Oral rehabilitation with an implant-supported mesostructure on a microvascularized mandibular graft: A 12-year follow-up study

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José Manuel Mendes

2017-06-01

Full Text Available Due to the increased survival of the population, treatment of oral cavity tumour patients is increasingly common. In this context, oral rehabilitation construction methods have been developed to contribute to improving the patient's quality of life. Developments in the areas of oral implantology and rehabilitation, along with microvascularized grafts, have increased the possibility of rehabilitating patients undergoing hemimandibulectomy with more effective and lasting treatment. This article aims to demonstrate an aesthetic and functional oral rehabilitation method, both in terms of the oral cavity and the lower face, in a young patient submitted to a left lateral hemimandibulectomy, using a mesostructure fixed onto implants.

A randomized clinical trial of oral hygiene care programmes during stroke rehabilitation.

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Dai, Ruoxi; Lam, Otto L T; Lo, Edward C M; Li, Leonard S W; McGrath, Colman

2017-06-01

The objectives of this study were to evaluate and compare the effectiveness of an advanced oral hygiene care programme (AOHCP) and a conventional oral hygiene care programme (COHCP) in improving oral hygiene, and reducing gingival bleeding among patients with stroke during outpatient rehabilitation. Subjects were randomized to receive (i) the COHCP comprising a manual toothbrush, toothpaste, and oral hygiene instruction, or (ii) the AOHCP comprising a powered toothbrush, 0.2% chlorhexidine mouthrinse, toothpaste, and oral hygiene instruction. Dental plaque, gingival bleeding, and other clinical oral health outcomes were assessed at baseline, the end of the clinical trial, and the end of observation period. Development of infectious complications was also monitored. Participants of both programmes had a significant reduction in the percentages of sites with moderate to abundant dental plaque (p<0.001) and with gingival bleeding (p<0.05). Those in the AOHCP had significantly less plaque and gingival bleeding than those in the COHCP controlling for other factors at the end of the clinical trial period (both p<0.001) and the observational period (plaque: p<0.05, gingival bleeding: p<0.01). Although both oral hygiene care programmes were effective in terms of plaque and gingival bleeding control, the AOHCP was more effective than the COHCP in reducing dental plaque and gingival bleeding. This study highlighted the value of oral hygiene programmes within stroke outpatient rehabilitation and provides evidence to advocate for the inclusion of oral hygiene care programmes within stroke outpatient rehabilitation for patients with normal cognitive abilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines.

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Butterworth, C; McCaul, L; Barclay, C

2016-05-01

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK and provides recommendations on the pre-treatment oral and dental assessment, during and after treatment and oral rehabilitation. Restorative dentists are core members of the multidisciplinary team treating head and neck cancer patients, involved from the treatment planning phase through to long-term rehabilitation. Recommendations • Preventative oral care must be delivered to patients whose cancer treatment will affect the oral cavity, jaws, salivary glands and oral accessibility. (G) • Close working and communication between the surgeons, oncologists and restorative dental specialists is important in ensuring optimal oral health outcomes. (G) • Intensity-modulated radiotherapy has been shown to reduce long-term xerostomia and should be offered to all appropriate patients. (R) • If patients are deemed at risk of trismus they should be warned and its progressive and potentially irreversible nature explained. (G) • Where it is known that adjuvant radiotherapy will be given, extractions should take place at primary surgery to maximise the time for healing and minimise the number of surgical events for patients. (G) • Osseointegrated implants should be considered for all patients having resection for head and neck cancer. (G).

Early intensive rehabilitation after oral cancer treatment.

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Bschorer, Maximilian; Schneider, Daniel; Hennig, Matthias; Frank, Bernd; Schön, Gerhard; Heiland, Max; Bschorer, Reinhard

2018-06-01

The treatment of oral cancer requires an effective rehabilitation strategy such as an early intensive rehabilitation (EIR) program. The medical records and data of 41 patients who participated in an EIR program and 20 control group patients were analyzed. These patients all underwent surgical resection of the primary tumor followed by microsurgical reconstruction using free flaps. The length of stay (LOS) at the acute care hospital was compared between the two groups. Four indexes were used to evaluate the effectiveness of the EIR program. EIR patients stayed an average of 11.6 fewer days at the acute care hospital. All indexes showed significant improvements (p < 0.001). The Barthel Index (BI) and the Early Intensive Rehabilitation Barthel Index (EIR-BI) improved by 36.0 and 103.6 points, respectively. At discharge, the Bogenhausener Dysphagia Score (BODS) had improved to a score of 11.0 compared to the 13.9 at admission. EIR patients had a Work Ability Index (WAI) score of 25.7. Length of stay at the acute care hospital can be reduced using early intensive rehabilitation if patients are transferred to an intensive rehabilitation clinic early. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Simplified Prosthetic Rehabilitation of a Patient after Oral Cancer Removal

OpenAIRE

Nikola Džakula; Josip Kranjčić; Denis Vojvodić

2016-01-01

The treatment of patients with oral cancer is complex: a multidisciplinary approach needs to be taken and maxillofacial and oral surgeons, an oncologist, a prosthodontist should be included, and a psychologist is often needed. This case report describes the prosthetic rehabilitation of a patient after surgical removal of oral cancer with obturator prosthesis. Resection cavity was located in central part of the hard palate and the condition belonged to Aramany class 3 maxillary defects. The tw...

Oral rehabilitation of the cancer patient: A formidable challenge.

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Petrovic, Ivana; Rosen, Evan B; Matros, Evan; Huryn, Joseph M; Shah, Jatin P

2018-05-03

Rehabilitation of oral functions following surgery on the jaws is a goal that is often difficult to achieve. Removable dentures supported by remaining teeth or gum are often unstable and seldom satisfactory. On the other hand, endosseous (dental) implants offer a mechanism to provide stability to the dentures. This review, discusses factors related to the tumor, patient, treatment, and physicians which impact upon the feasibility and success of dental implants in patients with oral cancer. © 2018 Wiley Periodicals, Inc.

Oral hygiene in patients with oral cancer undergoing chemotherapy and/or radiotherapy after prosthesis rehabilitation: protocol proposal.

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Rapone, B; Nardi, G M; DI Venere, D; Pettini, F; Grassi, F R; Corsalini, M

2016-01-01

This study was aimed at assessing the effectiveness and the importance of an oral hygiene (OH) protocol in patients undergoing radiation therapy and chemotherapy after prosthesis rehabilitation, in order to reduce or minimize oral complications. This study was carried out at the Department of Dental Science, at the University of Bari-Italy from December 2012 to December 2015 on 34 selected patients with primary oral cancer undergoing chemotherapy and radiotherapy after prosthesis rehabilitation. They were divided into 2 groups according to their age, sex and cancer therapy. Seventeen patients were assigned to the control group and seventeen in the experimental one. In the experimental group (Table 1), patients underwent an oral hygiene protocol whereas in the control group (Table 2) patients received the usual care provided within the clinical setting. All the patients gave written informed consent. It has been asked and obtained the authorisation from the Ethics Committee of the Dental Science and Surgery Department. Results show that in patients undergoing the oral hygiene protocol, the complications and the risks of infection and permanent dental problems have been minimized. Indeed, of the seventeen patients undergoing the OH protocol, 70% obtained positive results and were satisfied with the program outcome. The role of the health care providers is essential to educate patients to adhere to the prescribed treatments and reinforce their motivation in oral hygiene. The oral hygiene procedures prevent and ameliorate oral complications due to the radiation therapy and chemotherapy.

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP) - Part 4: oral rehabilitation.

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Freitas, José Alberto de Souza; Almeida, Ana Lúcia Pompéia Fraga de; Soares, Simone; Neves, Lucimara Teixeira das; Garib, Daniela Gamba; Trindade-Suedam, Ivy Kiemle; Yaedú, Renato Yassutaka Faria; Lauris, Rita de Cássia Moura Carvalho; Oliveira, Thais Marchini; Pinto, João Henrique Nogueira

2013-01-01

Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.

Dexmedetomidine, ketamine, and midazolam for oral rehabilitation: a case report.

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Kim, Bill W S; Peskin, Robert M

2015-01-01

Intravenous sedation is frequently provided by anesthesiologists for phobic patients undergoing elective dental treatment in outpatient settings. Propofol is one of the most commonly used anesthetic agents that can result in apnea and respiratory depression, thereby posing potential difficulties with perioperative airway management. Dexmedetomidine has been utilized successfully in intravenous sedation for a wide variety of procedures and holds potential as an alternative to propofol in outpatient dental settings. However, as a single agent, it may not provide adequate depth of sedation and analgesia for oral rehabilitation. In this case report we demonstrate an effective alternative intravenous deep-sedation technique for an adult phobic patient undergoing oral rehabilitation utilizing 3 agents in combination: dexmedetomidine, ketamine, and midazolam. This combination of agents may be especially useful for those patients with a history of substance abuse, where administration of opioids may be undesirable or contraindicated.

Mini-implants: alternative for oral rehabilitation of a child with ectodermal dysplasia.

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Mello, Bianca Zeponi Fernandes; Silva, Thiago Cruvinel; Rios, Daniela; Machado, Maria Aparecida Andrade Moreira; Valarelli, Fabrício Pinelli; Oliveira, Thais Marchini

2015-01-01

Ectodermal dysplasia is a rare congenital disease that affects several structures of ectodermal origin. The most commonly related oral characteristics are hypodontia, malformed teeth and underdeveloped alveolar ridges. New alternative treatments are needed due to the failure of the conventional prosthesis retention. This case report outlines the oral rehabilitation treatment of a 9-year-old girl with ectodermal dysplasia. The treatment was performed with conventional prosthesis upon mini-implants. The mini-implants provided prosthetic retention. The patient reported a good adaptation of the dental prosthesis and satisfaction with the treatment. The increased self-esteem improved the socialization skills of the girl. In this case report, use of prosthesis with mini-implants was satisfactory for prosthetic retention. However, clinical studies with long-term follow-up are needed to test the mini-implants as an alternative for oral rehabilitation of children with ectodermal dysplasia.

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP Part 4: Oral Rehabilitation

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Jose Alberto de Souza FREITAS

2013-06-01

Full Text Available Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.

[Ectodermal Capdepont syndrome and oral prosthetic rehabilitation. About a clinical case].

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Kumpanya, P; Matshumba, M; Sekele, I B; Mayunga, M; Lutula, P S; Ntumba, M K

2015-03-01

The authors describe the ectodermal Capdepont syndrome as an anomaly characterized by anhidrosis, hypotrichosis and anodontia diagnosed in a 22 year-old adult. In front of this anodontia, oral prosthetic rehabilitation remains the only solution.

Oral health-related quality of life in patients with stroke: a randomized clinical trial of oral hygiene care during outpatient rehabilitation.

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Dai, Ruoxi; Lam, Otto L T; Lo, Edward C M; Li, Leonard S W; McGrath, Colman

2017-08-09

This study was to evaluate the effectiveness of oral hygiene care in improving oral health- and health-related quality of life (OHRQoL and HRQoL) among patients receiving outpatient stroke rehabilitation. Subjects were randomized to: (1) a conventional oral hygiene care programme (COHCP) comprising a manual toothbrush, and oral hygiene instruction, or (2) an advanced oral hygiene care programme (AOHCP) comprising a powered toothbrush, 0.2% chlorhexidine mouthrinse, and oral hygiene instruction. The interventional period lasted for 3 months, followed by a 3-month observational period. HRQoL was assessed by SF-12, and OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14), General Oral Health Assessment Index (GOHAI), and Oral Health Transitional Scale (OHTS). Participants in AOHCP group had significantly better OHRQoL at the end of clinical trial as assessed by OHTS (p < 0.01), and at the end of observational study as assessed by GOHAI (p < 0.05) than those in the COHCP. Participants in the AOHCP group had significantly better HRQoL as assessed by physical component summary score (PCS) the end of both 3 and 6 months (both p < 0.05). This study provided the evidence that the AOHCP was more effective than the COHCP within stroke rehabilitation in improving subjective health.

Prosthetic Oral Rehabilitation of a Child With S-ECC: A Case Report with Histopathologic Analysis.

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Tannure, P N; Moraes, G G; Borba, McU; Abrahão, A; Andrade, Mtrc; Fidalgo, Tks

2015-01-01

The aim of this case report is to describe the treatment planning of a young child with severe early childhood caries (S-ECC) as well as the prosthetic rehabilitation technique. A 3-year-old female child was referred to the pediatric dentistry clinic with the chief complaint of tooth pain, difficulty in eating and recurrent hospitalizations caused by dental infections. The mother reported intermittent episodes of fever and recurrent swelling of child's face. The girl presented angular cheilitis and was referred to a dietitian. The treatment plain consisted on a behavior changes in oral hygiene habits, exodontias of all primary teeth and oral rehabilitation with a prosthesis. The extracted teeth with periapical lesions were submitted to histopathologic analysis (hematoxilin and eosin staining) and revealed an inflammatory infiltrate. The aesthetic requirement of children with S-ECC has been a challenge to pediatric dentists. In the present case, the oral rehabilitation provided for the children better aesthetic, nutrition, phonation, and functional conditions.

Simplified Prosthetic Rehabilitation of a Patient after Oral Cancer Removal.

Science.gov (United States)

Kranjčić, Josip; Džakula, Nikola; Vojvodić, Denis

2016-09-01

The treatment of patients with oral cancer is complex: a multidisciplinary approach needs to be taken and maxillofacial and oral surgeons, an oncologist, a prosthodontist should be included, and a psychologist is often needed. This case report describes the prosthetic rehabilitation of a patient after surgical removal of oral cancer with obturator prosthesis. Resection cavity was located in central part of the hard palate and the condition belonged to Aramany class 3 maxillary defects. The two-step impression technique of denture bearing area was used and the resection of cavity was performed. A primary impression-the impression of denture bearing area was made using irreversible hydrocolloid material, while the second impression - the impression of resection cavity was made using condensation silicone material and obturator prosthesis framework. The obturator prosthesis replaced lost teeth, improved oral function and esthetics at minimal costs.

Simplified Prosthetic Rehabilitation of a Patient after Oral Cancer Removal

Directory of Open Access Journals (Sweden)

Nikola Džakula

2016-01-01

Full Text Available The treatment of patients with oral cancer is complex: a multidisciplinary approach needs to be taken and maxillofacial and oral surgeons, an oncologist, a prosthodontist should be included, and a psychologist is often needed. This case report describes the prosthetic rehabilitation of a patient after surgical removal of oral cancer with obturator prosthesis. Resection cavity was located in central part of the hard palate and the condition belonged to Aramany class 3 maxillary defects. The two-step impression technique of denture bearing area and the resection cavity was performed. A primary impression- the impression of denture bearing area was made using irreversible hydrocolloid material, while the second impression – the impression of resection cavity was made using condensation silicone material and obturator prosthesis framework. The obturator prosthesis replaced lost teeth, improved oral function and esthetics at minimal costs.

Rehabilitation effect of oral drug on the patients with proliferative diabetic retinopathy after operation

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Wei Zu

2014-08-01

Full Text Available AIM:To observe the rehabilitation effect of oral Calcium Dobesilate Tablets and Epalrestat Tablets on the proliferative diabetic retinopathy(PDRpatients after vitrectomy.METHODS: After vitrectomy patients informed consent, they were randomly divided into intervention group and control group, and their vision and fundus were followed up and compared at 2d; 3, 6, 9, 12mo after operation.RESULTS: The recovery and sustainment of visual acuity, and subsiding of macular edema of patients in drug intervention group were significantly better than that in control group.CONCLUSION: PDR patients after vitrectomy actively orally take medicine to protect retina, which can improve vision and fundus rehabilitation.

Oral rehabilitation of a patient with sub - total maxillectomy

OpenAIRE

Romesh Soni; Shitu Jindal; B P Singh; Neelam Mittal; T P Chaturvedi; D R Prithviraj

2011-01-01

This clinical report describes oral rehabilitation of a patient with sub-total maxillectomy with palatine process of maxilla and horizontal plate of palatine bone intact to retain the maxillary obturator. Clinical examination has been performed to know the amount of favorable undercuts to be used for retention of the obturator for better functional efficiency. Successful prosthetic reconstruction of hemimaxillectomy defect is a challenging procedure that requires multidisciplinary expertise t...

Influence of negative affectivity and self-esteem on the oral health related quality of life in patients receiving oral rehabilitation

OpenAIRE

Özhayat, Esben Boeskov

2013-01-01

Background The aim of this study was to investigate if and how the personality traits Negative Affectivity (NA) and self-esteem influenced the Oral Health Related Quality of Life (OHRQoL) in patients receiving oral rehabilitation. Methods OHRQoL was measured by the Oral Health Impact Profile 49 (OHIP-49), NA with a short form of the Eysenck Personality Inventory Questionnaire (EPI-Q), and self-esteem with Rosenbergs Self-Esteem Scale (RSES) in 66 patients treated with removable dental prosthe...

Impact of orthodontic treatment on self-esteem and quality of life of adult patients requiring oral rehabilitation.

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de Couto Nascimento, Vanessa; de Castro Ferreira Conti, Ana Cláudia; de Almeida Cardoso, Maurício; Valarelli, Danilo Pinelli; de Almeida-Pedrin, Renata Rodrigues

2016-09-01

To evaluate whether orthodontic treatment in adults requiring oral rehabilitation is effective for increasing patients' self-esteem and quality of life (QoL). The sample consisted of 102 adult patients (77 women and 25 men) aged between 18 and 66 years (mean, 35.1 years) requiring oral rehabilitation and orthodontic treatment simultaneously. Rosenberg's Self-Esteem (RSE) Scale and a questionnaire about QoL based on the Oral Health Impact Profile (OHIP-14) were used to determine self-esteem and QoL scores retrospectively. Questionnaires were carried out in two stages, T1 (start of treatment) and T2 (6 months after). To compare score changes between T1 and T2, the data obtained from the RSE Scale were evaluated with paired t tests, and data from the quality-of-life questionnaire were assessed by applying descriptive statistics. The results showed a statistically significant increase in self-esteem (P < .001) and a great improvement on patients' QoL. Orthodontic treatment causes a significant increase in self-esteem and QoL, providing psychological benefits for adult patients in need of oral rehabilitation.

Lasting effect of an oral hygiene care program for patients with stroke during in-hospital rehabilitation: a randomized single-center clinical trial.

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Kim, Eun-Kyong; Park, Eun Young; Sa Gong, Jung-Whan; Jang, Sung-Ho; Choi, Youn-Hee; Lee, Hee-Kyung

2017-11-01

Because the oral hygiene is poorly prioritized in the immediate post-stroke period, we implemented an oral hygiene care program (OHCP) for stroke in-patients and evaluated its persistence after discharge. In all, 62 patients with stroke who were admitted to the rehabilitation ward were randomly assigned to two groups: 33 patients to the intervention group and 29 to the control group. The OHCP, including tooth brushing education and professional tooth cleaning, was administered to the intervention group twice a week six times during in-hospital rehabilitation. Oral health status was examined both at baseline and three months after discharge from the hospital. Oral hygiene status was examined at three- to four-day intervals five times during the hospitalization period. After OHCP, oral hygiene status including the plaque index, calculus index, and O'Leary plaque index improved significantly in the intervention group, compared to the control group (p < 0.05). In the intervention group, after administration of the OHCP for the fourth time, the O'Leary index improved significantly, and remained high when checked three months after discharge (p < 0.001). An OHCP conducted during in-hospital rehabilitation was effective in improving oral health and plaque control performance among patients with stroke, with effects still seen three months after discharge from the hospital. Implications for Rehabilitation Initial oral hygiene status and plaque control performance were poor in stroke patients who were in rehabilitation center. An oral hygiene care program during in-hospital rehabilitation was effective in improving oral hygiene status and plaque control performance among stroke patients at three months after discharge. Repeated tooth brushing education and professional tooth cleaning were necessary to improve plaque control performance of stroke patients.

Biofilm Formation on Different Materials Used in Oral Rehabilitation

OpenAIRE

Souza, Júlio C. M.; Mota, Raquel R. C.; Sordi, Mariane B.; Passoni, Bernardo B.; Benfatti, Cesar A. M.; Magini, Ricardo S.

2016-01-01

Abstract The aim of this study was to evaluate the density and the morphological aspects of biofilms adhered to different materials applied in oral rehabilitation supported by dental implants. Sixty samples were divided into four groups: feldspar-based porcelain, CoCr alloy, commercially pure titanium grade IV and yttria-stabilized zirconia. Human saliva was diluted into BHI supplemented with sucrose to grow biofilms for 24 or 48 h. After this period, biofilm was removed by 1% protease treatm...

Clinical importance of median mandibular flexure in oral rehabilitation: a review.

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Sivaraman, K; Chopra, A; Venkatesh, S B

2016-03-01

The mandible has a property to flex inwards around the mandibular symphysis with change in shape and decrease in mandibular arch width during opening and protrusion of the mandible. The mandibular deformation may range from a few micrometres to more than 1 mm. The movement occurs because of the contraction of lateral pterygoid muscles that pulls mandibular condyles medially and causes a sagittal movement of the posterior segments. This movement of mandible can have a profound influence on prognosis and treatment outcome for various restorative, endodontics, fixed, removable and implant-related prosthesis. The review unfolds the causes, importance and clinical implications of median mandibular flexure in oral rehabilitation. This review also highlights the appropriate preventive measures and techniques that should be adopted by clinicians to minimise the effect of flexural movement of the jaw during oral rehabilitation. This would not only help clinicians to achieve a good prosthesis with accurate fit and longevity but also maintain the health of the surrounding periodontal or periimplant gingival tissues and bone. © 2015 John Wiley & Sons Ltd.

Oral communication and auditory skills of hearing impaired children and adolescents and the speech therapy rehabilitation process

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Rafaela da Silva Bicas

Full Text Available ABSTRACT Purpose: to analyze auditory and oral communication behaviors in a group of children and adolescents, users of cochlear implants and to establish a relationship with factors that interfere with aural rehabilitation. Methods: participants were 13 children or adolescents with profound bilateral sensorineural hearing loss. Standardized procedures were applied to check: the auditory and oral communication behaviors of participants and their relationships with the child's age at diagnosis period; the interval between diagnosis and intervention, adaptation onset of the cochlear implant; the hearing age and aural rehabilitation period. Results: statistically significant data were found to correlate the interval between diagnosis and intervention with the scores in the evaluation procedures of oral communication. Conclusion: there was a significant impact on the development of oral communication when the period elapsed between the diagnosis and intervention was analyzed, in such way that the faster the intervention time, the better the results. It was also evident that the earlier the beginning of the use of cochlear implants, the greater the hearing age, and the longer the rehabilitation period, the better the scores in the procedures that evaluated auditory and verbal development.

Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

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Shankargouda Patil

Full Text Available Oral submucous fibrosis (OSF is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature.A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study.A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures.Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

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Patil, Shankargouda; Sarode, Sachin Chakradhar; Sarode, Gargi S; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

2017-01-01

Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

Risk factors for insufficient perioperative oral nutrition after hip fracture surgery within a multi-modal rehabilitation programme

DEFF Research Database (Denmark)

Foss, Nicolai B; Jensen, Pia S; Kehlet, Henrik

2007-01-01

To examine oral nutritional intake in the perioperative phase in elderly hip fracture patients treated according to a well-defined multi-modal rehabilitation program, including unselected oral nutritional supplementation, and to identify independent risk factors for insufficient nutritional intake....

Rehabilitation of exacerbated case of oral mucositis associated with renal failure following bone marrow transplantation

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Pavesi VCS

2009-01-01

Full Text Available Inflammation of oral mucosa induced by anti neoplastic drugs is an important, dose limiting and costly side effect of cancer therapy. Here is presented an exacerbated case of oral mucositis associated with renal failure in a patient who underwent bone marrow transplantation. The clinical aspects and an integrated rehabilitation program are discussed below.

Ellis-van Creveld Syndrome: A Rare Clinical Report of Oral Rehabilitation by Interdisciplinary Approach

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Talib Amin Naqash

2018-01-01

Full Text Available Ellis-van Creveld syndrome (EVC is a very rare genetic disorder that affects various tissues of ectodermal and mesodermal origin; patients with EVC present with typical oral deficiencies. The affected individuals are quite young at the time of oral evaluation. It is, therefore, important that these individuals are diagnosed and receive dental treatment at an early age for their physiologic and psychosocial well-being. Albeit there are numerous articles penned on the EVC, the treatise from an oral perspective is inadequate, covering only oral exhibitions and the preventive treatments. This article reviews the literature and serves as the first disquisition for oral rehabilitation of an EVC patient utilizing surgical, orthodontic, restorative, and prosthodontic management.

Computer-assisted technologies used in oral rehabilitation and the clinical documentation of alleged advantages - a systematic review.

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Jokstad, A

2017-04-01

The objective of this systematic review is to identify current computer-assisted technologies used for managing patients with a need to re-establish craniofacial appearance, subjective discomfort and stomatognathic function, and the extent of their clinical documentation. Electronic search strategies were used for locating clinical studies in MEDLINE through PubMed and in the Cochrane library, and in the grey literature through searches on Google Scholar. The searches for commercial digital products for use in oral rehabilitation resulted in identifying 225 products per November 2016, used for patient diagnostics, communication and therapy purposes, and for other computer-assisted applications in context with oral rehabilitation. About one-third of these products were described in about 350 papers reporting from clinical human studies. The great majority of digital products for use in oral rehabilitation has no clinical documentation at all, while the products from a distinct minority of manufacturers have frequently appeared in more or less scientific reports. Moore's law apply also to digital dentistry, which predicts that the capacity of microprocessors will continue to become faster and with lower cost per performance unit, and innovative software programs will harness these improvements in performance. The net effect is the noticeable short product life cycle of digital products developed for use in oral rehabilitation and often lack of supportive clinical documentation. Nonetheless, clinicians must request clinically meaningful information about new digital products to assess net benefits for the patients or the dental professionals and not accept only technological verbiage as a basis for product purchases. © 2017 John Wiley & Sons Ltd.

Oral rehabilitation of patients after maxillectomy. A systematic review.

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Dos Santos, D M; de Caxias, F P; Bitencourt, S B; Turcio, K H; Pesqueira, A A; Goiato, M C

2018-05-01

Patients who have maxillectomy can be rehabilitated with reconstructive surgery or obturator prostheses with or without osseointegratable implants. To identify studies on possible treatments in this group, we systematically searched the Scopus, Embase, PubMed/Medline, and Cochrane databases to collect data on patients' characteristics, radiotherapy, and results related to speech, swallowing, mastication or diet, chewing, aesthetics, and quality of life. Of the 1376 papers found, six were included, and one other was included after an additional search of references. A total of 252 patients were included, and of them, 86 had reconstructive surgery, 91 were treated with obturator prostheses, 39 had reconstructive surgery or obturator prostheses associated with implants, and 36 had reconstruction plus an obturator prosthesis. Data on radiotherapy were incomplete. There is a lack of consensus about the indication for rehabilitation, as the treatment must be based on the individual characteristics of each patient. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Oral health and nutritional status in a group of geriatric rehabilitation patients.

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Andersson, Pia; Westergren, Albert; Karlsson, Siv; Rahm Hallberg, Ingalill; Renvert, Stefan

2002-09-01

The aims of this study were to evaluate the oral health status and nutritional status in a group of geriatric rehabilitation patients, and to analyse the relationship between these two parameters. Nurses at the ward performed structured assessments of oral and nutritional status using the Revised Oral Assessment Guide and the Subjective Global Assessment form in 223 newly admitted patients. Most oral health problems were found among patients who stayed longer at the hospital and were more dependent on help as compared with the healthier patients. Thirty-four per cent of the patients were either severely undernourished, at risk or suspected to be undernourished (UN). Oral health problems were more common among UN patients (p oral health problem was found on teeth or dentures (48%). Problems related to the tongue and lips were also common among UN patients (56 and 44%, respectively). Oral health status was correlated (r = 0.32) to nutritional status. Problems with swallowing had the strongest association to the nutritional status (OR 6.05; 95% CI 2.41-15.18). This study demonstrated that poor oral health status was related to undernourishment.

Peripheral Exophytic Oral Lesions: A Clinical Decision Tree

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Hamed Mortazavi

2017-01-01

Full Text Available Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as “oral soft tissue lesion,” “oral tumor like lesion,” “oral mucosal enlargement,” and “oral exophytic lesion.” Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated and rough (squamous epithelium-originated. Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic, and mesenchymal lesions (benign and malignant neoplasms. In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

Implant-supported Oral Rehabilitation in Child with Ectodermal Dysplasia - 4-year Follow-up.

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Cezária Triches, Thaisa; Ximenes, Marcos; Oliveira de Souza, João Gustavo; Rodrigues Lopes Pereira Neto, Armando; Cardoso, Antônio Carlos; Bolan, Michele

2017-01-01

Ectodermal dysplasia (ED) is an anomaly determined by genetic factors that alter ectodermal structures such as skin, hair, nails, glands, and teeth. Children affected by this condition require extensive, comprehensive, and multidisciplinary treatment. An 8-year-old female patient visited the Dentistry Clinic of the Federal University of Santa Catarina with the chief complaint of multiple missing teeth. The mother reported that the patient had ED. Clinical and radiographic examination revealed the congenital absence of several primary and permanent teeth and tooth germs. Subsequent oral rehabilitation comprised the application of a maxillary denture and mandibular implant-supported fixed prosthesis. The child was also supplied with a wig for further enhancement of esthetics aimed at improving her emotional wellbeing. Psychological follow-up and speech therapy were also provided. After 4 years of follow-up, implant-supported oral rehabilitation has proved to be a satisfactory treatment option, allowing restoration of masticatory, phonetic, and esthetic function, as well as an improvement in the patient's self-esteem and social wellbeing.

PATHway: Decision Support in Exercise Programmes for Cardiac Rehabilitation.

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Filos, Dimitris; Triantafyllidis, Andreas; Chouvarda, Ioanna; Buys, Roselien; Cornelissen, Véronique; Budts, Werner; Walsh, Deirdre; Woods, Catherine; Moran, Kieran; Maglaveras, Nicos

2016-01-01

Rehabilitation is important for patients with cardiovascular diseases (CVD) to improve health outcomes and quality of life. However, adherence to current exercise programmes in cardiac rehabilitation is limited. We present the design and development of a Decision Support System (DSS) for telerehabilitation, aiming to enhance exercise programmes for CVD patients through ensuring their safety, personalising the programme according to their needs and performance, and motivating them toward meeting their physical activity goals. The DSS processes data originated from a Microsoft Kinect camera, a blood pressure monitor, a heart rate sensor and questionnaires, in order to generate a highly individualised exercise programme and improve patient adherence. Initial results within the EU-funded PATHway project show the potential of our approach.

Evolution of oral cancer treatment in an andalusian population sample: Rehabilitation with prosthetic obturation and removable partial prosthesis.

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Flores-Ruiz, Rafael; Castellanos-Cosano, Lizette; Serrera-Figallo, María-Angeles; Gutiérrez-Corrales, Aida; Gonzalez-Martin, Maribel; Gutiérrez-Pérez, Jose-Luis; Torres-Lagares, Daniel

2017-08-01

Radical surgical resection as a treatment modality for oral cancer often leads to an extensive deficit in both the maxillary and mandibular levels, where the use of a palatal obturator prosthesis (POP) or removable partial denture (RPP). The aim of this study was to evaluate the treatment with POP and RPP in patients treated for oral cancer in the Unit of Prosthetic Rehabilitation of the University Hospital Virgen del Rocío in a period of 20 years. Retrospective descriptive study during the years 1991 and 2011 analyzing oral cancer type, characteristics, treatment and follow-up. The sample consisted of patients whose tumor had previously been removed and who had been referred to the Oncological Rehabilitation Unit of the Oral and Maxillofacial Surgery Unit of the "Virgen del Rocío" University Hospital for rehabilitation. The inclusion criteria were patients whose underlying pathology was any type of neoplasia, which after its treatment had been referred to the aforementioned Oncological Prosthetic Rehabilitation unit. Of the 45 patients included in our study, 15 patients were rehabilitated with palatal obturator (33.3%) and 5 patients with removable partial denture (11.1%). The mean age of the sample of patients with POP was 57.3 ± 9.23, while the mean age of the sample of patients with RPP was 58 ± 13.5. The most common underlying pathology in patients with POP was squamous cell carcinoma (60%), whereas in patients with RPP it was 100%. The most frequent location found among POP patients was the upper jaw, while in the PRP patients there was no predominant location. The univariate and multivariate logistic regressions did not show any statistically significant association between the independent variables age, sex, smoking habit and alcoholic habit with the dependent variable type of rehabilitating prosthesis. Based on our data, we can conclude that RPP is used in few cases of oncological rehabilitation. The POP has a greater use, as long as the defect in the

Comparison of Multi-Criteria Decision Support Methods for Integrated Rehabilitation Prioritization

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Franz Tscheikner-Gratl

2017-01-01

Full Text Available The decisions taken in rehabilitation planning for the urban water networks will have a long lasting impact on the functionality and quality of future services provided by urban infrastructure. These decisions can be assisted by different approaches ranging from linear depreciation for estimating the economic value of the network over using a deterioration model to assess the probability of failure or the technical service life to sophisticated multi-criteria decision support systems. Subsequently, the aim of this paper is to compare five available multi-criteria decision-making (MCDM methods (ELECTRE, AHP, WSM, TOPSIS, and PROMETHEE for the application in an integrated rehabilitation management scheme for a real world case study and analyze them with respect to their suitability to be used in integrated asset management of water systems. The results of the different methods are not equal. This occurs because the chosen score scales, weights and the resulting distributions of the scores within the criteria do not have the same impact on all the methods. Independently of the method used, the decision maker must be familiar with its strengths but also weaknesses. Therefore, in some cases, it would be rational to use one of the simplest methods. However, to check for consistency and increase the reliability of the results, the application of several methods is encouraged.

Oral Rehabilitation for Amniotic Band Syndrome: An Unusual Presentation.

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Hotwani, Kavita; Sharma, Krishna

2015-01-01

Amniotic band syndrome (ABS) is a congenital disorder caused by entrapment of fetal parts in fibrous amniotic bands while in utero. The syndrome is underdiagnosed and its presentation is variable. The syndrome has been well described in the pediatric, orthopedic and obstetric literature; however, despite the discernable craniomaxillofacial involvement, ABS has not been reported in the dental literature very often. The present report describes a case of a patient with ABS and concomitant dental findings. How to cite this article: Hotwani K, Sharma K. Oral Rehabilitation for Amniotic Band Syndrome: An Unusual Presentation. Int J Clin Pediatr Dent 2015;8(1):55-57.

Impact of systemic diseases on oral health related quality of life after implant-prosthodontic rehabilitation

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Tina Pretnar

2014-08-01

Full Text Available Background: Implant-prosthodontic rehabilitation improves oral health related quality of life (OHRQoL, but the presence of systemic diseases can also affect the well-being of an individual.The study was carried out to determine the relationship between systemic diseases and OHRQoL after implant-prosthodontic rehabilitation on the basis of psychometric testing by a standardized questionnaire »Oral Health Impact Profile« (OHIP.Methods: 130 patients, who received one to eight Ankylos® implants (on average 2.6 ± 1.8 were included in this retrospective study in which all aspects of the OHRQoL construct were evaluated with a Slovenian version of the OHIP questionnaire. Data on all present systemic diseases were obtained from the existing health records. Dental status and dental restorations were identified on the basis of orthopantomographic images.Results: The majority of subjects had a cardiovascular disease (N = 37; 28.5 %, followed by a headache (N = 15, 11.5 %, allergies and asthma (n = 13, 10 %, and a rheumatic disease (N = 11, 8.5 %. Only osteoporosis was statistically significantly related to OHRQoL after implant-prosthodontic rehabilitation (p = 0.024. The best multiple linear regression model for the summary score for the questionnaire »Oral Health Impact Profile« for Slovenia (OHIP, and taking into account gender and age as confounding factors, included the number of remaining teeth and the presence of osteoporosis (p = 0.003, adjusted R2 = 0.104.Conclusions: The total number of remaining teeth in the oral cavity (p = 0.031, the presence of osteoporosis (p = 0.024, and taking into account the subject’s gender and age, are the most important clinical factors that affect the functioning of the SGS as well as psychosocial behavior of the patients after an implant-prosthodontic rehabilitation (adjusted R2 = 0.104. Other systemic diseases (cardiovascular disease, headache, allergies and

Strategic rehabilitation planning of piped water networks using multi-criteria decision analysis.

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Scholten, Lisa; Scheidegger, Andreas; Reichert, Peter; Maurer, Max; Mauer, Max; Lienert, Judit

2014-02-01

To overcome the difficulties of strategic asset management of water distribution networks, a pipe failure and a rehabilitation model are combined to predict the long-term performance of rehabilitation strategies. Bayesian parameter estimation is performed to calibrate the failure and replacement model based on a prior distribution inferred from three large water utilities in Switzerland. Multi-criteria decision analysis (MCDA) and scenario planning build the framework for evaluating 18 strategic rehabilitation alternatives under future uncertainty. Outcomes for three fundamental objectives (low costs, high reliability, and high intergenerational equity) are assessed. Exploitation of stochastic dominance concepts helps to identify twelve non-dominated alternatives and local sensitivity analysis of stakeholder preferences is used to rank them under four scenarios. Strategies with annual replacement of 1.5-2% of the network perform reasonably well under all scenarios. In contrast, the commonly used reactive replacement is not recommendable unless cost is the only relevant objective. Exemplified for a small Swiss water utility, this approach can readily be adapted to support strategic asset management for any utility size and based on objectives and preferences that matter to the respective decision makers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Decision making algorithm of the rehabilitation of agricultural lands contaminated with heavy natural radionuclides

International Nuclear Information System (INIS)

Khomutyinyin, Yu.V.; Yivanov, Yu.O.; Kirichenko, V.K.

2013-01-01

Problem of rehabilitation of agricultural land contaminated with heavy natural radionuclides ( 210 Pb, 210 Po, 226 Ra, 232 Th, 238 U) was considered. Algorithm of decision making support on advisability of rehabilitation of mentioned land was suggested. Proposed algorithm was tested on the base of agricultural farmlands located in the affected zone of Pridneprovsky Chemicals Plant and its tailing dumps

Influence of negative affectivity and self-esteem on the oral health related quality of life in patients receiving oral rehabilitation

DEFF Research Database (Denmark)

Øzhayat, Esben Boeskov

2013-01-01

(OHIP-49), NA with a short form of the Eysenck Personality Inventory Questionnaire (EPI-Q), and self-esteem with Rosenbergs Self-Esteem Scale (RSES) in 66 patients treated with removable dental prosthesis (RDP). The minimally important difference (MID), effect size (ES), and standard error......Background: The aim of this study was to investigate if and how the personality traits Negative Affectivity (NA) and self-esteem influenced the Oral Health Related Quality of Life (OHRQoL) in patients receiving oral rehabilitation. Methods: OHRQoL was measured by the Oral Health Impact Profile 49......L regardless of level of NA and self-esteem. High NA is associated with a large effect, but both high NA and low self-esteem is associated with poorer OHRQoL both before and after treatment....

Decision Support Model for Mosque Renovation and Rehabilitation (Case Study: Ten Mosques in Jakarta Barat, Indonesia)

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Utama, D. N.; Triana, Y. S.; Iqbal, M. M.; Iksal, M.; Fikri, I.; Dharmawan, T.

2018-03-01

Mosque, for Muslim, is not only a place for daily worshipping, however as a center of culture as well. It is an important and valuable building to be well managed. For a responsible department or institution (such as Religion or Plan Department in Indonesia), to practically manage a lot of mosques is not simple task to handle. The challenge is in relation to data number and characteristic problems tackled. Specifically for renovating and rehabilitating the damaged mosques, a decision to determine the first damaged mosque priority to be renovated and rehabilitated is problematic. Through two types of optimization method, simulated-annealing and hill-climbing, a decision support model for mosque renovation and rehabilitation was systematically constructed. The method fuzzy-logic was also operated to establish the priority of eleven selected parameters. The constructed model is able to simulate an efficiency comparison between two optimization methods used and suggest the most objective decision coming from 196 generated alternatives.

Oral Rehabilitation with Implant-Retained Overdenture in a Patient with Down Syndrome.

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Altintas, Nuray Yilmaz; Kilic, Serdar; Altintas, Subutay Han

2017-01-24

Down syndrome, known as trisomy 21, is the most common chromosomal disorder. The disorder affects mental and systemic development as well as oral structure, including dental anomalies, high susceptibility of periodontal disease, and poor quality of alveolar bone. This report presents a case of dental rehabilitation by means of dental implants of a patient with Down syndrome. Two titanium dental implants were placed in the maxilla, and three titanium dental implants were installed in the mandible. One implant was lost during the osseointegration period. The prosthetic rehabilitation was performed with implant-retained maxillary and mandibular overdentures with the Locator attachment system. After a 2-year follow-up period, the patient was doing well, and all implants were clinically stable with no signs of bone loss or inflammation. The present study emphasizes that implant-retained overdentures with Locator attachment system could be a therapeutic option even for patients with Down syndrome. This therapy prevents crestal bone loss around the implants, improves functional and esthetic outcomes, and provides optimum oral hygiene for patients with mild mental impairment. Careful patient selection and education of patients and caregivers are essential considerations for a successful and safe treatment with dental implants in Down syndrome patients. © 2017 by the American College of Prosthodontists.

Risk assessment models to predict caries recurrence after oral rehabilitation under general anaesthesia: a pilot study.

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Lin, Yai-Tin; Kalhan, Ashish Chetan; Lin, Yng-Tzer Joseph; Kalhan, Tosha Ashish; Chou, Chein-Chin; Gao, Xiao Li; Hsu, Chin-Ying Stephen

2018-05-08

Oral rehabilitation under general anaesthesia (GA), commonly employed to treat high caries-risk children, has been associated with high economic and individual/family burden, besides high post-GA caries recurrence rates. As there is no caries prediction model available for paediatric GA patients, this study was performed to build caries risk assessment/prediction models using pre-GA data and to explore mid-term prognostic factors for early identification of high-risk children prone to caries relapse post-GA oral rehabilitation. Ninety-two children were identified and recruited with parental consent before oral rehabilitation under GA. Biopsychosocial data collection at baseline and the 6-month follow-up were conducted using questionnaire (Q), microbiological assessment (M) and clinical examination (C). The prediction models constructed using data collected from Q, Q + M and Q + M + C demonstrated an accuracy of 72%, 78% and 82%, respectively. Furthermore, of the 83 (90.2%) patients recalled 6 months after GA intervention, recurrent caries was identified in 54.2%, together with reduced bacterial counts, lower plaque index and increased percentage of children toothbrushing for themselves (all P < 0.05). Additionally, meal-time and toothbrushing duration were shown, through bivariate analyses, to be significant prognostic determinants for caries recurrence (both P < 0.05). Risk assessment/prediction models built using pre-GA data may be promising in identifying high-risk children prone to post-GA caries recurrence, although future internal and external validation of predictive models is warranted. © 2018 FDI World Dental Federation.

The values underlying team decision-making in work rehabilitation for musculoskeletal disorders.

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Loisel, Patrick; Falardeau, Marlène; Baril, Raymond; José-Durand, Marie; Langley, Ann; Sauvé, Sandrine; Gervais, Julie

2005-05-20

This paper presents the results of a qualitative study on the values underlying the decision-making process of an interdisciplinary team working in a work rehabilitation facility of a Québec teaching hospital. In order to document the values underlying the decision-making process, a single case observational study was conducted. Interdisciplinary team weekly discussions on ongoing cases of 22 workers absent from work due to musculoskeletal disorders were videotaped. All discourses were transcribed and analyzed following an inductive and iterative approach. The values identified were validated by feedback from team members. Ten common decision values emerged from the data: (1) team unity and credibility, (2) collaboration with stakeholders, (3) worker's internal motivation, (4) worker's adherence to the program, (5) worker's reactivation, (6) single message, (7) reassurance, (8) graded intervention, (9) pain management and (10) return to work as a therapy. The analysis of these values led to the design of a model describing interrelations between them. This study throws light on some mechanisms underlying the decisions made by the team and determining its action. This improves understanding of the actions taken by an interdisciplinary team in work rehabilitation and may facilitate knowledge transfer in the training of other teams.

Imaging informatics-based multimedia ePR system for data management and decision support in rehabilitation research

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Wang, Ximing; Verma, Sneha; Qin, Yi; Sterling, Josh; Zhou, Alyssa; Zhang, Jeffrey; Martinez, Clarisa; Casebeer, Narissa; Koh, Hyunwook; Winstein, Carolee; Liu, Brent

2013-03-01

With the rapid development of science and technology, large-scale rehabilitation centers and clinical rehabilitation trials usually involve significant volumes of multimedia data. Due to the global aging crisis, millions of new patients with age-related chronic diseases will produce huge amounts of data and contribute to soaring costs of medical care. Hence, a solution for effective data management and decision support will significantly reduce the expenditure and finally improve the patient life quality. Inspired from the concept of the electronic patient record (ePR), we developed a prototype system for the field of rehabilitation engineering. The system is subject or patient-oriented and customized for specific projects. The system components include data entry modules, multimedia data presentation and data retrieval. To process the multimedia data, the system includes a DICOM viewer with annotation tools and video/audio player. The system also serves as a platform for integrating decision-support tools and data mining tools. Based on the prototype system design, we developed two specific applications: 1) DOSE (a phase 1 randomized clinical trial to determine the optimal dose of therapy for rehabilitation of the arm and hand after stroke.); and 2) NEXUS project from the Rehabilitation Engineering Research Center(RERC, a NIDRR funded Rehabilitation Engineering Research Center). Currently, the system is being evaluated in the context of the DOSE trial with a projected enrollment of 60 participants over 5 years, and will be evaluated by the NEXUS project with 30 subjects. By applying the ePR concept, we developed a system in order to improve the current research workflow, reduce the cost of managing data, and provide a platform for the rapid development of future decision-support tools.

Patients' views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury-A qualitative interview-based study.

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Scheel-Sailer, Anke; Post, Marcel W; Michel, Franz; Weidmann-Hügle, Tatjana; Baumann Hölzle, Ruth

2017-10-01

Involving patients in decision making is a legal requirement in many countries, associated with better rehabilitation outcomes, but not easily accomplished during initial inpatient rehabilitation after severe trauma. Providing medical treatment according to the principles of shared decision making is challenging as a point in case for persons with spinal cord injury (SCI). The aim of this study was to retrospectively explore the patients' views on their participation in decision making during their first inpatient rehabilitation after onset of SCI, in order to optimize treatment concepts. A total of 22 participants with SCI were interviewed in-depth using a semi-structured interview scheme between 6 months and 35 years post-onset. Interviews were transcribed verbatim and analysed with the Mayring method for qualitative content analysis. Participants experienced a substantially reduced ability to participate in decision making during the early phase after SCI. They perceived physical, psychological and environmental factors to have impacted upon this ability. Patients mentioned regaining their ability to make decisions was an important goal during their first rehabilitation. Receiving adequate information in an understandable and personalized way was a prerequisite to achieve this goal. Other important factors included medical and psychological condition, personal engagement, time and dialogue with peers. During the initial rehabilitation of patients with SCI, professionals need to deal with the discrepancy between the obligation to respect a patient's autonomy and their diminished ability for decision making. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Changes in the oral health-related quality of life in children following comprehensive oral rehabilitation under general anaesthesia.

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Yawary, Rana; Anthonappa, Robert P; Ekambaram, Manikandan; McGrath, Colman; King, Nigel M

2016-09-01

To assess changes in the oral health-related quality of life (OHRQoL), after comprehensive oral rehabilitation under general anaesthesia (CORGA), among children (i) <6 years using the Early Childhood Oral Health Impact Scale (ECOHIS) and (ii) aged 6-14 years using the child oral health-related quality of life (COHRQoL) instrument. A total of 136 healthy children who had CORGA were recruited over a period of 12 months. The parent or caregiver of the study participants completed the age-appropriate questionnaire prior to the dental treatment and at the subsequent follow-up appointments (2 weeks and 3 months). Data were analysed using repeated-measures anova and Bonferroni tests. The overall ECOHIS scores decreased significantly (P < 0.001) demonstrating large effect sizes. The greatest decreases were for the domains of child oral symptoms (57.5%) and psychology (38.7%) in the child impact section (CIS) and for the domain of parental distress (38.9%) and family function (40%) in the family impact section (FIS). For COHRQoL, the overall P-CPQ and FIS scores decreased significantly for all items (P < 0.001), demonstrating large effect sizes. The greatest decreases were for the domains of oral symptoms (77.7%), functional limitations (74.3%), and the FIS (80.1%). The OHRQoL of children in both age groups (<6 and 6-14 years) was significantly improved after CORGA. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Biofilm Formation on Different Materials Used in Oral Rehabilitation.

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Souza, Júlio C M; Mota, Raquel R C; Sordi, Mariane B; Passoni, Bernardo B; Benfatti, Cesar A M; Magini, Ricardo S

2016-01-01

The aim of this study was to evaluate the density and the morphological aspects of biofilms adhered to different materials applied in oral rehabilitation supported by dental implants. Sixty samples were divided into four groups: feldspar-based porcelain, CoCr alloy, commercially pure titanium grade IV and yttria-stabilized zirconia. Human saliva was diluted into BHI supplemented with sucrose to grow biofilms for 24 or 48 h. After this period, biofilm was removed by 1% protease treatment and then analyzed by spectrophotometry (absorbance), colony forming unit method (CFU.cm-2) and field-emission guns scanning electron microscopy (FEG-SEM). The highest values of absorbance and CFU.cm-2 were recorded on biofilms grown on CoCr alloys when compared to the other test materials for 24 or 48 h. Also, FEG-SEM images showed a high biofilm density on CoCr. There were no significant differences in absorbance and CFU.cm-2 between biofilms grown on zirconia, porcelain and titanium (p<0.05). Microbiological assays associated with microscopic analyses detected a higher accumulation of oral biofilms on CoCr-based materials than that on titanium or zirconia that are used for prosthetic structures.

Oral rehabilitation of a patient with amelogenesis imperfecta using removable overlay denture: a clinical report.

Science.gov (United States)

Ghodsi, S; Rasaeipour, S; Vojdani, M

2012-03-01

The aim of this study was oral rehabilitation of 17-year old patient with amelogenesis imperfecta using removable overlay denture in order to satisfy her esthetic and functional expectations and enhance her self-image. Amelogenesis imperfecta (AI) is a group of genetic disorders that primarily affect the quality and quantity of amelogenesis in both primary and permanent dentitions. The main clinical characteristics are severe attrition, tooth sensitivity and unesthetic appearance. This clinical report illustrates the oral rehabilitation of a 17-year-old girl with hypoplastic-hypomature type of AI with cobalt-chromium (Co-Cr) overlay removable partial denture (ORPD) that is one of the most economical and biocompatible replacements for noble metal and nickel-chromium (Ni-Cr) alloy. The presented case report suggests that Co-Cr ORPD can be a good temporary or even permanent treatment option for AI patients with limited budget, low esthetic concerns or medical limitations. There are major advantages in cast metal ORPDs; they are simpler, less traumatic and less expensive than fixed prosthetic options. This case report supports their use in patients with amelogenesis imperfecta.

Oral rehabilitation of primary dentition affected by amelogenesis imperfecta: a case report.

Science.gov (United States)

de Souza-e-Silva, Cíntia Maria; Parisotto, Thaís Manzano; Steiner-Oliveira, Carolina; Gavião, Maria Beatriz Duarte; Nobre-Dos-Santos, Marinês

2010-05-01

The purpose of the case report was to describe the treatment of a 4(1/2)-year-old boy with amelogenesis imperfect (AI) in the primary dentition. AI is a hereditary condition that affects the development of enamel, causing quantity, structural, and compositional anomalies involving all dentitions. Consequently, the effects can extend to both the primary and secondary dentitions. A 4(1/2)-year-old boy was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of amelogenesis imperfecta. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms of both maxillary and mandibular primary incisors and canines. Improvements in the patient's psychological behavior and the elimination of tooth sensitiveness were observed, and the reestablishment of a normal occlusion resulted in improved eating habits. The child was monitored in the Pediatric Dentistry Clinic at four-month intervals until the mixed dentition stage. The oral rehabilitation of young children with AI is necessary to reestablish the stomatognathic system function, so important for a child's systemic health. An adequate medical history and a careful clinical examination were essential for a correct diagnosis. Treatment was rendered that was appropriate for the child's age and clinical/psychological characteristics. Cost-effective restorative techniques involving stainless steel and composite-resin crowns are shown for the restoration of a young patient with amelogensis imperfecta.

Effect of early nutrition support on postoperative rehabilitation in patients with oral cancer

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Xing-An Zhang

2016-08-01

Full Text Available Objective: To explore the effect of early nutrition support on the postoperative nutrition metabolism and rehabilitation in patients with oral cancer. Methods: A total of 80 patients with oral cancer who were admitted in our hospital from January, 2013 to January, 2015 were included in the study, and divided into the observation group (early nutrition support and control group (routine treatments with 40 cases in each group. The postoperative basic nutrition requirement amount in the observation group was calculated according to HarrisNenedict formula. The appropriate pharmaceutics and nutritional pathway were selected. The patients in the control group were given routine diets after operation. The levels of ALB, PAB, TRF, TCL, IgM, IgG, and IgA before and after operation in the two groups were compared. The body mass and wound healing in the two groups were recorded and compared. Results: The body mass and serum TRF level after operation in the observation group were slightly reduced, but were not significantly different from those before operation (P>0.05. The serum ALB, PAB, and TLC levels after operation in the observation group were significantly reduced when compared with before operation (P0.05, but the above indicators were significantly elevated after operation (P<0.05. The peripheral blood IgM, IgG, and IgA levels 1 week after operation in the observation group were significantly higher than those in the control group (P<0.05. The stage I healing rate of the surgical wound in the observation group was significantly higher than that in the control group (P<0.05. Conclusions: The early nutrition support can effectively enhance the postoperative nutrition status and immunological function in patients with oral cancer, and is beneficial for the postoperative rehabilitation.

