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Rehabilitation Programme (rehabilitation + programme)

Distribution by Scientific Domains

Medical Sciences	75%
Psychology	13%
Humanities and Social Sciences	4%
3 Other Domains	8%

Distribution within Medical Sciences

Nursing General	56%
Consumer Health General	20%
Neurology	5%
6 Other Subdomains	19%

Kinds of Rehabilitation Programme

cardiac rehabilitation programme

Selected Abstracts

Feasibility of an exercise rehabilitation programme for cancer patients

EUROPEAN JOURNAL OF CANCER CARE, Issue 4 2006
C. STEVINSON bsc, research fellow
A growing body of evidence indicates the benefits of exercise as a rehabilitation intervention for cancer patients. However, few hospitals offer exercise-based rehabilitation programmes to patients. This study evaluated the feasibility and acceptability of a group-based exercise programme for cancer patients attending a local oncology centre. The intervention consisted of a weekly instructor-led circuit training class supplemented by home-based activity 4 days/week for 10 weeks. From 28 eligible patients, 12 were recruited (43%), of whom nine completed the intervention (75%). The three withdrawals were due to worsening of disease. Adherence (mean of 7.5 classes attended and 4 days/week of home activity performed) and tolerability (no adverse events) were good. Positive features of the programme identified in interviews with participants included the variety and scope of the exercises, and the empathetic but positive approach of the instructors. The small group format was highly valued with participants receiving social support and inspiration from each other. Perceived outcomes included improved fitness, reduced fatigue, enjoyment, enhanced mood and a sense of achievement. Several participants felt that the intervention represented a stepping stone to becoming habitual exercisers. Results suggested that the programme was feasible and acceptable to patients, but uptake was low, indicating a need for more effective recruitment strategies in order for a cost-effective service to be implemented. [source]

EFNS guideline on treatment of multiple sclerosis relapses: report of an EFNS task force on treatment of multiple sclerosis relapses

EUROPEAN JOURNAL OF NEUROLOGY, Issue 12 2005
F. Sellebjerg
Relapses, exacerbations or attacks of multiple sclerosis are the dominating feature of relapsing-remitting multiple sclerosis (MS), but are also observed in patients with secondary progressive MS. High-dose methylprednisolone is the routine therapy for relapses at present, but other treatments are also in current use. The objective of the task force was to review the literature on treatment of MS relapses to provide evidence-based treatment recommendations. Review was carried out on the literature with classification of evidence according to the EFNS guidelines for scientific task forces. Short-term, high-dose methylprednisolone treatment should be considered for the treatment of relapses of MS (level A recommendation). The optimal glucocorticoid treatment regimen, in terms of clinical efficacy and adverse events, remains to be established. A more intense, interdisciplinary rehabilitation programme should be considered as this probably further improves recovery after treatment with methylprednisolone (level B recommendation). Plasma exchange is probably efficacious in a subgroup of patients with severe relapses not responding to methylprednisolone therapy, and should be considered in this patient subgroup (level B recommendation). There is a need for further randomized, controlled trials in order to establish the optimal treatment regimen for relapses of MS. [source]

Developing compliance and resistance: the state, transnational social movements and tribal peoples contesting India's Narmada project

GLOBAL NETWORKS, Issue 4 2003
Ajay Gandhi
In this article I conceptualize a conflict over the Narmada damming project in central India by highlighting particular spatial fields and larger trajectories of political interaction. The Narmada project's maintenance and destabilization is evinced in a range of processes, including conflict over afforestation in tribal villages, protest narratives over resettlement in regional centres, and transnational lobbying of donor agencies. The interpenetration of social practices by different scales, and the mobility of discourses are emphasized. Further, I examine how organizational and social decisions such as implementing a rehabilitation programme, accepting state compensation and participating in public protest point to the contingent nature of power, revealing both complicity and disarticulation between involved parties. Descriptive points and commentary focus on the Indian riparian states implementing the project; the Narmada Bachao Andolan (Save the Narmada Movement); and affected adivasi (tribal) communities in the Narmada Valley. [source]

Cardiac rehabilitation programme for coronary heart disease patients: An integrative literature review

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2009
Nidal F Eshah RN, PhD(c)
Previous Western cardiac rehabilitation (CR) purported to improve patients' quality of life and health-related parameters for cardiovascular diseases (CVD). Nursing's role in CR was minimally identified. The purpose of this integrative literature review was to determine the effectiveness of current CR programmes and to determine if nurses are included in multidisciplinary CR teams. An online search of databases for the National Institutes of Health Library, Medline, CINAHL, Blackwell Synergy and PsychINFO electronic databases, with keywords,cardiac rehabilitation, lifestyle modification, secondary prevention, quality of life, effects of rehabilitation,identified 13 articles published 2001,2006 for inclusion. Cardiac rehabilitation programmes provided significant improvement in participants' quality of life, exercise capacity, lipid profile, body mass index, body weight, blood pressure, resting heart rate, survival rate, mortality rate and decreased myocardial infarction (MI) risk factors, although there was limited participation. They also decreased depression and anxiety. Eight studies included Nurses as CR providers, but without clear descriptions of their role. Nurses in developing countries need to participate in CR programmes to improve patients' participation, and to focus on modalities with lower overhead costs, such as home-based CR, and to clearly articulate their unique contributions. [source]

