Rehabilitation Research Articles

The use of autofluorescence stomatoscopy in the algorithm of diagnosing of the oral mucosal abnormalities of patients with tuberculosis infection

AIM. To evaluate the feasibility of using the autofluorescence stomatoscopy in dental examination of patients with tuberculosis infection.MATERIALS AND METHODS. The objects of the study were 75 patients aged 21 to 65 years (average age 47.9±2.1 years), 48 men and 27 women (64% and 36%, respectively) who are at the stages of treatment and reha bilitation of the underlying disease (pulmonary tuberculosis) in a specialized tuberculosis sanatorium. The design of the study included the generally standard stages of a comprehensive dental examination of patients, in which diseases of the oral mucosa and the red border of the lips were additionally detected using autofluorescence stomatoscopy, as well as a laboratory Candida test was carried out. The clinical picture of the diagnosed pathological conditions of the oral mucosa, autofluorescence images and their pathomorphological features were compared. The reports of the examined persons regarding the autofluorescence stomatoscopy were evaluated.RESULTS. It was shown that diseases of the oral mucosa and the red border of the lips in patients with tuberculosis infection are highly common (92%), are found more often in males and differ in the heterogeneity of their structure, which is dominated by candidiasis of the oral mucosa, traumatic lesions and various forms of cheilitis. The features of autofluorescence images of pathological conditions of the oral mucosa of different nature of the origin are marked. Positive feedback from patients after the autofluorescence stomatoscopy was recorded in 100% of cases.CONCLUSIONS. The use of the autofluorescence stomatoscopy in the algorithm of dental examination of patients with tuberculosis infection is appropriate because it allows to implement the principle of oncological alertness among specialists, helps the doctor to obtain additional information about the pathological process in real time and increases the motivation of the examined persons to maintain dental health.

Multi-Factor Evaluation of RHL Success in Neniari Village, Indonesia

General Background: Forest and land rehabilitation (RHL) is essential for addressing critical land conditions, aiming to transform unproductive lands into areas that can enhance community living standards through increased productivity. Specific Background: In Neniari Village, the RHL program has been implemented with mixed success, utilizing agroforestry systems and involving various species, including both timber and non-timber plants. Knowledge Gap: Existing studies often lack detailed analysis of the factors influencing RHL success at a community and ecological level. Aims: This study seeks to evaluate the overall success of the RHL program in Neniari Village by considering plant survival rates, environmental factors, and community participation. Results: The survival rate of plants averaged 70%, indicating a moderate level of rehabilitation success, which did not meet the targeted benchmarks. Novelty: This research uniquely combines biotic and abiotic factor analyses with community engagement levels to assess RHL outcomes. Implications: The findings highlight the need for enhanced community involvement and improved environmental condition management to boost RHL success rates, suggesting adjustments to future rehabilitation strategies.Highlights: Community Involvement: Higher levels of community participation are directly linked to the success of rehabilitation efforts, indicating the need for more focused engagement strategies. Plant Survival: An average survival rate of 70% among various plant species underlines the challenges of RHL in achieving its goals, pointing towards the necessity for improved environmental management. Agroforestry Benefits: Utilizing agroforestry systems has shown potential benefits in enhancing ecological diversity and economic returns, suggesting its suitability for RHL practices. Keywords: Forest Rehabilitation, Community Participation, Agroforestry Systems, Plant Survival Rates, Environmental Factors

POTENSI KEBERHASILAN REHABILITASI HUTAN BERDASARKAN PERENCANAAN SECARA PARTISIPATIF DI PROVINSI LAMPUNG

In forest management at the site level, involving local communities in Forest and Land Rehabilitation (RHL) activities is expected to have a real impact on the success and benefits of RHL activities. Community participation in RHL planning is carried out by giving the community the opportunity to directly choose the type, quantity and pattern of planting, determining the area and location of planting that will be used in RHL activities. This research aims to find out the reasons why farmers participate in the RHL program and whether the RHL planning pattern that accommodates the participation of the cultivating community can be well received and can increase the success of RHL. The determination of respondents was carried out using a random sampling technique with quota control, namely following information determined purposively so that 36 respondents were obtained, key information was selected based on role, knowledge, communicativeness and willingness to fill out interview questions. Data collection was carried out on September 21 2023, in the districts of West Lampung, East Lampung, South Lampung, Tanggamus, Pesawaran, Pesisir Barat, and Way Kanan. Data on farmers' opinions regarding participation in planning RHL activities collected was analyzed descriptively, while data on farmers' motivation to participate in RHL activities and sources of information on RHL activities were analyzed using regression (Regression Analysis). With community participation through selecting the type and determining the location of activities independently, it makes them confident to be involved in the implementation of RHL planning because with their participation the responsibility and success of RHL planting will increase. Furthermore, there is a relationship between farmers' information sources and motivation to participate in RHL activities. The availability of information will influence people's perceptions and motivation for RHL activities.