Four Common Simplifications of Multi-Criteria Decision Analysis do not hold for River Rehabilitation.

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Langhans, Simone D; Lienert, Judit

2016-01-01

River rehabilitation aims at alleviating negative effects of human impacts such as loss of biodiversity and reduction of ecosystem services. Such interventions entail difficult trade-offs between different ecological and often socio-economic objectives. Multi-Criteria Decision Analysis (MCDA) is a very suitable approach that helps assessing the current ecological state and prioritizing river rehabilitation measures in a standardized way, based on stakeholder or expert preferences. Applications of MCDA in river rehabilitation projects are often simplified, i.e. using a limited number of objectives and indicators, assuming linear value functions, aggregating individual indicator assessments additively, and/or assuming risk neutrality of experts. Here, we demonstrate an implementation of MCDA expert preference assessments to river rehabilitation and provide ample material for other applications. To test whether the above simplifications reflect common expert opinion, we carried out very detailed interviews with five river ecologists and a hydraulic engineer. We defined essential objectives and measurable quality indicators (attributes), elicited the experts´ preferences for objectives on a standardized scale (value functions) and their risk attitude, and identified suitable aggregation methods. The experts recommended an extensive objectives hierarchy including between 54 and 93 essential objectives and between 37 to 61 essential attributes. For 81% of these, they defined non-linear value functions and in 76% recommended multiplicative aggregation. The experts were risk averse or risk prone (but never risk neutral), depending on the current ecological state of the river, and the experts´ personal importance of objectives. We conclude that the four commonly applied simplifications clearly do not reflect the opinion of river rehabilitation experts. The optimal level of model complexity, however, remains highly case-study specific depending on data and resource

Oral rehabilitation with implant supported overdentures in patients with non-reconstructed segmental mandibulectomy: A report of two cases

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Rok Zupančič

2013-11-01

Full Text Available Background: Segmental mandibulectomy is most often performed as part of resection of advanced squamous cell carcinoma, which involves the mandible by extension from intraoral tissues and is usually followed by reconstruction of the mandible. However, not all mandibular defects can be surgically reconstructed, due to local or systemic factors. Oral rehabilitation with conventional removable dentures is often insufficient. In order to provide predictable support and denture retention, especially in the non-reconstructed cases of segmental mandibulectomy, dental implants are indicated.Case report: The authors describe oral rehabilitation with implant-supported overdenture in two non-reconstructed patients with similar mandibular defect, but different etiology, as well as different denture design and different outcome in terms of success and patient satisfaction. In the first case, the defect was caused by surgical treatment of cancer, which was followed by radiotherapy and prosthodontic treatment with an implant-supported mandibular overdenture anchored with a bar. In another case, the damage was due to a suicide attempt. This was initially followed by the surgical treatment of the injury. Afterwards, the prosthodontic treatment with an implant-supported and conical–crown-anchored mandibular overdenture was performed.Conclusions: The success of the prosthodontic oral rehabilitation of patients with segmental mandibulectomy depends on many factors. The size of the defect and the condition of the remaining hard and soft tissues, which are affected by radiotherapy, are crucial. The etiology of the defect, the opposing jaw status, maxillomandibular relationships, the consistency of mandibular movement and the denture design play an important role as well.

Patients' views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury - A qualitative interview-based study

NARCIS (Netherlands)

Scheel-Sailer, Anke; Post, Marcel W.; Michel, Franz; Weidmann-Hügle, Tatjana; Baumann Hölzle, Ruth

2017-01-01

Introduction: Involving patients in decision making is a legal requirement in many countries, associated with better rehabilitation outcomes, but not easily accomplished during initial inpatient rehabilitation after severe trauma. Providing medical treatment according to the principles of shared

The use of implant retained mandibular prostheses in the oral rehabilitation of head and neck cancer patients. A review and rationale for treatment planning

NARCIS (Netherlands)

Schoen, PJ; Reintsema, H; Raghoebar, GM; Vissink, A; Roodenburg, JLN

2004-01-01

Surgical treatment of malignancies in the oral cavity (tongue, floor of the mouth, alveolus, buccal sulcus, oropharynx) often results in an unfavourable anatomic situation for prosthodontic rehabilitation. The outcome is a severe disturbance of oral functioning despite the improved surgical

Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

Science.gov (United States)

Kanno, Takahiro; Mitsugi, Masaharu; Paeng, Jun-Young; Sukegawa, Shintaro; Furuki, Yoshihiko; Ohwada, Hiroyuki; Nariai, Yoshiki; Ishibashi, Hiroaki; Katsuyama, Hideaki; Sekine, Joji

2012-01-01

We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants) were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n = 4). A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80) after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation. PMID:22792105

Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

Directory of Open Access Journals (Sweden)

Takahiro Kanno

2012-01-01

Full Text Available We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n=4. A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80 after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation.

A decision-algorithm defining the rehabilitation approach: 'Facial oral tract therapy'

DEFF Research Database (Denmark)

Hansen, Trine S; Jakobsen, Daniela

2010-01-01

was developed by a research occupational therapist and an F.O.T.T. senior instructor. We used an inductive approach combining existing knowledge from: F.O.T.T. instructors, therapists trained in using the F.O.T.T. approach, and existing literature. A group of F.O.T.T. instructors and the originator...... and eating; oral hygiene; breathing, voice, and speech articulation; facial expression, giving guidance on interventions. The algorithm outlines all important components in the treatment that the therapist should decide to use or not to use in the intervention. The algorithm is supported by a manual...

A new spiral dental implant: a tool for oral rehabilitation of difficult cases.

Science.gov (United States)

Balan, I; Calcaterra, R; Lauritano, D; Grecchi, E; Carinci, F

2017-01-01

Spiral dental implant (SDI) is an implant with a conical internal helix that confers the characteristic of self-drilling, self-tapping, and self-bone condensing. These proprieties offer better control during insertion of SDI giving a high primary stabilization, even in poor quality bone. A shorter diameter of SDI results in reduced drilling during insertion and consequently less trauma and minimal bone loss. To address the research purpose, the investigators designed a retrospective cohort study. The study population was composed of 25 patients, 11 males and 14 females that have been treated by Dr. Balan with 187 SDI positioned in mandible and into maxilla bone. The implants were placed during the years 2013 to 2014 in Dr. Balan clinic. All patients underwent the same surgical protocol. Several variables are investigated: demographic (age and gender), anatomic (upper/lower jaws and tooth site), implant (length and diameter and type) variables, edentulism (partial or total), and comorbid status of health (i.e.: hypothyroidism, parodontitis, hypertension, diabetes, presence of cancer, heart disease, hepatitis and rheumatologic disease). Pearson Chi-Square test was used to investigate variables and p < 0.05 was considered statistically significant. Statistically it has been shown that females have a higher possibility of unsuccessful respect of male, with a "p value" of 0.014. Another important impact factor for success of implant insertion has been represented by concomitants pathologies: cancer represents the most negative high factor risk with a percentage of unsuccessful of 50%, followed by heart disease (15%), and diabetes (3.7%). SDIs are reliable tools for difficult cases of oral rehabilitation. They have a higher success and survival rate, which means stable results over time. No differences were detected among SDI lengths, implant/crown ratio. In addition, the insertion of SDIs in banked bone can be performed without adverse effects. Finally, flapless and

Nuclear and Radiological Emergency Management and Rehabilitation Strategies: Towards a EU approach for decision support tools

International Nuclear Information System (INIS)

Raskob, W.; Gering, F.; Lochard, J.; Nisbet, A.; Starostova, V.; Tomic, B.

2011-01-01

Highlights: → European emergency management and rehabilitation was strengthened. → Development of generic European handbooks for urban and agricultural areas. → Decision support systems became more operational. → Harmonisation of tools in Europe has been promoted. - Abstract: The 5-year multi-national project EURANOS (European Approach to Nuclear and Radiological Emergency Management and Rehabilitation Strategies), funded by the European Commission and 23 European Member States, started in April 2004. Integrating 17 national emergency management organisations with 33 research institutes, it brings together best practices, knowledge and technology to enhance the preparedness for Europe's response to any radiation emergency and long term contamination. Key objectives of the project are to collate information on the likely effectiveness and consequences of a wide range of countermeasures, to provide guidance to emergency management organisations and decision makers on the establishment of an appropriate response strategy and to further enhance advanced decision support systems (DSS), in particular, RODOS (Real-time On-line Decisions Support) decision support system), through feedback from their operational use. Further, the project aims to create regional initiatives leading to information exchange based on state-of-the-art information technologies, to develop guidance which assists Member States in developing a framework for the sustainable rehabilitation of living conditions in contaminated areas and to maintain and enhance knowledge and competence through emergency exercises, training and education, thus fostering best practice in emergency response. The project is divided into three major research activities and a set of demonstration projects which are split in two phases lasting over two and three years, respectively. The research activities address specific issues previously identified by the users or by previous research in the area. They are focused

Telescopic overdenture for oral rehabilitation of ectodermal dysplasia patient.

Science.gov (United States)

Gupta, Charu; Verma, Mahesh; Gupta, Rekha; Gill, Shubhra

2015-09-01

Reduced number of teeth with underdeveloped alveolar ridges poses a greatest prosthetic challenge in rehabilitation of ectodermal dysplasia patients (ED). Furthermore, surgical risks and financial constraints may preclude the implant supported prosthesis, the most desirable treatment option in an adult ED patient. Long edentulous span does not permit fixed dental prosthesis (FDP) as well. Telescopic denture by incorporating the best of both fixed and removable prosthesis can be a viable treatment alternative for ED patients with compromised dentition and limited finances. A 21-year-old young girl presented with chief complaint of esthetics and mastication due to missing upper and lower teeth. A provisional diagnosis of ED was made based on familial history, physical, and oral examination. This clinical report describes management of an adult ED patient by means of telescopic overdenture prosthesis in mandibular arch and FDP in maxillary arch which restored esthetics, function, and social confidence of the patient in a cost effective manner.

Telescopic overdenture for oral rehabilitation of ectodermal dysplasia patient

Directory of Open Access Journals (Sweden)

Charu Gupta

2015-01-01

Full Text Available Reduced number of teeth with underdeveloped alveolar ridges poses a greatest prosthetic challenge in rehabilitation of ectodermal dysplasia patients (ED. Furthermore, surgical risks and financial constraints may preclude the implant supported prosthesis, the most desirable treatment option in an adult ED patient. Long edentulous span does not permit fixed dental prosthesis (FDP as well. Telescopic denture by incorporating the best of both fixed and removable prosthesis can be a viable treatment alternative for ED patients with compromised dentition and limited finances. A 21-year-old young girl presented with chief complaint of esthetics and mastication due to missing upper and lower teeth. A provisional diagnosis of ED was made based on familial history, physical, and oral examination. This clinical report describes management of an adult ED patient by means of telescopic overdenture prosthesis in mandibular arch and FDP in maxillary arch which restored esthetics, function, and social confidence of the patient in a cost effective manner.

Reliability and Efficiency Factors in Decision Making for Rehabilitation of Pipelines

Directory of Open Access Journals (Sweden)

Alonso-Guzmán Carlos Daniel

2013-10-01

Full Text Available The methodology that has been developed suggests a sequence of interventions in the water distribution network, identifying the hierarchy of groups of pipes that must be renewed, taking into consideration all the factors associated, both endogenous and exogenous, and the technical limitations in the functioning of the water network considering the annual budget available for the rehabilitation of pipelines. The aim of this work is to develop a model to facilitate the decision-making to the managers of water distribution systems, considering a budget constraint, the amount of linear meters of each group of pipes that provides a maximum benefit in relation to the valuation of influence factors, the benefits and the cost of the rehabilitation. To ac- complish this, we use the genetic algorithms tool through Evolver and fuzzy logic, using EPANET to determine the cost of "saving" electricity and the recovered leak- age flow. This model is applied to a case study in the city of Celaya, Guanajuato, Mexico.

Immediate implant-supported oral rehabilitation using a photocurable plastic skull model and laser welding. A technical note on the screw-retained type: Part 1.

Science.gov (United States)

Tomotake, Yoritoki; Ishida, Osamu; Kanitani, Hideo; Ichikawa, Tetsuo

2002-01-01

This article describes a new procedure for immediate implant-supported oral rehabilitation using a photocurable resin skull model and a laser-welding apparatus. Preoperatively, the framework was fabricated on a photocurable resin skull model produced from a CT scan and individually designed guide template. The implants were immediately placed using the guide template; laser welding connected the components of framework. Despite the custom-made prosthesis, the total treatment from implant placement to superstructure placement can be completed within only 1 day. This procedure for immediate implant-supported oral rehabilitation using a photocurable resin skull model and a laser-welding apparatus may be useful for any implant system and patient.

[Fluoridation at Karl Marx Stadt. XIII. Caries reduction and oral rehabilitation].

Science.gov (United States)

Künzel, W

1976-07-01

12 years after water fluoridation (1971), the repercussions of the quantitative and qualitative changes in caries prevalence on the paedodontic care were studied on the basis of statistical findings from more than 36 000 subjects aged from 6 to 18 years. It was shown that the result of oral rehabilitation is substantially influenced by the increase in the number of subjects with primarily healthy dentitions and by the reduction in the number of carious teeth. Furthermore, the reduced number of cavities and fillings involving two or more surfaces and the less frequent occurrence of secondary caries have repercussion on the time spent by the paedodontist. Not least the caries reduction also influences the paedodontist/children ratio which has changed from 1:1659 in 1959 to 1:3208 in 1971.

Rehabilitation capital: a field-specific form of capital to understand rehabilitation in a Nordic welfare state

DEFF Research Database (Denmark)

Guldager, Rikke; Poulsen, Ingrid; Egerod, Ingrid

2018-01-01

resources in decision-making in a stroke unit. In particular, it focuses on the challenges in optimising the rehabilitation process faced by patients and relatives, and the strategies they use. Data were generated using participant observation and semi-structured interviews. Qualitative content analysis...... was applied to investigate the patients’ and relatives’ experiences of decision-making. We present a field-specific form of capital: An individual or a family’s resources that are valued in the field of rehabilitation as physical, behavioural and cognitively embedded attitudes and practices. Rehabilitation...... rehabilitation and may provide patients with an advantage, to ensure the best rehabilitation. The possession of Rehabilitation capital (high or low) contributes explanations for unequal practices and treatments at a micro-level in healthcare institutions....

Comparison of risk-based decision-support systems for brownfield site rehabilitation: DESYRE and SADA applied to a Romanian case study.

Science.gov (United States)

Stezar, I C; Pizzol, L; Critto, A; Ozunu, A; Marcomini, A

2013-12-15

Brownfield rehabilitation is an essential step for sustainable land-use planning and management in the European Union. In brownfield regeneration processes, the legacy contamination plays a significant role, firstly because of the persistent contaminants in soil or groundwater which extends the existing hazards and risks well into the future; and secondly, problems from historical contamination are often more difficult to manage than contamination caused by new activities. Due to the complexity associated with the management of brownfield site rehabilitation, Decision Support Systems (DSSs) have been developed to support problem holders and stakeholders in the decision-making process encompassing all phases of the rehabilitation. This paper presents a comparative study between two DSSs, namely SADA (Spatial Analysis and Decision Assistance) and DESYRE (Decision Support System for the Requalification of Contaminated Sites), with the main objective of showing the benefits of using DSSs to introduce and process data and then to disseminate results to different stakeholders involved in the decision-making process. For this purpose, a former car manufacturing plant located in the Brasov area, Central Romania, contaminated chiefly by heavy metals and total petroleum hydrocarbons, has been selected as a case study to apply the two examined DSSs. Major results presented here concern the analysis of the functionalities of the two DSSs in order to identify similarities, differences and complementarities and, thus, to provide an indication of the most suitable integration options. Copyright © 2013 Elsevier Ltd. All rights reserved.

Oral health-related quality of life after prosthetic rehabilitation: a longitudinal study with the OHIP questionnaire.

Science.gov (United States)

Jenei, Ágnes; Sándor, János; Hegedűs, Csaba; Bágyi, Kinga; Nagy, László; Kiss, Csongor; Szabó, Gyula; Márton, Ildikó J

2015-07-10

Aspects of oral health related quality of life (OHRQoL) attracted an increased attention recently. The aim of the study was to assess self-reported oral health related quality of life (OHRQoL) among patients requiring prosthetic rehabilitation and to determine the rate of improvement 1 month and 6-12 months after therapy. In addition, effect of age, gender, oral health indicators and denture types before treatment were assessed on OHRQoL as evaluated and reported by the patients. Hungarian version of OHIP-49 (OHIP-49-H) questionnaire was completed before oral rehabilitation (T0-phase) by 389 patients undergoing prosthetic replacement. After 1 month (T1-phase) and 6-12 months (T2-phase) recall periods 235 and 92 patients completed the questionnaire. The median interquartile range (IQR) values of the total OHIP-49-H score were calculated for T0-, T1- and T2-phases. Reliability of the questionnaire was checked by Cronbach's statistics. Age, gender, oral health indicators and denture types of patients before and after treatment were recorded and treatment-associated changes in OHRQoL were evaluated. The study demonstrated the excellent reliability and internal consistency of OHIP-49-H by a high and narrow range of Cronbach's alpha value (0.81-0.93). A median OHIP-49-H score of 52; IQR = 25-83 demonstrated a poor OHRQoL on first admission. Decreasing median total OHIP-49-H scores 1 month (24; IQR = 9-51; p < 0.001) and 6-12 months (20; IQR = 7-37; p = 0,055) after therapy indicated an improvement of OHRQoL. Patients' age and CPI value assessed before treatment proved to be significant factors of OHRQoL. Here we presented representative data about self-assessed OHRQoL of patients requiring prosthetic treatment from Hungary using OHIP-49-H questionnaire. The results demonstrated that the restoration of oral health was associated with an improvement in patients' OHRQoL. According to the demographical and T0 phase clinical status, the treatment was more

Decision making strategy on rehabilitation of wide territories of the Republic of Belarus contaminated by long-lived radionuclides following the Chernobyl accident

International Nuclear Information System (INIS)

Kenigsberg, J.; Ternov, V.

2002-01-01

In the remote period following radiation accidents accompanied by wide scaled contamination of the territory by long-lived radionuclides inevitably problem of the territory rehabilitation is raised. Actually, we are speaking about difficulties, for state authorities and for society, in a decision making process aimed at taking out territories, settlements, residing and/or working people from the status of accident and at return to 'normality'. Difficulty in the decision making is caused by insufficient development of dose criteria, levels of intervention when really existing annual effective doses is less than 5 mSv, justification of usage, scales and duration of countermeasures. The laws accepted in Belarus, Russia and Ukraine following the Chernobyl accident are practicing privileges and compensation of damage to population, residing in territories with density of soil contamination by 137 Cs exceeding 37 kBq/sq.m or annual effective dose exceeding 1 mSv. This makes the idea of rehabilitation unattractive. To simplify the process of decisions making perception by society, it is suggested a step by step way of decision making aimed at rehabilitation, based on radiological and non-radiological criteria. As to radiological criteria, it is necessary to refer to a level of annual effective dose and derived values (exposure dose rate, permissible levels of contamination for foodstuffs and environment). Nonradiological criteria include psychological and social-economic factors (attractiveness of rehabilitating territories for residing and making business, reservation of some privileges, maintenance of high level of medical service). (author)

Surgiplanner: a new method for one step oral rehabilitation of severe atrophic maxilla.

Science.gov (United States)

Busato, A; Vismara, V; Grecchi, F; Grecchi, E; Lauritano, D

2017-01-01

The implant-prosthetic rehabilitation of edentulous upper jaws has always been complex for surgeons and dentists. The lack of bone in both vertical and horizontal dimension does not allow the correct insertion of dental implants. In addition, patients with edentulous upper and lower arch have a loss of vertical dimension of the face and an aged expression. Many surgical techniques have been proposed to increase the bone volume, height and thickness, such as the Le Fort I osteotomy, the bone grafts and the placement of dental implants. Planning these surgical procedures is difficult, because it is not possible to reproduce the movements of osteotomized bone segments in three planes of space. This article describes the treatment of severe atrophy maxilla with a new approach using a new instrument named "Surgiplanner". Surgiplanner is a method that, only using a computerized axial tomography (CAT), allows to obtain a totally predetermined therapeutic result from both an aesthetic and functional point of view, with surgery of severe resorbed jaws. Surgiplanner allows repositioning of segment of the skeleton of the patient's face in a predetermined and controlled way for the best implant-supported oral rehabilitation.

Development of a Decision Support System to Predict Physicians' Rehabilitation Protocols for Patients with Knee Osteoarthritis

Science.gov (United States)

Hawamdeh, Ziad M.; Alshraideh, Mohammad A.; Al-Ajlouni, Jihad M.; Salah, Imad K.; Holm, Margo B.; Otom, Ali H.

2012-01-01

To design a medical decision support system (MDSS) that would accurately predict the rehabilitation protocols prescribed by the physicians for patients with knee osteoarthritis (OA) using only their demographic and clinical characteristics. The demographic and clinical variables for 170 patients receiving one of three treatment protocols for knee…

The Biological Activity of Propolis-Containing Toothpaste on Oral Health Environment in Patients Who Underwent Implant-Supported Prosthodontic Rehabilitation

Directory of Open Access Journals (Sweden)

Tadeusz Morawiec

2013-01-01

Full Text Available The soft and periodontal tissues surrounding dental implants are particularly susceptible to bacteria invasion and inflammatory reactions due to complex histological structures. This study was carried out to investigate the influence of a propolis-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Sixteen subjects who underwent an oral rehabilitation with dental implants were selected and randomly assigned into two groups, which received a newly formulated propolis-containing toothpaste (3% (CA or a negative control without an active ingredient (CC. Approximal plaque index (API, oral hygiene index (OHI, debris component, and sulcus bleeding index (SBI were assessed in three subsequent stages. During the first and last examinations, the swabs were employed for microbiological inoculation. Propolis-containing toothpaste was found to be distinctively effective in improving oral health and the occurrence of gingivitis triggered by dental plaque. The qualitative and quantitative changes in oral bacteria spectrum were observed. Antibacterial measures containing propolis might be used as a natural adjuvant to other active substances in individuals with a high risk of periodontal problems against pathogenic oral microflora.

Targeting, Monitoring and Effect of Oral Iron Therapy on Haemoglobin Levels in Older Patients Discharged to Primary Care from Inpatient Rehabilitation: A Cohort Study Using Routinely Collected Data.

Science.gov (United States)

Thomson, Zach; Hands, Katherine J; Witham, Miles D

2016-08-01

Oral iron is commonly prescribed to older patients with suspected or confirmed iron-deficiency anaemia; however, few studies have examined the effectiveness of oral iron therapy in the real world in this population. We therefore determined the prevalence of iron deficiency in older people prescribed oral iron, examined the response mounted to therapy and ascertained predictors of response to oral iron. We analysed a routinely collected, linked dataset from older patients who had undergone inpatient rehabilitation between 1999 and 2011. An initial analysis examined patients within this cohort who were prescribed iron after rehabilitation and derived three groups based upon their ferritin and transferrin indices: probably, possibly and not iron deficient. A second analysis compared pre- and post-treatment haemoglobin to determine the degree of response to iron therapy across each category of deficiency. Finally, patient demographics, linked biochemistry data and comorbid disease based on International Classification of Disease (ICD-10) codes from previous hospital admissions were used in regression modelling to evaluate factors affecting response to therapy. A total of 490 patients were prescribed oral iron within 90 days of rehabilitation discharge. Of these, 413 (84 %) had iron indices performed; 94 (23 %) were possibly deficient, 224 (54 %) were probably deficient, and 95 (23 %) were not deficient. Of the 490 patients, 360 had both pre- and post-treatment haemoglobin data and iron indices; probably deficient patients mounted a slightly greater response to oral iron (17 vs. 12 g/L for not deficient; p < 0.05). Only pre-treatment haemoglobin, mean cell volume and lower gastrointestinal pathology were significant predictors of a response to oral iron therapy. Notably, acid-suppressant use was not a predictor of response. We conclude that many older patients are exposed to oral iron without good evidence of either iron deficiency or a significant response to

Impact of Dental Rehabilitation on Oral Health-related Quality-of-life in Healthy Children and Those with Special Health Care Needs.

Science.gov (United States)

Farsi, Deema J; Farsi, Nada J; El-Housseiny, Azza A; Turkistani, Jihan M; Farsi, Najat M

2018-04-01

Aim: The aim of this study is to compare the effect of dental rehabilitation on oral health-related quality-of-life (OHRQoL) in children with special health care needs (CSHCN) and healthy children. Materials and methods: The prospective study's sample consisted of 213 parents of caries-affected children, who were aged 6 years or younger and were scheduled for dental rehabilitation under general anesthesia (DRGA). The parent-child dyads were recruited from three public hospitals in Jeddah between October 2014 and May 2016. They comprised healthy children (n = 133) and CSHCN (n = 80). Parents self-completed the early childhood oral health impact scale (ECOHIS) before and 1 month after DRGA. The parents also rated the overall oral health status of their children by answering a global question before and after DRGA. Results: At baseline, the CSHCN had significantly worse OHRQoL in most of the scale domains at 25.9 [standard deviation (SD) 11.3] and 19.9 (SD 10.3) respectively. The OHRQoL significantly improved in both groups postoperatively (p = 0.005, Wilcoxon rank-sum test). The effect size of the improvement in the CSHCN group (+1.8) was greater than that in the healthy group (+1.5) in all domains, except for the family impact and parental distress sections. Conclusion: The DRGA markedly improves OHRQoL in children aged 6 years or younger, and the improvement is even greater in CSHCN. Clinical significance: The substantial improvement in OHRQoL after DRGA highlights the importance of oral health care in young children, which should receive higher priority than it has been done to date. Keywords: Children with special health care needs, Dental caries, Early childhood oral health impact scale, General anesthesia, Oral health-related quality-of-life.

Influence of negative affectivity and self-esteem on the oral health related quality of life in patients receiving oral rehabilitation.

Science.gov (United States)

Özhayat, Esben Boeskov

2013-10-24

The aim of this study was to investigate if and how the personality traits Negative Affectivity (NA) and self-esteem influenced the Oral Health Related Quality of Life (OHRQoL) in patients receiving oral rehabilitation. OHRQoL was measured by the Oral Health Impact Profile 49 (OHIP-49), NA with a short form of the Eysenck Personality Inventory Questionnaire (EPI-Q), and self-esteem with Rosenbergs Self-Esteem Scale (RSES) in 66 patients treated with removable dental prosthesis (RDP). The minimally important difference (MID), effect size (ES), and standard error of the measurement (SEM) were used to clinically interpret the patient-reported effect. The OHIP-49 score was significantly higher and exceeded the MID pre- and post-treatment in participants with high EPI-Q and low RSES score compared to participants with low EPI-Q and high RSES score. The improvement in OHIP-49 score was significant and not limited by high EPI-Q and low RSES score. High EPI-Q score was associated high improvement in OHIP-49 score and the ES of the improvement in participants with high EPI-Q was large and exceeded the MID and SEM. Treatment with RDP improves the OHRQoL regardless of level of NA and self-esteem. High NA is associated with a large effect, but both high NA and low self-esteem is associated with poorer OHRQoL both before and after treatment.

Evaluation of computerized decision support for oral anticoagulation management based in primary care.

OpenAIRE

Fitzmaurice, D A; Hobbs, F D; Murray, E T; Bradley, C P; Holder, R

1996-01-01

BACKGROUND: Increasing indications for oral anticoagulation has led to pressure on general practices to undertake therapeutic monitoring. Computerized decision support (DSS) has been shown to be effective in hospitals for improving clinical management. Its usefulness in primary care has previously not been investigated. AIM: To test the effectiveness of using DSS for oral anticoagulation monitoring in primary care by measuring the proportions of patients adequately controlled, defined as with...

Oral rehabilitation of a patient with ectodermal dysplasia with prosthodontics treatment

Directory of Open Access Journals (Sweden)

Srinivas Nallanchakrava

2013-01-01

Full Text Available Ectodermal dysplasia (ED is a rare, congenital disease that involves the sweat glands, scalp hair, nails, skin pigmentation, and craniofacial structure. Oral symptoms of ED include multiple tooth abnormalities (such as hypodontia, anadontia, impacted teeth, and peg-shaped or conical anterior teeth and lack of normal alveolar ridge development. A 12-year-old male patient, in the absence of any other systemic abnormalities, exhibited typical characteristics of ED, visited our department of pedodontics and preventive dentistry at Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre. In the clinical and radiographic evaluation, it was occurred that he had only maxillary and mandibular first molars in his mouth. A maxillary and mandibular denture with clasps for retention was fabricated for prosthodontic rehabilitation after considering his growth and the number and condition of his present teeth. At the 18-month follow-up no major complications occurred and further future treatment included implants retained fixed partial dentures.

Class Evolution Tree: A Graphical Tool to Support Decisions on the Number of Classes in Exploratory Categorical Latent Variable Modeling for Rehabilitation Research

Science.gov (United States)

Kriston, Levente; Melchior, Hanne; Hergert, Anika; Bergelt, Corinna; Watzke, Birgit; Schulz, Holger; von Wolff, Alessa

2011-01-01

The aim of our study was to develop a graphical tool that can be used in addition to standard statistical criteria to support decisions on the number of classes in explorative categorical latent variable modeling for rehabilitation research. Data from two rehabilitation research projects were used. In the first study, a latent profile analysis was…

ORAL MANIFESTATIONS AND PROSTHETIC REHABILITATION IN HEREDITARY SENSORY AND AUTONOMIC NEUROPATHY (HSANTYPE IV:A CASE REPORT*

Directory of Open Access Journals (Sweden)

Duygu OFLUOĞLU

2016-04-01

Full Text Available Hereditary sensory and autonomic neuropathies (HSAN are rare genetic syndromes of unknown etiology. They are seen in early childhood and are categorized into six different types by their symptoms. HSAN type 4 demonstrates autosomal recessive transmission pattern, with such major characteristics as loss of sense of pain, self-mutilation, anhydrosis and mental retardation. Sympathetic innervations are deficient despite the existence of sweat glands. Sufferers are hypotonic without any tendon reflexes, and neuro-motor development is retarded. In some cases tactile sensation and vibration may be intact. Biting injuries due to lack of pain sensation cause laceration, ulceration and scarring of the tongue, lips and other parts of oral mucosa. Tooth luxation and severe dental attrition have been observed. This case report presents oral and dental findings, surgical treatments and prosthetic rehabilitation of an 11- year-old boy with HSAN type 4.

Influence of full mouth rehabilitation on oral health-related quality of life among disabled children.

Science.gov (United States)

Al-Nowaiser, Abeer M; Al Suwyed, Abdulaziz S; Al Zoman, Khalid H; Robert, Asirvatham A; Al Brahim, Tarfa; Ciancio, Sebastian G; Al Mubarak, Sultan A; El Meligy, Omar A

2017-10-01

The efficacy of full mouth rehabilitation (FMR) on oral health-related quality of life of physically disabled children was assessed. This prospective study was performed at Dental Department of Sultan Bin Abdulaziz Humanitarian City, Riyadh, and King Abdulaziz University Hospital, Jeddah, Saudi Arabia, during May 2012 to September 2014. A total of 186 physically disabled children aged 11-14 years were assigned to a test group (n = 97) or a control group (n = 89). FMR was applied for test group children at baseline and 3 months' visits, whereas those in the control group did not receive FMR. Both group children received dental kits and oral hygiene instructions. Children were asked to complete the Child Perceptions Questionnaire, whereas Parental-Caregiver Perceptions Questionnaire and Family Distress Domain questionnaire were completed by the parents/caregivers at baseline and 6 months' visits. Children in both groups showed positive trends in oral symptoms at 6 months compared with those at baseline. However, when they were compared to control, significant improvement in oral symptoms was observed in the test group at 6 months' visit (p < .05). Also when they were compared to control, significant improvements were observed in the functional limitation, emotional, and social well-being subscales of the Child Perceptions Questionnaire and on the Parental-Caregiver Perceptions Questionnaire scales at the end of the study (p < .05). Compared to the parents/caregivers of the control children, the parents/caregivers of the test-group children reported insignificant but positive trends in Family Distress Domain at the end of the study (p < .05). FMR in children reduced oral-related problems subsequently to a better oral health-related quality of life.

Oral rehabilitation and management of mentally retarded.

Science.gov (United States)

Solanki, Jitender; Khetan, Jitendra; Gupta, Sarika; Tomar, Deepak; Singh, Meenakshi

2015-01-01

High level of periodontal problems of dental caries are frequently observed in mentally handicapped children. This group of patients presents various problems when they face dental treatments. Identification of such population and providing them affordable oral health care is the new concept. A systematic method for identification and screening of persons with mental retardation has been developed and is being followed. Cost and fear are the most commonly cited barriers to dental care. Physical or mental may lead to deterioration in self-care, and oral care state have a low priority. Risk factors are inter-related and are often barriers to oral health. With advancements in today's world sufficient information and support is available for each and every individual to lead a healthy life which include the access to the oral health care. Factors such as fear, anxiety and dental phobia plays a vital role in acceptance of dental care and also the delaying of dental care. Lack of knowledge of oral and dental disease, awareness or oral need, oral side-effects of medication and organization of dental services are highlighted in the literature. All health personnel should receive training to support the concept of primary oral health care. Training about dealing with such mentally handicapped people should be addressed urgently among the health professionals.

Oral manifestations and prosthetic rehabilitation in hereditary sensory and autonomic neuropathy (HSAN)type IV: a case report.

Science.gov (United States)

Ofluoglu, Duygu; Altin, Nazli; Yaman, Elif; Tuna İnce, Elif Bahar; Aytepe, Zeynep; Tanyeri, Hakki

2016-01-01

Hereditary sensory and autonomic neuropathies (HSAN) are rare genetic syndromes of unknown etiology. They are seen in early childhood and are categorized into six different types by their symptoms. HSAN type 4 demonstrates autosomal recessive transmission pattern, with such major characteristics as loss of sense of pain, self-mutilation, anhydrosis and mental retardation. Sympathetic innervations are deficient despite the existence of sweat glands. Sufferers are hypotonic without any tendon reflexes, and neuro-motor development is retarded. In some cases tactile sensation and vibration may be intact. Biting injuries due to lack of pain sensation cause laceration, ulceration and scarring of the tongue, lips and other parts of oral mucosa. Tooth luxation and severe dental attrition have been observed. This case report presents oral and dental findings, surgical treatments and prosthetic rehabilitation of an 11- year-old boy with HSAN type 4.

Barriers in implementing evidence-informed health decisions in rural rehabilitation settings: a mixed methods pilot study.

Science.gov (United States)

Prakash, V; Hariohm, K; Balaganapathy, M

2014-08-01

Literature on the barriers to implementing research findings into physiotherapy practice are often urban centric, using self report based on the hypothetical patient scenario. The objective of this study was to investigate the occurrence of barriers, encountered by evidence informed practice-trained physiotherapists in the management of "real world" patients in rural rehabilitation settings. A mixed-methods research design was used. Physiotherapists working in rural outpatient rehabilitation settings participated in the study. In the first phase, we asked all participants (N = 5) to maintain a log book for a 4-week period to record questions that arose during their routine clinical encounters and asked them also to follow first four of the five steps of evidence-informed practice (ask, access, appraise and apply). In the second phase (after 4 weeks), we conducted a semistructured, direct interviews with the participants exploring their experiences involved in the process of implementing evidence-informed clinical decisions made during the study period. At the end of 4 weeks, 30 questions were recorded. For 17 questions, the participants found evidence but applied that evidence into their practice only in 9 instances. Being generalist practitioners, lack of outcomes specific to the patients were reported as barriers more so than time constraints in implementing evidence-informed practice. Practice setting, lack of patient-centered research and evidence-informed practice competency of physiotherapists can be significant barriers to implementing evidence-informed health decisions in rural rehabilitation setting. © 2014 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Multidisciplinary team approach in the oral rehabilitation of patients with cleidocranial dysplasia to achieve a functional aesthetic outcome.

Science.gov (United States)

Patel, D; Patel, N; Brennan, P A; Kwok, J

2017-11-01

Cleidocranial dysplasia is a hereditary congenital disorder that results in delayed ossification of midline structures, and is caused by mutations in the RunX2 (runt-related transcription factor 2) gene located on the short arm of chromosome 6. Successful treatment depends on multidisciplinary assessment and a comprehensive staged treatment plan. We present a case series of 12 patients who were managed with a specifically tailored combination of surgery, orthodontics, and prosthodontics to provide a functional dentition and restore their smile and facial contour. Successful dental rehabilitation can be challenging in this group because patients often have multiple dental anomalies and a reduced quantity and density of alveolar bone. Rehabilitation with early intervention and a carefully planned multidisciplinary approach has been successful in the long term. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Integrating Water Quality and River Rehabilitation Management - A Decision-Analytical Perspective

Science.gov (United States)

Reichert, P.; Langhans, S.; Lienert, J.; Schuwirth, N.

2009-04-01

Integrative river management involves difficult decisions about alternative measures to improve their ecological state. For this reason, it seems useful to apply knowledge from the decision sciences to support river management. We discuss how decision-analytical elements can be employed for designing an integrated river management procedure. An important aspect of this procedure is to clearly separate scientific predictions of the consequences of alternatives from objectives to be achieved by river management. The key elements of the suggested procedure are (i) the quantitative elicitation of the objectives from different stakeholder groups, (ii) the compilation of the current scientific knowledge about the consequences of the effects resulting from suggested measures in the form of a probabilistic mathematical model, and (iii) the use of these predictions and valuations to prioritize alternatives, to uncover conflicting objectives, to support the design of better alternatives, and to improve the transparency of communication about the chosen management strategy. The development of this procedure led to insights regarding necessary steps to be taken for rational decision-making in river management, to guidelines about the use of decision-analytical techniques for performing these steps, but also to new insights about the application of decision-analytical techniques in general. In particular, the consideration of the spatial distribution of the effects of measures and the potential added value of connected rehabilitated river reaches leads to favoring measures that have a positive effect beyond a single river reach. As these effects only propagate within the river network, this results in a river basin oriented management concept as a consequence of a rational decision support procedure, rather than as an a priori management paradigm. There are also limitations to the support that can be expected from the decision-analytical perspective. It will not provide the

Oral Rehabilitation of a Patient with Amelogenesis Imperfecta

Science.gov (United States)

Cogulu, Dilsah; Becerik, Sema; Emingil, Gülnur; Hart, P. Suzanne; Hart, Thomas C.

2014-01-01

Amelogenesis imperfecta is a hereditary disorder that causes defective enamel development in the primary and permanent teeth. Clinical treatment is important to address the esthetic appearance of affected teeth, reduce dentinal sensitivity, preserve tooth structure, and optimize masticatory function. The purpose of this case report was to describe the diagnosis, treatment planning, and dental rehabilitation of a patient with autosomal recessive amelogenesis imperfecta. The patient was followed for 5 years, and evaluation 3 years after restorations revealed no pathology associated with the rehabilitation. The patient’s esthetic and functional expectations were satisfied. PMID:20108745

Full-mouth rehabilitation with immediate loading of implants inserted with computer-guided flap-less surgery: a 3-year multicenter clinical evaluation with oral health impact profile.

Science.gov (United States)

Marra, Roberto; Acocella, Alessandro; Rispoli, Alessandra; Sacco, Roberto; Ganz, Scott D; Blasi, Andrea

2013-10-01

The purpose of this report is to present the clinical outcomes and patients' satisfaction of full-mouth rehabilitation using computer-aided flapless implant placement and immediate loading of a prefabricated prosthesis. The study included 30 consecutive fully edentulous patients who received 312 implants. Mandible and maxilla were treated in the same surgical session with computer-guided flapless approach using the NobelGuide protocol. Prefabricated screw-retained fixed prostheses were inserted at the end of surgery. Clinical and radiographic evaluations were assessed at 6, 12, and 36 months. At baseline and 6 months after surgery, patients answered Oral Health Impact Profile in Edentulous Adults questionnaire to assess satisfaction. The implant survival rate was 97.9%, whereas the average marginal bone loss was 1.9 ± 1.3 mm after 3 years. At 6 months, patients showed significantly greater satisfaction with their fixed rehabilitation when compared with conventional dentures. The results of this study confirm that rehabilitation with a prefabricated fixed prosthesis supported by implants placed with NobelGuide protocol is a viable and predictable treatment and increases patients' satisfaction and improves oral health-related quality of life.

Long-term outcomes of oral rehabilitation with dental implants in HIV-positive patients: A retrospective case series.

Science.gov (United States)

Gay-Escoda, C; Pérez-Álvarez, D; Camps-Font, O; Figueiredo, R

2016-05-01

The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Nine participants (57 implants) were included. The patients' median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented.

Esthetic evaluation of the facial profile in rehabilitated adults with complete bilateral cleft lip and palate.

Science.gov (United States)

Ferrari Júnior, Flávio Mauro; Ayub, Priscila Vaz; Capelozza Filho, Leopoldino; Pereira Lauris, José Roberto; Garib, Daniela Gamba

2015-01-01

To assess the facial esthetics of patients with complete bilateral cleft lip and palate, and to compare the judgment of raters related and unrelated to cleft care. The sample comprised 23 adult patients (7 women and 16 men) with a mean age of 26.1 years, rehabilitated at a single center. Standardized photographs of the right and left facial profile were taken of each patient and subjectively evaluated by 25 examiners: 5 orthodontists and 5 plastic surgeons with expertise in oral cleft rehabilitation, 5 orthodontists and 5 plastic surgeons without expertise in oral cleft rehabilitation, and 5 laypersons. The facial profiles were classified into 3 categories: esthetically unpleasant, esthetically acceptable, and esthetically pleasant. Intraexaminer and interexaminer agreements were evaluated with the Spearman correlation coefficient and Kendall coefficient of concordance. The differences between rater categories were analyzed using the Student-Newman-Keuls test (with P esthetically acceptable. Orthodontists and plastic surgeons related to oral cleft rehabilitation gave the best scores to the facial profiles, followed by layperson examiners and by orthodontists and plastic surgeons unrelated to oral cleft rehabilitation. The middle third of the face, the nose, and the upper lip were frequently pointed out as contributors to the esthetic impairment. The facial profile of rehabilitated adult patients with complete bilateral cleft lip and palate was considered esthetically acceptable because of morphologic limitations in the structures affected by the cleft. Laypersons and professionals unrelated to oral cleft rehabilitation seem to be more critical regarding facial esthetics than professionals involved with cleft rehabilitation. Copyright © 2015. Published by Elsevier Inc.

Dental status, dental rehabilitation procedures, demographic and oncological data as potential risk factors for infected osteoradionecrosis of the lower jaw after radiotherapy for oral neoplasms: a retrospective evaluation

International Nuclear Information System (INIS)

Niewald, Marcus; Fleckenstein, Jochen; Mang, Kristina; Holtmann, Henrik; Spitzer, Wolfgang J; Rübe, Christian

2013-01-01

Retrospective evaluation of the dental status of patients with oral cancer before radiotherapy, the extent of dental rehabilitation procedures, demographic and radiotherapy data as potential risk factors for development of infected osteoradionecrosis of the lower jaw. A total of 90 patients who had undergone radiotherapy for oral cancer were included into this retrospective evaluation. None of them had distant metastases. After tumour surgery the patients were referred to an oral and maxillofacial surgeon for dental examination and the necessary dental rehabilitation procedures inclusive potential tooth extraction combined with primary soft tissue closure. Adjuvant radiotherapy was started after complete healing of the gingiva (> 7 days after potential extraction). The majority of patients (n = 74) was treated with conventionally fractionated radiotherapy with total doses ranging from 50-70Gy whereas further 16 patients received hyperfractionated radiotherapy up to 72Gy. The records of the clinical data were reviewed. Furthermore, questionnaires were mailed to the patients’ general practitioners and dentists in order to get more data concerning tumour status and osteoradionecrosis during follow-up. The patients’ dental status before radiotherapy was generally poor. On average 10 teeth were present, six of them were regarded to remain conservable. Extensive dental rehabilitation procedures included a mean of 3.7 tooth extractions. Chronic periodontitis with severe attachment loss was found in 40%, dental biofilm in 56%. An infected osteoradionecrosis (IORN) grade II according to (Schwartz et al., Am J Clin Oncol 25:168-171, 2002) was diagnosed in 11 of the 90 patients (12%), mostly within the first 4 years after radiotherapy. We could not find significant prognostic factors for the occurrence of IORN, but a trendwise correlation with impaired dental status, rehabilitation procedures, fraction size and tumour outcome. The occurrence of IORN is an important long

Dental status, dental rehabilitation procedures, demographic and oncological data as potential risk factors for infected osteoradionecrosis of the lower jaw after radiotherapy for oral neoplasms: a retrospective evaluation

Energy Technology Data Exchange (ETDEWEB)

Niewald, Marcus; Fleckenstein, Jochen [Department of Radiotherapy and Radiooncology, Saarland University Medical Center, Kirrberger Str. 1, D-66421 Homburg (Germany); Mang, Kristina [Dental Practice, Duisburg (Germany); Holtmann, Henrik; Spitzer, Wolfgang J [Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str. 1, D-66421 Homburg (Germany); Rübe, Christian [Department of Radiotherapy and Radiooncology, Saarland University Medical Center, Kirrberger Str. 1, D-66421 Homburg (Germany)

2013-10-02

Retrospective evaluation of the dental status of patients with oral cancer before radiotherapy, the extent of dental rehabilitation procedures, demographic and radiotherapy data as potential risk factors for development of infected osteoradionecrosis of the lower jaw. A total of 90 patients who had undergone radiotherapy for oral cancer were included into this retrospective evaluation. None of them had distant metastases. After tumour surgery the patients were referred to an oral and maxillofacial surgeon for dental examination and the necessary dental rehabilitation procedures inclusive potential tooth extraction combined with primary soft tissue closure. Adjuvant radiotherapy was started after complete healing of the gingiva (> 7 days after potential extraction). The majority of patients (n = 74) was treated with conventionally fractionated radiotherapy with total doses ranging from 50-70Gy whereas further 16 patients received hyperfractionated radiotherapy up to 72Gy. The records of the clinical data were reviewed. Furthermore, questionnaires were mailed to the patients’ general practitioners and dentists in order to get more data concerning tumour status and osteoradionecrosis during follow-up. The patients’ dental status before radiotherapy was generally poor. On average 10 teeth were present, six of them were regarded to remain conservable. Extensive dental rehabilitation procedures included a mean of 3.7 tooth extractions. Chronic periodontitis with severe attachment loss was found in 40%, dental biofilm in 56%. An infected osteoradionecrosis (IORN) grade II according to (Schwartz et al., Am J Clin Oncol 25:168-171, 2002) was diagnosed in 11 of the 90 patients (12%), mostly within the first 4 years after radiotherapy. We could not find significant prognostic factors for the occurrence of IORN, but a trendwise correlation with impaired dental status, rehabilitation procedures, fraction size and tumour outcome. The occurrence of IORN is an important long

RECOVER - An Automated Burned Area Emergency Response Decision Support System for Post-fire Rehabilitation Management of Savanna Ecosystems in the Western US

Science.gov (United States)

Weber, K.; Schnase, J. L.; Carroll, M.; Brown, M. E.; Gill, R.; Haskett, G.; Gardner, T.

2013-12-01

In partnership with the Department of Interior's Bureau of Land Management (BLM) and the Idaho Department of Lands (IDL), we are building and evaluating the RECOVER decision support system. RECOVER - which stands for Rehabilitation Capability Convergence for Ecosystem Recovery - is an automatically deployable, context-aware decision support system for savanna wildfires that brings together in a single application the information necessary for post-fire rehabilitation decision-making and long-term ecosystem monitoring. RECOVER uses state-of-the-art cloud-based data management technologies to improve performance, reduce cost, and provide site-specific flexibility for each fire. The RECOVER Server uses Integrated Rule-Oriented Data System (iRODS) data grid technology deployed in the Amazon Elastic Compute Cloud (EC2). The RECOVER Client is an Adobe Flex web map application that is able to provide a suite of convenient GIS analytical capabilities. In a typical use scenario, the RECOVER Server is provided a wildfire name and geospatial extent. The Server then automatically gathers Earth observational data and other relevant products from various geographically distributed data sources. The Server creates a database in the cloud where all relevant information about the wildfire is stored. This information is made available to the RECOVER Client and ultimately to fire managers through their choice of web browser. The Server refreshes the data throughout the burn and subsequent recovery period (3-5 years) with each refresh requiring two minutes to complete. Since remediation plans must be completed within 14 days of a fire's containment, RECOVER has the potential to significantly improve the decision-making process. RECOVER adds an important new dimension to post-fire decision-making by focusing on ecosystem rehabilitation in semiarid savannas. A novel aspect of RECOVER's approach involves the use of soil moisture estimates, which are an important but difficult

When Safe Oral Feeding Is Threatened: End-of-Life Options and Decisions

Science.gov (United States)

Groher, Michael E.; Groher, Tammy Peutz

2012-01-01

Managing one's dysphagia at the end-of-life is challenging for the patient and the medical care team. Decisions surrounding oral feeding safety and the use of artificially administered hydration and nutrition require the medical care team to provide its best advice, taking into consideration the patient's health-related goals and the impact the…

The Importance of Patient Involvement in Stroke Rehabilitation

DEFF Research Database (Denmark)

Kristensen, Hanne Kaae; Tistad, Malin; Koch, Lena von

2016-01-01

OBJECTIVE: To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met. METHOD: Data...... was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess....... CONCLUSIONS: The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health services needs....

Survival, Function, and Complications of Oral Implants Placed in Bone Flaps in Jaw Rehabilitation: A Systematic Review.

Science.gov (United States)

Zhang, Lei; Ding, Qian; Liu, Cunrui; Sun, Yannan; Xie, Qiufei; Zhou, Yongsheng

2016-01-01

This systematic review attempted to determine the survival rate of implants placed in bone flaps in jaw rehabilitation and the functional gains and the most common complications related to these implants. An electronic search was undertaken of PubMed, EMBASE, and CNKI records from 1990 through July 2014. Two independent examiners read the titles and abstracts of the results to identify studies that met the inclusion criteria. Subsequently, the reference lists of the selected publications were hand searched. Descriptive statistics were used to report all data related to the survival rate of implants placed in bone flaps in jaw rehabilitation, the functional gains, and complications. A total of 20 studies were included for systematic review without repetition. The mean follow-up time after implant placement ranged from 1.75 to 9.5 years. Within the limitations of available studies, the survival rate of implants placed in bone flaps in jaw rehabilitation ranged from 82.4% to 100%. Of the 20 included studies, 15 reported a survival rate higher than 90%. The cumulative survival rate was 93.2%, with the longest follow-up time being 12.9 years. The most common complications related to these implants were peri-implant bone resorption or peri-implant inflammation, and peri-implant soft tissue proliferation. The main factors associated with the survival rate of implants in bone flaps were reported as time of implant placement and radiotherapy. Despite some persistent soft tissue problems and implant loss, most patients reached a satisfactory functional and esthetic outcome, as evaluated by clinical examination and subjectively by the patients at interview. Implant-supported dental prosthetic rehabilitation in reconstructed jaws improved the quality of life in terms of speech, nutrition, oral competence, and facial appearance. Placement of implants in bone flaps in jaw rehabilitation was demonstrated to be a reliable technique with a high survival rate. Multicentered

Radiological evaluation of long term complications of oral rehabilitations of thin ridges with titanium blade implants

Directory of Open Access Journals (Sweden)

P. Diotallevi

2014-03-01

Full Text Available Aim: The aim of this study was to assess the sensitivity of orthopantomography (OPT in the diagnosis of long term complications in oral rehabilitations with blade implants. Materials and methods A total of 235 blade implants in 189 patients, inserted between 1988 and 2003, were retrospectively analyzed. The records consisted of a first OPT taken between January and December 2010, and a second one 12 months after. The evaluation of implant health considered: integrity of the blade, normal radiological representation of the bone around the implant, dense and cortical appearance of bone around the implant collar. The evaluation of radiological complications considered: implant fracture, bone resorption around the implant, recession of the bone around the implant collar. Results The sensitivity of the panoramic evaluation was equal to 100%. The complications detected were 5 cases of periimplantitis, 9 cases of bone pericervical bone recession and 3 cases of fracture of the implant body. In cases of pericervical bone resorption the following radiological check up 12 months after the first one showed the progression of the disease in 6 out of 9 cases, with irreversible implant failure. In subjects with a radiological pattern of implant health there were no complications in the subsequent check up after 12 months. In the subjects with complications the specificity was equal to 100%. Conclusion The radiographic evaluation by the means of OPT has shown high sensitivity in the diagnosis of long term complications of oral rehabilitations with blade implants and allows prompt therapeutic interventions. Radiological complications appeared mostly in the long term check ups and mainly consisted in recession of the bone around the neck or around the entire implant. More rarely implant fractures occurred, which, in the case of blades, sometimes were not associated with any clinical symptoms: therefore, postsurgical evaluation should not be separated from

Functional oral intake and time to reach unrestricted dieting for patients with traumatic brain injury

DEFF Research Database (Denmark)

Hansen, T.S.; Engberg, Anders; Larsen, K.

