Learning about the changing needs for prosthetics service provision from routinely collected digital centre management data: An exemplar study across three clinics in Cambodia

Biomechanics in anthropology

Biomechanics is the set of tools that explain organismal movement and mechanical behavior and links the organism to the physicality of the world. As such, biomechanics can relate behaviors and culture to the physicality of the organism. Scale is critical to biomechanical analyses, as the constitutive equations that matter differ depending on the scale of the question. Within anthropology, biomechanics has had a wide range of applications, from understanding how we and other primates evolved to understanding the effects of technologies, such as the atlatl, and the relationship between identity, society, culture, and medical interventions, such as prosthetics. Like any other model, there is great utility in biomechanical models, but models should be used primarily for hypothesis testing and not data generation except in the rare case where models can be robustly validated. The application of biomechanics within anthropology has been extensive, and holds great potential for the future.

Rehabilitation professionals' perspectives of factors influencing return to occupation for people with lower limb amputation in East, South, and Southeast Asian developing countries: A qualitative study

Objective

To identify barriers and enablers for return to occupation (RTO) for people with lower limb amputation (LLA) in East, South, and Southeast Asian developing countries from the perspective of rehabilitation professionals.

Methods

A convenience sample of rehabilitation professionals working in Asian developing countries participated in online in-depth interviews between September 2021 and February 2022. Interview transcripts were analyzed and thematically coded to the modified Health Care Delivery System Approach (HCDSA) framework. COREQ guidelines were followed.

Results

Twenty-eight interviewees from 13 countries shared their experiences of factors related to RTO for people with LLA. Identified factors described barriers and facilitators for RTO at all four HCDSA framework levels. The "environmental" level had the most identified factors (n = 56) and the "care team" level the least (n = 31). Common environmental RTO challenges included cultural attitudes to women; lack of rural/remote services; inadequate numbers and regulation of rehabilitation professionals; inappropriate prosthesis; limited government support for rehabilitation, and reliance on charitable models.

Conclusions

Despite varied cultural, religious, and geographical characteristics, consistent factors impacting RTO were identified within these thirteen countries. Identified barriers to RTO underline the need for improvements throughout service systems from the acute-care focus on saving life without consideration of RTO, the rehabilitation focused primarily on mobility, to the lack of occupational rehabilitation services and supporting policy in these countries. These interlinked factors at different levels of healthcare service systems reinforce the importance of systems approaches to best utilize limited resources toward improving RTO in this region.