User-centered Design and Formative Evaluation of a Web Application to Collect and Visualize Real-time Clinician Well-being Levels

Abstract Background Clinician burnout is increasingly prevalent in the health care workplace. Hospital leadership needs an informatics tool to measure clinicians' well-being levels and provide empirical evidence to improve their work environment. Objectives This study aimed to (1) design and implement a web-based application to collect and visualize clinicians' well-being levels and (2) conduct formative usability evaluation. Methods Clinician and staff well-being champions guided the development of the Well-being Check application. User-centered design and Agile principles were used for incremental development of the app. The app included a customizable survey and an interactive visualization. The survey consisted of six standard, two optional, and three additional questions. The interactive visualization included various charts and word clouds with filters for drill-down analysis. The evaluation was done primarily with the rehabilitation (REHAB) team using data-centered approaches through historical survey data and qualitative coding of the free-text explanations and user-centered approaches through the System Usability Scale (SUS). Results The evaluation showed that the app appropriately accommodated historical survey data from the REHAB team, enabling the comparison between self-assessed and perceived team well-being levels, and summarized key drivers based on the qualitative coding of the free-text explanations. Responses from the 23 REHAB team members showed an above-average score (SUS: 80.22), indicating high usability of the app. Conclusion The Well-being Check app was developed in a user-centered manner and evaluated to demonstrate its effectiveness and usability. Future work includes iterative refinement of the app and designing a pre-poststudy using the app to measure the change in clinicians' well-being levels for quality improvement intervention.

Evaluating the Success of Watershed Rehabilitation Efforts in Gowa Regency: A Case Study on Forest and Land Restoration

The Ministry of Environment and Forestry designates forest and land rehabilitation (RHL) initiatives as a top priority in national policies. Forest and land rehabilitation refers to the deliberate actions taken to restore, preserve, and enhance the functionality of forests and land. Therefore, this study is to assess the viability of cultivating RHL plants. The methodology employed is the observation approach, which entails gathering data firsthand at the specific site. Plant area measurements are conducted on the physical planting area, quantified in hectares, and then compared to the intended plant area as specified in the design. Plant evaluation and assessment is conducted using the Systematic Sampling with Random Start approach, which involves randomly selecting the first measurement plot and then systematically selecting successive measuring plots. The sampling utilised a 5% interval. Rectangular measurement plots are formed with dimensions of 40 meters by 25 meters, resulting in an area of 0.1 hectares. The number of measuring plots can be determined by multiplying the percentage of interest (5%) by the plot area (in hectares) and then dividing by the area of each measuring plot (in hectares). This calculation results in a total of 43 measuring plots. The research findings indicate that the success rate of plant development varies between 76.33% and 77.17%, with an average value of 76.62%.

Effectiveness of Physiotherapy Methods in Medical Rehabilitation of Patients with Shoulder and Scapular Pain Syndrome in a Sanatorium: a Randomized Clinical Study

