The Effectiveness and Common Features of Reablement Services on Clients’ Daily Functioning: A Systematic Review

This systematic review, guided by the ReAble-definition, (1) provides an overview of reablement interventions and their effect on Activities of Daily Living (ADL), and (2) identifies common features of effective interventions. A systematic search was conducted from 2002 to 2020, identifying nineteen studies from eight countries with a total of 6,534 participants. Ten studies (with moderate to high quality) revealed improvements in ADL functioning. Three common intervention features were identified within effective interventions: use of multidisciplinary teams; a protocoled or standardized assessment; and using multiple components such as ADL-training, education and exercise programs. This review emphasizes that future studies should provide a more consistent and detailed reporting on the intervention and its components. Furthermore, a uniform approach regarding components, follow-up times and outcome measures can contribute to the comparison of reablement interventions and better determine their effectiveness, independent of the healthcare system or country in which it is used.

Descriptive Analysis of Forces Applied by Trained Clinicians During Two-Handed Instrument-Assisted Soft Tissue Mobilization

Instrument-assisted soft tissue mobilization (IASTM) is a common intervention among clinicians. Despite the popularity, little is known about the forces applied by the clinician with the instruments during treatment. The purpose of this investigation was to examine the forces applied by trained clinicians using IASTM instruments during a simulated treatment. Eleven IASTM trained (Graston Technique, Técnica Gavilán, or RockBlades) clinicians (Physical Therapist = 2, Chiropractor = 2, Athletic Trainer = 7) participated in the study. Each clinician performed 75 two-handed strokes distributed evenly across five different IASTM instruments on a skin simulant attached to a force plate. IASTM stroke application was analyzed for peak normal forces (Fpeak) and mean normal forces (Fmean) by stroke. We observed an average Fpeak of 8.9N and Fmean of 6.0N across all clinicians and instruments. Clinicians and researchers may use the descriptive values as a reference for application of IASTM in practice and research.

Extracorporeal Membrane Oxygenation for Acute Toxic Inhalations: Case Reports and Literature Review

Previous studies have shown that poisoning is a major threat to human health. Inhalation of acute toxic gas has been linked to serious health consequences. Among the antidotes for poisoning currently used, supportive care is the most common intervention in clinical practice. Severe acute respiratory distress syndrome (ARDS) and/or refractory cardiogenic shock or cardiac arrest caused by toxins are associated with high mortality and are difficult to treat. Extracorporeal membrane oxygenation (ECMO) is an aggressive supportive measure used to manage severely poisoned patients. This study presents two cases of acute toxic gases inhalation, severe ARDS and circulatory instability induced by bromine inhalation, and ARDS induced by nitric acid inhalation which were successfully treated with ECMO. The ECMO techniques used in the animal models and in human cases to treat severe poisoning are described as well as the indications, contraindications, complications, and weaning of ECMO.

Conducting proportional meta-analysis in different types of systematic reviews: a guide for synthesisers of evidence

Background Single group data present unique challenges for synthesises of evidence. Proportional meta-analysis is becoming an increasingly common technique employed for the synthesis of single group data. Proportional meta-analysis shares many similarities with the conduct and reporting of comparative, or pairwise, meta-analysis. While robust and comprehensive methods exist detailing how researchers can conduct a meta-analysis that compares two (or more) groups against a common intervention, there is a scarcity of methodological guidance available to assist synthesisers of evidence in the conduct, interpretation, and importance of proportional meta-analysis in systematic reviews. Main body This paper presents an overview targeted to synthesisers of evidence and systematic review authors that details the methods, importance, and interpretation of a proportional meta-analysis. We provide worked examples of how proportional meta-analyses have been conducted in research syntheses previously and consider the methods, statistical considerations, and presentation of this technique. Conclusion This overview is designed to serve as practical guidance for synthesisers of evidence in the conduct of proportional meta-analyses.

Pharmacy services for the 2019 Fédération Internationale de Natation (FINA) World Masters Championships in Gwangju, South Korea

Background The role of sports pharmacists is being emphasized in international athletic events. This study aimed to describe the pharmacy services for the 2019 Fédération Internationale de Natation (FINA) World Masters Championships in Gwangju, South Korea. Method Research focused on athletes and coaching staff who received medications after visiting medical centers and pharmacies located in the athletes’ village from July 5 to July 29, 2019. We collected daily results of pharmacy operation and prescription interventions. The data were analyzed using Microsoft Excel, and were expressed as frequency (%). Results Throughout the tournament, 633 patients received medication at the athletes’ village pharmacy (gender: 338 men [53.4%], 295 women [46.6%]; nationality: 299 Korean [47.2%], 334 overseas players [52.8%]; patient type: 150 athletes [23.7%], 427 non-athletes [67.5%]). Therapy for musculoskeletal disorders was the most common (n = 29, 19.3%), and oral NSAIDs (n = 56, 22.0%) were the most frequently dispensed medication in athletes. Pharmacists intervened for 47 out of 491 prescriptions (9.6%), with dosage change (n = 21, 44.7%) being the most common intervention type. Conclusion Sports pharmacists at FINA World Masters Championships played a pivotal role in ensuring the safe usage of medications by all participants, especially athletes. This study results will be a useful reference for pharmacy services at future international or domestic sports competitions.

