scholarly journals Intervention bimanual stimulates the abilities in infants with asymmetry

2021 ◽  
Vol 34 ◽  
Author(s):  
Mayara Thais Correr Ribeiro ◽  
Luzia Iara Pfeifer
Keyword(s):  
Hand Function ◽  
Intensive Therapy ◽  
Functional Independence ◽  
Function Evaluation ◽  
Constraint Induced Movement Therapy ◽  
Effective Interventions ◽  
Intervention Protocol ◽  
Clinically Significant ◽  
The Impact

Abstract Introduction: The cerebral palsy and brachial plexus injury may cause asymmetry in the use of the upper limbs (UL). This condition requires early treatment to reduce the impact of the child's life; therefore, several proposed interventions aim to increase their functional independence. The Constraint-Induced Movement Therapy (CIMT) and Hand-Arm Bimanual Intensive Therapy (HABIT) have been widely considered effective interventions to improve hand function. Objective: Investigate the effects of an intervention protocol based on the CIMT and HABIT theoretical foundations in the stimulation of manual function in infants with the UL asymmetry. Methods: Five infants (6-24 months) participated in the study. To evaluate the motor function of infants we used Pediatric Motor Activity Log (PMAL-R) and Manual Function Evaluation (AMIGO), and to assess the caregiver's perception of the participation of the infant in daily tasks, we used the Pediatric Disability Assessment Inventory (PEDI). All evaluations occurred before, immediately after the intervention, and after four months for follow-up recording, and were analyzed descriptively by Jacobson- Truax method. Results: The results between evaluation and reevaluation demonstrated evolution in all aspects studied. In the PEDI self-care session, an average of 38.6 (±8.4) - 44.2 (±7.4); PEDI Mobility: 28.8 (±20.3) - 36.28 (±21.7); PEDI Social Function: 40.1 (±10.2) - 42.3 (±8.9). The PMAL-R quantity and quality results evidence a highly positive clinical significance in all infants. Conclusion: The application of the modified restriction intervention protocol resulted in reliable and clinically significant changes in all cases.

Impact of Length of Stay on Functional Outcomes of TBI Patients

2005 ◽  
Vol 71 (11) ◽  
pp. 920-930 ◽  
Author(s):  
M.L. Hawkins ◽  
F.D. Lewis ◽  
R.S. Medeiros
Keyword(s):  
Length Of Stay ◽  
Functional Outcomes ◽  
Inpatient Care ◽  
Average Length ◽  
Functional Independence ◽  
Average Length Of Stay ◽  
Group 2 ◽  
The Impact ◽  
Group 1

The purpose of this study was to compare the functional outcomes of two groups of patients with traumatic brain injury (TBI) with attention to the impact of reduced length of stay (LOS) in the trauma center (TC) and rehabilitation hospital (RH). From 1991 to 1994, 55 patients, Group 1, with serious TBI (Abbreviated Injury Scale score ≥3) were admitted to a level 1 TC and subsequently transferred to a comprehensive inpatient RH. These results have been previously published. From 1996 to 2002, 64 similarly injured patients, Group 2, received inpatient care at the same TC and RH. These patients had a marked decrease in length of stay. Functional Independence Measures (FIM) were obtained at admission (Adm), discharge (D/C), and at 1 year follow-up for both groups. The average length of stay at the TC dropped from 36 days in Group 1 to 26 days in Group 2. In addition, the average length of stay at the RH dropped from 46 days (Group 1) to 25 days (Group 2); overall, an average reduction of 31 days of inpatient care. Group 2 had significantly lower FIM scores at the time of RH discharge for self-care, locomotion, and mobility compared to Group 1. At the 1 year follow-up, however, there were no significant differences between Groups 1 and 2 in these FIM scores. FIM scores at 1 year were higher in Group 2 for communication (90% vs 71%) and social cognition (77% vs 49%) compared to Group 1. Over one-fourth of each group returned to work by the 1 year follow-up. Socially disruptive behavior occurred at least weekly in 28 per cent (Group 1) and 23 per cent (Group 2) of patients. The outcome for serious TBI is better than generally perceived. Reduction of inpatient LOS did not adversely affect the ultimate functional outcome. The decreased LOS placed a greater demand on outpatient rehabilitative services as well as a greater burden on the family of the brain-injured patient

Telephone counseling improves adherence to colposcopy among lower-income minority women.