INTRODUCTION. The high prevalence of shoulder pain syndrome (SPS) determines the relevance of the development of new comprehensive methods of rehabilitation of this category of patients.
 AIM. To evaluate the clinical effectiveness of shockwave therapy (SWT) and pulsed low-frequency electrostatic field (PLEF) in patients with SPS undergoing medical rehabilitation in a sanatorium-resort organization in comparison with traditional health resort treatment.
 MATERIALS AND METHODS. The comparative analysis of medical rehabilitation efficiency was carried out in 90 patients with SPS aged 31–68 years undergoing medical rehabilitation in the health resort complex “Vulan” — a clinical branch of National Medical Research Center for Rehabilitation and Balneology. All patients were divided into 3 groups of 30 persons each by the method of simple randomization. Group 1 patients (control) received traditional health resort treatment, including ozokeritotherapy, physical exercise therapy, electrotherapy with sinusoidal modulated currents and manual massage. Patients of the second group (comparison) received against the background of the above complex 3 SWT procedures on the shoulder joint once a week. Group 3 patients (main group) received, in addition to traditional treatments, 3 SWT and 8 field PLEF treatments administered every other day. The effectiveness of rehabilitation was evaluated according to the severity of pain syndrome (VAS scale), Swanson’s scale for the shoulder. Movement volume before and after rehabilitation was measured with an orthopedic angle gauge. Microcirculation state was assessed by laser Doppler flowmetry (LDF). Leukert scale was used to assess the state of well-being. The results of the study were assessed 18 days after the beginning of rehabil itation measures.
 RESULTS AND DISCUSSION. Patients who additionally received SWT and PLEF against the background of traditional health resort treatment noted a significant reduction in the severity of pain syndrome, while in the main group pain regression was noted earlier (on day 4–5), whereas in the comparison group the same results were obtained by the day 14th . In the control group, patients noted significant changes on the VAS scale only by the end of the rehabilitation course. On the Swanson scale, the most significant positive results were also obtained by the patients in the main group: the pain decreased on average 2.6-fold, the volume of active movements in the shoulder joint increased 2.7-fold, and activity in everyday life 1.9-fold. Statistical differences in the Swanson Scale scores with the comparison group were obtained with regard to pain syndrome and volume of active movements. When comparing with the control group, reliable differences were revealed in all Swanson’s scale indicators in both the main group and the comparison group. When studying the dynamics of microcirculation according to LDF data, it was noted that reliable changes in the main indices of the LDF-gram were revealed only in the groups that received innovative physical therapy interventions.
 CONCLUSION. Thus, the inclusion of modern physiotherapeutic techniques of SWT and PLEF into the program of health resort treatment of patients with SPS allows to increase significantly the efficiency of medical rehabilitation carried out in the sanatorium organization.

Vegetation Analysis and Community Perception of Forest and Land Rehabilitation (RHL) (Case Study in Gunung Malang Village, Pringgabaya District, East Lombok Regency)

This study is an attempt to determine the level of vegetation density resulting from the 2017 RHL planting in Gunung Malang Village. The study method for evaluating the plant density index is done by determining the number of sample plots based on Stratified Random Sampling is a technique used to determine the number of samples, if the population is stratified but not proportional. Taking into account the determination of the sample based on the potential of the arable land which then classified by taking three criteria, namely the potential with high, medium, and low levels which are classified based on secondary vegetation data of the cultivators. Data collection was carried out using a census inventory with Plot Samples were taken based on the area under cultivation. The results of the plant evaluation are then processed by calculating the density level index formula which is analyzed to obtain the value of Density and Relative Density (KR) to determine the density level of the area so that conclusions can be drawn. The results of the study show that the results of the analysis of the 2017 RHL vegetation density level of the remaining number are only 103 tree stands at this time with a density value of 2.4772 or (2.48%) with a relative density of 1 or (100%). From the results of the RHL density analysis, the density level was relatively low when compared to the number of seeds planted. With the current remaining stands, the percentage of growth is less than 75% of the total number of seedlings planted, so this RHL activity can be said to be unsuccessful based on PermenLHK No. 2 of 2020. 
 Keywords; Evaluation, perception, Land and Forest Rehabilitation, Gunung Malang Village

Gene expression and locomotor recovery in adult rats with spinal cord injury and plasma-synthesized polypyrrole/iodine application combined with a mixed rehabilitation scheme.

