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https://www.readbyqxmd.com/read/28730889/purposefulness-as-a-critical-factor-in-functioning-disability-and-health
#1
Joshua Y Lee, Emily A Ready, Eric N Davis, Philip C Doyle
Guided by theoretical frameworks of health and illness such as the International Classification of Functioning, Disability, and Health (ICF), we seek to describe the importance of purposefulness in the context of rehabilitation. We argue that ascribing meaning to life events, particularly changes in health, and acting in a manner that is driven by purpose is a universal characteristic of human beings. The ability to contextualize purposefulness within the broader biopsychosocial model of illness may provide a greater understanding of the relationship of purpose in the process of rehabilitation...
August 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28729323/gait-outcomes-of-older-adults-receiving-subacute-hospital-rehabilitation-following-orthopaedic-trauma-a-longitudinal-cohort-study
#2
Saira A Mathew, Paul Varghese, Suzanne S Kuys, Kristiann C Heesch, Steven M McPhail
OBJECTIVES: This study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination. DESIGN: A longitudinal cohort study was conducted. SETTING: Australian tertiary hospital subacute rehabilitation wards. PARTICIPANTS: Patients aged ≥60 years recovering from orthopaedic trauma (n=746, 71% female) were eligible for inclusion...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28724500/a-20-year-review-of-pediatric-pregnant-trauma-from-a-level-i-trauma-center
#3
Tanya L Zakrison, Xiomara Ruiz, Nicholas Namias, Marie Crandall
BACKGROUND: Trauma in pregnancy remains an important but understudied public health issue. We aimed to determine the prevalence of interpersonal violence in our pregnant trauma population (including pediatric) over the last 20 years, from our Level I trauma center. METHODS: We conducted a descriptive, retrospective chart review to identify all pregnant trauma patients between Jan 1993 and Sept 2013. Pediatric was ≤18 years of age. We evaluated demographics, mechanism of injury, injury location, disposition, and outcome data...
July 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28720041/burden-of-hand-maladies-in-us-emergency-departments
#4
David L Colen, Justin P Fox, Benjamin Chang, Ines C Lin
BACKGROUND: Hand conditions commonly present to the emergency department (ED), yet data are lacking regarding the magnitude of hand-related conditions in the emergency setting. The purpose of this study is to describe the burden and quantify the health care resource utilization of hand conditions seen in EDs across the United States. METHODS: Using the National Emergency Department Sample, we identified all ED encounters by patients at least 18 years of age that were associated with a hand condition in 2009 to 2012...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716636/a-simplified-clinical-prediction-rule-for-prognosticating-independent-walking-after-spinal-cord-injury-a-prospective-study-from-a-canadian-multicenter-spinal-cord-injury-registry
#5
Katharine E Hicks, Yichen Zhao, Nader Fallah, Carly Rivers, Vanessa Noonan, Tova Plashkes, Eugene K Wai, Darren M Roffey, Eve Tsai, Jerome Paquet, Najmedden Attabib, Travis Marion, Henry Ahn, Philippe Phan
BACKGROUND: Context: Traumatic spinal cord injury (SCI) is a debilitating condition with limited treatment options for neurological or functional recovery. The ability to predict the prognosis of walking post-injury with emerging prediction models could aid in rehabilitation strategies and reintegration into the community. PURPOSE: To re-validate an existing clinical prediction model for independent ambulation (van Middendorp et al. 2011) utilising acute and long-term post-injury follow-up data, and to investigate the accuracy of a simplified model using prospectively collected data from a Canadian multicenter SCI database, the Rick Hansen Spinal Cord Injury Registry (RHSCIR)...
July 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28715416/signatures-of-inflammation-and-impending-multiple-organ-dysfunction-in-the-hyperacute-phase-of-trauma-a-prospective-cohort-study
#6
Claudia P Cabrera, Joanna Manson, Joanna M Shepherd, Hew D Torrance, David Watson, M Paula Longhi, Mimoza Hoti, Minal B Patel, Michael O'Dwyer, Sussan Nourshargh, Daniel J Pennington, Michael R Barnes, Karim Brohi
BACKGROUND: Severe trauma induces a widespread response of the immune system. This "genomic storm" can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28713032/psychosocial-rehabilitation-after-war-trauma-with-adaptive-disclosure-design-and-rationale-of-a-comparative-efficacy-trial
#7
Julie D Yeterian, Danielle S Berke, Brett T Litz
BACKGROUND: Posttraumatic stress disorder (PTSD) from warzone exposure is associated with chronic and disabling social and occupational problems. However, functional impairment is rarely assessed or targeted directly in PTSD treatments, which instead focus on symptom reduction. Trauma-related contributors to diminished functioning, including guilt, shame, and anger resulting from morally compromising or loss-based war experiences, are also underemphasized. The goal of this clinical trial is to fill a substantial gap in the treatment of military-related PTSD by testing a modified Adaptive Disclosure (AD) therapy for war-related PTSD stemming from moral injury and traumatic loss focused on improving psychosocial functioning AD...
