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1.
Rehabilitation pharmacotherapy: A scoping review.
Kose, E, Wakabayashi, H
Geriatrics & gerontology international. 2020;(7):655-663
Abstract
Many patients in rehabilitation facilities are affected by polypharmacy. Polypharmacy is associated with rehabilitation outcomes and functional recovery. Consequently, a combination of rehabilitation and pharmacotherapy may improve the outcomes of older people undergoing rehabilitation. A recent report described the concept of rehabilitation pharmacotherapy. The concept envisages helping frail older people and people with disabilities to achieve the highest possible body function, activity level and quality of life. There are two key tenets of rehabilitation pharmacotherapy: "pharmacotherapy in consideration of rehabilitation" and "rehabilitation in consideration of pharmacotherapy." "Pharmacotherapy in consideration of rehabilitation" includes use of drugs to treat impairment, activity limitation and participation restriction based on the International Classification of Functioning, Disability, and Health. "Rehabilitation in consideration of pharmacotherapy" refers to tailoring of rehabilitation considering the content of pharmacotherapy. With respect to drugs and motor dysfunction, anticholinergic drugs are associated with dysphagia and fractures. Increased use of potentially inappropriate medications may adversely affect the nutritional status. With respect to activities of daily living, polypharmacy and use of potentially inappropriate medications negatively affect the improvement in motor function during rehabilitation. Potent anticholinergic drugs are more likely to impede the improvement in cognitive function. In this review, we address the concept of rehabilitation pharmacotherapy and discuss its importance from the perspective of polypharmacy, the effect of drugs on disability and disease, nutritional status and activities of daily living. Geriatr Gerontol Int 2020; 20: -.
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2.
Blended diets for gastrostomy fed children and young people: a scoping review.
Breaks, A, Smith, C, Bloch, S, Morgan, S
Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. 2018;(5):634-646
Abstract
BACKGROUND The present review aimed to identify what is known about the use of blended diets in gastrostomy fed children and young people (i.e. children and young people refers to those who are aged up to 25 years with special educational needs or a disability in accordance with Part 3 of the Children and Family Act 2014; within the review, the word children is used for simplicity but encompasses young people too) and to identify gaps in the literature on this topic to inform future research and policy. METHODS A scoping review methodology was used searching the online databases PUBMED, PsychINFO, CINAHL, SCOPUS and AMED, EMBASE for articles that addressed issues pertaining to blended diets. The review identified a broad range of literature, regardless of study design, and described and evaluated the quality, range and nature of research activity related to the use of blenderised diets. RESULTS Forty-three studies were included in the review. The studies focused on nutrition, equipment, the views of carers and patients, and the views of professionals. Several studies described the lack of evidence regarding pros and cons of blended diets and highlighted the need for further research into the field. CONCLUSIONS There were gaps in the evidence base regarding the impact of blended diets on the health and well-being of the children who receive them and upon the carers who feed the children. The nutritional impact of blended diets is not fully understood and the knowledge and views of professionals involved in the care of those receiving blended diets varies.
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3.
Care of Adults With Intellectual and Developmental Disabilities: Cerebral Palsy.
Jones, KB, Wilson, B, Weedon, D, Bilder, D
FP essentials. 2015;:26-30
Abstract
Cerebral palsy (CP) is a group of disorders that primarily affect motor function. This developmental disability is becoming more common in adults as life expectancy increases for individuals with CP. Many physical, medical, mental, and behavioral health conditions are associated with CP, and assistance should be provided to patients with CP to optimize function, when available. These comorbidities include intellectual disabilities, seizures, muscle contractures, abnormal gait, osteoporosis, communication disorders, malnutrition, sleep disorders, and mental health disorders, such as depression and anxiety. The physician should be familiar with screening for and assisting patients with these issues. Optimizing quality of life requires individualized care plans that may include physical therapy, muscle relaxants, surgery, and nutritional support. Other issues to be addressed include methods to facilitate employment; sexual concerns; and support through local and national organizations for patients, families, and caregivers.
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4.
[Advocacy and early discharge under the new system of hospitalization for medical care and protection].