Physical and chemical restraints in acute care: Their potential impact on the rehabilitation of older people

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2005
Sarah Mott RN PhD FRCNA
Agitation is a major problem for older people and is present in over half of the hospitalizations for people > 65 years of age. In a previous study by the authors, results indicated that nursing actions often did not meet best-practice standards in the care of older, agitated patients. This paper builds on these results by reviewing the literature pertaining to the use of restraints and contributes to the body of knowledge surrounding the impact of the acute-care experience on rehabilitation outcomes. Successful rehabilitation relies on the improvement of functional health outcomes and, for this to happen, physical and emotional well-being are important. The sequelae of restraint use in acute care have the potential to alter peoples' ability to participate fully in a rehabilitation programme, thereby placing their future placement at risk. This paper explores the outcomes of restraint use in the acute-care setting and presents the argument that their effects are likely to be detrimental to rehabilitation outcomes. [source]

Emotional outcome after intensive care: literature review

JOURNAL OF ADVANCED NURSING, Issue 1 2008
Janice E. Rattray
Abstract Title., Emotional outcome after intensive care: literature review. Aim., This paper is a report of a literature review to identify (a) the prevalence of emotional and psychological problems after intensive care, (b) associated factors and (c) interventions that might improve this aspect of recovery. Background., Being a patient in intensive care has been linked to both short- and long-term emotional and psychological consequences. Data sources., The literature search was conducted during 2006. Relevant journals and databases were searched, i.e. Medline and CINAHL, between the years 1995 and 2006. Review methods., The search terms were ,anxiety', ,depression', posttraumatic stress', ,posttraumatic stress disorder' and ,intensive care'. Results., Fifteen papers were reviewed representing research studies of anxiety, depression and posttraumatic stress, and seven that represented intensive care follow-up clinics and patient diaries. Being in intensive care can result in significant emotional and psychological problems for a number of patients. For the majority of patients, symptoms of distress will decrease over time but for a number these will endure for some years. Current evidence indicates that emotional problems after intensive care are related to both subjective and objective indicators of a patient's intensive care experience. Evidence suggests some benefit in an early rehabilitation programme, daily sedation withdrawal and the use of patient diaries. However, additional research is required to support such findings. Conclusion., Our understanding of the consequences of intensive care is improving. Psychological care for intensive care patients has lagged behind care for physical problems. We now need to focus on developing and evaluating appropriate interventions to improve psychological outcome in this patient group. [source]

The effect of a pulmonary rehabilitation programme on older patients with chronic pulmonary disease

JOURNAL OF CLINICAL NURSING, Issue 1 2008
Kim Ae Kyung RN
Aim., The aim of this study was to answer the question: is there an effect on the respiratory capacity and activity tolerance of older patients with chronic obstructive pulmonary disease who participate in a pulmonary rehabilitation programme? Background., Pulmonary rehabilitation is now an integral part of chronic obstructive pulmonary disease management. Evidence supports the positive effects of breath training and exercising training on quality of life, exercise tolerance and improved physical condition of individual with chronic obstructive pulmonary disease. Limited empirical documentation exists to support the effectiveness of a nurse managed rehabilitation programme for older patients with chronic obstructive pulmonary disease. The study was done to evaluate the effects of pulmonary rehabilitation provided by nurses on the pulmonary function, gas exchange and exercise tolerance in older patients with chronic obstructive pulmonary disease. Design., A one group pre-test,post-test design was used to evaluate the effects of a pulmonary rehabilitation programme. Method., The sample consisted of 20 patients with chronic obstructive pulmonary disease who participated in a pulmonary rehabilitation programme including breathing exercises, upper-limb exercises and inspiratory muscle training. Results., The findings indicated improvement in exercise performance and a decrease in dyspnea after participation in the pulmonary rehabilitation programme. Relevance to clinical practice., The clinical nurse can make a significant impact on the illness trajectory and quality of life for patients with chronic obstructive pulmonary disease. The nurse has a critical role in helping patient with chronic obstructive pulmonary disease learn to cope, adjust and adapt to life with a chronic illness. Active nurse involvement with a patient in a pulmonary rehabilitation programme can assist in the identification of factors that motivate the patient, help in establishing realistic out comes expectations and provide patient teaching opportunities. The nurse can assist the patient to develop skills of self-awareness regarding particular symptoms, self-monitoring and health status change identification. [source]

A nurse-led cardiac rehabilitation programme improves health behaviours and cardiac physiological risk parameters: evidence from Chengdu, China

