scholarly journals Multisystem atrophy: a case report with clinical and functional findings relevant to functional Physiotherapy

2021 ◽  
Author(s):  
Daniela Maria RIbeiro Vaz ◽  
Adrielle Galanti ◽  
Veronica Corrêa César Rodrigues César ◽  
Ana Paula Oliveira Borges
Keyword(s):  
Case Report ◽  
Motor Coordination ◽  
Olivopontocerebellar Atrophy ◽  
Functional Impairments ◽  
Trunk Flexion ◽  
Cross Sectional ◽  
Male Individual ◽  
The Individual ◽  
And Function

Introduction: Multiple System Atrophy (MSA) is a severe neurodegenerative disease that has parkinsonian, autonomic, cerebellar, and pyramidal features. It is prevalent at 3.4 to 4.9 cases per 100,000 population, and is most common after the age of 60. It is called Striatonigral Degeneration, with a predominance of parkinsonian symptoms; it is known as Olivopontocerebellar Atrophy, with cerebellar symptoms, and Shy-Drager syndrome with autonomic symptoms. Physiotherapy plays an important role in the rehabilitation of kinetic-functional impairments. Objective: To report the case of a volunteer with SMA in order to highlight the neurological findings for neurofunctional rehabilitation. Methods: This is an observational, cross-sectional case report study that was conducted at the Clínica Escola de Fisioterapia da Universidade de Franca (UNIFRAN), with the approval of the CEP (CAAE 83164918.2.0000.5495), of a 55-year-old male individual, referred to physiotherapy, diagnosed with SMA. Neurological evaluation was performed in the sector, of sensitivity, movement, tone, reflexes, motor coordination, balance, gait and function. Results: The individual reports that 4 years ago he started having difficulty walking and talking. He was diagnosed with Parkinson’s disease. He underwent a new evaluation, arriving at the current diagnosis. In the physical therapy evaluation dysautonomia, dysarthria, dysdiadochokinesia, dysmetria, hypertonia by rigidity, akinesia and bradykinesia, trunk flexion posture, balance deficit, tetraparesis and fetinated gait were observed. Conclusion: The impairments found impair the patient’s ability to perform several ADLs. This study emphasizes the value of neurofunctional physiotherapeutic semiology for an effective therapeutic treatment that promotes independence and quality of life possible for the individual with SMA.

scholarly journals Multisystem atrophy: a case report with clinical and functional findings relevant to functional Physiotherapy

2021 ◽  
Author(s):  
Daniela Maria RIbeiro Vaz ◽  
Adrielle Galanti ◽  
Veronica Corrêa César Rodrigues ◽  
Ana Paula Oliveira Borges
Keyword(s):  
Case Report ◽  
Motor Coordination ◽  
Olivopontocerebellar Atrophy ◽  
Functional Impairments ◽  
Trunk Flexion ◽  
Cross Sectional ◽  
Male Individual ◽  
The Individual ◽  
And Function

Introduction: Multiple System Atrophy (MSA) is a severe neurodegenerative disease that has parkinsonian, autonomic, cerebellar, and pyramidal features. It is prevalent at 3.4 to 4.9 cases per 100,000 population, and is most common after the age of 60. It is called Striatonigral Degeneration, with a predominance of parkinsonian symptoms; it is known as Olivopontocerebellar Atrophy, with cerebellar symptoms, and Shy-Drager syndrome with autonomic symptoms. Physiotherapy plays an important role in the rehabilitation of kinetic- functional impairments. Objective: To report the case of a volunteer with SMA in order to highlight the neurological findings for neurofunctional rehabilitation. Methods: This is an observational, cross-sectional case report study that was conducted at the Clínica Escola de Fisioterapia da Universidade de Franca (UNIFRAN), with the approval of the CEP (CAAE 83164918.2.0000.5495), of a 55-year-old male individual, referred to physiotherapy, diagnosed with SMA. Neurological evaluation was performed in the sector, of sensitivity, movement, tone, reflexes, motor coordination, balance, gait and function. Results: The individual reports that 4 years ago he started having difficulty walking and talking. He was diagnosed with Parkinson’s disease. He underwent a new evaluation, arriving at the current diagnosis. In the physical therapy evaluation dysautonomia, dysarthria, dysdiadochokinesia, dysmetria, hypertonia by rigidity, akinesia and bradykinesia, trunk flexion posture, balance deficit, tetraparesis and fetinated gait were observed. Conclusion: The impairments found impair the patient’s ability to perform several ADLs. This study emphasizes the value of neurofunctional physiotherapeutic semiology for an effective therapeutic treatment that promotes independence and quality of life possible for the individual with SMA.