2008-01-01

. INTERVENTION: Facial oral tract therapy. MAIN OUTCOME MEASURE: Unrestricted dieting assessed by the Functional Oral Intake Scale (FOIS). RESULTS: We found that 93% of all patients had problems with functional oral intake at admission. Within 126 days of rehabilitation, 64% recovered to unrestricted dieting...... instrument (Wald chi(2)=44.40, Poral intake was found to be very common for patients with severe TBI admitted to a subacute rehabilitation department. For those who recovered during hospital rehabilitation......, return to unrestricted dieting happened within 126 days of rehabilitation. The chance of returning to unrestricted dieting depends on the severity of the brain injury and can be predicted by GCS score, RLAS level, FIM score, and functional oral intake at admission. These results are important when...

Prosthodontic rehabilitation of completely edentulous patient with partial glossectomy

Directory of Open Access Journals (Sweden)

Aditi Garg

2016-01-01

Full Text Available Oral cancer accounts for about 40% of all cancers inflicting the human beings. Those involving the tongue results in mild to severe deficiencies of phonation, deglutition, mastication, and taste depending upon the degree and extent tissues involved. Often rehabilitation of such patient is a challenge for the prosthodontist and involves a careful observation and evaluation of the residual oral function and ways to restore them. This article presents a case report of prosthodontic rehabilitation completely edentulous patient, who underwent partial glossectomy following surgical resection of the squamous cell carcinoma involving left lateral borders of the tongue. An attempt was made to restore the comfort and function of the patient with the help of palatal augmentation prosthesis, with additional assistance through speech therapy and simple oral exercises.

The effects of rehabilitative voir dire on juror bias and decision making.

Science.gov (United States)

Crocker, Caroline B; Kovera, Margaret Bull

2010-06-01

During voir dire, judges frequently attempt to "rehabilitate" venirepersons who express an inability to be impartial. Venirepersons who agree to ignore their biases and base their verdict on the evidence and the law are eligible for jury service. In Experiment 1, biased and unbiased mock jurors participated in either a standard or rehabilitative voir dire conducted by a judge and watched a trial video. Rehabilitation influenced insanity defense attitudes and perceptions of the defendant's mental state, and decreased scaled guilt judgments compared to standard questioning. Although rehabilitation is intended to correct for partiality among biased jurors, rehabilitation similarly influenced biased and unbiased jurors. Experiment 2 found that watching rehabilitation did not influence jurors' perceptions of the judge's personal beliefs about the case.

[Implementation of quality management in medical rehabilitation--current challenges for rehabilitation facilities].

Science.gov (United States)

Enge, M; Koch, A; Müller, T; Vorländer, T

2010-12-01

The legal responsibilities imposed upon rehabilitation facilities under section 20 (2a) SGB IX, necessitate fundamental decisions to be taken regarding the development of quality management systems over and above the existing framework. This article is intended to provide ideas and suggestions to assist rehabilitation facilities in implementing a quality management system, which is required in addition to participation in the quality assurance programmes stipulated by the rehabilitation carriers. In this context, the additional internal benefit a functioning quality management system can provide for ensuring a high level of quality and for maintaining the competitiveness of the rehabilitation facility should be taken into account. The core element of these observations, hence, is a list of requirements which enables assessment of the quality of consultants' performance in setting up a quality management system. © Georg Thieme Verlag KG Stuttgart · New York.

RECOVER: An Automated, Cloud-Based Decision Support System for Post-Fire Rehabilitation Planning

Science.gov (United States)

Schnase, J. L.; Carroll, M. L.; Weber, K. T.; Brown, M. E.; Gill, R. L.; Wooten, M.; May, J.; Serr, K.; Smith, E.; Goldsby, R.; Newtoff, K.; Bradford, K.; Doyle, C.; Volker, E.; Weber, S.

2014-11-01

RECOVER is a site-specific decision support system that automatically brings together in a single analysis environment the information necessary for post-fire rehabilitation decision-making. After a major wildfire, law requires that the federal land management agencies certify a comprehensive plan for public safety, burned area stabilization, resource protection, and site recovery. These burned area emergency response (BAER) plans are a crucial part of our national response to wildfire disasters and depend heavily on data acquired from a variety of sources. Final plans are due within 21 days of control of a major wildfire and become the guiding document for managing the activities and budgets for all subsequent remediation efforts. There are few instances in the federal government where plans of such wide-ranging scope and importance are assembled on such short notice and translated into action more quickly. RECOVER has been designed in close collaboration with our agency partners and directly addresses their high-priority decision-making requirements. In response to a fire detection event, RECOVER uses the rapid resource allocation capabilities of cloud computing to automatically collect Earth observational data, derived decision products, and historic biophysical data so that when the fire is contained, BAER teams will have a complete and ready-to-use RECOVER dataset and GIS analysis environment customized for the target wildfire. Initial studies suggest that RECOVER can transform this information-intensive process by reducing from days to a matter of minutes the time required to assemble and deliver crucial wildfire-related data.

RECOVER: An Automated Cloud-Based Decision Support System for Post-fire Rehabilitation Planning

Science.gov (United States)

Schnase, John L.; Carroll, Mark; Weber, K. T.; Brown, Molly E.; Gill, Roger L.; Wooten, Margaret; May J.; Serr, K.; Smith, E.; Goldsby, R.;

Decision trees to characterise the roles of permeability and solubility on the prediction of oral absorption.

Science.gov (United States)

Newby, Danielle; Freitas, Alex A; Ghafourian, Taravat

2015-01-27

Oral absorption of compounds depends on many physiological, physiochemical and formulation factors. Two important properties that govern oral absorption are in vitro permeability and solubility, which are commonly used as indicators of human intestinal absorption. Despite this, the nature and exact characteristics of the relationship between these parameters are not well understood. In this study a large dataset of human intestinal absorption was collated along with in vitro permeability, aqueous solubility, melting point, and maximum dose for the same compounds. The dataset allowed a permeability threshold to be established objectively to predict high or low intestinal absorption. Using this permeability threshold, classification decision trees incorporating a solubility-related parameter such as experimental or predicted solubility, or the melting point based absorption potential (MPbAP), along with structural molecular descriptors were developed and validated to predict oral absorption class. The decision trees were able to determine the individual roles of permeability and solubility in oral absorption process. Poorly permeable compounds with high solubility show low intestinal absorption, whereas poorly water soluble compounds with high or low permeability may have high intestinal absorption provided that they have certain molecular characteristics such as a small polar surface or specific topology. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Release strategies for rehabilitated sea otters

Science.gov (United States)

DeGange, Anthony R.; Ballachey, Brenda E.; Bayha, Keith; Williams, Terrie M.; Davis, Randall W.

1995-01-01

According to the U.S. Fish and Wildlife Services’ (USFWS) Response Plan for sea otters (USFWS, in preparation), in the event of an oil spill, the decision to release sea otters from rehabilitation centers following treatment will be linked to the decision on whether to capture sea otters for treatment. Assuming a scenario similar to the Exxon Valdez oil spill (EVOS), once the decision to capture sea otters is made, the ultimate goal is to return as many sea otters to the wild as possible, even though the rescue may not be expected to produce results significant at the population level. The decision by the USFWS to proceed with capture, rehabilitation, and release will be made on a case-by-case basis (USFWS, in preparation). Many factors will influence the decision. Perhaps the most important factors in deciding when and where to release sea otters are the location and availability of suitable release sites and verification that the otters are free of diseases that might be transmitted to the wild population.Alternative release strategies for sea otters will be contained in the sea otter response portion of the USFWS’s oil spill contingency plans for Alaska and California that are being developed as required by the Oil Pollution Act of 1990. Public review of these plans before they are implemented will help to reduce public concern about the survival of rehabilitated otters, their biological effect on the release area, and the potential introduction or spread of disease into the wild sea otter population.The objective of this chapter is to review alternative strategies for the disposition of rehabilitated sea otters. Our assumption is that returning as many animals to the wild as possible, whether it be for humanitarian or biological reasons, is the ultimate goal of this effort (Figure 10.1).

Prosthetic Rehabilitation After Fibular Free Flap Surgery of Mandibular Defects in a Patient With Oral Squamous Cell Carcinoma.

Science.gov (United States)

Yoon, Hyung-In

2016-10-01

This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.

Developing post-disaster physical rehabilitation: role of the World Health Organization Liaison Sub-Committee on Rehabilitation Disaster Relief of the International Society of Physical and Rehabilitation Medicine.

Science.gov (United States)

Gosney, James; Reinhardt, Jan Dietrich; Haig, Andrew J; Li, Jianan

2011-11-01

This special report presents the role of the World Health Organization (WHO) Liaison Sub-Committee on Rehabilitation Disaster Relief (CRDR) of the International Society of Physical and Rehabilitation Medicine (ISPRM) in developing an enhanced physical rehabilitation relief response to large-scale natural disasters. The CRDR has stated that disaster rehabilitation is an emerging subspecialty within physical and rehabilitation medicine (PRM). In reviewing the existing literature it was found that large natural disasters result in many survivors with disabling impairments, that these survivors may have better clinical outcomes when they are treated by PRM physicians and teams of rehabilitation professionals, that the delivery of these rehabilitation services to disaster sites is complicated, and that their absence can result in significant negative consequences for individuals, communities and society. To advance its agenda, the CRDR sponsored an inaugural Symposium on Rehabilitation Disaster Relief as a concurrent scientific session at the 2011 ISPRM 6th World Congress in San Juan, Puerto Rico. The symposium included oral and poster presentations on a range of relevant topics and concluded with an international non-governmental organization panel discussion that addressed the critical question "How can rehabilitation actors coordinate better in disaster?" Building upon the symposium, the CRDR is developing a disaster rehabilitation evidence-base, which will inform and educate the global professional rehabilitation community about needs and best practices in disaster rehabilitation. The Journal of Rehabilitation Medicine (JRM) has commissioned this special report to announce a series of papers on disaster rehabilitation from the symposium's scientific programme. Authors are invited to submit papers on the topic for inclusion in this special series. JRM also encourages expert commentary in the form of Letters to the Editor.

Prosthodontic rehabilitation in patient with ectodermal dysplasia combining preprosthetic techniques: a case report.

Science.gov (United States)

Pombo Castro, María; Luaces Rey, Ramón; Arenaz Búa, Jorge; Santana-Mora, Urbano; López-Cedrún Cembranos, José Luís

2013-10-01

Oral manifestations in ectodermal dysplasia include oligodontia, alveolar ridges hypoplasia, and others. Due to the special conditions in terms of unhealthy teeth and lack of bone, implant-supported rehabilitation seems to offer the most satisfactory outcome. A 27-year-old male diagnosed with ectodermal dysplasia was referred to our department for oral rehabilitation. Oral manifestations included oligodontia, maxillary and mandibular atrophy, mandibular alveolar ridge with knife-edge morphology, and conical teeth. Treatment planning consisted of a Le Fort I osteotomy with interpositional grafts, bilateral sinus lift, and placement of maxillary and mandibular inlay and onlay corticocancellous grafts, using autologous iliac crest bone. In the second surgery, all remaining teeth were removed and 11 endosteal implants were placed. Six months after implant placement, a bimaxillary fixed implant-supported prosthesis was delivered, maintaining a satisfactory esthetic and functional result after a 2-year follow-up. The use of combined preprosthetic techniques allows the placement of endosteal implants and a fixed implant-supported prosthesis in patients with oligodontia and ectodermal dysplasia, providing an esthetic and functional oral rehabilitation.

Virtual reality in rehabilitation after stroke

Directory of Open Access Journals (Sweden)

Krasnova-Goleva V.V.

2016-01-01

Full Text Available After a stroke many people have serious problems in motion activity, decline in cognitive activity, as well as a number of psychological problems that may accompany the man for many years. Motivational rehabilitation component plays a decisive role in the process of recovery after suffering a stroke. At present one of the most successful methods of rehabilitation is considered to be a recovery through "observation-imitation”, because this method enhances the plasticity of the brain and, as a result, rehabilitation potential. Modern rehabilitation using virtual reality had demonstrated good results to improve motor and cognitive skills, as well as the psychological condition

A Prospective Longitudinal Study on Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients with 1-Year Follow-Up: The Role of CD4+ Level, Smoking Habits, and Oral Hygiene.

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Gherlone, Enrico F; Capparé, Paolo; Tecco, Simona; Polizzi, Elisabetta; Pantaleo, Giuseppe; Gastaldi, Giorgio; Grusovin, Maria Gabriella

2016-10-01

A recent study showed that implant-prosthetic rehabilitation in well-controlled HIV patients gave slightly worse results than in an healthy population, and failures were all linked to infection. The aim of this study was to examine the associations between the success of implant-prosthetic treatment and systemic CD4+ level, smoking habits, and oral hygiene. This mono-centric study included HIV patients with a stable disease and good oral hygiene requiring implant rehabilitation. Each patient received at least one dental implant. Prosthesis were delivered after 90 days in the upper jaw and 60 days in the lower jaw. Primary outcome measures were prosthetic failures, implant failures, peri-implant marginal bone level changes, and biological complications (peri-implantitis, pus, pain, paresthesia). The possible association with CD4 count, smoking habits, and oral hygiene was analyzed. Sixty-eight patients received 194 implants, and 66 patients (190 implants) were followed for 1 year. No significant associations were found between CD4+ count, oral hygiene-associated variables, and any of the outcome measures. If compared with nonsmoking/light smoking patients, patients who smoked >10 cigarettes/day suffered a statistically significant greater number of implant failures (p ≤ .005), presented a comparatively higher number of peri-implantitis (p 10 cigarettes/day) demonstrated an increased risk of early implant failure, peri-implantitis, episodes of pus, and self-reported pain. © 2015 Wiley Periodicals, Inc.

Function after oral oncological intervention, reconstruction and rehabilitation

NARCIS (Netherlands)

Speksnijder, C.M.

2011-01-01

In the Netherlands, the incidence of oral cancer is increasing. Progress in (reconstructive) surgery, radiotherapy and chemotherapy, however, has improved survival and loco-regional control while trying to preserve or restore oral function and quality of life. Despite the progress in treatment,

8 CFR 1003.37 - Decisions.

Science.gov (United States)

2010-01-01

... decision of the Immigration Judge may be rendered orally or in writing. If the decision is oral, it shall be stated by the Immigration Judge in the presence of the parties and a memorandum summarizing the oral decision shall be served on the parties. If the decision is in writing, it shall be served on the...

Rehabilitation of large maxillary defect with two-piece maxillary obturators

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Kanchan P Dholam

2015-01-01

Full Text Available The insertion and removal of an obturator in large maxillary defects with or without trismus is difficult. Fabrication of a two-piece obturator in such cases overcomes this problem. This article describes rehabilitation of large maxillary defects with two piece maxillary obturator of three types. All these obturators have a maxillary plate and a bulb component, which are approximated together by various techniques namely, silicone cover, embedded magnets, and press studs. Prosthetic rehabilitation of large maxillary defects with two-piece obturators offers the possibility of adequate oral rehabilitation by fabricating light weight prosthesis, which is easy to use. The bulb covers the undercut areas of the defect enhancing the facial contour and retention. It facilitates easy examination of underlying tissues, recreation of the anatomic barrier between the oral and nasal cavities and restoration of the function and esthetics. Thus, it adds to the quality of life.

Supported Decision-Making: Implications from Positive Psychology for Assessment and Intervention in Rehabilitation and Employment.

Science.gov (United States)

Uyanik, Hatice; Shogren, Karrie A; Blanck, Peter

2017-12-01

Purpose This article reviews existing literature on positive psychology, supported decision-making (SDM), employment, and disability. It examines interventions and assessments that have been empirically evaluated for the enhancement of decision-making and overall well-being of people with disabilities. Additionally, conceptual themes present in the literature were explored. Methods A systematic review was conducted across two databases (ERIC and PsychINFO) using various combination of keywords of 'disabilit*', work rehabilitation and employment terms, positive psychology terms, and SDM components. Seven database searches were conducted with diverse combinations of keywords, which identified 1425 results in total to be screened for relevance using their titles and abstracts. Database search was supplemented with hand searches of oft-cited journals, ancestral search, and supplemental search from grey literature. Results Only four studies were identified in the literature targeting SDM and positive psychology related constructs in the employment and job development context. Results across the studies indicated small to moderate impacts of the assessment and interventions on decision-making and engagement outcomes. Conceptually there are thematic areas of potential overlap, although they are limited in the explicit integration of theory in supported decision-making, positive psychology, disability, and employment. Conclusion Results suggest a need for additional scholarship in this area that focuses on theory development and integration as well as empirical work. Such work should examine the potential utility of considering positive psychological interventions when planning for SDM in the context of career development activities to enhance positive outcomes related to decision-making, self-determination, and other positive psychological constructs.

Rehabilitation time before disability pension.

Science.gov (United States)

Støver, Morten; Pape, Kristine; Johnsen, Roar; Fleten, Nils; Sund, Erik R; Claussen, Bjørgulf; Ose, Solveig Osborg; Bjørngaard, Johan Håkon

2012-10-30

The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.

Rehabilitation time before disability pension

Directory of Open Access Journals (Sweden)

Støver Morten

2012-10-01

Full Text Available Abstract Background The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. Methods A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. Results The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. Conclusions There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.

Effect of a dedicated oral care program on periodontal status of medically compromised patients at the Toronto Rehabilitation Institute Dental Clinic.

Science.gov (United States)

Schlosser, Robert; Hebbes, Trudy

2016-01-01

Medically compromised patients attending the dental clinic at the Toronto Rehabilitation Institute have considerable gingival inflammation and breath odor. The objective of this study was to evaluate the effect of toothbrushing on the periodontal status of these patients and to determine if there were any additional benefit in combining brushing with an application of an antibiotic rinse. During the first 7 days of the study, the teeth of 11 participants were brushed twice a day by a dental hygienist using a soft-bristle suction toothbrush without toothpaste. Soft interproximal brushes were used to clean interproximal surfaces from the facial aspect. During the second week, facial and interproximal cleaning were repeated in the same patients, but the toothbrush and interproximal brush were dipped in 10-mL of a solution consisting of water and 40 mg/mL of metronidazole with nystatin. Each patient underwent an oral examination and biofilm sampling at baseline, after brushing without toothpaste (week 1), and after brushing with antibiotic solution (week 2). After week 1, tissues improved substantially, and there was a notable change in the biofilm on the teeth. The addition of an antibiotic solution increased healing and resulted in a further decrease in oral biofilm. Medically compromised patients would benefit considerably from a treatment regimen of antibiotic solution to decrease oral infection followed by a daily oral care program of brushing and interdental cleaning to maintain healthy oral tissues.

Oral features and computerized rehabilitation of a young patient with CHARGE syndrome using minimally invasive long-term interim CAD-CAM restorations.

Science.gov (United States)

Liebermann, Anja; Rafael, Caroline Freitas; Edelhoff, Daniel; Ramberger, Marc; Schweiger, Josef; Maziero Volpato, Claudia Angela; Saeidi Pour, Reza

2017-04-01

Patients with CHARGE syndrome (where CHARGE stands for coloboma of the iris or retina, heart defects or cardiac malformations, atresia/stenosis of the choanae, retardation of growth and development, genital anomalies, and ear abnormalities) present several orofacial anomalies. Their treatment depends on the specific type of manifestation. To perform the complex oral rehabilitation and achieve a conservative, esthetic, and functional exploration of the definitive treatment goal, computer-aided design and computer-aided manufacturing (CAD-CAM) polymers can be used as long-term interim restorations. This article reports the treatment of a young patient with CHARGE syndrome combined with oral alterations. CAD-CAM polymers offer an intermediate treatment with satisfying esthetics and function at low biological cost until bone growth is completed. This period facilitates additional planning for the definitive restoration. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Oral Rehabilitation of Adult Edentulous Siblings Severely Lacking Alveolar Bone Due to Ectodermal Dysplasia: A Report of 2 Clinical Cases and a Literature Review.

Science.gov (United States)

Wu, Yiqun; Zhang, Chenping; Squarize, Cristiane H; Zou, Duohong

2015-09-01

The oral conditions of adult edentulous patients with ectodermal dysplasia (ED) often lead to decreased physical and psychological health, and the negative effects can become as extreme as social and psychological isolation. However, restoring oral function of adult edentulous patients with ED using zygomatic implants (ZIs) or conventional implants (CIs) remains challenging for dentists because of the severe atrophy of these patients' alveolar ridges. This report describes 2 cases of adult edentulous siblings with ED; they exhibited severe alveolar bone atrophy and were treated with ZIs and CIs as bases to augment the bone in their anterior jaws. For these patients, bone augmentation was completed with an autogenous fibular graft. Although there was mild evidence of bone graft resorption in the maxilla, the bone augmentation procedures were successful in the 2 patients. Effective osseointegration of the implants was obtained. After placement, the functional and esthetic results of the oral rehabilitation were acceptable. More importantly, restoration of the patients' oral function enhanced their self-confidence and self-esteem. Therefore, restoring oral function in adult patients with ED and edentulous jaws using ZIs and CIs as the bases for bone augmentation is an effective approach. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Failures in the rehabilitation treatment with removable partial dentures.

Science.gov (United States)

Benso, Bruna; Kovalik, Ana C; Jorge, Janaina H; Campanha, Nara H

2013-11-01

Despite being functional and having aesthetic benefits, the acceptance of patients regarding the use of removable partial dentures (RPDs) has been low. In part, this is due to the deleterious effects that causes discomfort to the patient. Success depends not only on the care expended by the patient, including daily care and oral hygiene, but also on common goals set by their professional and clinical staff, aiming beyond aesthetics, to incorporate issues of functionality and the well-being of patients. For rehabilitation treatment with RPDs to reach the desired level of success without damaging the support structure, all the steps (diagnose, cavity preparation, adaptation of the metal structures, functional of distal extension and posterior follow-up) in the rehabilitative treatment should be carefully developed. A literature review was carried out, searching through MEDLINE (PubMed) articles published between 1965 and December 2012 including clinical trials and reviews about the use of RPDs. This study describes factors that lead to failures and complications in oral rehabilitation through the use of RPDs and suggests possible solutions.

Oral rehabilitation of a patient with temporomandibular joint ankylosis caused by ankylosing spondylitis: A case report

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Brkić Zlata

2017-01-01

Full Text Available Introduction. Ankylosing spondylitis (AS/Morbus Bechterew is a chronic inflammatory rheumatoid disease. The temporomandibular joint (TMJ dysfunction is involved in 4–35% of AS cases, and is correlated to the severity and extension of AS. Even though AS-caused TMJ ankylosis is exceptional, one should have high index of suspicion of TMJ ankylosis in AS for an early detection, because it is an extremely serious and disabling condition that causes problems with mastication, swallowing, digestion, speech, appearance and poor oral hygiene with heavy caries. Case report. A 54-year-old male patient sought medical attention at the Department of Periodontology and Oral Medicine, Clinic for Dentistry at the Military Medical Academy, Belgrade, Serbia, with the chief complaint of pain in the area of the upper left canine in the presence of limited mouth opening. The treatment plan consisted of upper left canine management and rehabilitation of the remaining teeth in the frontal and the premolar region in both, the upper and lower jaw. Even though molar region needed to be treated, unfortunately it was not in the treatment plan because ankylosis of TMJ made the treatment impossible. Conclusions. The patients with AS-caused TMJ ankylosis are considered a diagnostic challenge to routine dentistry. Accent should be given to early diagnosis and multidisciplinary approach in the treatment of the AS patients towards the favorable disease course and outcome.

Economic aspects of hydroelectric power scheme rehabilitation

International Nuclear Information System (INIS)

Dupuy, M.

1991-01-01

As part of the management of a utility, it is necessary to check, beyond the technical aspect, the economic suitability of deciding whether to perform the maintenance or rehabilitation of an installation. The decision criteria involved are to be found within the framework of the utility's management system itself. After having set out the decision-making process of hydroelectric power station maintenance or rehabilitation, the document goes on to give a description of the economic advantage of such an operation. The latter is determined after having properly defined the overall cost of maintenance or rehabilitation: direct expenses and induced costs, and expected savings: economic performance, short and medium-term reduction of expenses as a result of the profitability and productivity of the rehabilitation. The profitability is calculated as the ratio between the economic balance and the amount of the operation. Productivity means the improvement of the utility's management indicators. The random aspect of savings and a simple method making it possible to integrate them into a calculation is mentioned, as well as the classification and aggregation of various operations of a similar nature that have to come into the budget requirements of the utility. (Author)

EFFECT OF POLYMER PROSTHETIC CONSTRUCTION TREATED WITH GLOW-DISCHARGE PLASMA ON ORAL MUCOSA (CLINICAL CASE

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E. O. Kudasova

2017-01-01

Full Text Available Prosthetic material should induce minimal pathological reaction when in contact with the oral mucosa, especially during oral rehabilitation of patients with tumors of the oral mucosa. The article presents monitoring of a patient after surgery for cancer of the buccal mucosa at the stage of orthopedic rehabilitation. Treatment plan proposed complex oral rehabilitation. A maxillary complete removable denture was manufactured as well as metalloceramic and partial mandibular dentures. Plasma chemical modification of the removable dentures was planned after correction of the prosthetics and primary adaptation. Removable dentures were applied at the maxilla and mandibula. Per our recommendations, the patient was examined weekly for a month and monthly for 6 months. No new tumors or pathological elements were observed.Conclusions. Changes in critical surface tension of the removable dentures made of acrylic plastic improve their biological characteristics as demonstrated by positive clinical dynamics. Prosthetic constructions with hydrophilic surface are recommended in complex clinical cases when patients with tumors of the oral mucosa require dentures.

Patientdeltagelse under rehabilitering efter en rygmarvsskade

DEFF Research Database (Denmark)

Angel, Sanne

2010-01-01

insight into patient participation. The ability and need for participation changed through the six-phased process of regaining meaning after a spinal cord injury; no will to participate, developing/generating strength to participate, need for participation and will to participate in decision......This paper investigates the patient's ability and need for participation during rehabilitation. The application of Ricoeur's phenomenological-hermeneutic interpretation theory with a narrative approach revealed that the rehabilitation process of 12 persons was successful in providing specific......-making. Concurrently, the existential meaning of patient participation was uncovered. The conclusion was that the professional's hard work of stimulating the patient to participate and then permit the patient to take part was decisive in relation to the patient's existence and recovery....

The Importance of Patient Involvement in Stroke Rehabilitation

Science.gov (United States)

2016-01-01

Objective To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met. Method Data was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess the participants' perceptions of involvement in decisions on care or treatment and needs for health services in 11 problem areas: mobility, falls, incontinence, pain, fatigue, emotion, concentration, memory, speaking, reading, and sight. The perceived impact of stroke in eight areas was assessed using the Stroke Impact Scale (SIS) 3.0. Eleven logistic regression models were created to explore associations between having health services needs met in each problem area respectively (dependent variable) and the independent variables. In all models the independent variables were: age, sex, SIS domain corresponding to the dependent variable, or stroke severity in cases when no corresponding SIS domain was identified, and involvement in decisions on care and treatment. Results The 63 participants who returned the questionnaires had a mean age of 72 years, 33 were male and 30 were female. Eighty percent had suffered a mild stroke. The number of participants who reported problems varied between 51 (80%, mobility) and 24 (38%, sight). Involvement in decisions on care and treatment was found to be associated with having health services needs met in six problem areas: falls, fatigue, emotion, memory, speaking, and reading. Conclusions The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health

Oral and masticatory rehabilitation using osseointegrated dental implants after resective treatment of multicystic ameloblastoma in the lower jaw with a fibula graft

Directory of Open Access Journals (Sweden)

João Ricardo Almeida Grossi

2018-01-01

Full Text Available Ameloblastoma is an aggressive odontogenic tumor which typically occurs between third and fourth decade of life that often needs resective approach. Immediate reconstruction may show better results. The treatment of multicystic ameloblastoma in the mandible being a rare case that occurred in the late second decade of life, which was surgically removed along with the affected teeth with safety margins, and the region was immediately reconstructed using a vascularized graft, removed from the fibula. Its integration, in combination with osseointegrated dental implants and fixed implant-supported prostheses, restored chewing function and esthetics. After 6 years from fibular graft and 24 months of dental implants, an excellent outcome was observed, with oral health and normal functions properly restored, and the immediate reconstruction of the mandible in resective cases, associated with oral rehabilitation with dental implants, may be considered a suitable treatment option.

Determination of Pavement Rehabilitation Activities through a Permutation Algorithm

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Sangyum Lee

2013-01-01

Full Text Available This paper presents a mathematical programming model for optimal pavement rehabilitation planning. The model maximized the rehabilitation area through a newly developed permutation algorithm, based on the procedures outlined in the harmony search (HS algorithm. Additionally, the proposed algorithm was based on an optimal solution method for the problem of multilocation rehabilitation activities on pavement structure, using empirical deterioration and rehabilitation effectiveness models, according to a limited maintenance budget. Thus, nonlinear pavement performance and rehabilitation activity decision models were used to maximize the objective functions of the rehabilitation area within a limited budget, through the permutation algorithm. Our results showed that the heuristic permutation algorithm provided a good optimum in terms of maximizing the rehabilitation area, compared with a method of the worst-first maintenance currently used in Seoul.

[Oral and dental health and oral and dental support of home patients--role of dental hygienist in the home service nursing station].

Science.gov (United States)

Hayashi, T; Kimura, M; Tamura, N; Hirata, S; Yabunaka, T; Kamimura, Y

1999-12-01

Home patients have few chances for going out, so communication with their family means a lot. Talking and eating are particular pleasures. Therefore, oral and dental health and oral and dental support are very important for home patients. A dental hygienist from our clinic visits and offers oral and dental health (oral care) and oral and dental support (oral rehabilitation) to home patients as part of a care plan with home care nurses. Moreover, as general conditions are closely related with oral function, maintaining oral and dental health and regular oral and dental support are very important in order to improve the quality of life (QOL) of home patients.

Implant-based oral rehabilitation of a variant model of type I dentinal dysplasia: A rare case report

Directory of Open Access Journals (Sweden)

Sowmya Nettem

2014-01-01

Full Text Available Dentin dysplasia is an exceptionally rare, autosomal-dominant, hereditary condition, primarily characterized by defective dentin formation affecting both the deciduous and permanent dentitions. The etiology remains imprecise to date, in spite of the numerous hypotheses put forward and the constant updates on this condition. This case report of type I dentin dysplasia exhibits radiographic findings that are unique and diverse from the classical findings of various subtypes of this disease reported to date. This article also depicts the implant-based oral rehabilitation of the young patient diagnosed with this variant model of dentin dysplasia type I. Early diagnosis and implementation of this preventive and curative therapy is vital for avoiding premature exfoliation of deciduous and permanent dentition and the associated residual ridge resorption, thereby overcoming functional and esthetic deficits and ensuring protection of the remaining dentition from further harm.

Early recovery after abdominal rectopexy with multimodal rehabilitation

DEFF Research Database (Denmark)

Basse, Linda; Billesbølle, Per; Kehlet, Henrik

2002-01-01

status III to IV, were scheduled for abdominal rectopexy with a multimodal rehabilitation program including 48 hours thoracic epidural analgesia or patient-controlled anesthesia (3 patients), early oral nutrition and mobilization, and a planned two-day postoperative hospital stay. Follow-up was done...

Pre-assessment to assess the match between cost-effectiveness results and decision makers'information needs: (An Illustration Using Two Cases in Rehabilitation Medicine in The Netherlands)

NARCIS (Netherlands)

IJzerman, Maarten Joost; Reuzel, Robert P.B.; Severens, Hans L.

2003-01-01

Objective: To determine if a pre-assessment can be used to establish whether cost-effectiveness results would meet the actual information needs of Dutch healthcare decision makers. Methods: Two recent studies in rehabilitation medicine served as study material. Based on Wholey, a limited

Pre-assessment to assess the match between cost-effectiveness results and decision makers' information needs: an illustration using two cases in rehabilitation medicine in The Netherlands.

NARCIS (Netherlands)

IJzerman, M.J.; Reuzel, R.P.B.; Severens, J.L.

2003-01-01

OBJECTIVE: To determine if a pre-assessment can be used to establish whether cost-effectiveness results would meet the actual information needs of Dutch healthcare decision makers. METHODS: Two recent studies in rehabilitation medicine served as study material. Based on Wholey, a limited

Oral Rehabilitation Outcomes Network-ORONet

NARCIS (Netherlands)

Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

2013-01-01

The published literature describing clinical evidence used in treatment decision-making for the management of tooth loss continues to be characterized by a lack of consistent outcome measures reflecting not only clinical performance but also a range of patient concerns. Recognizing this problem, an

Nuclear and radiological emergency management and rehabilitation strategies: towards a EU approach for decision support tools (EURANOS)

International Nuclear Information System (INIS)

Raskob, W.; Gering, F.; Lochard, J.; Nisbet, A.; Starostova, V.; Tomic, B.

2010-01-01

The 5-year multi-national project EURANOS, funded by the European Commission and 23 European Member States, started in April 2004. Integrating 17 national emergency management organisations with 33 research institutes, it brings together best practices, knowledge and technology to enhance the preparedness for Europe's response to any radiation emergency and long term contamination. Key objectives of the project are to collate information on the likely effectiveness and consequences of a wide range of countermeasures, to provide guidance to emergency management organisations and decision makers on the establishment of an appropriate response strategy and to further enhance advanced decision support systems (DSS), in particular, RODOS, through feedback from their operational use. Further, the project aims to create regional initiatives leading to information exchange based on state-of-the-art information technologies, to develop guidance which assists Member States in developing a framework for the sustainable rehabilitation of living conditions in contaminated areas

Oral rehabilitation and psychosocial evaluation of a patient with bulimia nervosa following Teeth in a Day® immediate loading protocol.

Science.gov (United States)

Balshi, Thomas J; Wolfinger, Glenn J; Alfano, Stephen G; Croce, J Neil Della; Balshi, Stephen F

2015-04-01

The purpose of this patient report is to accurately portray the clinical experience of treating an active bulimic patient by employing an immediately loaded dental implant protocol to provide the patient with an expedited esthetic and functional result. Implementation of a psychometric component statistically quantifies the psychological effects of the oral rehabilitation. A 34-year-old woman presented with severe dental perimolysis (erosion) resulting from a 28-year history of bulimic behaviors. Clinical and radiographic evaluation of the existing dentition indicated advanced dental erosion and previous restoration attempts in a state of failure. The patient's existing teeth were extracted and treated with full maxillary and mandibular implant-supported prostheses, following the Teeth in a Day® (TIAD) immediate functional loading protocol. Psychometric assessment was conducted through administration of a 20-item questionnaire, as seen in previous literature. Radiographic and clinical analysis suggested all implant fixtures to be viable and accompanied by normal levels of alveolar bone 7 months into treatment. Questionnaire results at the new-patient presentation (T1) resulted in a composite score of 4.0 (SD = 2.9; P = 0.004), indicating severe body-image dysphoria. At 3 months postoperative (T2), the questionnaire score was 0.4 (SD = -1.7; P = 0.09). The final psychometric questionnaire at 7 months (T3) resulted in a score of 0.5 (SD = -1.5; P = 0.12). The patient was followed for a total of 7 years following implant placement. In this patient report, oral rehabilitation using the TIAD protocol provided an expedited and predictable alternative method for restoring functional abilities, esthetics, and self-esteem to a severely depressed bulimic patient. Psychometrically, at the postoperative (T2) and final testing period (T3), the patient's body image profile was no longer considered to be significantly different from established normative values.

Oral Rehabilitation of a Severe Periodontally Involved Patient with Mucous Membrane Pemphigoid: A 15-Year Follow-Up Case Report.

Science.gov (United States)

Megarbane, Jean-Marie; Freiha, Cécile; Mokbel, Nadim

Mucous membrane pemphigoid (MMP) refers to a group of chronic autoimmune subepithelial diseases distinguished by erosive lesions of the mucous membranes and skin. Its treatment consists of inhibition of the inflammatory reaction by means of corticosteroids and symptomatic medication. This is a report of a patient suffering from a combination of MMP and severe generalized chronic periodontitis. The patient has been treated with oral corticosteroids, initial phase therapy, extraction with immediate implant placement, and periodontal surgery where the prognosis was questionable. The case has been followed up for 15 years. Periodontal therapy with immediate implant placement was determined to be a viable modality to achieve a total rehabilitation of a case suffering from MMP combined with severe generalized chronic periodontitis.

A Virtual Environment to Improve the Detection of Oral-Facial Malfunction in Children with Cerebral Palsy.

Science.gov (United States)

Martín-Ruiz, María-Luisa; Máximo-Bocanegra, Nuria; Luna-Oliva, Laura

2016-03-26

The importance of an early rehabilitation process in children with cerebral palsy (CP) is widely recognized. On the one hand, new and useful treatment tools such as rehabilitation systems based on interactive technologies have appeared for rehabilitation of gross motor movements. On the other hand, from the therapeutic point of view, performing rehabilitation exercises with the facial muscles can improve the swallowing process, the facial expression through the management of muscles in the face, and even the speech of children with cerebral palsy. However, it is difficult to find interactive games to improve the detection and evaluation of oral-facial musculature dysfunctions in children with CP. This paper describes a framework based on strategies developed for interactive serious games that is created both for typically developed children and children with disabilities. Four interactive games are the core of a Virtual Environment called SONRIE. This paper demonstrates the benefits of SONRIE to monitor children's oral-facial difficulties. The next steps will focus on the validation of SONRIE to carry out the rehabilitation process of oral-facial musculature in children with cerebral palsy.

Factors Predicting Recovery of Oral Intake in Stroke Survivors with Dysphagia in a Convalescent Rehabilitation Ward.

Science.gov (United States)

Ikenaga, Yasunori; Nakayama, Sayaka; Taniguchi, Hiroki; Ohori, Isao; Komatsu, Nahoko; Nishimura, Hitoshi; Katsuki, Yasuo

2017-05-01

Percutaneous endoscopic gastrostomy may be performed in dysphagic stroke patients. However, some patients regain complete oral intake without gastrostomy. This study aimed to investigate the predictive factors of intake, thereby determining gastrostomy indications. Stroke survivors admitted to our convalescent rehabilitation ward who underwent gastrostomy or nasogastric tube placement from 2009 to 2015 were divided into 2 groups based on intake status at discharge. Demographic data and Functional Independence Measure (FIM), Dysphagia Severity Scale (DSS), National Institutes of Health Stroke Scale, and Glasgow Coma Scale (GCS) scores on admission were compared between groups. We evaluated the factors predicting intake using a stepwise logistic regression analysis. Thirty-four patients recovered intake, whereas 38 achieved incomplete intake. Mean age was lower, mean body mass index (BMI) was higher, and mean time from stroke onset to admission was shorter in the complete intake group. The complete intake group had less impairment in terms of GCS, FIM, and DSS scores. In the stepwise logistic regression analysis, BMI, FIM-cognitive score, and DSS score were significant independent factors predicting intake. The formula of BMI × .26 + FIM cognitive score × .19 + DSS score × 1.60 predicted recovery of complete intake with a sensitivity of 88.2% and a specificity of 84.2%. Stroke survivors with dysphagia with a high BMI and FIM-cognitive and DSS scores tended to recover oral intake. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Advances in wearable technology for rehabilitation.

Science.gov (United States)

Bonato, Paolo

2009-01-01

Assessing the impact of rehabilitation interventions on the real life of individuals is a key element of the decision-making process required to choose a rehabilitation strategy. In the past, therapists and physicians inferred the effectiveness of a given rehabilitation approach from observations performed in a clinical setting and self-reports by patients. Recent developments in wearable technology have provided tools to complement the information gathered by rehabilitation personnel via patient's direct observation and via interviews and questionnaires. A new generation of wearable sensors and systems has emerged that allows clinicians to gather measures in the home and community settings that capture patients' activity level and exercise compliance, the effectiveness of pharmacological interventions, and the ability of patients to perform efficiently specific motor tasks. Available unobtrusive sensors allow clinical personnel to monitor patients' movement and physiological data such as heart rate, respiratory rate, and oxygen saturation. Cell phone technology and the widespread access to the Internet provide means to implement systems designed to remotely monitor patients' status and optimize interventions based on individual responses to different rehabilitation approaches. This chapter summarizes recent advances in the field of wearable technology and presents examples of application of this technology in rehabilitation.

Radiation therapy of tumors of the oral cavity

International Nuclear Information System (INIS)

Parsons, J.T.; Million, R.R.

1987-01-01

Both operation and irradiation can cure a high percentage of patients with oral cavity carcinomas. The decision as to which modality is best (or whether to combine both modalities or offer only palliative treatment) in a particular patient is frequently complex and involves consideration of a number of factors before rational therapy can be planned. 1. Tumor location and distribution. 2. Tumor volume. 3. Tumor differentiation. 4. Known patterns of spread. 5. Functional, rehabilitative, and cosmetic aspects and their impact on the patient's life style and occupation. 6. The wishes of the patient and family. 7. Availability of a given treatment in the patient's geographic area. 8. Experience of the patient's physicians. 9. Anticipated cure rates with the various modes of therapy. 10. Expense. 11. The patient's age. 12. Tobacco and alcohol consumption. 13. Presence of other serious medical problems

Health-related quality of life after maxillectomy: obturator rehabilitation compared with flap reconstruction.

Science.gov (United States)

Breeze, J; Rennie, A; Morrison, A; Dawson, D; Tipper, J; Rehman, K; Grew, N; Snee, D; Pigadas, N

2016-10-01

Health-related quality of life (QoL) reported by patients has the potential to improve care after ablative surgery of the midface, as existing treatment algorithms still generally revolve around outcomes assessed traditionally only by clinicians. Decisions in particular relate to reconstruction with a flap compared with rehabilitation with an obturator, the need for adjuvant treatment, and morbidity related to the size of the defect. We prospectively collected health-related QoL assessments for 39 consecutive patients treated by maxillectomy between 01 January 2010 and 31 December 2014 using the University of Washington Quality of Life Questionnaire, and who had a mean (SD) duration of follow-up of 14 (4). We made sub-group analyses using paired t tests and analysis of variance (ANOVA) to compare reconstruction with a flap with rehabilitation with obturators, size of the vertical defect, and whether adjuvant treatment with radiotherapy or chemoradiotherapy adversely affected it. Overall there was a significant decrease in health-related QoL after treatment compared with before (p<0.001), but there was no significant difference in the effects of any of the paired reconstructive and rehabilitation treatments on it. Obturators remain an important option for rehabilitation in selected patients in addition to reconstruction with a flap. We found that neither increasing the size of the vertical defect (in an attempt to ensure clear margins) nor the use of postoperative radiotherapy seemed to have any adverse effect on QoL. More patients are required before we can conclude that the potential survival benefits of such measures may outweigh any adverse effects. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skelettal class-III conditions: review of the literature and report of a case

Directory of Open Access Journals (Sweden)

Meyer Ulrich

2007-01-01

Full Text Available Abstract Background Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. Methods Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skelettal class-III conditions due to cleft palate are described. Results A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. Conclusion Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.

Rapid rehabilitation in elderly patients after laparoscopic colonic resection

DEFF Research Database (Denmark)

Bardram, Linda; Funch-Jensen, P; Kehlet, H

2000-01-01

BACKGROUND: Introduction of the laparoscopic surgical technique has reduced hospital stay after colonic resection from about 8-10 to 4-6 days. In most studies, however, specific attention has not been paid to changes in perioperative protocols required to maximize the advantages of the minimally ...... rehabilitation protocol of pain relief, early mobilization and oral nutrition....... invasive procedure. In the present study the laparoscopic approach was combined with a perioperative multimodal rehabilitation protocol. METHODS: After laparoscopically assisted colonic resection, patients were treated with epidural local anaesthesia for 2 days, early mobilization and enteral nutrition...

A Virtual Environment to Improve the Detection of Oral-Facial Malfunction in Children with Cerebral Palsy

Directory of Open Access Journals (Sweden)

María-Luisa Martín-Ruiz

2016-03-01

Full Text Available The importance of an early rehabilitation process in children with cerebral palsy (CP is widely recognized. On the one hand, new and useful treatment tools such as rehabilitation systems based on interactive technologies have appeared for rehabilitation of gross motor movements. On the other hand, from the therapeutic point of view, performing rehabilitation exercises with the facial muscles can improve the swallowing process, the facial expression through the management of muscles in the face, and even the speech of children with cerebral palsy. However, it is difficult to find interactive games to improve the detection and evaluation of oral-facial musculature dysfunctions in children with CP. This paper describes a framework based on strategies developed for interactive serious games that is created both for typically developed children and children with disabilities. Four interactive games are the core of a Virtual Environment called SONRIE. This paper demonstrates the benefits of SONRIE to monitor children’s oral-facial difficulties. The next steps will focus on the validation of SONRIE to carry out the rehabilitation process of oral-facial musculature in children with cerebral palsy.

Prosthetic rehabilitation for a patient with microstomia: a case report

Directory of Open Access Journals (Sweden)

Moslehifard E

2011-04-01

Full Text Available "nFabrication of dental prosthesis for patients with microstomia has long been a problem for dentists. Microstomia is defined as an abnormally small oral orifice. Prosthetic rehabilitation of microstomia patients presents difficulties at all stages, from the preliminary impressions to fabrication of prosthesis. This study described a method for making impressions for patients with limited opening of the oral cavity which the use of a full-size impression tray was not possible.

Determining level of care appropriateness in the patient journey from acute care to rehabilitation

Science.gov (United States)

2011-01-01

Background The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual utilization review tool, modified to also include reasons why utilization criteria are not met. Additional data on team decision making about appropriateness for rehabilitation, and readiness for transfer, were collected on a subset of patients. Results There were 696 episodes of care (7189 bed days). Days meeting acute level of care criteria were 56% (stroke, hip fracture and joint replacement patients) and 33% (other patients, from the time of referral). Most inappropriate days in acute care were due to delays in processes/scheduling (45%) or being more appropriate for rehabilitation or lower level of care (30%). On the subset of patients, the acute care team and the utilization review tool deemed patients ready for rehabilitation transfer earlier than the rehabilitation team (means of 1.4, 1.3 and 4.0 days from the date of referral, respectively). From when deemed medically stable for transfer by the acute care team, 28% of patients became unstable. From when deemed stable by the rehabilitation team or utilization review, 9% and 11%, respectively, became unstable. Conclusions A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of care, including

Determining level of care appropriateness in the patient journey from acute care to rehabilitation

Directory of Open Access Journals (Sweden)

Bashford Guy

2011-10-01

Full Text Available Abstract Background The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual utilization review tool, modified to also include reasons why utilization criteria are not met. Additional data on team decision making about appropriateness for rehabilitation, and readiness for transfer, were collected on a subset of patients. Results There were 696 episodes of care (7189 bed days. Days meeting acute level of care criteria were 56% (stroke, hip fracture and joint replacement patients and 33% (other patients, from the time of referral. Most inappropriate days in acute care were due to delays in processes/scheduling (45% or being more appropriate for rehabilitation or lower level of care (30%. On the subset of patients, the acute care team and the utilization review tool deemed patients ready for rehabilitation transfer earlier than the rehabilitation team (means of 1.4, 1.3 and 4.0 days from the date of referral, respectively. From when deemed medically stable for transfer by the acute care team, 28% of patients became unstable. From when deemed stable by the rehabilitation team or utilization review, 9% and 11%, respectively, became unstable. Conclusions A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of

The development of an adaptive upper-limb stroke rehabilitation robotic system

Science.gov (United States)

2011-01-01

Background Stroke is the primary cause of adult disability. To support this large population in recovery, robotic technologies are being developed to assist in the delivery of rehabilitation. This paper presents an automated system for a rehabilitation robotic device that guides stroke patients through an upper-limb reaching task. The system uses a decision theoretic model (a partially observable Markov decision process, or POMDP) as its primary engine for decision making. The POMDP allows the system to automatically modify exercise parameters to account for the specific needs and abilities of different individuals, and to use these parameters to take appropriate decisions about stroke rehabilitation exercises. Methods The performance of the system was evaluated by comparing the decisions made by the system with those of a human therapist. A single patient participant was paired up with a therapist participant for the duration of the study, for a total of six sessions. Each session was an hour long and occurred three times a week for two weeks. During each session, three steps were followed: (A) after the system made a decision, the therapist either agreed or disagreed with the decision made; (B) the researcher had the device execute the decision made by the therapist; (C) the patient then performed the reaching exercise. These parts were repeated in the order of A-B-C until the end of the session. Qualitative and quantitative question were asked at the end of each session and at the completion of the study for both participants. Results Overall, the therapist agreed with the system decisions approximately 65% of the time. In general, the therapist thought the system decisions were believable and could envision this system being used in both a clinical and home setting. The patient was satisfied with the system and would use this system as his/her primary method of rehabilitation. Conclusions The data collected in this study can only be used to provide insight into

Glenohumeral osteoarthritis: overview, therapy, and rehabilitation.

Science.gov (United States)

Macías-Hernández, Salvador Israel; Morones-Alba, Juan Daniel; Miranda-Duarte, Antonio; Coronado-Zarco, Roberto; Soria-Bastida, María de Los Angeles; Nava-Bringas, Tania; Cruz-Medina, Eva; Olascoaga-Gómez, Andrea; Tallabs-Almazan, Laura Verónica; Palencia, Chanell

2017-08-01

Glenohumeral osteoarthritis (GHOA) is a common cause of pain and functional disability of the shoulder. Despite the limited evidence, there are several options for the treatment of this pathology. The aim of this article is to provide current information on the characteristics of the disease and the pathophysiology, evidence based on medical and surgical treatments with emphasis on the rehabilitation process. It was performed with an extensive literature review, mainly clinical practice guidelines, randomized controlled trials, reviews, focusing on the rehabilitation management. There are few clinical practice guidelines that address GHOA as a pathology with unique characteristics. Evidence based treatment recommendations are mostly supported by low-quality evidence and experts' opinions, with few high levels of evidence studies guiding treatment decisions. Despite the lack of good quality evidence, rehabilitation programs have proven to be efficient and reliable, and this revision provides information and recommendations in this field. Implication of Rehabilitation Glenohumeral osteoarthritis is a common cause of pain and functional disability of the shoulder There are few clinical practice guidelines that address Glenohumeral Osteoarthritis as a pathology with unique characteristics, and recommendations for rehabilitation and therapeutic exercise are poor The paper provides current information on the characteristics of the disease, its rehabilitation process, and could be of interest for rehabilitation professionals to direct their practices in this field.

Prioritizing sewer rehabilitation projects using AHP-PROMETHEE II ranking method.

Science.gov (United States)

Kessili, Abdelhak; Benmamar, Saadia

2016-01-01

The aim of this paper is to develop a methodology for the prioritization of sewer rehabilitation projects for Algiers (Algeria) sewer networks to support the National Sanitation Office in its challenge to make decisions on prioritization of sewer rehabilitation projects. The methodology applies multiple-criteria decision making. The study includes 47 projects (collectors) and 12 criteria to evaluate them. These criteria represent the different issues considered in the prioritization of the projects, which are structural, hydraulic, environmental, financial, social and technical. The analytic hierarchy process (AHP) is used to determine weights of the criteria and the Preference Ranking Organization Method for Enrichment Evaluations (PROMETHEE II) method is used to obtain the final ranking of the projects. The model was verified using the sewer data of Algiers. The results have shown that the method can be used for prioritizing sewer rehabilitation projects.

Whose decision is it anyway? How clinicians support decision-making participation after acquired brain injury.

Science.gov (United States)

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2013-01-01

To raise professional awareness of factors that may influence the support offered by clinicians to people with acquired brain injury (ABI), and to consider the potential implications of these factors in terms of post-injury rehabilitation and living. A review of the literature was conducted to identify factors that determine how clinicians provide support and influence opportunities for individuals with ABI to participate in decision making across the rehabilitation continuum. Clinical case studies are used to highlight two specific issues: (1) hidden assumptions on the part of the practitioner, and (2) perceptions of risk operating in clinical practice. There are a range of factors which may influence the decision-making support provided by clinicians and, ultimately, shape lifetime outcomes for individuals with ABI. A multidimensional framework may assist clinicians to identify relevant factors and consider their potential implications including those that influence how clinicians involved in supporting decision making approach this task. Participation in decision making is an undisputed human right and central to the provision of person-centred care. Further research is required to understand how clinical practice can maximise both opportunities and support for increased decision-making participation by individuals with ABI. There is an increasing focus on the rights of all individuals to be supported to participate in decision making about their life. A number of changes associated with ABI mean that individuals with ABI will require support with decision making. Clinicians have a critical role in providing this support over the course of the rehabilitation continuum. Clinicians need to be aware of the range of factors that may influence the decision-making support they provide. A multidimensional framework may be used by clinicians to identify influences on the decision-making support they provide.

Rehabilitating a patient with bruxism-associated tooth tissue loss: a literature review and case report.

Science.gov (United States)

Yip, Kevin Hak-Kong; Chow, Tak W; Chu, Frederick C S

2003-01-01

Tooth tissue loss from bruxism has been demonstrated to be associated with various dental problems such as tooth sensitivity, excessive reduction of clinical crown height, and possible changes of occlusal relationship. A literature search revealed a number of treatment modalities, with an emphasis on prevention and rehabilitation with adhesive techniques. Rehabilitating a patient with bruxism-associated tooth tissue loss to an acceptable standard of oral health is clinically demanding and requires careful diagnosis and proper treatment planning. This article describes the management of excessive tooth tissue loss in a 43-year-old woman with a history of bruxism. The occlusal vertical dimension of the patient was re-established with the use of an acrylic maxillary occlusal splint, followed by resin composite build-up. Full-mouth oral rehabilitation ultimately involved constructing multiple porcelain veneers, adhesive gold onlays, ceramo-metal crowns, and fixed partial dentures.

