RESUMO
Introductions: Reduplicative paramnesia (RP) is a rare and poorly understood phenomenon in which a person believes the place they are in has been replicated and exists in two places at once. There is minimal extant theoretical work addressing possible cognitive mechanisms subtending RP.Method: We present a new case of RP and discuss the therapeutic and theoretical implications of this case for the management and understanding of this phenomenon. Using the hypothetico-deductive approach to a neuropsychological case, we examine the phenomenon in the light of one and two-factor approaches to understanding the genesis of delusions.Results: The individual discussed in this case showed some evidence of relatively efficient incorporation of new evidence (belief updating) despite concurrently maintaining a delusional belief system.Conclusion: This case raises novel challenges for the two-factor account of neurological delusions.
Assuntos
Delusões , Transtornos da Memória , Humanos , Delusões/psicologia , Testes NeuropsicológicosRESUMO
This paper systematically and critically reviews the literature on the intersection of circular economy practices (CEPs) and sustainability performance (SP). We synthesize and analyze the extant literature to uncover the knowledge gaps, highlight the contradictory views, and provide a comprehensive overview of the field. Following a detailed database search, we selected 104 empirical studies published in peer-reviewed journals for analysis. Our review reports the publication trends, top publishing journal outlets, research methodologies, and empirical contexts. We outline the theoretical underpinnings, identify the diverse circular economy practices and the key factors that impact circular economy practices and sustainable performance. The review shows a propensity for most authors to reuse established theories or not use theory at all, revealing the need for theory development. Furthermore, our analysis revealed that R&D and innovation, digital technologies, organizational capabilities/resources, and stakeholder and institutional pressure substantially influence the CEPs - SP relationship. Through our detailed assessment of the existing literature, we identified and proposed several themes and avenues for future research.
Assuntos
Conservação dos Recursos Naturais , Desenvolvimento SustentávelRESUMO
Healthcare is delivered in a very complicated environment where numerous variables affect the patient related outcomes. A multidisciplinary team that places a high priority on patient satisfaction and healthcare quality can help to simplify and manage the environment of complex healthcare delivery. The foundation of rehabilitation treatments is a multidisciplinary team approach to provide interventions and care for the patients. Regardless of the population studied, multidisciplinary rehabilitation has been shown to be more effective than therapy delivered by individual therapists in a number of different populations. Due to the patient's complex impairments, a team-based approach is necessary for assessments and facilitates coordinated care planning in the rehabilitation settings. The aim of this paper is to offer a narrative review of the advantages and challenges of multidisciplinary team working. The key components of teamwork in rehabilitation are the individualization of patient care and effective team communication.
Assuntos
Medicina Física e Reabilitação , Humanos , Equipe de Assistência ao PacienteRESUMO
BACKGROUND: Moderately severe or major trauma (injury severity score (ISS) > 8) is common, often resulting in physical and psychological problems and leading to difficulties in returning to work. Vocational rehabilitation (VR) can improve return to work/education in some injuries (e.g. traumatic brain and spinal cord injury), but evidence is lacking for other moderately severe or major trauma. METHODS: ROWTATE is an individually randomised controlled multicentre pragmatic trial of early VR and psychological support in trauma patients. It includes an internal pilot, economic evaluation, a process evaluation and an implementation study. Participants will be screened for eligibility and recruited within 12 weeks of admission to eight major trauma centres in England. A total of 722 participants with ISS > 8 will be randomised 1:1 to VR and psychological support (where needed, following psychological screening) plus usual care or to usual care alone. The ROWTATE VR intervention will be provided within 2 weeks of study recruitment by occupational therapists and where needed, by clinical psychologists. It will be individually tailored and provided for ≤ 12 months, dependent on participant need. Baseline assessment will collect data on demographics, injury details, work/education status, cognitive impairment, anxiety, depression, post-traumatic distress, disability, recovery expectations, financial stress and health-related quality of life. Participants will be followed up by postal/telephone/online questionnaires at 3, 6 and 12 months post-randomisation. The primary objective is to establish whether the ROWTATE VR intervention plus usual care is more effective than usual care alone for improving participants' self-reported return to work/education for at least 80% of pre-injury hours at 12 months post-randomisation. Secondary outcomes include other work outcomes (e.g. hours of work/education, time to return to work/education, sickness absence), depression, anxiety, post-traumatic distress, work self-efficacy, financial stress, purpose in life, health-related quality of life and healthcare/personal resource use. The process evaluation and implementation study will be described elsewhere. DISCUSSION: This trial will provide robust evidence regarding a VR intervention for a major trauma population. Evidence of a clinically and cost-effective VR intervention will be important for commissioners and providers to enable adoption of VR services for this large and important group of patients within the NHS. TRIAL REGISTRATION: ISRCTN: 43115471. Registered 27/07/2021.
Assuntos
Reabilitação Vocacional , Retorno ao Trabalho , Ferimentos e Lesões , Humanos , Análise Custo-Benefício , Inglaterra , Custos de Cuidados de Saúde , Estudos Multicêntricos como Assunto , Ensaios Clínicos Pragmáticos como Assunto , Qualidade de Vida , Reabilitação Vocacional/métodos , Reabilitação Vocacional/economia , Fatores de Tempo , Resultado do Tratamento , Ferimentos e Lesões/psicologia , Ferimentos e Lesões/reabilitação , Ferimentos e Lesões/economiaRESUMO
Although multiple factors still pose challenges to inpatient/outpatient rehabilitation for survivors of COVID-19, rehabilitation plays a key role for this patient population. This study aimed to improve Physical and Rehabilitation Medicine (PRM) physician's professional practice for persons with COVID-19-related functioning limitations, to promote functional recovery and reduce activity limitations and/or participation restrictions. A systematic review of the scientific literature was performed from December 2019 to August 2022, followed by production of recommendations through 5 Delphi rounds, by consensus among the delegates of all European countries represented in the Union of European Medical Specialists PRM Section. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The PRM physician's role for persons with COVID-19-related limitations of functioning is to develop, foster, and monitor the implementation of an individual rehabilitation project tailored to the patient's age, previous medical and functional status, current comorbidities and complications, activity limitations and participation restrictions and personal and environmental factors. This is done by applying the concept of a multi-specialty integrated service model with multi-professional/interdisciplinary teams, providing care at all stages of COVID-19 illness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section.