Spinal cord injury (SCI) can cause paralysis, for which effective therapeutic strategies have not been developed yet. The only accepted strategy for patients is rehabilitation (RB), although this does not allow complete recovery of lost functions, which makes it necessary to combine it with strategies such as plasma-synthesized polypyrrole/iodine (PPy/I), a biopolymer with different physicochemical properties than PPy synthesized by conventional methods. After SCI in rats, PPy/I promotes functional recovery. Therefore, the purpose of this study was to increase the beneficial effects of both strategies and identify which genes activate PPy/I when applied alone or in combination with a mixed scheme of RB by swimming and enriched environment (SW/EE) in rats with SCI. Microarray analysis was performed to identify mechanisms of action underlying the effects of PPy/I and PPy/I+SW/EE on motor function recovery as evaluated by the BBB scale. Results showed robust upregulation by PPy/I in genes related to the developmental process, biogenesis, synapse, and synaptic vesicle trafficking. In addition, PPy/I+SW/EE increased the expression of genes related to proliferation, biogenesis, cell development, morphogenesis, cell differentiation, neurogenesis, neuron development, and synapse formation processes. Immunofluorescence analysis showed the expression of β-III tubulin in all groups, a decreased expression of caspase-3 in the PPy/I group and GFAP in the PPy/I+SW/EE group (p < 0.05). Better preservation of nerve tissue was observed in PPy/I and PPy/SW/EE groups (p < 0.05). In the BBB scale, the control group scored 1.72 ± 0.41, animals with PPy/I treatment scored 4.23 ± 0.33, and those with PPy/I+SW/EE scored 9.13 ± 0.43 1 month after follow-up. Thus, PPy/I+SW/EE could represent a therapeutic alternative for motor function recovery after SCI.

The microbiome of an outpatient rehabilitation clinic and predictors of contamination: A pilot study.

Understanding sources of microbial contamination in outpatient rehabilitation (REHAB) clinics is important to patients and healthcare providers. The purpose of this study was to characterize the microbiome of an outpatient REHAB clinic and examine relationships between clinic factors and contamination. Forty commonly contacted surfaces in an outpatient REHAB clinic were observed for frequency of contact and swiped using environmental sample collection kits. Surfaces were categorized based on frequency of contact and cleaning and surface type. Total bacterial and fungal load was assessed using primer sets specific for the 16S rRNA and ITS genes, respectively. Bacterial samples were sequenced using the Illumina system and analyzed using Illumina-utils, Minimum Entropy Decomposition, QIIME2 (for alpha and beta diversity), LEfSe and ANCOM-BC for taxonomic differential abundance and ADONIS to test for differences in beta diversity (p<0.05). Porous surfaces had more bacterial DNA compared to non-porous surfaces (median non-porous = 0.0016ng/μL, 95%CI = 0.0077-0.00024ng/μL, N = 15; porous = 0.0084 ng/μL, 95%CI = 0.0046-0.019 ng/μL, N = 18. p = 0.0066,DNA. Samples clustered by type of surface with non-porous surfaces further differentiated by those contacted by hand versus foot. ADONIS two-way ANOVA showed that the interaction of porosity and contact frequency (but neither alone) had a significant effect on 16S communities (F = 1.7234, R2 = 0.0609, p = 0.032). Porosity of surfaces and the way they are contacted may play an underestimated, but important role in microbial contamination. Additional research involving a broader range of clinics is required to confirm results. Results suggest that surface and contact-specific cleaning and hygiene measures may be needed for optimal sanitization in outpatient REHAB clinics.

Factors Influencing Farmers' Decision to Participate in the RHL (Forest and Land Rehabilitation) Program in Lengkiti District, OKU Regency

This research aims to determine what factors influence farmers' decisions to participate in Forest and Land Rehabilitation activities in Lengkiti District, OKU Regency. This study employed a survey approach of research. In this work, logistic regression analysis was utilized to analyze the data. The findings revealed that the independent variables: number of family members, land area, and workdays, significantly affected coffee growers' decisions to participate in the Forest and Land Rehabilitation (RHL) program.

Voice rehabilitation after laryngectomy: problems, complications and ways of their elimination

Voice rehabilitation after laryngectomy: problems, complications and ways of their elimination

PENGGUNAAN SISTEM INFORMASI GEOGRAFIS DALAM PENGELOLAAN DAERAH ALIRAN SUNGAI MENGGUNAKAN MODEL SOIL AND WATER ASSESMENT TOOL (SWAT)