JOURNAL OF CLINICAL NURSING, Issue 10 2007
Xiaolian Jiang MSc
Aim., The aim of this study was to examine the effect of a cardiac rehabilitation programme on health behaviours and physiological risk parameters in patients with coronary heart disease in Chengdu, China. Background., Epidemiological studies indicate a dose-, level- and duration-dependent relationship exists between cardiac behavioural and physiological risks and coronary heart disease incidence as well as subsequent cardiac morbidity and mortality. Cardiac risk factor modification has become the very primary goal of modern cardiac rehabilitation programmes. Design methods., A randomized controlled trial was conducted. Coronary heart disease patients (n = 167) who met the sampling criteria in two tertiary medical centres in Chengdu, south-west China, were randomly assigned to either an intervention group (the cardiac rehabilitation programme) or control group (the routine care). The change of health behaviours (walking performance, step II diet adherence, medication adherence, smoking cessation) and physiological risk parameters (serum lipids, blood pressure, body weight) were assessed to evaluate the programme effect. Results., Patients in the intervention group demonstrated a significantly better performance in walking, step II diet adherence, medication adherence; a significantly greater reduction in serum lipids including triglyceride, total cholesterol, low-density lipoprotein; and significantly better control of systolic and diastolic blood pressure at three months. The majority of these positive impacts were maintained at six months. The effect of the programme on smoking cessation, body weight, serum high-density lipoprotein, was not confirmed. Conclusions., A cardiac rehabilitation programme led by a nurse can significantly improve the health behaviours and cardiac physiological risk parameters in coronary heart disease patients. Nurses can fill significant treatment gaps in the risk factor management of patients with coronary heart disease. Relevance to clinical practice., This study raises attention regarding the important roles nurses can play in cardiac rehabilitation and the unique way for nurses to meet the rehabilitative care needs of coronary heart disease patients. Furthermore, the hospital,home bridging nature of the programme also created a model for interfacing the acute care and community rehabilitative care. [source]

Meta-analysis of the effects of respiratory rehabilitation programmes on exercise capacity in accordance with programme characteristics

JOURNAL OF CLINICAL NURSING, Issue 1 2007
HyunSoo Oh PhD
Aims and objectives., This study was performed to investigate the effects of respiratory rehabilitation programmes on exercise capacity in terms of the programme type, the protocol used and other programme characteristics. Background., As the suitable rehabilitation programmes have not been specified, diverse programmes are provided in clinics. Design., Meta-analysis of the primary study results Methods., A computerized search through MEDLINE and CINHAL in addition to tracking down references cited in bibliographies of primarily searched studies were performed to obtain sample studies. Finally 19 research reports were examined. Results., The results of meta-regression showed that the combined effect size of the programmes on exercise capacity was unaffected by forced expiratory volume (in one second), age, the duration and frequency of the programme, or study quality. In addition, the results of meta- anova indicated that the combined effect size was not affected by (i) whether a programme was hospital based or not, (ii) whether a programme was lower-extremity or combined low- and upper-extremity exercise training, (iii) measurement time, and (iv) exercise intensity. Conclusions., The effects of programmes on exercise capacity were not differed in terms of the places where rehabilitation programmes were applied, programme content, measurement time, exercise target sites of body, and the duration and frequency of the programme. Relevance to clinical practice., The results of the present study can provide objective data when constructed or applied on a respiratory rehabilitation programme in clinics. [source]

Psychometric properties of the MacNew heart disease health-related quality of life instrument in patients with heart failure

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2008
Stefan Höfer
Abstract Rationale, aims and objectives, Heart failure (HF) is a severe chronic disease and impairs health-related quality of life (HRQL). While validated specific HRQL instruments are required for evaluation of treatment and rehabilitation in patients with HF, a single validated measure to document changes in HRQL for patients with different heart disease diagnoses would be invaluable. The purpose of this analysis was the psychometric analysis of the German MacNew Heart Disease Questionnaire (MacNew) in HF patients, which has previously been shown to be reliable and valid in patients with myocardial infarction, angina pectoris and arrhythmia. Methods, We recruited 89 patients (61.7 ± 11.5 years; 84.3% male) in two Austrian and one Swiss cardiology department with documented HF (effect sizes 28.9 ± 10.1%). The self-administered MacNew, the Short Form-36 (SF-36) and the Hospital Anxiety and Depression Scale were completed. Internal consistency reliability (Cronbach's ,), discriminative and evaluative validity were assessed. Results, Cronbach's , exceeded 0.80. Each MacNew scale differentiated between patients with and without anxiety (3.9 ± 1.0 vs. 5.3 ± 0.8, all P < 0.001), with and without depression (4.2 ± 1.2 vs. 5.2 ± 0.9 all P < 0.03) and by the SF-36 health transition item (deteriorate = 4.39, no change = 4.95, improve = 5.45, all P < 0.02). Evaluative validity was demonstrated with effect sizes >0.70 for a subsample attending a 12-week outpatient rehabilitation programme. Conclusions, The German language version of the MacNew demonstrates consistently acceptable psychometric properties of reliability, validity and responsiveness in patients with documented HF. Together with previous documentation of reliability, validity and responsive, these findings strengthen the argument for the MacNew as a potential ,core' HRQL measure, at least in the German language. [source]

