BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,i...BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.展开更多
Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of suc...Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of such surgeries,the article highlights the critical need for effective postoperative care strategies.This editorial provides an overview of rehabilitation care for pain in elderly knee replacement patients,emphasizing the importance of a multimodal approach to postoperative recovery.Furthermore,the article advocates for a patient-centered,comprehensive rehabilitation regimen that enhances recovery and quality of life in elderly patients undergoing knee replacement surgery.展开更多
Fractures of femur proximal extremity(FFPE)are the most common fragility fractures requiring hospitalization,with a high risk of mortality,low independence in the activities of daily living and severe consequences on ...Fractures of femur proximal extremity(FFPE)are the most common fragility fractures requiring hospitalization,with a high risk of mortality,low independence in the activities of daily living and severe consequences on healthrelated quality of life.Timing for surgery has a key role in the management of elderly patients with FFPE as recommended by the Australian and New Zealand guidelines and the National Institute for Health and Care Excellence guidelines.Early surgery(within 48 h from hospital admission)allows significant benefits in terms of lower rates of postoperative complications and risk of death and can provide better functional outcomes.Therefore,time for surgery could be considered as a comorbidity marker.The choice between conservative or surgical approach surprisingly seems to be still not strongly supported by available literature,but it seems that both 30 d and 1 year risk of mortality is higher with the conservative treatment rather than with surgery.In light of these considerations,the optimization of FFPE management care is mandatory to improve functional outcomes and to reduce sanitary costs.Albeit it is widely accepted that transdisciplinary approach to patients suffering from FFPE is mandatory to optimize both short-term and long-term outcomes,the feasibility of a comprehensive approach in clinical practice is still a challenge.In particular,the large variability of figures involved could be considered both a resource and an additional disadvantage taking into account the difficulty to coordinate multidisciplinary approach covering care in all settings.Therefore,the aim of the present article was to summarize current evidence supporting transdisciplinary management of patients with FFPE,highlighting the benefits,feasibility and limitations of this approach.展开更多
This review presents a conceptual framework and supporting evidence that links impaired motor control after sport-related concussion(SRC)to increased risk for musculoskeletal injury.Multiple studies have found that at...This review presents a conceptual framework and supporting evidence that links impaired motor control after sport-related concussion(SRC)to increased risk for musculoskeletal injury.Multiple studies have found that athletes who are post-SRC have higher risk for musculoskeletal injury compared to their counterparts.A small body of research suggests that impairments in motor control are associated with musculoskeletal injury risk.Motor control involves the perception and processing of sensory information and subsequent coordination of motor output within the central nervous system to perform a motor task.Motor control is inclusive of motor planning and motor learning.If sensory information is not accurately perceived or there is interference with sensory information processing and cognition,motor function will be altered,and an athlete may become vulnerable to injury during sport participation.Athletes with SRC show neuroanatomic and neurophysiological changes relevant to motor control even after meeting return to sport criteria,including a normal neurological examination,resolution of symptoms,and return to baseline function on traditional concussion testing.In conjunction,altered motor function is demonstrated after SRC in muscle activation and force production,movement patterns,balance/postural stability,and motor task performance,especially performance of a motor task paired with a cognitive task(i.e.,dual-task condition).The clinical implications of this conceptual framework include a need to intentionally address motor control impairments after SRC to mitigate musculoskeletal injury risk and to monitor motor control as the athlete progresses through the return to sport continuum.展开更多
Multiple sclerosis is the commonest cause of chronic neurological disability in young adults. Patients typically have a normal life span, though with accrued time multiple disabilities with a significant impact on qua...Multiple sclerosis is the commonest cause of chronic neurological disability in young adults. Patients typically have a normal life span, though with accrued time multiple disabilities with a significant impact on quality of life. This article presents the current literature on symptomatic treatment and rehabilitation for persons with multiple sclerosis. A comprehensive multidisciplinary approach addresses the acute, intermediate and long-term medical, psychological and social issues faced by these individuals. Prevention of medical complications, maintenance and restoration of functional independence, addressing psychosocial factors and issues relating to quality of life are integral to the rehabilitation processes.展开更多