1992 ◽  
Vol 10 (2) ◽  
pp. 330-333 ◽  
Author(s):  
C Lerman ◽  
P Hanjani ◽  
C Caputo ◽  
S Miller ◽  
E Delmoor ◽  
...  
Keyword(s):  
Patient Adherence ◽  
Telephone Counseling ◽  
Minority Women ◽  
Screening Tests ◽  
Lower Income ◽  
Counseling Intervention ◽  
Intervention Protocol ◽  
Patient Reported ◽  
The Impact

PURPOSE A randomized trial was conducted to evaluate the impact of a telephone counseling intervention to improve patient adherence to colposcopic examination for suspected cervical intraepithelial neoplasia (CIN). METHODS Subjects were lower-income, minority women who missed a scheduled initial appointment for colposcopy at an urban medical clinic. Patients were randomly assigned to either a control condition (n = 42) or a telephone counseling condition (n = 48). The 15-minute, structured telephone counseling intervention protocol addressed educational, psychosocial, and practical barriers to colposcopy adherence. RESULTS The most common patient-reported barriers to colposcopy adherence included a lack of understanding of the purpose of colposcopy (50%), worry about or fear of cancer (25%), and forgetting (23%). Telephone counseling was found to be highly effective in addressing these barriers and improving adherence to diagnostic follow-up and treatment. Of patients in the control condition, 43% complied with a rescheduled colposcopy appointment, compared with 67% in the telephone counseling condition. Logistic regression analysis indicated that the effect of telephone counseling was independent of sociodemographic confounder variables (odds ratio = 2.6; P less than .003). Additionally, 74% of patients who received the initial telephone counseling adhered to recommended treatment, compared with 53% of patients in the control condition. CONCLUSION Brief, structured telephone contact may be a cost-effective mechanism for improving adherence to diagnostic follow-up and treatment for a variety of cancer screening tests.

Outcomes of septoplasty

2000 ◽  
Vol 122 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Noah S. Siegel ◽  
Richard E. Gliklich ◽  
Farhan Taghizadeh ◽  
Yuchiao Chang
Keyword(s):  
Health Survey ◽  
General Health ◽  
Short Form ◽  
Female Gender ◽  
Normative Values ◽  
History Of ◽  
Clinically Significant ◽  
The Impact ◽  
Specific Health

A prospective nonrandomized study of consecutive patients presenting to the Massachusetts Eye and Ear Infirmary for septoplasty was conducted to evaluate patient-based outcome. Patients received statistically validated measures of general health status (Short Form-12) and nasal specific health (Nasal Health Survey) before and 6 and 12 months after surgery. Multiple perioperative patient- and surgeon-dependent treatment variables were also evaluated to determine the impact on outcome. A total of 161 patients were entered into the study, and 93 were available for statistical analysis. At 9 months the mean follow-up (range 6–12 months), both symptom and medication subscores of the Nasal Health Survey, and the total score demonstrated significant improvement ( P < 0.05); 71% of patients had clinically significant improvement as determined by at least a 50% decrease in duration of nasal symptoms. Measures of general health did not differ significantly from normative values at baseline and did not change after surgical intervention. Predictor analysis revealed that female gender and a history of previous nasal surgery predicted worse outcome.

Effectiveness of Hand-Arm Bimanual Intensive Therapy on Hand Function among Children with Unilateral Spastic Cerebral Palsy: A Meta-Analysis

2020 ◽  
Vol 83 (2) ◽  
pp. 131-137
Author(s):  
Khalid Alahmari ◽  
Jaya Shanker Tedla ◽  
Devika Rani Sangadala ◽  
Debjani Mukherjee ◽  
Ravi Shankar Reddy ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Effect Size ◽  
Meta Analysis ◽  
Hand Function ◽  
Intensive Therapy ◽  
Spastic Cerebral Palsy ◽  
Randomized Controlled ◽  
Constraint Induced Movement Therapy ◽  
Evidence Database ◽  
The Individual

Background: Hand-arm bimanual intensive therapy (HABIT) has been shown to be an effective method for improving upper-extremity function. However, owing to ambiguity within the evidence of HABIT’s effects on hand function among children with unilateral spastic cerebral palsy (CP), this meta-analysis sought to elucidate whether the same was true in this patient population. Summary: A computerized database search yielded 468 studies. After meticulous scrutiny and screening of these studies according to the selection criteria, 4 full-text articles were included in the meta-analysis. All 4 studies underwent a methodological quality assessment according to the Physiotherapy Evidence Database Scale (PEDro), with a score of greater than 8. Five comparisons were then made involving the 4 selected randomized controlled trials (RCTs). The effect size was measured using the correlation coefficient (r value). The effect sizes of the individual studies were 0.006, 0.03, 0.04, 0.22, and 0.15. The total effect size was 0.06. Key Message: This meta-analysis determined that there is a trivial benefit using HABIT when compared to constraint-induced movement therapy or structured and unstructured bimanual therapy in pediatric patients with unilateral spastic CP. More RCTs are needed to substantiate our evidence.

