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Rehabilitation Centres (rehabilitation + centre)
Selected AbstractsDysphagia and dysphonia among persons with post-polio syndrome , a challenge in neurorehabilitationACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010S. Söderholm Söderholm S, Lehtinen A, Valtonen K, Ylinen A. Dysphagia and dysphonia among persons with post-polio syndrome , a challenge in neurorehabilitation. Acta Neurol Scand: 2010: 122: 343,349. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective,,, To study the occurrence of dysphagia and dysphonia in persons with post-polio syndrome admitted into the centre for neurological rehabilitation in Finland. Materials and methods,,, Fifty-one persons with post-polio syndrome who were rehabilitated at Käpylä Rehabilitation Centre, Helsinki, Finland, in 2003,2004 were interviewed on problems with swallowing and voice production. Pulmonary function testing and grip strength measurement were performed. A clinical assessment of oral motor and laryngeal functions was carried out for those who reported daily problems with voice production or swallowing. Results,,, Fifteen persons (29.4%) reported daily problems with swallowing or voice production. In the clinical assessment, the most commonly observed deficits in swallowing included decreased pharyngeal transit (n = 13) and the food catching in the throat (n = 4). The disturbance of co-ordination of breathing and voice production was seen in 12 persons. There were no significant differences in any of the potential predictors between the groups. Conclusions,,, Professionals need to be aware of the routine evaluation of dysphagia and dysphonia in patients with post-polio syndrome. [source] Influence of chronic alcohol abuse and ensuing forced abstinence on static subjective accommodation function in humansOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 3 2001Hugh Campbell Summary Purpose. Acute alcohol ingestion can change accommodation, but the long term effects of sustained alcohol consumption on accommodative function have not been studied in detail. This study was thus undertaken on individuals with a history of alcohol abuse. Methods. Thirty-seven male individuals aged 25,56 years (average 40 years) from an alcohol rehabilitation centre in Inverness, Scotland, were assessed on admission and after a week of forced abstinence. The results were compared to a paired age-matched set of control male subjects. The static amplitude of accommodation was measured by an RAF rule, and the pupil size measured with a pupil gauge. Results. On admission, the group mean measured amplitude of accommodation was 4.7±2.2 D (mean±SD). These values for the alcoholics were lower than age-matched controls (of5.9±2.9 D). The slope of the age-dependent decline in RAF rule accommodation measures was significantly smaller for the alcoholics compared to controls (at 0.215±0.027 D/year versus0.332±0.015 D/year, respectively; p <0.001), with the younger alcoholics showing a greater impairment. Following abstinence, there was no measurable change in accommodation measured, indicating the lower amplitude in the alcoholics was not attributable to circulatory alcohol levels. The resting pupil diameter in the alcoholics was4.37±0.63 mm compared to the controls of3.97±0.75 mm, with a higher incidence of small pupils (,3 mm) in the controls. Conclusions. The results indicate that chronic alcohol use can adversely affect subjective static accommodation, especially in younger alcoholics, as well as cause slight mydriasis. [source] ,Difficult Asthma': Can Symptoms be Controlled in a Structured Environment?PEDIATRIC PULMONOLOGY, Issue 8 2009K. De Boeck MD Abstract Objective Difficult asthma implies persistent asthma symptoms despite therapy with high doses of inhaled corticosteroids. The objective was to evaluate children with difficult asthma in a setting that excludes aggravating factors such as poor treatment adherence and adverse environmental influences. Patients and Methods Sixty children (,6 years) had been referred because of difficult asthma to the rehabilitation centre over a period of 10 years. The diagnosis of poor asthma symptom control was confirmed if exacerbations continued during stay in the centre or if symptoms interfered with daily activities at least 3 times a week. Results The median stay at the centre was 5 months. In four patients a diagnosis other than asthma was made. In five patients symptom control remained difficult. In the remaining 51 children, asthma symptoms became well controlled. Many factors contributed to poor asthma control in the home setting: poor treatment adherence (n,=,32), parental smoking (n,=,22), allergen exposure (n,=,10). Psychosocial problems occurred in 36 children. Contributing factors often co-existed. During stay at the centre, lung function improved in the group with well controlled asthma symptoms (P,<,0.001) but not in the group with continued poor symptom control. In the majority of children who obtained good symptom control, this persisted in the years following discharge. Conclusion Of 60 children referred with a diagnosis of difficult asthma, optimal medical management in a structured environment resulted in good symptom control in 51 patients; symptom control remained poor in 5 patients, a diagnosis other than asthma was made in 4 patients. Pediatr Pulmonol. 