Chronic disease is a main contributor to the disproportionately high burden of illness experienced by Aboriginal and Torres Strait Islander Australians. However, there are very few programs addressing chronic disease ...Chronic disease is a main contributor to the disproportionately high burden of illness experienced by Aboriginal and Torres Strait Islander Australians. However, there are very few programs addressing chronic disease self-management and rehabilitation which are designed specifically for urban Aboriginal and Torres Strait Islander people. This paper aims to explore client and staff perceptions of the Work It out Program, a chronic disease rehabilitation and self-management program designed for urban Aboriginal and Torres Strait Islander people. The study used a mixed methods approach to explore the success, barriers and self-reported outcomes of the program. Quantitative data were collected through a structured survey, comprising social and demographic data. Qualitative data were collected through interviews using Most Significant Change theory. Twenty-eight participants were recruited, 6 staff and 22 clients (M = 7, F = 21) with an age range between 21 and 79 years of age (Mean = 59.00, SD = 17.63). Interviews were completed in 2013 across four Work It out locations in Southeast Queensland. Semi-structured interviews were conducted either individually or in groups of two or three, depending on the participants’ preference. Thematic analysis of the data revealed six main themes;physical changes, lifestyle improvements, social and emotional well-being, perceptions about the successful features of the program, perceived barriers to the program and changes for the future. This exploratory study found that clients and staff involved in the Work It out Program perceived it as an effective self-management and rehabilitation program for urban Aboriginal and Torres Strait Islander Australians. Further evaluation with a larger sample size is warranted in order to establish further outcomes of the program.展开更多
The motivation for cost-effective management of highway pavements is evidenced not only by the massive expenditures associated with these activities at a national level but also by the consequences of poor pavement co...The motivation for cost-effective management of highway pavements is evidenced not only by the massive expenditures associated with these activities at a national level but also by the consequences of poor pavement condition on road users.This paper presents a state-of-the-art review of multi-objective optimization(MOO)problems that have been formulated and solution techniques that have been used in selecting and scheduling highway pavement rehabilitation and maintenance activities.First,the paper presents a taxonomy and hierarchy for these activities,the role of funding sources,and levels of jurisdiction.The paper then describes how three different decision mechanisms have been used in past research and practice for project selection and scheduling(historical practices,expert opinion,and explicit mathematical optimization)and identifies the pros and cons of each mechanism.The paper then focuses on the optimization mechanism and presents the types of optimization problems,formulations,and objectives that have been used in the literature.Next,the paper examines various solution algorithms and discusses issues related to their implementation.Finally,the paper identifies some barriers to implementing multi-objective optimization in selecting and scheduling highway pavement rehabilitation and maintenance activities,and makes recommendations to overcome some of these barriers.展开更多
Based on an analysis of our research results and the main problems relating to urban rainwater treatment, we propose a new approach to urban rainwater management in China. The necessity and feasibility of such a new a...Based on an analysis of our research results and the main problems relating to urban rainwater treatment, we propose a new approach to urban rainwater management in China. The necessity and feasibility of such a new approach are discussed. From an ecological point of view all components of the global system, including residents living in cities, have the same right to enjoy rainwater. Therefore, urban rainwater should neither be simply drained as waste water, nor be completely harvested as a kind of resource. The objective of this new approach is to maintain the natural hydrological cycle in urban areas during urbanization. When necessary, it could also be used to regulate the amount of runoff, evaporation and infiltration in a city in order to rehabilitate the hydrological cycle given the local conditions. Three basic principles should be adopted in rainwater management, i.e., separation of rainfall from sewage, limited utilization and small and decentralized facilities. Four methods can be used for urban rainwater management: rainwater harvest, rainwater infiltration, rainwater storage and rainwater pipes. The natural hydrological cycle in urban areas could be rehabilitated through rainwater management, which is of great importance for sustainable development of our cities.展开更多
