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http://www.webmedcentral.com/images/Header_Logo.giftext/html2010-10-19T22:06:39+01:00http://www.webmedcentral.com/Dr. William R CulbertsonPatterns Of Speech Articulation In Subjects With Neurogenic Dysphagia And Dysarthria
http://www.webmedcentral.com/article_view/1042
The purpose of this descriptive study was to examine place-manner-voicing features and neuromuscular substrates of articulation and swallowing in a group of nursing home residents having concurrent dysarthria and dysphagia. Similar muscle groups function in speech articulation and swallowing, accounting for the high coincidence of dysarthria and dysphagia in neurological impairment. Subjects were forty patients residing in two skilled nursing facilities in Las Vegas, Nevada. The results described place, manner, and voicing characteristics of articulation patterns in neurologically impaired nursing home subjects with and without dysphagia. Place-of-articulation anomalies identified for the dysphagia group were most frequently at the blade-prepalatal site. Manner-of-articulation anomalies among the dysphagia group occurred most often for fricatives. Perceptual changes of soft or weak vocal loudness were most common quality anomalies among the dysphagia group subjects. text/html2010-12-03T17:44:21+01:00http://www.webmedcentral.com/Dr. Ann Sophie G HanssonRestart - Return To Work After Long-tem Sickness Absence From Work. A Quasi-experimental Study
http://www.webmedcentral.com/article_view/1209
Background: People with long-term sickness absence due to diffuse health problems are difficult to rehabilitate back to work. In this quasi-experimental study 48 individuals with time-limited sickness benefit were recruited to a return to work (RTW) project. The intervention group (30) participated in a 12-month programme based on a cognitive approach with the aim of strengthening the individuals’ self-esteem and empowerment. The reference group (18) received rehabilitation as usual. Methods: Evaluation methods used for the study group were self-reported questionnaires at baseline, before intervention and at follow-up after 1 year. Results: One year after the intervention 27% had returned to full or part-time work and yet another 10% were in work training and 13% in rehabilitation/treatment with an optimistic back to work prognosis. In the reference group only 1 person had partially (25%) returned to work. Subjectively rated health (SRH) and sleep quality improved following the intervention. MADRS scores decreased during the year for the intervention group. The results support the idea that return to work is an important contributor to better self-perceived mental health for people who have been outside the labour market for a long time. Conclusion: The project shows that long-term sickness absence due to diffuse and subjective health problems is not a permanent condition even in participants with substantial work absences periods. In addition, the importance of structured co-operation between the authorities and the project leaders is supported by previous research.text/html2011-04-27T17:08:28+01:00http://www.webmedcentral.com/Dr. Mohsen Adib-HajbagheryEffects of Pursed Lip Breathing on Ventilation and Activities of Daily Living in Patients with COPD
http://www.webmedcentral.com/article_view/1904
BackgroundBreathing rehabilitation techniques are designed to reduce symptoms, decrease disability, increase participation in physical and social activities, and improve the overall quality of life for individuals with chronic respiratory diseases. However, the role of these techniques remains unclear. This study examined the effects of pursed-lip breathing (PLB) on the respiratory function, arterial blood gases and the activities of daily living in patients with COPD.MethodsA before-after quasi-experimental study was conducted on 40 COPD patients in Kashan, Iran. Spirogram and ABG were tested before and after three-months of PLB exercise and the Airway Questionnaire 20 (AQ20) was used to assess activities of daily living. Wilcoxon matched pairs was used for statistical analysis.ResultsO2sat was significantly increased (P < 0.05) and a tendency toward an increase in PaO2 was observed after three months of exercise. In addition, a decrease in PaCO2 (P < 0.05) and the respiratory rate (P < 0.001) was observed. Activities of daily living was also increased (P < 0.001). Forced expired volume second one (FEV1%) and forced vital capacity (FVC) did not change (P > 0.05).ConclusionBreathing retraining program can improve lung functions, arterial blood gas and the levels of activities of daily living. Therefore, breathing retraining should be included in respiratory physiotherapy programs in patients with COPD.text/html2011-07-08T17:38:32+01:00http://www.webmedcentral.com/Dr. Simon B ThompsonEffortless Effort: Current Views on Assessing Malingering litigants in Neuropsychological Assessments