The effects of a back rehabilitation programme for patients with chronic low back pain

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2007
Lynne Gaskell M (Res) Grad Dip Phys MCSP SRP
Abstract Aim, The aim of this paper was to perform a pragmatic before,after analysis of a back rehabilitation programme (BRP) for patients with chronic low back pain (LBP). A total of 877 patients were recruited onto the BRP, which were carried out at four centres within the Wrightington, Wigan and Leigh NHS Trust. The BRP consisted of nine 2-hour group sessions of therapy run over 5 weeks and included 1 hour of exercise and 1 hour of education, advice problem solving and goal setting. Method, Using the Wilcoxen signed rank tests and paired t -tests levels of pain, disability, anxiety and depression were significantly reduced pre-post programme (P < 0.001). In addition, the levels of fitness and perceived control improved significantly (P < 0.001) suggesting that participants were better able to manage their LBP. Conclusion, Overall, the BRP proved to be effective in reducing pain, disability, anxiety and depression levels for people with chronic LBP. However, despite significant improvements in outcome measures only 50% of the patients completed the BRP and questionnaires post BRP. The implications of the findings are discussed with respect to modified programmes and alternative management for patients within different subgroups of LBP. [source]

The experiences and perceived changes of Chinese ex-mental patients attending a holistic psychiatric rehabilitation programme: a qualitative study

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2008
A. L. LUK
The paper reports a study on the subjective experiences and perceived personal changes of Chinese ex-mental patients attending a psychiatric holistic rehabilitation programme. The programme adopted a self-help group approach in which holistic aspects of physical, psycho-social and spiritual needs are emphasized. There are different rehabilitation programmes for chronic mental patients. However, spiritual element is not consciously included in most of these programmes. Furthermore, few studies document the changes of participants attending psychiatric rehabilitation adopting self-help and holistic care principles. A qualitative approach using an in-depth interview was adopted. A total of 20 members from the programme, which was about one-sixth of all the regular group members were recruited. All interviews were audiotaped and transcribed. Data were coded, categorized and developed to different themes using content analysis. Totally, there were 52 themes developed from the data. However, only 13 themes on experiences in the group and nine themes on the perceived personal changes were reported. By attending the programme, participants had positive feelings and gained many positive learning opportunities when interacting with peers. Interacting with group counsellors was also very beneficial to them. Though there were only some improvements physically, there were clear perceived positive changes in the psychological, social and spiritual dimensions. These findings are consistent with those found in the quantitative measures reported previously. The subjective experiences of the participants were positive and they perceived positive personal changes after joining the group. The findings support the effectiveness of the long-term nature of self-help group. Furthermore, the holistic programme helps members rediscover meaning and purpose of life and the religious practices in the group can be regarded to be a protective factor to stress not only to those believers but also to the non-believers. [source]

Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson's disease,

MOVEMENT DISORDERS, Issue 3 2010
Michelangelo Bartolo MD
Abstract People with Parkinson's disease (PD) often have a posture characterized by lateral trunk flexion poorly responsive to antiparkinsonian drugs. To examine the effects of a rehabilitation programme (daily individual 90-minute-sessions, 5-days-a-week for 4-consecutive weeks) on lateral trunk flexion and mobility, 22 PD patients with mild to severe lateral trunk flexion, and 22 PD patients without trunk flexion were studied. Patients were evaluated using the Unified Parkinson's Disease Rating Scale motor subscale (UPDRS-III) score, and the kinematic behavior of the trunk was recorded by means of an optoelectronic system to determine: a) trunk flexion, inclination and rotation values in the erect standing posture; b) ranges of trunk flexion and inclination during trunk movements. After the treatment, significant decreases in trunk flexion [24°(4) vs. 14°(3), P < 0.001] and inclination in the static condition [23°(5) vs. 12°(4), P < 0.001)] were observed, both of which were maintained at the 6-month follow up. During the trunk flexion task, a significantly increased range of trunk flexion [64°(15) vs. 83°(15), P < 0.001] was observed; similarly, during the lateral bending task, the range of trunk inclination was found to be significantly increased, both toward the side of the trunk deviation [29°(8) vs. 42°(13), P < 0.01] and toward the contralateral side [14°(6) vs 29°(11), P < 0.01]. No further significant changes were observed at the 6-month follow-up. Trunk flexion and inclination values in the upright standing posture correlated slightly with the UPDRS-III score. Our findings show that significant improvements in axial posture and trunk mobility can be obtained through the 4-week rehabilitation programme described, with a parallel improvement in clinical status. © 2010 Movement Disorder Society [source]

Physiotherapy rehabilitation in patients with massive, irreparable rotator cuff tears