Research in rehabilitation treatment for patients with severe traumatic Brain Injury

DEFF Research Database (Denmark)

Schow, Trine

2010-01-01

it difficult if not impossible to investigate treatment outcome. This thesis has dealt with one of the widely used rehabilitation approaches used for, among others, swallowing difficulties: Facial Oral Tract Therapy (FOTT) ©. The studies in this thesis show that swallowing difficulties often occur in patients......  The therapeutic rehabilitation of patients with traumatic brain injury (TBI) has a limited evidence-based foundation. The current rehabilitation approaches have been developed mainly through clinical practice. They often consist of many components that are defined in incomplete ways, making...... with severe TBI admitted for subacute rehabilitation (93%), pneumonia was found in 12%. The many components of FOTT are defined in a treatment manual; we developed and tested a method that can measure whether therapist uses FOTT appropriately. In addition, we developed and validated a FOTT clinical evaluation...

Prosthetic rehabilitation of a patient after partial maxillectomy: A clinical report

OpenAIRE

Rodrigues, Shobha J.; Saldanha, Sharon

2011-01-01

Malignant melanoma of the oral cavity is very rare. This clinical report describes a method for prosthetic rehabilitation of a patient with malignant melanoma of the palate following partial maxillectomy with a closed hollow interim obturator.

Telescopic overdenture for oral rehabilitation of ectodermal dysplasia patient

OpenAIRE

Gupta, Charu; Verma, Mahesh; Gupta, Rekha; Gill, Shubhra

2015-01-01

Reduced number of teeth with underdeveloped alveolar ridges poses a greatest prosthetic challenge in rehabilitation of ectodermal dysplasia patients (ED). Furthermore, surgical risks and financial constraints may preclude the implant supported prosthesis, the most desirable treatment option in an adult ED patient. Long edentulous span does not permit fixed dental prosthesis (FDP) as well. Telescopic denture by incorporating the best of both fixed and removable prosthesis can be a viable treat...

Understanding consumer and clinician preferences and decision making for rehabilitation following arthroplasty in the private sector.

Science.gov (United States)

Buhagiar, Mark A; Naylor, Justine M; Simpson, Grahame; Harris, Ian A; Kohler, Friedbert

2017-06-19

To understand private consumer and clinician preferences towards different rehabilitation modes following knee or hip arthroplasty, and identify factors which influence the chosen rehabilitation pathway. Mixed methods cross-sectional study involving 95 semi-structured interviews of consumers (patients and carers) and clinicians (arthroplasty surgeons, physiotherapists and rehabilitation physicians) in Sydney, Australia, during 2014-2015. Participants were asked about the acceptability of different modes of rehabilitation provision, and factors influencing their chosen rehabilitation pathway. Interviews were in person or via the telephone. Qualitative analysis software was used to electronically manage qualitative data. An analytical approach guided data analysis. Pre-operative preferences strongly influenced the type of rehabilitation chosen by consumers. Key factors that influenced this were both intrinsic and extrinsic, including; the previous experience of self or known others, the perceived benefits of the chosen mode, a sense of entitlement, the role of orthopaedic surgeons and influence of patient preference, a patient's clinical status post-surgery, the private hospital business model and insurance provider involvement. The acceptability of rehabilitation modes varied between clinician groups. No one rehabilitation mode provided following arthroplasty is singularly preferred by stakeholders. Factors other than the belief that a particular mode was more effective than another appear to dominate the pathway followed by private arthroplasty consumers, indicating evidence-based policies around rehabilitation provision may have limited appeal in the private sector.

[Decision making in cariology

NARCIS (Netherlands)

Verdonschot, E.H.A.M.; Liem, S.L.; Palenstein Helderman, W.H. van

2003-01-01

By conducting an oral examination, during radiographic examination and in treatment planning procedures dentists make numerous decisions. A dentist will be required to make his decisions explicit. Decision trees and decision analyses may play an important role. In a decision analysis, the

The effect of interventions to prevent and treat malnutrition in patients admitted for rehabilitation: a systematic review with meta-analysis.

Science.gov (United States)

Collins, J; Porter, J

2015-02-01

Malnutrition occurs frequently among patients in rehabilitation, leading to poorer outcomes. Evidence of the effects of interventions to prevent or treat malnutrition is required to guide clinical practice in this setting. This systematic review aimed to determine the effect of oral nutrition interventions implemented in rehabilitation on nutritional and functional outcomes. Five databases were searched to identify relevant publications; intervention trials of oral nutrition interventions (such as oral nutrition supplements, foodservice interventions, clinical care processes, enhanced eating environments) conducted with patients admitted for rehabilitation, reporting dietary intake, anthropometric, biochemical or functional outcomes. The reviewers determined study eligibility and assessed the included studies for risk of bias. Outcome data were combined narratively and by meta-analyses. From 1765 publications, 10 studies trialling oral nutrition supplements, foodservice interventions and clinical care processes (of neutral or positive quality) were identified. Compared to meals alone, oral nutritional supplements significantly improved energy and protein intake, with some evidence for improvements in anthropometry and length of stay. There was little evidence that speciality supplements were beneficial compared to standard versions. Meta-analyses demonstrated significantly greater energy [weighted mean difference (WMD) = 324 kcal, 212-436 kcal 95% confidence interval (CI)] and protein (WMD = 9.1 g, 0.2-17.9 g 95% CI) intake with energy dense meals. Opposing results were reported in studies investigating enhanced clinical care processes. The provision of oral nutrition supplements and energy dense meals improved energy and protein intake and therefore may comprise effective strategies for addressing malnutrition in rehabilitation. The effect of these strategies on other nutritional and functional outcomes should be explored further. © 2014 The British

Prosthetic rehabilitation of a patient after partial maxillectomy: A clinical report

Directory of Open Access Journals (Sweden)

Shobha J Rodrigues

2011-01-01

Full Text Available Malignant melanoma of the oral cavity is very rare. This clinical report describes a method for prosthetic rehabilitation of a patient with malignant melanoma of the palate following partial maxillectomy with a closed hollow interim obturator.

Acceptability and Feasibility of a Shared Decision-Making Model in Work Rehabilitation: A Mixed-Methods Study of Stakeholders' Perspectives.

Science.gov (United States)

Coutu, Marie-France; Légaré, France; Durand, Marie-José; Stacey, Dawn; Labrecque, Marie-Elise; Corbière, Marc; Bainbridge, Lesley

2018-04-16

Purpose To establish the acceptability and feasibility of implementing a shared decision-making (SDM) model in work rehabilitation. Methods We used a sequential mixed-methods design with diverse stakeholder groups (representatives of private and public employers, insurers, and unions, as well as workers having participated in a work rehabilitation program). First, a survey using a self-administered questionnaire enabled stakeholders to rate their level of agreement with the model's acceptability and feasibility and propose modifications, if necessary. Second, eight focus groups representing key stakeholders (n = 34) and four one-on-one interviews with workers were conducted, based on the questionnaire results. For each stakeholder group, we computed the percentage of agreement with the model's acceptability and feasibility and performed thematic analyses of the transcripts. Results Less than 50% of each stakeholder group initially agreed with the overall acceptability and feasibility of the model. Stakeholders proposed 37 modifications to the objectives, 17 to the activities, and 39 to improve the model's feasibility. Based on in-depth analysis of the transcripts, indicators were added to one objective, an interview guide was added as proposed by insurers to ensure compliance of the SDM process with insurance contract requirements, and one objective was reformulated. Conclusion Despite initially low agreement with the model's acceptability on the survey, subsequent discussions led to three minor changes and contributed to the model's ultimate acceptability and feasibility. Later steps will involve assessing the extent of implementation of the model in real rehabilitation settings to see if other modifications are necessary before assessing its impact.

Assessments of risk indices and decision-making support within risk based land management and sustainable rehabilitation of radioactive contaminated territories

International Nuclear Information System (INIS)

Yatsalo, B.; Didenko, V.; Golikov, V.

2002-01-01

Description of the applied Geoinformation Decision-Support System PRANA for risk based land management and rehabilitation of territories of Bryansk region (Russia), subjected to radioactive contamination as a result of the Chernobyl accident, is presented. The main blocks of PRANA DSS, including electronic maps, databases and models are described. Implementation of vector land use map with corresponding integration of different models allows integrating both local and regional level of analysis and practical implementation (from each field and settlement up to farm and district and regional levels). Some examples of model assessments (map of countermeasures and doses) are presented

Relatives´ strategies in sub-acute brain injury rehabilitation: the warrior, the observer and the hesitant

DEFF Research Database (Denmark)

Guldager, Rikke; Willis, Karen; Larsen, Kristian

2018-01-01

of rehabilitation. Conclusions: Acknowledging the relatives’ positions during the rehabilitation process enables better understanding and support of the relatives in the rehabilitation process in order to meet their (and thus the patients’) diverse needs. Relevance to clinical practice: The findings have practice...... implications in informing how clinicians meet, interact, communicate, and involve relatives of adult patients’ with traumatic brain injury in decision-making during rehabilitation....

Oral Rehabilitation and Management of Mentally Retarded

OpenAIRE

Solanki, Jitender; Khetan, Jitendra; Gupta, Sarika; Tomar, Deepak; Singh, Meenakshi

2015-01-01

High level of periodontal problems of dental caries are frequently observed in mentally handicapped children. This group of patients presents various problems when they face dental treatments. Identification of such population and providing them affordable oral health care is the new concept. A systematic method for identification and screening of persons with mental retardation has been developed and is being followed. Cost and fear are the most commonly cited barriers to dental care. Physic...

Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient

Directory of Open Access Journals (Sweden)

Philip S. Mehler

2010-01-01

Full Text Available Weight restoration is crucial for successful treatment of anorexia nervosa. Without it, patients may face serious or even fatal medical complications of severe starvation. However, the process of nutritional rehabilitation can also be risky to the patient. The refeeding syndrome, a problem of electrolyte and fluid shifts, can cause permanent disability or even death. It is essential to identify at-risk patients, to monitor them carefully, and to initiate a nutritional rehabilitation program that aims to avoid the refeeding syndrome. A judicious, slow initiation of caloric intake, requires daily management to respond to entities such as liver inflammation and hypoglycemia that can complicate the body's conversion from a catabolic to an anabolic state. In addition, nutritional rehabilitation should take into account clinical characteristics unique to these patients, such as gastroparesis and slowed colonic transit, so that measures can be taken to ameliorate the physical discomforts of weight restoration. Adjunct methods of refeeding such as the use of enteral or parenteral nutrition may play a small but important role in a select patient group who cannot tolerate oral nutritional rehabilitation alone.

Nutritional Rehabilitation: Practical Guidelines for Refeeding the Anorectic Patient

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Mehler, Philip S.; Winkelman, Amy B.; Andersen, Debbie M.; Gaudiani, Jennifer L.

2010-01-01

Weight restoration is crucial for successful treatment of anorexia nervosa. Without it, patients may face serious or even fatal medical complications of severe starvation. However, the process of nutritional rehabilitation can also be risky to the patient. The refeeding syndrome, a problem of electrolyte and fluid shifts, can cause permanent disability or even death. It is essential to identify at-risk patients, to monitor them carefully, and to initiate a nutritional rehabilitation program that aims to avoid the refeeding syndrome. A judicious, slow initiation of caloric intake, requires daily management to respond to entities such as liver inflammation and hypoglycemia that can complicate the body's conversion from a catabolic to an anabolic state. In addition, nutritional rehabilitation should take into account clinical characteristics unique to these patients, such as gastroparesis and slowed colonic transit, so that measures can be taken to ameliorate the physical discomforts of weight restoration. Adjunct methods of refeeding such as the use of enteral or parenteral nutrition may play a small but important role in a select patient group who cannot tolerate oral nutritional rehabilitation alone. PMID:20798756

Zygoma Implant-Supported Prosthetic Rehabilitation of a Patient After Bilateral Maxillectomy.

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Celakil, Tamer; Ayvalioglu, Demet Cagil; Sancakli, Erkan; Atalay, Belir; Doganay, Ozge; Kayhan, Kivanc Bektas

2015-10-01

Maxillectomy defects may vary from localized to extensive soft and hard tissue loss. In addition to physical and psychologic damages, functional and aesthetic aspects must be restored. This clinical report describes the rehabilitation of a patient with a zygoma implant-supported obturator prosthesis caused by a subtotal bilateral maxillectomy due to a squamous oral cell carcinoma. Prosthetic rehabilitation of this patient was performed after zygoma implant surgery. A maxillary obturator prosthesis supported by 2 osseointegrated zygoma implants was fabricated. Despite limited mouth opening and anatomic deficiencies, the patient's aesthetic and functional demands were fulfilled.

Among Patients Undergoing Ablative Treatment for Oral Cancer, Does the Provision of Oral Rehabilitation Improve the Quality of Life? A Review of the Current Literature.

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Petrosyan, Vahe; Ball, Dimity; Harrison, Rebecca; Ameerally, Phillip

2016-05-01

The impact of oral cancer and its treatment is well documented; therefore, oral rehabilitation (OH; eg, with prosthetics, osseointegrated implants, etc) can be indicated to restore some level of form, function, and well-being. The purpose of this study was to review the current literature and evaluate the impact of OH on quality of life (QoL) after ablative surgery. A systematic literature search was conducted using EMBASE, MEDLINE, and PsychINFO. The study population was composed of all articles published from 2000 to 2015. To be included, studies had to use validated, specific head and neck QoL measurements (European Organization for Research and Treatment of Cancer QoL Head and Neck Module or University of Washington QoL Questionnaire). Only 8 articles met these inclusion criteria. In this review, OH was the primary predictor variable and QoL was the primary outcome variable. The 8 articles reviewed used a range of designs, including 1 randomized controlled trial, 3 prospective cohort studies, 3 case series, and 1 single-measurement cross-sectional descriptive study. Sample sizes were small (n = 26 to 102), and there was limited randomization and control of intervention and comparator groups. The overall level of evidence was weak. All studies showed a link between OH and QoL, but the results varied in significance (P < .01 to P = .95). Overall, there appears to be improvement in QoL to varying degrees after OH. However, a more systematic use of QoL measurements is needed before any definitive conclusions can be drawn. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Rehabilitation of a patient with complete mandibulectomy and partial glossectomy

International Nuclear Information System (INIS)

Meyerson, M.D.; Johnson, B.H.; Weitzman, R.S.

1980-01-01

Following a number of radiologic and surgical procedures for the treatment of oral cancer, a patient with severe facial difigurement and alteration of the vocal tract acquired acceptable speech. Consultation among referring physicians and speech pathologists can aid such a patient by facilitating the rehabilitative process through improvement of communicative skills

Oral hygiene practices and knowledge among stroke-care nurses: A multicentre cross-sectional study.

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Ab Malik, Normaliza; Mohamad Yatim, Saari; Hussein, Norhayati; Mohamad, Hanita; McGrath, Colman

2017-12-21

To investigate oral health knowledge for stroke care and the clinical practices performed for oral hygiene care in Malaysia. Oral hygiene care following stroke is important as the mouth can act as a reservoir for opportunistic infections that can lead to aspirational pneumonia. A national cross-sectional survey was conducted in Malaysia among public hospitals where specialist stroke rehabilitation care is provided. All (16) hospitals were invited to participate, and site visits were conducted. A standardised questionnaire was employed to determine nurses' oral health knowledge for stroke care and existing clinical practices for oral hygiene care. Variations in oral health knowledge and clinical practices for oral hygiene care were examined. Questionnaires were completed by 806 nurses across 13 hospitals. Oral health knowledge scores varied among the nurses; their mean score was 3.7 (SD 1.1) out of a possible 5.0. Approximately two-thirds (63.6%, n = 513) reported that some form of "mouth cleaning" was performed for stroke patients routinely. However, only a third (38.3%, n = 309) reported to perform or assist with the clinical practice of oral hygiene care daily. Their oral health knowledge of stroke care was associated with clinical practices for oral hygiene care (p oral hygiene care is less than ideal, and there are deficiencies in oral health knowledge for stroke care. Oral health knowledge was associated with clinical practice of providing oral hygiene care. This has implications for training and integrating oral hygiene care within stroke rehabilitation. © 2017 John Wiley & Sons Ltd.

Factors influencing the provision of oral hygiene care following stroke: an application of the Theory of Planned Behaviour.

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Ab Malik, Normaliza; Mohamad Yatim, Saari; Lam, Otto L T; Jin, Lijian; McGrath, Colman

2018-04-01

This study aimed to examine "intention to" and "performance of" oral hygiene care to stroke patients using the Theory of Planned Behavior. A large scale survey of 13 centers in Malaysia was conducted involving 806 nurses in relation to oral hygiene care intentions and practices. In addition, information on personal and environmental factors was collected. The response rate was 95.6% (778/806). The domains of the Theory of Planned Behavior were significantly associated with general intention to perform oral hygiene care: attitudes (β = 0.21, p behavior control (β = 0.04, p behavior was associated with general intention scores (OR =1.13, 95%CI =1.05-1.22, p Theory of Planned Behavior provides understanding of "intention to" and "performance of" oral hygiene care to stroke patients. Several provider and environmental factors were also associated with intentions and practices. This has implications for understanding and improving the implementation of oral hygiene care in stroke rehabilitation. Implications for Rehabilitation Oral hygiene care is crucial for stroke patients as it can prevent oral health problems and potentially life threatening events (such as aspiration pneumonia). Despite oral hygiene care being relative simple to perform, it is often neglected during stroke rehabilitation. A large-scale national survey was conducted to understand "intentions to" and "performance of" oral hygiene care to stroke patients using the Theory of Planned Behavior social cognition model. These study findings may have implications and use in promoting oral hygiene care to stroke patients:i) by understanding the pathways and influences to perform oral hygiene care.ii) to conduct health promotion and health education based on behavioral models such as Theory of Planned Behavior.

Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape.

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Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline

2015-01-01

With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers

Hospitalisation impacts on oral hygiene: an audit of oral hygiene in a metropolitan health service.

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Danckert, Rachael; Ryan, Anna; Plummer, Virginia; Williams, Cylie

2016-03-01

Poor oral health has been associated with systemic diseases, morbidity and mortality. Many patients in hospital environments are physically compromised and rely upon awareness and assistance from health professionals for the maintenance or improvement of their oral health. This study aimed to identify whether common individual and environment factors associated with hospitalisation impacted on oral hygiene. Data were collected during point prevalence audits of patients in the acute and rehabilitation environments on three separate occasions. Data included demographic information, plaque score, presence of dental hygiene products, independence level and whether nurse assistance was documented in the health record. Data were collected for 199 patients. A higher plaque score was associated with not having a toothbrush (p = 0.002), being male (p = 0.007), being acutely unwell (p = 0.025) and requiring nursing assistance for oral hygiene (p = 0.002). There was fair agreement between the documentation of requiring assistance for oral care and the patient independently able to perform oral hygiene (ICC = 0.22). Oral hygiene was impacted by factors arising from hospitalisation, for those without a toothbrush and male patients of acute wards. Establishment of practices that increase awareness and promote good oral health should be prioritised. © 2015 Nordic College of Caring Science.

An application of the AHP in water resources management: a case study on urban drainage rehabilitation in Medan City

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Tarigan, A. P. M.; Rahmad, D.; Sembiring, R. A.; Iskandar, R.

2018-02-01

This paper illustrates an application of Analytical Hierarchy Process (AHP) as a potential decision-making method in water resource management related to drainage rehabilitation. The prioritization problem of urban drainage rehabilitation in Medan City due to limited budget is used as a study case. A hierarchical structure is formed for the prioritization criteria and the alternative drainages to be rehabilitated. Based on the AHP, the prioritization criteria are ranked and a descending-order list of drainage is made in order to select the most favorable drainages to have rehabilitation. A sensitivity analysis is then conducted to check the consistency of the final decisions in case of minor changes in judgements. The results of AHP computed manually are compared with that using the software Expert Choice. It is observed that the top three ranked drainages are consistent, and both results of the AHP methods, calculated manually and performed using Expert Choice, are in agreement. It is hoped that the application of the AHP will help the decision-making process by the city government in the problem of urban drainage rehabilitation.

Outcome of Rehabilitation and Swallowing Therapy after Percutaneous Endoscopic Gastrostomy in Dysphagia Patients.

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Toh Yoon, Ezekiel Wong; Hirao, Jun; Minoda, Naoko

2016-12-01

The objective of this study was to investigate the outcomes of rehabilitation (with swallowing therapy) after percutaneous endoscopic gastrostomy (PEG) in patients with neurogenic dysphagia. Forty-seven patients (29 males and 18 females) who were transferred to the rehabilitation ward of our hospital after receiving PEG tube placements during a 5-year period were enrolled in this study. Patients' demographic data, comorbidities, nutritional statuses, and laboratory biomarkers before the PEG procedure were collected. Rehabilitation (with swallowing therapy) outcomes such as changes in Functional Independence Measure (FIM) and dysphagia grade (using Fujishima's classification) were evaluated. Significant improvements in FIM scores and dysphagia grades after rehabilitation therapy were observed. Twenty-seven patients (57.4 %) were discharged with some oral intake and 10 patients (21.3%) were discharged PEG-free (defined as the PEG tube not being used or removed). Factors associated with being discharged with some oral intake were increase in FIM score (adjusted OR 1.10, 95 % CI 1.02-1.19) and higher baseline dysphagia grade (adjusted OR 1.88, 95 % CI 1.04-3.39). Factors associated with being discharged PEG-free were longer rehabilitation period (OR 1.03, 95 % CI 1.01-1.04), absence of respiratory disorders (OR 0.12, 95 % CI 0.03-0.35), and increase in FIM score (OR 1.17, 95 % CI 1.08-1.28). Changes in dysphagia grade were significantly correlated with changes in FIM score (r 2  = 0.46, p dysphagia.

Surgical Treatment, Oral Rehabilitation, and Orthognathic Surgery After Failure of Pharmacologic Treatment of Central Giant Cell Lesion: A Case Report.

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Maia Nogueira, Renato Luiz; Osterne, Rafael Lima Verde; Cavalcante, Roberta Barroso; Abreu, Ricardo Teixeira

2016-12-01

Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluating rehabilitation efforts following the Milford Flat Fire: successes, failures, and controlling factors

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Duniway, Michael C.; Palmquist, Emily C.; Miller, Mark E.

2015-01-01

Uncontrolled wildfire in arid and semiarid ecosystems has become an increasing concern in recent decades. Active rehabilitation of fire-affected areas is often quickly initiated to minimize long-term ecosystem damage. However, the complex soil-geomorphic-vegetation patterns and low and variable moisture conditions in these regions makes restoration challenging. To further inform these post-fire management decisions, we present results from 5 years of vegetation and sediment flux monitoring following the Milford Flat Fire in west-central Utah, USA. Our sampling design includes monitoring plots in areas not burned, areas burned but where no rehabilitation was attempted, and burned areas where various rehabilitation approaches were implemented. At each of the 25 plots, vegetation cover and composition data were collected annually, and wind-driven sediment flux was measured using passive dust traps. To evaluate effectiveness of post-fire rehabilitation treatments in establishing desired species and limiting dominance of undesired species, we analyzed the temporal response of individual species and functional groups as well as community-level multivariate responses. The warm and dry conditions that persisted for approximately 12 months post-treatment, coupled with the surface disturbing rehabilitation approaches used, resulted in near-surface dust fluxes several orders of magnitude higher in treated areas than in unburned or burned areas where no rehabilitation occurred. These dry conditions and high surface sediment flux limited the establishment of seeded species in rehabilitation areas for nearly 3 years. Post-fire rehabilitation did not limit dominance by invasive annual species of concern. Perennial species composition in the areas burned but not subject to post-fire rehabilitation was relatively similar to unburned throughout the study period. In contrast, the burned plots where rehabilitation was attempted were characterized by no (successful. Though dry

Rehabilitation of oropharyngeal dysphagia in children with cerebral palsy: A systematic review of the speech therapy approach

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Hirata, Gisela Carmona; Santos, Rosane Sampaio

2012-01-01

Summary Introduction: There are an estimated 30,000–40,000 new cases of cerebral palsy per year in Brazil. Motor disorders caused by cerebral palsy can lead to dysphagia as they may alter the preparatory, oral, pharyngeal, and esophageal phases. Aim: To identify existing rehabilitation methods of swallowing disorders in cerebral palsy, with emphasis on the pursuit of research using the Bobath concept, the Castillo Morales concept, oral sensorimotor therapy, and continuing education. Summary of the findings: We performed a systematic review of the medical and speech therapy literature on the rehabilitation of oropharyngeal dysphagia in children with cerebral palsy spanning 1977–2010 and from all languages and nations. Among the 310 articles retrieved, only 22 (7.09%) addressed therapeutic rehabilitation of oropharyngeal dysphagia in children with cerebral palsy. Of the 22 reports, 12 (54.5%) were from Canada, 3 (13.6%) were from Japan, 2 (9%) were from Brazil, 2 (9%) were from Germany, 1 (4.5%) was from the USA, 1 (4.5%) was from the United Kingdom, and 1 (4.5%) was from Poland. Of these reports, 63.6% used oral sensorimotor therapy as a therapeutic method, 36.3% reported continuing education as a therapeutic approach, and only 18.1% and 9% used the Bobath concept and Castillo Morales concept, respectively. Conclusion: Even with a constantly increasing cerebral palsy population, few studies include (re)habilitation in the treatment of oropharyngeal dysphagia in these children. PMID:25991964

Rehabilitation of oropharyngeal dysphagia in children with cerebral palsy: A systematic review of the speech therapy approach

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Hirata, Gisela Carmona

2012-01-01

Full Text Available Introduction: There are an estimated 30,000-40,000 new cases of cerebral palsy per year in Brazil. Motor disorders caused by cerebral palsy can lead to dysphagia as they may alter the preparatory, oral, pharyngeal, and esophageal phases. Aim: To identify existing rehabilitation methods of swallowing disorders in cerebral palsy, with emphasis on the pursuit of research using the Bobath concept, the Castillo Morales concept, oral sensorimotor therapy, and continuing education. Summary of the findings: We performed a systematic review of the medical and speech therapy literature on the rehabilitation of oropharyngeal dysphagia in children with cerebral palsy spanning 1977-2010 and from all languages and nations. Among the 310 articles retrieved, only 22 (7.09% addressed therapeutic rehabilitation of oropharyngeal dysphagia in children with cerebral palsy. Of the 22 reports, 12 (54.5% were from Canada, 3 (13.6% were from Japan, 2 (9% were from Brazil, 2 (9% were from Germany, 1 (4.5% was from the USA, 1 (4.5% was from the United Kingdom, and 1 (4.5% was from Poland. Of these reports, 63.6% used oral sensorimotor therapy as a therapeutic method, 36.3% reported continuing education as a therapeutic approach, and only 18.1% and 9% used the Bobath concept and Castillo Morales concept, respectively. Conclusion: Even with a constantly increasing cerebral palsy population, few studies include (rehabilitation in the treatment of oropharyngeal dysphagia in these children.

Aesthetic and Functional Rehabilitation of the Primary Dentition Affected by Amelogenesis Imperfecta

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Maria Carolina Salomé Marquezin

2015-01-01

Full Text Available The objective of this case report was to describe the oral rehabilitation of a five-year-old boy patient diagnosed with amelogenesis imperfecta (AI in the primary dentition. AI is a group of hereditary disorders that affects the enamel structure. The patient was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of AI. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms. The main objectives of the selected treatment were to enhance the esthetics, restore masticatory function, and eliminate the teeth sensitivity. The child was monitored in the pediatric dentistry clinic at four-month intervals until the mixed dentition stage. Treatment not only restored function and esthetic, but also showed a positive psychological impact and thereby improved perceived quality of life. The preventive, psychological, and curative measures of a young child with AI were successful. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, and resin-filled celluloid forms to reestablish the oral functions and improve the child’s psychosocial development.

Aesthetic and Functional Rehabilitation of the Primary Dentition Affected by Amelogenesis Imperfecta

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Marquezin, Maria Carolina Salomé; Zancopé, Bruna Raquel; Pacheco, Larissa Ferreira; Gavião, Maria Beatriz Duarte; Pascon, Fernanda Miori

2015-01-01

The objective of this case report was to describe the oral rehabilitation of a five-year-old boy patient diagnosed with amelogenesis imperfecta (AI) in the primary dentition. AI is a group of hereditary disorders that affects the enamel structure. The patient was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of AI. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms. The main objectives of the selected treatment were to enhance the esthetics, restore masticatory function, and eliminate the teeth sensitivity. The child was monitored in the pediatric dentistry clinic at four-month intervals until the mixed dentition stage. Treatment not only restored function and esthetic, but also showed a positive psychological impact and thereby improved perceived quality of life. The preventive, psychological, and curative measures of a young child with AI were successful. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, and resin-filled celluloid forms to reestablish the oral functions and improve the child's psychosocial development. PMID:25705526

The role of rehabilitation specialists in Canadian NICUs: a national survey.

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Limperopoulos, Catherine; Majnemer, Annette

2002-01-01

Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). A national survey was conducted to elucidate the current roles of rehabilitation specialists. Occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) departments in all Canadian health care institutions with tertiary level NICUs (n = 38) were surveyed by telephone. Results indicate that 16% have no rehabilitation coverage, while 11% receive very limited external services (< 1/month). Over half of the OT and PT departments provide weekly services whereas only 5/38 provide SLP coverage. Service delivery includes assessment and a number of therapeutic interventions. Splinting and feeding are predominantly performed by OT, whereas chest physiotherapy and ROM are carried out primarily by PT. Rehabilitation specialists are actively involved in education and case management. The extent of involvement of rehabilitation specialists was discrepant, and highly associated with the type of facility. Rehabilitation services, when provided, are comprehensive and include evaluation, treatment, teaching, decision-making, and family support.

Prosthetic rehabilitation in a four-year-old child with severe early childhood caries: a case report.

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Parisotto, Thaís Manzano; de Souza-E-Silva, Cintia Maria; Steiner-Oliveira, Carolina; Nobre-dos-Santos, Marinês; Gavião, Maria Beatriz Duarte

2009-03-01

The purpose of this case report was to describe the oral rehabilitation of a 4-year-old girl presenting early childhood caries (ECC). ECC is highly prevalent in developing countries and its severity increases with age. This disease implies serious consequences for the development of the stomatognathic system and for the child's quality of life. As young children are usually anxious about dental treatment, their level of co-operation is limited, leading to a challenging situation. A 4-year-old girl was brought by her mother for dental treatment with the complaint of pain. The clinical examination revealed extensive carious coronary destructions. After preventive and curative measures, the oral rehabilitation was performed; it included the use of stainless steel crowns, resin filled celluloid crowns with previous cementation of glass post pins when necessary, an amalgam restoration, orthodontic treatment, and a partial removable prosthesis. The child has been monitored in the Pediatric Dentistry Clinic at 4-monthly intervals. The oral rehabilitation was able to reestablish the oral health in the primary arches mutilated by early childhood caries. This is important for the establishment of an adequate mixed and permanent dentition, for proper facial and maxillary growth, and to the child's psychological and social development. The full management, including preventive, psychological, and curative measures of a young child with severe ECC was found successful after 8 months of follow up. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, resin filled celluloid crowns, and partial removable prosthesis to reestablish the oral functions and improve the child's psycho-social development.

Tissue integration in oral and maxillo-facial reconstruction

International Nuclear Information System (INIS)

Van Steenberghe, D.

1986-01-01

These proceedings on tissue-integrated prostheses in the rehabilitation of the head and neck area cover both basic scientific and clinical aspects in intra- as well as extra-oral applications. Also the discussions and conclusions of the 'State-of-the-Art' meeting are included. (Auth.)

Factors affecting return to oral intake in inpatient rehabilitation after acquired brain injury.

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Kjaersgaard, Annette; Nielsen, Lars Hedemann; Sjölund, Bengt H

2015-01-01

To extend previous observations by investigating if differences exist in time to initiation or to recovery of total oral intake in patients with acquired brain injury assessed by either Facial-Oral Tract Therapy (F.O.T.T.) or Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and to investigate whether other factors influence these outcomes. Randomized controlled trial. One hundred and nineteen patients with dysphagia in inpatient neurorehabilitation were randomized. The main outcome was time to maximum on the Functional Oral Intake Scale. There was no difference in time to initiation or recovery of total oral intake using F.O.T.T. or FEES. Oral intake was initiated for 42% on admission and 92% at discharge; 2.5% of the patients were on total oral intake within 24 hours of admission and 37% at discharge. The likelihood of recovery to total oral intake before discharge was found to depend on age, Functional Independence Measure score, length of stay and number of dysphagia interventions. There was no significant difference in time to initiation and recovery of total oral intake before discharge, whether assessed by F.O.T.T. or FEES, indicating that an instrumental assessment is unnecessary for standard evaluation. Age, functional independence and length of stay had a significant influence.

Orodental status and medical problems of stroke inpatients undergoing rehabilitation at a rehabilitation hospital in Japan.

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Asahi, Yoshinao; Omichi, Shiro; Ono, Takahiro

2015-09-01

Many stroke patients may have oral problems and systemic diseases, but clinical information on treatment provided to stroke patients for dental problems during inpatient rehabilitation is rare. The objective of this study was to research stroke inpatients' requirements for dental treatment and the accompanying risks. We included 165 stroke patients undergoing inpatient rehabilitation at Morinomiya Hospital during the year 2010 and researched the causes of stroke and the patients' orodental status, underlying diseases, antithrombotic drugs prescribed and special considerations or difficulties in the treatment. Cerebral infarction was the most common causes of stroke. Many patients had hypertension, heart disease or diabetes mellitus, and 54.5% had been prescribed antithrombotic drugs. Dentists diagnosed 57.0% patients with untreated dental cavities. Approximately 30% did not use dentures despite having a requirement. In total, 142 patients underwent dental treatment including periodontal treatment, prosthetic treatment and tooth extraction under management of circulation and haemostasis such as monitoring vital signs and surgical splints in cases of the difficult extraction. The current study revealed a high requirement for dental treatment among stroke patients and demonstrated the effectiveness of performing dental treatment during inpatient rehabilitation of these patients. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

An Interdisciplinary Approach for Rehabilitating a Patient with Amelogenesis Imperfecta: A Case Report

Directory of Open Access Journals (Sweden)

Niloufar Khodaeian

2012-01-01

Full Text Available Amelogenesis imperfecta (AI has been defined as a group of hereditary enamel defects. It can be characterized by enamel hypoplasia, hypomaturation, or hypocalcification of the teeth. AI may be associated with some other dental and skeletal developmental defects. Restoration for patients with this condition should be oriented toward the functional and esthetic rehabilitation. This clinical report describes the oral rehabilitation of a young patient diagnosed with the hypoplastic type of AI in posterior teeth and hypomatured type of AI in anterior teeth.

Oral Rehabilitation in a Patient with Major Maxillofacial Trauma: A Case Management

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Elif Bahar Tuna

2012-01-01

Full Text Available Traumatic injuries may cause anatomic deficiencies in soft and hard tissues. These defects often result in the loss of attached mucosa and alveolar processes, which might reduce potential prosthesis support and require bone and skin grafting. As a result of major maxillofacial trauma, complete or partial avulsion of the palate may require extensive surgical and prosthodontic rehabilitation. The appropriate treatment for the maxillary defect demands a multidisciplinary approach by a team which consists of various fields of dentistry and medicine. The planning prostheses should replace not only missing teeth but also lost soft tissues and bone, and they should include the hard palate, residual alveolar ridges, and, in some instances, the soft palate. This paper describes the treatment procedures including plastic surgery operation procedures and prosthetic rehabilitation in a 19-year-old woman after her severe bicycle accident.

Knowledge Translation: The Bridging Function of Cochrane Rehabilitation.

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Negrini, Stefano; Gimigliano, Francesca; Arienti, Chiara; Kiekens, Carlotte

2017-12-12

Cochrane Rehabilitation is aimed to ensure that all rehabilitation professionals can apply Evidence Based Clinical Practice and take decisions according to the best and most appropriate evidence in this specific field, combining the best available evidence as gathered by high-quality Cochrane systematic reviews, with their own clinical expertise and the values of patients. This mission can be pursued through knowledge translation. The aim of this article is to shortly present what knowledge translation is, how and why Cochrane (previously known as Cochrane Collaboration) is trying to reorganize itself in light of knowledge translation, and the relevance that this process has for Cochrane Rehabilitation and in the end for the whole world of rehabilitation. It is well known how it is difficult to effectively apply in everyday life what we would like to do and to apply the scientific knowledge in the clinical field: this is called the know-do gap. In the field of evidence-based medicine, where Cochrane belongs, it has been proven that high-quality evidence is not consistently applied in practice. A solution to these problems is the so-called knowledge translation. In this context, Cochrane Rehabilitation is organized to provide the best possible knowledge translation in both directions (bridging function), obviously toward the world of rehabilitation (spreading reviews), but also to the Cochrane community (production of reviews significant for rehabilitation). Cochrane is now strongly pushing to improve its knowledge translation activities, and this creates a strong base for Cochrane Rehabilitation work, focused not only on spreading the evidence but also on improving its production to make it more meaningful for the world of rehabilitation. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Opting in and opting out: a grounded theory of nursing's contribution to inpatient rehabilitation.

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Pryor, Julie; Walker, Annette; O'Connell, Beverly; Worrall-Carter, Linda

2009-12-01

To develop a grounded theory of nursing's contribution to patient rehabilitation from the perspective of nurses working in inpatient rehabilitation. Grounded theory method, informed by the theoretical perspective of symbolic interactionism, was used to guide data collection and analysis, and the development of a grounded theory. Five inpatient rehabilitation units in Australia. Thirty-five registered and 18 enrolled nurses participated in audio-taped interviews and/or were observed during periods of their everyday practice. The analysis revealed a situation whereby nurses made decisions about when to 'opt in' and when to 'opt out' of inpatient rehabilitation. This occurred on two levels: with their interaction with patients and allied health professionals, and when faced with negative system issues that impacted on their ability to contribute to patient rehabilitation. The primary contribution nurses made to inpatient rehabilitation was working directly with patients, enabling them to self-care. Nurses coached patients when their decisions about 'opting in' and 'opting out' were based on assessment of the person in their particular context. In contrast, the nurses mostly distanced themselves from system-based problems, 'opting out' of addressing them. They did this not to make their working lives easier, but more manageable. System-based problems impacted negatively on the nurses' ability to deliver comprehensive rehabilitation care. As a consequence, some nurses felt unable to influence the care and they withdrew professionally to make their work lives more manageable.

Evaluating rehabilitation efforts following the Milford Flat Fire: successes, failures, and controlling factors

Science.gov (United States)

Duniway, Michael C.; Palmquist, Emily C.; Miller, Mark E.

2015-01-01

Uncontrolled wildfire in arid and semiarid ecosystems has become an increasing concern in recent decades. Active rehabilitation of fire-affected areas is often quickly initiated to minimize long-term ecosystem damage. However, the complex soil-geomorphic-vegetation patterns and low and variable moisture conditions in these regions makes restoration challenging. To further inform these post-fire management decisions, we present results from 5 years of vegetation and sediment flux monitoring following the Milford Flat Fire in west-central Utah, USA. Our sampling design includes monitoring plots in areas not burned, areas burned but where no rehabilitation was attempted, and burned areas where various rehabilitation approaches were implemented. At each of the 25 plots, vegetation cover and composition data were collected annually, and wind-driven sediment flux was measured using passive dust traps. To evaluate effectiveness of post-fire rehabilitation treatments in establishing desired species and limiting dominance of undesired species, we analyzed the temporal response of individual species and functional groups as well as community-level multivariate responses. The warm and dry conditions that persisted for approximately 12 months post-treatment, coupled with the surface disturbing rehabilitation approaches used, resulted in near-surface dust fluxes several orders of magnitude higher in treated areas than in unburned or burned areas where no rehabilitation occurred. These dry conditions and high surface sediment flux limited the establishment of seeded species in rehabilitation areas for nearly 3 years. Post-fire rehabilitation did not limit dominance by invasive annual species of concern. Perennial species composition in the areas burned but not subject to post-fire rehabilitation was relatively similar to unburned throughout the study period. In contrast, the burned plots where rehabilitation was attempted were characterized by no (post-fire rehabilitation

Rehabilitation of Posterior Maxilla with Obturator Supported by Zygomatic Implants

Directory of Open Access Journals (Sweden)

Sankalp Mittal

2018-01-01

Full Text Available Prosthetic rehabilitation of atrophic maxilla and large maxillary defects can be done successfully by zygomatic implant-supported prosthesis. Zygomatic implants are an avant-garde to complex and invasive-free vascularised osteocutaneous flaps, distraction osteogenesis, and the solution to flap failures. A treated case of tuberculous osteomyelitis, with a class II (Aramany’s classification maxillary defect, reported to oral maxillofacial department, Government Dental College (RUHS-CODS. The defect in this group was unilateral, retaining the anterior teeth. The patient was previously rehabilitated with a removable maxillary obturator. Inadequate retention affected essential functions like speaking, mastication, swallowing, esthetics, and so on due to lack of sufficient supporting tissues. A fixed prosthetic rehabilitation of posterior maxillary defect was done with obturator supported with two single-piece zygomatic implants. At 1-year follow-up, the patient was comfortable with the prosthesis, and no further complaints were recorded.

"Rehabilitation schools for scoliosis" thematic series: describing the methods and results

OpenAIRE

Rigo, Manuel D; Grivas, Theodoros B

2010-01-01

Abstract The Scoliosis Rehabilitation model begins with the correct diagnosis and evaluation of the patient, to make treatment decisions oriented to the patient. The treatment is based on observation, education, scoliosis specific exercises, and bracing. The state of research in the field of conservative treatment is insufficient. There is some evidence supporting scoliosis specific exercises as a part of the rehabilitation treatment, however, the evidence is poor and the different methods ar...

Study on Language Rehabilitation for Aphasia.

Science.gov (United States)

Yu, Zeng-Zhi; Jiang, Shu-Jun; Jia, Zi-Shan; Xiao, Hong-Yu; Zhou, Mei-Qi

2017-06-20

The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015. Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based. The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full. Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians' first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine. At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia.

Tissue engineering: state of the art in oral rehabilitation.

Science.gov (United States)

Scheller, E L; Krebsbach, P H; Kohn, D H

2009-05-01

More than 85% of the global population requires repair or replacement of a craniofacial structure. These defects range from simple tooth decay to radical oncologic craniofacial resection. Regeneration of oral and craniofacial tissues presents a formidable challenge that requires synthesis of basic science, clinical science and engineering technology. Identification of appropriate scaffolds, cell sources and spatial and temporal signals (the tissue engineering triad) is necessary to optimize development of a single tissue, hybrid organ or interface. Furthermore, combining the understanding of the interactions between molecules of the extracellular matrix and attached cells with an understanding of the gene expression needed to induce differentiation and tissue growth will provide the design basis for translating basic science into rationally developed components of this tissue engineering triad. Dental tissue engineers are interested in regeneration of teeth, oral mucosa, salivary glands, bone and periodontium. Many of these oral structures are hybrid tissues. For example, engineering the periodontium requires growth of alveolar bone, cementum and the periodontal ligament. Recapitulation of biological development of hybrid tissues and interfaces presents a challenge that exceeds that of engineering just a single tissue. Advances made in dental interface engineering will allow these tissues to serve as model systems for engineering other tissues or organs of the body. This review will begin by covering basic tissue engineering principles and strategic design of functional biomaterials. We will then explore the impact of biomaterials design on the status of craniofacial tissue engineering and current challenges and opportunities in dental tissue engineering.

Shortcomings of prosthodontic rehabilitation of patients living in long-term care facilities.

Science.gov (United States)

Steinmassl, P-A; Steinmassl, O; Kraus, G; Dumfahrt, H; Grunert, I

2016-04-01

Removable dentures are a non-invasive, cost-effective prosthodontic solution for the reduced dentition. Their intended purpose is the rehabilitation of harmonious oral function and aesthetics on a long-term basis. The prevalence of removable dentures among patients of advanced age is high and the quality of the dentures is often poor. The aim of this study was to find the most important shortcomings of removable dentures and address the main targets for improving the quality of prosthodontic rehabilitation. The records from dental check-ups in Austrian residential homes were analysed retrospectively. Dental anamnesis questionnaires and data from the clinical examinations of 105 denture wearers were analysed. The functional condition and retention of 192 dentures had been assessed, as well as the impact of the dentures on the intra-oral tissues. Insufficient denture retention was very common, particularly in the lower jaw (56·0%). Problems with the masticatory function were reported by 26.7% of the denture wearers, 11·4% were dissatisfied with the denture aesthetics, and 4·8% had difficulties with phonetics. Traumatic ulcers were found in 18·1%. Cracks, broken pieces (6·3%) or missing denture teeth (2·1%) were rare. It may be assumed that the findings of the present study also apply to a great percentage of community-dwelling seniors. The most important issues in prosthodontic rehabilitation with removable dentures are denture retention and masticatory function. Regular dental check-ups, denture adjustment and, when necessary, relining can maintain the primary denture quality and prevent damages of the oral tissues caused by ill-fitting dentures. © 2015 John Wiley & Sons Ltd.

[Networking as a subject of research and quality characteristic of rehabilitation].

Science.gov (United States)

Mau, W

2010-12-01

Rehabilitation has to meet numerous challenges in the sectorized health service and social security system. Rehabilitation science has analysed these problems at the interfaces between different actors and domains of care in a number of studies. In research projects and quality assurance, the solution-oriented and networking aspects of rehabilitation particularly of persons with chronic illnesses and disabilities are of interest. Therefore, exemplary studies concerning interface analyses leading to solutions and networking activities are discussed in this article. Different problems and fields of action regarding access to rehabilitation are presented: the role of physicians in practice concerning the patients' applications for rehabilitation, post-acute rehabilitation since introduction of the Diagnosis Related Groups in the acute hospital setting, and the involvement of companies and different funding agencies. With regard to networking in rehabilitation, issues dealt with are work-related interventions as well as challenges for the rehabilitation team concerning joint presentation of concepts in the face of an increasing differentiation of competences and a new distribution of roles and tasks. In this context, quality management within the rehabilitation facilities as well as internal and external patient-orientation including shared decision-making are highly significant during the rehabilitation process. The planning of activities to be realized after discharge from the rehabilitation facility is dealt with in greater detail in view of recommendations for and implementation of physical activities and stepwise return-to-work measures. Rehabilitation has an important course-setting function by supporting rehabilitants on their way toward self-management. Networking within, including and by means of rehabilitation requires considerable effort, which needs to be followed along by research and quality assurance. Due to its multifaceted competences and experiences

Community ambulation: influences on therapists and clients reasoning and decision making.

Science.gov (United States)

Corrigan, Rosemary; McBurney, Helen

2008-01-01

Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

Prevalence of Presenting Conditions in Grey Seal Pups (Halichoerus grypus Admitted for Rehabilitation

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Marc A. C. Silpa

2015-01-01

Full Text Available A retrospective survey was performed on the presenting conditions of 205 live grey seal pups (Halichoerus grypus admitted to the Cornish Seal Sanctuary in Gweek, United Kingdom between May 2005 and March 2011. The purpose of the survey was to examine the prevalence of various presenting signs at the sanctuary. The presenting signs were classified into nine non-mutually exclusive categories: ocular disorders, nasal disorders, oral disorders, respiratory disorders, orthopaedic disorders, puncture wounds, abrasions, netting injuries, and onychia. The sex ratio of seal pups in this study was 1.35 males per female. Of the 205 examined for rehabilitation, 22 (10.73% did not survive to release. 68.78% of grey seal pups presented with puncture wounds, 47.80% with respiratory disorders, 46.34% with ocular disorders, 42.63% malnourished, 36.59% with abrasions, 25.37% with oral disorders, 23.90% with nasal disorders, 11.71% with orthopaedic disorders, 9.27% with onychia, and 3.41% presented with netting injuries. 52% were normothermic, 42% were hyperthermic, and 5% were hypothermic. Associations between gender, outcome of rehabilitation, hospitalisation time and presenting disorders were examined. In addition, admissions rates were found to display seasonality. The results of this study will aid in future preparation of grey seal rehabilitation facilities.

Complaints reported by patients with cancer of oral cavity, submitted to radiotherapy; Queixas apresentadas pelos pacientes submetidos a radioterapia de cavidade oral

Energy Technology Data Exchange (ETDEWEB)

Bergamasco, Mariana; Miranda, Renata Puccinelli de [Centro Universitario de Araraquara - UNIARA, SP (Brazil)]. E-mail: mari_bergamasco@yahoo.com.br

2006-01-15

The oral cavity is of fundamental importance to the speech, chewing, deglutition, suction and salivation functions. When an illness like cancer develops in this region, radiation therapy is very important, but can cause many sequels to the affected functions and structures of the Oral Motor System, especially to chewing, deglutition and speech. In such cases, the phonoaudiology support as part of a multidisciplinary staff can help providing esthetic and functional rehabilitation as well as social re-integration for a better quality of life of these patients. (author)

Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System.

Science.gov (United States)

Armstrong, Joshua J; Sims-Gould, Joanie; Stolee, Paul

Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial.

Zygoma implants in oral rehabilitation: A review of 28 cases.

Science.gov (United States)

Agbara, Rowland; Goetze, Elizabeth; Koch, Felix; Wagner, Wilfred

2017-01-01

The functional and esthetic rehabilitation of patients with atrophic maxilla or posterior maxillary defect is often challenging. The aim of this study was to determine patient demographics, indications, success rate, and complications following the use of zygoma implants. All patients who had zygoma implant placement in our clinic between 1998 and 2013 were retrospectively assessed for implant outcome. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 16 and Microsoft Excel 2007 test for significance (ρ) using Pearson's Chi-square (χ 2 ) set at 0.05. A total of 28 patients consisting of 22 females (78.6%) and 6 males (21.4%) were treated, and their age ranged from 41 years to 83 years with a mean age of 60.3 ± 10.6 years. The main indication for zygoma implant placement was atrophic maxilla 12 (42.9%). In the prosthetic rehabilitation of the patients, 2 had epithetic prostheses, and 2 had obturators while 18 patients had conventional removable dental prostheses. Four patients (14.3%) had perimplantitis and one implant was accidentally placed into the maxillary sinus. A cumulative success rate of 88.1% was obtained from this retrospective analysis. A cumulative success rate of 88.1% reported in this study is lower than the reports from other studies. The difference in success rates may be related to different criteria for assessment of zygoma implant success and to the difference in inclusion criteria and follow-up period.

Lumbar spinal fusion patients' demands to the primary health sector: evaluation of three rehabilitation protocols

DEFF Research Database (Denmark)

Soegaard, Rikke; Christensen, Finn B; Lauerberg, Ida

2006-01-01

Very few studies have investigated the effects or costs of rehabilitation regimens following lumbar spinal fusion. The effectiveness of in-hospital rehabilitation regimens has substantial impact on patients' demands in the primary health care sector. The aim of this study was to investigate patie...... service utilization in the primary health care sector as compared to the usual regimen and a training exercise regimen. The results stress the importance of a cognitive element of coping in a rehabilitation program.......Very few studies have investigated the effects or costs of rehabilitation regimens following lumbar spinal fusion. The effectiveness of in-hospital rehabilitation regimens has substantial impact on patients' demands in the primary health care sector. The aim of this study was to investigate patient......-articulated demands to the primary health care sector following lumbar spinal fusion and three different in-hospital rehabilitation regimens in a prospective, randomized study with a 2-year follow-up. Ninety patients were randomized 3 months post lumbar spinal fusion to either a 'video' group (one-time oral...

Development of a shared decision-making tool to assist patients and clinicians with decisions on oral anticoagulant treatment for atrial fibrillation.

Science.gov (United States)

Kaiser, Karen; Cheng, Wendy Y; Jensen, Sally; Clayman, Marla L; Thappa, Andrew; Schwiep, Frances; Chawla, Anita; Goldberger, Jeffrey J; Col, Nananda; Schein, Jeff

2015-12-01

Decision aids (DAs) are increasingly used to operationalize shared decision-making (SDM) but their development is not often described. Decisions about oral anticoagulants (OACs) for atrial fibrillation (AF) involve a trade-off between lowering stroke risk and increasing OAC-associated bleeding risk, and consideration of how treatment affects lifestyle. The benefits and risks of OACs hinge upon a patient's risk factors for stroke and bleeding and how they value these outcomes. We present the development of a DA about AF that estimates patients' risks for stroke and bleeding and assesses their preferences for outcomes. Based on a literature review and expert discussions, we identified stroke and major bleeding risk prediction models and embedded them into risk assessment modules. We identified the most important factors in choosing OAC treatment (warfarin used as the default reference OAC) through focus group discussions with AF patients who had used warfarin and clinician interviews. We then designed preference assessment and introductory modules accordingly. We integrated these modules into a prototype AF SDM tool and evaluated its usability through interviews. Our tool included four modules: (1) introduction to AF and OAC treatment risks and benefits; (2) stroke risk assessment; (3) bleeding risk assessment; and (4) preference assessment. Interactive risk calculators estimated patient-specific stroke and bleeding risks; graphics were developed to communicate these risks. After cognitive interviews, the content was improved. The final AF tool calculates patient-specific risks and benefits of OAC treatment and couples these estimates with patient preferences to improve clinical decision-making. The AF SDM tool may help patients choose whether OAC treatment is best for them and represents a patient-centered, integrative approach to educate patients on the benefits and risks of OAC treatment. Future research is needed to evaluate this tool in a real-world setting. The

Belarus: Towards a new post-Chernobyl rehabilitation strategy

International Nuclear Information System (INIS)

Trofimchik, Z.

