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1.
Ann Med ; 53(1): 1935-1944, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34726085

RESUMO

Currently, there is limited research reporting the symptoms of long COVID among athletes, and the recommendations for athletes returning to competition/training who have experienced long COVID symptoms. Therefore, the aim of this systematic review is to synthesise the recommendations for returning athletes who have experienced long COVID symptoms. The protocol was registered in PROSPERO under CRD42021265939. Two authors searched the electronic databases PubMed, Embase, Scopus, the Cochrane Library, Web of Science, CINAHL, PsycINFO, and SPORTDiscus from August 2019-July 2021. Search terms included words related to "long COVID", "athlete" and "return". Data extraction was completed for each study by two independent investigators for: (1) first author name; (2) year of publication; (3) journal; (4) Definition of athlete (i.e. elite or non-elite) (5) Recommendations reported. A total of 220 records were found. Following title and abstract screening, 61 studies were eligible for full text screening. Overall, no studies, commentaries, editorials or reviews provided specific recommendations for "long COVID" defined as COVID-19 signs and symptoms lasting for over 4 weeks as a result of COVID-19 infection. In addition, we found no studies which reported symptoms of athletes suffering from long COVID. Despite the lack of evidence, we did find eight separate professional recommendations for managing "long-term effects" and "ongoing" or "prolonged" symptoms and COVID-19 complications among athletes. Practitioners should be aware of both mental and physical symptoms of long COVID, and additional considerations may be required for athletes who have undergone intensive care. The present review provides a list of recommendations based on existing literature that may be followed and implemented for returning athletes.Key MessagesFurther research, including longitudinal research of athletes who have tested positive for COVID-19, is required to develop evidenced-based guidelines for athletes with ongoing COVID-19 symptoms.Prior to returning to play after COVID-19 infection, a thorough medical history, physical and psychological examination should be conducted by a medical professional.Athletes should continue to monitor and record their own physical and psychological markers of health.


Assuntos
Atletas , Desempenho Atlético/fisiologia , COVID-19/complicações , COVID-19/fisiopatologia , COVID-19/reabilitação , Humanos
2.
PLoS One ; 16(10): e0258296, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34710123

RESUMO

OBJECTIVES: 3D-printed (3DP) customized temporary cranial protection solutions following decompressive craniectomy (DC) are currently not widely practiced. A pilot trial of a 3DP customized head protection prototype device (HPPD) on 10 subjects was conducted during the subacute rehabilitation phase. MATERIALS AND METHODS: Subjects > 30 days post-DC with stable cranial flaps and healed wounds were enrolled. HPPD were uniquely designed based on individuals' CT scan, where the base conformed to the surface of the individual's skin covering the cranial defect, and the lateral surface three-dimensionally mirrored, the contralateral healthy head. Each HPPD was fabricated using the fused deposition modeling method. These HPPD were then fitted on subjects using a progressive wearing schedule and monitored over 1, 2, 4, 6 and 8 follow-up (FU) weeks. Outcomes during FU included; reported wearing time/day (hours), subjective pain, discomfort, pruritus, dislodgment, cosmesis ratings; and observed wound changes. The primary outcome was safety and tolerability without pain or wound changes within 30 minutes of HPPD fitting. RESULTS: In all, 10 enrolled subjects received 12 HPPDs [5/10 male, mean (SD) age 46 (14) years, mean (SD) duration post-DC 110 days (76)] and all subjects tolerated 30 minutes of initial HPPD fitting without wound changes. The mean (SD) HPPD mass was 61.2 g (SD 19.88). During 8 weeks of FU, no HPPD-related skin dehiscence was observed, while 20% (2/10) had transient skin imprints, and 80% (8/10) reported self-limiting pressure and pruritis. DISCUSSION: Findings from this exploratory study demonstrated preliminary feasibility and safety for a customized 3DP HPPD for temporary post-DC head protection over 8 weeks of follow-up. Monitoring and regular rest breaks during HPPD wear were important to prevent skin complications. CONCLUSION: This study suggests the potential for wider 3DP technology applications to provide cranial protection for this vulnerable population.