July 14, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28712604/-sometimes-you-feel-like-the-freak-show-a%C3%A2-qualitative-assessment-of-emergency-care-experiences-among-transgender-and-gender-nonconforming-patients
#8
Elizabeth A Samuels, Chantal Tape, Naomi Garber, Sarah Bowman, Esther K Choo
STUDY OBJECTIVE: Transgender, gender-variant, and intersex (trans) people have decreased access to care and poorer health outcomes compared with the general population. Little has been studied and documented about such patients' emergency department (ED) experiences and barriers to care. Using survey and qualitative research methods, this study aims to identify specific areas for improvement and generate testable hypotheses about the barriers and challenges for trans individuals needing acute care...
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28706765/trauma-and-hypothermia-in-antarctica-an-emergency-medicine-marine-simulation-scenario
#9
Chrystal Horwood, Kerry-Lynn Williams, Tate Skinner, Robert Brown, Tia Renouf, Adam Dubrowski
Simulation has been shown to improve both learner knowledge and patient outcomes. Many emergency medicine training programs incorporate simulation into their curricula to provide learners with experiences that are rare to encounter in practice, yet performance with a high degree of competence is critical. One rare encounter, which is depicted in the report, is the management of a trauma patient who was hypothermic after falling from an expedition vessel into the cold Southern Ocean. The unique scenario presented in this technical report incorporates CanMEDS learning objectives including the communicator, health advocate, and collaborator roles...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28705216/surgical-management-of-hawkins-type-iii-talar-neck-fracture-through-the-approach-of-medial-malleolar-osteotomy-and-mini-plate-for-fixation
#10
Hui Liu, Zhida Chen, Wenrong Zeng, Yuanfei Xiong, Yongzhi Lin, Huacheng Zhong, Jin Wu
BACKGROUND: Fractures of the talar neck are relatively uncommon yet current interventions suffer from a high incidence of complications and poor functional outcomes. In the present study, we report a surgical treatment of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation and discuss the therapeutic effects after long-term follow-up. METHODS: From January 2010 to January 2015, 21 patients with 22 fractures were treated using this approach within days of sustaining the injury...
July 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28704796/prison-mental-health-in-reach-teams-serious-mental-illness-and-the-care-programme-approach-in-england
#11
Charlie Brooker, Russell Webster
The delivery of prison mental health services in England is examined over the last 12 years. Resources for services have grown significantly during this period and improved organisational models for the delivery of services are now in place. During this period however the challenges of working in the prison environment have increased. The paper argues that a history of sexual abuse or violence are common amongst prisoners and the Care Programme Approach (CPA) provides the vehicle to assess these histories through the use of routine enquiry...
July 5, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28698337/protocol-for-a-multicentre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#12
Ceri Battle, Zoe Abbott, Hayley A Hutchings, Claire Oâ Neill, Sam Groves, Alan Watkins, Fiona E Lecky, Sally Jones, James Gagg, Richard Body, Philip A Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697624/evaluating-a-novel-intervention-to-reduce-trauma-symptoms-and-sexual-risk-taking-qualitative-exit-interviews-with-sexual-minority-men-with-childhood-sexual-abuse
#13
S Wade Taylor, Brett M Goshe, Samantha M Marquez, Steven A Safren, Conall O'Cleirigh
Childhood sexual abuse (CSA) continues to affect sexual minority men (SMM) at disproportionate levels and contributes to multiple negative health outcomes, including sexual-risk taking and HIV acquisition. This paper presents qualitative evaluative feedback from SMM (N = 9) who participated in a 10-session Cognitive Behavioral Therapy-Trauma and Sexual Health (CBT-TSH) intervention to reduce CSA-related posttraumatic stress reaction and distress. The treatment was designed to increase accurate sexual risk appraisals and to improve self-care health behaviors related to HIV/STI acquisition...
July 12, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28697422/the-relationship-between-trauma-centrality-self-efficacy-posttraumatic-stress-and-psychiatric-co-morbidity-among-syrian-refugees-is-gender-a-moderator
#14
Man Cheung Chung, Nowf AlQarni, Shamsa Al Muhairi, Britt Mitchell
This study examined the inter-relationship between trauma centrality, self-efficacy, posttraumatic stress disorder (PTSD) and psychiatric co-morbidity among a group of Syrian refugees living in Turkey, and whether gender would moderate the mediational effect of self-efficacy on the impact of trauma centrality on distress. Seven hundred and ninety-two Syrian refugees completed the Harvard Trauma Questionnaire, General Health Questionnaire-28, Centrality of Event Scale and Generalized Self-Efficacy Scale. The results showed that 52% met the cutoff for PTSD...