2004-01-01

Today, Belarus still has to deal with many problems that resulted owing to the extensive contamination of its territory after the Chernobyl accident. These problems remain omnipresent in everyday life of the affected population and have a continuous impact on the economic well being of the country. This paper describes the major changes that have been carried out in the rehabilitation strategies in Belarus since the Chernobyl accident. The evolution of the legal and administrative framework for rehabilitation and actions taken in this context over the past two decades are summarized. The continuing challenges faced by the population in the affected areas are discussed and the key principles underlying rehabilitation strategies (that are both practicable and accepted) are identified. The latter include openness, voluntary participation, collective decision-making and empowerment of local population and professionals. These principles have underpinned the development of recent national and international initiatives that are described. (authors)

Early functional, esthetic, and psychological rehabilitation of preschool child with nonsyndromic oligodontia and anodontia in mixed dentition stage through conservative systematic approach: A case report with 5-year follow-up

Directory of Open Access Journals (Sweden)

Manu Rathee

2016-01-01

Full Text Available Missing teeth are a common developmental abnormality in humans. It may manifest as absence of varying numbers of primary and/or secondary teeth. Early treatment and follow-up are the key to successful rehabilitation of young patients with congenitally missing teeth. It is critical that oral rehabilitation is started early to maintain and correct the oral functions. Mucosa borne removable prostheses are the commonly selected treatment options for the young patients who present with oligodontia or anodontia. This clinical report describes esthetic, functional, and psychological rehabilitation of a young boy with severe oligodontia in maxillary arch and anodontia in mandibular arch. The individualized conservative graded approach in prosthetic rehabilitation with removable acrylic prosthesis helped to achieve esthetics, functionality, and psychological benefits.

Early functional, esthetic, and psychological rehabilitation of preschool child with nonsyndromic oligodontia and anodontia in mixed dentition stage through conservative systematic approach: A case report with 5-year follow-up.

Science.gov (United States)

Rathee, Manu; Malik, Poonam; Dua, Madhuri; Yadav, Vikas

2016-01-01

Missing teeth are a common developmental abnormality in humans. It may manifest as absence of varying numbers of primary and/or secondary teeth. Early treatment and follow-up are the key to successful rehabilitation of young patients with congenitally missing teeth. It is critical that oral rehabilitation is started early to maintain and correct the oral functions. Mucosa borne removable prostheses are the commonly selected treatment options for the young patients who present with oligodontia or anodontia. This clinical report describes esthetic, functional, and psychological rehabilitation of a young boy with severe oligodontia in maxillary arch and anodontia in mandibular arch. The individualized conservative graded approach in prosthetic rehabilitation with removable acrylic prosthesis helped to achieve esthetics, functionality, and psychological benefits.

Pre-prosthetic surgical alterations in maxillectomy to enhance the prosthetic prognoses as part of rehabilitation of oral cancer patient.

Science.gov (United States)

El Fattah, H; Zaghloul, A; Pedemonte, E; Escuin, T

2012-03-01

After maxillectomy, prosthetic restoration of the resulting defect is an essential step because it signals the beginning of patient's rehabilitation. The obturator used to restore the defect should be comfortable, restore adequate speech, deglutition, mastication, and be cosmetically acceptable, success will depend on the size and location of the defect and the quantity and integrity of the remaining structures, in addition to pre-prosthetic surgical preparation of defect site. Preoperative cooperation between the oncologist surgeon and the maxillofacial surgeon may allow obturation of a resultant defect by preservation of the premaxilla or the tuberosity on the defect side and maintaining the alveolar bone or teeth adjacent to the defect. This study evaluates the importance of pre-prosthetic surgical alterations at the time maxillectomy on the enhancement of the prosthetic prognoses as part of the rehabilitation of oral cancer patient. The study was carried out between 2003- 2008, on 66 cancer patients(41 male-25 female) age ranged from 33 to 72 years, at National Cancer Institute, Cairo University, whom underwent maxillectomy surgery to remove malignant tumor as a part of cancer treatment. Patients were divided in two groups. Group A: Resection of maxilla followed by preprosthetic surgical preparation. Twenty-four cancer patients (13 male - 11 female). Group B: Resection of maxilla without any preprosthetic surgical preparation. Forty-two cancer patients (28 male-14 female). Outcome variables measured included facial contour and aesthetic results, speech understandability, ability to eat solid foods, oronasal separation, socializing outside the home, and return-to-work status. Flap success and donor site morbidity were also studied. To improve the prosthetic restoration of maxillary defect resulting maxillary resection as part treatment of maxillofacial tumor depends on the close cooperation between prosthodontist and surgeon, by combination of pre

[Geriatric rehabilitation care: Doing the right things right].

Science.gov (United States)

de Vos, A J B M; van Balen, R; Gobbens, R J J; Bakker, T J E M

2018-02-01

Geriatric rehabilitation concerns short-term integrated multidisciplinary care aimed at functional recovery and social participation for relatively frail elderly. Given the geriatric clients' complex care issues, nurses should possess sufficient and appropriate competencies in order to identify and assess the relevant symptoms and intervene effectively. Yet, nurses experience a certain apprehensiveness to perform their tasks and express difficulties in multidisciplinary communication and collaboration in a constructive manner. In addition to the client's and informal care giver's perception of their input in the geriatric rehabilitation process, this study provides an in-depth understanding of the way nurses perceive their role in geriatric rehabilitation. This descriptive study entails a quantitative and a qualitative component. The quantitative component concerns questionnaires for clients, informal care givers, nurses, and team leaders. The qualitative component aims to obtain in-depth information (i. e. opinions, meanings, and reflections) with regard to the decision making process and the performance of the rehabilitation care by means of open-ended questions (in the questionnaire) and semi-structured interviews. Clients and informal care givers rate specific themes in geriatric rehabilitation in a more negative light than nurses and team leaders do. These themes concern the provision of information in the hospital (prior to admission in the rehabilitation facility), involvement in the draw-up of the treatment plan and rehabilitation goals, geriatric rehabilitation as a 24/7 activity, and taking into account the client's other life events. The latter three findings in particular, are caused by nurses' apprehensiveness to perform their tasks adequately. Nurses working in geriatric rehabilitation, experience apprehensiveness to perform their tasks adequately. Uncertainty about the client's reaction or fear of damaging the relationship of trust, results

[Rehabilitation of asthmatic patients in the chest hospital (author's transl)].

Science.gov (United States)

Meister, W

1976-01-01

Modern chest hospitals offer favourable conditions for the rehabilitation of asthmatic patients. In the Central Hospital for Heart- and Lung Diseases at Bad Berka 421 patients with asthma were rehabilitated under clinical conditions in 1972 and 1973. Their rehabilitation was based on individualized long-term plans for treatment taking in consideration environmental factors which might have triggered the attacks. We report on experiences with diagnostic and therapeutic procedures and the results of vocational rehabilitation. 284 patients (67.4%) could return to their work, 4.5% were disabled, 16.5% remained invalids and 11.6% were old-age pensioners or children. The results depended on age, on the type of asthma, on the severity of cardio-pulmonary impairment, on certain concomitant diseases and on the patients cooperation. Possibilities for elimination of factors starting an attack sometimes proved decisive. For the maintenance of rehabilitatory success subsequent ambulatory long-term care by a specialist is provided.

Maxillofacial prosthodontic rehabilitation of a patient with oral complications during and after multimodality therapy for the management of oral squamous cell carcinoma.

Science.gov (United States)

Acharya, Varun; Chambers, Mark S

2015-06-01

Multimodality cancer therapy involving surgical resection, chemotherapy, and radiation therapy is frequently employed in the management of head and neck cancer. Patients who have undergone such therapy face substantial challenges during and after treatment. Prosthodontic rehabilitation is essential during and after tumor ablation to restore function, esthetics, and minimize interruption in daily routine. This clinical report describes the challenges faced by a patient undergoing multimodality therapy for a squamous cell carcinoma of the maxillary sinus and the stages involved in prosthodontic rehabilitation. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Rehabilitative potential of Ayurveda for neurological deficits caused by traumatic spinal cord injury

Directory of Open Access Journals (Sweden)

Sanjeev Rastogi

2014-01-01

Full Text Available Spinal cord injury (SCI is associated with worst outcomes and requires a prolonged rehabilitation. Ayurvedic indigenous methods of rehabilitation are often utilized to treat such conditions. A case of SCI was followed up for 3 months upon an Ayurvedic composite intervention and subsequently reported. The composite treatment plan involved Ayurvedic oral medications as well as a few selected external and internal pancha karma procedures. A substantial clinical and patient centered outcome improvement in existing neurological deficits and quality of life was observed after 3 months of the Ayurvedic treatment given to this case.

Clinical benefits of oral nutritional supplementation for elderly hip fracture patients: a single blind randomised controlled trial.

Science.gov (United States)

Myint, Ma Wai Wai; Wu, Jenny; Wong, Euann; Chan, Suk Ping; To, Tze Shing Jess; Chau, Mei Wa Rosanna; Ting, Kwai Hing; Fung, Pui Man; Au, Kit Sing Derrick

2013-01-01

malnutrition is an important risk factor for poor outcome in patients recovering after hip fracture surgery. This study aimed to investigate the clinical, nutritional and rehabilitation effects of an oral nutritional supplementation (ONS) in an inpatient rehabilitation setting. this was an observer-blinded randomised controlled trial of elderly post-surgical proximal femoral fracture patients. A ready-to-use oral liquid nutritional supplementation (18-24 g protein and 500 kcal per day) in addition to hospital diet was compared with hospital diet only. Both groups received usual rehabilitation therapy and oral calcium and vitamin D supplements. Outcomes were compared at discharge from rehabilitation and after 4 weeks of discharge. The primary outcome parameters were the serum albumin level, the body mass index (BMI), the functional independence measure (FIM) and the elderly mobility scale (EMS). Secondary outcome parameters were frequency of complications, inpatient length of stay, mortality and acute hospital use within 6 months after discharge. a total of 126 patients were recruited, 65 in the supplementation arm and 61 in the control arm. There was a significant difference in change in BMI with a decrease of 0.25 and 0.03 kg/m(2) in the ONS group and 0.72 and 0.49 kg/m(2) in the control group at hospital discharge and follow-up, respectively (P = 0.012). The length of stay in rehabilitation ward was shortened by 3.80 (SE = 1.81, P = 0.04) days favouring the ONS group. The total number of infection episodes was also reduced significantly. No difference was observed in the rate of change of the serum albumin level, the FIM and the EMS. clinical and nutritional benefits were seen in this trial but rehabilitation benefits could not be demonstrated.

Feasibility of web-based decision aids in neurological patients

NARCIS (Netherlands)

van Til, Janine Astrid; Drossaert, Constance H.C.; Renzenbrink, Gerbert J.; Snoek, Govert J.; Dijkstra, Evelien; Stiggelbout, Anne M.; IJzerman, Maarten Joost

2010-01-01

Decision aids (DAs) may be helpful in improving patients' participation in medical decision-making. We investigated the potential for web-based DAs in a rehabilitation population. Two self-administered DAs focused on the treatment of acquired ankle-foot impairment in stroke and the treatment of

Promoting shared decision-making in rehabilitation: development of a framework for situations when patients with Dysphagia refuse diet modification recommended by the treating team.

Science.gov (United States)

Kaizer, Franceen; Spiridigliozzi, Anna-Maria; Hunt, Matthew R

2012-03-01

To address the risks of aspiration pneumonia, patients with dysphagia may be prescribed a modified diet. The goal of diet modification is to decrease the risk of patients aspirating food due to their diminished swallowing reflex. Some patients may not accept diet modification or may not adhere to the treatments identified by the interdisciplinary team. Such scenarios may result in important moral uncertainty and concern for clinicians. As a result of several ethics consultations related to this issue, a working group of the Clinical Ethics Committee at the Jewish Rehabilitation Hospital in Laval, Quebec, Canada, developed a framework for responding to situations when patients do not adhere to recommended diet modification. The goal of this tool is to facilitate discussion and collaboration between clinicians and patients, to clarify assumed versus real risk, and to promote shared decision-making in dysphagia care. In this article we examine the clinical context of diet modification for patients with dysphagia in rehabilitation hospitals, explore ethical aspects of this topic, present the clinical algorithm, and discuss our experience with developing and piloting this tool.

[Domiciliary rehabilitation: an innovative form of outpatient medical rehabilitation].

Science.gov (United States)

Schmidt-Ohlemann, M; Schweizer, C

2009-02-01

Domiciliary rehabilitation is an innovative form of outpatient medical rehabilitation. All components of service provision are delivered in the rehabilitant's home by a multidisciplinary team headed by a physician. The key context factors in the rehab process can be taken into account firsthand. The target group of domiciliary rehabilitation consists of multimorbid patients with severe functional limitations and complex assistance needs, whose rehabilitation options would be poor without this outreach service. Here, as suggested by the WHO concept of functional health, the interaction between health condition and environmental factors is kept in view much better than in other forms of rehabilitation. The positive effects and the efficiency of the rehabilitation measures provided can be assessed very well at a high descriptive level. This fact had been a precondition for legal establishment of domiciliary rehabilitation as a regular service. Domiciliary rehabilitation not only complies with key demands in the health and social policy fields, such as priority of outpatient over inpatient treatment or rehabilitation to precede and accompany long term care, it also constitutes an alternative concept challenging the traditional inpatient rehabilitation approach. The patient, hence, no longer is to fit into the institutional framework of outpatient or inpatient rehabilitation, but the team will fit into the specifics of the patient's unique social and material situation.

Sociodemographic profile and career decisions of Australian oral health profession students.

Science.gov (United States)

Mariño, Rodrigo; Au-Yeung, Winnie; Habibi, Elmira; Morgan, Michael

2012-09-01

This study collected and analyzed recent information regarding the sociodemographic profile and career decisions of Australian oral health profession students (earning B.D.Sc. and B.O.H. degrees) and the reasons for their career choice. Data were collected during the 2009-10 academic year via a web-based survey. A total of 829 students participated; the response rates for each oral health course at the seven participating universities ranged from 15.0 percent to 88.7 percent. The respondents had an average age of 21.4 years, ranging from eighteen to fifty-one. The majority of the respondents were female (61.4 percent), single (91.0 percent), and of Asian ethnicity (65.0 percent), and almost half had attended a public secondary school (49.7 percent). Most of the responding students either lived in rented accommodation (44.0 percent) or with their parents (28.6 percent), and 41.5 percent reported having an urban address. Most respondents' fathers (67.2 percent) and mothers (54.8 percent) had completed undergraduate or postgraduate education and were employed in managerial or professional occupations (68.5 percent and 54.9 percent, respectively). Most of the students said they had selected their course in high school (66.8 percent) and were most influenced in their career choice by self-motivation (85.3 percent) and caring for and helping other people (86.6 percent). The majority of the respondents reported wishing to work in a city (51.5 percent), practicing general dentistry (31.8 percent) in either the public or private sector (40.2 percent each). This article provides a preliminary look at the future dental workforce of Australia, identifying issues for further analysis and assisting each university to address current inequalities and challenges.

"Rehabilitation schools for scoliosis" thematic series: describing the methods and results

Directory of Open Access Journals (Sweden)

Grivas Theodoros B

2010-12-01

Full Text Available Abstract The Scoliosis Rehabilitation model begins with the correct diagnosis and evaluation of the patient, to make treatment decisions oriented to the patient. The treatment is based on observation, education, scoliosis specific exercises, and bracing. The state of research in the field of conservative treatment is insufficient. There is some evidence supporting scoliosis specific exercises as a part of the rehabilitation treatment, however, the evidence is poor and the different methods are not known by most of the scientific community. The only way to improve the knowledge and understanding of the different physiotherapy methodologies (specific exercises, integrated into the whole rehabilitation program, is to establish a single and comprehensive source of information about it. This is what the SCOLIOSIS Journal is going to do through the "Rehabilitation Schools for Scoliosis" Thematic Series, where technical papers coming from the different schools will be published.

The role of pain for early rehabilitation in fast track surgery.

DEFF Research Database (Denmark)

Holm, Bente; Kristensen, Morten Tange; Myhrmann, Lis

, pain medication with only oral analgesics. Two trained physiotherapists assessed all patients on postoperative day 1 (POD 1) and on the day of discharge (DOD) for: Independence in three basic functions of transfer and ambulation: 1) Get in and out of bed, 2) Sit to stand from a chair and 3) Walking...... is not a restricting factor for early rehabilitation....

Oral Rehabilitation of Young Adult with Amelogenesis Imperfecta.

Science.gov (United States)

Leung, Vincent Ws; Low, Bernard; Yang, Yanqi; Botelho, Michael G

2018-05-01

Amelogenesis imperfecta is a heterogeneous group of hereditary disorders that affect the enamel formation of the primary and permanent dentitions while the remaining tooth structure is normal. Appropriate patient care is necessary to prevent adverse effects on dental oral health, dental disfigurement, and psychological well-being. This clinical report presents a 27-year-old Chinese male with amelogenesis imperfecta (AI) and his restorative management. This clinical report presents a 27-year-old Chinese male with AI and his restorative management. Extraoral examination showed a skeletal class III profile and increased lower facial proportion. Intraorally, all the permanent dentition was hypoplastic with noticeable tooth surface loss and a yellow-brown appearance. This was complicated with a mild maloc-clusion and food packing on his posterior teeth. The patient wanted to improve his appearance and masticatory efficiency. Orthodontic treatment was performed to treat the mild malocclu-sion and create physiological interproximal spacing to minimize tooth preparation and facilitate oral hygiene. This report demonstrates how a multidisciplinary approach for the management of AI can achieve a predictable, functional, and esthetic outcome. Orthodontic treatment facilitated a conservative prosthodontic treatment outcome by selectively increasing interproximal space, minimizing tooth preparation, correcting posterior bilateral cross-bite, as well as an anterior reverse overjet and derotation of the canines. This case report demonstrates the effective restoration of AI using a multidisciplinary approach to overcome crowding using a relatively conservative approach.

The importance of 'global meaning' for people rehabilitating from spinal cord injury.

Science.gov (United States)

Littooij, E; Leget, C J W; Stolwijk-Swüste, J M; Doodeman, S; Widdershoven, G A M; Dekker, J

2016-11-01

Qualitative study. To explore whether aspects of global meaning (that is, fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) are associated with processes and outcomes in rehabilitation, as experienced by people with spinal cord injury (SCI). People living in the community receiving outpatient rehabilitation in a Dutch rehabilitation center. In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed using qualitative research methods: structural and provisional coding. Core values, relationships, worldview, identity and inner posture (that is, the way in which people relate to the facts of life) were associated with various processes and outcomes of rehabilitation. Elements of the rehabilitation process included motivation, regulation of emotion, making decisions and handling stress. Elements of the outcome of rehabilitation included physical functioning, emotional functioning, social functioning and subjective sense of meaning. The influence was positive, with the exception of one case in which worldview and inner posture were negatively associated with motivation. Besides that, respondents emphasized the importance of rehabilitation professionals attuning to their global meaning. All aspects of global meaning were positively associated with various processes and outcomes of rehabilitation. It is recommended that rehabilitation professionals are aware of the importance of global meaning to people with SCI and that they take people's fundamental beliefs and life goals into account.

Clinical Holistic Medicine: Holistic Rehabilitation

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available Quality of life, health, and ability are often lost at the same time and most often in one decaying existential movement over 5 or 10 years. This “lost life” is mostly too slow to be felt as life threatening, but once awakened to reality, it provokes the deepest of fears in patients: the fear of death itself and destruction of our mere existence. The horrible experience of having “lost life””, often without even noticing how it happened, can be turned into a strong motivation for improvement. Personal development is about finding the life deeply hidden within in order to induce revitalization and rehabilitation. Rehabilitation is about philosophy of life with the integration of the repressed painful feelings and emotions from the past and the letting go of the associated negative beliefs and decisions. The holistic medical toolbox builds on existential theories (the quality of life theories, the life mission theory, the theory of character, the theory of talent, and the holistic process theory and seems to have the power to rehabilitate the purpose of life, the character of the person, and fundamental existential dimensions of man: (1 love; (2 strength of mind, feelings, and body; and 3 joy, gender, and sexuality; allowing the person once again to express and realize his talents and full potential. The principles of rehabilitation are not very different from other healing, but the task is often more demanding for the holistic physician as the motivation and resources often are very low and the treatment can take many years.

Oral Rehabilitation of a Patient With Ectodermal Dysplasia Treated With Fresh-Frozen Bone Allografts and Computer-Guided Implant Placement: A Clinical Case Report.

Science.gov (United States)

Maiorana, Carlo; Poli, Pier Paolo; Poggio, Carlo; Barbieri, Paola; Beretta, Mario

2017-05-01

Ectodermal dysplasia (ED) is an inherited disorder characterized by abnormality of ectodermally derived structures. A recurrent oral finding is oligodontia, which in turn leads to a severely hypotrophic alveolar process with typical knife-edge morphology and adverse ridge contours. This unfavorable anatomy can seriously hamper proper implant placement. Fresh-frozen bone (FFB) allografts recently have been proposed to augment the residual bone volume for implant placement purposes; however, scientific evidence concerning the use of FFB to treat ED patients is absent. Similarly, data reporting computer-aided template-guided implant placement in medically compromised patients are limited. Thus the purpose of this report is to illustrate the oral rehabilitation of a female patient affected by ED and treated with appositional FFB block grafts and consecutive computer-guided flapless implant placement in a 2-stage procedure. Fixed implant-supported dental prostheses were finally delivered to the patient, which improved her self-esteem and quality of life. During the follow-up recall 1 year after the prosthetic loading, the clinical examination showed healthy peri-implant soft tissues with no signs of bleeding on probing or pathologic probing depths. The panoramic radiograph confirmed the clinical stability of the result. Peri-implant marginal bone levels were radiographically stable with neither pathologic bone loss at the mesial and distal aspects of each implant nor peri-implant radiolucency. Within the limitations of this report, the use of FFB allografts in association with computer-aided flapless implant surgery might be considered a useful technique in patients affected by ED. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Rehabilitation outcome in hemorrhagic transformation of ischemic stroke: a case presentation

Directory of Open Access Journals (Sweden)

Ioana Stanescu

2018-06-01

Full Text Available Hemorrhagic transformation (HT may occur as a part of the natural history of acute ischemic stroke, with incidence between 13-43% in computer-tomography (CT studies. Detection of HT in a patient with ischemic stroke is important in establishing treatment in the acute phase in assessing prognosis and in taking therapeutical decisions for secondary stroke prevention. There were controversies regarding optimal treatment in acute ischemic stroke with HT, especially if the patient needs further anticoagulant or antiplatelet treatment. Rehabilitation treatment needs to be continued for post-stroke patients who developed HT, because HT does not decrease rehabilitation outcome. We present rehabilitation treatment and prognosis in a case of hemorrhagic transformation after an embolic ischemic stroke treated with anticoagulants, which required reinitiation of anticoagulant treatment.

Systematic overview of economic evaluations of health-related rehabilitation.

Science.gov (United States)

Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

2016-01-01

Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Use of GIS in the rehabilitation assessment of the Chernobyl exclusion zone

International Nuclear Information System (INIS)

Arkhipov, A.; Kuchma, N.; Arkhipov, N.; Nagorsky, V.

2002-01-01

The main task of the Geographical Information System of the Chernobyl exclusion zone is to estimate the applicability and perform the analysis of the body of radioecological information on the basis of which the administrative decisions about the use of territories can be made. This system is rather virtual and has several logical levels: storage of the primary radioecological and land use information; the analysis of possible ways for rehabilitation of contaminated lands; the economic evaluations based primarily on the cost-benefit comparison of scenarios with use of different countermeasures and those implementing usual technologies. This includes GIS-analysis and evaluation of risks as the basis for the decision-making. The paper presents the results of application of sophisticated GIS to the practice of radioecological research and land rehabilitation. (author)

Oral supplement enriched in HMB combined with pulmonary rehabilitation improves body composition and health related quality of life in patients with bronchiectasis (Prospective, Randomised Study).

Science.gov (United States)

Olveira, Gabriel; Olveira, Casilda; Doña, Esperanza; Palenque, Francisco Javier; Porras, Nuria; Dorado, Antonio; Godoy, Ana M; Rubio-Martínez, Elehazara; Rojo-Martínez, Gemma; Martín-Valero, Rocío

2016-10-01

Pulmonary Rehabilitation (PR) is recommended for bronchiectasis but there is no data about its effect on body composition. The aim of this study is to assess the effect of Pulmonary Rehabilitation (PR) for 12 weeks in normally-nourished non-cystic-fibrosis bronchiectasis patients compared with the effect of PR plus a hyperproteic oral nutritional supplement enriched with beta-hydroxy-beta-methylbutyrate (HMB) on body composition, muscle strength, quality of life and serum biomarkers. single center randomized controlled trial, parallel treatment design: Participants were randomly assigned to receive PR for 12 weeks or PR plus ONS (PRONS) (one can per day). Outcome assessments were performed at baseline, 12 weeks and 24 weeks: body composition (Dual-energy X-Ray Absorptiometry (DEXA), mid-arm muscle circumference (MAMC), phase angle by Bio-impedance), health related quality of life (Spanish QOL-B-V3.0, Physical Functioning Scale), handgrip strength, diet questionnaire, and plasma levels of prealbumin, myostatin and somatomedin-c. Thirty patients were randomized (15 per group) without differences in clinical and respiratory variables. In the PRONS group bone mineral density (BMD), mean and maximum handgrip dynamometry, MAMC, QOLB and prealbumin were significantly increased from baseline at 12 and 24 weeks and Fat free Mass (FFM) and FFM index, at 12 weeks. In the PR group only mean handgrip dynamometry and prealbumin were significantly increased at 12 and 24 weeks. In both groups plasma myostatin was reduced at 12 weeks (without significant differences). The addition of a hyperproteic ONS enriched with HMB to Pulmonary Rehabilitation could improve body composition, BMD, muscle strength and health related quality of life in bronchiectasis patients. Clinical Trials Number NCT02048397. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Potential clinical application of masseter and temporal muscle massage treatment using an oral rehabilitation robot in temporomandibular disorder patients with myofascial pain.

Science.gov (United States)

Ariji, Yoshiko; Nakayama, Miwa; Nishiyama, Wataru; Ogi, Nobumi; Sakuma, Shigemitsu; Katsumata, Akitoshi; Kurita, Kenichi; Ariji, Eiichiro

2015-10-01

To investigate the safety, suitable treatment regimen, and efficacy of masseter and temporal muscle massage treatment using an oral rehabilitation robot. Forty-one temporomandibular disorder (TMD) patients with myofascial pain (8 men, 33 women, median age: 46 years) were enrolled. The safety, suitable massage regimen, and efficacy of this treatment were investigated. Changes in masseter muscle thickness were evaluated on sonograms. No adverse events occurred with any of the treatment sessions. Suitable massage was at pressure of 10 N for 16 minutes. Five sessions were performed every 2 weeks. Total duration of treatment was 9·5 weeks in median. Massage treatment was effective in 70·3% of patients. Masseter muscle thickness decreased with treatment in the therapy-effective group. This study confirmed the safety of massage treatment, and established a suitable regimen. Massage was effective in 70·3% of patients and appeared to have a potential as one of the effective treatments for myofascial pain.

Relationship between tongue strength, lip strength, and nutrition-related sarcopenia in older rehabilitation inpatients: a cross-sectional study

Directory of Open Access Journals (Sweden)

Sakai K

2017-08-01

Full Text Available Kotomi Sakai,1,2 Enri Nakayama,2 Haruka Tohara,3 Keiji Kodama,4 Takahiro Takehisa,5 Yozo Takehisa,6 Koichiro Ueda2 1Department of Rehabilitation Medicine, Setagaya Memorial Hospital, 2Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, 3Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 4Department of Internal Medicine, 5Department of Orthopaedic Surgery, Setagaya Memorial Hospital, Tokyo, 6Department of Internal Medicine, Hakuai Memorial Hospital, Tokushima, Japan Objective: The objective of this study was to clarify the relationship between tongue strength, lip strength, and nutrition-related sarcopenia (NRS.Patients and methods: A total of 201 older inpatients aged ≥65 years (70 men, median age: 84 years, interquartile range: 79–89 years consecutively admitted for rehabilitation were included in this cross-sectional study. The main factors evaluated were the presence of NRS diagnosed by malnutrition using the Mini-Nutrition Assessment – Short Form, sarcopenia based on the criteria of the Asian Working Group for Sarcopenia, tongue strength, and lip strength. Other factors such as age, sex, comorbidity, physical function, cognitive function, and oral intake level were also assessed.Results: In all, 78 (38.8% patients were allocated to the NRS group, and 123 (61.2% patients were allocated to the non-NRS group. The median tongue strength and lip strength (interquartile range were significantly lower in the NRS group (tongue: 22.9 kPa [17.7–27.7 kPa] and lip: 7.2 N [5.6–9.8 N] compared with the non-NRS group (tongue: 29.7 kPa [24.8–35.1 kPa] and lip: 9.9 N [8.4–12.3 N], P<0.001 for both. Multivariable logistic regression analysis showed that NRS was independently associated with tongue strength (odds ratio [OR] =0.93, 95% confidence interval [CI] 0.87–0.98, P=0.012 and lip

Treatment of Orally Handicapped Edentulous Older Adults Using Dental Implants.

Science.gov (United States)

Zahedi, Charles

2016-07-01

The oral handicap of complete edentulism is the terminal outcome of a multifactorial process involving biological factors and patient-related factors. Fully edentulous orally handicapped older adults have been neglected because removable acrylic dentures have been the classic therapy for complete edentulism but are only rehabilitative, not therapeutic. Not replacing missing teeth with stable dentures could prevent adequate food intake. Osseointegrated endosseous implants used as a therapeutic adjunct can reduce the problem of long-term bone resorption to less than 0.1 mm per year. Implant-borne prostheses substantially increase the overall health and quality of life of orally handicapped fully edentulous older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

Oral Health-related quality of life and clinical outcomes of immediately or delayed loaded implants in the rehabilitation of edentulous jaws: a retrospective comparative study.

Science.gov (United States)

Cosola, Saverio; Marconcini, Simone; Giammarinaro, Enrica; Poli, Gian L; Covani, Ugo; Barone, Antonio

2018-04-16

Patient-centred outcomes are being given great attention by the dental scientific community. The Oral Health Impact Profile -14 questionnaire (OHIP-14) has been introduced to address patients' success criteria when describing the impact of oral rehabilitations on quality of life (OHrQoL). Thirty-five patients wearing a full-arch implant-prosthesis being in place between 4 and 6 years before this analysis were considered eligible and then enrolled in the present retrospective study. According to their prosthetic anamnesis, two groups were defined: delayed loading group (IL-group) and immediate loading group (IL-group). At the moment of analysis, clinical and radiographic parameters were collected, and patients were asked to complete the Oral Health Impact Profile -14 questionnaire (OHIP-14) in order to measure their OHrQoL. Independent t-test showed total OHIP-14 scores to be not significantly different between groups; however, the domains "Functional limitation" and "physical disability" resulted significantly higher in patients within the DL-group. On the contrary, social disability was higher in the IL-group. When the comparison was performed taking sex into account, no significant differences between groups were highlighted. Instead, the stratification for years of follow-up led to significant evidences. When the follow-up was shorter (less-than-5 years), the functional limitation reported scores were higher. Within the limitations of this study, the analysis supports the absence of significant differences between immediate loading and delayed loading full-arch protocol in term of clinical, radiological parameters and OHrQoL.

Emergence of a rehabilitation medicine model for low vision service delivery, policy, and funding.

Science.gov (United States)

Stelmack, Joan

2005-05-01

A rehabilitation medicine model for low vision rehabilitation is emerging. There have been many challenges to reaching consensus on the roles of each discipline (optometry, ophthalmology, occupational therapy, and vision rehabilitation professionals) in the service delivery model and finding a place in the reimbursement system for all the providers. The history of low vision, legislation associated with Centers for Medicare and Medicaid Services coverage for vision rehabilitation, and research on the effectiveness of low vision service delivery are reviewed. Vision rehabilitation is now covered by Medicare under Physical Medicine and Rehabilitation codes by some Medicare carriers, yet reimbursement is not available for low vision devices or refraction. Also, the role of vision rehabilitation professionals (rehabilitation teachers, orientation and mobility specialists, and low vision therapists) in the model needs to be determined. In a recent systematic review of the scientific literature on the effectiveness of low vision services contracted by the Agency for Health Care Quality Research, no clinical trials were found. The literature consists primarily of longitudinal case studies, which provide weak support for third-party funding for vision rehabilitative services. Providers need to reach consensus on medical necessity, treatment plans, and protocols. Research on low vision outcomes is needed to develop an evidence base to guide clinical practice, policy, and funding decisions.

Early oral feeding after elective abdominal surgery--what are the issues?

DEFF Research Database (Denmark)

Bisgaard, Thue; Kehlet, Henrik

2002-01-01

This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdomin...... surgical programs in abdominal surgery provide a rational basis for future studies to investigate and facilitate enforced oral feeding after major abdominal procedures.......This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdominal...... procedures. It appears that several factors may promote postoperative oral feeding such as thoracic epidural analgesia, multimodal anti-emetic treatment, opioid-sparing analgesia, selective peripheral opioid antagonists, and enforced oral nutrition. Recent data from multimodal fast-track rehabilitation...

Evaluation of oral stereognostic ability after rehabilitating patients with complete dentures: in vivo study.

Science.gov (United States)

Meenakshi, S; Gujjari, Anil Kumar; Thippeswamy, H N; Raghunath, N

2014-12-01

Stereognosis has been defined as the appreciation of the form of objects by palpation. Whilst this definition holds good for the manual exploration of objects, it is possible for the shape of objects to be explored intra orally referred to as oral stereognosis. To better understand patients' relative satisfaction with complete dentures, differences in oral stereognostic perception, based on the identification of 6 edible objects was analyzed in a group of 30 edentulous individuals at 3 stages, namely, just before (pre-treatment), 30 min after (30 min post-treatment) and 1 month after (1 month post-treatment) the insertion of new dentures. The time required to identify each object was recorded and the correctness of identification of each object was scored using oral stereognostic score. Descriptive statistics, Wilcoxon signed rank test, Spearman's rank correlation test, Pearson Chi square test was used to statistically analyze the data obtained. OSA scores was significantly increased 1 month post-treatment compared to 30 min post-treatment (p < 0.05). It was found that Oral stereognostic test is reliable for measuring patients' oral stereognostic perception and may be used as one of the clinical aids in appreciating the functional limitations imposed by the prostheses.

Qualitative research in rehabilitation science: opportunities, challenges, and future directions.

Science.gov (United States)

VanderKaay, Sandra; Moll, Sandra E; Gewurtz, Rebecca E; Jindal, Pranay; Loyola-Sanchez, Adalberto; Packham, Tara L; Lim, Chun Y

2018-03-01

Qualitative research has had a significant impact within rehabilitation science over time. During the past 20 years the number of qualitative studies published per year in Disability and Rehabilitation has markedly increased (from 1 to 54). In addition, during this period there have been significant changes in how qualitative research is conceptualized, conducted, and utilized to advance the field of rehabilitation. The purpose of this article is to reflect upon the progress of qualitative research within rehabilitation to date, to explicate current opportunities and challenges, and to suggest future directions to continue to strengthen the contribution of qualitative research in this field. Relevant literature searches were conducted in electronic data bases and reference lists. Pertinent literature was examined to identify current opportunities and challenges for qualitative research use in rehabilitation and to identify future directions. Six key areas of opportunity and challenge were identified: (a) paradigm shifts, (b) advancements in methodology, (c) emerging technology, (d) advances in quality evaluation, (e) increasing popularity of mixed methods approaches, and (f) evolving approaches to knowledge translation. Two important future directions for rehabilitation are posited: (1) advanced training in qualitative methods and (2) engaging qualitative communities of research. Qualitative research is well established in rehabilitation and has an important place in the continued growth of this field. Ongoing development of qualitative researchers and methods are essential. Implications for Rehabilitation Qualitative research has the potential to improve rehabilitation practice by addressing some of the most pervasive concerns in the field such as practitioner-client interaction, the subjective and lived experience of disability, and clinical reasoning and decision making. This will serve to better inform those providing rehabilitation services thereby benefiting

[Role of endo-osseus implant in odonto-oral rehabilitation].

Science.gov (United States)

Vanhakendover, S

2003-01-01

Dental implants have critically changed the restorative procedures available to edentulous patients. Biocompatible materials, precise surgical techniques and improved instrumentation give well trained practicioners various opportunities to achieve successful treatments. The necessity of combining full expertise in surgery and rational prosthetic planning with comprehensive occlusal management is emphasized. Recent advances in periodontal treatment of osseous and soft tissue defects, new grafting techniques and surgical approaches have dramatically enlarged the scope of oral implantology.

Closed-loop brain-machine-body interfaces for noninvasive rehabilitation of movement disorders.

Science.gov (United States)

Broccard, Frédéric D; Mullen, Tim; Chi, Yu Mike; Peterson, David; Iversen, John R; Arnold, Mike; Kreutz-Delgado, Kenneth; Jung, Tzyy-Ping; Makeig, Scott; Poizner, Howard; Sejnowski, Terrence; Cauwenberghs, Gert

2014-08-01

Traditional approaches for neurological rehabilitation of patients affected with movement disorders, such as Parkinson's disease (PD), dystonia, and essential tremor (ET) consist mainly of oral medication, physical therapy, and botulinum toxin injections. Recently, the more invasive method of deep brain stimulation (DBS) showed significant improvement of the physical symptoms associated with these disorders. In the past several years, the adoption of feedback control theory helped DBS protocols to take into account the progressive and dynamic nature of these neurological movement disorders that had largely been ignored so far. As a result, a more efficient and effective management of PD cardinal symptoms has emerged. In this paper, we review closed-loop systems for rehabilitation of movement disorders, focusing on PD, for which several invasive and noninvasive methods have been developed during the last decade, reducing the complications and side effects associated with traditional rehabilitation approaches and paving the way for tailored individual therapeutics. We then present a novel, transformative, noninvasive closed-loop framework based on force neurofeedback and discuss several future developments of closed-loop systems that might bring us closer to individualized solutions for neurological rehabilitation of movement disorders.

An effective and comprehensive model for optimal rehabilitation of separate sanitary sewer systems.

Science.gov (United States)

Diogo, António Freire; Barros, Luís Tiago; Santos, Joana; Temido, Jorge Santos

2018-01-15

In the field of rehabilitation of separate sanitary sewer systems, a large number of technical, environmental, and economic aspects are often relevant in the decision-making process, which may be modelled as a multi-objective optimization problem. Examples are those related with the operation and assessment of networks, optimization of structural, hydraulic, sanitary, and environmental performance, rehabilitation programmes, and execution works. In particular, the cost of investment, operation and maintenance needed to reduce or eliminate Infiltration from the underground water table and Inflows of storm water surface runoff (I/I) using rehabilitation techniques or related methods can be significantly lower than the cost of transporting and treating these flows throughout the lifespan of the systems or period studied. This paper presents a comprehensive I/I cost-benefit approach for rehabilitation that explicitly considers all elements of the systems and shows how the approximation is incorporated as an objective function in a general evolutionary multi-objective optimization model. It takes into account network performance and wastewater treatment costs, average values of several input variables, and rates that can reflect the adoption of different predictable or limiting scenarios. The approach can be used as a practical and fast tool to support decision-making in sewer network rehabilitation in any phase of a project. The fundamental aspects, modelling, implementation details and preliminary results of a two-objective optimization rehabilitation model using a genetic algorithm, with a second objective function related to the structural condition of the network and the service failure risk, are presented. The basic approach is applied to three real world cases studies of sanitary sewerage systems in Coimbra and the results show the simplicity, suitability, effectiveness, and usefulness of the approximation implemented and of the objective function proposed

Reliability of computer designed surgical guides in six implant rehabilitations with two years follow-up.

Science.gov (United States)

Giordano, Mauro; Ausiello, Pietro; Martorelli, Massimo; Sorrentino, Roberto

2012-09-01

To evaluate the reliability and accuracy of computer-designed surgical guides in osseointegrated oral implant rehabilitation. Six implant rehabilitations, with a total of 17 implants, were completed with computer-designed surgical guides, performed with the master model developed by muco-compressive and muco-static impressions. In the first case, the surgical guide had exclusively mucosal support, in the second case exclusively dental support. For all six cases computer-aided surgical planning was performed by virtual analyses with 3D models obtained by dental scan DICOM data. The accuracy and stability of implant osseointegration over two years post surgery was then evaluated with clinical and radiographic examinations. Radiographic examination, performed with digital acquisitions (RVG - Radio Video graph) and parallel techniques, allowed two-dimensional feedback with a margin of linear error of 10%. Implant osseointegration was recorded for all the examined rehabilitations. During the clinical and radiographic post-surgical assessments, over the following two years, the peri-implant bone level was found to be stable and without appearance of any complications. The margin of error recorded between pre-operative positions assigned by virtual analysis and the post-surgical digital radiographic observations was as low as 0.2mm. Computer-guided implant surgery can be very effective in oral rehabilitations, providing an opportunity for the surgeon: (a) to avoid the necessity of muco-periosteal detachments and then (b) to perform minimally invasive interventions, whenever appropriate, with a flapless approach. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Evaluation of Oral Stereognostic Ability After Rehabilitating Patients with Complete Dentures: In Vivo Study

OpenAIRE

Meenakshi, S.; Gujjari, Anil Kumar; Thippeswamy, H. N.; Raghunath, N.

2013-01-01

Stereognosis has been defined as the appreciation of the form of objects by palpation. Whilst this definition holds good for the manual exploration of objects, it is possible for the shape of objects to be explored intra orally referred to as oral stereognosis. To better understand patients’ relative satisfaction with complete dentures, differences in oral stereognostic perception, based on the identification of 6 edible objects was analyzed in a group of 30 edentulous individuals at 3 stages...

Prosthetic rehabilitation of the dentate maxillectomy patient from a delayed surgical to an interim obturator: A clinical case report

Directory of Open Access Journals (Sweden)

Angleena Y Daniel

2015-01-01

Full Text Available The surgical management of maxillary pathosis results in direct communication between the oral and nasal cavity, imposing problems such as nasal regurgitation, unintelligent speech, difficulty in deglutition and compromised esthetics. A restoration of these defects is not always possible surgically, but prosthetic rehabilitation is an established treatment modality. Early rehabilitation can improve the quality of life and reduce the psychological trauma caused by surgical excision. Surgical and interim obturators placed during the initial phase can improve the outcome of the definitive prosthesis. This article presents a case report of a patient with partial maxillectomy who has been rehabilitated with a delayed surgical and an interim obturator.

Selection for inpatient rehabilitation after acute stroke: a systematic review of the literature.

Science.gov (United States)

Hakkennes, Sharon J; Brock, Kim; Hill, Keith D

2011-12-01

To identify patient-related factors that have been found to correlate with functional outcomes post acute stroke to guide clinical decision making with regard to rehabilitation admission after acute stroke. We systematically searched the scientific literature between 1966 and January 2010. The primary source of studies was the electronic databases Medline, CINAHL, and Embase. The search was supplemented with citation tracking. Two reviewers independently applied the inclusion criteria to identify relevant articles from the citations obtained through the literature search. Eligible studies included systematic reviews of prognostic indicators, studies of prognostic indicators of acute discharge disposition, and studies of rehabilitation admission criteria after acute stroke. Of the 8895 studies identified, 83 articles, representing 79 studies, were included in the review. One reviewer extracted the data relating to the participants, prognostic indicators, and outcomes. A second reviewer independently checked data extracted with disagreement resolved by a third reviewer. Quality of included studies was assessed for internal and external validity. Of the 79 studies, 26 were systematic reviews of prognostic indicators of functional level and/or discharge disposition, 48 were studies of prognostic indicators of acute discharge disposition, and 6 were studies of rehabilitation selection criteria. The methodologic quality of the included studies was generally poor. Age, cognition, functional level after stroke, and, to a lesser extent, continence were found to have a consistent association with outcome across all 3 research areas. In addition, stroke severity was also associated with acute discharge disposition, final discharge disposition, and functional level. Sex and side of stroke appeared to have no association across all 3 of the research areas. This review highlights a number of important prognostic indicators and rehabilitation selection criteria that may assist

Assessing the progress of rehabilitation in patients with ACL reconstruction using the International Knee Documentation Committee Subjective Knee Form

International Nuclear Information System (INIS)

Leguizamon, J H; Braidot, A; Catalfamo Formento, P

2011-01-01

There are numerous assessment tools designed to provide information on the results of reconstructive surgery of anterior cruciate ligament (ACL). They are also used for monitoring progress and facilitating clinical decision-making during the rehabilitation process. A brief summary of some existing tools specifically designed to evaluate knee ligament injuries is presented in this article. Then, one of those outcome measures, the International Knee Documentation Committee Subjective Knee Form (IKDC) was applied to a group of patients (N = 10) who had undergone surgery for ACL reconstruction. The patients attended the same physiotherapy service and followed a unified rehabilitation protocol. The assessment was performed twice: four and six months after surgery. The results showed an improvement in the rehabilitation of most patients tested (verified by a difference equal to or greater than 9 points on the IKDC outcome between measurements 1 and 2). The IKDC probed to be an instrument of quick and easy application. It provided quantitative data about the progress of rehabilitation and could be applied in everyday clinical physiotherapy practice. However, the results suggested considering the IKDC as one component of an evaluation kit to make decisions regarding the progress of the rehabilitation treatment.

Cancer rehabilitation in Austria--aspects of Physical Medicine and Rehabilitation.

Science.gov (United States)

Maehr, Bruno; Keilani, Mohammad; Wiltschke, Christoph; Hassler, Marco; Licht, Thomas; Marosi, Christine; Huetterer, Elisabeth; Cenik, Fadime; Crevenna, Richard

2016-02-01

In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.

Prosthetic Rehabilitation of Mandibular Defects with Fixed-removable Partial Denture Prosthesis Using Precision Attachment: A Twin Case Report.

Science.gov (United States)

Munot, Vimal Kantilal; Nayakar, Ramesh P; Patil, Raghunath

2017-01-01

The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.

I.C.A.R.: tool of intercomparison of actions for the rehabilitation in post-accidental phase

International Nuclear Information System (INIS)

Reales, N.; Cessac, B.

2006-01-01

In the event of a nuclear crisis, from the emergency to the post -accidental phase, decision makers may need specific information to choose a rehabilitation strategy among the available options. As the post accidental phase constitutes a very complex situation, involving many stakes at different levels, technical experts must be able to provide clear and argued recommendations adapted to the decision makers demand. In order to fit this problematic and to enhance its expertise capacities, I.R.S.N. is currently developing a coherent package of operational decision -aiding tools. Among them, I.C.A.R. is a new interactive software used to investigate the likely consequences of a range of recovery options for the post -accidental phase. This tool is based on an intercomparison methodology of relevant technical and radiological indicators related to the implementation of rehabilitation strategies and the associated consequences I.C.A.R. is composed of 4 main sub-modules: The scenario of accident module, used to define the characteristics of the accident and of the contaminated environment (date, deposited radionuclides). The radiological diagnosis module provides indicators related to the radiological effectiveness of the rehabilitation strategies (gain of exposure of various groups of population, contamination of the environment and the food products).The construction of rehabilitation strategies module, used to build new strategies from existing rehabilitation options and to insert them in the comparison process. The technical assessment module, used to compare some technical criteria related to the implementation of selected rehabilitation strategies (human and materials means, duration, amount of generated waste). According to the use made of I.C.A.R. two main axes were developed: accessibility and flexibility. So structure, calculation speed and user-interface of I.C.A.R. allow an intuitive, simple and convivial use. For example, the graphic mode is largely used to

Occupational rehabilitation in Hong Kong: current status and future needs.

Science.gov (United States)

Kwok, H K H; Szeto, G P Y; Cheng, A S K; Siu, H; Chan, C C H

2011-03-01

This paper reviews the development of occupational rehabilitation in Hong Kong, both in terms of the science as well as the service for injured workers. Besides, it also reviews the existing Employees' Compensation Ordinance for work injury to illustrate how the policy could influence the success and development of the discipline. Five experienced occupational rehabilitation providers, including 1 occupational medicine specialist, 3 occupational therapists, and 1 physiotherapist critically reviewed the past and current development of occupational rehabilitation in Hong Kong as well as the local contextual factors, which could influence its future development. Since the enactment of the Employees' Compensation Ordinance in the 1950s, there have been progressive improvements in the field of occupational rehabilitation in Hong Kong. Services in the early years were mostly based on the biomedical model, where doctors and patients tended to focus on clinical symptoms and physical pathology when making clinical decisions. Since then, remarkable academic achievements have been made in the field locally, from the validation of clinical instruments for assessment of work capacity, assessment of employment readiness to the evaluation of efficacy of interventional programs for injured workers focusing on work related outcomes. However, there has been a relatively lack of progress in the development of related policies and implementation of related programs for occupational rehabilitation. There is no built in linkage between rehabilitation, compensation and prevention in the current system in Hong Kong, and there is no rehabilitation policy specific to those workers with occupational diseases and injuries. There are still deficiencies in the development and provision of occupational rehabilitation services in Hong Kong. Incorporation of requirements for occupational rehabilitation at the legislation and policy levels should be seriously considered in the future. Besides, the

Characteristics of a Danish population of adults with acquired deafblindness receiving rehabilitation services

DEFF Research Database (Denmark)

Dammeyer, Jesper Herup

2013-01-01

The aim of this study is to report on the characteristics of a population of 916 individuals with acquired deafblindness receiving national Danish counselling and rehabilitation services. Age, gender, prevalence, social status, and communication mode are some of the data included in this study....... Results show that 70% of the population was older than 79 years, 15% was between 65 and 79 years, and 15% of the population was younger than 65 years. Oral speech was used by 86%, sign language by 10%, and tactile sign language by 4%. Among individuals younger than 65 years, less than 50% was employed...... or in education. Results are discussed with respect to the organization of the Danish counselling and rehabilitation service system....

[Need for Information about Medical Rehabilitation of Persons with German Pension Insurance: a Written Survey].

Science.gov (United States)

Walther, Anna Lena; Falk, Johannes; Deck, Ruth

2017-07-26

Aim In order to acquire target group-specific information on rehabilitation for members of the German pension insurance, they were asked about their ideas about medical rehabilitation and desired information regarding subjects and kind of information transfer. Method The core of the project was a written survey of members of the German pension insurance. N=600 insured people were invited to participate in the study. The questionnaire was developed in a qualitative pre-study. Results N=196 questionnaires were evaluated. Recovery of working ability was mentioned by most persons as the aim of medical rehabilitation. The most common idea regarding indication for rehabilitation was a specific operation. Physiotherapy was most often considered as therapy during medical rehabilitation. Information about formal steps, realistic aims and rehabilitation clinics were important. A conversation with their physician, written information material and a website were the preferred information pathways. Two-thirds of participants thought that information about medical rehabilitation was important even though they had no rehabilitation indication at the time of survey. Conclusion The identified target-related information needs can be considered in a need-oriented development of information material. These can contribute to an informed decision for members of the German pension insurance for or against medical rehabilitation or an application for rehabilitation. Moreover, patient-oriented information can contribute to more successful rehabilitation participation, higher satisfaction with and a better rating of medical rehabilitation. © Georg Thieme Verlag KG Stuttgart · New York.

[Screening for rehabilitation needs of patients in care of family practitioners].

Science.gov (United States)

Pullwitt, D H; Krause, O; Hildebrand, F; Fischer, G C

1997-11-01

Family doctors play an important role in promoting the access of patients to rehabilitation. On the one hand they are very often the first professionals to be contacted if patients want to take part in rehabilitation procedures whereas on the other hand there are also many patients whose need for rehabilitation remains undisclosed. No detailed estimates are available on how many of such patients exist in German GP-practices although it should be an important task of family doctors to discuss the pros and cons of rehabilitation particularly with their patients who are in need of it. We performed a non-representative pilot study in three GP offices during ten working days. patients older than 29 years were screened for their "rehabilitation status" with an instrument frequently used in German rehabilitation clinics. The patients were also asked whether or not they would like to participate in a rehabilitation procedure and what was the reason for their decision. Not knowing the patients' answers their doctors rated whether or not it would be appropriate for their patients to take part in rehabilitation. Additionally the doctors stated what kind of rehabilitation should be performed and what could be ist aims. In a sample of 181 patients about one-third was found to be in a severe "rehabilitation status", about one third in a state with higher than normal values--although not severe--and also approx. another third had a normal status. Family doctors stated that for one-third of their patients rehabilitation would be undoubtedly suitable at the time of the screening. In about two thirds of the cases the results of the questionnaire and the doctors' ratings corresponded. Some patients felt completely healthy although the results of the questionnaire and the doctors' statements rated them as being in need of rehabilitation. Other patients in need of rehabilitation rejected it for other than health-related reasons. The results of our study give evidence to the family

Exploring Methods to Investigate Sentencing Decisions

Science.gov (United States)

Merrall, Elizabeth L. C.; Dhami, Mandeep K.; Bird, Sheila M.

