POST-OPERATIVE REHABILITATION FOR PATIENTS WITH DEGENERATIVE DISK DISEASES

2019 ◽  
pp. 17-25
Author(s):  
I.V. Borodulina ◽  
S.O. Arestov ◽  
A.O. Gushcha ◽  
N.G. Badalov ◽  
A.A. Mukhina
Keyword(s):  
Management Strategy ◽  
Clinical Effect ◽  
Functional Limitation ◽  
Neurological Impairment ◽  
Situational Factors ◽  
Postoperative Rehabilitation ◽  
Neurologic Impairment ◽  
Individual Program ◽  
Personalized Approach ◽  
The Impact

Surgical treatment for degenerative disk diseases is widespread today. Surgery is used to decompress neural structures, eliminate pain and symptoms of neurologic impairment. Nevertheless, a successful surgical intervention does not always guarantee a favorable clinical effect, which is associated with various factors: the duration of a disease, compensatory abilities of patients, and their emotional state. Thus, post-operative rehabilitation, based on a multimodal patient-oriented personalized approach, becomes very relevant. Post-operative rehabilitation considers the degree of functional limitation or loss and the impact of situational factors. According to the concept of post-operative rehabilitation as a personalized management strategy, it is advisable to divide patients into the following groups: those who do not have alert complaints or neurological impairment after surgery; those who have chronic pain; those who have residual or persistent neurological impairment. Such an approach allows physicians to suggest an individual program for rehabilitation treatment. Keywords: postoperative rehabilitation, degenerative disk diseases, multimodal patient-oriented personalized approach.

scholarly journals BASICS OF A PERSONALIZED APPROACH TO MEDICAL AND PSYCHOLOGICAL SUPPORT OF CARDIAC SURGERY PATIENTS

2021 ◽  
Vol 9 (4) ◽  
pp. 339-354
Author(s):  
O.V. Nikolaeva ◽  
◽  
T.A. Karavaeva ◽  
◽  
◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Work Experience ◽  
Early Stage ◽  
Modern Medicine ◽  
Psychological Support ◽  
Psychological Status ◽  
Postoperative Rehabilitation ◽  
Clinical Stages ◽  
Personalized Approach ◽  
The Impact

The concept of a personalized approach is becoming more and more popular in modern medicine. Today it is often understood as a multidisciplinary approach designed to improve therapeutic options, as well as help diagnose diseases at an early stage. In a cardiac surgery clinic, such an approach can take into account not only biological, but also psychological risk factors for the disease, especially its history, clinical condition, mental and psychological status to create an individual route within the framework of medical and psychological support for the patient at the stages of treatment and rehabilitation. The aim of the work was to develop, based on the analysis of the literature and the authors' own work experience, the organizational and psychological foundations for the implementation of a personalized approach in medical and psychological support of cardiac patients. The fundamental principles of support in the work include the following: the principle of accessibility, the principle of openness, the principle of continuity, the principle of complexity, the principle of integrativity, the principle of differentiation, the principle of variability, the principle of participativeness, the principle of awareness, the principle of prevention. In the process of medical and psychological support of cardiac surgical patients within the framework of a personalized approach, the most optimal was the identification of the following clinical stages, different in duration and content, corresponding to the periods of outpatient and inpatient treatment and rehabilitation of patients: preoperative outpatient, preoperative inpatient, early postoperative, postoperative inpatient, postoperative rehabilitation and rehabilitation outpatient stages. For each of the clinical stages of medical and psychological support, a differentiation of goals, objectives, duration and expected results of the impact was carried out, which makes it possible to personalize the programs for accompanying a cardiac patient and individualize the route for each patient, taking into account the specificity and relevance of the influence of biologi cal, psychological and social factors.

Influence of internal and external risks on sustainability of financial system of Аltai krai

2018 ◽  
Vol 35 (4) ◽  
pp. 133-136
Author(s):  
R. N. Ibragimov
Keyword(s):  
Sustainable Development ◽  
Financial Stability ◽  
Management Strategy ◽  
Financial System ◽  
Risk Management Strategy ◽  
The Sustainable Development ◽  
The Stability ◽  
The Impact

The article examines the impact of internal and external risks on the stability of the financial system of the Altai Territory. Classification of internal and external risks of decline, affecting the sustainable development of the financial system, is presented. A risk management strategy is proposed that will allow monitoring of risks, thereby these measures will help reduce the loss of financial stability and ensure the long-term development of the economy of the region.