MUSCULOSKELETAL CARE, Issue 3 2006
Roberta Ainsworth FSCP SRP MSc BA (Hons)
Abstract Background:,Massive rotator cuff tears provide a challenge for effective rehabilitation. Work has been ongoing at Torbay Hospital, Devon since 2000 to develop an exercise programme for the management of this patient group. This programme has been evaluated in a pilot study and a further randomised controlled trial is currently taking place which will enable us to estimate the treatment effect. This paper discusses the background to the development of the rehabilitation programme, the programme itself and the results of the pilot study. The pilot study was an evaluation of the rehabilitation programme. Objectives:,This study examined the effectiveness of a physiotherapy regime for the treatment of patients with massive rotator cuff tears. Methods: Patients identified through primary and secondary care referrals to physiotherapy with a clinical diagnosis of a massive rotator cuff tear underwent an ultrasound scan to confirm the diagnosis. A massive cuff tear was one where the leading edge of the tear had retracted past the glenoid margin. The clinical diagnosis was based on the presence of some or all of the following signs: positive humeral thrust on elevation, gross weakness and wasting of supraspinatus and infraspinatus, infraspinatus lag and rupture of the long head of biceps. Eligible patients were invited to take part in the study and informed consent was obtained. The baseline assessment was carried out and then the patient undertook the treatment programme. Outcome measures were reassessed 12 weeks from the baseline assessment. Design:,A cohort study of 10 patients evaluating the change from baseline to twelve weeks in the shoulder function of patients undergoing a programme of anterior deltoid strengthening and functional rehabilitation. The outcome measures used were the Oxford Shoulder Disability Questionnaire (OSDQ) and SF36. The OSDQ is validated for use with the UK population and has 12 questions with 5 point responses. The lowest (best) score is 12 and the highest (worse) score is 60. Results: Scores on the OSDQ improved with all patients. The mean improvement was 9 (range 3 to 16, standard deviation 10.3). The SF36 showed an improvement in the pain scores for all patients (mean 22 points) and an overall improvement of 10 points for the sections on role limitation due to physical health. There was an overall decline in perceived general health (9 points) and in role limitation due to emotional health (23 points). Conclusions:,As all 10 patients showed improved scores on the OSDQ, in spite of the long-standing nature of many of their shoulder problems, this rehabilitation programme was shown to improve shoulder function in this group of patients. The variation shown in the quality of life scores reflects the age group of this cohort who had a mean age of 75.5 years. All patients deemed their pain and function to have improved over the three-month period. [source]

A pilot study of a pulmonary rehabilitation programme evaluated by four adults with chronic obstructive pulmonary disease

OCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2008
Anna Norweg
Abstract The purpose of this qualitative study was to analyse participants' perceptions of a pulmonary rehabilitation programme, which combined occupational therapy with physical therapy. Semi-structured interviews were used to collect data from four adults with chronic obstructive pulmonary disease (COPD) who attended an outpatient pulmonary rehabilitation programme in New York City. Features of the occupational therapy programme reported to be valuable were biofeedback and clinician support. Participants reported more control of dyspnoea, improved mental health and confidence in performing daily activities, less fatigue, more physically active lifestyles and hope for the future. Limitations of the study were that participants were interviewed only once and themes were not verified with participants. The study results also cannot be generalized. Further research is needed to evaluate the effectiveness of occupational therapy in promoting self-management and coping skills and restoring occupational performance in adults with COPD. Participants' responses provide additional support for developing cognitive-behavioural protocols in occupational therapy and measuring their effectiveness in relieving anxiety symptoms and promoting dyspnoea management. Copyright © 2008 John Wiley & Sons, Ltd. [source]

The Prison Service Drug Strategy: The Extent to which Prisoners Need and Receive Treatment

THE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 3 2005
Malcolm Ramsay
The article draws on a large pre-release survey of prisoners. Nearly two-thirds of those reporting problems staying off drugs before they were imprisoned subsequently received some treatment in prison, while one in ten went on an intensive rehabilitation programme. However, long-sentence prisoners were disproportionately likely to receive treatment. Outstanding challenges include a need to improve access to different types of treatment, especially for short-term prisoners, if treatment is to play as full a part as possible in addressing prisoners' drug problems and reducing reoffending. [source]

Cognitive-behavioural rehabilitation of high-risk violent offenders: Investigating treatment change with explicit and implicit measures of cognition

APPLIED COGNITIVE PSYCHOLOGY, Issue 3 2010
Devon L. L. Polaschek
Important as it is both to risk of re-offending and to cognitive behavioural treatment, violent cognition is seldom measured in rehabilitation programmes, and even more rarely linked to measures of violence risk. Most often, researchers measure violent cognition by having offenders complete transparent self-report questionnaires. This approach may be flawed both by socially desirable responding and by theoretical speculation that stronger links exist between automatic rather than explicit, consciously deliberated cognition and violent behaviour. We measured violent cognition in several ways; collecting data with two self-report scales, along with two Implicit Association Tests (IATs) from men commencing and completing an intensive cognitive-behavioural rehabilitation programme for high-risk violent prisoners. We addressed the questions of whether these two forms of assessment,explicit and implicit,are related, and which is most strongly linked to estimates of violence, based on the Violence Risk Scale. Explicit and implicit tests were not related to each other, although both self-report scales, and one of the IATs elicited significantly more pro-social responses following treatment. Further, the Aggression Questionnaire (AQ) scores were significantly correlated with dynamic risk both pre- and post-programme, while post-programme, scores on one of the two IATs was significantly correlated with dynamic and static risk, as measured pre- and post-programme. These findings suggest that implicit and explicit measures may be assessing different aspects of cognition, and only some are related to violence risk. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Convalescence after colonic surgery with fast-track vs conventional care