The authors have presented a technique of full occlusal rehabilitation in a case of severe dental fluorosis. In this technique, maxillary and mandibular anterior teeth were simultaneously prepared and restored first. ...The authors have presented a technique of full occlusal rehabilitation in a case of severe dental fluorosis. In this technique, maxillary and mandibular anterior teeth were simultaneously prepared and restored first. This was followed by simultaneous preparation of maxillary and mandibular posterior teeth that were restored in canine guided occlusion. The technique and sequence followed here is unique and is not available in dental literature. This technique reduces number of appointments while fulfilling all objectives. Periodontal followup over 3 years was satisfactory. A restorative treatment protocol has been devised for fluorosis which will act as a guide for the dental practitioners.展开更多
In this review intended for medical staff involved in patient rehabilitation,we provided an overview of the basic methods for managing amputation stumps.After the amputation surgery,it is imperative to optimize the re...In this review intended for medical staff involved in patient rehabilitation,we provided an overview of the basic methods for managing amputation stumps.After the amputation surgery,it is imperative to optimize the remaining physical abilities of the amputee through rehabilitation processes,including postoperative rehabilitation,desensitization,and continuous application of soft or rigid dressings for pain reduction and shaping of the stump.Depending on the situation,a prosthesis may be worn in the early stage of recovery or an immediate postoperative prosthesis may be applied to promote stump maturation.Subsequently,to maintain the range of motion of the stump and to prevent deformation,the remaining portion of the limb should be positioned to prevent contracture.Continuous exercises should also be performed to improve muscle strength to ensure that the amputee is able to perform activities of daily living,independently.Additionally,clean wound or edema management of the stump is necessary to prevent problems associated with wearing the prosthesis.Our review is expected to contribute to the establishment of basic protocols that will be useful for stump management from the time of completion of amputation surgery to the fitting of a prosthesis to optimize patient recovery.展开更多
Deforestation and forest degradation are having profound negative impacts on social-ecological systems in the emerging economies across the tropics.Consequently,interest in restoring and rehabilitating degraded forest...Deforestation and forest degradation are having profound negative impacts on social-ecological systems in the emerging economies across the tropics.Consequently,interest in restoring and rehabilitating degraded forests has been growing.This paper explores current issues related to addressing forest degradation in the Lancang-Mekong Region(LMR)of Southeast Asia through a review of the use of criteria and indicators for forest degradation and rehabilitation.Forest degradation must be understood in the context of its underlying drivers,which are numerous and complex.Understanding these underlying drivers of degradation requires diagnosing the entwined political,social,economic,and environmental systems that aff ect forests.Landscapes are the relevant scales to diagnose and intervene for improved forests.Interventions to restore or rehabilitate forests should be process-driven,focused on the underlying social,ecological and political processes that degrade landscapes.Interventions should also include negotiation among all actors infl uencing and competing for natural resource claims in forest landscapes.Criteria and indicators for forest landscape restoration should therefore help to improve the governance of forest landscapes.Criteria and indicators provide measures of the biophysical outcomes of degradation,in addition to processes,but these should be adapted to changing contexts and emerging challenges,and should rectify any pre-existing fl awed change-logic.Restoration activities should synthesize,integrate,and build upon the rich history of pre-existing restoration guidelines,but should be adaptable in order to be applied eff ectively in the contexts of local landscapes.This project is facilitating a dialogue around the use of criteria and indicators to help solve the degradation challenge in the LMR.We will trial the use of the criteria and indicators generated through this research in the LMR to learn what works and what doesn’t.This will provide an opportunity to build consensus around the ways in which restoration investments made by governments,civil society,and the private sector can infl uence sustainability.展开更多
Charcot-Marie-Tooth (CMT) disease, which encompasses several hereditary motor and sensory neuropathies, is one of the most common neuro-muscular disorders. 80% of patients having CMT disease are diagnosed with per cav...Charcot-Marie-Tooth (CMT) disease, which encompasses several hereditary motor and sensory neuropathies, is one of the most common neuro-muscular disorders. 80% of patients having CMT disease are diagnosed with per cavus deformity. Orthosis is widespread and varies widely in forms. The paper arises the necessity of habilitation at the earliest possible stage as only a few patients use it. The meta-analysis of 412 scientific papers concerning this problem demonstrates the getting better gate, balance and the stopping CMT progression which is scientifically proven. It is also shown that patients with CMT use low prevalence of orthotics, and demonstrate low compliance of patients (for various reasons), high expectations from this habilitation technique.展开更多
Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants...Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR;in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67 - 0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.展开更多
Cancer Rehabilitation is a new discipline,a combination of tumor medication,immunology,psychology,nutritional science and exercise physiology etc..The core of cancer rehabilitation is the therapy of natural immunology...Cancer Rehabilitation is a new discipline,a combination of tumor medication,immunology,psychology,nutritional science and exercise physiology etc..The core of cancer rehabilitation is the therapy of natural immunology,which aims at activating T-cells,and restoring the bone marrow function impaired during chemo-radiation therapy.Cancer rehabilitation seeks to achieve the gradual recovery of the immune system,which in turn hinders recurrence and metastasis.In addition,with the help of psychological consultation,nutritional and physical exercise guidance,cancer patients may have a better chance at managing the risk of recurrence and metastasis,extending life expectancy with an improved quality of life.展开更多
Whiplash injuries are a global health problem and a significant financial burden for both health care systems,and insurance providers.The diverse symptomatology after whiplash injury both in the somatic,emotional and ...Whiplash injuries are a global health problem and a significant financial burden for both health care systems,and insurance providers.The diverse symptomatology after whiplash injury both in the somatic,emotional and behavioral sphere prompted separation of the Whiplash Associated Disorders(WAD)as a separate category of diseases.The exact mechanism of whiplash injury is still under debate and theories explaining pathogenesis of WAD are very diverse ranging from purely biomechanical to neurophysiological,emphasizing central sensitization but the core disability seems to be strictly connected to somatosensory dysfunction.As a result,the optimal algorithm of rehabilitation has not been established and data published in the current literature on effectiveness of such algorithms are inconsistent.Based on the presented here of Head Neutral Reference Point(HNRP),the objective of central desensitization is to restore valid somatosensory output from Cranio-cervical Junction(CCJ).This new concept of rehabilitation after whiplash presented here is based on clinical observations and is supported by initial results.展开更多
目的:探讨多学科围术期疼痛干预对胸腔镜肺叶切除术(VATS)术后疼痛、术后恢复和并发症的影响。方法:选取施行VATS治疗的116例患者为研究对象。依据干预方式不同将116例VATS患者分为对照组和观察组,每组各58例。对照组实施常规疼痛干预;...目的:探讨多学科围术期疼痛干预对胸腔镜肺叶切除术(VATS)术后疼痛、术后恢复和并发症的影响。方法:选取施行VATS治疗的116例患者为研究对象。依据干预方式不同将116例VATS患者分为对照组和观察组,每组各58例。对照组实施常规疼痛干预;观察组实施多学科围术期疼痛干预。比较两组疼痛情况[数字疼痛评分法(NRS)]、术后恢复情况、术后康复质量[Quality of Recovery-15,QoR-15]及并发症发生情况。结果:术后24 h及术后72 h观察组静息及咳嗽时NRS评分均低于对照组(P<0.05)。观察组术后首次下床活动时间、首次排气时间、首次经口进食时间及术后住院时间均短于对照组(P<0.05)。术后72 h,两组QoR-15评分均高于术后24 h(P<0.05),且观察组术后24、72 h QoR-15评分均高于对照组(P<0.05)。观察组总并发症发生率低于对照组(8.61%vs.22.41%,P<0.05)。结论:多学科围术期疼痛干预可降低VATS术后疼痛,促进术后恢复进程,提升康复质量,并能在一定程度上减少并发症发生。展开更多
文摘BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.
文摘Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of such surgeries,the article highlights the critical need for effective postoperative care strategies.This editorial provides an overview of rehabilitation care for pain in elderly knee replacement patients,emphasizing the importance of a multimodal approach to postoperative recovery.Furthermore,the article advocates for a patient-centered,comprehensive rehabilitation regimen that enhances recovery and quality of life in elderly patients undergoing knee replacement surgery.
文摘Fractures of femur proximal extremity(FFPE)are the most common fragility fractures requiring hospitalization,with a high risk of mortality,low independence in the activities of daily living and severe consequences on healthrelated quality of life.Timing for surgery has a key role in the management of elderly patients with FFPE as recommended by the Australian and New Zealand guidelines and the National Institute for Health and Care Excellence guidelines.Early surgery(within 48 h from hospital admission)allows significant benefits in terms of lower rates of postoperative complications and risk of death and can provide better functional outcomes.Therefore,time for surgery could be considered as a comorbidity marker.The choice between conservative or surgical approach surprisingly seems to be still not strongly supported by available literature,but it seems that both 30 d and 1 year risk of mortality is higher with the conservative treatment rather than with surgery.In light of these considerations,the optimization of FFPE management care is mandatory to improve functional outcomes and to reduce sanitary costs.Albeit it is widely accepted that transdisciplinary approach to patients suffering from FFPE is mandatory to optimize both short-term and long-term outcomes,the feasibility of a comprehensive approach in clinical practice is still a challenge.In particular,the large variability of figures involved could be considered both a resource and an additional disadvantage taking into account the difficulty to coordinate multidisciplinary approach covering care in all settings.Therefore,the aim of the present article was to summarize current evidence supporting transdisciplinary management of patients with FFPE,highlighting the benefits,feasibility and limitations of this approach.
