Rehabilitation services play an important role in optimizing functional ability and societal integration for people with disabilities. The Madagascar Rehabilitation Programme (2011-2013) resulted ...from a global training partnership and led to 8 doctors achieving a university diploma in rehabilitation medicine. This paper describes a 2014 evaluation of the programme methods, results and learning points.
A combination of qualitative methods was used for the evaluation, based on a Theory of Change model, with informants from Madagascar and the UK.
Malagasy trainees and UK volunteers gained new theoretical knowledge and practical skills. For Madagascar, it led to changes in working practice and the formation of a national rehabilitation association. Key to its success was the strong collaboration between Malagasy and UK professionals, with support from the University and Ministry of Health in Madagascar, and the UK partners. Having a clear common vision ensured the programme met the needs of the Malagasy clinicians.
Rehabilitation is increasingly recognized as an important focus for international development. Successful rehabilitation training programmes can be achieved at modest costs with global health partnerships. The combination of factors that enabled this programme to be a success is reproducible in other contexts.
Vocational rehabilitation: an educational review Chamberlain, M Anne; Fialka Moser, Veronika; Schüldt Ekholm, Kristina ...
Journal of rehabilitation medicine,
2009, Letnik:
41, Številka:
11
Journal Article
Recenzirano
Odprti dostop
The aim of this review is to describe aspects of vocational rehabilitation relevant for a physician aiming to become a specialist in physical and rehabilitation medicine (PRM). The review discusses ...the epidemiology of incapacity for work, the major patient groups in vocational rehabilitation (musculoskeletal and psychiatric diagnoses comprise approximately 50-70% of the patients), the influence of different kinds of environmental and individual risk factors on work resumption (such as the legal framework, application of the law, resources for rehabilitation and its effectiveness, the degree of co-operation between vocational rehabilitation agencies, economic factors/labour market situation, medical and personal factors). The review describes different models of vocational rehabilitation, the effectiveness of various vocational rehabilitation programmes on work resumption or sick leave (where strong evidence is reported for multi-modal rehabilitation programmes for patients with long-lasting musculoskeletal pain). Finally, there are sections about the PRM physician's history-taking in vocational rehabilitation (using the International Classification of Functioning, Disability and Health (ICF)), and report writing with a structure where ICF body functions and activity limitations are reported separately.
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Many conditions may affect the temporomandibular joint (TMJ), but its incidence in individual joint diseases is low. However, inflammatory arthropathies, particularly rheumatoid and psoriatic ...arthritis and ankylosing spondylitis, appear to have a propensity for affecting the joint. Symptoms include pain, restriction in mouth opening, locking, and noises, which together can lead to significant impairment. Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients. Symptom deterioration does not necessarily follow disease progression, but when it does, TMJ arthroscopy and arthrocentesis can help modulate pain, increase mouth opening, and relieve locking. These minimally invasive procedures have few complications and can be repeated. Operations to repair or remove a damaged intra-articular disc or to refine joint anatomy are used in select cases. Total TMJ replacement is reserved for patients where joint collapse or fusion has occurred or in whom other treatments have failed to provide adequate symptomatic control. It yields excellent outcomes and is approved by the National Institute of Health and Care Excellence (NICE), UK. Knowledge of the assessment and treatment of the TMJ, which differs from other joints affected by inflammatory arthritis due to its unique anatomy and function, is not widespread outside of the field of oral and maxillofacial surgery. The aim of this article is to highlight the peculiarities of TMJ disease secondary to rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis and how to best manage these ailments, which should help guide when referral to a specialist TMJ surgeon is appropriate.
These are United States business users, too, the kind of customers that computer manufacturers have courted since the bottom fell out of the home computer market in the mid-1980s. Granted, they ...aren't in Fortune 500 corporations, which often have internal support organizations for personal computers. But they are business customers who presumably can pay for service contracts or costly repairs.
Within the past few months, two lawsuits have been filed in Southern California - one against Epson America Inc. and the other against Nissan Motor Corp. - alleging that workers have been fired as a ...result of their personal electronic mail messages being read by their bosses. Just what the messages contained is unclear. A spokesman for two employees who are suing Nissan would only say the messages were of a "personal" nature and not company business. Anyone who has read about computer break-ins - or for that matter, the backup copies of incriminating electronic mail messages Ollie North thought he had deleted - should realize that even with passwords protecting them, your electronic mail can be read by folks you don't want to see it.