http://www.webmedcentral.com/article_view/2014
Neuropsychological assessment is often revealing and valuable not only to assist litigants in their rehabilitation but also to build a case towards claiming compensation in the legal system. However, sometimes malingering litigants with unscrupulous views attempt to deceive assessors through performances that actually do not reflect their true effort. It may suspected by assessors but it can often be difficult to establish categorically. Therefore, there is a need to decide which performances are true and which are spurious. A comprehensive profile that also takes account of the litigant’s lifestyle and background may be more revealing than only accepting face-value performances on a few neuropsychological tests.text/html2013-12-06T05:32:46+01:00http://www.webmedcentral.com/Dr. Sander KolaTreatment of Chronic Lumbagos Through Rehabilitation
http://www.webmedcentral.com/article_view/4456
Lumbago is common and affects 80%-90% of the population over age 25-50 years. Objectives: Treatment of pain and improvement of articular amplitudes in patients with chronic lumbago with electrotherapy and exercises in the cabinet. The prospective study was done in the Physiotherapy Center of the University hospital center “Mother Teresa”, Tirana, during a period of 6 months: May 2012- November 2012. Study were taken in 36 cases (18 F: 18 M) diagnosed with lumbago clinical clonicete of the group age 20-60 years old.In this study we showed that patients with chronic lumbago treated with physiotherapy have significant improvements in the level of the pain, muscular force and articulated ROM were improved.Patients in the opening balance muscular strength had grade 3 muscle and after 10 sessions of physiotherapy the final balance of muscular force becomes 6 grade muscular.The ROM-articulated in the opening balance flexion is 48°, and then the final flexion balance becomes 64.7°.The ROM-articulated in the opening balance extension average is 14.7° and we made extension final balance averaging 18.1°.ROM articulated in the opening balance of lateral inclination is averaging 22.7°, the balance becomes final average 26.5° inclination.Based on these reports we conclude that: Rehabilitation Physiotherapy is the proper treatment for chronic lumbago, because improves the condition of patients, CLE and has no side effects. It is recommended to perform physiotherapy twice in year.text/html2014-10-09T12:40:00+01:00http://www.webmedcentral.com/Dr. Khurshid MattooSynchronizing a multi-disciplinary team to rehabilitate an aesthetically handicapped patient suffering from developmental abnormality of amelogenesis imperfecta
http://www.webmedcentral.com/article_view/4710
Purpose: Reported literature has focused largely on the early management of children and young adolescents. This article describes systematic, sequential and synchronized, psychological and restorative management of an adult patient suffering from amelogenesis imperfecta with a fairly good prognosis. The focus of this report is to attribute the specific roles of various medical and dental specialties’.
Materials and Methods: Extensive treatment in four basic phases has been outlined which in turn help suffering patient to understand the extent of treatment in advance. The treatment ranges from patient education and motivation to full mouth rehabilitation. Various methods that educate the patient in advance, about his role towards achieving a successful outcome have not been followed.
Results: patients suffering from amelogenesis imperfecta should never be treated casually. A serious preventive and basic psychological therapy followed by extensive restorative treatment over a period of time is advised. Correct sequence of treatment phases is essential to not only eliminate patient’s fear and apprehension but also install confidence in his judgment during the entire course of rehabilitation.
Conclusion: Extensive treatment such as full mouth rehabilitation should be approached with caution and planned in phases without compromising need of a multidisciplinary approach. text/html2015-01-17T09:52:38+01:00http://www.webmedcentral.com/Dr. Birgit GurrOn-the-Spot: Training nurses about effective communication with acute stroke patients
http://www.webmedcentral.com/article_view/4800
In 2013 Robert Francis QC concluded that the Mid Staffordshire NHS Foundation Trust had a culture focused on doing the systems business and not that of the patient. Unfortunately it is arguable that this is becoming the public view of much of the NHS.One of the recommendations of the public enquiry was that more training and support is needed for healthcare professionals, in particular for those with nursing and leadership roles (Francis, 2013). Moreover, the enquiry demonstrated the need for education about the implementation of compassionate care. Initiatives to improve the quality of care may be vital in the future of healthcare organisations (Neale, Vincent, & Darzi, 2007).