Assuntos
Lesões Encefálicas/cirurgia , Craniectomia Descompressiva , Impressão Tridimensional , Crânio/cirurgia , Adulto , Idoso , Lesões Encefálicas/fisiopatologia , Lesões Encefálicas/reabilitação , Cognição , Estudos de Coortes , Craniectomia Descompressiva/efeitos adversos , Estudos de Viabilidade , Feminino , Dispositivos de Proteção da Cabeça , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Avaliação de Resultados em Cuidados de Saúde , Projetos Piloto , Crânio/fisiopatologia
3.
Chron Respir Dis ; 18: 14799731211046022, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34637351

RESUMO

Objectives: The objectives of this study were to determine the proportion of patients with interstitial lung disease (ILD) referred to pulmonary rehabilitation (PR) and to understand their experiences of participation or non-participation. Methods: Adults (>18 years old) with a diagnosis of ILD were identified from the Alfred Health ILD registry in Melbourne. Information regarding PR referral and attendance were collected from medical records. Semi-structured interviews with open-ended questions were conducted with patients who had been referred to PR. Results: Of 336 patients eligible for inclusion, PR referral was identified in 137 patients (40.7%). Patients referred to PR had worse respiratory function than those not referred (forced vital capacity mean 64 (SD 23) vs 79 (19) % predicted) and more desaturation during a 6-min walk test (86.6 (7.8%) vs 88.5 (7.0%)). Semi-structured interviews identified three major themes: valued components of PR (supervision and individualization, improved confidence with exercise, education and peer support); limited knowledge about PR prior to attendance and barriers to attending PR (lack of perceived benefits, fear of exercise and accessibility). Discussion: Over 40% of patients who attended a specialist ILD clinic were referred to pulmonary rehabilitation, with higher referral rates in those with more severe disease. There are opportunities to improve patient knowledge regarding the role and expected benefits of PR in people with ILD.


Assuntos
Doenças Pulmonares Intersticiais , Doença Pulmonar Obstrutiva Crônica , Adolescente , Tolerância ao Exercício , Humanos , Doenças Pulmonares Intersticiais/reabilitação , Doenças Pulmonares Intersticiais/terapia , Avaliação de Resultados da Assistência ao Paciente , Doença Pulmonar Obstrutiva Crônica/terapia , Encaminhamento e Consulta , Teste de Caminhada
4.
Medicine (Baltimore) ; 100(42): e27384, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34678866

RESUMO

ABSTRACT: To evaluate the real aerobic capacity is difficult due to impaired limbs function in stroke patients. Oxygen uptake efficiency slope (OUES) could represent the aerobic capacity in submaximal exercise test. Hence, we designed this observational study to investigate the application of the OUES for evaluating aerobic capacity in these patients.Thirty-seven stroke patients were classified into 2 groups according to their Brunnstrom stage of affected lower limbs. Patients underwent cardiopulmonary exercise testing to assess cardiorespiratory fitness. Minute ventilation and oxygen consumption were measured, and OUES was calculated, compared with healthy reference values, and correlated with the peak oxygen consumption. The predictive validity of submaximal OUES was derived.Study participants' OUES (median 566.2 [IQR, 470.0-711.6]) was 60% of healthy reference values and correlated positively with the peak oxygen consumption (r = 0.835) (P < .01). The predictive validity of oxygen uptake efficiency slope at 50% of maximal exercise duration (OUES50) and oxygen uptake efficiency slope at 75% of maximal exercise duration (OUES75) for oxygen uptake efficiency slope at 100% of maximal exercise duration (OUES100) was 0.877 and 0.973, respectively (P < .01). The OUES50, OUES75, and OUES100 groups were not significantly different; agreement of submaximal and maximal OUES values was strong.OUES is a valuable submaximal index for evaluating cardiorespiratory fitness in stroke patients. Moderate-to-high concurrent validity of this parameter with peak oxygen consumption and the high predictive validity of OUES50 and OUES75 for OUES100 suggest maximal exercise testing in stroke patients who cannot reach maximal exercise is unnecessary.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Teste de Esforço/métodos , Consumo de Oxigênio/fisiologia , Reabilitação do Acidente Vascular Cerebral/métodos , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Paraplegia/reabilitação , Índices de Gravidade do Trauma
5.
Maturitas ; 152: 32-47, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34674806