You hooked up to the computer via an acoustic coupler - an antique sort of modem into which you shoved a phone receiver. You typed everything in upper case. You could only use the machine to write ...programs in the BASIC language. There was no user interface, and everything was printed on rolls of cheap yellow paper. In other ways, though, our children's acceptance of computers poses a challenge. Part of my attitude about computers as marvels also makes me skeptical about them. I don't believe they're omnipotent. I'm readily willing to accept that the answers they give, the data they spit out, can be wrong. I will concede that they aren't the answer to every problem from illiteracy to declining industrial productivity and government bureaucracy. So as I introduce my next kid to the everyday world of the computer, I'll do it with a sense of caution and a healthy dose of skepticism. And if my kids have too many fights over the thing, maybe I'll have to take it away and make them read a few books printed on paper. Then, I might get to use the computer once in a while.
Software Process Improvement OConnor, Rory V; Baddoo, Nathan; Gallego, Juan Cuadrago ...
2009, 2009-08-21, Letnik:
42
eBook
This volume constitutes the refereed proceedings of the 16th EuroSPI conference in Alcala (Madrid region) during September 2-4. The 18 revised full papers presented were carefully reviewed and ...selected. They are organized in topical sections on SPI and the testing process, SPI measurement and assessment, agile and open source issues, SPI and management issues, process life cycle and quality issues, standards and reference models. This textbook is intended for the use by SPI (Software Process Improvement) managers and researchers, quality managers, and experienced project and research managers.
Intravenous heparin is routinely given after thrombolytic therapy for patients with acute myocardial infarction in the United States and in some, but by no means all, other countries. Several trials ...have documented improved infarct-artery patency in patients treated with heparin; however, none was large enough individually to assess the effect of heparin on clinical outcomes. We performed a systematic overview of the 6 randomized controlled trials (1,735 patients) to summarize the available data concerning the risks and benefits of intravenous heparin versus no heparin after thrombolytic therapy. Mortality before hospital discharge was 5.1% for patients allocated to intravenous heparin compared with 5.6% for controls (relative risk reduction of 9%, odds ratio 0.91, 95% confidence interval 0.59 to 1.39). Similar rates of recurrent ischemia and reinfarction were observed among those allocated to heparin therapy or control. The rates of total stroke, intracranial hemorrhage, and severe bleeding were similar in patients allocated to heparin; however, the risk of any severity of bleeding was significantly higher (22.7% vs 16.2%; odds ratio 1.55, 95% confidence interval 1.21 to 1.98). There was no significant difference in the observed effects of heparin between patients receiving tissue-type plasminogen activator and those receiving streptokinase or anisoylated plasminogen streptokinase activator complex, or between patients who did and did not receive aspirin. The findings of this overview demonstrate that insufficient clinical outcome data are available to support or to refute the routine use of intravenous heparin therapy after thrombolysis. It is not known if these findings are due to lack of statistical power, inappropriate levels of anticoagulation, or lack of benefit of intravenous heparin. Large randomized studies of heparin (and of newer antithrombotic regimens) are needed to establish the role of such therapy.
Three-dimensional kinematic variables and their relationship to the physiology of racing wheelchair propulsion were studied. Six male wheelchair athletes performed two trials (medium and maximum ...speed) of 3 min each. VO
2
, VO
2
/kg, V
E
, and HR were measured. Results showed that at medium speed, wrist velocity on hand contact was significantly correlated with VO
2
/kg. At maximum speed, elbow velocity during preparatory phase was significantly correlated with VO
2
. Stepwise regression showed wrist trajectory angle and elbow velocity during preparatory phase were significantly correlated with VO
2
/kg. Results indicate that kinematic variables recorded prior to and on hand contact with the pushrim are significant variables in developing a more efficient racing wheelchair propulsion technique. Results of this study indicate a need to educate coaches of wheelchair track athletes concerning the best racing wheelchair propulsion technique.
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