Measuring the impact and sustainability of a statewide program for identifying minority and underserved clients at risk for hereditary breast and ovarian cancer (HBOC): An eight-year follow up including transitions during the COVID pandemic.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18546-e18546
Author(s):  
Alice S. Kerber ◽  
Sheryl G. A. Gabram ◽  
Diane Durrence ◽  
Janet Y. Shin ◽  
Nancy M. Paris ◽  
...  
Keyword(s):  
Public Health ◽  
Genetic Testing ◽  
High Risk ◽  
Surveillance Data ◽  
Health Centers ◽  
Care Providers ◽  
Underserved Women ◽  
Clinically Significant ◽  
The Impact

e18546 Background: The Georgia Breast Cancer Genomics Program was created with 2011-2014 funding from the Centers for Disease Control and Prevention and the Georgia Department of Public Health (GDPH). In collaboration with GDPH and the Georgia Center for Oncology Research and Education (Georgia CORE), the goal of the program has been to reduce disparities among high-risk minority and underserved women. The objective of this study is to report the 8-year surveillance data for women at increased risk for HBOC in statewide public health centers. The effect of the COVID pandemic on the program and sustainability is also reported. Methods: From 11/1/2012-12/31/2020, the program provided education, outreach and collected surveillance data using an online genetics referral screening tool as recommended by USPSTF. Providers in 159 counties and health centers across Georgia were educated in cancer family history collection and appropriate referral to genetics. When an individual was found to be at high risk, she was referred to the Georgia CORE Genetics Advanced Practice Nurse for additional education, genetic testing and follow-up. Results: Online screenings attributable to GDPH totaled 29,087 with 1,656 positive screens. 28 % of clients were less than 25 years of age and 56 % ranged from 25-54. Race: 33 % white, 41 % black, 15 % Hispanic and 11 % other or N/A. 92 % of referrals were uninsured. Genetic testing was started or completed on 430 clients. 36 individuals declined testing after counseling (reconsideration, insurance, unknown reasons) and were provided with contact information. 47 (11%) pathogenic, clinically significant mutations were identified including 37 (79 %) HBOC related mutations and 10 (21 %) Lynch related mutations. Variants of uncertain significance were identified in 90 (21 %) clients, with multiple variants in 40 of those. 27 clients have been served through GDPH for physician consultation and surveillance. 13 were referred to area resources: one diagnosed with cancer, and 7 chose referral to other health care providers. Because of the pandemic, the program transitioned to telecommunications and remote access to testing in 5/2020. From 5/2020-12/2020, 34 clients completed testing (41% minority, all uninsured). 10 (29%) clinically significant mutations were identified and heightened surveillance initiated. Conclusions: The GDPH and Georgia CORE collaborative genomics program has served clients over the past 8 years, adjusting to changing resources while reaching a significant number of minority and underserved women. The program successfully converted to remote services during the COVID pandemic. Lessons learned from this transition have been incorporated into planning for future program sustainability.

The impact of therapeutic relatives’ groups on the course of illness of schizophrenic patients

1995 ◽  
Vol 10 (1) ◽  
pp. 17-27 ◽  
Author(s):  
G Buchkremer ◽  
H Schulze Mönking ◽  
R Holle ◽  
WP Hornung
Keyword(s):  
Control Group ◽  
Course Of Illness ◽  
Self Help ◽  
Before And After ◽  
Schizophrenic Patients ◽  
Clinically Significant ◽  
Self Help Groups ◽  
The Impact ◽  
Relapse Rates

SummaryThis study considers the question of whether relapse rates among schizophrenic patients can be reduced by means of relatives' groups. In a randomized, controlled intervention study, two therapeutic strategies (therapeutic relatives' groups, initiated relatives' self-help groups) were compared with each other and with a control group. Interventions were confined to the relatives, with the patients continuing their standard treatment. The study involved 151 relatives of 99 chronic DSMIII schizophrenics. Data were collected before and after a 1-year intervention phase and in a 2-year follow-up. No difference existed between the groups with respect to rehospitalization data. However, numerous differences recorded in the psychopathological findings and in living and working circumstances suggest that therapeutic work with relatives is of clinically significant benefit.