Subluxed Shoulders Need TLC: Pilot Study of the T-L-C Taping Method to Address Hemiplegic Shoulder Pain, Passive Range of Motion, and Subluxation

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Hemiplegic shoulder pain and subluxation are prevalent sequelae following stroke. A gap in the literature exists for shoulder assessments specifically for taping, a common intervention. Studies and tape methods primarily focus on mechanical corrections. However, muscle tone and management, which are prevalent topics in neurological rehabilitation, are rarely addressed. The T-L-C taping method consists of a uniform assessment approach of the shoulder specifically to guide Kinesio® Tape application Primary Author and Speaker: Steven Frey Additional Authors and Speakers: Mark Stumpf, Jacob Wright, and Sara Stephenson Contributing Authors: John Wong, Lauren Loges

Implementation of a clinical pharmacist-led service to optimize management of refractory chemotherapy-induced nausea and vomiting in adult hematology/oncology clinic

Objective Chemotherapy-induced nausea and vomiting (CINV) is a common and potentially debilitating adverse effect of chemotherapy. Refractory CINV can be particularly difficult to control. This report provides details on the implementation and evaluation of a pharmacist-led program for the management of refractory CINV in hematology and oncology clinics. Methods A pharmacist-led program open to adult outpatients with refractory CINV was implemented at University of Wisconsin. Pharmacists conducted baseline and follow-up assessments, provided patient education, and started, discontinued, and/or adjusted antiemetics as clinically necessary for all enrolled patients. Retrospective chart review was used to describe the proportion of patients whose CINV improved through pharmacist intervention, effect of the program on antiemetic adherence, categorization of pharmacist interventions, and duration of patient enrollment. Results Forty-six patients were enrolled between February 2019 and January 2020. Forty-one patients (89.1%) had an overall reduction in their nausea and vomiting from baseline. Eleven patients (23.9%) met criteria for nonadherence to prescribed antiemetics at baseline; all patients were adherent at unenrollment. A total of 111 pharmacist interventions were made. The most common intervention was addition of new breakthrough antiemetic. The least common intervention was dose escalation of a previously prescribed antiemetic. The average number of interventions made per patient was 2.5. On average, patients were enrolled in the program for 16.6 days and met with a pharmacist three times. Conclusion Implementation of this program standardized and streamlined pharmacist involvement with refractory CINV. Enrollment resulted in a measurable reduction in nausea and/or vomiting for patients with refractory CINV.

Comparative effectiveness of Metarhizium rileyi, novaluron, and glyphosate on immune system, development, and redox metabolism of Anticarsia gemmatalis

Anticarsia gemmatalis is one of the most important pests in world soybean crop. The most common intervention is the application of agrochemicals, such as novaluron and glyphosate. Among biological control agents, much attention has been drawn to entomopathogenic fungi, as Metarhizium rileyi. Here, we examined the changes that occur in the immune system (total and differential hemocyte count), secondary effects (caterpillar morphology), and oxidative metabolism after the caterpillars were exposed to M. rileyi, novaluron or glyphosate. M. rileyi was able to induce changes in the width, length, and weight of A. gemmatalis pupae, along with an increased in the number of defense cells. Novaluron prompt changes the insect’s immunity, and glyphosate caused milder immunological effects. However, it caused significant secondary effects including malformations in pupae and adults, and an increase in nitric oxide (NO) levels. Mortality observed when treating insects with novaluron and malformations due to glyphosate treatments did not occur due to oxidative stress. However, when insects were exposed to M. rileyi, we verified significantly increased levels of NO and concluded that these insects died due to oxidative stress. Our data provide evidence that contributes to better understanding the mechanism of herbicide-fungus interaction in the management of Anticarsia gemmatalis.

Archaeological glass conservation and restoration intervention materials – a literature review

Conservation and restoration on archaeological objects in glass often involve the removal of materials from previous restorations and comprise a deep knowledge about present and past methodologies. This article presents a literature survey and critical analysis of the main materials used in the different stages of intervention: cleaning, consolidation, joining fragments and filling gaps. A considerable number of used products was identified, which illustrates the use of various methodologies among professionals from this area. Cleaning methods vary from mechanical methods using a brush (less invasive) to the use of various acidic solutions, some of which can endanger the integrity of objects, being the most common ethylenediamine tetra-acetic acid. We highlight the use of epoxy resins as adhesive, consolidant and filler, as well as the acrylic resin Paraloid B-72, identified as reversible, colorless, stable and inert. This survey and analysis of the bibliography reveals the need to implement common intervention methodologies dedicated to this material.