scholarly journals Clinical-enabled aspects after Neurotoxoplasmosis in a patient with immunosuppression: a case report

2021 ◽  
Author(s):  
Adrielle Galanti ◽  
Verônia Corrêa César Rodrigues ◽  
Daniela Maria Ribeiro Vaz ◽  
Ana Paula Oliveira Borges
Keyword(s):  
Case Report ◽  
Motor Coordination ◽  
Clinical Investigation ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Fine Motor ◽  
Cross Sectional ◽  
Right Cerebral Hemisphere ◽  
The Right ◽  
Immunodeficiency Syndrome

Background: Neurotoxoplasmosis is an opportunistic infection caused by the protozoan Toxoplasma Gondii, frequent in patients with Acquired Immunodeficiency Syndrome who become immunosuppressed by the presence of the disease. It can be presented by one or more brain abscesses, encephalitis or ventriculitis. Objectives: case report of a volunteer after neurological sequelae of neurotoxoplasmosis in order to highlight the relevant findings for a neurofunctional rehabilitation. Design and setting: This is an observational, cross-sectional case report type study conducted at the Clínica Escola de Fisioterapia of the University of Franca (UNIFRAN), with CEP approval (CAAE 83164918.2.0000.5495). Methods: Female patient, 53 years old. In the physiotherapy sector, neurological evaluation of the components was performed: sensitivity, movement, tone, reflexes, motor coordination, balance and gait. Balance and gait were assessed using the Berg Balance Scale, the Standing and Walking Test and the Dynamic Walking Index. Results: After clinical investigation, neurological toxoplasmosis infection was found in the right cerebral hemisphere. The physiotherapeutic evaluation showed the presence of left hemiparesis, the presence of spastic hypertonia, patellar and achilles hyperreflexia, the absence of fine motor skills and the presence of a reaping gait. The BSE result was 32 points, the TUG was 10.3 seconds and IMD was 20 points. Conclusion: The compromises found have an impact on the functionality of the volunteer. This study emphasizes the valorization of neurofunctional physiotherapeutic semiology for a treatment proposal that promotes greater functional independence.

Changes in Burnout Among Oncology Physician Assistants Between 2015 and 2019

2021 ◽  
pp. OP.21.00051
Author(s):  
Eric D. Tetzlaff ◽  
Heather M. Hylton ◽  
Karen J. Ruth ◽  
Zachary Hasse ◽  
Michael J. Hall
Keyword(s):  
Maslach Burnout Inventory ◽  
Physician Assistants ◽  
Cross Sectional ◽  
Hours Worked ◽  
Factors Associated ◽  
Patients With Cancer ◽  
Professional Characteristics ◽  
Cross Sectional Design ◽  
The Individual