The Soil and Water Assessment Tool (SWAT) model which is integrated with the Geographic Information System (GIS) can provide an overview or prediction of the influence of land management on watershed hydrology in accordance with the interests of evaluating and monitoring watershed management activities. The purpose of this study was to analyze the management of the Bukit Suligi Micro sub-watershed based on land use patterns, as a basis for determining the best recommendations for Forest and Land Rehabilitation activities by planting forestry trees based on community participation in Sei Kuning Village, Tandun District, Rokan Hulu Regency. The research method is processing primary and secondary data using a SWAT model integrated with GIS in analyzing hydrological characteristics in land use scenarios in the management of the Bukit Suligi Micro Watershed, as a basis for determining the best recommendations in Forest and Land Rehabilitation (RHL). community participation-based forestry tree planting activities in the Village. The best option in the land use scenario is the second scenario, which in its implementation in the field is the application of agroforestry to the existing Protected Forest Rehabilitation, only needing to insert forest plants based on community participation in Sei Kuning Village, Tandun District, Rokan Hulu Regency.

Influence of rehabilitation on mental state in patients with lumbar intervertebral disc damage.

The present study aims to investigate the mental state changes in patients with lumbar intervertebral disc damage after rehabilitation program using a self-administered questionnaire IRES-3. The study was conducted in the Specialized Hospitals for Rehabilitation - National Complex EAD, branches Hissar and Banite, Bulgaria. It included 124 patients - 34 men and 90 women, aged from 35 to 85 years. The questionnaire IRES-3, validated by the authors for the Bulgarian population, was used for measurement of the subjective evaluation of the rehabilitation effect. Measurements were performed at the beginning, end and three months after rehabilitation (RH). The subjective evaluation of the patients' mental state included the following scales: depression, fear, exhaustion of vitality, self-confidence and symptom: cognitive functioning. We found a statistically significant improvement of the scores three months after rehabilitation compared to the beginning of rehabilitation for all scales. The only exceptions are the scales exhaustion of vitality and symptom: cognitive functioning. We found a statistically significant improvement of the self-rated mental state after performed rehabilitation in patients with chronic diseases.

Can Early Neuromuscular Rehabilitation Protocol Improve Disability after a Hemiparetic Stroke? A Pilot Study.

Background: The impairment of limb function and disability are among the most im portant consequences of stroke. To date, however, little research has been done on the early reha bilitation trial (ERT) after stroke in these patients. The purpose of this study was to evaluate the impact of ERT neuromuscular protocol on motor function soon after hemiparetic stroke. The sample included twelve hemiparetic patients (54.3 ± 15.4 years old) with ischemic stroke (n = 7 control, n = 5 intervention patients). ERTwas started as early as possible after stroke and included passive range of motion exercises, resistance training, assisted standing up, and active exercises of the healthy side of the body, in addition to encouraging voluntary contraction of affected limbs as much as possible. The rehabilitation was progressive and took 3 months, 6 days per week, 2–3 h per session. Fu gle-Meyer Assessment (FMA), Box and Blocks test (BBT) and Timed up and go (TUG) assessments were conducted. There was a significantly greater improvement in the intervention group com pared to control: FMA lower limbs (p = 0.001), total motor function (p = 0.002), but no significant difference in FMA upper limb between groups (p = 0.51). The analysis of data related to BBT showed no significant differences between the experimental and control groups (p = 0.3). However, TUG test showed significant differences between the experimental and control groups (p = 0.004). The most important finding of this study was to spend enough time in training sessions and provide adequate rest time for each person. Our results showed that ERT was associated with improved motor function but not with the upper limbs. This provides a basis for a definitive trial.

WATERSHED MANAGEMENT APPROACH AS AN ALTERNATIVE SOLUTION FOR FLOOD PROBLEM IN NORTHERN PART OF CENTRAL JAVA (Pendekatan Pengelolaan DAS Sebagai Alternatif Solusi Masalah Banjir di Jawa Tengah Utara)

The flood disaster in northern Central Java was caused by rainfall, the influence of tidal surges, and ground subsidence in various sites. This study aims to give alternative solutions to flood control in Central Java watersheds draining to the north coast. By identifying the flood water discharge areas, the amount of runoff causing flooding can be reduced. By overlaying maps of floodwater discharge, land cover, degraded land, and forest functions, 12 recommendations of forests and land rehabilitation (RHL) are obtained, suited to the area's concerns. The recommendations are planned only for the areas with vulnerable and highly vulnerable to floodwater discharge, so priority is given to activities that incorporate runoff into the ground as much as possible to reduce the flood volume. The RHL is grouped into the enrichment of plants in open areas with the function of forest areas, enhancing terraces to reduce erosion, increasing soil fertility, and constructing infiltration wells or bio pores. Of the 31 regencies/cities whose rivers flow into the north coast, there are 5 (five) regencies/cities whose RHL recommendations are applied to more than 50% of the area, namely Salatiga City (99%), Semarang district/city (76%), Jepara Regency (71%), Pekalongan Regency (55%), and Brebes Regency (51%).