Otsuka, A
Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica. 2014;(4):302-8
Abstract
The Act on Mental Health and Welfare for the Mentally Disabled was partially amended during the 183rd ordinary session of the Diet, on June 13, 2013. The revision abolished the system of guardianship that had long imposed conflicting roles on families of people with mental disorders. Various issues and concerns remain, however, including the requirement that consent for hospitalization be provided by a family member. Many people who need involuntary hospitalization find themselves in situations where it is difficult to continue living in the community. At the time of hospital admission, along with a medical examination, it is necessary to assess the patient's support system in the community and ascertain whether "hospitalization for medical care and protection" is, in fact, the only option. When hospitalization for medical care and protection is determined to be unavoidable, treatment and planning focused on early discharge and the patient's return to life in the community should be initiated immediately after hospitalization. Actual patient outcomes clearly indicate that early discharge is often the result when medical institutions collaborate and network with multidisciplinary teams and community support workers immediately after hospitalization. It is hoped that the amended law will have a practical impact that will result in similar outcomes throughout the nation in the future. At the same' time, it is crucial to expand staffing in medical institutions, foster a culture of team treatment, and promote the creation of better community mental health systems that include housing, social resources, and family support.
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5.
Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA.
Bauer, UE, Briss, PA, Goodman, RA, Bowman, BA
Lancet (London, England). 2014;(9937):45-52
Abstract
With non-communicable conditions accounting for nearly two-thirds of deaths worldwide, the emergence of chronic diseases as the predominant challenge to global health is undisputed. In the USA, chronic diseases are the main causes of poor health, disability, and death, and account for most of health-care expenditures. The chronic disease burden in the USA largely results from a short list of risk factors--including tobacco use, poor diet and physical inactivity (both strongly associated with obesity), excessive alcohol consumption, uncontrolled high blood pressure, and hyperlipidaemia--that can be effectively addressed for individuals and populations. Increases in the burden of chronic diseases are attributable to incidence and prevalence of leading chronic conditions and risk factors (which occur individually and in combination), and population demographics, including ageing and health disparities. To effectively and equitably address the chronic disease burden, public health and health-care systems need to deploy integrated approaches that bundle strategies and interventions, address many risk factors and conditions simultaneously, create population-wide changes, help the population subgroups most affected, and rely on implementation by many sectors, including public-private partnerships and involvement from all stakeholders. To help to meet the chronic disease burden, the US Centers for Disease Control and Prevention (CDC) uses four cross-cutting strategies: (1) epidemiology and surveillance to monitor trends and inform programmes; (2) environmental approaches that promote health and support healthy behaviours; (3) health system interventions to improve the effective use of clinical and other preventive services; and (4) community resources linked to clinical services that sustain improved management of chronic conditions. Establishment of community conditions to support healthy behaviours and promote effective management of chronic conditions will deliver healthier students to schools, healthier workers to employers and businesses, and a healthier population to the health-care system. Collectively, these four strategies will prevent the occurrence of chronic diseases, foster early detection and slow disease progression in people with chronic conditions, reduce complications, support an improved quality of life, and reduce demand on the health-care system. Of crucial importance, with strengthened collaboration between the public health and health-care sectors, the health-care system better uses prevention and early detection services, and population health is improved and sustained by solidifying collaborations between communities and health-care providers. This collaborative approach will improve health equity by building communities that promote health rather than disease, have more accessible and direct care, and focus the health-care system on improving population health.
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6.
Psychological and social consequences after reconstruction of upper extremity trauma: methods of detection and management.
Galanakos, SP, Bot, AG, Zoubos, AB, Soucacos, PN
Journal of reconstructive microsurgery. 2014;(3):193-206
Abstract
Upper extremity trauma and resulting disability is a stressful event and can affect a patient's personality. Several studies have shown that this injury type has serious psychological and/or social consequences. We systematically reviewed the evidence on the consequences of disability after a complex trauma (combination of soft tissue, osseous, vascular, and nerve involvement) of the upper extremity. We tried to find out the potential crucial factors that could determine the final hand function. In addition, we considered the challenges that need to be addressed to eliminate the adverse or negative effects that arise from upper limb trauma. In the literature, there is a growing interest to study changes in patients' quality of life and return to work. Psychological morbidity is an important part of patients' perceived general health. These issues could play an important role in the final functional outcome of the therapy. An early identification and treatment of trauma-related distress in patients may prevent progression of psychological pathology and mitigate negative effects on general health status. It may be important to evaluate the amount of psychological distress when caring for patients with hand injuries.
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7.
Other physical consequences of disability.