PURPOSE Burnout has significant implications for the individual provider, the oncology workforce, and the quality of care for patients with cancer. The primary aim of this study was to explore temporal changes in burnout among physician assistants (PAs) in oncology in 2019 compared with 2015. METHODS Oncology PAs were surveyed to assess for burnout using the Maslach Burnout Inventory according to the same cross-sectional design of the study performed in 2015. Comparison between oncology PAs in 2015 and 2019 in the prevalence of burnout and personal and professional characteristics was performed. RESULTS Two hundred thirty-four participants completed the full-length survey. The participants in 2015 and 2019 were similar in age (41.8 v 40.3 years), sex (88.8% v 86.3% female), number of years as a PA in oncology (9.6 v 10), and percentage involved in academic practice (55.2% v 59.2%). There was a significant increase in burnout in 2019 compared with 2015 with 48.7% of PAs reporting at least one symptom of burnout compared with 34.8% (odds ratio for burnout, 2019 v 2015 = 1.92 [95% CI, 1.40 to 2.65], P < 0.001). The odds of burnout remained higher in 2019 compared with 2015 when adjusted for age, sex, relationship status, practice setting, subspecialty, practice type, and hours worked. Factors associated with burnout in both 2015 and 2019 include the percentage of time spent on patient care, collaborative physician relationship, number of hours worked, and satisfaction with compensation. No new factors associated with burnout emerged in 2019 that were not identified in 2015. CONCLUSION The rate of burnout of oncology PAs has significantly increased. Burnout in oncology PAs is multifactorial, and the increase cannot be easily explained. Additional research is needed to better define the drivers of PA burnout.

scholarly journals Evaluating the Service Quality of the Hotel Establishments in Sports Tourism With Regard to the Athletes

2018 ◽  
Vol 8 (2) ◽  
pp. 29
Author(s):  
Hasan Osmanoglu ◽  
Hanifi Üzüm
Keyword(s):  
Service Quality ◽  
Pearson Correlation ◽  
Team Sports ◽  
Sport Tourism ◽  
Cross Sectional ◽  
Quality Perception ◽  
The Individual ◽  
Sport Facilities ◽  
Individual Sports

The purpose of this study was to evaluate the service quality of the hotels which are provided sport tourism by athletes according to some variables.The research was conducted with cross-sectional research method as one of the general survey models and relational screening model. Target group of the study also constituted the sample group. This sample was formed of 389 athletes in total as 247 males and 142 females from team sports in Turkish Football, Volleyball, Basketball leagues in years 2016-2017 and individual sports.“Sport Tourism Service Quality Scale” (STSQS) developed by Osmanoğlu et al. (2017) was employed as data collecting tool in this study. The scale was formed of 28 items and 5 sub-dimensions as “Sport facilities, α=0.96”, “Staff, α=0.82”, “Entertainment, α=0.90”, “Hygiene, α=0.85” and “Room quality, α=0.80”. The data was analysed by applying one-way analysis of variance (ANOVA), Tukey’s Post-Hoc test and Pearson Correlation analysis. The level of significance for this study was decided as p<0.05.In conclusion with the study, service quality perception scores of the athletes were established to be high-level at room quality, hygiene and staff sub-dimensions and medium level at sport facilities and entertainment sub-dimensions. It was noted that service quality perception of the individual sports athletes is higher than the team sports athletes at staff and hygiene sub-dimensions (p<0.05). Regarding duration of stay, the mean of the ones that stay for 5 nights and above was observed to be significantly higher than the ones that stay one-two days and three-four days at sport facilities and staff sub-dimensions. Between the sport facilities, staff, hygiene and entertainment sub-dimensions of hotel classification and service quality, a significant distinction was seen in favor of the five star hotels (p<0,05). 

scholarly journals The Role of Adrenoceptors in the Retina

Cells ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 2594
Author(s):  
Yue Ruan ◽  
Tobias Böhmer ◽  
Subao Jiang ◽  
Adrian Gericke
Keyword(s):  
Visual Information ◽  
Vision Loss ◽  
Retinal Diseases ◽  
System A ◽  
The Central Nervous System ◽  
The Individual ◽  
And Function ◽  
The Brain

The retina is a part of the central nervous system, a thin multilayer with neuronal lamination, responsible for detecting, preprocessing, and sending visual information to the brain. Many retinal diseases are characterized by hemodynamic perturbations and neurodegeneration leading to vision loss and reduced quality of life. Since catecholamines and respective bindings sites have been characterized in the retina, we systematically reviewed the literature with regard to retinal expression, distribution and function of alpha1 (α1)-, alpha2 (α2)-, and beta (β)-adrenoceptors (ARs). Moreover, we discuss the role of the individual adrenoceptors as targets for the treatment of retinal diseases.