COLORECTAL DISEASE, Issue 8 2006
D. H. Jakobsen
Abstract Objective, To compare convalescence after colonic surgery with a fast-track rehabilitation programme vs conventional care. Background, Introduction of a multimodal rehabilitation programme (fast-track) with focus on epidural anaesthesia, minimal invasive surgical techniques, optimal pain control, and early nutrition and mobilization together with detailed patient information have led to a shorter hospital stay after colonic surgery. There are not much data on convalescence after discharge. Methods, A prospective, controlled, non-randomized interview-based assessment in 160 patients undergoing an elective, uncomplicated, open colonic resection or the Hartmann reversal procedure with a fast-track or a conventional care programme in two university hospitals. A structured interview-based assessment was performed preoperatively, and day 14 and 30 postoperatively. Results, Patients undergoing colonic surgery with a fast-track programme regained functional capabilities earlier with less fatigue and need for sleep compared with patients having conventional care. Despite early discharge of the fast-track patients (mean 3.4 days vs 7.5 days), no differences were found according to the need for home care, social care and visit to general practitioners, although the fast-track group had an increased number of visits at the outpatient clinic for wound care. More patients in the fast-track group were re-admitted, but the overall mean total hospital stay was 4.2 days vs 8.3 days in the conventional group. Conclusion, A fast-track rehabillitation programme led to a shorter hospital stay, less fatigue and earlier resumption of normal activities, without the increased need for support after discharge compared with conventionally treated patients after uncomplicated colonic resection. [source]

Low internalised restraint predicts criminal recidivism in young female prisoners

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2009
Ellen Kjelsberg
Background,The Weinberger Adjustment Inventory (WAI) measures social-emotional adjustment along two dimensions: distress and restraint. Four types of adjustment according to this measure have been shown to correlate with criminal recidivism among young male prisoners: reactive (high distress, low restraint), suppressor (high distress, high restraint), non-reactive (low distress, low restraint) and repressor (low distress, high restraint). Aim,To evaluate the predictive potential of the WAI among young female prisoners. Methods,Women under 30 years old, consecutively admitted to one of three Norwegian prisons, were asked to complete the WAI. Most of those eligible (102, 94%) did so. Re-conviction data were collected from the National Crime Register 38 months (SD = 9.0) after release. Results,The overall re-conviction rate was 38%. Rates differed according to the four WAI types: 53% in the non-reactive, 50% in the reactive, 22% in the suppressor and 11% in the repressor group (p = 0.006). Kaplan,Meier analyses showed that group differences were explained by the WAI restraint dimension (p = 0.008). Differences on the distress dimension did not influence re-conviction. Cox regression analysis (adjusting for age at first court conviction and prior offences) found that women with low restraint scores were almost three times as likely to re-offend as women with high restraint scores. Conclusion,The WAI appears to be an effective tool for identifying women who are particularly vulnerable to re-offending. Evidence of high capacity for restraint is protective, regardless of distress levels and even after adjusting for the effect of other criminologically important factors. The findings are suggestive that there may be value in individualising ,treatment' or rehabilitation programmes for prisoners. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Mental health outcomes of adjudicated males and females: the aftermath of juvenile delinquency and problem behaviour

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2004
Mélanie Corneau
Background Empirical evidence indicates that the rates of mental health problems and disorders are relatively high among adjudicated youths, especially females, yet few longitudinal studies have focused on gender differences regarding their mental health outcomes as adults. Aims The present study was designed to assess the prevalence rates of self-reported suicide attempts and psychological help-seeking in young adults adjudicated for antisocial behaviours in adolescence. This study also assessed gender differences in the prevalence rates of mental health problems and disorders reported by participants. Methods Structured interviews assessing personal and social adaptation were conducted on three occasions with 292 adjudicated male and 113 female youths (mean age 15 years on the first occasion). Data from the third testing wave (mean age 23.51 at T3) provide information on their mental health outcomes in adulthood. Results Results indicate that in individuals with a history of juvenile delinquency and/or problem behaviour over 10% of the males and 20% of the females reported suicide attempts, and one-fifth and one-third respectively reported psychological consultation. Similar and lower proportions reported psychiatric hospitalization and/or drug addiction programme/therapy at the beginning of adulthood. Implications for practice The present study suggests that these youths may need more mental health directed interventions in their assessment rehabilitation programmes. Copyright © 2004 Whurr Publishers Ltd. [source]