2010-01-01

The determinants of sentencing are of much interest in criminal justice and legal research. Understanding the determinants of sentencing decisions is important for ensuring transparent, consistent, and justifiable sentencing practice that adheres to the goals of sentencing, such as the punishment, rehabilitation, deterrence, and incapacitation of…

Preliminary study of acoustic analysis for evaluating speech-aid oral prostheses: Characteristic dips in octave spectrum for comparison of nasality.

Science.gov (United States)

Chang, Yen-Liang; Hung, Chao-Ho; Chen, Po-Yueh; Chen, Wei-Chang; Hung, Shih-Han

2015-10-01

Acoustic analysis is often used in speech evaluation but seldom for the evaluation of oral prostheses designed for reconstruction of surgical defect. This study aimed to introduce the application of acoustic analysis for patients with velopharyngeal insufficiency (VPI) due to oral surgery and rehabilitated with oral speech-aid prostheses. The pre- and postprosthetic rehabilitation acoustic features of sustained vowel sounds from two patients with VPI were analyzed and compared with the acoustic analysis software Praat. There were significant differences in the octave spectrum of sustained vowel speech sound between the pre- and postprosthetic rehabilitation. Acoustic measurements of sustained vowels for patients before and after prosthetic treatment showed no significant differences for all parameters of fundamental frequency, jitter, shimmer, noise-to-harmonics ratio, formant frequency, F1 bandwidth, and band energy difference. The decrease in objective nasality perceptions correlated very well with the decrease in dips of the spectra for the male patient with a higher speech bulb height. Acoustic analysis may be a potential technique for evaluating the functions of oral speech-aid prostheses, which eliminates dysfunctions due to the surgical defect and contributes to a high percentage of intelligible speech. Octave spectrum analysis may also be a valuable tool for detecting changes in nasality characteristics of the voice during prosthetic treatment of VPI. Copyright © 2014. Published by Elsevier B.V.

Benefits of rehabilitation with implants in masticatory function: is patient perception of change in accordance with the real improvement?

Science.gov (United States)

Vieira, Rogeria Acedo; Melo, Ana Cláudia Moreira; Budel, Lucimara A; Gama, Josiane Cristina; de Mattias Sartori, Ivete Aparecida; Thomé, Geninho

2014-06-01

This study aimed to compare the index of satisfaction and masticatory function of edentulous patients before and after rehabilitation and to evaluate if patients' perception of the changes in their oral health status is in agreement with the results of masticatory performance test. Fourteen edentulous patients were rehabilitated with lower implant-supported fixed prosthesis and upper removable dentures. Index of satisfaction and masticatory capacity (subjective analysis) and performance test (objective analysis) were evaluated before and 20 days and 8 months after rehabilitation. The patients were asked to respond a yes/no masticatory capacity questionnaire and to rate their oral satisfaction on a 0 to 10 Visual Analogue Scale (VAS). Masticatory performance test comprised the ability of the individual to pulverize an artificial test food (Optocal), after 20 and 40 masticatory strokes. When baseline answers were compared to answers 8 months after treatment, all questions, excepting the ones that considered pain and social disability, were statistically different. Wilcoxon test was used to compare index of satisfaction before and after treatment. All answers showed statistically significant differences, excluding the one that referred to ease of cleaning the prostheses. Considering the masticatory performance test, Student t test (normally distributed) and Wilcoxon test (non-normally distributed) were used to test the null hypothesis that the weight of the particles of the test food left in sieves were equal in all times of evaluation. In the larger sieve with 20 cycles, statistically significant differences were observed between baseline and 8 months, 20 days and 8 months. With 40 strokes, baseline and 20 days, baseline and 8 months and 20 days and 8 months showed significant differences. It was concluded that oral rehabilitation leads to better masticatory function in edentulous patients and there is a coincidence between patient perception and real improvement on

Improving the education in the field of patient autonomy in rehabilitation doctors working with engineers

Directory of Open Access Journals (Sweden)

Bliuc Roxana Elena

2017-01-01

Full Text Available The present study analyzes the use of bioethical expertise of Romanian rehabilitation doctors working in a hospital for engineering professionals, the Romanian Railways Clinical Hospital Iasi. The knowledge of the specific legislation by the medical personnel, proper communication, shared decision making and the use of informed consent are essential for effective healthcare provided to engineers, a group of professionals with a great contribution to the development of rehabilitation robotics and medical technology.

Pipeline rehabilitation planning

Energy Technology Data Exchange (ETDEWEB)

Palmer-Jones, Roland; Hopkins, Phil; Eyre, David [PENSPEN (United Kingdom)

2005-07-01

An operator faced with an onshore pipeline that has extensive damage must consider the need for rehabilitation, the sort of rehabilitation to be used, and the rehabilitation schedule. This paper will consider pipeline rehabilitation based on the authors' experiences from recent projects, and recommend a simple strategy for planning pipeline rehabilitation. It will also consider rehabilitation options: external re-coating; internal lining; internal painting; programmed repairs. The main focus will be external re-coating. Consideration will be given to rehabilitation coating types, including tape wraps, epoxy, and polyurethane. Finally it will discuss different options for scheduling the rehabilitation of corrosion damage including: the statistical comparison of signals from inspection pigs; statistical comparison of selected measurements from inspection pigs and other inspections; the use of corrosion rates estimated for the mechanisms and conditions; expert judgement. (author)

Assessment of Oral Status in Pediatric Patients with Special Health Care Needs receiving Dental Rehabilitation Procedures under General Anesthesia: A Retrospective Analysis.

Science.gov (United States)

Solanki, Neeraj; Kumar, Anuj; Awasthi, Neha; Kundu, Anjali; Mathur, Suveet; Bidhumadhav, Suresh

2016-06-01

Dental problems serve as additional burden on the children with special health care needs (CSHCN) because of additional hospitalization pressure, they face for the treatment of various serious medical problems. These patients have higher incidence of dental caries due to increased quantity of sugar involved in the drug therapies and lower salivary flow in the oral cavity. Such patients are difficult to treat with local anesthesia or inhaled sedatives. Single-sitting dental treatment is possible in these patients with general anesthesia. Therefore, we conducted this retrospective analysis of oral health status of CSHCN receiving various dental treatments in a given population. A total of 200 CSHCN of age 14 years or less reporting in the pediatric wing of the general hospital from 2005 to 2014 that underwent comprehensive dental treatment under general anesthesia were included in the study. Patients with history of any additional systemic illness, any malignancy, any known drug allergy, or previous history of any dental treatment were excluded from the study. Complete mouth rehabilitation was done in these patients under general anesthesia following standard protocols. Data regarding the patient's disability, type, duration, and severity of disability was collected and analyzed. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Chi-square test, Student's t-test, and one-way analysis of variance were used to assess the level of significance. Statistically significant results were obtained while analyzing the subject's decayed missing filled/decayed extracted filled teeth indices divided based on age. Significant difference was observed only in cases where patients underwent complete crown placement even when divided based on type of disability. While analyzing the prevalence, statistically significant results were observed in patients when divided based on their age. In CSHCN, dental pathologies and caries indices are

Complaints reported by patients with cancer of oral cavity, submitted to radiotherapy

International Nuclear Information System (INIS)

Bergamasco, Mariana; Miranda, Renata Puccinelli de

2006-01-01

The oral cavity is of fundamental importance to the speech, chewing, deglutition, suction and salivation functions. When an illness like cancer develops in this region, radiation therapy is very important, but can cause many sequels to the affected functions and structures of the Oral Motor System, especially to chewing, deglutition and speech. In such cases, the phonoaudiology support as part of a multidisciplinary staff can help providing esthetic and functional rehabilitation as well as social re-integration for a better quality of life of these patients. (author)

Evaluation of computerized decision support for oral anticoagulation management based in primary care.

Science.gov (United States)

Fitzmaurice, D A; Hobbs, F D; Murray, E T; Bradley, C P; Holder, R

1996-09-01

Increasing indications for oral anticoagulation has led to pressure on general practices to undertake therapeutic monitoring. Computerized decision support (DSS) has been shown to be effective in hospitals for improving clinical management. Its usefulness in primary care has previously not been investigated. To test the effectiveness of using DSS for oral anticoagulation monitoring in primary care by measuring the proportions of patients adequately controlled, defined as within the appropriate therapeutic range of International Normalised Ratio (INR). All patients receiving warfarin from two Birmingham inner city general practices were invited to attend a practice-based anticoagulation clinic. In practice A all patients were managed using DSS. In practice B patients were randomized to receive dosing advice either through DSS or through the local hospital laboratory. Clinical outcomes, adverse events and patient acceptability were recorded. Forty-nine patients were seen in total. There were significant improvements in INR control from 23% to 86% (P > 0.001) in the practice where all patients received dosing through DSS. In the practice where patients were randomized to either DSS or hospital dosing, logistic regression showed a significant trend for improvement in intervention patients which was not apparent in the hospital-dosed patients (P DSS through the full 12 months (24 days to 36 days) (P = 0.033). Adverse events were comparable between hospital and practice-dosed patients, although a number of esoteric events occurred. Patient satisfaction with the practice clinics was high. Computerized DSS enables the safe and effective transfer of anticoagulation management from hospital to primary care and may result in improved patient outcome in terms of the level of control, frequency of review and general acceptability.

The innovative rehabilitation team: an experiment in team building.

Science.gov (United States)

Halstead, L S; Rintala, D H; Kanellos, M; Griffin, B; Higgins, L; Rheinecker, S; Whiteside, W; Healy, J E

1986-06-01

This article describes an effort by one rehabilitation team to create innovative approaches to team care in a medical rehabilitation hospital. The major arena for implementing change was the weekly patient rounds. We worked to increase patient involvement, developed a rounds coordinator role, used a structured format, and tried to integrate research findings into team decision making. Other innovations included use of a preadmission questionnaire, a discharge check list, and a rounds evaluation questionnaire. The impact of these changes was evaluated using the Group Environment Scale and by analyzing participation in rounds based on verbatim transcripts obtained prior to and 20 months after formation of the Innovative Rehabilitation Team (IRT). The results showed decreased participation by medical personnel during rounds, and increased participation by patients. The rounds coordinator role increased participation rates of staff from all disciplines and the group environment improved within the IRT. These data are compared with similar evaluations made of two other groups, which served as control teams. The problems inherent in making effective, lasting changes in interdisciplinary rehabilitation teams are reviewed, and a plea is made for other teams to explore additional ways to use the collective creativity and resources latent in the team membership.

Application of Fuzzy Logic in Oral Cancer Risk Assessment.

Science.gov (United States)

Scrobotă, Ioana; Băciuț, Grigore; Filip, Adriana Gabriela; Todor, Bianca; Blaga, Florin; Băciuț, Mihaela Felicia

2017-05-01

The mapping of the malignization mechanism is still incomplete, but oxidative stress is strongly correlated to carcinogenesis. In our research, using fuzzy logic, we aimed to estimate the oxidative stress related-cancerization risk of the oral potentially malignant disorders. Serum from 16 patients diagnosed (clinical and histopathological) with oral potentially malignant disorders (Dept. of Cranio-Maxillofacial Surgery and Radiology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania) was processed fluorometric for malondialdehyde and proton donors assays (Dept. of Physiology,"Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania). The values were used as inputs, they were associated linguistic terms using MIN-MAX method and 25 IF-THEN inference rules were generated to estimate the output value, the cancerization risk appreciated on a scale from 1 to 10 - IF malondialdehyde is very high and donors protons are very low THEN the cancer risk is reaching the maximum value (Dept. of Industrial Engineering, Faculty of Managerial and Technological Engineering, University of Oradea, Oradea, Romania) (2012-2014). We estimated the cancerization risk of the oral potentially malignant disorders by implementing the multi-criteria decision support system based on serum malondialdehyde and proton donors' values. The risk was estimated as a concrete numerical value on a scale from 1 to 10 depending on the input numerical/linguistic value. The multi-criteria decision support system proposed by us, integrated into a more complex computerized decision support system, could be used as an important aid in oral cancer screening and establish future medical decision in oral potentially malignant disorders.

Prevalence and association of oral candidiasis with dysphagia in individuals with acquired brain injury

DEFF Research Database (Denmark)

Odgaard, Lene; Kothari, Mohit

2017-01-01

Objective: To describe the prevalence of oral candidiasis (OC) in individuals with acquired brain injury (ABI) and to evaluate the association of OC with improvement in dysphagia. Design: Longitudinal observational study. Methods: Individuals with ABI admitted to rehabilitation were recruited over...

COPD online-rehabilitation versus conventional COPD rehabilitation

DEFF Research Database (Denmark)

Hansen, Henrik; Bieler, Theresa; Beyer, Nina

2017-01-01

BACKGROUND: Rehabilitation of patients with chronic obstructive pulmonary disease (COPD) is a key treatment in COPD. However, despite the existing evidence and a strong recommendation from lung associations worldwide, 50% of patients with COPD decline to participate in COPD rehabilitation program......, symptoms, anxiety and depression symptoms, disease specific and generic quality of life. Primary endpoint is 10/12 weeks from baseline, while secondary endpoints are 22, 36, 62 weeks from baseline assessments. DISCUSSION: The study will likely contribute to knowledge regarding COPD tele...... accessibility and compliance. The aim of this multicenter RCT study is to compare the potential benefits of a 10-week online COPD rehabilitation program (CORe) with conventional outpatient COPD rehabilitation (CCRe). METHODS: This study is a randomized assessor- and statistician blinded superiority multicenter...

Current concepts of oral and maxillofacial rehabilitation and treatment in aviation.

Science.gov (United States)

Yuce, Esra; Koçer, Gulperi; Çini, Turan Atila

2016-01-01

Aerospace medicine is the medical discipline responsible for assessing and conserving the health, safety, and performance of individuals involved in air and space travel. With the upward trend in airline travel, flight-related oral conditions requiring treatment have become a source of concern for aircrew members. Awareness and treatment of any potential physiological problems for these aircrews have always been critical components of aviation safety. In a flight situation, oral and maxillofacial problems may in fact become life-threatening clinical conditions. The unusual nature of aerospace medicine requires practitioners to have unique expertise. Special attention to aerospace medicine will open the way for professionals to develop and apply their skills and capabilities. Both dentists and aviators should be aware of the issues involved in aviation dentistry. This article presents the principles of prevention, treatment guidelines, and dental-related flight restrictions.

Oral Rehabilitation and Management for Secondary Sjögren's Syndrome in a Child.

Science.gov (United States)

Fidalgo, Tatiana Kelly da Silva; Nogueira, Carla; Andrade, Marcia Rejane Thomas Canabarro; Valente, Andrea Graciene Lopez Ramos; Tannure, Patricia Nivoloni

2016-01-01

The aim of this paper is to describe a rare case report of a pediatric patient with secondary Sjögren's syndrome (SSS). A 12-year-old female child was referred to the Pediatric Dentistry Clinic with the chief complaint of tooth pain, dry mouth, and tooth sensibility. The patient was submitted to orthodontic treatment prior to syndrome diagnosis. The clinical treatment consisted of the interruption of orthodontic treatment and restoring the oral condition with dental treatment and the use of artificial saliva in an innovative apparatus. Dental therapy involved the control of dental caries, periodontal disease, and opportunistic fungal infections and the use of fluoride-rich solutions. The present clinical case describes clinical and laboratory aspects of SSS in pediatric patients. The management of the oral findings promoted an improvement in the oral health status and quality of life of the child.

Rehabilitation Engineering Sourcebook [and] Rehabilitation Engineering Sourcebook Supplement I.

Science.gov (United States)

Institute for Information Studies, Falls Church, VA.

Intended for use by rehabilitation counselors and work supervisors, the sourcebook contains 173 problems and solutions provided by rehabilitation engineering. A section titled "Guidelines for Formulating Problem Statements" is intended to summarize the most effective ways for either disabled individuals or rehabilitation practitioners to…

Oral rehabilitation of patients with Chediak-Higashi syndrome using zygoma and root form implant-supported fixed prostheses: A report of two patients.

Science.gov (United States)

Alzoubi, Fawaz; Bedrossian, Edmond; Wong, Allen

2016-12-01

Chediak-Higashi syndrome (CH-S) is a rare genetic immunodeficiency disorder. Fewer than 500 individuals with CH-S have been reported worldwide in the past 20 years. The dental management of patients in whom CH-S has been diagnosed has been rarely reported and only in the form of a case report. All reports addressed the severe periodontal disease found in those patients, and most studies concluded that periodontal treatment had an unfavorable prognosis. As a result, complete edentulism at an early age because of severe periodontal disease is expected. The purpose of this report was to present 2 patients with CH-S seeking oral rehabilitation after early tooth loss and severe bone resorption as a manifestation of severe periodontal disease. The treatment used bilateral zygoma implants and an all-on-4 concept. The complications encountered and management with a 5-year post-surgery follow-up are also presented. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

An ergonomic analysis of work in the process of professional rehabilitation in Brazil.

Science.gov (United States)

Cabral, A; Souza e Silva, M; Louzada, E; Cesar, W

2012-01-01

The purpose of this study is to describe the use of the Ergonomic Analysis of Work (EAW) in the process of rehabilitating workers, insured by the National Institute of Social Security (INSS) in Brazil, and to conduct a brief analysis of the instrument used by this body. Information obtained from EAW enabled the demand, the requirements of the activity and the skills needed to perform the tasks in the workplace to be determined, thus aiding the decision of the INSS as to rehabilitating the workers and their return to their jobs.

Prosthetic rehabilitation of mandibular defects with fixed-removable partial denture prosthesis using precision attachment: A twin case report

Directory of Open Access Journals (Sweden)

Vimal Kantilal Munot

2017-01-01

Full Text Available The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.

Barriers to rehabilitative care for young breast cancer survivors: a qualitative understanding.

Science.gov (United States)

Miedema, Baukje; Easley, Julie

2012-06-01

The goal of this study was to assess the rehabilitation needs of young women breast cancer survivors under the age of 50 and to identify factors that may impact or prevent cancer rehabilitation utilization. Utilizing a grounded theory methodology, 35 young breast cancer survivors were interviewed twice in four Atlantic Canadian provinces. A considerable number of barriers exist to receiving rehabilitative care post-treatment for young breast cancer survivors. The systemic barriers include the lack of availability of services, travel issues, cost of services, and the lack of support to address the unique needs for this age group. However, the most complicated barriers to accessing rehabilitative care were personal barriers which related more to choice and circumstances, such as the lack of time due to family responsibilities and appointment fatigue. Many of these personal barriers were rooted in the complex set of gender roles of young women as patients, mothers, workers, and caregivers. The contexts of young women's lives can have a substantial impact on their decisions to seek and receive rehabilitative care after breast cancer treatment. The systemic barriers can be reduced by introducing more services or financial assistance; however, the personal barriers to rehabilitation services are difficult to ameliorate due to the complex set of roles within and outside the family for this group of young breast cancer survivors. Health care providers need to take into consideration the multiple contexts of women's lives when developing and promoting breast cancer rehabilitation services and programs.

A spatial decision support system for pipe-break susceptibility ...

African Journals Online (AJOL)

lying properties. Existing decision support systems available in the field of water distribution system maintenance mainly focus on leak detection and pipe rehabilitation/replacement strategies. These existing systems, however, do not address the ...

Towards an ecologically grounded functional practice in rehabilitation.

Science.gov (United States)

Vaz, Daniela Virgínia; Silva, Paula Lanna; Mancini, Marisa Cotta; Carello, Claudia; Kinsella-Shaw, Jeffrey

2017-04-01

According to the International Classification of Functioning, Disability and Health, effective rehabilitation requires interventions that go beyond minimizing pathological conditions and associated symptoms. The scope of practice must include promoting an individual's activity within relevant contexts. We argue that best practice requires decisions that are not only evidence-based but also theory-based. Perception and action theories are essential for interpreting evidence and clinical phenomena as well as for developing new interventions. It is our contention that rehabilitation goals can best be achieved if inspired by the ecological approach to perception and action, an approach that focuses on the dynamics of interacting constraints of performer, task and environment. This contrasts with organism-limited motor control theories that have important influence in clinical practice. Parallels between such theories and the medical model of care highlight their fundamental inconsistency with the current understanding of functioning. We contend that incorporating ecological principles into rehabilitation research and practice can help advance our understanding of the complexity of action and provide better grounding for the development of effective functional practice. Implications and initial suggestions for an ecologically grounded functional practice are outlined. Copyright © 2017 Elsevier B.V. All rights reserved.

[Oral health related knowledge and health behavior of parents and school children].

Science.gov (United States)

Lalić, Maja; Aleksić, Ema; Gajić, Mihajlo; Malesević, Doka

2013-01-01

The family provides the background for developing behaviors, attitudes and knowledge related to oral health of children. The aim of this study was to compare oral health behavior of parents and their children and to asses the impact of parental behavior on children's oral health. This cross-sectional study included 99 parent--child pairs (12 to 15 years old). Data on oral health behavior, knowledge and attitudes regarding oral hygiene, fluorides and nutrition of parents and their children were collected by questionnaires. The parental dental health was assessed according to self-reported data on tooth loss and prosthodontic rehabilitation, while the dental status of children was determined by clinical examination. The parents reported the use of dental floss (p knowledge on fluorides. Approximately one third of parents thought they should not control sugar consumption of their child. There was a statistically significant correlation between parental oral hygiene and their habit to control the child in brushing with the child's oral health status. Oral health education activities directed towards the prevention of risk factors for developing caries should involve both parents and their children, because parental behavior is a significant predictor of children's oral health.

Prosthetic rehabilitation of a preschooler with induced anodontia - A clinical report

Directory of Open Access Journals (Sweden)

Shivayogi M Hugar

2011-01-01

Full Text Available A case of prosthetic rehabilitation with complete dentures for a three year nine months old child is presented. Dental prosthesis are frequently used to avoid psychologic, speech, or swallowing problems in preschooler children. The case was followed up for a period of three years. These prosthesis were modified as the child grew and as the permanent teeth erupted into the oral cavity the dentures were trimmed from the areas of erupting teeth to facilitate their eruption.

Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

Science.gov (United States)

Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

2016-05-01

Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Orthodontic treatment for oral rehabilitation after multiple maxillofacial bone fractures.

Science.gov (United States)

Nakamura, Yoshiki; Ogino, Tomoko Kuroiwa; Hirashita, Ayao

2008-09-01

We present the orthodontic treatment of a patient with occlusal dysfunction after plastic surgery for multiple maxillofacial bone fractures caused by a traffic accident. The patient had mandibular deviation to the right because of inappropriate repositioning and fixation of the fractured bone and complete avulsion of both mandibular central incisors. The bilateral mandibular incisors, canines, and premolars were also suspected of partial avulsion or alveolar bone fracture. Several tests, including percussion and dental computed tomography, were performed on these teeth to rule out ankylosis and confirm tooth movement. Camouflage orthodontic treatment was carried out with expansion of the maxillary arch, alignment of both arches, and space closure between the mandibular lateral incisors to improve the occlusion. Good occlusion and interdigitation were obtained. Orthodontic treatment is useful for the rehabilitation of occlusal dysfunction caused by multiple maxillofacial bone fractures.

Liminality and decision making for upper limb surgery in tetraplegia: a grounded theory.

Science.gov (United States)

Dunn, Jennifer A; Hay-Smith, E Jean C; Whitehead, Lisa C; Keeling, Sally

2013-07-01

To explore, from the perspective of the person with tetraplegia, the issues that influenced decision making about upper limb surgery and develop a conceptual framework describing the decision making process. Purposive and theoretical sampling of 22 people with tetraplegia, followed by interviews. Ten people had upper limb surgery and 12 had not. Verbatim transcripts were analyzed with constructivist grounded theory. Participants responded to the offer of surgery in one of three ways: yes, let me have it; no thanks; or possibly. Many influences on the decision about surgery had a temporal element, such as hope for the cure or recovery from SCI, inadequate physical or social supports while rehabilitating, life roles and goals, and the avoidance of re-hospitalization. The conceptual framework illustrated that many participants entered a liminal state within which they required a stimulus to review their decision about upper limb surgery. Decision making is a temporal process, and for some the process was a prolonged and liminal one. Therefore, multiple offers for surgery are required to allow for changing thoughts and circumstances throughout an individual's lifetime. Flexibility with regard to timing for surgery and type of rehabilitation may increase the uptake, especially for women. • Multiple offers for upper limb surgery are required throughout an individual's lifetime to account for changing thoughts and priorities. • Identification of the type of support required (informational, emotional) may assist in decreasing the time taken to make the decision about surgery. • Flexibility in surgical and rehabilitation options, especially for women, may increase the uptake of surgery.

Monitoring of patient's opinion on the quality and availability of rehabilitation organization in modern conditions

Directory of Open Access Journals (Sweden)

Shapovalenko Т.V.

2013-12-01

Full Text Available Aim: to study the patients opinion of the center of restorative medicine and rehabilitation of «Medical rehabilitation center» of MOH of Russia: the organization and availability of rehabilitation and restorative treatment. Material and Methods. Anonymous survey of 490 patients using the specially designed questionnaire. Results. The most of the respondents, almost 3A (76,1% gave the «good» and «excellent» marks, 19,8% — «satisfactory», 4,1% — «unsatisfactory». Conclusion. Results of this research can be used by health care regulatory bodies when developing the administrative decisions directed on improvement of availability and quality of rendering this specialized medical care.

Multivisceral Transplantation Rehabilitation Program-Case Report.

Science.gov (United States)

Loschi, T M; Cinacchi, M P R G; Baccan, M D T A; Marques, F; Pedroso, P T; Meira Filho, S P; Scacchetti, T; Pavão, D N

2018-04-01

Multivisceral transplantation is the treatment for multiple abdominal organ failure. The patient experiences reduced food intake and absorption of nutrients, contributing to weight loss and decreased muscle mass, reducing functional capacity. A physical and nutritional rehabilitation program based on adequate caloric intake associated with supervised physical exercise seems to support a gain of muscle mass, re-establishing its capacity and functional independence. A rehabilitation program was carried out, consisting of low-intensity aerobic exercise on treadmill, exercises of global strengthening (50% of 1 maximum repetition [1RM], with progressive increase), and nutritional monitoring (oral hypercaloric diet, hyperproteic supplementation daily and after exercise). Initial and final evaluation included weight, muscle mass index, brachial circumference (BC), tricipital cutaneous fold (TCF), hand grip strength (HGS), 6-minute walk test (6MWT), 1RM, vital capacity (VC), and respiratory muscle strength. After the program, functional capacity was evaluated through the 6MWT (92%), 1RM test, VC (55%), respiratory muscle strength, HGS at 5 kg, weight gain (4.75%), increase of BC in 2 cm, and TCF in 2 mm. The program contributed to functional independence, improved quality of life, and social reintegration, suggesting the importance of a supervised physical activity program associated with adequate nutritional intake after multivisceral transplantation. Copyright © 2018 Elsevier Inc. All rights reserved.

Comprehensive rehabilitation using dental implants in generalized aggressive periodontitis

Directory of Open Access Journals (Sweden)

Asha Ramesh

2017-01-01

Full Text Available Generalized aggressive periodontitis (GAP is a debilitating form of the disease and it results in deteriorating effects on the esthetic and functional aspects of the oral cavity. This case report describes the comprehensive rehabilitation of GAP patient using dental implants. The treatment planning involved thorough scaling and root planning (SRP with oral hygiene instructions. The patient was motivated to adhere to a strict oral hygiene regimen following which periodontal flap surgery employing guided tissue regeneration and bone grafts was performed. Bacterial culture for anaerobic microorganisms was done using a gas pack pre- and postperiodontal treatment to confirm the effectiveness of the periodontal treatment regimen and also to proceed with dental implant placement. The rigorous maintenance program ensured the stability of the periodontium following which immediate placement of dental implants in the maxillary and mandibular anterior region was done. The fixed metal-ceramic prosthesis was fabricated in a step-by-step process and the patient was recalled on a periodic basis over a 3-year follow-up duration. This case is a testimonial to the postperiodontal treatment long-term stability with excellent patient cooperation and strict maintenance protocol.

Free vascularized flaps for reconstruction of the mandible: complications, success, and dental rehabilitation.

Science.gov (United States)

van Gemert, Johannes T M; van Es, Robert J J; Rosenberg, Antoine J W P; van der Bilt, Andries; Koole, Ron; Van Cann, Ellen M

2012-07-01

To evaluate complications and success of mandibular reconstruction with free fibula flaps, iliac crest flaps, and forearm flaps with reconstruction plates and to evaluate dental rehabilitation after these reconstructions. Eighty-three patients with segmental mandibular defects were included. Correlation analyses were used to determine the relationship between reconstruction type and clinical parameters with recipient-site complications and success. The dental rehabilitation was evaluated in successfully reconstructed survivors. Multivariate analyses showed significant correlations between flap type and success (P < .0001). Of the patients, 51 (61%) were alive 2 years after the reconstruction. Mandibular reconstruction with a free forearm flap and reconstruction plate was associated with higher complication rates at the recipient site and higher failure rates compared with reconstruction with free vascularized bone flaps. Of the 32 successfully reconstructed survivors, 14 (44%) had a complete dental rehabilitation, of which 10 had dental implants and 4 did not. Only 6 (29%) of the edentulous survivors ultimately had an implant-supported prosthesis. Reconstruction of the mandible with a free vascularized bone flap is superior to reconstruction with a free forearm flap with a reconstruction plate. Complete dental rehabilitation was reached in fewer than half of the surviving patients. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Advances in rehabilitation medicine.

Science.gov (United States)

Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

2013-10-01

Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

Rehabilitating closed mining sites in North Rhine Westphalia's coal basin

International Nuclear Information System (INIS)

Mennekes, A.; Bekemeier, K.

2004-01-01

The Ruhr is a German region undergoing a reconversion. In recent years, several thousand jobs have been lost in the coal, iron and steel industries, especially in coal mines. This trend is going to continue. Rehabilitating former industrial sites so that they can welcome new industries and businesses, is decisive for this region. A rapid and financially advantageous reconversion requires coherence and continuity in the rehabilitation measures undertaken by the companies that serve as receivers, by local authorities and by investors who want to launch new projects. All these parties must manage the various phases of this process in a spirit of coordination. Germany can boast of a series of successful reconversions into industrial areas, exhibition facilities, nature reserves, tourist centers and leisure and rest places

A unique case of craniopagus twins: considerations and challenges for dental rehabilitation.

Science.gov (United States)

Campbell, Karen M

2013-01-01

The purpose of this case report was to describe oral findings and outline challenges and considerations for general anesthetic (GA) and dental management of 4-year-old female craniopagus (cranially conjoined) twins, at high risk for medical comorbidity, who presented for treatment of severe early childhood caries. This hospital-based procedure required good interdisciplinary communication, cooperation, and presurgical planning to address unique challenges and ensure positive postoperative outcomes. Two separate anesthesia teams delivered GA simultaneously to each twin. To minimize anesthetic exposure, two pediatric dental teams completed dental care concurrently. Extensive plaque accumulation and unusual "mirror-image" caries distribution were attributed to frequency and postural pooling during feeding. The rehabilitation objective was to provide definitive dental management, minimizing future need for dental retreatment under GA. Two-month follow-up revealed intact dental restorations, good oral hygiene, and weight gain. For these unique twins however, the challenge of long-term oral health maintenance remains.

Identification of the Criteria for Decision Making of Cut-Away Peatland Reuse.

Science.gov (United States)

Padur, Kadi; Ilomets, Mati; Põder, Tõnis

2017-03-01

The total area of abandoned milled peatlands which need to be rehabilitated for sustainable land-use is nearly 10,000 ha in Estonia. According to the agreement between Estonia and the European Union, Estonia has to create suitable conditions for restoration of 2000 ha of abandoned cut-away peatlands by 2023. The decisions on rehabilitation of abandoned milled peatlands have so far relied on a limited knowledgebase with unestablished methodologies, thus the decision making process needs a significant improvement. This study aims to improve the methodology by identifying the criteria for optimal decision making to ensure sustainable land use planning after peat extraction. Therefore relevant environmental, social and economic restrictive and weighted comparison criteria, which assess reuse alternatives suitability for achieving the goal, is developed in cooperation with stakeholders. Restrictive criteria are arranged into a decision tree to help to determine the implementable reuse alternatives in various situations. Weighted comparison criteria are developed in cooperation with stakeholders to rank the reuse alternatives. The comparison criteria are organised hierarchically into a value tree. In the situation, where the selection of a suitable rehabilitation alternative for a specific milled peatland is going to be made, the weighted comparison criteria values need to be identified and the presented approach supports the optimal and transparent decision making. In addition to Estonian context the general results of the study could also be applied to a cut-away peatlands in other regions with need-based site-dependent modifications of criteria values and weights.

Content analysis to locate assistive technology in Queensland's motor injury insurance rehabilitation legislation and guidelines.

Science.gov (United States)

Steel, Emily J

2018-06-08

Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. Policy documents were analyzed iteratively with set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. The policies frame rehabilitation in a medical model that assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.

Comprehensive oral-health assessment of individuals with acquired brain-injury in neuro-rehabilitation setting.

Science.gov (United States)

Kothari, Mohit; Spin-Neto, Rubens; Nielsen, Jørgen Feldbæk

2016-01-01

To perform a detailed clinical oral health assessment and oral-health-related social and behavioural aspect assessment in individuals with acquired brain injury (ABI). Prospective observational study. Thirteen individuals with ABI were recruited. Individual's social and behavioural history, bed-side oral examination score (BOE), tooth condition and periodontal status (bleeding, plaque and clinical attachment loss) were thoroughly examined. The entire examination took up to 60 minutes, using proper dental armamentarium. All evaluated individuals were diagnosed with chronic generalized periodontitis. A relationship between active periodontal disease and severe BOE score was observed (p = 0.01). Significant interaction between severe BOE scores (≥ 15 or ≥ 14) and periodontal disease severity of ≥ 2 mm (p = 0.01) was observed. The same interaction was seen between severe BOE scores and the combination of 75% extent and 2 mm severity (p = 0.01). Severity and activity of periodontitis showed dependence on individual brushing frequency (p = 0.03 and p = 0.05, respectively). Individuals with ABI had a poor status across a range of oral-, dental- and periodontal-related parameters. Further structured studies are required to define evidence-based assessment approaches for such clinical reality.

Hepatic abscess linked to oral actinomycetes: a case report.

Science.gov (United States)

De Farias, Deborah G

2015-01-01

Organ abscesses are rare, life-threatening complications that can be caused by bacteremia from oral infections. Metastatic infection is a well-established concept. Dental and periapical infections can cause infections in distant organs and tissues. The frequency of these systemic infections and systemic diseases is open to debate, as some patients are more susceptible to infections than others. This article presents the case report of a 52-year-old woman who was hospitalized with a hepatic abscess after a routine periodontal maintenance procedure. The patient had poor oral health, involving several nonrestorable teeth, multiple failed endodontic treatments, and asymptomatic chronic periapical pathologies. Her dental history included previous diagnoses of moderate generalized chronic periodontitis and advanced localized periodontitis. It was possible that bacteremia developed during her most recent dental treatment, leading to the hepatic abscess. Systemic antibiotic therapy, drainage of the hepatic abscess, and oral rehabilitation resulted in complete recovery.

Useful Method To Optimize The Rehabilitation Effort At A SCI Rehabilitation Centre

DEFF Research Database (Denmark)

Steensgaard, Randi; Dahl Hoffmann, Dorte

“Useful Method To Optimize The Rehabilitation Effort At A SCI Rehabilitation Centre” The Nordic Spinal Cord Society (NoSCoS) Meeting, Trondheim......“Useful Method To Optimize The Rehabilitation Effort At A SCI Rehabilitation Centre” The Nordic Spinal Cord Society (NoSCoS) Meeting, Trondheim...

Stroke Rehabilitation.

Science.gov (United States)

Belagaje, Samir R

2017-02-01

Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a

Building oral health research infrastructure: the first national oral health survey of Rwanda.

Science.gov (United States)

Morgan, John P; Isyagi, Moses; Ntaganira, Joseph; Gatarayiha, Agnes; Pagni, Sarah E; Roomian, Tamar C; Finkelman, Matthew; Steffensen, Jane E M; Barrow, Jane R; Mumena, Chrispinus H; Hackley, Donna M

2018-01-01

Oral health affects quality of life and is linked to overall health. Enhanced oral health research is needed in low- and middle-income countries to develop strategies that reduce the burden of oral disease, improve oral health and inform oral health workforce and infrastructure development decisions. To implement the first National Oral Health Survey of Rwanda to assess the oral disease burden and inform oral health promotion strategies. In this cross-sectional study, sample size and site selection were based on the World Health Organization (WHO) Oral Health Surveys Pathfinder stratified cluster methodologies. Randomly selected 15 sites included 2 in the capital city, 2 other urban centers and 11 rural locations representing all provinces and rural/urban population distribution. A minimum of 125 individuals from each of 5 age groups were included at each site. A Computer Assisted Personal Instrument (CAPI) was developed to administer the study instrument. Nearly two-thirds (64.9%) of the 2097 participants had caries experience and 54.3% had untreated caries. Among adults 20 years of age and older, 32.4% had substantial oral debris and 60.0% had calculus. A majority (70.6%) had never visited an oral health provider. Quality-of-life challenges due to oral diseases/conditions including pain, difficulty chewing, self-consciousness, and difficulty participating in usual activities was reported at 63.9%, 42.2% 36.2%, 35.4% respectively. The first National Oral Health Survey of Rwanda was a collaboration of the Ministry of Health of Rwanda, the University of Rwanda Schools of Dentistry and Public Health, the Rwanda Dental Surgeons and Dental (Therapists) Associations, and Tufts University and Harvard University Schools of Dental Medicine. The international effort contributed to building oral health research capacity and resulted in a national oral health database of oral disease burden. This information is essential for developing oral disease prevention and management

All on Four® fixed implant support rehabilitation: a masticatory function study.

Science.gov (United States)

De Rossi, Moara; Santos, Carla Moreto; Migliorança, Reginaldo; Regalo, Simone Cecílio Hallak

2014-08-01

Fixed implant-supported prostheses according to All-on-Four® (Nobel Biocare, Goteborg, Sweden) principles have become an accepted treatment modality in totally edentulous patients, whereas the functional effect of this therapy is limited. The purpose of this study was to evaluate the muscular function of patients totally rehabilitated with All-on-Four. This study evaluated 63 patients. Twenty-one patients were successfully rehabilitated with maxillary and mandibular All-on-Four (no dropout implants, satisfactory aesthetic and function demands prosthesis), 21 patients were dentate, and 21 were rehabilitated with double complete dentures. Electromyography was carried out during clenching, nonhabitual and habitual chewing, and rest. All values were standardized as percentage of a maximum voluntary contraction. Data were analyzed by ANOVA to compare groups and paired t-test was used for comparison between sides within each group. All groups presented symmetric muscular activity. The All-on-Four and dentate groups had a similar muscles surface electromyography (sEMG) contraction pattern, that is, a higher sEMG activity of masseter than temporalis muscles, differing (p ≤ .05) from those of denture group. Not one statistical difference was found between All-on-Four and dentate groups. The muscular function similarity of All-on-Four and dentate patients shows that this treatment concept may be considered as a good option for oral rehabilitation in edentulous patients. © 2013 Wiley Periodicals, Inc.

Why do the street children of Kathmandu do not want to live in rehabilitation homes?

Science.gov (United States)

Gurung, Anoop Singh

2013-12-01

The general objective of the present study was to identify the factors associated with street children's decision to live in Rehabilitation homes. It was a cross sectional study with 118 respondents. Data were collected by snowball sampling using constructed questionnaire and focus group discussion was also done for in-depth understanding. Descriptive, Chi-square and multivariate logistic regression study was carried out based on the PRECEDE model to analyze the data. Lack of care (p-value = 0.005), attitude of the respondents (p-value = 0.004), strict rules within the organizations (p-value = 0.025) and resilience of the respondents (p-value = 0.001) were significantly associated with the decision of the children to live in rehabilitation homes. The results of the multivariate logistic regression confirmed that children who were weakly resilient were 4.5 times more likely (OR = 4.54, 95% CI: 1.28-16.06), moderately resilient were 4 times more likely to live in rehabilitation homes (OR = 4.24, 95% CI: 1.53-11.68), than strong resilient. Children with favorable attitude were 16 times more likely to join rehabilitation homes (OR = 16.30, 95% CI: 1.78-149.10) than those favorable ones. The results showed that the children had open access to rehabilitation programs and services, but they had an unfavorable attitude towards the organizations. Most of the children were resilient and well aware of their situation. Organizations were mostly seen by these children as a means of support, but not the only option to better their life, indicating that programs and services should be planned accordingly and should not focus on institutionalizing them as the only solution.

Learning from professionals: Exploring cognitive rehabilitation strategies for the definition of the functional requirements of a telerehabilitation platform.

Science.gov (United States)

Rosso, Giovanni; Frisiello, Antonella; Trizio, Marco; Mosso, Cristina O; Bazzani, Marco

2018-04-01

In the past few years, the advances in Information and Communication Technology (ICT) led to the development of platforms and applications that aim to support cognitive rehabilitation therapy that contributes to extend patients' treatment at home. In our research we adopted the Human Centered Approach to design a cognitive rehabilitation platform that is able to provide tools and features tailored to the professional needs and strategies and also able to engage patients in their treatment process. In order to explore the clinicians' point of view on the neuropsychological intervention strategies, we applied two different techniques often used in human factors research: the Critical Decision Method to study professionals' strategies with a descriptive perspective, and the Hierarchical Task Analysis to analyze the processes with a normative view. The results of our research showed that the hybrid approach adopted allowed us to have a better focus on the cognitive rehabilitation process and on the professionals' decision making mechanism. This led to a better understanding of functional requirements for supporting clinician's strategic decision making, in terms of personalization of treatments, cognitive exercises settings and feedback customization. In conclusion, our research highlights the value of the CDM to focus deeply on which functionalities professionals require from a cognitive telerehabilitation system and allowed us to design more precisely clinician-patients interactions inside the system compared to prescriptive methods currently used. Our study offers contribution to the comprehension of the rehabilitation processes, suggesting the positive impacts of an "extended" clinic treatment by adopting a flexible and adaptable tool. Copyright © 2017. Published by Elsevier Ltd.

Implant Rehabilitation Planning Protocol for the Edentulous Patient According to Denture Space, Lip Support, and Smile Line.

Science.gov (United States)

Lago, Laura; Rilo, Benito; Fernández-Formoso, Noelia; DaSilva, Luis

2017-08-01

Rehabilitation with implants is a challenge. Having previous evaluation criteria is key to establishing the best treatment for the patient. In addition to clinical and radiological aspects, the prosthetic parameters must be taken into account in the initial workup, since they allow discrimination between fixed and removable rehabilitation. We present a study protocol that analyzes three basic prosthetic aspects. First, denture space defines the need to replace teeth, tissue, or both. Second, lip support focuses on whether or not to include a flange. Third, the smile line warns of potential risks in esthetic rehabilitation. Combining these parameters allows us to make a decision as to the most suitable type of prosthesis. The proposed protocol is useful for assessing the prosthetic parameters that influence decision making as to the best-suited type of restoration. From this point of view, we think it is appropriate for the initial approach to the patient. In any case, other considerations of study may amend the proposal. © 2016 by the American College of Prosthodontists.

Rehabilitation robotics.

Science.gov (United States)

Krebs, H I; Volpe, B T

2013-01-01

This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. Copyright © 2013 Elsevier B.V. All rights reserved.

The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair.

Science.gov (United States)

Thigpen, Charles A; Shaffer, Michael A; Gaunt, Bryce W; Leggin, Brian G; Williams, Gerald R; Wilcox, Reg B

2016-04-01

This is a consensus statement on rehabilitation developed by the American Society of Shoulder and Elbow Therapists. The purpose of this statement is to aid clinical decision making during the rehabilitation of patients after arthroscopic rotator cuff repair. The overarching philosophy of rehabilitation is centered on the principle of the gradual application of controlled stresses to the healing rotator cuff repair with consideration of rotator cuff tear size, tissue quality, and patient variables. This statement describes a rehabilitation framework that includes a 2-week period of strict immobilization and a staged introduction of protected, passive range of motion during weeks 2-6 postoperatively, followed by restoration of active range of motion, and then progressive strengthening beginning at postoperative week 12. When appropriate, rehabilitation continues with a functional progression for return to athletic or demanding work activities. This document represents the first consensus rehabilitation statement developed by a multidisciplinary society of international rehabilitation professionals specifically for the postoperative care of patients after arthroscopic rotator cuff repair. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Rehabilitation and older people.

OpenAIRE

Young, J.

1996-01-01

Rehabilitation is concerned with lessening the impact of disabling conditions. These are particularly common in older people and considerable health gain can be achieved by successful rehabilitation. Hospital doctors and general practitioners should be aware of the core principles of rehabilitation, be able to recognise rehabilitation need in their patients, and have sufficient knowledge of their local rehabilitation services to trigger the referral process.

Oral manifestations and dental management of a child with Zellweger syndrome.

Science.gov (United States)

Lertsirivorakul, Jinda; Wongswadiwat, Malinee; Treesuwan, Panta

2014-01-01

Zellweger syndrome (ZS) is a rare autosomal recessive disorder, resulting from an impairment in peroxisome function. It is characterized by craniofacial dysmorphism and neurological abnormalities, and involves several systems, which may complicate dental and anesthesia management. The case of a 7-year-old girl diagnosed with ZS is described with emphasis on oral manifestations, oral rehabilitation under general anesthesia (GA), and home oral care. Apart from the unique features of ZS, she presented with clinodactyly, distinctive palatal vault, Class III malocclusion, missing teeth, microdontia, and delayed dental formation. Dental treatment under GA was conducted with concerns of risk of respiratory insufficiency. Oral home care by the parent and regular recall visits were essential to maintain good oral health. Children with ZS may survive into late childhood. They, however, present multiple health problems that are of special concern for not only the pediatric dentist but also the anesthesiologist. Collaboration with the medical team is essential for optimal care of these patients. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Community-Based Rehabilitation to Improve Stroke Survivors' Rehabilitation Participation and Functional Recovery.

Science.gov (United States)

Ru, Xiaojuan; Dai, Hong; Jiang, Bin; Li, Ninghua; Zhao, Xingquan; Hong, Zhen; He, Li; Wang, Wenzhi

2017-07-01

The aim of this study was to evaluate the effectiveness of a community-based rehabilitation appropriate technique (CRAT) intervention program in increasing rehabilitation participation and improving functional recovery of stroke survivors. This study followed a quasi-experimental design. In each of 5 centers servicing approximately 50,000 individuals, 2 communities were designated as either the intervention or control community. A CRAT intervention program, including 2-year rehabilitation education and 3-month CRAT treatment, was regularly implemented in the intervention communities, whereas there was no special intervention in the control community. Two sampling surveys, at baseline and after intervention, were administered to evaluate the rehabilitation activity undertaken. In intervention communities, stroke survivor's motor function, daily activity, and social activity were evaluated pretreatment and posttreatment, using the Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire. The proportion of individuals participating in rehabilitation-related activity was increased significantly (P rehabilitation (P 0.05). Community-based rehabilitation appropriate technique increases rehabilitation participation rates and enhances motor function, daily activity, and social activity of stroke survivors.

78 FR 35758 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

Science.gov (United States)

2013-06-14

... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority...

Ambivalence in rehabilitation

DEFF Research Database (Denmark)

Christensen, Jan; Langberg, Henning; Doherty, Patrick

2017-01-01

BACKGROUND: Knowledge about the organization and factors of importance to rehabilitation of veterans with lower limb amputation is sparse. The aim of this study was, therefore, to improve understanding of the influences of "military identity" on the organization of rehabilitation services...... and to investigate those factors influential in achieving successful rehabilitation, including interprofessional collaboration between different sectors involved in the rehabilitation of veterans with lower limb amputations. METHODS: We used a qualitative exploratory design, triangulating interviews and participant...... observation. Data were generated using in-depth semi-structured interviews (n = 6) exploring in-hospital and post-hospital rehabilitation in Danish veterans after unilateral lower limb amputation due to trauma. We conducted four sessions of participant observation, during weekly post...

Rehabilitating torture survivors

DEFF Research Database (Denmark)

Sjölund, Bengt H; Kastrup, Marianne; Montgomery, Edith

2009-01-01

survivors can be addressed from an evidence base generated both from traumatized and non-traumatized patient populations. Thus, trauma-focused cognitive behavioural therapy and/or eye movement desensitization and reprocessing, as well as interdisciplinary pain rehabilitation, should be components......, in December 2008. The main topics were: the context of torture; mental problems including psychotherapy; internet-based therapy and pharmaco-therapy; chronic pain; social integration and family; and functioning and rehabilitation. Available evidence highlights the importance of an interdisciplinary approach......, "Rehabilitating Torture Survivors", was organized by the Rehabilitation and Research Centre for Torture Victims (a rehabilitation clinic and global knowledge and research centre with government support) in collaboration with the Centre for Transcultural Psychiatry at Rigshospitalet in Copenhagen, Denmark...

Factors influencing treatment decision-making for maintaining or extracting compromised teeth.

Science.gov (United States)

Lang-Hua, Bich Hue; McGrath, Colman P J; Lo, Edward C M; Lang, Niklaus P

2014-01-01

To evaluate treatment decision-making with respect to maintaining periodontally compromised teeth among dentists with or without postgraduate qualifications in implant dentistry. A series of patient scenarios with varying degrees of periodontal disease levels was presented to dental practitioners. Practitioners' decision-making outcome was determined, and intention to retain the compromised teeth was analyzed in bivariate and regression analyses (accounting for postgraduate implant training, gender, years in dental practice, and implant placement experience). This study involved 30 dental practitioners with postgraduate implant qualifications (GDPP), 33 dental practitioners without postgraduate implant qualifications (GDP), and 27 practitioners undergoing training for postgraduate implant qualifications (GDPT). Variations in treatment decision-making were evident between the three groups. Differences in treatment approaches to retaining compromised teeth were apparent. Furthermore, variations in rehabilitation of extracted scenarios existed in terms of use of implant and number of implants need for rehabilitation. Accounting for dentist and practice factors in regression analyses, GDPP/GDPT were three times as likely to retain periodontally compromised upper molar, with or without pain, compared to GDP (without pain OR 3.10, 95%CI 1.04, 10.62 P = 0.04; with pain OR 3.08, 95%CI 1.09, 8.14 P = 0.03). Variations in treatment decision-making with respect to retaining periodontally compromised teeth exist between dental practitioners with and those without postgraduate training in implant dentistry. Furthermore differences in management approaches in how they would retain the teeth or rehabilitate the dental arch were apparent. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

Development and evaluation of learning module on clinical decision-making in Prosthodontics.

Science.gov (United States)

Deshpande, Saee; Lambade, Dipti; Chahande, Jayashree

2015-01-01

Best practice strategies for helping students learn the reasoning skills of problem solving and critical thinking (CT) remain a source of conjecture, particularly with regard to CT. The dental education literature is fundamentally devoid of research on the cognitive components of clinical decision-making. This study was aimed to develop and evaluate the impact of blended learning module on clinical decision-making skills of dental graduates for planning prosthodontics rehabilitation. An interactive teaching module consisting of didactic lectures on clinical decision-making and a computer-assisted case-based treatment planning software was developed Its impact on cognitive knowledge gain in clinical decision-making was evaluated using an assessment involving problem-based multiple choice questions and paper-based case scenarios. Mean test scores were: Pretest (17 ± 1), posttest 1 (21 ± 2) and posttest 2 (43 ± 3). Comparison of mean scores was done with one-way ANOVA test. There was overall significant difference in between mean scores at all the three points (P posttest 1 > pretest. Blended teaching methods employing didactic lectures on the clinical decision-making as well as computer assisted case-based learning can be used to improve quality of clinical decision-making in prosthodontic rehabilitation for dental graduates.

ORAL INJURIES ASSOCIATED WITH THE USE OF COMPLETE ENTURE

Directory of Open Access Journals (Sweden)

Thanny de Paula Mascarenhas Barbosa

2011-05-01

Full Text Available Nowadays the complete denture still is a very used method of treatment in the rehabilitation of persons who lost their teeth. Oral lesions may occur due to the use of denture with deficiency in confection, or even an inadequate orientation of the patient by the dental surgeon about the use of the dentures and its cleaning. Among the oral lesions caused by the use of complete denture most frequent were the chronic atrophic candidiasis, chronic hyperplastic candidiasis, inflammatory fibrous hyperplasia, angular cheilitis, and traumatic ulceration. A neoplasic lesion wasn’t found associated with the use of dentures. This study aims to identify through a literature review of the prevalence of major diseases due to the use of complete dentures as well as their treatments.

Oral Rehabilitation and Management for Secondary Sjögren’s Syndrome in a Child

Directory of Open Access Journals (Sweden)

Tatiana Kelly da Silva Fidalgo

2016-01-01

Full Text Available The aim of this paper is to describe a rare case report of a pediatric patient with secondary Sjögren’s syndrome (SSS. A 12-year-old female child was referred to the Pediatric Dentistry Clinic with the chief complaint of tooth pain, dry mouth, and tooth sensibility. The patient was submitted to orthodontic treatment prior to syndrome diagnosis. The clinical treatment consisted of the interruption of orthodontic treatment and restoring the oral condition with dental treatment and the use of artificial saliva in an innovative apparatus. Dental therapy involved the control of dental caries, periodontal disease, and opportunistic fungal infections and the use of fluoride-rich solutions. The present clinical case describes clinical and laboratory aspects of SSS in pediatric patients. The management of the oral findings promoted an improvement in the oral health status and quality of life of the child.