RESUMO

Two behavioral change-based strategies for promoting adherence to physical activity (PA) suggested to have the greatest potential are the pedometer and Motivational Interviewing (MI). However, there are no comparisons between these two strategies identifying which one is more effective for improving PA adherence. This systematic review and meta-analysis aimed to determine which PA motivation strategy is more effective for promoting adherence to self-directed PA in female breast cancer survivors. Studies implementing self-directed PA which used a step tracker and/or MI for motivation in female breast cancer survivors were identified from the following databases at two timepoints, September 2019 and June 2020: CENTRAL, PubMed, CINAHL, PsycINFO, and Sportdiscuss. Sixteen randomized controlled trials (RCTs) were selected for data extraction, whereas ten RCTs were included in meta-analysis. Meta-analysis was performed on pooled data to estimate the standardized mean differences in PA duration and step count, and 95% confidence intervals. The number of participants meeting PA recommendations was also analyzed. Subgroup analysis was performed for three motivational strategies (pedometer combined with counselling, with print material or with motivational interviewing). Meta-analysis showed that pedometer combined with another intervention has a small effect on step count (p = 0.03) and a moderate effect on duration of moderate-vigorous physical activity (MVPA) (p = <0.0001) compared to controls. Additionally, motivational strategies increase the number of participants who meet a PA goal (p = 0.005). The findings of this review endorse the use of a step tracker combined with counselling, print material or MI based on behavioral change theory. This approach provided the most consistent positive effect on adherence to self-directed PA among breast cancer survivors. Future studies should evaluate differences between measures of adherence to self-directed PA, to identify the best motivation strategy for improving patient adherence and health outcomes. Systematic review registration: PROSPERO Registration number CRD42020148542.


Assuntos
Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Exercício Físico/psicologia , Monitores de Aptidão Física , Entrevista Motivacional , Cooperação do Paciente/psicologia , Acelerometria , Neoplasias da Mama/reabilitação , Feminino , Humanos , Motivação , Cooperação do Paciente/estatística & dados numéricos , Dispositivos Eletrônicos Vestíveis
6.
Lancet Psychiatry ; 8(10): 866-867, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34537100
7.
JBJS Case Connect ; 11(3)2021 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-34559695

RESUMO

CASE: Parsonage-Turner syndrome, also known as brachial neuritis or neuralgic amyotrophy, is characterized by sudden-onset pain and subsequent weakness of the shoulder. Known precipitating factors include viral and bacterial infections and certain immunizations. Isolated cases after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported. We report the case of a 66-year-old woman with right shoulder dysfunction and medial scapular winging after immunization with the SARS-CoV-2 BNT162b2 vaccine (Pfizer). CONCLUSION: After physical therapy, the patient resumed her normal activities of daily living. Findings from this case represent the first known documentation of Parsonage-Turner syndrome after SARS-CoV-2 BNT162b2 vaccination.


Assuntos
Neurite do Plexo Braquial/etiologia , Vacinas contra COVID-19/efeitos adversos , Idoso , Neurite do Plexo Braquial/diagnóstico , Neurite do Plexo Braquial/reabilitação , Feminino , Humanos , Modalidades de Fisioterapia
8.
Folia Med Cracov ; 61(2): 117-127, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34510169

RESUMO

Mucormycosis is an invasive fungal disease caused by saprophytic molds and is characterized by a fulminant course and high mortality. Reported increase of disease cases and more frequent mucormycosis superinfections in COVID-19 patients are of a serious concern. Head and neck area is the most typical location of mucormycosis and often the first symptoms are eminent in oral cavity, therefore a dentist may be the first healthcare practitioner to recognize signs of this dangerous and potentially fatal disease. Urgent diagnosis and implementation of appropriate treatment are essential for the patient's survival. The dentist's participation in postoperative care is necessary and due to the destructive nature of radical surgical treatment, prosthetic rehabilitation is required to improve the patient's function and quality of life. Furthermore the vigilance of dentists will also allow early recognition of frequent recurrences of this insidious infection.