Macfarlane, J
Handbook of clinical neurology. 2013;:315-22
Abstract
Prevention of secondary complications of neurological disease is important in minimizing impairment and maximizing the long-term activity and participation of individuals. Immobility in itself has a range of adverse effects on the body and its functioning, which are outlined. A number of complications commonly encountered in the rehabilitation of individuals after neurological disease are discussed in more detail: osteoporosis, pressure ulcers, venous thromboembolism, and heterotopic ossification. For each of these, definitions/classifications, prevalence/incidence rates, diagnosis, prevention, and management are discussed. Every effort is made to provide information specific to the rehabilitation of neurological conditions and the evidence base behind practice is emphasized, with up-to-date references. Nutrition has also been shown to affect functional outcomes in a number of neurological conditions and the main issues in the rehabilitation setting are outlined. Tremor and ataxia are significant causes of limitation of activity and participation in individuals affected, and assessment and management of these are briefly discussed.
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8.
Learner-to-learner visual acuity screening: a solution for early identification of visual acuity disabilities.
Cook, SP, Pasio, SC
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde. 2013;(2):94-5
Abstract
BACKGROUND The National School Health Policy guidelines (2002) stipulate that primary school learners should have their vision, speech, hearing, mental health, teeth, nutrition and development screened annually. In reality, especially in under-resourced areas such as the Eastern Cape, many learners with disabilities are not identified, with profound consequences for their ability to learn. METHOD This article describes a cost-effective and community-empowering solution, Learner-to-Learner Visual Acuity Screening, whereby secondary school learners were trained to conduct basic visual acuity (VA) eye screening for foundation-phase learners. RESULTS Of a group of Grade R learners, 30% were identified as having impaired VA and referred for ophthalmic or optometric evaluation. CONCLUSIONS This project created greater awareness among learners, parents and teachers regarding abnormal VA and increased interaction between secondary and primary school learners. This simple and cost-effective strategy could be easily and effectively replicated in other schools, helping to address the need for basic eye care.
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9.
[Barriers to professional activity among people with cardiovascular diseases].
Kleniewska, A, Ojrzanowski, M, LipiĆska-Ojrzanowska, A, Wiszniewska, M, Walusiak-Skorupa, J
Medycyna pracy. 2012;(1):105-15
Abstract
Cardiovascular diseases (CVD) are a very important issue for the health care system. They are usually chronic diseases widespread in the society that require costly treatment and cause long-term sick absenteeism and partial or total incapacity for work. CVD are one of the most common cause of disability in Poland, therefore they constitute a medical, social and economic problem. Low occupational activity of people with CVD at working age requires special effort to develop and implement methods of their professional activation. A key role in this process should be played by physicians of occupational health services (OHS). In the case of disabled workers with cardiovascular disease, the decision about avoiding professional activity is often medically unjustified. It arises from a lack of sufficient knowledge ofjurisprudence and the fear of both the physician and the employee ofpatient's health deteriorations. Therefore, educational actions addressed to OHS physicians and to the patients are needed to enable the patients with CVD to remain at or to return to work.
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10.
[Health promotion, prevention, and rehabilitation in the elderly].
Mau, W, Reuter, S
Deutsche medizinische Wochenschrift (1946). 2011;(43):2199-204
Abstract
Considering the increasing disability with higher age and the demographic changes health promotion, prevention and rehabilitation are of high relevance for the maintenance and restoration of activity and participation of the elderly. Among the most important goals of prevention are mobility including physical activity and prevention of falls, adequate nutrition, maintenance of mental health, social integration and function. Different conditions of geriatric rehabilitation in Germany focussing either on acute care hospitals with early rehabilitation (inpatient or outpatient) or on rehabilitation in specialized centres lead to regional disparities. The application for rehabilitation measures has to consider the need, ability to participate, specified goals and prognosis after the interventions. Disease specific rehabilitation has to be differentiated from general geriatric rehabilitation addressing typical multimorbidity and geriatric syndromes. Significant characteristics of geriatric rehabilitation are regular patient oriented discussions within the multi-professional and interdisciplinary team coordinated by geriatricians. This includes prioritizing the patient's problems according to their significance and availability of effective therapy, evaluation of the results and adjustment of treatment goals if necessary. Standardised geriatric assessments should be applied. Geriatric rehabilitation including the interdisciplinary team increases function and reduces the risks of nursing home admissions and mortality. Therefore, the access to and the capacities of geriatric rehabilitation should be further improved.