2009; 44:743,748. © 2009 Wiley-Liss, Inc. [source] Therapists' experiences and perceptions of teamwork in neurological rehabilitation: reasoning behind the team approach, structure and composition of the team and teamworking processesPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2006Kitty Maria Suddick Abstract Background and Purpose.,Teamwork and the interdisciplinary team approach have been strongly advocated for use in the provision of neurological rehabilitation services. However, whether teamwork has been adopted, and in what form, has yet to be established. The present study investigated therapists' experiences and perceptions of the reasoning behind the team approach in neurological rehabilitation, the structure and composition of the team within which they worked and the teamworking process,Method.,This article reports part of an exploratory qualitative study. Five occupational therapists and five physiotherapists from three teams: a rehabilitation centre; a community team; and a stroke unit based within the UK. Semi-structured interviews were undertaken with each participant and then transcribed. Content and thematic analysis of the qualitative interview data was carried out, with respondents validating both the transcription and analysis stages.,Results.,Perceived composition and structure of the neurological rehabilitation team was variable across teams and between individual team members. There was disparity as to whether patients were included within the neurological team; the interdisciplinary team approach had not been consistently adopted and there were sub-teams and other team memberships in existence. Reasoning behind the team approach supported the perceived benefits of teamwork from a number of perspectives, and the activities reported as part of the team process were diverse.,Conclusions.,Different teams may choose to use different strategies depending on the aims and context of the team effort. In some instances interdisciplinary teamwork and patient-centred approaches were not adopted consistently and the process of teamwork itself is both complex and diverse. Copyright © 2006 John Wiley & Sons, Ltd. [source] Is the historical war against wildlife over in southern Europe?ANIMAL CONSERVATION, Issue 3 2009A. Martínez-Abraín Abstract Most southern European regions have experienced a rapid economical change during the last decades, moving from a historical economy based on agriculture to a society based on industry and technology. We test here whether causes of admission of birds admitted to a large southern European rehabilitation centre, during a 14-year period (1994,2007), reflect these socio-economical changes. Specifically, we estimated the trends in the number of birds admitted to the centre by shooting (S) over the number of birds admitted due to impacts caused by infrastructures (I), for the 10 most commonly admitted species with complete time series available. Species were grouped in three groups following ecological traits: raptors (diurnal and nocturnal) and aquatic birds. Trends were estimated by means of the slope of a linear regression of the log-transformed S/I ratio over time, which provided the finite population growth rate (,) and its 95% confidence intervals. We used the ratio to prevent possible biases caused by changes in wild population densities over the years. We conclude that the overall trend in the S/I ratio, as well as the trends for all three bird groups considered, were negative, and indicated a c. 10% annual reduction in the number of birds admitted by shooting in relation to those admitted by infrastructure-related injuries. Causal relationships were analysed by means of Poisson regressions on absolute numbers. Importantly we show that despite the direct historical war against wildlife seems to be coming to an end in southern Europe, impact to wildlife continues in an indirect way, as collateral damages caused by our post-industrial way of life. So the overall scenario is most likely not one of improved conservation status in southern Europe, but rather one of shifting ways of impacting wildlife in parallel with socio-economic changes. [source] Towards integrated paediatric services in the Netherlands: a survey of views and policies on collaboration in the care for children with cerebral palsyCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2007B. J. G. Nijhuis Abstract Aim, Worldwide, family-centred and co-ordinated care are seen as the two most desirable and effective methods of paediatric care delivery. This study outlines current views on how team collaboration comprising professionals in paediatric rehabilitation and special education and the parents of children with disabilities should be organized, and analyses the policies of five paediatric rehabilitation settings associated with the care of 44 children with cerebral palsy (CP) in the Netherlands. Methods, For an overview of current ideas on collaboration, written statements of professional associations in Dutch paediatric rehabilitation were examined. The policy statements of the five participating settings were derived from their institutional files. Documents detailing the collaborative arrangements involving the various professionals and parents were evaluated at the institutional level and at the child level. Involvement of the stakeholders was analysed based on team conferences. Results, Also in the Netherlands collaboration between rehabilitation and education professionals and parents is endorsed as the key principle in paediatric rehabilitation, with at its core the team conference in which the various priorities and goals are formulated and integrated into a personalized treatment plan. As to their collaborative approaches between rehabilitation centre and school, the five paediatric settings rarely differed, but at the child level approaches varied. Teams were large (averaging 10.5 members), and