Assuntos
Antifúngicos/uso terapêutico , COVID-19/complicações , Assistência Odontológica , Mucormicose/terapia , Doenças Orbitárias/terapia , Procedimentos Cirúrgicos Otorrinolaringológicos , Rinite/terapia , Sinusite/terapia , Humanos , Mucormicose/complicações , Mucormicose/diagnóstico , Mucormicose/reabilitação , Doenças Orbitárias/complicações , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/reabilitação , Cuidados Pós-Operatórios , Próteses e Implantes , Rinite/complicações , Rinite/diagnóstico , Rinite/reabilitação , SARS-CoV-2 , Sinusite/complicações , Sinusite/diagnóstico , Sinusite/reabilitação
11.
BMC Cancer ; 21(1): 1019, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521359

RESUMO

BACKGROUND: Patients who have breast cancer surgery are at risk of axillary web syndrome (AWS), an under-recognized postsurgical complication which can result in shoulder morbidity and functional impairment. Emerging studies have indicated that AWS may persist beyond the first few months after surgery, although few studies have assessed the prevalence and association of AWS beyond a year after diagnosis. Therefore, the aim of this study was to investigate the prevalence and associations for AWS in post-operative breast cancer patients up to 3 years after surgery. METHODS: This cross sectional observational study was conducted at a community-based cancer rehabilitation center. Patients were evaluated for the presence of AWS via physical examination. Disease-related data was obtained from clinical review and medical records. Descriptive statistics were utilized to illustrate patient demographics and clinical characteristics. Logistic regression analyses were used to determine associations of AWS. RESULTS: There were 111 Asian women who were recruited, who had undergone breast surgery and were referred to a national outpatient rehabilitation center. The prevalence of AWS in this population was 28.9%. In the multivariate regression model, significant factors were age < 50 years (OR = 3.51; 95% CI = 1.12-11.0; p = 0.031) and ALND (OR = 6.54; 95% CI = 1.36-31.3; p = 0.019). There was reduced shoulder flexion ROM (p < 0.001) in patients with AWS compared to patients without AWS. CONCLUSIONS: A high prevalence of AWS was reported in breast cancer survivors even at 3 years after breast surgery. Our findings highlight the need to identify breast cancer survivors with AWS even in the survivorship phase, and develop strategies to raise awareness and minimize functional impairment in these patients.


Assuntos
Grupo com Ancestrais do Continente Asiático , Neoplasias da Mama/cirurgia , Complicações Pós-Operatórias/epidemiologia , Adulto , Fatores Etários , Axila , Neoplasias da Mama/etnologia , Neoplasias da Mama/reabilitação , Métodos Epidemiológicos , Feminino , Humanos , Linfedema/diagnóstico , Pessoa de Meia-Idade , Exame Físico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etnologia , Amplitude de Movimento Articular , Centros de Reabilitação , Articulação do Ombro , Dor de Ombro/epidemiologia , Dor de Ombro/etnologia , Síndrome , Fatores de Tempo
12.
MMW Fortschr Med ; 163(15): 24-26, 2021 09.
Artigo em Alemão | MEDLINE | ID: mdl-34478081
13.
BMJ Open Respir Res ; 8(1)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34489236

RESUMO

Many patients struggle with ongoing symptoms in different domains (physical, mental, cognitive) after hospitalisation for COVID-19, calling out for a multidisciplinary approach. An outpatient multidisciplinary rehabilitation programme, according to a respiratory rehabilitation strategy, was set up for adult patients who were able to attend group sessions during 12 weeks. Results of 22 adult patients with COVID-19, of which 15 had required intensive care, were analysed and some general impressions and challenges of rehabilitation in COVID-19 were reported. Impressive results on physical recovery were determined after 6 weeks and 3 months, with significant improvement of lung function, muscle force and exercise capacity variables. A positive evolution of mental and cognitive burden was present, although less pronounced than the physical recovery. These mental and cognitive consequences seem, next to musculoskeletal and medical complications, the most challenging aspect of rehabilitating patients with COVID-19. These real-world data show feasibility and efficiency of a multidisciplinary respiratory rehabilitation programme after moderate to severe COVID-19 disease.