SIT TO STAND TEST OSTEOARTHRITIS PATIENTS

Osteoarthritis is a disease found in the elderly or often called a degenerative disease. The prevalence of total osteoarthritis in Indonesia was 34.3 million in 2002 and reached 36.5 million in 2007. An estimated 40% of the population above 70 years old suffer from osteoarthritis, and 80% of osteoarthritis patients have limited mobility in various degrees from mild to severe resulting in reducing the quality of life because of the high prevalence. The development of a simple approach to quantitatively estimating functional motor performance in various ages is very important for early detection of locomotive syndrome (LS), one of which is the sit to stand test (STST). In Indonesia, there are no studies that discuss STST, so the cut off point or even the average can be different. This can be influenced by differences in culture, demographics, activities, or treatment regimens. Based on the problem above, the researcher tries to find out the average and standard deviation of STST scores in Osteoathritis patients at Ahmad Yani Hospital, Surabaya by accidental sampling method on secondary data, namely Medical Records in 2019 at the Rehab ilitation outpatient clinic of Ahmad Yani Hospital in August-September 2019. The data recorded is in the form of quantitative data in units of seconds. Furthermore, the data is processed using SPSS 17 and displays the average value and standard deviation.

Recovery of motor function after traumatic spinal cord injury by using plasma-synthesized polypyrrole/iodine application in combination with a mixed rehabilitation scheme.

Traumatic spinal cord injury (TSCI) can cause paralysis and permanent disability. Rehabilitation (RB) is currently the only accepted treatment, although its beneficial effect is limited. The development of biomaterials has provided therapeutic possibilities for TSCI, where our research group previously showed that the plasma-synthesized polypyrrole/iodine (PPy/I), a biopolymer with different physicochemical characteristics than those of the PPy synthesized by conventional methods, promotes recovery of motor function after TSCI. The present study evaluated if the plasma-synthesized PPy/I applied in combination with RB could increase its beneficial effects and the mechanisms involved. Adult rats with TSCI were divided into no treatment (control); biopolymer (PPy/I); mixed RB by swimming and enriched environment (SW/EE); and combined treatment (PPy/I + SW/EE) groups. Eight weeks after TSCI, the general health of the animals that received any of the treatments was better than the control animals. Functional recovery evaluated by two scales was better and was achieved in less time with the PPy/I + SW/EE combination. All treatments significantly increased βIII-tubulin (nerve plasticity) expression, but only PPy/I increased GAP-43 (nerve regeneration) and MBP (myelination) expression when were analyzed by immunohistochemistry. The expression of GFAP (glial scar) decreased in treated groups when determined by histochemistry, while morphometric analysis showed that tissue was better preserved when PPy/I and PPy/I + SW/EE were administered. The application of PPy/I + SW/EE, promotes the preservation of nervous tissue, and the expression of molecules related to plasticity as βIII-tubulin, reduces the glial scar, improves general health and allows the recovery of motor function after TSCI. The implant of the biomaterial polypyrrole/iodine (PPy/I) synthesized by plasma (an unconventional synthesis method), in combination with a mixed rehabilitation scheme with swimming and enriched environment applied after a traumatic spinal cord injury, promotes expression of GAP-43 and βIII-tubulin (molecules related to plasticity and nerve regeneration) and reduces the expression of GFAP (molecule related to the formation of the glial scar). Both effects together allow the formation of nerve fibers, the reconnection of the spinal cord in the area of injury and the recovery of lost motor function. The figure shows the colocalization (yellow) of βIII-tubilin (red) and GAP-43 (green) in fibers crossing the epicenter of the injury (arrowheads) that reconnect the rostral and caudal ends of the injured spinal cord and allowed recovery of motor function.