Alcohol use and negative affect in the offence cycle

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2003
Andrew Day
Introduction It is commonly acknowledged that, for many offenders, alcohol use is strongly associated with criminal behaviour. The belief held by many professionals that the two phenomena are associated, probably in a causal way, has led to the inclusion of alcohol use as a ,criminogenic need' in many settings where rehabilitation programmes are used to reduce recidivism. However, the mechanisms and pathways involved in the alcohol,crime link remain poorly understood. Argument and conclusion This paper reviews the literature relating to alcohol,offending links and draws some inferences about the role of alcohol use as a criminogenic need in offender rehabilitation. It is proposed that the bi-directional relationship between alcohol use and negative affective states is important in understanding the offence cycle, and that deficits in self-regulation not only characterize both alcohol misuse and negative affect but are also implicated in the offending behaviour itself. Copyright © 2003 Whurr Publishers Ltd. [source]

Mental health care reform in Sweden, 1995

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2001
C.-G. Stefansson
Objective:,To describe the content of the Community Mental Health Care reform in Sweden, in effect from 1995 and directed to severely mentally ill people (SMI). Method:,Evaluating changes, at local and national level, in living conditions among SMI and resources of services directed to them, by using registers, questionnaires, interviews and case studies. Results:,A survey, covering 93% of the population, identified 43 000 SMI (prevalence of 0.63%); 4000 long-stay patients and 400 rehabilitation programmes were transferred from psychiatric services to social services (15% of the budget of psychiatric services). Employment and rehabilitation projects, family support and user programmes and educational projects for social services staff, were launched (funded by state subsidies). Conclusion:,SMI still have difficulties in obtaining adequate support on the basis of disability laws and there continue to be barriers between social services and psychiatric services. [source]

NGO Initiatives in Risk Reduction: An Overview

DISASTERS, Issue 3 2001
Charlotte Benson
NGOs appear to be well placed to play a significant role in natural disaster mitigation and preparedness (DMP), working, as they do, with poorer and marginalised groups in society. However, there is little information on the scale or nature of NGO DMP activities. This paper reports the findings of a study seeking to address that gap. It confirms that NGOs are involved in a diverse range of DMP activities but that a number of them are not labelled as such. Moreover, evidence of the demonstrable quality and benefits of DMP involvement is poor. The paper concludes that a number of problems need to be overcome before DMP can be satisfactorily mainstreamed into NGO development and post-disaster rehabilitation programmes. However, there are some early indications of momentum for change. [source]

Methadone and impairment in apprehended drivers

ADDICTION, Issue 3 2009
Jean-Paul Bernard
ABSTRACT Aims According to Norwegian guidelines, patients who are in opioid-assisted rehabilitation programmes are permitted to drive a motor vehicle provided that certain requirements are met. The purpose of this study was to investigate apprehended drivers who had methadone in their blood at the time of apprehension and, further, the relationship between blood methadone concentration and impairment as measured by the clinical test of impairment (CTI). Methods The division of Forensic Toxicology and Drug Abuse (DFTDA) at the Norwegian Institute of Public Heath analyses blood samples from all drivers suspected of driving under the influence of drugs nation-wide. Cases with positive results for methadone in blood were collected over the period 2001,2006. Results A total of 635 drivers with methadone found in their blood samples were identified. The majority of drivers were men (>80%), aged between 30 and 40 years. Methadone was the only psychoactive drug detected in blood in only 10 cases. Benzodiazepines were a frequent finding (in approximately 90% of cases). A significant difference in blood methadone concentration was found between cases where only methadone was detected [median 0.46 mg/l (range 0.19,0.65)] and cases where methadone was detected in combination with other psychoactive drugs [median 0.28 mg/l (range 0.06,1.24)]. A CTI had been carried out, in conjunction with blood sampling, in 577 of the cases. A concentration,impairment relationship was not seen for methadone in these cases. Conclusions Cases of driving impairment involving methadone alone were very rare, with combination use most frequent. No correlation between methadone concentration and impairment as judged by the CTI was seen either for these cases or for the material as a whole. [source]

The influence of head and neck position on kinematics of the back in riding horses at the walk and trot

EQUINE VETERINARY JOURNAL, Issue 1 2005
M. RHODIN
Summary Reasons for performing study: A common opinion among riders and in the literature is that the positioning of the head and neck influences the back of the horse, but this has not yet been measured objectively. Objectives: To evaluate the effect of head and neck position on the kinematics of the back in riding horses. Methods: Eight Warmblood riding horses in regular work were studied on a treadmill at walk and trot with the head and neck in 3 different predetermined positions achieved by side reins attached to the bit and to an anticast roller. The 3-dimensional movement of the thoracolumbar spine was measured from the position of skin-fixed markers recorded by infrared videocameras. Results: Head and neck position influenced the movements of the back, especially at the walk. When the head was fixed in a high position at the walk, the flexion-extension movement and lateral bending of the lumbar back, as well as the axial rotation, were significantly reduced when compared to movements with the head free or in a low position. At walk, head and neck position also significantly influenced stride length, which was shortest with the head in a high position. At trot, the stride length was independent of head position. Conclusions: Restricting and restraining the position and movement of the head and neck alters the movement of the back and stride characteristics. With the head and neck in a high position stride length and flexion and extension of the caudal back were significantly reduced. Potential relevance: Use of side reins in training and rehabilitation programmes should be used with an understanding of the possible effects on the horse's back. [source]