scholarly journals Short-Term Predictors for Weight Correction Success of the First Paediatric Weight Correction Programme in Children’s Clinical University Hospital in Riga

Medicina ◽  
2019 ◽  
Vol 55 (3) ◽  
pp. 75 ◽  
Author(s):  
Jurgita Gailite ◽  
Dana Apela ◽  
Iveta Dzīvīte-Krišāne ◽  
Dace Gardovska
Keyword(s):  
Waist Circumference ◽  
Weight Status ◽  
Age Groups ◽  
Female Gender ◽  
University Hospital ◽  
Baseline Body Mass Index ◽  
Clinically Significant ◽  
The Impact ◽  
Weight Correction

Background and objectives: The efficacy of a weight correction programme can be affected by such predictors as the number of contact hours, gender, age, baseline weight, parental weight status, psycho-emotional status, insulin resistance, and socioeconomic status. The aim of this current study was to evaluate the overall efficacy of the Weight Correction Programme at Children’s Clinical University Hospital, and explore the impact of the probable predictors. We evaluated the efficacy depending on gender, age, parental weight status, signs of depression, baseline body mass index z-score (z-BMI), and baseline waist circumference. Materials and Methods: The data were gathered from medical records. The inclusion criteria were as follows: Entered the programme by 13 June 2017, at least five years old, follow-up data available. All the respondents were divided into two age groups: <10 years old and ≥10 years old. Results: The study included 181 respondents. They were 5 to 17 years old on the first day of participation in the Weight Correction Programme. Results indicated that 117 (65%) patients managed to reduce z-BMI and 69 (38%) patients achieved clinically significant reduction of z-BMI. Boys had four times higher odds (odds ratio (OR) = 4,22; CI 1.37–13.05; p = 0.012) to reduce their z-BMI by at least 0.20 units than girls. The respondents of the older age group (≥10 years) had a better chance to reduce z-BMI than the younger ones (OR = 11,51; CI 2.04–64.83; p = 0.006). The odds to reduce z-BMI were lower by 7% for every extra cm of waist circumference (OR = 0.93; CI 0.88–0.99; p = 0.014) for reducing z-BMI. The follow-up time was also a positive predictor, and with every month the odds for clinically significant z-BMI reduction increased by 7% (OR = 1.07; CI 1.00–1.15; p = 0.047). The parental weight status, signs of depression, and baseline z-BMI were not significant predictors. Conclusions: More than half of the patients of the respondents managed to reduce their z-BMI. Female gender, younger age, and larger waist circumference were negative predictors.

Evaluation of a specialty hepatitis C virus telephone pharmacy service

2021 ◽  
Author(s):  
Ashley A Sabourin ◽  
Kaleigh K Fisher-Grant ◽  
Adam R Saulles ◽  
Rima A Mohammad
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Pharmacy Service ◽  
Hcv Infection ◽  
Pharmacy Services ◽  
Specialty Pharmacy ◽  
Clinically Significant ◽  
Direct Acting ◽  
The Impact

Abstract Purpose Direct-acting antivirals (DAAs) used to treat hepatitis C virus (HCV) infection are associated with significant drug-drug interactions (DDIs). Pharmacists are well positioned to identify and mitigate these DDIs. Data to guide assessment of the impact of HCV specialty pharmacy services on identifying and addressing DDIs with DAAs are lacking. The overall purpose of the study described here was to determine the incidence and severity of DDIs identified by specialty pharmacists among patients treated with DAAs prior to and 1 month into therapy. Methods An observational, retrospective study was conducted to evaluate the impact of specialty pharmacy services in mitigating DDIs associated with use of DAAs. Adult patients with HCV infection (n = 200) who received DAAs and were enrolled with a specialty pharmacy service over a 1-year period were included. Endpoints included number, severity, and type of DDIs and DDIs per patient at baseline and 1 month into therapy, pharmacists’ interventions, and safety and clinical outcomes. Results Fifty-nine percent of patients had at least 1 DDI. A total of 170 DDIs were identified (137 at baseline and 33 at 1-month follow-up), and the mean number of DDIs per patient significantly decreased from baseline to 1-month follow-up (from 1.38 to 0.16, P &lt; 0.0001). The rate of “potentially clinically significant” or “critical” interactions was significantly lower at 1-month follow-up vs baseline assessment (69.6% vs 81.7%, P &lt; 0.0001). The most commonly identified DDIs involved acid suppressive medications (49.6% and 66.6% of DDIs at baseline and follow-up assessment, respectively) and cardiovascular medications (26.2% and 21.2%, respectively). Total number of DDI interventions was 131, with an acceptance rate of 85%. Most common intervention was patient education and monitoring. Conclusion Approximately 60% of patients had DDIs with DAAs. Implementing HCV specialty pharmacy services significantly decreased DDIs while maintaining SVR12.