Gastrostomy Tubes Placed in Children With Neurologic Impairment: Associated Morbidity and Mortality

2021 ◽  
pp. 088307382110001
Author(s):  
Jody L. Lin ◽  
Joseph Rigdon ◽  
Keith Van Haren ◽  
MyMy Buu ◽  
Olga Saynina ◽  
...  
Keyword(s):  
Severe Pneumonia ◽  
Sensitivity Analyses ◽  
Tube Placement ◽  
Composite Outcome ◽  
Eligibility Criteria ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Neurologic Impairment ◽  
Increased Risk ◽  
The Impact

Background: Gastrostomy tube (G-tube) placement for children with neurologic impairment with dysphagia has been suggested for pneumonia prevention. However, prior studies demonstrated an association between G-tube placement and increased risk of pneumonia. We evaluate the association between timing of G-tube placement and death or severe pneumonia in children with neurologic impairment. Methods: We included all children enrolled in California Children’s Services between July 1, 2009, and June 30, 2014, with neurologic impairment and 1 pneumonia hospitalization. Prior to analysis, children with new G-tubes and those without were 1:2 propensity score matched on sociodemographics, medical complexity, and severity of index hospitalization. We used a time-varying Cox proportional hazard model for subsequent death or composite outcome of death or severe pneumonia to compare those with new G-tubes vs those without, adjusting for covariates described above. Results: A total of 2490 children met eligibility criteria, of whom 219 (9%) died and 789 (32%) had severe pneumonia. Compared to children without G-tubes, children with new G-tubes had decreased risk of death (hazard ratio [HR] 0.47, 95% confidence interval [CI] 0.39-0.55) but increased risk of the composite outcome (HR 1.21, CI 1.14-1.27). Sensitivity analyses using varied time criteria for definitions of G-tube and outcome found that more recent G-tube placement had greater associated risk reduction for death but increased risk of severe pneumonia. Conclusion: Recent G-tube placement is associated with reduced risk of death but increased risk of severe pneumonia. Decisions to place G-tubes for pulmonary indications in children with neurologic impairment should weigh the impact of severe pneumonia on quality of life.

scholarly journals Impact of a training program on the performance of graduating Canadian residents on a national urology exam: Results of the last 20 years

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Naji J. Touma ◽  
Darren T. Beiko ◽  
Andrew E. MacNeily ◽  
Michael J. Leveridge
Keyword(s):  
Training Program ◽  
Training Programs ◽  
Certification Exams ◽  
Certification Exam ◽  
Individual Program ◽  
The Mean ◽  
And Performance ◽  
The Individual ◽  
The Impact ◽  
Oral Component

Introduction: Many factors impact the performance of graduating residents on certification exams. It is thought that most factors are related to the individual candidate’s ability, motivation, and work ethic. Less understood, however, is whether a training program has any impact on the preparation and performance of its graduates on certification exams. We present 20 years of results of a national preparatory exam that all graduating residents complete about three months before the Royal College of Physicians and Surgeons of Canada (RCPSC) qualifying urology exam. This exam, known colloquially as QUEST, aims to simulate the RCPSC exam with written and oral components. We aimed to analyze the impact of a training program on the performance of its residents. Methods: A retrospective review of exam results from 1997–2016 was conducted. During that time, 495 candidates from all 12 Canadian urology training programs undertook the exam. The performance of graduating residents from each individual program was grouped together for any given year. The different programs were anonymized, as the aim of this study is to assess the impact of a training program and not to rate the different programs. Statistical analysis using one-way ANOVA was conducted. Results: All training programs fall within one standard deviation of the mean for the written component, the oral component, and the overall score. The residents of four training programs had statistically better scores than the overall mean of the written component. The residents of three out of these four training programs also had statistically better scores than the overall mean of the oral component and the overall results of the exam. Conclusions: Most Canadian training programs prepare their residents adequately for this simulated certification exam in urology. However, there are some training programs that consistently prepare graduating residents to outperform their peers.

Cardiac Disease in Pregnancy

2018 ◽  
Vol 29 (3) ◽  
pp. 295-302 ◽  
Author(s):  
Stephanie Martin ◽  
Julie Arafeh
Keyword(s):  
Cardiac Disease ◽  
Management Strategy ◽  
Pregnant Patient ◽  
The United States ◽  
Patient Treatment ◽  
Physiological Changes ◽  
Mortality And Morbidity ◽  
Disease Management Strategy ◽  
Maternal Mortality And Morbidity ◽  
The Impact

In the United States, cardiac disease is a leading contributor to maternal mortality and morbidity. This review addresses the impact of cardiac disease on management of pregnancy and how the physiological changes of pregnancy complicate patient treatment. Approaches to assessing risk in pregnant women with cardiac disease are reviewed. Key elements of a successful disease management strategy are reviewed. Management of cardiac arrest in a pregnant patient is discussed.