文摘This review presents a conceptual framework and supporting evidence that links impaired motor control after sport-related concussion(SRC)to increased risk for musculoskeletal injury.Multiple studies have found that athletes who are post-SRC have higher risk for musculoskeletal injury compared to their counterparts.A small body of research suggests that impairments in motor control are associated with musculoskeletal injury risk.Motor control involves the perception and processing of sensory information and subsequent coordination of motor output within the central nervous system to perform a motor task.Motor control is inclusive of motor planning and motor learning.If sensory information is not accurately perceived or there is interference with sensory information processing and cognition,motor function will be altered,and an athlete may become vulnerable to injury during sport participation.Athletes with SRC show neuroanatomic and neurophysiological changes relevant to motor control even after meeting return to sport criteria,including a normal neurological examination,resolution of symptoms,and return to baseline function on traditional concussion testing.In conjunction,altered motor function is demonstrated after SRC in muscle activation and force production,movement patterns,balance/postural stability,and motor task performance,especially performance of a motor task paired with a cognitive task(i.e.,dual-task condition).The clinical implications of this conceptual framework include a need to intentionally address motor control impairments after SRC to mitigate musculoskeletal injury risk and to monitor motor control as the athlete progresses through the return to sport continuum.
文摘Multiple sclerosis is the commonest cause of chronic neurological disability in young adults. Patients typically have a normal life span, though with accrued time multiple disabilities with a significant impact on quality of life. This article presents the current literature on symptomatic treatment and rehabilitation for persons with multiple sclerosis. A comprehensive multidisciplinary approach addresses the acute, intermediate and long-term medical, psychological and social issues faced by these individuals. Prevention of medical complications, maintenance and restoration of functional independence, addressing psychosocial factors and issues relating to quality of life are integral to the rehabilitation processes.
文摘Chronic disease is a main contributor to the disproportionately high burden of illness experienced by Aboriginal and Torres Strait Islander Australians. However, there are very few programs addressing chronic disease self-management and rehabilitation which are designed specifically for urban Aboriginal and Torres Strait Islander people. This paper aims to explore client and staff perceptions of the Work It out Program, a chronic disease rehabilitation and self-management program designed for urban Aboriginal and Torres Strait Islander people. The study used a mixed methods approach to explore the success, barriers and self-reported outcomes of the program. Quantitative data were collected through a structured survey, comprising social and demographic data. Qualitative data were collected through interviews using Most Significant Change theory. Twenty-eight participants were recruited, 6 staff and 22 clients (M = 7, F = 21) with an age range between 21 and 79 years of age (Mean = 59.00, SD = 17.63). Interviews were completed in 2013 across four Work It out locations in Southeast Queensland. Semi-structured interviews were conducted either individually or in groups of two or three, depending on the participants’ preference. Thematic analysis of the data revealed six main themes;physical changes, lifestyle improvements, social and emotional well-being, perceptions about the successful features of the program, perceived barriers to the program and changes for the future. This exploratory study found that clients and staff involved in the Work It out Program perceived it as an effective self-management and rehabilitation program for urban Aboriginal and Torres Strait Islander Australians. Further evaluation with a larger sample size is warranted in order to establish further outcomes of the program.
基金This work is supported by the Next Generation Transportation Systems Center(NEXTRANS),USDOT's Region 5 University Transportation CenterThe work is also affiliated with Purdue University College of Engineering's Institute for Control,Optimization,and Networks(ICON)and Center for Intelligent Infrastructure(CII)initiatives.