scholarly journals Trajectories of Psychopathology According to Continuation or Discontinuation of Child Abuse: A Longitudinal Observational Study

2021 ◽  
Vol 18 (17) ◽  
pp. 8968
Author(s):  
Eunji Jung ◽  
Joung-Sook Ahn ◽  
Jaehyun Han ◽  
Min-Hyuk Kim
Keyword(s):  
Childhood Abuse ◽  
Risk Groups ◽  
Developmental Trajectory ◽  
Late Childhood ◽  
Tracking Data ◽  
Longitudinal Observational Study ◽  
Effective Interventions ◽  
Clinically Significant

Long-term exposure to childhood abuse and occurrence of mental illness are positively correlated. Using long-term tracking data in Korea, we identified the characteristics of children and adolescents who experienced abuse and impact thereof on their psychopathology. Using the Korea Welfare Panel data, 354 teenagers in grades 4–6 of elementary school participated, were assessed at baseline, and monitored 3 years later. They were categorized into Never, Occurrence, Continuation, and Discontinuation groups according to changes in the abuse experienced. Psychopathology was evaluated using K-CBCL. Childhood abuse experience significantly affected psychopathology. At the baseline, the Continuation and Discontinuation groups had a higher severity of psychopathology than the Never group. Psychopathology at the baseline was associated with whether the patient experienced abuse that year. In the follow-up observation, the risk of psychopathology in the Occurrence and Continuation groups was higher than that in the Never group. The Discontinuation group had decreased psychopathology, which was not clinically significant in the follow-up observation (INT aRR = 2.09; 95% CI 0.61–7.13, EXT aRR = 4.23; 95% CI 1.12–16.07). Stopping abuse in late childhood reduces adolescents’ psychopathology in the long term, meaning they can recover their normal developmental trajectory according to risk groups and provide effective interventions including discontinuation of abuse.

scholarly journals Group physiotherapy with survivors of torture in urban and camp settings in Jordan and Kenya

2021 ◽  
Vol 30 (3) ◽  
pp. 27-42
Author(s):  
Laura Janet Pizer Gueron ◽  
Arobogust Amoyi ◽  
Winnie Chao ◽  
Justine Chepngetich ◽  
Jepkemoi Joanne Kibet ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Group Treatment ◽  
Community Education ◽  
Pelvic Floor Dysfunction ◽  
Interdisciplinary Treatment ◽  
Care Providers ◽  
Biopsychosocial Perspective ◽  
Clinically Significant ◽  
The Impact

Introduction:  In this paper we report provisional field results on the impact of CVT’s (the Center for Victims of Torture) interdisciplinary group treatment on physiotherapy indicators in refugees living in urban and camp settings in Kenya and Jordan. The physiotherapy component of this model includes pain neuroscience education, sleep hygiene, posture and body mechanics instruction and healing of pain and trauma from a biopsychosocial perspective, in a program of ten weekly sessions. This program is supported by a clinical assessment that records a broad set of indicators of participant experience and functioning. In addition, some survivors report having pelvic floor dysfunction and data will be offered about a subset of survivors looking at prevalence of these issues. Methods: Survivors are identified through referral systems, community education and sensitization campaigns, contacts and trainings with other NGOs and health care providers. Prospective survivors are screened into CVT services or referred to other agencies that can better meet their needs. CVT focuses its services on refugees with physical and emotional difficulties that may be effectively treated through its interdisciplinary treatment model and who have survived torture or related human rights violations. Following an informed consent process, survivors participate in a comprehensive individual assessment and then progress to the 10-week program. Wherever possible, follow-up assessments are conducted 2 weeks after the sessions end, and at 3, and 9 months following completion of the 10-week long intervention. Results: On average, participants who completed 3-month follow-up assessments showed statistically and clinically significant improvements on physiotherapy indicators. Discussion: Provisional results are encouraging and suggest that the model is adaptable to the needs of different populations and settings. As nearly all participants receive both counseling and physiotherapy, it is difficult to know which benefits can be attributed to physiotherapy alone. 

Sign in / Sign up

Export Citation Format

Share Document