scholarly journals Specialty Physician Designation in Referrals from a Vertically Integrated PCMH

2019 ◽  
Vol 6 ◽  
pp. 233339281985038
Author(s):  
Andrew D. Schreiner ◽  
Keri T. Holmes-Maybank ◽  
Jingwen Zhang ◽  
Justin Marsden ◽  
Patrick D. Mauldin ◽  
...  
Keyword(s):  
Medical Home ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Cross Sectional ◽  
Medical Specialties ◽  
The Individual

Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% ( P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.

scholarly journals FREE TRANSPORTATION SERVICE RECIPIENTS MAY HAVE BETTER QUALITY OF LIFE BUT STILL LACK IN IMPROVING HEALTH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S175-S176
Author(s):  
Machiko R Tomita
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Grocery Stores ◽  
Cross Sectional ◽  
Transportation Services ◽  
Transportation Service ◽  
And Function

Abstract This study aimed to determine if service recipients (SRs) of free transportation services experience better quality of life, health, and function compared to pre-service recipients (PSRs). We conducted a cross-sectional study using personal interviews with 43 PSRs and 30 SRs belonged to a volunteer organization. Outcome measures were Older People’s Quality of Life (QoL), Center for Epidemiology Study-Depression, and Instrumental Activities of Daily Living (IADL). Total sample (N=73) had a mean age of 78.5 years and mostly female (86.3%). The majority of PSRs wanted to go to Drs’ offices (74.4%) and Grocery stores (60.5%), followed by Drug stores (44.2%), when the service becomes available. The figures were substantially smaller among SR (40.0%, 30%, and 13.3%, respectively). In PSRs, 67.4% expected to improve health once they start receiving the service, and 70. 0% of SRs said it did with the service. Using independent t-tests, SRs were significantly better in depression (p&lt;.001), IADL (p=0.29) and most QoL items (life overall, social relationship, home and neighborhood, psychological and emotional well-being and leisure and activities; p=.047-p=.001), except for perceived health and finance. SRs (100%) were very satisfied with the service and drivers, but 80% of SRs said they wished to use more driving services than the allowable four times per month maximum. This limitation was due to the insufficient number of volunteers compared to a large number of people in need. Availability of more volunteer drivers will likely improve SRs health. Effective approaches to increase the number of driving volunteers are necessary.

scholarly journals Recognition and Treatment of Tardive Dyskinesia in Individuals with Intellectual Disability

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Robert O. Morton ◽  
Lucas C. Morton ◽  
Rissa Fedora
Keyword(s):  
Quality Of Life ◽  
Intellectual Disability ◽  
Tardive Dyskinesia ◽  
Daily Functioning ◽  
Functional Impairments ◽  
Behavioral Disturbances ◽  
Abnormal Movements ◽  
History Of ◽  
The Individual

Individuals with intellectual disability (ID) commonly suffer from comorbid psychiatric and behavioral disorders that are frequently treated by antipsychotic medications. All individuals exposed to first- and second/third- generation antipsychotics are at risk for developing tardive dyskinesia (TD), characterized by abnormal, involuntary movements of the mouth/tongue/jaw, trunk, and extremities. TD can be highly disruptive for affected individuals and their caregivers, causing embarrassment, isolation, behavioral disturbances, and reduced functioning and quality of life. Information on TD incidence in individuals with ID is limited, but 2 small US studies reported TD prevalence rates of 42-45% in inpatients with ID. The safety and efficacy of vesicular monoamine transporter type 2 (VMAT2) inhibitors approved for treatment of TD in adults have been demonstrated in multiple clinical trials, but they excluded individuals with ID. Clinical characteristics and treatment outcomes of 5 adults (aged 28–63 years) with mild-to-severe ID and TD are presented, illustrating TD symptoms before/after treatment. All individuals had multiple comorbid psychiatric, behavioral, and other medical conditions, history of antipsychotic exposure, and abnormal movements affecting the tongue/mouth/jaw ( n = 5 ), upper extremities ( n = 5 ), lower extremities ( n = 3 ), and trunk ( n = 2 ), resulting in diminished ability to speak ( n = 2 ), ambulate ( n = 3 ), and perform activities of daily living ( n = 3 ). Treatment with valbenazine resulted in meaningful improvements in TD symptoms and improved daily functioning, demeanor, and social/caregiver interactions. Given the high likelihood of antipsychotic exposure in the ID population, it is appropriate to screen for TD at every clinical visit through careful monitoring for abnormal movements and questioning the individual/caregiver regarding abnormal movements or TD-related functional impairments (i.e., speaking, swallowing, eating, ambulating, and social functioning). In this study, 5 individuals with ID and TD received once-daily valbenazine and experienced marked improvement in TD symptoms and daily functioning, resulting in increased quality of life for affected individuals and caregivers.