文摘The motivation for cost-effective management of highway pavements is evidenced not only by the massive expenditures associated with these activities at a national level but also by the consequences of poor pavement condition on road users.This paper presents a state-of-the-art review of multi-objective optimization(MOO)problems that have been formulated and solution techniques that have been used in selecting and scheduling highway pavement rehabilitation and maintenance activities.First,the paper presents a taxonomy and hierarchy for these activities,the role of funding sources,and levels of jurisdiction.The paper then describes how three different decision mechanisms have been used in past research and practice for project selection and scheduling(historical practices,expert opinion,and explicit mathematical optimization)and identifies the pros and cons of each mechanism.The paper then focuses on the optimization mechanism and presents the types of optimization problems,formulations,and objectives that have been used in the literature.Next,the paper examines various solution algorithms and discusses issues related to their implementation.Finally,the paper identifies some barriers to implementing multi-objective optimization in selecting and scheduling highway pavement rehabilitation and maintenance activities,and makes recommendations to overcome some of these barriers.
基金Projects 40371113 supported by the National Natural Science Foundation of China and OF060096Young Foundation of China University of Mining &Technology
文摘Based on an analysis of our research results and the main problems relating to urban rainwater treatment, we propose a new approach to urban rainwater management in China. The necessity and feasibility of such a new approach are discussed. From an ecological point of view all components of the global system, including residents living in cities, have the same right to enjoy rainwater. Therefore, urban rainwater should neither be simply drained as waste water, nor be completely harvested as a kind of resource. The objective of this new approach is to maintain the natural hydrological cycle in urban areas during urbanization. When necessary, it could also be used to regulate the amount of runoff, evaporation and infiltration in a city in order to rehabilitate the hydrological cycle given the local conditions. Three basic principles should be adopted in rainwater management, i.e., separation of rainfall from sewage, limited utilization and small and decentralized facilities. Four methods can be used for urban rainwater management: rainwater harvest, rainwater infiltration, rainwater storage and rainwater pipes. The natural hydrological cycle in urban areas could be rehabilitated through rainwater management, which is of great importance for sustainable development of our cities.
文摘The authors have presented a technique of full occlusal rehabilitation in a case of severe dental fluorosis. In this technique, maxillary and mandibular anterior teeth were simultaneously prepared and restored first. This was followed by simultaneous preparation of maxillary and mandibular posterior teeth that were restored in canine guided occlusion. The technique and sequence followed here is unique and is not available in dental literature. This technique reduces number of appointments while fulfilling all objectives. Periodontal followup over 3 years was satisfactory. A restorative treatment protocol has been devised for fluorosis which will act as a guide for the dental practitioners.
基金Supported by the National Research Foundation of Korea Grant funded by the Korean government,No.NRF2021R1A2C1013073.
文摘In this review intended for medical staff involved in patient rehabilitation,we provided an overview of the basic methods for managing amputation stumps.After the amputation surgery,it is imperative to optimize the remaining physical abilities of the amputee through rehabilitation processes,including postoperative rehabilitation,desensitization,and continuous application of soft or rigid dressings for pain reduction and shaping of the stump.Depending on the situation,a prosthesis may be worn in the early stage of recovery or an immediate postoperative prosthesis may be applied to promote stump maturation.Subsequently,to maintain the range of motion of the stump and to prevent deformation,the remaining portion of the limb should be positioned to prevent contracture.Continuous exercises should also be performed to improve muscle strength to ensure that the amputee is able to perform activities of daily living,independently.Additionally,clean wound or edema management of the stump is necessary to prevent problems associated with wearing the prosthesis.Our review is expected to contribute to the establishment of basic protocols that will be useful for stump management from the time of completion of amputation surgery to the fitting of a prosthesis to optimize patient recovery.