July 3, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28692619/effects-of-a-systematic-quality-improvement-process-to-decrease-complications-in-trauma-patients-with-prehospital-peripheral-intravenous-access
#15
Angie Garrett, Stacy A Drake, John B Holcomb
Peripheral intravenous (PIV) catheterization is commonly performed, and its complications are costly, may result in serious health issues, and may adversely affect patient satisfaction. At our large urban Level I trauma center, we identified a cluster of 7 PIV complications from prehospital insertions in a 5-month period. Several of the patients developed noninfectious as well as infectious, limb-threatening complications requiring aggressive operative intervention. A performance improvement project was chartered to identify the cause of PIV complications and review current nursing practice...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28691851/initiation-dropout-and-outcome-from-evidence-based-psychotherapies-in-a-va-ptsd-outpatient-clinic
#16
Barbara L Niles, Craig P Polizzi, Emily Voelkel, Elizabeth S Weinstein, Katharine Smidt, Lisa M Fisher
Trauma-focused, evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD) have been widely promoted in the Veterans Health Administration to provide access to state-of-the-art treatments, but dropout rates may affect the impact of TF-EBPs. The current study summarizes findings from a program evaluation of 67 veterans assigned to trauma-focused treatment in a Veterans Affairs outpatient PTSD clinic. Outcomes of interest include attendance rates, dropout rates and patterns, treatment paths, changes in self-reported symptoms, and clinician ratings...
July 10, 2017: Psychological Services
https://www.readbyqxmd.com/read/28689194/risk-factors-and-outcomes-associated-with-post-traumatic-headache-after-mild-traumatic-brain-injury
#17
Yilmaz Tansel, Gerwin Roks, Myrthe de Koning, Myrthe Scheenen, Harm van der Horn, Gerben Plas, Gerard Hageman, Guus Schoonman, Jacoba Spikman, Joukje van der Naalt
OBJECTIVES: To determine the prevalence and potential risk factors of acute and chronic post-traumatic headache (PTH) in patients with mild to moderate traumatic brain injury (TBI) in a prospective longitudinal observational multicentre study. Acute PTH (aPTH) is defined by new or worsening of pre-existing headache occurring within 7 days after trauma, whereas chronic PTH (cPTH) is defined as persisting aPTH >3 months after trauma. An additional goal was to study the impact of aPTH and cPTH in terms of return to work (RTW), anxiety and depression...
July 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28688786/perception-of-barriers-to-diagnosis-and-receipt-of-treatment-for-neuropsychiatric-disturbances-following-traumatic-brain-injury
#18
Jennifer S Albrecht, Lyndsay M O'Hara, Kara A Moser, C Daniel Mullins, Vani Rao
OBJECTIVE: To explore perceptions of barriers and facilitators to diagnosis and receipt of treatment for neuropsychiatric disturbances (NPD) following traumatic brain injury (TBI). DESIGN: Qualitative study employing semi-structured interviews and focus groups SETTING: A clinic specializing in the treatment of TBI NPD, an urban trauma center, and a large urban academic hospital PARTICIPANTS: Ten health care providers who treat individuals with TBI, 18 persons with TBI and 5 caregivers MAIN OUTCOME MEASURES: Topic guides for the interviews and focus groups were guided by prior literature, clinical experience, and the goals of the project and focused on the three most common TBI NPD: depression, anxiety, and post-traumatic stress disorder...
July 5, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28684197/adjustment-to-hand-injury-cross-sectional-survey-exploring-adjustment-in-relation-to-illness-perceptions-and-coping-strategies
#19
Catherine Turkington, Martin Dempster, Jennifer Maguire
STUDY DESIGN: Cross-sectional descriptive. INTRODUCTION: Hand injuries are highly prevalent, and the impact they have on physical, emotional, and functional adjustment is well recognized. Increasingly, adjustment to health conditions including hand injuries is being understood in terms of psychological variables. PURPOSE OF THE STUDY: To examine the role of illness beliefs and coping strategies in adjustment to hand injury. Adjustment was considered from a complete perspective including quality of life (QOL) and functional ability as well as mood and trauma symptoms...
July 3, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28678814/long-term-health-status-and-trajectories-of-seriously-injured-patients-a-population-based-longitudinal-study
#20
Belinda J Gabbe, Pam M Simpson, Peter A Cameron, Jennie Ponsford, Ronan A Lyons, Alex Collie, Mark Fitzgerald, Rodney Judson, Warwick J Teague, Sandra Braaf, Andrew Nunn, Shanthi Ameratunga, James E Harrison
BACKGROUND: Improved understanding of the quality of survival of patients is crucial in evaluating trauma care, understanding recovery patterns and timeframes, and informing healthcare, social, and disability service provision. We aimed to describe the longer-term health status of seriously injured patients, identify predictors of outcome, and establish recovery trajectories by population characteristics. METHODS AND FINDINGS: A population-based, prospective cohort study using the Victorian State Trauma Registry (VSTR) was undertaken...
July 2017: PLoS Medicine
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