When More IS Too Much: Compound Caregiving, Barriers to Services, and Service Support for Older Families of People With Disabilities

2021 ◽  
pp. 104438942110484
Author(s):  
Preethy S. Samuel ◽  
Kathryn Wright ◽  
Christina Marscak-Topolewski ◽  
Rosanne DiZazzo-Miller
Keyword(s):  
Quality Of Life ◽  
Support Programs ◽  
Family Quality Of Life ◽  
Cross Sectional ◽  
Service Support ◽  
Family Level ◽  
Older Families ◽  
The Individual ◽  
Barriers To Services

Using the theoretical lens of Family Quality of Life, this study evaluated perceptions of older compound caregivers (i.e., caring for more than one family member) regarding their need for services. Quantitative analysis of cross-sectional data collected from 112 caregivers (50 years and older) demonstrated that compound caregivers faced more barriers in accessing services for their families than noncompound caregivers. Although all caregivers shared similar perceptions on the importance, opportunities, initiative, and attainment of service support for their families, compound caregivers had lower stability and satisfaction than noncompound caregivers. Findings highlight the need to develop support programs to equip older caregivers in managing their daily challenges at the individual and family level.

MARITAL SATISFACTION AND QUALITY OF LIFE IN PATIENTS WITH ALCOHOL AND OPIOID DEPENDENCE SYNDROME: A HOSPITAL BASED STUDY

2021 ◽  
pp. 28-29
Author(s):  
Vinay Kumar ◽  
Sunila Rathee ◽  
Sidharth Arya ◽  
Priti Singh ◽  
Rajiv Gupta
Keyword(s):  
Quality Of Life ◽  
Marital Satisfaction ◽  
Alcohol Dependence ◽  
Marital Quality ◽  
Opioid Dependence ◽  
Marital Adjustment ◽  
Satisfaction Scale ◽  
Cross Sectional ◽  
The Individual

Background: Opioid and alcohol consumption is considered as an on-going stressor, not only for the individual, but for family members as well. Spouses are particularly affected given the intimate nature of their relationship and constant exposure to the behaviour of the dependent persons. Quality of life has emerged as an important treatment outcome measure for alcohol and opioid dependence whose natural course comprises of remission and relapse. Objective: To assess the quality of life, marital adjustment and among the patients of alcohol and opioid dependence syndrome. Materials and Methods: This was a cross sectional hospital based study and included 100 treatment seeking population 50 each with alcohol dependence and opioid dependence as per ICD-10 criteria. The participants were purposively selected and informed consent were taken. Research tools were Hindi version of Kansas Marital Satisfaction scale and WHOQOL-BREF. Results: The mean age of the participants were 34.87 +12.48 years. The study did not observe a signicant difference in the overall domains of quality of life. Except the overall health domain, quality of life was more in alcohol subjects as compared to opioid subjects (p < 0.05). There was a signicant difference in the marital quality of life which was lower in opioid dependence than alcohol dependence subjects. Conclusion: Improved marital adjustment are most important part of improved quality of life and its sustainability plays key role in preventing relapse and reaching to the recuperation. Effective management for the alcohol and opioid patients must include the marital intervention to improve the recovery and rehabilitation of the patients.

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