文摘Deforestation and forest degradation are having profound negative impacts on social-ecological systems in the emerging economies across the tropics.Consequently,interest in restoring and rehabilitating degraded forests has been growing.This paper explores current issues related to addressing forest degradation in the Lancang-Mekong Region(LMR)of Southeast Asia through a review of the use of criteria and indicators for forest degradation and rehabilitation.Forest degradation must be understood in the context of its underlying drivers,which are numerous and complex.Understanding these underlying drivers of degradation requires diagnosing the entwined political,social,economic,and environmental systems that aff ect forests.Landscapes are the relevant scales to diagnose and intervene for improved forests.Interventions to restore or rehabilitate forests should be process-driven,focused on the underlying social,ecological and political processes that degrade landscapes.Interventions should also include negotiation among all actors infl uencing and competing for natural resource claims in forest landscapes.Criteria and indicators for forest landscape restoration should therefore help to improve the governance of forest landscapes.Criteria and indicators provide measures of the biophysical outcomes of degradation,in addition to processes,but these should be adapted to changing contexts and emerging challenges,and should rectify any pre-existing fl awed change-logic.Restoration activities should synthesize,integrate,and build upon the rich history of pre-existing restoration guidelines,but should be adaptable in order to be applied eff ectively in the contexts of local landscapes.This project is facilitating a dialogue around the use of criteria and indicators to help solve the degradation challenge in the LMR.We will trial the use of the criteria and indicators generated through this research in the LMR to learn what works and what doesn’t.This will provide an opportunity to build consensus around the ways in which restoration investments made by governments,civil society,and the private sector can infl uence sustainability.
文摘Charcot-Marie-Tooth (CMT) disease, which encompasses several hereditary motor and sensory neuropathies, is one of the most common neuro-muscular disorders. 80% of patients having CMT disease are diagnosed with per cavus deformity. Orthosis is widespread and varies widely in forms. The paper arises the necessity of habilitation at the earliest possible stage as only a few patients use it. The meta-analysis of 412 scientific papers concerning this problem demonstrates the getting better gate, balance and the stopping CMT progression which is scientifically proven. It is also shown that patients with CMT use low prevalence of orthotics, and demonstrate low compliance of patients (for various reasons), high expectations from this habilitation technique.
文摘Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR;in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67 - 0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.
文摘Cancer Rehabilitation is a new discipline,a combination of tumor medication,immunology,psychology,nutritional science and exercise physiology etc..The core of cancer rehabilitation is the therapy of natural immunology,which aims at activating T-cells,and restoring the bone marrow function impaired during chemo-radiation therapy.Cancer rehabilitation seeks to achieve the gradual recovery of the immune system,which in turn hinders recurrence and metastasis.In addition,with the help of psychological consultation,nutritional and physical exercise guidance,cancer patients may have a better chance at managing the risk of recurrence and metastasis,extending life expectancy with an improved quality of life.
文摘Whiplash injuries are a global health problem and a significant financial burden for both health care systems,and insurance providers.The diverse symptomatology after whiplash injury both in the somatic,emotional and behavioral sphere prompted separation of the Whiplash Associated Disorders(WAD)as a separate category of diseases.The exact mechanism of whiplash injury is still under debate and theories explaining pathogenesis of WAD are very diverse ranging from purely biomechanical to neurophysiological,emphasizing central sensitization but the core disability seems to be strictly connected to somatosensory dysfunction.As a result,the optimal algorithm of rehabilitation has not been established and data published in the current literature on effectiveness of such algorithms are inconsistent.Based on the presented here of Head Neutral Reference Point(HNRP),the objective of central desensitization is to restore valid somatosensory output from Cranio-cervical Junction(CCJ).This new concept of rehabilitation after whiplash presented here is based on clinical observations and is supported by initial results.
文摘目的:探讨多学科围术期疼痛干预对胸腔镜肺叶切除术(VATS)术后疼痛、术后恢复和并发症的影响。方法:选取施行VATS治疗的116例患者为研究对象。依据干预方式不同将116例VATS患者分为对照组和观察组,每组各58例。对照组实施常规疼痛干预;观察组实施多学科围术期疼痛干预。比较两组疼痛情况[数字疼痛评分法(NRS)]、术后恢复情况、术后康复质量[Quality of Recovery-15,QoR-15]及并发症发生情况。结果:术后24 h及术后72 h观察组静息及咳嗽时NRS评分均低于对照组(P<0.05)。观察组术后首次下床活动时间、首次排气时间、首次经口进食时间及术后住院时间均短于对照组(P<0.05)。术后72 h,两组QoR-15评分均高于术后24 h(P<0.05),且观察组术后24、72 h QoR-15评分均高于对照组(P<0.05)。观察组总并发症发生率低于对照组(8.61%vs.22.41%,P<0.05)。结论:多学科围术期疼痛干预可降低VATS术后疼痛,促进术后恢复进程,提升康复质量,并能在一定程度上减少并发症发生。