Assuntos
COVID-19 , Terapia Respiratória , Adulto , COVID-19/reabilitação , Cuidados Críticos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Resultado do Tratamento
14.
Eur J Phys Rehabil Med ; 57(4): 607-619, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34519194

RESUMO

BACKGROUND: More than 40% of individuals with whiplash injury experience persistent neck pain and disability years later, called whiplash-associated disorders (WAD). A randomized controlled trial evaluated three exercise interventions in WAD and found that neck-specific exercise (NSE) and NSE with a behavioral approach (NSEB) significantly improve disability compared to prescribed physical activity (PPA). However, the relationship between neck-related function and disability is inconclusive and needs to be further investigated. AIM: The present study compares the effect of NSE, NSEB, and PPA on neck muscle endurance (NME), active cervical range of motion (AROM), grip strength, and pain intensity immediately before and after the physical tests, and neck disability in individuals who are below or above the cut-off for normative reference values regarding NME, AROM, and grip strength. DESIGN: Follow-up to a multicenter randomized clinical trial. SETTING: Primary healthcare centers and hospital outpatient services. POPULATION: The selected population of this study included 216 patients with persistent WAD grades II and III. METHODS: This is a secondary analysis including 12 months' follow-up. NME, AROM, grip strength, pain, and self-reported disability were recorded at baseline, 3, 6, and 12 months. Linear mixed models were used, and sub-group analyses evaluated by non-parametric tests. RESULTS: NSE and NSEB resulted in greater improvements compared to PPA (P<0.01) in ventral (only males) and dorsal NME, AROM, and pain intensity during testing. We found no significant between-group differences in grip strength and no significant differences between the NSE and NSEB groups. Improvement in disability was seen at the 12-month follow-up of NSE and/or NSEB for individuals both below and above the cut-off reference values for NME and AROM. Individuals in the PPA group below the reference values for NME and AROM reported increasing disability at 12 months compared to baseline. CONCLUSIONS: The results suggest that neck-specific exercises (i.e., NSE, NSEB) improve clinical function and decrease disability in chronic WAD compared to PPA, but PPA can increase disability for patients with low neck-related function. CLINICAL REHABILITATION IMPACT: Higher neck-related function seems to be important for reduced disability in persistent WAD grades II and III. Neck-specific exercises could lead to higher neck-related function.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Pessoas com Deficiência/reabilitação , Terapia por Exercício/métodos , Exercício Físico/fisiologia , Músculos do Pescoço/fisiopatologia , Traumatismos em Chicotada/fisiopatologia , Traumatismos em Chicotada/reabilitação , Adulto , Doença Crônica/reabilitação , Terapia Combinada , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Medição da Dor , Amplitude de Movimento Articular/fisiologia
15.
Int Heart J ; 62(5): 980-987, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34544978

RESUMO

Angiopoietin-like protein 2 (ANGPTL2) promotes chronic inflammation and plays a key role in the pathogenesis of heart failure. Cardiac rehabilitation (CR) is an integral component of heart failure management and has been shown to have anti-inflammatory effects. However, ANGPTL2 concentration in chronic heart failure patients undergoing CR has not been evaluated. This study aimed to investigate serum ANGPTL2 levels and their associated factors and compare the results with those of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with chronic heart failure undergoing phase III CR.A total of 56 patients were enrolled. Clinical characteristics including body composition, grip strength, exercise tolerance, duration of CR, blood counts and biochemistry, and echocardiographic parameters were evaluated for their association with serum ANGPTL2 and NT-proBNP levels.The median (first and third quartiles) value of ANGPTL2 was 4.05 (2.70-5.57) ng/mL. Clinical parameters that correlated with serum ANGPTL2 levels were body weight, body mass index, body fat mass, body fat percentage, anaerobic threshold (AT), C-reactive protein, and total protein (TP), which were mostly distinct from those that correlated with serum NT-proBNP levels. A multivariate analysis revealed that AT and TP were independent factors related to ANGPTL2 levels, whereas age, left ventricular ejection fraction, and left atrial dimension were independently related to NT-proBNP levels.These observations suggest that CR increases the exercise tolerance and exhibits anti-inflammatory effects simultaneously, and this situation is reflected by decreased serum ANGPLT2 and TP levels. ANGPTL2 may be a useful marker of inflammation and impaired exercise tolerance in patients with chronic heart failure.