Neurorehabilitation and its impact on functional status in patients who have suffered a stroke

Stroke represents the main cause of functional dependence and in the Portuguese adult population. Objectiveto analyse the impact of rehabilitation on functional state and basic activities of daily life (ABVD), 8 weeks following a stroke, in a population of elderly people in north-western Portugal. MethodologyObservational, longitudinal and retrospective study. The patients were grouped into 3 groups according to the rehabilitation treatment received: Non-rehabilitation (NR), light rehabilitation (RL) and intense rehabilitation (RI).Sociodemographic data, clinical variables (on stroke), hospital stay, rehabilitative treatment, and functional status (Barthel Index) were collected. Results350 patients, with a mean age of 75.83 (±8.02) years. The hospital stay was longer in the group of RL (19.7 (±8.69)), RI (17.67 (±10.05)) and of those who did not undergo rehabilitation (10.97 (±6.96)), (p = .001).A significant increase (p < .001) was observed in the Barthel index scores from admission to 8 weeks after the stroke.Age (p = .003) and hospital stay (p = .013) were shown as risk factors for functional dependence. Similarly, taking as a reference the patients who did not undergo rehabilitation, the subjects who underwent light rehabilitation (OR (95% CI): 6.37 (1.74−23.25), p = .005) and intensive rehabilitation (OR (95% CI): 2.28 (1.08−4.82, p = .030), had a significantly higher risk of presenting functional dependence Conclusionundergoing intensive rehabilitation improves functional state and ABVD compared to light rehabilitation, 8 weeks following a stroke in elderly patients.

Aggression and Violence Toward Healthcare Workers in a Psychiatric Service in Italy: A Retrospective Questionnaire-Based Survey.

Workplace violence and aggression are receiving increasing attention, especially when perpetrated in at-risk services such as psychiatric and emergency departments. Many healthcare providers have been victims of verbal aggressions (VAs) and physical aggressions (PAs), as well as injuries (INs), at the hands of patients. We conducted a 1-year retrospective questionnaire-based survey to assess workplace violence and aggression experienced by staff working at the Psychiatric Service of the Health District of Bolzano-Bozen (Italy). We performed parametric statistics. Logistic regression estimated the size of the association between PA occurrence and staff characteristics. Our psychiatric service's employees were frequent victims (91.5%) of 1 or more aggression/injury in the previous year. VAs and INs showed comparable frequencies among the three sites of our service, that is, the inpatient (INP), the outpatient (OUTP), and the rehabilitation (REHAB) units, differently from PAs, which were more common at INP (p < 0.001). The logistic regression model showed that female sex, working at INP, and a shorter psychiatry work experience predicted PAs occurrence. Most of the staff felt they could benefit from aggression management. Findings show that VAs, PAs, and INs are common among our psychiatric service's employees and point to the need to provide staff training on de-escalation.

Neurorrehabilitación y su impacto en el estado funcional en pacientes que han sufrido un ictus

Stroke represents the main cause of functional dependence and in the Portuguese adult population. ObjectiveTo analyse the impact of rehabilitation on functional state and basic activities of daily life (ABVD), 8weeks following a stroke, in a population of elderly people in north-western Portugal. MethodologyObservational, longitudinal and retrospective study. The patients were grouped into 3 groups according to the rehabilitation treatment received: non-rehabilitation (NR), light rehabilitation (RL) and intense rehabilitation (RI).Sociodemographic data, clinical variables (on stroke), hospital stay, rehabilitative treatment, and functional status (Barthel index) were collected. Results350 patients, with a mean age of 75.83 (± 8.02) years. The hospital stay was longer in the group of RL (19.7 [±8.69]), RI (17.67 [±10.05]) and of those who did not undergo rehabilitation (10.97 [±6.96]) (P=.001).A significant increase (P<.001) was observed in the Barthel index scores from admission to 8weeks after the stroke.Age (P=.003) and hospital stay (P=.013) were shown as risk factors for functional dependence. Similarly, taking as a reference the patients who did not undergo rehabilitation, the subjects who underwent light rehabilitation (OR: 6.37; 95%CI: 1.74-23.25; P=.005) and intensive rehabilitation (OR: 2.28; 95%CI: 1.08-4.82; P=.030), had a significantly higher risk of presenting functional dependence ConclusionUndergoing intensive rehabilitation improves functional state and ABVD compared to light rehabilitation, 8 weeks following a stroke in elderly patients.