Work–life balance: a systematic literature review and bibliometric analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kumari Rashmi ◽  
Aakanksha Kataria
Keyword(s):  
Content Analysis ◽  
Bibliometric Analysis ◽  
Work Life ◽  
Situational Factors ◽  
Work Life Balance ◽  
Future Research ◽  
Life Balance ◽  
Content Type ◽  
Research Themes ◽  
The Impact

Purpose The purpose of this paper is to provide a clear view of current dynamics and research diversification of extant literature in the field of work-life balance (WLB). This paper provides a systematic and critical analysis of WLB literature using bibliometric analysis.Design/methodology/approach Scopus database has been used for carrying out this review that is based on 945 research papers published from 1998 to 2020. The prominence of the research is assessed by studying the publication trend, sample statistics, theoretical foundation, the highly cited research articles and journals, most commonly used keywords, research themes of top four recognized clusters, sub-themes within each cluster and thematic overview of WLB corpus formed on the premise of bibliographic coupling. Additionally, content analysis of recently published papers revealed emerging research patterns and potential gaps.Findings Major findings indicate that the research area consists of four established and emerging research themes based on clusters formed as (1) flexible work arrangements, (2) gender differences in WLB, (3) work–life interface and its related concepts, and (4) WLB policies and practices. Emerging themes identified through content analysis of recent articles include gender discrepancy, the impact of different forms of contextual (situational) factors and organizational culture.Originality/value This research paper is the first of its kind on the subject of WLB as it provides multifariousness of study fields within the WLB corpus by using varied bibliographic mapping approaches. It also suggests viable avenues for future research.

Osteoarthritis—management

2013 ◽  
pp. 1187-1196
Author(s):  
Claire Y. J. Wenham ◽  
Philip G. Conaghan
Keyword(s):  
Functional Limitation ◽  
Anatomical Site ◽  
Treatment Goals ◽  
Pain Mechanisms ◽  
Muscle Strengthening ◽  
Inflammatory Drugs ◽  
Topical Capsaicin ◽  
The Impact ◽  
Corticosteroid Injections

Osteoarthritis (OA) is a common condition which often causes pain and functional limitation, significantly impacting on a person’s quality of life. A comprehensive assessment of the impact of OA should be performed before selecting therapies and treatment goals. Current recommended therapies include a combination of pharmacological and non-pharmacological therapies, which should be considered for all people with OA, regardless of anatomical site of involvement. Non-pharmacological treatments include education, muscle strengthening and aerobic exercises, weight loss if appropriate, splints and devices, and aids. Pharmacological therapies include paracetamol, oral and topical non-steroidal anti-inflammatory drugs, topical capsaicin, intra-articular corticosteroid injections, and opioids. Many existing therapies have only a small analgesic effect size and, in the case of drug therapies, may be associated with important side effects, so an individual’s symptoms and comorbidities must be taken into account when selecting therapies. For those who do not respond to these treatments, surgery such as a total joint arthroplasty may be required. There is a strong need for new analgesic treatments for OA. As it is becoming increasingly clear that the sources of pain in OA are complex and multifactorial, future treatments for OA will need to target both peripheral and central pain mechanisms.

scholarly journals A strategy for seed management with climate change

2009 ◽  
Vol 85 (1) ◽  
pp. 39-42 ◽  
Author(s):  
B.S.P. Wang ◽  
E K Morgenstern
Keyword(s):  
Climate Change ◽  
Management Strategy ◽  
Seed Source ◽  
Seedling Production ◽  
Key Words Adaptation ◽  
Physiological Quality ◽  
Seed Management ◽  
Species Adaptability ◽  
The Impact ◽  
And Storage

While climate change has been generally accepted by the forestry community, we are still searching for ways and means to alleviate its impact. We still have to collect seeds, for example, to support continued reforestation programs. To provide some guidance for meeting the changing environments, we felt it is important to review the current seed management strategy, discuss species adaptability and seed source as well as collection, handling, germination, treatment and storage. Further, we give recommendations to minimize the impact of climate change. Key words: adaptation, seed source, collection, handling, storage, dormancy treatment, germination, genetic and physiological quality, seedling production

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