Assuntos
Proteínas Semelhantes a Angiopoietina/sangue , Reabilitação Cardíaca/métodos , Insuficiência Cardíaca/metabolismo , Inflamação/metabolismo , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Idoso , Limiar Anaeróbio/fisiologia , Biomarcadores/sangue , Proteínas Sanguíneas/análise , Composição Corporal/fisiologia , Proteína C-Reativa/análise , Reabilitação Cardíaca/tendências , Estudos de Casos e Controles , Doença Crônica , Estudos Transversais , Ecocardiografia/métodos , Tolerância ao Exercício/fisiologia , Feminino , Força da Mão/fisiologia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/reabilitação , Humanos , Inflamação/complicações , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Volume Sistólico , Função Ventricular Esquerda/fisiologia
16.
Artigo em Russo | MEDLINE | ID: mdl-34481432

RESUMO

OBJECTIVE: To study the effectiveness of a course of intravenous administration of cytoflavin in combination with a standard rehabilitation program for post-COVID fatigue syndrome caused by mitochondrial dysfunction. MATERIAL AND METHODS: The dynamic examination of 45 patients with post-COVID syndrome at the second stage of rehabilitation was carried out. The patients were subdivided into 2 groups comparable in gender and age. The volume of lung damage in patients of both groups was also comparable at range of 25-80%. Twenty-four patients of the control group were treated with the standard post-COVID rehabilitation protocol: pulse magnetic therapy, inhalation therapy, aeroion therapy, infrared laser therapy, course aerobic training, psychotherapy, and standard drug therapy. Twenty-one patients of the main group additionally received intravenous administration of cytoflavin daily for 10 days. The dynamics of the scores on the Rehabilitation Routing Scale, HDRS, the Asthenic Status Scale, and the 6-minute walk test was analyzed. RESULTS AND CONCLUSION: The additional intravenous administration of cytoflavin at the complex rehabilitation of post-COVID syndrome can significantly improve the therapeutic results: it significantly improves the overall functional state, reduces depression and fatigue level and increases tolerance to physical exertion.


Assuntos
COVID-19 , Fadiga/reabilitação , Mitocôndrias/patologia , COVID-19/reabilitação , Fadiga/virologia , Humanos , Resultado do Tratamento
18.
PLoS One ; 16(9): e0257675, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34547048

RESUMO

Wildlife rehabilitation is a publicly popular practice, though not without controversy. State wildlife agencies frequently debate the ecological impact of rehabilitation. By analyzing case records, we can clarify and quantify the causes for rehabilitation, species involved, and treatment outcomes. This data would aid regulatory agencies and rehabilitators in making informed decisions, as well as gaining insight into causes of species mortality. In New York State, the Department of Environmental Conservation (NYSDEC) has licensed rehabilitators since 1980 and annual reporting is required. In this study, we analyzed 58,185 individual wildlife cases that were attended by New York rehabilitators between 2012 and 2014. These encompassed 30,182 (51.9%) birds, 25,447 (43.7%) mammals, 2,421 (4.2%) reptiles, and 75 (0.1%) amphibians. We identified patterns among taxonomic representation, reasons for presentation to a rehabilitation center, and animal disposition. Major causes of presentation were trauma (n = 22,156; 38.1%) and orphaning (n = 21,679; 37.3%), with habitat loss (n = 3,937; 6.8%), infectious disease (n = 1,824; 3.1%), and poisoning or toxin exposure (n = 806; 1.4%) playing lesser roles. The overall release rate for animals receiving care was 50.2% while 45.3% died or were euthanized during the rehabilitation process. A relatively small number (0.3%) were permanently non-releasable and placed in captivity; 4.1% had unknown outcomes. A comparable evaluation in 1989 revealed that wildlife submissions have increased (annual mean 12,583 vs 19,395), and are accompanied by a significant improvement in release (50.2% in the study period vs 44.4% in 1989) (χ2(1) = 90.43, p < 0.0001). In this manuscript, we aim to describe the rehabilitator community in New York State, and present the causes and outcomes for rehabilitation over a three-year period.