Feasibility of an exercise rehabilitation programme for cancer patients

Constitutive opioid receptor activation: a prerequisite mechanism involved in acute opioid withdrawal

ADDICTION BIOLOGY, Issue 2 2005
E Freye
The opioid receptor antagonist naltrexone, which is used in detoxification and rehabilitation programmes in opioid addicts, can precipitate opioid withdrawal symptoms even in patients who have no opioid present. We tested the hypothesis that in order to precipitate withdrawal, opioids need to convert the inactive opioid receptor site via protein kinase C into a constitutively active form on which the antagonist precipitates withdrawal. Acute abstinence symptoms were induced by the potent opioid receptor agonist sufentanil (21?,g/kg), given for 6 days, which was followed by the antagonist naltrexone (20?,g/kg i.v.) in the awake trained canine (n,=,10). Abrupt displacement of opioid binding resulted in acute withdrawal symptoms: increase in blood pressure, heart rate, increase in amplitude height of somatosensory evoked potential, reduced tolerance to colon distention and a significant increase in grading of vegetative variables (restlessness, panting, thrashing of the head, whining, yawning, gnawing, salivation and/or rhinorrhoea, mydriasis, stepping of extremities and vomiting). Following a washout period of 14 days, the same animals were given the highly specific protein kinase C inhibitor H7 (250?,g/kg) prior to the same dosages of sufentanil and naltrexone. Such pretreatment was able to either attenuate or completely abolish the acute withdrawal symptoms. The data suggest that for precipitation of withdrawal, intracellular phosphorylation is a prerequisite in order to activate the opioid ,-receptor. In such a setting, naltrexone acts like an ,inverse agonist? relative to the action of the antagonist on a non-preoccupied receptor site not being exposed previously to a potent opioid agonist. [source]

How to link biomanipulation and sustainable fisheries management: a step-by-step guideline for lakes of the European temperate zone

FISHERIES MANAGEMENT & ECOLOGY, Issue 3-4 2004
T. Mehner
Abstract Biomanipulation, the reduction of planktivorous fish to enhance filter-feeding zooplankton, has been used to rehabilitate eutrophied lakes. However, efficacy and long-term success were dependent on nutrient load, lake morphometry and biomanipulation measures. The ongoing focus on sustainable use of aquatic resources offers the chance to perform lake rehabilitation using a combined strategy of nutrient load reduction and traditional inland fisheries management techniques. Particularly in Central and Western Europe where piscivorous fish are the target species of most commercial and recreational fisheries, an enhancement of the piscivores by stocking and harvest regulations may act successfully in the co-management of ecosystem and fisheries. Guidelines are presented on how biomanipulation can be used as in lake rehabilitation by considering the objectives and constraints of traditional fisheries management. Alternatives in the decision tree are elucidated by examples from biomanipulations and lake management programmes in the temperate zone of Europe and North America. It is suggested that biomanipulation may support many lake rehabilitation programmes where fisheries' stakeholders are the principal user groups. [source]

Effectiveness of Supportive Educative Learning programme on the level of strain experienced by caregivers of stroke patients in Thailand

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2010
R. Oupra RN MSc MNS PhD
Abstract In Thailand, the crude death rate from stroke is 10.9/100 000 population and increasing. Unlike Western countries where community rehabilitation programmes have been established to provide services following the acute stage of stroke recovery, there is no stroke rehabilitation team in the community in Thailand. Therefore, family caregivers are the primary source for ongoing care and support. While family members accompany patients during their hospitalisation, they receive little information about how to assist their relatives, and as a result feel inadequately trained, poorly informed and dissatisfied with the support that is available after discharge. Family caregivers report that they suffer both physically and psychologically and find themselves overwhelmed with strain, experiencing burden and exhaustion. This study aimed to develop and implement a nurse-led Supportive Educative Learning programme for family caregivers (SELF) of stroke survivors in Thailand and to evaluate the effect of the SELF programme on family caregiver's strain and quality of life. This was a non-randomised comparative study with concurrent controls, using a two-group pre-test and post-test design. A total of 140 stroke survivors and 140 family caregivers were recruited; 70 patients/caregiver pair in each group. Caregivers of patients admitted to the intervention hospital following an acute stroke received the intervention, while caregivers of patients admitted to the comparison hospital received the usual care provided at the hospital. The data were collected prior to discharge of the patients and after 3 months. The family caregivers in the intervention group had a significantly better quality of life than the comparison group (GHQ-28 at discharge t = 2.82, d.f. = 138, P = 0.006; and at 3 months t = 6.80, d.f. = 135, P < 0.001) and they also reported less strain (Caregiver Strain Index at discharge t = 6.73, d.f. = 138, P < 0.001; and at 3 months t = 7.67, d.f. = 135, P < 0.001). This research demonstrated that providing education and support to the family caregiver of stroke survivors can reduce caregiver strain and enhance their quality of life. [source]