all three stakeholder groups were represented, but involvement differed per setting, as did the roles and contributions of the individual team members. Conclusion, Collaboration between rehabilitation and education professionals and parents is supported and encouraged nationwide. Views on collaboration have been formulated, and general guidelines on family-centred and co-ordinated care are available. Yet, collaborative practices in Dutch paediatric care are still developing. Protocols that carefully delineate the commitments to collaborate and that translate the policies into practical, detailed guidelines are needed, as they are a prerequisite for successful teamwork. [source] Waiting time for rehabilitation services for children with physical disabilitiesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2002D. Ehrmann Feldman Abstract Background Early rehabilitation may minimize disability and complications. However, children often wait a long time to gain admission to rehabilitation centres. Objectives To describe waiting times for paediatric physical and occupational therapy and to determine factors associated with these waiting times. Research Design The study was a prospective cohort design. Patients were followed from 1 January 1999 to 1 March 2000. Subjects All children with physical disabilities, aged 0,18 years, referred in 1999 from the Montreal Children's Hospital to paediatric rehabilitation centres. Measures Data on date of referral, date of first appointment at the rehabilitation centre, age, gender, diagnosis, region and language were obtained from the rehabilitation transfer database. Primary family caregivers of children who were transferred to a rehabilitation facility participated in a telephone interview regarding their perceptions of the transfer process. Results There were 172 children referred to rehabilitation facilities. The mean age of the children was 2.5 years. Average waiting time was 157.4 days (SD 57.1) for occupational therapy and 129.4 days (SD 51.6) for physical therapy. Decreased waiting time was associated with living in the city as opposed to the suburbs (hazard ratio = 1.77; 95% confidence interval = 0.92,3.41) and inversely associated with age (hazard ratio = 0.46; 95% confidence interval = 0.34,0.62). Among the 41 primary family caregivers who participated in the survey, higher empowerment scores were associated with shorter waits for rehabilitation. Conclusion Waiting time for rehabilitation services needs to be reduced. Empowered parents appear to manoeuvre within the system to reduce waiting times for their children. [source] Reference values for anaerobic performance and agility in ambulatory children and adolescents with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2010OLAF VERSCHUREN Aim, The aim of this study was to provide reference values of anaerobic performance and agility in a group of children and adolescents with spastic cerebral palsy (CP). Method, A total of 300 children (184 males, 116 females) with spastic CP were recruited from 26 rehabilitation centres in six different countries. Of these, 215 were classified at GMFCS level I (mean age 11y 2mo, SD 3y, range 6,18y) and 85 were classified at GMFCS level II (mean age 11y; SD 3y 1mo, range 6,18y). The children performed the Muscle Power Sprint Test (MPST) and the 10×5m sprint test in a standardized manner. To establish reference values, reference curves were created using generalized additive models for location, scale, and shape. Results, Height-related reference curves were created based on performance on the two tests. Interpretation, This study provides height-related reference values for anaerobic performance and agility for children and adolescents with CP classified at GMFCS levels I and II. These curves are clinically relevant and provide a user-friendly method in the interpretation of anaerobic performance and agility for children with spastic CP. [source] Depression among mothers of children and adults with an intellectual disability in TurkeyINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2010Hatice Yildirim Sari PhD RN Yildirim Sari H, Ba,bakkal Z. International Journal of Nursing Practice 2010; 16: 248,253 Depression among mothers of children and adults with an intellectual disability in Turkey The aim of this study was to determine sociodemographic factors that play a role in depression among mothers of children and adult with an intellectual disability. The research was conducted in 24 special education and rehabilitation centres in Izmir (in Turkey) provincial centre in which intellectually disabled individuals are taught. A total of 355 mothers were reached in the research. Data were collected using face-to-face interviews. Two forms were used for data collection in the research: Family Description Questionnaire Form and Beck Depression Inventory. The mothers included in the study had mean depression scores of 16.7 ± 10.06 (minimum: 0, maximum: 49). There was a significant relation between depression scores of the mothers and education level of the mothers and their spouses and financial status of the families. Mothers with insufficient income and lower education levels were found to be at risk of depression. [source] Music therapy in physical medicine and rehabilitationAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 3 2000Stanley Paul The therapeutic effects of music are being recognized increasingly in the field of rehabilitation medicine. More music therapists are being employed in physical medicine and rehabilitation centres, with the goal of using music therapy services to assist in the physical recovery and health