Assuntos
Animais Selvagens/lesões , Conservação dos Recursos Naturais/estatística & dados numéricos , Ferimentos e Lesões/veterinária , Anfíbios/lesões , Animais , Aves/lesões , Ecossistema , Feminino , Masculino , Mamíferos/lesões , New York , Répteis/lesões , Estudos Retrospectivos , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/reabilitação
19.
PLoS One ; 16(9): e0257462, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34534254

RESUMO

CONTEXT: Aphasia is a post-stroke condition that can dramatically impact a person with aphasia's (PWA) communication abilities. To date, few if any studies have considered the cost and cost-effectiveness of functional change in aphasia nor considered measures of patient's value for aphasia treatment. OBJECTIVE: To assess the cost, cost-effectiveness, and perceived value associated with improved functional communication in individuals receiving telerehabilitation treatment for aphasia. DESIGN: Twenty PWA completed between 5 and 12 telehealth rehabilitation sessions of 45-60 minutes within a 6-week time frame using a Language-Oriented Treatment (LOT) designed to address a range of language issues among individuals with aphasia. National Outcomes Measures (NOMS) comprehension and verbal expression and the ASHA Quality of Communication Life (QCL) were completed prior to and at the completion of rehabilitation to obtain baseline and treatment measures. RESULTS: Age, education, and race are significantly correlated with improvement in the NOMS verbal expression. African Americans (OR = 2.0917) are twice as likely as Whites to experience improvement after treatment. The likelihood of improvement also increases with each additional year of education (OR = 1.002) but decrease with age (OR = 0.9463). A total of 15 PWA showed improvement in NOMS comprehension and nine patients showed improvement in NOMS verbal expression. Improving patients attended between five and 12 treatment sessions. The average cost of improvement in NOMS comprehension was $1,152 per patient and NOMS verbal expression was $1,128 per patient with individual treatment costs varying between $540 and $1,296. However, on average, the monetary equivalent in patient's improved QCL was between $1,790.39 to $3,912,54-far exceeding the financial cost of treatment. CONCLUSIONS: When measuring the functional improvement of patients with aphasia, patient's quality of communication life received from treatment exceeded financial cost of services provided.


Assuntos
Afasia/economia , Custos de Cuidados de Saúde , Avaliação de Resultados em Cuidados de Saúde/economia , Telerreabilitação/economia , Afro-Americanos , Fatores Etários , Afasia/etnologia , Afasia/reabilitação , Escolaridade , Grupo com Ancestrais do Continente Europeu , Humanos , Modelos Logísticos , Razão de Chances , Qualidade de Vida , Fonoterapia , Telerreabilitação/métodos
20.
J Rehabil Med ; 53(10 (October)): jrm00232, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34557928

RESUMO

OBJECTIVE: To determine the multidimensionality of acceptance of spinal cord injury (SCI). PARTICIPANTS: Adults with SCI who were admitted to an SCI centre between 1991 and 2020. METHODS: All eligible participants (n=686) were invit-ed to complete a survey via REDCap. A 4-dimensional model was hypothesized, which included "Accepting Reality", "Value Change", "Letting Go of Control" and "Behavioural Engagement". Items from 3 accept-ance scales were selected to collectively reflect these 4 dimensions: (i) Spinal Cord Lesion-related Coping Strategies Questionnaire, (ii) Coping Orientations to Problems Experienced, and (iii) a modified Acceptance and Action Questionnaire. A split-sample principal component analysis (PCA) and confirmatory factor analysis (CFA) approach was used. RESULTS: Complete data were provided by 431 participants (62.8%). A PCA on sub-sample one suggest-ed a 4-factor model based on eigenvalues ≥ 1, corresponding to the hypothesized model of acceptance. A CFA on sub-sample 2 showed good model fit, adding further support to the model. CONCLUSION: These findings suggest that acceptance is a multidimensional construct with 4 facets that represent distinct, but interconnected, psychological processes. This model of acceptance can be used as a framework for future research and clinical practice to deepen our understanding of acceptance processes following severe injuries, such as SCI.


Assuntos
Adaptação Psicológica , Formação de Conceito , Traumatismos da Medula Espinal/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos da Medula Espinal/reabilitação , Inquéritos e Questionários
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