Shuttle Walking Test as Predictor of Survival in Chronic Obstructive Pulmonary Disease Patients Enrolled in a Rehabilitation Program

DEFF Research Database (Denmark)

Ringbæk, Thomas; Martinez, Gerd; Brøndum, Eva

2010-01-01

BACKGROUND: The Incremental Shuttle Walking Test (ISWT) is used to assess exercise capacity in chronic obstructive pulmonary disease (COPD) and is employed as an outcome measure for pulmonary rehabilitation. We studied the value of this test in predicting survival in COPD patients enrolled...... in a rehabilitation program. METHODS: A total of 416 patients performed an ISWT before entering a 7-week outpatient pulmonary rehabilitation program. Their survival was observed over a mean period of 4.5 years (range = 1.2-7.2 years). RESULTS: During the observation period, 169 (40.6%) patients died. Univariate...... analyses showed that the ISWT as well as age, gender, present and previous tobacco smoking, forced expiratory volume in 1 second, body mass index, oxygen saturation at rest, long-term oxygen therapy, Medical Research Council dyspnea score, and treatment with oral corticosteroids were significantly...

Assessment of oral health status among endosulfan victims in endosulfan relief and remediation cell - A cross-sectional survey

Directory of Open Access Journals (Sweden)

Mundoor Manjunath Dayakar

2015-01-01

Full Text Available Background: Endosulfan is a highly toxic agrichemical used in the cashew plantations. The Stockholm Convention held in April 2011 recommended a global ban on the manufacture and use of endosulfan because of its adverse effects on human health and the environment. Its impact on the quality of food, water, and beverages; and its ability to cause neurobehavioral disorders, congenital malformations in female subjects, and abnormalities related to the male reproductive system are studied, but however information regarding the oral health of endosulfan victims is scant. Objectives: To assess the oral health status of the endosulfan victim in rehabilitation center. Method and Methodology: A cross sectional study on 18 subjects of 4-50 years of age were interviewed and examined using modified WHO oral health assessment proforma (1997 in Endosulfan Relief and Remediation Cell in Kokkada, Belthangady Taluk, Dakshina Kannada district, Karnataka, India. Results: Among the subjects, 10 (>50% were found to be in age group <20 years. The overall oral health status of the endosulfan victim's in rehabilitation center considered to be poor, as many of the subjects suffered from major medical problems like mental retardation, physical disabilities etc. Conclusion: This study emphasizes the need for special attention from government and voluntary organization to improve overall health status of the victims.

[Acute Care Rehabilitation is the First Link in a Chain of Rehabilitation Interventions].

Science.gov (United States)

Beyer, Joachim; Seidel, Egbert J

2017-08-01

An early, intensive rehabilitative therapy accelerates the recovery of the functions of patients. It contributes to a reduction in the complication rate as well as an improvement in physical and social functioning/participation in the long-term follow-up. Early rehabilitation must be strengthened on the basis of the existing structures: the creation and maintenance of adequately qualified early-stage rehabilitation facilities, at least in hospitals with priority and maximum supply contracts. Patients with long-term intensive care and polytrauma must be rehabilitated as soon as possible (intensive medical rehabilitation).Specialists in physical and rehabilitative medicine, rehabilitative geriatrists, neurologists, orthopaedists and accident surgeons and other regional physicians must cooperate in a targeted manner. Exclusion criteria using corresponding OPS codes must be canceled. Additional specialist physician groups (anesthetists and intensive care physicians, general practitioners, accident and thoracic surgeons, internists) must be sensitized to the importance of early rehabilitation.In the case of more than 500,000 hospital beds, 25,000 beds should be identified as age- and diagnosis-independent early-care beds in the country-specific bed-care plans. A cost-covering financing of the different, personal and cost-intensive early rehabilitation must be ensured. A phase model similar to the BAR guidelines for neurological-neurosurgical early rehabilitation is to be considered for other disease entities.In order to make the rehabilitation process as successful as possible, medical (acute) treatment, medical rehabilitation, occupational integration and social integration have to be understood as a holistic event and are effectively interrelated, as a continuous process which accompanies the entire disease phase-wise. For this purpose, a continuous case management or a rehabilitation guidance has to be established. © Georg Thieme Verlag KG Stuttgart · New York.

Gamified In-Home Rehabilitation for Stroke Survivors: Analytical Review

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Paul Tamayo-Serrano

2018-03-01

Full Text Available A stroke is a life-changing event that may end up as a disability, with repercussions on the patient’s quality of life. Stroke rehabilitation therapies are helpful to regain some of the patient’s lost functionality. However, in practice stroke patients may suffer from a gradual loss of motivation. Gamified systems are used to increase user motivation, hence, gamified elements have been implemented into stroke rehabilitation therapies in order to improve patients’ engagement and adherence. This review work focuses on selecting and analyzing developed and validated gamified stroke rehabilitation systems published between 2009 and 2017 to identify the most important features of these systems. After extensive research, 32 articles have met the selection criteria, resulting in a total of 28 unique works. The works were analyzed and a total of 20 features were identified. The features are explained, making emphasis on the works that implement them extensively. Finally, a classification of features based on objectives is proposed, which was used to identify the relationships between features and implementation gaps. It was found that there is a tendency to develop low-cost solutions as in-home therapy systems and provide a variety of games. This review allowed the definition of the opportunities for future research direction such as systems addressing the three rehabilitation areas; data analytics to make decisions; motivational content identification based on automatic engagement detection and emotion recognition; and alert systems for patient´s safety.

Tele-rehabilitation using in-house wearable ankle rehabilitation robot.

Science.gov (United States)

Jamwal, Prashant K; Hussain, Shahid; Mir-Nasiri, Nazim; Ghayesh, Mergen H; Xie, Sheng Q

2018-01-01

This article explores wide-ranging potential of the wearable ankle robot for in-house rehabilitation. The presented robot has been conceptualized following a brief analysis of the existing technologies, systems, and solutions for in-house physical ankle rehabilitation. Configuration design analysis and component selection for ankle robot have been discussed as part of the conceptual design. The complexities of human robot interaction are closely encountered while maneuvering a rehabilitation robot. We present a fuzzy logic-based controller to perform the required robot-assisted ankle rehabilitation treatment. Designs of visual haptic interfaces have also been discussed, which will make the treatment interesting, and the subject will be motivated to exert more and regain lost functions rapidly. The complex nature of web-based communication between user and remotely sitting physiotherapy staff has also been discussed. A high-level software architecture appended with robot ensures user-friendly operations. This software is made up of three important components: patient-related database, graphical user interface (GUI), and a library of exercises creating virtual reality-specifically developed for ankle rehabilitation.

HISTORY OF NEUROPSYCHOLOGICAL REHABILITATION

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N. A. Varako

2014-01-01

Full Text Available ABSTRACT. The article reviews the history of neuropsychological rehabilitation. It begins with the description of first rehabilitation programs developed by Paul Broca and Shepherd Franz. Franz’s experimental work for motor recovery in monkeys and correlation between active movement or affected limb immobilization and rehabilitation outcomes are described in further details. Special focus is given on ideas of famous German neurologist and psychiatrist Kurt Goldstein, who laid the foundation for modern approach in rehabilitation. Goldstein developed the idea of connection between rehabilitation and patient’s daily life. He also pointed out the necessity of psychological care of patients with brain damage.Russian neuropsychological approach is presented by its founders L.S. Vygotskiy and A.R. Luriya. Aspects of higher mental processes structure and options of its correction such as “cognitive prosthesis” are described in the sense of the approach.Y. Ben-Yishay, G. Prigatano, B. Wilson represent neuropsychological rehabilitation of the second half of the 20th century. The idea of a holistic approach for rehabilitation consists of such important principles as patient’s active involvement in a process of rehabilitation, work of a special team of rehabilitation professionals, inclusion of patient’s family members. The short review of a new rehabilitation approach for patients in coma, vegetative states and critical patients under resuscitation is given. 

Relationship between candidate communication ability and oral certification examination scores.

Science.gov (United States)

Lunz, Mary E; Bashook, Philip G

2008-12-01

Structured case-based oral examinations are widely used in medical certifying examinations in the USA. These orals assess the candidate's decision-making skills using real or realistic patient cases. Frequently mentioned but not empirically evaluated is the potential bias introduced by the candidate's communication ability. This study aimed to assess the relationship between candidate communication ability and medical certification oral examination scores. Non-doctor communication observers rated a random sample of 90 candidates on communication ability during a medical oral certification examination. The multi-facet Rasch model was used to analyse the communication survey and the oral examination data. The multi-facet model accounts for observer and examiner severity bias. anova was used to measure differences in communication ability between passing and failing candidates and candidates grouped by level of communication ability. Pearson's correlations were used to compare candidate communication ability and oral certification examination performance. Candidate separation reliability values for the communication survey and the oral examination were 0.85 and 0.97, respectively, suggesting accurate candidate measurement. The correlation between communication scores and oral examination scores was 0.10. No significant difference was found between passing and failing candidates for measured communication ability. When candidates were grouped by high, moderate and low communication ability, there was no significant difference in their oral certification examination performance. Candidates' communication ability has little relationship to candidate performance on high-stakes, case-based oral examinations. Examiners for this certifying examination focused on assessing candidate decision-making ability and were not influenced by candidate communication ability.

75 FR 21273 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Science.gov (United States)

2010-04-23

... Rehabilitation of Individuals Who are Mentally Ill. 84.129J Rehabilitation Psychology. 84.129P Specialized... students with community-based rehabilitation service providers are encouraged. Projects must include an... Mentally Ill. 84.129J Rehabilitation 100,000 2 Psychology. 84.129P Specialized Personnel 100,000 3 for...

[Orthodontic and oral surgery therapy in cleidocranial dysplasia].

Science.gov (United States)

Balaton, Gergely; Tarján, Ildikó; Balaton, Péter; Barabási, Zoltán; Gyulai Gál, Szabolcs; Nagy, Katalin; Vajó, Zoltán

2007-02-01

A cleidocranial dysplasia is an autosomal dominant inherited condition consisting of generalized skeletal disorder. Associated dental signs are present in 93,5%; failure of tooth eruption with multiple supernumerary teeth, dilaceration of roots, crown germination, microdontia, high arched palate, midface hypoplasia, high gonion angle. The molecular- genetic analysis revealed a missense mutation in the CBFA1 gene located on chromosome 6p21, which is considered to be etiological factor for CCD. Orthodontic and oral surgery therapy of a 13 year-old child with CCD was performed due to aesthetic and functional problems. The supernumerary germs were removed and the teeth were aligned with orthodontic appliances. Temporary functional rehabilitation was solved with partial denture. The presented case and the literature data support the importance of early diagnosis of CCD. The good collaboration of the orthodontic and maxillo-facial surgery specialists help achieve the correct rehabilitation of the patient.

SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

Directory of Open Access Journals (Sweden)

STANESCU Ioana

2014-09-01

Full Text Available Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition. KEY WORDS: swallowing, dysphagia, functional anatomy, rehabilitation, neuroplasticity

Rehabilitation after stroke.

Science.gov (United States)

Knecht, Stefan; Hesse, Stefan; Oster, Peter

2011-09-01

Stroke is becoming more common in Germany as the population ages. Its long-term sequelae can be alleviated by early reperfusion in stroke units and by complication management and functional restoration in early-rehabilitation and rehabilitation centers. Selective review of the literature. Successful rehabilitation depends on systematic treatment by an interdisciplinary team of experienced specialists. In the area of functional restoration, there has been major progress in our understanding of the physiology of learning, relearning, training, and neuroenhancement. There have also been advances in supportive pharmacotherapy and robot technology. Well-organized acute and intermediate rehabilitation after stroke can provide patients with the best functional results attainable on the basis of our current scientific understanding. Further experimental and clinical studies will be needed to expand our knowledge and improve the efficacy of rehabilitation.

Reflective action assessment with a prospective clinical problem solving tool in the context of rehabilitation medicine: an illustrative case study.

Science.gov (United States)

Kellett, David; Mpofu, Elias; Madden, Richard

2013-06-01

This study describes a case formulation approach applying a prospective ICF derived clinical tool to assess rehabilitation needs for a community dwelling stroke survivor with care from an outpatient rehabilitation medicine clinic. Case history data on the person were assessed for rehabilitation management planning using a prospective tool to interlink current with projected future functional status in everyday settings. Implicit assessment with reflective action informed decision points at each stage of the rehabilitation process. As a result of reflective action using the prospective tool, rehabilitation management led to significant changes in client participation after limitations to mobility and self care were mapped to the living conditions of the stroke survivor. The context sensitive rehabilitative plan resulted in higher subjective health-related quality of life in the stroke survivor and significant other and enhanced their capacity for participation. Reflective action informed assessment applying ICF concepts to clinical problem solving resulted in positive gains in health-related quality of life in a stroke survivor.

Novel digital imaging techniques to assess the outcome in oral rehabilitation with dental implants: a narrative review.

Science.gov (United States)

Benic, Goran I; Elmasry, Moustafa; Hämmerle, Christoph H F

2015-09-01

To examine the literature on novel digital imaging techniques for the assessment of outcomes in oral rehabilitation with dental implants. An electronic search of Medline and Embase databases including studies published prior to 28th December 2014 was performed and supplemented by a manual search. A synthesis of the publications was presented describing the use of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, optical scanning, spectrophotometry or optical coherence tomography (OCT) related to the outcome measures in implant therapy. Most of the digital imaging techniques have not yet sufficiently been validated to be used for outcome measures in implant dentistry. In clinical research, cone beam CT (CBCT) is increasingly being used for 3D assessment of bone and soft tissue following augmentation procedures and implant placement. Currently, there are no effective methods for the reduction of artifacts around implants in CBCT. Optical scanning is being used for the 3D assessment of changes in the soft tissue contour. The combination of optical scan with pre-operative CBCT allows the determination of the implant position and its spatial relation to anatomical structures. Spectrophotometry is the method most commonly used to objectively assess the color match of reconstructions and peri-implant mucosa to natural dentition and gingiva. New optical imaging techniques may be considered possible approaches for monitoring peri-implant soft tissue health. MRI and ultrasonography appear promising non-ionizing radiation imaging modalities for the assessment of soft tissue and bone defect morphologies. Optical scanners and OCT may represent efficient clinical methods for accurate assessment of the misfit between the reconstructions and the implants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Oral health determinants among female addicts in Iran

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S Jalal Pourhashemi

2015-01-01

Full Text Available Context: Addiction results in a range of health problems especially in the oral cavity. Aims: This study assessed the oral health status among women with a history of drug abuse in Tehran, Iran. Settings and Design: A cross-sectional study was conducted through structured interviews and clinical examinations of women at three rehabilitation centers in Tehran. Materials and Methods: Data on background characteristics, addiction history, knowledge, attitudes and behaviors, and oral health indices were collected. Statistical Analysis Used: We used MANOVA test and multiple logistic regression models to analyze the data. Results: We assessed 95 participants aged 37.88 ± 10.65 years. The most commonly reported drugs used prior to treatment were opiates (77.2%. The mean knowledge and attitude score among the patients was 80.83 ± 12.89 (37.5-100. Less than half of the dentate women reported tooth brushing as "rarely or never" (44.2%. Most of them (81.8% had never used dental floss and 76.1% were daily smokers. The mean score of dental caries index (decayed, missed and filled teeth of the participants was 20.2 ± 7.18 and 17 subjects were edentulous (17.9%. Factors such as age, drug type, duration of addiction, time of last dental visit, and frequency of brushing were associated with oral health status among these women. Conclusions: Women with a history of drug abuse in our study suffered from poor oral health. Although they had an acceptable level of knowledge and attitude toward oral health, their oral health, and hygiene was poor. These results call for more attention in designing and implementing oral health programs for addicts.

Interaction of a physician and a specialist on physical rehabilitation at violations of activity of the musculoskeletal system

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Andrii Hertsyk

2016-08-01

Full Text Available Purpose: the improvement of cooperation and the interaction of an attending physician and a specialist on physical rehabilitation at violations of activity of musculoskeletal system. Material & Methods: physical rehabilitation is considered as a difficult system with the hierarchically-ordered structure. The analysis of references and the system analysis are applied. Results: the modern approaches to coordination of centers of decision-making and the management in hierarchical systems are analyzed. The ways of the interlevel coordination in organizational systems are revealed. The need of coordination of activity of an attending physician and a specialist on physical rehabilitation is proved. The content and the direction of coordination signals for the system of physical rehabilitation at violations of activity of the musculoskeletal system are determined. Conclusions: the coordination of activity of an attending physician and a specialist on physical rehabilitation at violations of activity of the musculoskeletal system has to occur in certain ways: on purposes, on restrictions, in time, on input and output parameters.

REHABILITATION NEEDS AND PLANS AMONG PATIENTS WITH CANCER, ASSESSED AT HOSPITALS AND WHEN REHABILITATION BEGINS

DEFF Research Database (Denmark)

Handberg, Charlotte; Maribo, Thomas; Jensen, Charlotte Maria

and the specifics of needs and plans facilitates targeted rehabilitation interventions. Implications: Systematic needs assessment in cancer rehabilitation unveil the requirement of physical rehabilitation. Supervised physical activity renders an intervention possible tailored the special needs cancer patients have......Background: Systematic assessment of rehabilitation needs is prerequisite for sufficient rehabilitation, but little is known about patients' needs. Purpose: The aim of this study was to describe specific stated rehabilitation needs and plans among patients with cancer at hospitals when diagnosed...... and when municipal rehabilitation begins. Methods: Needs-assessment-forms for rehabilitation from 188 cancer patients from two hospitals and two municipal cancer rehabilitation programmes were analysed. The forms included 1) stated needs: 58 fixed areas categorised in six domains and 2) an area to document...

Cancer rehabilitation in Denmark

DEFF Research Database (Denmark)

Hansen, Helle Ploug; Tjørnhøj-Thomsen, Tine

2008-01-01

A fundamental assumption behind cancer rehabilitation in many Western societies is that cancer survivors can return to normal life by learning to deal with the consequences of their illness and their treatment. This assumption is supported by increasing political attention to cancer rehabilitation...... and a growth in residential cancer-rehabilitation initiatives in Denmark (Danish Cancer Society 1999; Government of Denmark 2003). On the basis of their ethnographic fieldwork in residential-cancer rehabilitation courses, the authors examine the new rehabilitation discourse. They argue that this discourse has...

Dental wear caused by association between bruxism and gastroesophageal reflux disease: a rehabilitation report

Directory of Open Access Journals (Sweden)

Naila Aparecida de Godoi Machado

2007-08-01

Full Text Available Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic, psychological and hereditary factors. The association between bruxism, feeding and smoking habits and digestive disorders may lead to serious consequences to dental and related structures, involving dental alterations (wear, fractures and cracks, periodontal signs (gingival recession and tooth mobility and muscle-joint sensivity, demanding a multidisciplinary treatment plan. This paper presents a case report in which bruxism associated with acid feeding, smoking habit and episodes of gastric reflow caused severe tooth wear and great muscular discomfort with daily headache episodes. From the diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow up with counseling on diet and smoking habits and management of the gastric disorders. This was followed by the installation of an interocclusal acrylic device in centric relation of occlusion (CRO for reestablishment of the occlusal stability, vertical dimension of occlusion, anterior guides and return to normal muscle activity (90-day use approximately. After remission of initial symptoms, oral rehabilitation was implemented in CRO by means of full resin composite restorations and new interocclusal device for protection of restorations. Satisfactory esthetics, improved function and occlusal stability were obtained after oral rehabilitation. The patient has attended annual follow-ups for the past 2 years. The multidisciplinary treatment seems to be the key for a successful rehabilitation of severe cases of dental wear involving the association of different health disorders.

Dental wear caused by association between bruxism and gastroesophageal reflux disease: a rehabilitation report.

Science.gov (United States)

Machado, Naila Aparecida de Godoi; Fonseca, Rodrigo Borges; Branco, Carolina Assaf; Barbosa, Gustavo Augusto Seabra; Fernandes Neto, Alfredo Júlio; Soares, Carlos José

2007-08-01

Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic, psychological and hereditary factors. The association between bruxism, feeding and smoking habits and digestive disorders may lead to serious consequences to dental and related structures, involving dental alterations (wear, fractures and cracks), periodontal signs (gingival recession and tooth mobility) and muscle-joint sensitivity, demanding a multidisciplinary treatment plan. This paper presents a case report in which bruxism associated with acid feeding, smoking habit and episodes of gastric reflow caused severe tooth wear and great muscular discomfort with daily headache episodes. From the diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow up with counseling on diet and smoking habits and management of the gastric disorders. This was followed by the installation of an interocclusal acrylic device in centric relation of occlusion (CRO) for reestablishment of the occlusal stability, vertical dimension of occlusion, anterior guides and return to normal muscle activity (90-day use approximately). After remission of initial symptoms, oral rehabilitation was implemented in CRO by means of full resin composite restorations and new interocclusal device for protection of restorations. Satisfactory esthetics, improved function and occlusal stability were obtained after oral rehabilitation. The patient has attended annual follow-ups for the past 2 years. The multidisciplinary treatment seems to be the key for a successful rehabilitation of severe cases of dental wear involving the association of different health disorders.

The Effect of Full-Mouth Rehabilitation on Oral Health-Related Quality of Life for Children with Special Health Care Needs.

Science.gov (United States)

El-Meligy, Omar; Maashi, Manal; Al-Mushayt, Abdullah; Al-Nowaiser, Abeer; Al-Mubark, Sultan

2016-01-01

Changes in oral health-related quality of life (OHRQoL) among 40 children with special health care needs (CSHCN) aged 5-14 years before and 12 months after full-mouth rehabilitation (FMR) under general anesthesia (GA) in two hospitals in Jeddah city were assessed. The questionnaire was delivered to the parents/caregivers at baseline (pre-operative) and at the 12-month post-operative follow-up visit. Medical and dental histories and clinical findings were correlated accordingly. The follow-up response rate was 87.5% with 35 children completing a 12-month follow-up visit. The age range was from 5 to 12 years with a mean of 7.3 ± 2.4 years. More than half of the study sample was boys (63%) in the 5-8 year age-group (69%). The impact on OHRQoL was reportedly negative before FMR under GA, with overall scores ranging from 12 to 68 and a mean of 43.34 ± 14.83. OHRQoL improved significantly in all aspects evaluated (P<0.05) following FMR under GA with overall scores ranging from 4 to 41 and a mean of 18.86 ± 8.54. Treating CSHCN under GA, with 3-month recall visits for the patients, had a significant long-term effect on their OHRQoL extending up to 12 months postoperatively.

Measuring acute rehabilitation needs in trauma: preliminary evaluation of the Rehabilitation Complexity Scale.

Science.gov (United States)

Hoffman, Karen; West, Anita; Nott, Philippa; Cole, Elaine; Playford, Diane; Liu, Clarence; Brohi, Karim

2013-01-01

Injury severity, disability and care dependency are frequently used as surrogate measures for rehabilitation requirements following trauma. The true rehabilitation needs of patients may be different but there are no validated tools for the measurement of rehabilitation complexity in acute trauma care. The aim of the study was to evaluate the potential utility of the Rehabilitation Complexity Scale (RCS) version 2 in measuring acute rehabilitation needs in trauma patients. A prospective observation study of 103 patients with traumatic injuries in a Major Trauma Centre. Rehabilitation complexity was measured using the RCS and disability was measured using the Barthel Index. Demographic information and injury characteristics were obtained from the trauma database. The RCS was closely correlated with injury severity (r=0.69, p<0.001) and the Barthel Index (r=0.91, p<0.001). However the Barthel was poor at discriminating between patients rehabilitation needs, especially for patients with higher injury severities. Of 58 patients classified as 'very dependent' by the Barthel, 21 (36%) had low or moderate rehabilitation complexity. The RCS correlated with acute hospital length of stay (r=0.64, p=<0.001) and patients with a low RCS were more likely to be discharged home. The Barthel which had a flooring effect (56% of patients classified as very dependent were discharged home) and lacked discrimination despite close statistical correlation. The RCS outperformed the ISS and the Barthel in its ability to identify rehabilitation requirements in relation to injury severity, rehabilitation complexity, length of stay and discharge destination. The RCS is potentially a feasible and useful tool for the assessment of rehabilitation complexity in acute trauma care by providing specific measurement of patients' rehabilitation requirements. A larger longitudinal study is needed to evaluate the RCS in the assessment of patient need, service provision and trauma system performance

[Rehabilitation in rheumatology].

Science.gov (United States)

Luttosch, F; Baerwald, C

2010-10-01

Rehabilitation in rheumatology focuses on prevention of functional disorders of the musculoskeletal system, maintenance of working ability and prevention of care dependency. Drug treatment alone rarely results in long-term remission, therefore rehabilitative measures must be integrated into rheumatic care. Rehabilitative therapy in rheumatology includes physiotherapy, patient education and occupational therapy. Positive effects of physical therapy methods have been proven by various studies. Patient education and occupational therapy are important tools for stabilizing the course of the disease. To maintain positive rehabilitative results patients have to be involved in the selection of treatment measures and should take an active part in the long-term treatment process. Despite proven efficacy of physical measures there is evidence for a lack of utilization of rehabilitative therapy due to increasing cost pressure in the health care system which will further increase over time.

The Implementation of Data Warehouse and OLAP for Rehabilitation Outcome Evaluation: ReDWinE System

Science.gov (United States)

Guo, Fei-Ran; Parmanto, Bambang; Irrgang, James J.; Wang, Jiunjie; Fang, Huaijin

2000-01-01

We created a data warehouse and OLAP system on the web for outcome evaluation of rehabilitation services. Thirteen outcome indicators were use in this research. Efficiency of therapists and clinics, expected utility of treatments and graphic patterns were generated for data exploration, data mining and decision support. Users can retrieve plenty of graphs and statistical tables without knowing database structure or attributes. Our experiences showed that multi-dimensional database and OLAP could serve as a decision support system.

Techniques of radioactive soil processing at rehabilitation of contamination territories - 59199

International Nuclear Information System (INIS)

Volkov, Victor; Chesnokov, Alexander; Danilovich, Alexey; Zverkov, Yury; Koltyshev, Sergey; Semenov, Sergey; Shisha, Anatoly

2012-01-01

Rehabilitation of nuclear- and radiation objects assumes dealing with and removal of considerable volumes of a radioactive soil. A similar situation was faced at the remediation of such sufficiently large objects, as old radioactive waste storages at the territory of 'Kurchatov Institute' and elimination of consequences of radiation accident at Podolsk plant of nonferrous metals. At rough estimates the volumes of a radioactive soil at territory of 'Kurchatov institute' were 15-20 thousand m 3 , volumes of a removed soil at carrying out of urgent measures in territory of Kirovo-Chepetsk chemical plant exceeded 20-25 thousand m 3 , volumes of a low active waste at the territory of Podolsk plant may reach 20 thousand m 3 . Such considerable volumes demand creation of technologies of their processing, an effective measuring technique of levels of their contamination and ways of considerable (in times) decrease of their volumes at the expense of decontamination or separation. Works have been aimed at the decision of these problems at carrying out of rehabilitation of territory 'Kurchatov institute'. During works technologies of radiation and water-gravitational separation of a radioactive soil have been offered and are realized in practice. A facility of water -gravitational separation of the soil was created and used within 5 years. It allowed decreasing of volumes of the low active waste in 5-6 times. In further the facility was supplied by a facility of radiation separation of the soil that has raised its efficiency. On turn there is a start-up question in experimental operation of facility of radiation separation of low active slag for Podolsk plant of nonferrous metals. The decision of these problems will allow to gain experience of creation of through technology of the processing of a radioactive soil and decrease in its volumes for using it as a design decisions for rehabilitation of other large scale radioactive-contaminated territories and industrial objects

The Intensive Dysphagia Rehabilitation Approach Applied to Patients With Neurogenic Dysphagia: A Case Series Design Study.

Science.gov (United States)

Malandraki, Georgia A; Rajappa, Akila; Kantarcigil, Cagla; Wagner, Elise; Ivey, Chandra; Youse, Kathleen

2016-04-01

To examine the effects of the Intensive Dysphagia Rehabilitation approach on physiological and functional swallowing outcomes in adults with neurogenic dysphagia. Intervention study; before-after trial with 4-week follow-up through an online survey. Outpatient university clinics. A consecutive sample of subjects (N=10) recruited from outpatient university clinics. All subjects were diagnosed with adult-onset neurologic injury or disease. Dysphagia diagnosis was confirmed through clinical and endoscopic swallowing evaluations. No subjects withdrew from the study. Participants completed the 4-week Intensive Dysphagia Rehabilitation protocol, including 2 oropharyngeal exercise regimens, a targeted swallowing routine using salient stimuli, and caregiver participation. Treatment included hourly sessions twice per week and home practice for approximately 45 min/d. Outcome measures assessed pre- and posttreatment included airway safety using an 8-point Penetration Aspiration Scale, lingual isometric pressures, self-reported swallowing-related quality of life (QOL), and level of oral intake. Also, patients were monitored for adverse dysphagia-related effects. QOL and adverse effects were also assessed at the 4-week follow-up (online survey). The Intensive Dysphagia Rehabilitation approach was effective in improving maximum and mean Penetration Aspiration Scale scores (PDysphagia Rehabilitation approach was safe and improved physiological and some functional swallowing outcomes in our sample; however, further investigation is needed before it can be widely applied. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Dental implants in patients with oral mucosal diseases - a systematic review.

Science.gov (United States)

Reichart, P A; Schmidt-Westhausen, A M; Khongkhunthian, P; Strietzel, F P

2016-05-01

To reveal dental implants survival rates in patients with oral mucosal diseases: oral lichen planus (OLP), Sjögren's syndrome (SjS), epidermolysis bullosa (EB) and systemic sclerosis (SSc). A systematic literature search using PubMed/Medline and Embase databases, utilising MeSH and search term combinations identified publications on clinical use implant-prosthetic rehabilitation in patients with OLP, SjS, EB, SSc reporting on study design, number, gender and age of patients, follow-up period exceeding 12 months, implant survival rate, published in English between 1980 and May 2015. After a mean observation period (mOP) of 53·9 months (standard deviation [SD] ±18·3), 191 implants in 57 patients with OLP showed a survival rate (SR) of 95·3% (SD ±21·2). For 17 patients with SjS (121 implants, mOP 48·6 ± 28·7 months), 28 patients with EB (165 implants, mOP 38·3 ± 16·9 months) and five patients with SSc (38 implants, mOP 38·3 ± 16·9 months), the respective SR was 91·7 ± 5·97% (SjS), 98·5 ± 2·7% (EB) and 97·4 ± 4·8% (SSc). Heterogeneity of data structure and quality of reporting outcomes did not allow for further comparative data analysis. For implant-prosthetic rehabilitation of patients suffering from OLP, SjS, EB and SSc, no evidence-based treatment guidelines are presently available. However, no strict contraindication for the placement of implants seems to be justified in patients with OLP, SjS, EB nor SSc. Implant survival rates are comparable to those of patients without oral mucosal diseases. Treatment guidelines as for dental implantation in patients with healthy oral mucosa should be followed. © 2015 John Wiley & Sons Ltd.

20 CFR 416.1448 - Deciding a case without an oral hearing before an administrative law judge.

Science.gov (United States)

2010-04-01

... § 416.1448 Deciding a case without an oral hearing before an administrative law judge. (a) Decision... the decision is based. (b) Parties do not wish to appear. (1) The administrative law judge may decide... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Deciding a case without an oral hearing...

Case descriptions of fibropapillomatosis in rehabilitating loggerhead sea turtles Caretta caretta in the southeastern USA.

Science.gov (United States)

Page-Karjian, Annie; Norton, Terry M; Harms, Craig; Mader, Doug; Herbst, Larry H; Stedman, Nancy; Gottdenker, Nicole L

2015-08-20

Fibropapillomatosis (FP) is a debilitating neoplastic disease that affects all species of hard-shelled sea turtles, including loggerhead turtles Caretta caretta. FP can represent an important clinical concern in rehabilitating turtles, since managing these infectious lesions often requires special husbandry provisions including quarantine, and FP may affect clinical progression, extend rehabilitation duration, and complicate prognoses. Here we describe cases of rehabilitating loggerhead turtles with FP (designated FP+). Medical records of FP+ loggerhead cases from 3 sea turtle rehabilitation facilities in the southeastern USA were reviewed. Between 2001 and 2014, FP was observed in 8 of 818 rehabilitating loggerhead turtles (0.98% overall prevalence in admitted patients). FP+ loggerhead size classes represented were large juvenile (straight carapace length, SCL: 58.1-80 cm; n=7) and adult (SCL>87 cm; n=1). Three turtles presented with FP, and 5 developed tumors during rehabilitation within a range of 45 to 319 d. Sites of new tumor growth included the eyes, sites of trauma, neck, and glottis. FP+ turtles were scored as mildly (3/8), moderately (4/8), or heavily (1/8) afflicted. The mean total time in rehabilitation was 476±355 d (SD) (range: 52-1159 d). Six turtles were released without visible evidence of FP, 1 turtle was released with mild FP, and 1 turtle with internal FP was euthanized. Clinical decision-making for FP+ loggerhead patients can be aided by such information as time to tumor development, anatomic locations to monitor for new tumor growth, husbandry considerations, diagnostic and treatment options, and comparisons to FP in rehabilitating green turtles Chelonia mydas.

24 CFR 7.42 - Enforcement of EEOC final decisions.

Science.gov (United States)

2010-04-01

... action for enforcement of the decision pursuant to title VII, the ADEA, the Equal Pay Act or the Rehabilitation Act and to seek judicial review of the Department's refusal to implement the ordered relief in... Urban Development EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment...

Establishing a compulsory drug treatment prison: Therapeutic policy, principles, and practices in addressing offender rights and rehabilitation.

Science.gov (United States)

Birgden, Astrid; Grant, Luke

2010-01-01

A Compulsory Drug Treatment Correctional Center (CDTCC) was established in Australia in 2006 for repeat drug-related male offenders. Compulsory treatment law is inconsistent with a therapeutic jurisprudence approach. Despite the compulsory law, a normative offender rehabilitation framework has been established based on offender moral rights. Within moral rights, the offender rehabilitation framework addresses the core values of freedom (supporting autonomous decision-making) and well-being (supporting support physical, social, and psychological needs). Moral rights are underpinned by a theory or principle which, in this instance, is a humane approach to offender rehabilitation. While a law that permits offenders to choose drug treatment and rehabilitation is preferable, the article discusses the establishment of a prison based on therapeutic policy, principles, and practices that respond to participants as both rights-violators and rights-holders. The opportunity for accelerated community access and a therapeutic alliance with staff has resulted in offenders actively seeking to be ordered into compulsory drug treatment and rehabilitation. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Multi-disciplinary decision making in general practice.

Science.gov (United States)

Kirby, Ann; Murphy, Aileen; Bradley, Colin

2018-04-09

Purpose Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents. The purpose of this paper is to explore Irish General Practitioners' (GPs) experience of switching between all OACs for Arial Fibrillation (AF) patients; prevalence of multi-disciplinary decision making in OAC switching decisions and seeks to determine the GP characteristics that appear to influence the likelihood of multi-disciplinary decision making. Design/methodology/approach A probit model is used to determine the factors influencing multi-disciplinary decision making and a multinomial logit is used to examine the factors influencing who is involved in the multi-disciplinary decisions. Findings Results reveal that while some multi-disciplinary decision-making is occurring (64 per cent), it is not standard practice despite international guidelines on integrated care. Moreover, there is a lack of patient participation in the decision-making process. Female GPs and GPs who have initiated prescriptions for OACs are more likely to engage in multi-disciplinary decision-making surrounding switching OACs amongst AF patients. GPs with training practices were less likely to engage with cardiac consultants and those in urban areas were more likely to engage with other (non-cardiac) consultants. Originality/value For optimal decision making under uncertainty multi-disciplinary decision-making is needed to make a more informed judgement and to improve treatment decisions and reduce the opportunity cost of making the wrong decision.

Effect of oral hygiene interventions on opportunistic pathogens in patients after stroke.

Science.gov (United States)

Lam, Otto L T; McMillan, Anne S; Samaranayake, Lakshman P; Li, Leonard S W; McGrath, Colman

2013-02-01

Despite the role of the oral cavity as a reservoir of opportunistic pathogens for infection in patients following stroke, the evaluation of the effects of oral hygiene interventions has been largely neglected. This randomized clinical trial included 102 patients undergoing hospital-based rehabilitation for stroke. Patients were randomized to one of 3 groups: oral hygiene instruction (OHI) only; OHI and 0.2% chlorhexidine mouth rinse twice daily; or OHI, 0.2% chlorhexidine mouth rinse twice daily, and assisted brushing twice weekly. Oral samples were obtained at baseline and after 3 weeks for detection of Staphylococcus aureus, aerobic and facultatively anaerobic gram-negative bacilli, and yeasts. Almost three-quarters (72.8%) of the patients harbored oral anaerobic gram-negative bacilli at baseline, and more than half had detectable S aureus (56.8%) and yeasts (59.3%). Percentage frequencies and viable counts of pathogens remained relatively stable during the course of the clinical trial, and no significant differences were observed among the 3 patient groups. In our study cohort, there was no significant difference in the effectiveness of the 3 different oral hygiene interventions on the prevalence or viable counts of oral opportunistic pathogens. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Computer Assisted REhabilitation (CARE) Lab: A novel approach towards Pediatric Rehabilitation 2.0.

Science.gov (United States)

Olivieri, Ivana; Meriggi, Paolo; Fedeli, Cristina; Brazzoli, Elena; Castagna, Anna; Roidi, Marina Luisa Rodocanachi; Angelini, Lucia

2018-01-01

Pediatric Rehabilitation therapists have always worked using a variety of off-the-shelf or custom-made objects and devices, more recently including computer based systems. These Information and Communication Technology (ICT) solutions vary widely in complexity, from easy-to-use interactive videogame consoles originally intended for entertainment purposes to sophisticated systems specifically developed for rehabilitation.This paper describes the principles underlying an innovative "Pediatric Rehabilitation 2.0" approach, based on the combination of suitable ICT solutions and traditional rehabilitation, which has been progressively refined while building up and using a computer-assisted rehabilitation laboratory. These principles are thus summarized in the acronym EPIQ, to account for the terms Ecological, Personalized, Interactive and Quantitative. The paper also presents the laboratory, which has been designed to meet the children's rehabilitation needs and to empower therapists in their work. The laboratory is equipped with commercial hardware and specially developed software called VITAMIN: a virtual reality platform for motor and cognitive rehabilitation.

Prevalence and characteristics of impaired glucose metabolism in patients referred to comprehensive cardiac rehabilitation: the DANSUK study

DEFF Research Database (Denmark)

Boas Soja, Anne Merete; Zwisler, Ann-Dorthe Olsen; Melchior, Thomas

2006-01-01

and mortality. We studied the prevalence of impaired glucose metabolism (T2DM, IGT and impaired fasting glucose; IFG) in patients referred to cardiac rehabilitation, and further studied whether we could identify groups in which an oral glucose tolerance test (OGTT) need not be performed. METHODS: As part...... of a cardiac rehabilitation trial, 201 patients participated. Patients without a diagnosis of T2DM (N=159) underwent an OGTT 3 months after inclusion. RESULTS: Forty-two patients (21%) had known T2DM at enrolment. Based on the OGTT, 26 patients (13%) had unrecognized T2DM, 36 (18%) had IGT and 19 (9%) were...... predictive value of 39%. CONCLUSION: More than 60% of the patients (123/201) referred to cardiac rehabilitation had impaired glucose metabolism and 18% of the screened patients (29/159) would be misclassified if an OGTT was omitted. IFG and IGT did not identify the same patients or the same cardiovascular...

Oral Health Education in Children before Dental Treatment under General Anesthesia.

Science.gov (United States)

Valéra, Marie-Cécile; Aragon, Isabelle; Monsarrat, Paul; Vaysse, Fréderic; Noirrit-Esclassan, Emmanuelle

The aim of this study was to evaluate the attitude of parents towards the oral health of their children before oral rehabilitation under general anesthesia (GA). Children receiving dental treatment under GA between November 2013 and July 2014 in the Pediatric Dentistry Department (University Hospital Center, Toulouse, France) were enrolled in an oral health preventive program. An anonymous questionnaire was self-administered by the parents during the pre-operative session. The sample comprised 67 children with a mean age of 4.8 years. 48 % of the parents had difficulties in maintaining the oral hygiene of their child. Two thirds of them reported a lack of cooperation. An adult cleaned the child's teeth in 43% of the cases. 14% of the study population brushed their teeth twice a day or more. In addition, half of the parents reported that they modified food consumption or teeth cleaning habits of their children since the initial consultation. This study suggests a low compliance of parents and children with the recommendations on oral hygiene and food consumption given at the initial visit and demonstrates the feasibility of a preventive program in this population.

Mechanical bowel preparation and oral antibiotic prophylaxis in colorectal surgery: Analysis of evidence and narrative review.

Science.gov (United States)

Badia, Josep M; Arroyo-García, Nares

2018-05-14

The role of oral antibiotic prophylaxis and mechanical bowel preparation in colorectal surgery remains controversial. The lack of efficacy of mechanical preparation to improve infection rates, its adverse effects, and multimodal rehabilitation programs have led to a decline in its use. This review aims to evaluate current evidence on antegrade colonic cleansing combined with oral antibiotics for the prevention of surgical site infections. In experimental studies, oral antibiotics decrease the bacterial inoculum, both in the bowel lumen and surgical field. Clinical studies have shown a reduction in infection rates when oral antibiotic prophylaxis is combined with mechanical preparation. Oral antibiotics alone seem to be effective in reducing infection in observational studies, but their effect is inferior to the combined preparation. In conclusion, the combination of oral antibiotics and mechanical preparation should be considered the gold standard for the prophylaxis of postoperative infections in colorectal surgery. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies - USP (HRAC-USP) - Part 2: Pediatric Dentistry and Orthodontics

Science.gov (United States)

FREITAS, José Alberto de Souza; GARIB, Daniela Gamba; OLIVEIRA, Thais Marchini; LAURIS, Rita de Cássia Moura Carvalho; de ALMEIDA, Ana Lúcia Pompéia Fraga; NEVES, Lucimara Teixeira; TRINDADE-SUEDAM, Ivy Kiemle; YAEDÚ, Renato Yassutaka Faria; SOARES, Simone; PINTO, João Henrique Nogueira

2012-01-01

The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies - University of São Paulo (HRAC-USP). Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP). At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics. PMID:22666849

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies - USP (HRAC-USP - Part 2: Pediatric Dentistry and Orthodontics

Directory of Open Access Journals (Sweden)

José Alberto de Souza Freitas

2012-04-01

Full Text Available The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies - University of São Paulo (HRAC-USP. Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP. At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics.

Rehabilitative treatment of cleft lip and palate: experience of the Hospital for Rehabilitation of Craniofacial Anomalies-USP (HRAC-USP)--part 2: pediatric dentistry and orthodontics.

Science.gov (United States)

Freitas, José Alberto de Souza; Garib, Daniela Gamba; Oliveira, Marchini; Lauris, Rita de Cássia Moura Carvalho; Almeida, Ana Lúcia Pompéia Fraga de; Neves, Lucimara Teixeira; Trindade-Suedam, Ivy Kiemle; Yaedú, Renato Yassutaka Faria; Soares, Simone; Pinto, João Henrique Nogueira

2012-01-01

The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies-University of São Paulo (HRAC-USP). Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP). At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics.

48 CFR 15.102 - Oral presentations.

Science.gov (United States)

2010-10-01

... document what the Government relied upon in making the source selection decision. The method and level of... Section 15.102 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS... impact (including cost) on small businesses. In considering the costs of oral presentations, contracting...

An imaging informatics-based ePR (electronic patient record) system for providing decision support in evaluating dose optimization in stroke rehabilitation

Science.gov (United States)

Liu, Brent J.; Winstein, Carolee; Wang, Ximing; Konersman, Matt; Martinez, Clarisa; Schweighofer, Nicolas

2012-02-01

Stroke is one of the major causes of death and disability in America. After stroke, about 65% of survivors still suffer from severe paresis, while rehabilitation treatment strategy after stroke plays an essential role in recovery. Currently, there is a clinical trial (NIH award #HD065438) to determine the optimal dose of rehabilitation for persistent recovery of arm and hand paresis. For DOSE (Dose Optimization Stroke Evaluation), laboratory-based measurements, such as the Wolf Motor Function test, behavioral questionnaires (e.g. Motor Activity Log-MAL), and MR, DTI, and Transcranial Magnetic Stimulation (TMS) imaging studies are planned. Current data collection processes are tedious and reside in various standalone systems including hardcopy forms. In order to improve the efficiency of this clinical trial and facilitate decision support, a web-based imaging informatics system has been implemented together with utilizing mobile devices (eg, iPAD, tablet PC's, laptops) for collecting input data and integrating all multi-media data into a single system. The system aims to provide clinical imaging informatics management and a platform to develop tools to predict the treatment effect based on the imaging studies and the treatment dosage with mathematical models. Since there is a large amount of information to be recorded within the DOSE project, the system provides clinical data entry through mobile device applications thus allowing users to collect data at the point of patient interaction without typing into a desktop computer, which is inconvenient. Imaging analysis tools will also be developed for structural MRI, DTI, and TMS imaging studies that will be integrated within the system and correlated with the clinical and behavioral data. This system provides a research platform for future development of mathematical models to evaluate the differences between prediction and reality and thus improve and refine the models rapidly and efficiently.

[Rehabilitation of chronic obstructive pulmonary diseases at the lung hospital (author's transl)].

Science.gov (United States)

Meister, W

1979-12-01

The modern lung hospital offers favorable conditions for the rehabilitation of patients suffering from chronic obstructive pulmonary diseases. In the years from 1972 to 1976 2398 patients suffering from chronic bronchitis, bronchial asthma and pulmonary emphysema were subjected to a rehabilitation process at the central hospital for heart and lung diseases Bad Berka. A long-term therapy plan based on a most accurate investigation possible of all the factors which trigger off the complaint in each case was used as baseline. An account is given of the resulting diagnostic and therapeutic program carried out. In the case of chronic obstructive pulmonary diseases it is particularly difficult to assess the effectiveness of rehabilitation measures. One aspect dealt with is the restoration of working capacity. 56.7% of the men and 56.8% of the women were capable of working when they were dismissed. 31.6% of male and 26.4% of female patients were invalids, 11.7% and 16.8% respectively were old age pensioners. Rehabilitation success depended on variables such as age, degree of cardio-pulmonary limitation in performance, as well as on certain concomitant diseases and the patient's cooperation. A decisive factor in some cases was also whether suitable employment could be found for these patients whose age ranges between 40 and 60.

Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.

Science.gov (United States)

Resnik, Linda; Meucci, Marissa R; Lieberman-Klinger, Shana; Fantini, Christopher; Kelty, Debra L; Disla, Roxanne; Sasson, Nicole

2012-04-01

The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

8 CFR 1103.3 - Denials, appeals, and precedent decisions.

Science.gov (United States)

2010-01-01

... types of cases may be appealed. Decisions under the appellate jurisdiction of the Board of Immigration... argument regarding appeal before AAU—(1) Request. If the affected party desires oral argument, the affected party must explain in writing specifically why oral argument is necessary. For such a request to be...

Zygomatic bone graft for oral-antral communication closure and implant placement.

Science.gov (United States)

Peñarrocha-Diago, Miguel; García, Berta; Gomez, Dolores; Balaguer, José

2007-01-01

The roots of molar and premolar maxillary teeth are often very close to the floor of the maxillary sinus. As a result, extraction of these teeth can leave an oral-antral communication or lead to a fistula that requires treatment. A woman with an oral-antral communication secondary to extraction of a maxillary molar is presented. The communication was closed by means of a bone graft harvested from the wall of the sinus (zygomatic bone). After 3 months, 2 dental implants were placed, one in the pterygoid area and the other with parasinusal angulation. Rehabilitation followed in the form of a screw-retained, fixed prosthesis 3 months after implant placement. There have been no complications after 1 year of follow-up. This surgical technique allowed closure of an oral-antral communication produced by molar extraction through placement of a zygomatic bone graft and subsequent placement of 2 dental implants.

Stroke rehabilitation.

Science.gov (United States)

Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert

2011-05-14

Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

Geriatric Rehabilitation ('Alters-Rehabilitation'): The New Challenge for Social Medicine and Science.

Science.gov (United States)

Barolin, G. S.

1996-01-01

This discussion of geriatric rehabilitation stresses the importance of holistic and permanent rehabilitation with a fluent transition from the acute phase to the rehabilitation phase under one specialist's care and in one institution. Recommendations include mixed age groups in one ward; systematic education of relatives; follow-up rehabilitation…

A systematic review of functional outcome and quality of life following reconstruction of maxillofacial defects using vascularized free fibula flaps and dental rehabilitation reveals poor data quality

NARCIS (Netherlands)

Wijbenga, Johan G.; Schepers, Rutger H.; Werker, Paul M. N.; Witjes, Max J. H.; Dijkstra, Pieter U.

Background: Reconstruction and oral rehabilitation of segmental maxillofacial defects resulting from ablative surgery is commonly achieved by osteocutaneous vascularized free fibula (VFFF) transplantation combined with implant-supported dental prostheses. We systematically reviewed the literature

Decision-making support on rehabilitation of radioactive contaminated territories based on the use of site-specific PRANA DSS

International Nuclear Information System (INIS)

Yatsalo, B.I.; Mirzeabassov, O.A.; Okhrimenko, I.V.; Pichugina, I.A.

2000-01-01

Geographic Information System (GIS) PRANA is a Decision Support System (DSS) for countermeasure analysis in agriculture in the long-term period of liquidating the consequences of a nuclear accident. However, though PRANA(-98) is used at the Chernobyl Department (Ministry of Agriculture) and at the Bryansk Centre of Agrochemical Radiology for practical needs, but its possibilities are limited by the questions of agriculture. Conceptual requirements to GIS-DSSs, which are some considerable extension of the PRANA(-98) and meet all the main demands to DSSs for practical use, research and training on rehabilitation of contaminated territories, were elaborated in contacts with interested parties in Russia: Ministry of Agriculture, Minatom, Emercom, Ministry of Health, Ministry of Science and Administration of Bryansk region. Realisation of the planned requirements and tasks have been achieved not through developing the only universal system, but through creating several GIS-DSSs (family of PRANA systems, each of them is intended for analysis of specific range of problems): - GIS-DSS for practical use (with introduction at appropriate Ministries and Centres); - GIS-DSS for research and for scientific and practical estimations; - GIS-DSS for training of the specialists; - GIS-DSS as well as computer realisation of thematic blocks for use as lectures, seminars and tests/questionnaires for aims of education (students, specialists); - elements of distributed systems and remote access to components of GIS-DSS (for practical use, training and education). The following sections, which have been realised in accordance with the chosen level of the system, represent in the aggregate a basis of each GIS-DSS indicated above: - databases (radioecological, economic, demographic and other monitoring data); - libraries of electronic maps (including different layers of vector maps of land use for territories under consideration); - spatial analysis of various data from databases

Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update

Directory of Open Access Journals (Sweden)

Nyl

2016-02-01

Full Text Available John Nyland,1,2 Alma Mattocks,1 Shane Kibbe,2 Alaa Kalloub,2,3 Joe W Greene,4 David N M Caborn2,3 1Athletic Training Program, Kosair Charities College of Health and Natural Sciences, Spalding University, Louisville, KY, USA; 2Department of Orthopedic Surgery, University of Louisville, Louisville, KY, USA; 3Shea Orthopedic Group, Louisville, KY, USA; 4Norton Orthopedic and Sports, Louisville, KY, USA Abstract: Anatomical discoveries and a growing appreciation of the knee as a complex organ are driving innovations in patient care decision-making following anterior cruciate ligament (ACL injury. Surgeons are increasing their efforts to restore combined mechanical-neurosensory ACL function and placing more consideration on when to reconstruct versus repair native anatomical structures. Surgical options now include primary repair with or without reinforcing the injured ACL with suture-based internal bracing, and growing evidence supports biological augmentation using platelet-rich plasma and mesenchymal stem cells to enhance tissue healing. Physical therapists and athletic trainers are increasing their efforts to facilitate greater athlete cognitive engagement during therapeutic exercise performance to better restore nonimpaired neuromuscular control activation amplitude and timing. Knee brace design and use needs to evolve to better match these innovations and their influence on the rehabilitation plan timetable. There is a growing appreciation for the multifaceted characteristics of the rehabilitation process and how they influence neuromuscular, educational, and psychobehavioral treatment goal achievement. Multiple sources may influence the athlete during the return to sports process and clinical outcome measures need to be refined to better evaluate these influences. This update summarizes contemporary ACL surgical, medical, and rehabilitation interventions and future trends. Keywords: arthroscopy, knee, function, outcomes, decision-making 

78 FR 27038 - Final Priorities; National Institute on Disability and Rehabilitation Research-Rehabilitation...

Science.gov (United States)

2013-05-09

... settings, including the community, rehabilitation service- delivery institutions, vocational rehabilitation...) Vocational rehabilitation (VR) practices that contribute to improved employment outcomes for individuals with... or more priorities, we designate the type of each priority as absolute, competitive preference, or...

75 FR 21606 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Science.gov (United States)

2010-04-26

... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9626... education and training for rehabilitation personnel; (3) Disseminate, in a cost-effective manner...

Impact of a multidisciplinary rehabilitation nutrition team on evaluating sarcopenia, cachexia and practice of rehabilitation nutrition.

