sarkies 1,2,3,*, Lauren M. Robins 3, Megan Jepson 3, Cylie M. Williams 3, Nicholas F. Taylor 4,5, Lisa O'Brien 6, Jenny Martin 7, Anne Bardoel 8, Meg [...]