Maintaining standards of practice for the public benefit has been advocated since the beginning of the NHS.The media attention over recent years has brought quality of care very much into the public eye and it has become a new priority in healthcare politics in the UK.
The focus on patient-centred care and providing value for money means that there is a greater need to ensure that health professionals have the knowledge and skills to effectively and compassionately support patients. Training health professionals has the potential to impact positively on their skill base, attitudes, knowledge and behaviours (O’Brien et al., 2001). In fact, some research has suggested that training professionals may be just as effective as financial incentives for improving the quality of healthcare (Epstein, 2008).
Everyday the NHS is facing significant challenges. The country’s population is growing, people are living longer and the demands on health care services are outstripping its staffing and financial resources (The Department of Health, 2004). Stretched services put little priority on training. Opportunities for training are often limited, fragmented, disruptive and costly for NHS trusts. For example, if a hospital ward intended to offer training to 50 staff members on a chosen topic for one hour, they would have to: rota staff to attend the training (mostly probably in a number of small groups), provide cover on the ward for the staff who attend training, pay the wages of the staff attending training and the staff providing cover and meet the costs of the trainer. Furthermore, time is required to organise the training itself and the staff rota, thus incurring more costs.
The organisation of staff training is without the consideration of staff shortages, sickness and a service’s financial budget. It is clear that just organising staff training is a complicated process within healthcare services, even before considering the most effective way to deliver the training.
There is a growing literature base investigating effective training for healthcare workers. Such training may increase the skill base, knowledge and confidence of healthcare staff. However, didactic sessions alone are unlikely to produce changes in care approaches and improve care processes or patient outcomes. Bloom (2005) identified that didactic presentations in a lecture format and distributing printed information had no effect on professional approach and behaviour. Learning methods that encourage active participation may be more effective in implementing change compared to classroom based or online learning. However, the ideal balance between theoretical teaching and practical learning remains unknown. It is arguable however, that staff need the academic knowledge as well as the practical experience in order to provide a good quality of care. text/html2018-07-13T06:03:57+01:00http://www.webmedcentral.com/Dr. Kang ChengRehabilitation Models of Mechanisms, Preventions and Treatments of Amyotrophic Lateral Sclerosis Caused by Toxic Invasions
http://www.webmedcentral.com/article_view/5502
Amyotrophic lateral sclerosis (ALS) is an adult-onset, progressive and fatal neurodegenerative disorder; there is no cure for ALS to date and the causes of this degeneration are still unknown.
In this study, I prose rehabilitation models to describe mechanisms, global preventions and treatments of ALS caused by toxic invasions, in a perspective of biomedical and biochemical infophysics, based on published clinical data and our previous models of meridian channel system.
Of the mechanisms, I think, toxic invasions to ALS patients, who are exposure to toxins (metals, such as aluminum and manganese or chemical materials, such as hazard of pesticides), are mostly launched from sweat (major) and sebaceous (minor) glands, wounds or esophagus; after the invasions, the toxins may progressively spread to the whole bodies via networks of the meridian, nervous and/or cardiovascular systems for most cases of metal or chemical causes based on published data; physical diffusions play roles in the invasions and spreads.
The principle of my global prevention model after the exposures is an elimination of all of possible invading or invaded toxicants on the complete skin and/or in the whole bodies via sweat (major) and sebaceous (minor) glands, and the meridian channels, using the running (tap) water (37 - 40 oC) and massages.
The principle of my global treatment model is the same as or similar to that of my global prevention model after the exposures, except periodic or repeated expelling and diffusing of the toxins with intervals of hours, until curing ALS caused by the toxic invasions.
In one sentence, my treatment principle is: how the toxicants can invade us, we can expel them, no matter what they are, where they launch the invasions from, and how they affect the (motor) neurons.
Because of no side effects, like sing, song or music therapies, my models in this paper can be applied directly and may be the first choice, in clinic trials. Additionally, the preventions and treatments can be accomplished in most medical centers and/or patient homes; and the clinic costs are affordable to most patients (families).