Science.gov (United States)

Kokura, Yoji; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Nakahara, Saori

2017-01-01

To determine whether the presence of a multidisciplinary rehabilitation nutrition team affects sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. A cross-sectional study using online questionnaire among members of the Japanese Association of Rehabilitation Nutrition (JARN) was conducted. Questions were related to sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. 677 (14.7%) questionnaires were analysed. 44.5% reported that their institution employed a rehabilitation nutrition team, 20.2% conducted rehabilitation nutrition rounds and 26.1% conducted rehabilitation nutrition meetings. A total of 51.7%, 69.7%, 69.0% and 17.8% measured muscle mass, muscle strength, physical function and cachexia, respectively. For those with a rehabilitation nutrition team, 63.5%, 80.7%, 82.4% and 22.9% measured muscle mass, muscle strength, physical function and cachexia, respectively, whereas 46.7%, 78.0% and 78.1% of the respondents reported implementation of nutrition planning strategies in consideration of energy accumulation, rehabilitation training in consideration of nutritional status and use of dietary supplements, respectively. Multivariate logistic regression analysis showed that the use of a rehabilitation nutrition team independently affected sarcopenia evaluation and practice of rehabilitation nutrition but not cachexia evaluation. The presence of a multidisciplinary rehabilitation nutrition team increased the frequency of sarcopenia evaluation and practice of rehabilitation nutrition. J. Med. Invest. 64: 140-145, February, 2017.

Rehabilitation of disturbed land

Energy Technology Data Exchange (ETDEWEB)

Bell, L.C. [Australian Centre for Minesite Rehabilitation Research, Kenmore, Qld. (Australia)

1996-12-31

This chapter discusses the objectives of rehabilitation of lands in Australian disturbed by mining. It gives advice on rehabilitation planning and outlines the factors influencing post-mining land use and rehabilitation strategies, including climate, topography, hydrology, properties of soils, overburden and mineral processing wastes, flora and fauna and social considerations. Finally, the key elements of a rehabilitation plan are discussed, namely: landscape reconstruction; selective handling of overburden; and establishment and maintenance of a vegetative cover. 12 figs., 1 tab.

DECISION SUPPORT FOR RENEWAL OF WASTEWATER COLLECTIONS AND WATER DISTRIBUTION SYSTEMS

Science.gov (United States)

The decision of how to accomplish the renewal of existing wastewater collection and water distribution systems involves the evaluation of many criteria and parameters. These criteria must be evaluated thoroughly to determine the best way of rehabilitating or replacing these syste...

75 FR 21617 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Science.gov (United States)

2010-04-26

... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... The Assistant Secretary for Special Education and Rehabilitative Services may change the maximum..., Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9635 Filed 4-23-10; 8...

Motivational Rehabilitation using Serious Games

OpenAIRE

Antoni Jaume i Capó; Javier Varona Gómez; Gabriel Moyà; Francisco Perales

2013-01-01

Research studies show that serious games help to motivate users in rehabilitation processes, and rehabilitation results are better when users are motivated. In long term rehabilitation for maintaining capacities, the demotivation of chronic patients is common. In this work, we have implemented balance rehabilitation video game for cerebral palsy patients. The video game was developed using the prototype development paradigm and following desirable features for rehabilitation serious games pre...

Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management

OpenAIRE

Wakabayashi, Hidetaka; Sakuma, Kunihiro

2014-01-01

Malnutrition and sarcopenia often occur in rehabilitation settings. The prevalence of malnutrition and sarcopenia in older patients undergoing rehabilitation is 49–67 % and 40–46.5 %, respectively. Malnutrition and sarcopenia are associated with poorer rehabilitation outcome and physical function. Therefore, a combination of both rehabilitation and nutrition care management may improve outcome in disabled elderly with malnutrition and sarcopenia. The concept of rehabilitation nutrition as a c...

Validity of patient-reported swallowing and speech outcomes in relation to objectively measured oral function among patients treated for oral or oropharyngeal cancer.

Science.gov (United States)

Rinkel, R N P M; Verdonck-de Leeuw, I M; de Bree, R; Aaronson, N K; Leemans, C R

2015-04-01

The objective of this study was to test the construct validity of the patient-reported outcomes Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI) in relation to objectively measured oral function among patients treated for oral or oropharyngeal cancer. The study sample consisted of patients treated for oral or oropharyngeal cancer. Outcome measures were the SWAL-QOL and the SHI, and the Functional Rehabilitation Outcomes Grade (FROG), a test to measure oral and shoulder function. Spearman's rank correlation coefficient was used to test associations between the SHI and SWAL-QOL scales, and the FROG scales. During a study period of 3 months, 38 patients (21 males, 17 females; mean age 54 years) were included who visited the outpatient clinic for follow-up care 6-155 months after surgical treatment (n = 14) or combined surgery and radiotherapy (n = 24) for oral (n = 21) or oropharyngeal cancer (n = 17). Most SWAL-QOL and SHI scales (except the SWAL-QOL Fatigue scale) correlated significantly with one or more FROG oral function scales. None of the SWAL-QOL and SHI scales correlated significantly with the FROG shoulder function scale. These results support the construct validity of the SWAL-QOL and SHI questionnaires for assessing speech and swallowing problems in daily life that are moderately but significantly related to oral function. A multidimensional assessment protocol is recommended for use in clinical practice and for research purposes for measuring oral function and swallowing- and speech-related problems in daily life among head and neck cancer patients.

Research-based evidence in stroke rehabilitation: an investigation of its implementation by physiotherapists and occupational therapists.

Science.gov (United States)

Kristensen, Hanne Kaae; Ytterberg, Charlotte; Jones, Dorrie Lee; Lund, Hans

2016-12-01

Stroke rehabilitation is a multidimensional process that is designed to facilitate restoration of and/or adaptation to loss of functioning. The use of research-based evidence in informed decision-making is insufficient. Occupational therapy and physiotherapy constitute important contributions to rehabilitation. The study aim was to investigate characteristics of the implementation of research-based evidence in stroke rehabilitation by occupational therapists and physiotherapists, using the International Classification of Functioning, Disability and Health as a conceptual framework. A prospective cohort study, including all service levels within stroke rehabilitation. Consecutive patients with stroke admitted to a university hospital between May and December 2012 were enrolled by 13 therapists. Documentation of daily practice was collected from medical records. Analysis compared the therapists' documentation with the national clinical guidelines for physiotherapy and occupational therapy in the rehabilitation of adults with brain injury. The study included 131 patients. The therapists' praxis was seen to be in agreement with the majority of the national clinical guidelines. However, joint goal-setting and evaluation using standardized measures were seldom documented. Although the therapists recognize evidence-based practice as a framework for achieving quality in rehabilitation, findings suggest that they do not employ research-based evidence to the fullest extent. Implications for Rehabilitation In order to individualize the rehabilitation offered, more attention and focus on involving and giving words to patients' expectations, perceptions, experiences, and perspectives is needed. With the intention of enabling meaningful participation the health professionals need to pay more attention to the importance of environmental factors. Both guidelines and clinical practice should consider all components of the International Classification of Functioning, Disability and

Oral health and cardiovascular care: Perceptions of people with cardiovascular disease

Science.gov (United States)

Salamonson, Yenna; Ajwani, Shilpi; Bhole, Sameer; Bishop, Joshua; Lintern, Karen; Nolan, Samantha; Rajaratnam, Rohan; Redfern, Julie; Sheehan, Maria; Skarligos, Fiona; Spencer, Lissa; Srinivas, Ravi

2017-01-01

Main objective The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health. Method A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews. Data was analysed using thematic analysis. Results Results suggested that while oral health was considered relevant there was high prevalence of poor oral health among participants, especially those from socioeconomic disadvantaged background. Awareness regarding the importance of oral health care its impact on cardiovascular outcomes was poor among participants. Oral health issues were rarely discussed in the cardiac setting. Main barriers deterring participants from seeking oral health care included lack of awareness, high cost of dental care and difficulties in accessing the public dental service. Findings also revealed that participants were interested in receiving further information about oral health and suggested various mediums for information delivery. The concept of cardiac care clinicians, especially nurses providing education, assessment and referrals to ongoing dental care was well received by participants who felt the post-acute period was the most appropriate time to receive oral health care advice. The issues of oral health training for non-dental clinicians and how to address existing barriers were highlighted by participants. Relevance to clinical practice The lack of oral health education being provided to patients with cardiovascular disease offers an opportunity to improve care and potentially, outcomes. In view of the evidence linking poor oral health with cardiovascular disease, cardiac care clinicians, especially nurses, should be appropriately trained to promote oral health in

Oral health and cardiovascular care: Perceptions of people with cardiovascular disease.

Directory of Open Access Journals (Sweden)

Paula Sanchez

Full Text Available The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health.A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews. Data was analysed using thematic analysis.Results suggested that while oral health was considered relevant there was high prevalence of poor oral health among participants, especially those from socioeconomic disadvantaged background. Awareness regarding the importance of oral health care its impact on cardiovascular outcomes was poor among participants. Oral health issues were rarely discussed in the cardiac setting. Main barriers deterring participants from seeking oral health care included lack of awareness, high cost of dental care and difficulties in accessing the public dental service. Findings also revealed that participants were interested in receiving further information about oral health and suggested various mediums for information delivery. The concept of cardiac care clinicians, especially nurses providing education, assessment and referrals to ongoing dental care was well received by participants who felt the post-acute period was the most appropriate time to receive oral health care advice. The issues of oral health training for non-dental clinicians and how to address existing barriers were highlighted by participants.The lack of oral health education being provided to patients with cardiovascular disease offers an opportunity to improve care and potentially, outcomes. In view of the evidence linking poor oral health with cardiovascular disease, cardiac care clinicians, especially nurses, should be appropriately trained to promote oral health in their practice. Affordable and accessible

38 CFR 21.283 - Rehabilitated.

Science.gov (United States)

2010-07-01

.... (Authority: 38 U.S.C. 3100) (c) Rehabilitation to the point of employability has been achieved. The veteran who has been found rehabilitated to the point of employability shall be declared rehabilitated if he... professional knowledge and skills obtained under the rehabilitation plan; or (3) Pursues additional education...

The Effectiveness of Using Linguistic Classroom Activities in Teaching English Language in Developing the Skills of Oral Linguistic Performance and Decision Making Skill among Third Grade Intermediate Students in Makah

Science.gov (United States)

Alshareef, Fahd Majed

2016-01-01

The study aimed to reveal the effectiveness of the use of certain classroom language activities in teaching English language in the development of oral linguistic performance and decision-making among intermediate third-grade students in Makah, and it revealed a statistically significant correlation relationship between the averages of the study…

Predictors of dental rehabilitation in children aged 3-12 years.

Science.gov (United States)

Gopinath, Vellore Kannan; Awad, Manal A

2015-01-01

The aim of this study was to evaluate the proportion of completed treatments and to study the factors affecting the full mouth dental rehabilitation in pediatric patients treated by undergraduate students at the College of Dental Medicine Teaching Clinics, University of Sharjah. A retrospective study was conducted on 270 children aged less than 12 years (mean age 7.6, SD 2.04). Comprehensive dental rehabilitation reports of child patients that were completed by final year dental undergraduate students from the year 2009 to 2011 were reviewed. Data on complete history, oral examination, dental charting, and treatment plan were collected from pediatric dentistry case sheet. Dental caries was charted using WHO 1997 criteria. Dental treatment needs and completion of dental care delivered to children involved in this study were assessed using DMFT/deft scores. Percentages of treatment provided included completed restorations (94%) and space management (84%) in primary dentition, whereas 98% of restoration and 94% of required sealants were completed in permanent dentition. The percentage of completed dental treatment including sealant placement was 61%. Age of the child and the number of decayed teeth present before the start of the treatment significantly correlated with the children in the incomplete treatment category (P dental care was provided in a holistic approach to the children attending College of Dental Medicine training clinics. Age of the child and the number of decayed teeth were the factors affecting dental rehabilitation in children aged 3-12 years.

78 FR 14480 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

Science.gov (United States)

2013-03-06

... and rehabilitation research; (2) foster an exchange of expertise, information, and training methods to... disabilities, as well as to build the research capacity of entities with close cultural and social connections... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Center on Research...

Possibilities of reconstruction and implant-prosthetic rehabilitation following mandible resection

Directory of Open Access Journals (Sweden)

Konstantinović Vitomir S.

2013-01-01

Full Text Available Introduction. Mandible reconstruction is still very challenging for surgeons. Mandible defects could be the consequence of ablative surgery for malignancies, huge jaw cysts, infection and trauma. Segmental resection of the mandible may compromise orofacial function and often lead to patients psychological disorders. Despite very frequent use of microvascular flaps, autogenous bone grafts are still very reliable technique for mandible reconstruction. Comprehensive therapy means not only mandible reconstruction, but prosthodontic rehabilitation supported by dental implants, which can significantly improve patients quality of life. The aim of this paper was to evaluate possible techniques of mandible reconstruction and to present a patient who had been submitted to mandible resection and reconstruction with autogenous iliac bone graft and prosthodontic rehabilitation with fixed denture anchoraged by disc-shaped implants in early loading protocol. Case report. Mandible reconstruction was performed simultaneously with resection. Autogenous iliac bone graft was taken, reshaped and placed in two parts, to the required optimal contour of the mandible. After graft consolidation, decision was made for prosthodontics rehabilitation with fixed dentures supported by implants. In addition to the standard preoperative procedures, planning was done based on a biomodel gained by rapid prototyping after CT scan. It offered a real 3D planning to obtain a proper shape, dimension and the position of implants. Conclusion. If bone dimensions of a reconstructed mandible are insufficient, like in the presented case, the use of basal osseointegrated implants may be a method of choice. Avoiding bone augmentation procedures, as well as early loading protocol for this type of implants, shorten the total rehabilitation time, which is very convenient for patients. Fixed denture supported by dental implants is the best solution for comprehensive rehabilitation after mandible

Humanoid assessing rehabilitative exercises.

Science.gov (United States)

Simonov, M; Delconte, G

2015-01-01

This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". The article presents the approach in which the rehabilitative exercise prepared by healthcare professional is encoded as formal knowledge and used by humanoid robot to assist patients without involving other care actors. The main objective is the use of humanoids in rehabilitative care. An example is pulmonary rehabilitation in COPD patients. Another goal is the automated judgment functionality to determine how the rehabilitation exercise matches the pre-programmed correct sequence. We use the Aldebaran Robotics' NAO humanoid to set up artificial cognitive application. Pre-programmed NAO induces elderly patient to undertake humanoid-driven rehabilitation exercise, but needs to evaluate the human actions against the correct template. Patient is observed using NAO's eyes. We use the Microsoft Kinect SDK to extract motion path from the humanoid's recorded video. We compare human- and humanoid-operated process sequences by using the Dynamic Time Warping (DTW) and test the prototype. This artificial cognitive software showcases the use of DTW algorithm to enable humanoids to judge in near real-time about the correctness of rehabilitative exercises performed by patients following the robot's indications. One could enable better sustainable rehabilitative care services in remote residential settings by combining intelligent applications piloting humanoids with the DTW pattern matching algorithm applied at run time to compare humanoid- and human-operated process sequences. In turn, it will lower the need of human care.

48 CFR 871.208 - Rehabilitation facilities.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rehabilitation facilities... Vocational Rehabilitation and Employment Service 871.208 Rehabilitation facilities. Charges by rehabilitation facilities for the rehabilitation services provided under 38 U.S.C. Chapter 31 are paid in the same manner as...

Comprehensive cardiac rehabilitation

DEFF Research Database (Denmark)

Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O

2006-01-01

OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

[Diagnossis and treatment of complicated anterior teeth esthetic defects by combination of whole-process digital esthetic rehabilitation with periodontic surgery].

Science.gov (United States)

Li, Z; Liu, Y S; Ye, H Q; Liu, Y S; Hu, W J; Zhou, Y S

2017-02-18

To explore a new method of whole-process digital esthetic prosthodontic rehabilitation combined with periodontic surgery for complicated anterior teeth esthetic defects accompanied by soft tissue morphology, to provide an alternative choice for solving this problem under the guidance of three-dimensional (3D) printing digital dental model and surgical guide, thus completing periodontic surgery and digital esthetic rehabilitation of anterior teeth. In this study, 12 patients with complicated esthetic problems accompanied by soft tissue morphology in their anterior teeth were included. The dentition and facial images were obtained by intra-oral scanning and three-dimensional (3D) facial scanning and then calibrated. Two esthetic designs and prosthodontic outcome predictions were created by computer aided design /computer aided manufacturing (CAD/CAM) software combined with digital photography, including consideration of white esthetics and comprehensive consideration of pink-white esthetics. The predictive design of prostheses and the facial appearances of the two designs were evaluated by the patients. If the patients chose the design of comprehensive consideration of pink-white esthetics, they would choose whether they would receive periodontic surgery before esthetic rehabilitation. The dentition design cast of those who chose periodontic surgery would be 3D printed for the guide of periodontic surgery accordingly. In light of the two digital designs based on intra-oral scanning, facing scanning and digital photography, the satisfaction rate of the patients was significantly higher for the comprehensive consideration of pink-white esthetic design (Pesthetic rehabilitation. The 3D printed digital dental model and surgical guide provided significant instructions for periodontic surgery, and achieved success transfer from digital design to clinical application. The prostheses were fabricated by CAD/CAM, thus realizing the whole-process digital esthetic rehabilitation

Amelogenesis Imperfecta: Rehabilitation and Brainstorming on the Treatment Outcome after the First Year

Directory of Open Access Journals (Sweden)

Ayça Deniz İzgi

2015-01-01

Full Text Available Amelogenesis imperfecta (AI affects enamel on primary and permanent dentition. This hereditary disorder is characterized by loss of enamel, poor esthetics, and hypersensitivity. Functional and cosmetic rehabilitation is challenging with variety of treatment options. This report presents the treatment of an AI patient using conventional fixed dentures and discusses issues related to posttreatment complications and prosthetic treatment outcome after 1 year of follow-up. A 19-year-old male AI patient with impaired self-esteem presented with hypersensitive, discolored, and mutilated teeth. Clinical examination revealed compromised occlusion and anterior open-bite. After hygiene maintenance full-coverage porcelain-fused-to-metal fixed restorations were indicated and applied. At the end of the treatment acceptable functional and esthetic results could be achieved. However, nearly a year after treatment a gingival inflammation in the esthetic zone complicated the outcome. Insufficient oral hygiene was to be blamed. Tooth sensitivity present from early childhood in these patients may prevent oral hygiene from becoming a habit. The relaxation due to relieve of hypersensitivity after treatment makes oral hygiene learning difficult. Continuous oral hygiene maintenance motivation may be crucial for the success of the treatment of AI patients. Treatment of AI patients should be carefully planned and an acceptable risk-benefit balance should be established.

Why evidence-based medicine is a good approach in physical and rehabilitation medicine. Thesis.

Science.gov (United States)

Negrini, S

2014-10-01

According to a good definition, evidence-based medicine (EBM) is: "The explicit, conscientious, and judicious use of the current best evidence in making decisions about the care of individual patients (and populations)". More appropriate in a clinical context like that of physical and rehabilitation medicine (PRM) is looking at evidence based clinical practice (EBCP), whose definition is: "The integration of best research evidence with clinical expertise and patient values". In the past the term evidence-based physical and rehabilitation medicine (EBPRM) was also proposed. In this thesis, after some historical notes on EBM and on PRM, we will discuss why in our view EBPRM must be the real foundation of our everyday PRM clinical practice.

Ambras Syndrome: First Reported Case in Bangladesh and its Oral Rehabilitation.

Science.gov (United States)

Khan, M H; Ashrafuzzaman, S M; Taib, A N; Alam, M T; Khan, S H; Goldstein, S K; Rahman, R

2015-10-01

People with rare hypertrichosis syndromes became crowd-drawing money-making phenomena in many 19th century sideshow acts. These individuals have been referred to as dog-men, hair-men, and werewolves. In 1993, Baumister et al. described congenital hypertrichosis lanuginose or Ambras syndrome: a distinct form of congenital hypertrichosis characterized by excessive hair growth over the body and face associated with facial and occasional dental anomalies. Much is not known about this syndrome since fewer than 50 cases have been documented worldwide. In this case report, a nine year old girl presented with excessive hair growth throughout her body that was denser along her midline. Furthermore, her face displayed the typical dysmorphic features characteristic of Ambras syndrome: a round tip nose, thickened nasal cartilage, antiverted nares, prominent philtrum with deep groove, and a trapezoid mouth. Oral examination revealed normal oral mucosa with completely missing and unerupted decidious and permanent teeth. Panoramic radiographs confirmed unerupted deciduous teeth. Previous case reports have mentioned the presence of occasional dental anomalies such as retarded first and second dentition and absence of some teeth. However, this is the first reported case of Ambras syndrome presenting with complete anodontia. Prior cytogenetic studies performed on persons with Ambras syndrome have implicated a balanced pericentric inversion of chromosome 8. However, it is likely that dental anomalies are likely a result of a different genetic rearrangement. Further studies are needed to explore the cause of this rare phenotype of Ambras syndrome with complete unerupted dentition.

A qualitative study using the Theoretical Domains Framework to investigate why patients were or were not assessed for rehabilitation after stroke.

Science.gov (United States)

Lynch, Elizabeth A; Luker, Julie A; Cadilhac, Dominique A; Fryer, Caroline E; Hillier, Susan L

2017-07-01

To explore the factors perceived to affect rehabilitation assessment and referral practices for patients with stroke. Qualitative study using data from focus groups analysed thematically and then mapped to the Theoretical Domains Framework. Eight acute stroke units in two states of Australia. Health professionals working in acute stroke units. Health professionals at all sites had participated in interventions to improve rehabilitation assessment and referral practices, which included provision of copies of an evidence-based decision-making rehabilitation Assessment Tool and pathway. Eight focus groups were conducted (32 total participants). Reported rehabilitation assessment and referral practices varied markedly between units. Continence and mood were not routinely assessed (4 units), and people with stroke symptoms were not consistently referred to rehabilitation (4 units). Key factors influencing practice were identified and included whether health professionals perceived that use of the Assessment Tool would improve rehabilitation assessment practices (theoretical domain 'social and professional role'); beliefs about outcomes from changing practice such as increased equity for patients or conversely that changing rehabilitation referral patterns would not affect access to rehabilitation ('belief about consequences'); the influence of the unit's relationships with other groups including rehabilitation teams ('social influences' domain) and understanding within the acute stroke unit team of the purpose of changing assessment practices ('knowledge' domain). This study has identified that health professionals' perceived roles, beliefs about consequences from changing practice and relationships with rehabilitation service providers were perceived to influence rehabilitation assessment and referral practices on Australian acute stroke units.

Changes in general and oral health-related quality of life in immediate or conventionally loaded dental implants: a nonrandomized clinical trial.

Science.gov (United States)

Dolz, Javier; Silvestre, Francisco J; Montero, Javier

2014-01-01

To evaluate changes in the general and oral health-related quality of life (using the European Quality of Life indicator and the Oral Health Impact Profile-49 [OHIP-49], respectively) of patients treated with conventionally or immediately loaded implants. This clinical trial consisted of a clinical oral examination and a questionnaire-based interview carried out before and after both surgery and definitive prosthetic rehabilitation in a consecutive sample of patients requiring dental implants. According to the clinical diagnosis and patient preference, patients were assigned to the immediate loading group (IL group; n = 29) or the conventional loading group (CL group; n = 75). The change summary scores and effect sizes were calculated in the intermediate stage and at the final follow-up, taking baseline scores as reference. The oral health-related quality of life and oral satisfaction after implant therapy were significantly better than at baseline, with an even greater benefit when the implants were loaded immediately than when prosthetic rehabilitation was delayed. However, there were no significant differences in between-group comparisons in the ratings of general health status. The effect size for the OHIP-49 exceeded the threshold value of 0.8 for the domains functional limitation, pain/discomfort, and psychological discomfort in both groups and also for physical disability and psychological disability in the IL group. A gradual improvement in oral well-being scores, but not in those of general well-being, were observed for both groups from the intermediate stage to the final evaluation. This benefit was markedly greater for the IL group.

Rehabilitation of pure alexia

DEFF Research Database (Denmark)

Starrfelt, Randi; Ólafsdóttir, Rannveig Rós; Arendt, Ida-Marie

2013-01-01

that pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions like alexia severity, and associated deficits. Many patients reported to have pure alexia......-designed and controlled studies of rehabilitation of pure alexia....

Inpatient or outpatient rehabilitation after herniated disc surgery? - Setting-specific preferences, participation and outcome of rehabilitation.

Science.gov (United States)

Löbner, Margrit; Luppa, Melanie; Konnopka, Alexander; Meisel, Hans J; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; Angermeyer, Matthias C; König, Hans-Helmut; Riedel-Heller, Steffi G

2014-01-01

To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and improve rehabilitation effects such as return

European approach to nuclear and radiological emergency management and rehabilitation strategies (EURANOS)

International Nuclear Information System (INIS)

Raskob, W.

2007-01-01

The 5-year multi-national project EURANOS, funded by the European Commission and 23 European Member States, started in April 2004. Integrating 17 national emergency management organisations with 33 research institutes, it brings together best practice, knowledge and technology to enhance the preparedness for Europe's response to any radiation emergency and long-term contamination. Key objectives of the project are to collate information on the likely effectiveness and consequences of a wide range of countermeasures, to provide guidance to emergency management organisations and decision makers on the establishment of an appropriate response strategy and to further enhance advanced decision support systems, in particular, RODOS (Real-time On-Line DecisiOn Support), through feedback from their operational use. The research activities focused on emergency actions and countermeasures, the enhancement of decision support systems for operational application and the development of strategies for the sustainable rehabilitation of contaminated territories. The demonstration activities exercise the developed methods and tools in the actual operational environment. (orig.)

77 FR 4288 - Arbitration Panel Decision Under the Randolph-Sheppard Act

Science.gov (United States)

2012-01-27

... February 5, 2009, permit application to operate vending machines at the Southern Oregon Rehabilitation... Blind for a permit to operate the Clinic vending machines.'' Arbitration Panel Decision After reviewing... vending machines are part and parcel of that facility. The panel noted that the parties' differing...

Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

Science.gov (United States)

2013-06-19

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Technologies to Support Successful Aging with Disability under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

A tough-love pedagogy in rehabilitation: integration of rehabilitation ideology with local cultures.

Science.gov (United States)

Chang, Ling-Hui; Wang, Jye

2009-09-01

This study problematizes a unique therapeutic relationship in rehabilitation and how the interaction reflects the integration of rehabilitation ideology with local cultures. The data drew from a larger ethnographic study of a rehabilitation unit in Taiwan. Participants included 21 patient-caregiver pairs and their rehabilitation professionals. They participated in in-depth interviews and participant observation. A tough-love pedagogy emerged as a unique therapeutic relationship in the unit. Patients were asked to interpret the stress with therapy as an inevitable, beneficial experience toward recovery. A prevalent supposition that equated poor physical performance with weak morale legitimized the approach. Cultural metaphors used to describe and define rehabilitation transformed the stress that patients experienced with strenuous exercises into a beneficial substance that aids recovery. The transformation of the therapeutic relationship into a pedagogical one helped connect rehabilitation to shared educational experiences. In the unit, the complicit practice of therapists, caregivers, and patients established and perpetuated the practice of a tough-love pedagogy. The congruence between this tough-love approach and traditional Chinese pedagogical principles made the approach legitimate and desired.

Cultural adaptation of a pediatric functional assessment for rehabilitation outcomes research.

Science.gov (United States)

Arestad, Kristen E; MacPhee, David; Lim, Chun Y; Khetani, Mary A

2017-09-15

Significant racial and ethnic health care disparities experienced by Hispanic children with special health care needs (CSHCN) create barriers to enacting culturally competent rehabilitation services. One way to minimize the impact of disparities in rehabilitation is to equip practitioners with culturally relevant functional assessments to accurately determine service needs. Current approaches to culturally adapting assessments have three major limitations: use of inconsistent translation processes; current processes assess for some, but not all, elements of cultural equivalence; and limited evidence to guide decision making about whether to undertake cultural adaptation with and without language translation. The aims of this observational study are (a) to examine similarities and differences of culturally adapting a pediatric functional assessment with and without language translation, and (b) to examine the feasibility of cultural adaptation processes. The Young Children's Participation and Environment Measure (YC-PEM), a pediatric functional assessment, underwent cultural adaptation (i.e., language translation and cognitive testing) to establish Spanish and English pilot versions for use by caregivers of young CSHCN of Mexican descent. Following language translation to develop a Spanish YC-PEM pilot version, 7 caregivers (4 Spanish-speaking; 3 English-speaking) completed cognitive testing to inform decisions regarding content revisions to English and Spanish YC-PEM versions. Participant responses were content coded to established cultural equivalencies. Coded data were summed to draw comparisons on the number of revisions needed to achieve cultural equivalence between the two versions. Feasibility was assessed according to process data and data quality. Results suggest more revisions are required to achieve cultural equivalence for the translated (Spanish) version of the YC-PEM. However, issues around how the participation outcome is conceptualized were

Inpatient or outpatient rehabilitation after herniated disc surgery? - Setting-specific preferences, participation and outcome of rehabilitation.

Directory of Open Access Journals (Sweden)

Margrit Löbner

Full Text Available OBJECTIVE: To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient and setting-specific rehabilitation outcomes. METHODS: The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years. Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%. The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale, pain intensity (numeric analog scale, health-related quality of life (Short Form 36 Health Survey, subjective prognosis of gainful employment (SPE-scale as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. RESULTS: The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%. Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%. Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56% compared to only one third of the inpatient rehabilitees (33% returned to work three months after disc surgery (p<.001. CONCLUSION: The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures

Engaging the hearts and minds of clinicians in outcome measurement - the UK Rehabilitation Outcomes Collaborative approach.

Science.gov (United States)

Turner-Stokes, Lynne; Williams, Heather; Sephton, Keith; Rose, Hilary; Harris, Sarah; Thu, Aung

2012-01-01

This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) "needs" for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term.

Problematising risk in stroke rehabilitation.

Science.gov (United States)

Egan, Mary Y; Kessler, Dorothy; Ceci, Christine; Laliberté-Rudman, Debbie; McGrath, Colleen; Sikora, Lindsey; Gardner, Paula

2016-11-01

Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or

Prosthetic rehabilitation of edentulous patient with limited oral access: A clinical report

Directory of Open Access Journals (Sweden)

Sandeep Kumar

2012-01-01

Full Text Available Microstomia may result from surgical treatment of orofacial neoplasms, cleft lips, maxillofacial trauma, burns, radiotherapy or scleroderma. A maximal oral opening that is smaller than the size of a complete denture can make prosthetic treatment challenging. This clinical report presents the prosthodontic management of a total edentulous patient with microstomia. Sectional mandibular and maxillary trays and foldable mandibular and maxillary denture were fabricated for the total edentulous patient.

A survey on the current status of rehabilitation services and burnout of rehabilitation professionals in Shanghai.

Science.gov (United States)

Lu, Wenliang; Zhou, Ping; Zheng, Songbai; Xue, Di

2017-01-01

Although many studies have discussed burnout in clinical physicians, the evidence literature about physical rehabilitation professionals is still limited in China. To understand the current status of rehabilitation services and burnout of rehabilitation professionals in Shanghai. Twenty-four hospitals located in three districts of Shanghai were selected for this study. The questionnaire surveys of 24 hospitals and their 221 rehabilitation professionals and 235 other medical professionals were conducted. The percentages of the hospitals that had rehabilitation departments in three districts of Shanghai ranged from 25.0% to 88.9%, suggesting a great variation in distribution of rehabilitation resources. Only one tertiary general hospital had 12 beds for inpatient rehabilitation. The surveyed rehabilitation professionals who had graduate or undergraduate education accounted for 64.90% as a whole, but 49.32% in community health centers, 66.67% in secondary general hospitals, and 77.78% in tertiary general hospitals. The average scores for emotional exhaustion, cynicism and low professional efficacy were 11.66, 7.48, and 10.36 respectively. This study reveals that the resources in the field of rehabilitation in Shanghai need to be enhanced to meet its future demands. It is also recommended that the managers in secondary general hospitals and the local government pay more attention to the rehabilitation professionals in the secondary general hospitals because they are reporting higher emotional exhaustion. Finally, the value of rehabilitation services to help persons with disabilities need to be better conveyed to all interested parties.

Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners.

Science.gov (United States)

Leland, Natalie E; Lepore, Michael; Wong, Carin; Chang, Sun Hwa; Freeman, Lynn; Crum, Karen; Gillies, Heather; Nash, Paul

2018-03-01

The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California. Purposive sampling of facilities was conducted to capture variation in key characteristics known to impact care delivery for this patient population (e.g., financial resources, staffing, and patient case-mix). Questions aimed to elicit practitioners' perspectives on high quality hip fracture rehabilitation practices. Each session was audio-recorded and transcribed. Data were systematically analyzed using a modified grounded theory approach. Seven themes emerged: objectives of care; first 72 h; positioning, pain, and precautions; use of standardized assessments; episode of care practices; facilitating insight into progress; and interdisciplinary collaboration. Clinical guidelines are critical tools to facilitate clinical decision-making and achieve desired patient outcomes. The findings of this study highlight the practitioners' perspective on what constitutes high quality hip fracture rehabilitation. This work provides critical information to advance the development of stakeholder-driven rehabilitation clinical guidelines. Future research is needed to verify the findings from other stakeholders (e.g., patients), ensure the alignment of our findings with current evidence, and develop measures for evaluating their delivery and relationship to desired outcomes. Implications for Rehabilitation This study highlights occupational and physiotherapy therapy practitioners' perspectives on the cumulative best

Final priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priorities.

Science.gov (United States)

2013-06-11

The Assistant Secretary for Special Education and Rehabilitative Services announces priorities under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for a Rehabilitation Engineering Research Center (RERC) on Rehabilitation Strategies, Techniques, and Interventions (Priority 1), Information and Communication Technologies Access (Priority 2), Individual Mobility and Manipulation (Priority 3), and Physical Access and Transportation (Priority 4). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve community living and participation, health and function, and employment outcomes of individuals with disabilities.

12 CFR 268.503 - Enforcement of final EEOC decisions.

Science.gov (United States)

2010-01-01

... the decision pursuant to title VII, the ADEA, the Equal Pay Act or the Rehabilitation Act and to seek... RESERVE SYSTEM RULES REGARDING EQUAL OPPORTUNITY Remedies and Enforcement § 268.503 Enforcement of final... Procedures Act, 5 U.S.C. 701 et seq., and the mandamus statute, 28 U.S.C. 1361, or to commence de novo...

Effect of Rehabilitation Technology Services on Vocational Rehabilitation Outcomes of Individuals with Multiple Sclerosis

Science.gov (United States)

Chiu, Chung-Yi; Tansey, Timothy N.; Chan, Fong; Strauser, David; Frain, Michael P.; Arora, Simran

2015-01-01

Objectives: To examine the effect of rehabilitation technology interventions on the employment or job retention outcomes of individuals with multiple sclerosis (MS) served by the state-federal vocational rehabilitation program using a case-control study design. Participants: Data for this study were extracted from the Rehabilitation Services…

Rehabilitation Robots: Concepts and Applications in Stroke Rehabilitation

Directory of Open Access Journals (Sweden)

Mohammad Ali Ahmadi-Pajouh

2017-02-01

Full Text Available Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist disable people to eat and perform daily activities. There are also clinical rehabilitation robots which can train handicaps. They can help subjects as a passive tool that improves low level impairments such as rigidity. On the other hand robots can train brain as an active tool to have a better movement again. We will see how robots can help therapist to apply repetitive passive movements in quadriplegic subject (i.e. in Brunnstrom stages 1 to 3. On the other hand they can teach subjects how to complete a task in an active manner (i.e. in stages 5 and 6 which can facilitate neuroplasticity. There are different robots designed for different organs; for example rehabilitation of upper extremities (e.g. Gloreha or lower extremities (e.g. Lokomat. There are also exoskeleton robots to help subjects to grip objects and perform ADLs easily (e.g. Bioservo or help paraplegic patient to walk again (e.g. Rewalk. In this talk, we will also discuss about how robots are helping rehab specialist to improve standard protocols. For example we will show how action observation therapy, bimanual therapy, assistive active therapy, proprioceptive facilitation and passive mobilization therapy are realized using an upper extremity rehabilitation robot. Robotics is the future of technology and rehabilitation needs this technology. Be part of this technology!

EVALUATING PATIENTS’ NEEDS AMONG REHABILITATION SETTING

Directory of Open Access Journals (Sweden)

Mohammed M. J. Alqahtani

2015-09-01

Full Text Available Patient’ needs have been found to be crucial to the success of rehabilitation and recovery. To understand what patients want from their rehabilitation services should be addressed in the rehabilitation intervention. This study aims to examine patients’ needs for rehabilitation services as well as to examine the validity of a self-report questionnaire that developed to measure what patient needs from rehabilitation services in Saudi Arabia. Tow hundreds-eighty patients, from inpatients and outpatients, with stroke, spinal cord and brain injury completed the Patient’s Needs Questionnaire (PNQ. In general, the result showed that patients are in highly needs for Psychological Interventions, even before Rehabilitation and Treatment component. In detail, Psychological Intervention and Emotional Support were significantly greater in inpatients than in outpatients. Outpatients, in contrast, affirmed the Religious Support component significantly more than inpatients did. The statistical analysis of PNQ yielded four components: psychological interventions, rehabilitation and treatment, religious support, and explanation/reassurance. These components accounted for 48.71% of the total variances. Rehabilitation services is not only the component of rehabilitation intervention and medical treatments, indeed, it is a holistic intervention that understand the psychological, religious, and reassurance demands. The health provider in Saudi Arabia should develop a rehabilitation goal menu based on patient-centred care needs. The PNQ is a valuable and practical tool for the identification of patients’ needs from rehabilitation services.

Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

Science.gov (United States)

2013-06-14

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Universal Interfaces and Information Technology Access under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

Practice variation in the structure of stroke rehabilitation in four rehabilitation centres in the Netherlands

NARCIS (Netherlands)

Groeneveld, Iris F.; Meesters, Jorit J. L.; Arwert, Henk J.; Roux-Otter, Nienke; Ribbers, Gerard M.; van Bennekom, Coen A. M.; Goossens, Paulien H.; Vliet Vlieland, Thea P. M.

2016-01-01

To describe practice variation in the structure of stroke rehabilitation in 4 specialized multidisciplinary rehabilitation centres in the Netherlands. A multidisciplinary expert group formulated a set of 23 elements concerning the structure of inpatient and outpatient stroke rehabilitation,

Recent Development of Rehabilitation Robots

Directory of Open Access Journals (Sweden)

Zhiqin Qian

2015-02-01

Full Text Available We have conducted a critical review on the development of rehabilitation robots to identify the limitations of existing studies and clarify some promising research directions in this field. This paper is presented to summarize our findings and understanding. The demands for assistive technologies for elderly and disabled population have been discussed, the advantages and disadvantages of rehabilitation robots as assistive technologies have been explored, the issues involved in the development of rehabilitation robots are investigated, some representative robots in this field by leading research institutes have been introduced, and a few of critical challenges in developing advanced rehabilitation robots have been identified. Finally to meet the challenges of developing practical rehabilitation robots, reconfigurable and modular systems have been proposed to meet the identified challenges, and a few of critical areas leading to the potential success of rehabilitation robots have been discussed.

An Oral Contraceptive Drug Interaction Study

Science.gov (United States)

Bradstreet, Thomas E.; Panebianco, Deborah L.

2004-01-01

This article focuses on a two treatment, two period, two treatment sequence crossover drug interaction study of a new drug and a standard oral contraceptive therapy. Both normal theory and distribution-free statistical analyses are provided along with a notable amount of graphical insight into the dataset. For one of the variables, the decision on…

Assessing the performance of sewer rehabilitation on the reduction of infiltration and inflow.

Science.gov (United States)

Staufer, P; Scheidegger, A; Rieckermann, J

2012-10-15

Inflow and Infiltration (I/I) into sewer systems is generally unwanted, because, among other things, it decreases the performance of wastewater treatment plants and increases combined sewage overflows. As sewer rehabilitation to reduce I/I is very expensive, water managers not only need methods to accurately measure I/I, but also they need sound approaches to assess the actual performance of implemented rehabilitation measures. However, such performance assessment is rarely performed. On the one hand, it is challenging to adequately take into account the variability of influential factors, such as hydro-meteorological conditions. On the other hand, it is currently not clear how experimental data can indeed support robust evidence for reduced I/I. In this paper, we therefore statistically assess the performance of rehabilitation measures to reduce I/I. This is possible by using observations in a suitable reference catchment as a control group and assessing the significance of the observed effect by regression analysis, which is well established in other disciplines. We successfully demonstrate the usefulness of the approach in a case study, where rehabilitation reduced groundwater infiltration by 23.9%. A reduction of stormwater inflow of 35.7%, however, was not statistically significant. Investigations into the experimental design of monitoring campaigns confirmed that the variability of the data as well as the number of observations collected before the rehabilitation impact the detection limit of the effect. This implies that it is difficult to improve the data quality after the rehabilitation has been implemented. Therefore, future practical applications should consider a careful experimental design. Further developments could employ more sophisticated monitoring methods, such as stable environmental isotopes, to directly observe the individual infiltration components. In addition, water managers should develop strategies to effectively communicate statistically

REHABILITATION IN CARDIOLOGY AND CARDIOSURGERY

Directory of Open Access Journals (Sweden)

N. V. Galtseva

2015-01-01

Full Text Available At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled training in patients with CAD, making a complex program of cardio rehabilitation, kinds of control during cardio training are described in details. In this review the second phase of physical rehabilitation after cardiac surgery – a stationary phase, protocols of which are subjective and often contested, is considered. More frequently physical rehabilitation after coronary artery bypass surgery is doing breathing exercises, as there is data that physical exercises, in which tangential force vector in or around the sternum appears, should be avoided for at least 3 months after surgery. On the other hand, avoiding of heaving during the first weeks after surgery leads to more pronounced atrophy of the chest muscles. But there is data, according to which, early beginning of an adapted program of cardio rehabilitation (1–2 weeks after surgery is safely, it accelerates recovery and does not increase problems with the sternum. In this review the following idea is suggested: in order to follow the stages of rehabilitation after cardiac surgery it is necessary to start it on the stationary stage, and control of load rehabilitation programs must be carried out using hemodynamic changes during exercises, energy, SF-36 questionnaire. 

When a policy decision meets practice realities: The case of cancer survivorship care and rehabilitation needs assessment.

Science.gov (United States)

Handberg, Charlotte; Thorne, Sally; Maribo, Thomas

2018-04-01

To analyze and describe health professionals' attitudes and perspectives on the complexities of cancer survivorship and rehabilitation needs assessment in a shared cancer care context. The design and methodology for this study was Interpretive Description and the analysis was informed by Symbolic Interactionism as the theoretical framework. Between April and December 2015 an ethnographic fieldwork was carried out by the first author in haematological wards at two Danish hospitals and in two primary care settings conducting cancer survivorship care programs. Participants were 41 health professionals working with needs assessment. The findings revealed an understanding of the health professionals' attitudes and perspectives and were distinguishable in relation to three structural conditions associated with the dimensions of survivorship care: Patient Context, Workplace Priorities and Practice Culture. Despite shared beliefs that needs assessment was essential to ensure survivorship care, the differential conditions surrounding the hospital and the primary care settting impeded the wider idea of formalized needs assessment, creating barriers to a seamless link between the sectors. Meaningful resolution of these disjunctures will require broad solutions, recognizing that the organization of healthcare into disconnected systems, with their different conditions, history, habits and traditions, will certainly plague the "transition" problems in healthcare unless a wider perspective is taken. Thoughtful and informed clinicians working with decision makers and those who know the evidence and can interpret systems in context can certainly bring better options to light in order to develop high quality survivorship care that will support patients throughout their cancer trajectory. Copyright © 2018 Elsevier Ltd. All rights reserved.

Motivational Rehabilitation using Serious Games

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Antoni Jaume i Capó

2013-11-01

Full Text Available Research studies show that serious games help to motivate users in rehabilitation processes, and rehabilitation results are better when users are motivated. In long term rehabilitation for maintaining capacities, the demotivation of chronic patients is common. In this work, we have implemented balance rehabilitation video game for cerebral palsy patients. The video game was developed using the prototype development paradigm and following desirable features for rehabilitation serious games presented in the literature. We have tested the video game with a set of users who abandoned therapy due to demotivation in the previous year. Results show that the set of users improved their balance and motivation.

Rehabilitation as a positive obligation

NARCIS (Netherlands)

Meijer, S.

2017-01-01

Although the emphasis in European penal policy now lies on the rehabilitative aim of imprisonment, the concept of rehabilitation remains vague and is being interpreted differently in different European countries. This paper looks at rehabilitation from a legal perspective and aims to clarify the

[History of the rehabilitation of the deaf child].

Science.gov (United States)

Noyon, P

1995-01-01

As a deaf mute, because mute and more often than not deaf, and then deaf and dumb, because deaf and therefore dumb, the deaf child inevitably deprived of spontaneous speech was considered up to the end of the middle ages as having no possibility of language or of thought, left to the sorry fate of being part of a sporadic population expressing themselves by gestures, a language bereft of past and future, understood only by a few members of the family or occasionally deaf neighbours. During the Renaissance, it appeared that with specific education the deaf child could talk, have a language, and therefore thought. Due merit must be given to 16th century Spain. In the 18th century, France discovered that gestures can also be a language, collated and constructed thanks to the collaboration of the partially deaf. From then on, gestual language flourished in America whilst the rest of Europe continued to prefer oral rehabilitation. With current medical progress, the deaf are no longer deaf. Deafness in the child still exists, however, but there are no longer any mutes. The deaf child can achieve access to language, which may be oral or gestual. The choice between these two modes of expression is still very tropical.

Inpatient or Outpatient Rehabilitation after Herniated Disc Surgery? – Setting-Specific Preferences, Participation and Outcome of Rehabilitation

Science.gov (United States)

Löbner, Margrit; Luppa, Melanie; Konnopka, Alexander; Meisel, Hans J.; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; Angermeyer, Matthias C.; König, Hans-Helmut; Riedel-Heller, Steffi G.

2014-01-01

Objective To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. Methods The longitudinal observational study referred to 534 consecutive disc surgery patients (18–55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. Results The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). Conclusion The results suggest a “pre-selection” of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and

Interferential current sensory stimulation, through the neck skin, improves airway defense and oral nutrition intake in patients with dysphagia: a double-blind randomized controlled trial

Directory of Open Access Journals (Sweden)

Maeda K

2017-11-01

Full Text Available Keisuke Maeda,1,2 Takayuki Koga,3 Junji Akagi4 1Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center, Kumamoto, 2Palliative Care Center, Aichi Medical University, Nagakute, 3Department of Swallowing and Nutritional Therapy, 4Department of Surgery, Tamana Regional Health Medical Center, Tamana, Tamana City, Kumamoto, Japan Background: Neuromuscular electrical stimulation with muscle contraction, administered through the skin of the neck, improves a patient’s swallowing ability. However, the beneficial effects of transcutaneous electrical sensory stimulation (TESS, without muscle contraction, are controversial. We investigated the effect of TESS, using interferential current, in patients undergoing dysphagia rehabilitation. Methods: This double-blind, randomized controlled trial involved 43 patients who were prescribed in-hospital dysphagia rehabilitation for ≥3 weeks. Patients were randomly assigned to the sensory stimulation (SS or sham groups; all received usual rehabilitative care plus 2 weeks of SS or sham intervention. Outcome measures included cough latency times against a 1% citric acid mist, functional oral intake scale (FOIS scores, and oral nutritional intake – each determined after the second and third week following treatment initiation. Results: Mean patient age was 84.3±7.5 years; 58% were women. The SS and sham groups had similar baseline characteristics. Changes in cough latency time at 2 weeks (-14.1±14.0 vs -5.2±14.2 s, p=0.047 and oral nutrition intake at 3 weeks (437±575 vs 138±315 kcal/day, p=0.042 improved more in the SS group than in the sham group. Changes in cough frequency and FOIS scores indicated better outcomes in the SS group, based on substantial effect sizes. Conclusion: TESS, using interferential current through the neck, improved airway defense and nutrition in patients suffering from dysphagia. Further large-scale studies are needed to confirm the technique�

Engaging the hearts and minds of clinicians in outcome measurement – the UK rehabilitation outcomes collaborative approach

Science.gov (United States)

2012-01-01

Purpose This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Key messages and implications Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) “needs” for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. Conclusions By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term. PMID:22506959

Goals of patient care system change with video-based education increases rates of advance cardiopulmonary resuscitation decision-making and discussions in hospitalised rehabilitation patients.

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Johnson, Claire E; Chong, Jeffrey C; Wilkinson, Anne; Hayes, Barbara; Tait, Sonia; Waldron, Nicholas

2017-07-01

Advance cardiopulmonary resuscitation (CPR) discussions and decision-making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non-beneficial CPR. To assess the utility and safety of two interventions to increase CPR decision-making, documentation and communication for hospitalised older patients. A pre-post study tested two interventions: (i) standard ward-based education forums with CPR content; and (ii) a combined, two-pronged strategy with 'Goals of Patient Care' (GoPC) system change and a structured video-based workshop; against usual practice (i.e. no formal training). Participants were a random sample of patients in a hospital rehabilitation unit. The outcomes were the proportion of patients documented as: (i) not for resuscitation (NFR); and (ii) eligible for rapid response team (RRT) calls, and rates of documented discussions with the patient, family and carer. When compared with usual practice, patients were more likely to be documented as NFR following the two-pronged intervention (adjusted odds ratio (aOR): 6.4, 95% confidence interval (CI): 3.0; 13.6). Documentation of discussions with patients was also more likely (aOR: 3.3, 95% CI:1.8; 6.2). Characteristics of patients documented NFR were similar between the phases, but were more likely for RRT calls following Phase 3 (P 0.03). An increase in advance CPR decisions occurred following GoPC system change with education. This appears safe as NFR patients had the same level of frailty between phases but were more likely to be eligible for RRT review. Increased documentation of discussions suggests routine use of the GoPC form may improve communication with patients about their care. © 2017 Royal Australasian College of Physicians.

Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?

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Księżopolska-Orłowska, Krystyna; Pacholec, Anna; Jędryka-Góral, Anna; Bugajska, Joanna; Sadura-Sieklucka, Teresa; Kowalik, Katarzyna; Pawłowska-Cyprysiak, Karolina; Łastowiecka-Moras, Elżbieta

2016-01-01

Rehabilitation slows the progress of rheumatoid arthritis (RA) and prevents progression of disability. This study aimed to compare the impact of two rehabilitation programmes on pain, disease activity, locomotor function, global health and work ability forecast in RA patients. Sixty-four employed women aged 24-65 years participated in the study. All patients underwent individual and instrumental kinesiotherapy. Thirty-two patients underwent cryogenic chamber therapy and local cryotherapy as well as non-weight-bearing, instrumental and individual kinesiotherapy. The remaining 32 patients received traditional rehabilitation in the form of electromagnetic and instrumental therapy, individual and pool-based non-weight-bearing kinesiotherapy. Rehabilitation lasted 3 weeks. Patients were examined three times: prior to rehabilitation, after 3 weeks of therapy and 3 months after completion of rehabilitation. The following study instruments were used: to assess disease activity: DAS-28; functional impairment: HAQ-DI; pain severity: VAS; patients' overall well-being: a scale from 0 to 100 (Global Health Index); and patients' own prognosis of fitness for work: the 6th question from Work Ability Index (WAI). Statistical analysis of data was performed using the STATISTICA 8.0 package. Mixed-design two-way analysis of variance was used for hypothesis testing. All patients improved after rehabilitation. The group of patients those who underwent cryotherapy had improved DAS-28, HAQ-DI, VAS and global health scores immediately following the 3-week rehabilitation programme (p cryotherapy resulted in greater improvement in disease activity DAS-28 [F(2,105) = 5.700; p = 0.007; η(2) = 0.084] and HAQ-DI locomotor function scores [F(2,109) = 6.771; p = 0.003; η(2) = 0.098] compared to traditional rehabilitation. The impact of both forms of rehabilitation on patients' own prognosis of work ability in the next 2 years was not significant. Results of patients who underwent

Satisfaction and Related Factors among the Service Users of Private Rehabilitation Centers

Directory of Open Access Journals (Sweden)

Shahrzad Pakjouei

2014-12-01

Full Text Available Objectives: The aim of present study was determining the level of satisfaction and its relative factors among parents of mentally retarded children using the services of private rehabilitation centers. Methods: This was a descriptive-analytical study that was conducted on parents of 150 mentally retarded children, who were selected by quota sampling from eight private rehabilitation centers in Tehran. Questionnaires were used to collect data, and correlation tests, independent t-test, and one-way analysis of variance were utilized to analyze data. Results: Upon the results, overall 88% of participants expressed their satisfaction. The major related factors were the behavior of managers and employees, receiving training for follow-up rehabilitation and education programs for the child at home, and the child's progress. The factors related to dissatisfaction included nutrition services, physical condition of the center and lack of parental participation in decision- making on matters related to the child. A significant relationship was found between parental satisfaction and family size, father's job, and the number of other disabled people in the family. Discussion: According to the findings, it seems that patient satisfaction is also affected by the behavioral aspects of care, in addition to the technical aspects. Considering the humans’ need for respect and compassion and the sense of being valuable, this finding could be anticipated. The managers of private rehabilitation centers, for attracting and retain clients, need to pay attention to the factors which have impact on service users’ satisfaction.

Vocational rehabilitation: a multidisciplinary intervention.

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Gobelet, C; Luthi, F; Al-Khodairy, A T; Chamberlain, M A