maintenance of clients. In spite of the benefits of physical rehabilitation programs, client participation to their full potential is often not observed. Music encourages participation in exercises and activities. Music can ease the discomfort and difficulty associated with exercise and therapy activities, and help ensure consistent participation. One of the goals of the music therapist is to provide a means for the client to express him/herself in a musical activity. Music therapy and rehabilitation medicine are starting to find a common niche in working together with clients who have various neurological, orthopaedic, and paediatric conditions. Therapeutic application of music in rehabilitation contributes to the quality of life of individuals with disabilities. Combined goals could include improving strength, range of motion, balance, communication, and cognition. Continued efforts in clinical practice and research will build on the information already available to further define possible applications of music therapy in rehabilitation, and its outcome and benefits. Occupational therapists can use the therapeutic medium of music, and the services of the music therapy discipline, in assisting clients to maximize their functional independence in their daily occupational roles. [source] One-year stability of the Measure of Processes of CareCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2007R. C. Siebes Abstract Background, The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. Methods, Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1,18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. Results, All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443,0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. Conclusions, The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted. [source] Parent participation in paediatric rehabilitation treatment centres in the Netherlands: a parents' viewpointCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2007R. C. Siebes Abstract Aim, The importance of family-centred care and services has been increasingly emphasized in paediatric rehabilitation. One aspect of family-centred care is parent involvement in their child's treatment. The aims of this study were (1) to describe how, and to what extent parents are involved in the paediatric rehabilitation treatment process in the Netherlands; (2) to determine the level of parents' satisfaction about the services they and their child have received; and (3) to describe what ideas parents have to enhance their involvement in the treatment process. Methods, A total of 679 parents of children aged 1,20 years who participated in our longitudinal study on family centred care in the Netherlands. The children had various diagnoses and were treated in nine out of 23 Dutch paediatric rehabilitation centres. A random sample of 75 parents was interviewed within 4 weeks after completion of the Measure of Processes of Care and the Client Satisfaction Questionnaire. A Quality of Care cycle with six stages was used to structure the evaluation. Results, The data showed that parents are involved in all stages of their child's rehabilitation process in various ways. The average level of parent satisfaction about the services received was high. According to the interviewed parents, the communication between professionals and parents, parents' involvement in goal setting, and parents' involvement in treatment could be improved upon. Conclusion, Parents are to a large extent involved in all stages of the treatment process in Dutch paediatric rehabilitation settings. Although parents valued the services received, they suggested various ways to enhance parent participation. [source] Waiting time for rehabilitation services for children with physical disabilitiesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2002D. Ehrmann Feldman Abstract Background Early rehabilitation may minimize disability and complications. However, children often wait a long time to gain admission to rehabilitation centres. Objectives To describe waiting times for paediatric physical and occupational therapy and to determine factors associated with these waiting times. Research Design The study was a prospective cohort design. Patients were followed from 1 January 1999 to 1 March 2000. Subjects All children with physical disabilities, aged 0,18 years, referred in 1999 from the Montreal Children's Hospital to paediatric rehabilitation centres. Measures Data on date of referral, date of first appointment at the rehabilitation centre, age, gender, diagnosis, region and language were obtained from the rehabilitation transfer database. Primary family caregivers of children who were transferred to a rehabilitation facility participated in a telephone interview regarding their perceptions of the transfer process. Results There were 172 children referred to rehabilitation facilities. The mean age of the children was 2.5 years. Average waiting time was 157.4 days (SD 57.1) for occupational therapy and 129.4 days (SD 51.6) for physical therapy. Decreased waiting time was associated with living in the city as opposed to the suburbs (hazard ratio = 1.77; 95% confidence interval = 0.92,3.41) and inversely associated with age (hazard ratio = 0.46; 95% confidence interval = 0.34,0.62). Among the 41 primary family caregivers who participated in the survey, higher empowerment scores were associated with shorter waits for rehabilitation. Conclusion Waiting time for rehabilitation services needs to be reduced. Empowered parents appear to manoeuvre within the system to reduce waiting times for their children. [source] | ||||||||||