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https://www.readbyqxmd.com/read/28817780/us-internists-awareness-and-use-of-overtreatment-guidelines-a-national-survey
#1
Kira L Ryskina, Eric S Holmboe, Elizabeth Bernabeo, Rachel M Werner, Judy A Shea, Judith A Long
OBJECTIVES: To assess physician views and perceived adoption of overtreatment guidelines and measure whether adoption of these guidelines influenced the recommendation of a targeted service. STUDY DESIGN: A cross-sectional survey mailed from July 2014 to January 2015 to 902 internists who completed residency between 2003 and 2013, randomly selected from the American Medical Association Masterfile. METHODS: Poisson regression was used to model the rate of recommending a targeted service included in the guidelines, based on the level of guideline adoption...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28817359/developing-the-storyline-for-an-advance-care-planning-video-for-surgery-patients-patient-centered-outcomes-research-engagement-from-stakeholder-summit-to-state-fair
#2
Rebecca A Aslakson, Anne L R Schuster, Thomas J Lynch, Matthew J Weiss, Lydia Gregg, Judith Miller, Sarina R Isenberg, Norah L Crossnohere, Alison M Conca-Cheng, Angelo E Volandes, Thomas J Smith, John F P Bridges
BACKGROUND: Patient-centered outcomes research (PCOR) methods and social learning theory (SLT) require intensive interaction between researchers and stakeholders. Advance care planning (ACP) is valuable before major surgery, but a systematic review found no extant perioperative ACP tools. Consequently, PCOR methods and SLT can inform the development of an ACP educational video for patients and families preparing for major surgery. OBJECTIVE: The objective is to develop and test acceptability of an ACP video storyline...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817305/foot-massage-touch-and-presence-in-decreasing-anxiety-during-a-magnetic-resonance-imaging-a-feasibility-study
#3
Rajni Parmar, Barbara B Brewer, Laura A Szalacha
OBJECTIVES: The purpose of the study was to determine (1) recruitment feasibility; (2) intervention adherence; (3) intervention acceptability; and (4) the preliminary effects of touch or foot massage interventions on anxiety during a magnetic resonance imaging (MRI). DESIGN: A quasi-experimental design was used. INTERVENTION: Foot massage and touch were the intervention groups and "presence" was the control group. SETTING: The study was conducted at the Center for Neurosciences, a freestanding facility, in southern Arizona...
August 17, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28816866/differences-in-tear-film-biochemistry-of-symptomatic-and-asymptomatic-lens-wearers
#4
Simin Masoudi, Fiona J Stapleton, Mark D P Willcox
SIGNIFICANCE: The concentration of selected proteins and inflammatory mediators in tears of symptomatic and asymptomatic contact lens wearers were quantified. The level of leukotriene B4 was higher in the symptomatic group. This may suggest that inflammation can be the cause of discomfort sensation at the end of day. PURPOSE: The present study aims to quantify the concentration of selected tear lipids and proteins in symptomatic and asymptomatic contact lens wearers...
August 14, 2017: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/28816827/the-relationship-between-fear-avoidance-and-objective-biomechanical-measures-of-function-in-patients-with-adult-degenerative-scoliosis
#5
Ram Haddas, Isador H Lieberman, Andrew Block
STUDY DESIGN: A prospective cohort study. OBJECTIVE: The current study utilized quantitative gait analysis to examine the relationship of fear-avoidance beliefs to gait patterns in patients with adult degenerative scoliosis (ADS). SUMMARY OF BACKGROUND DATA: Among patients with chronic spine pain, fear-avoidance beliefs are predictive of behavioral deficiencies, poor work and surgery outcomes. The impact of such beliefs on patients with major spinal deformity has yet to be investigated...
August 14, 2017: Spine
https://www.readbyqxmd.com/read/28816205/on-site-and-laboratory-evaluations-of-soundscape-quality-in-recreational-urban-spaces
#6
Lærke C Bjerre, Thea M Larsen, A Josefine Sørensen, Sébastien Santurette, Cheol-Ho Jeong
CONTEXT: Regulations for quiet urban areas are typically based on sound level limits alone. However, the nonacoustic context may be crucial for subjective soundscape quality. AIMS: This study aimed at comparing the role of sound level and nonacoustic context for subjective urban soundscape assessment in the presence of the full on-site context, the visual context only, and without context. MATERIALS AND METHODS: Soundscape quality was evaluated for three recreational urban spaces by using four subjective attributes: loudness, acceptance, stressfulness, and comfort...
July 2017: Noise & Health
https://www.readbyqxmd.com/read/28816204/deep-band-modulated-phrase-perception-in-quiet-and-noise-in-individuals-with-auditory-neuropathy-spectrum-disorder-and-sensorineural-hearing-loss
#7
Hemanth Narayan Shetty, Vishal Kooknoor
CONTEXT: Deep band modulation (DBM) improves speech perception in individuals with learning disability and older adults, who had temporal impairment in them. However, it is unclear on perception of DBM phrases at quiet and noise conditions in individuals with auditory neuropathy spectrum disorder (ANSD) and sensorineural hearing loss (SNHL), as these individuals suffer from temporal impairment. AIM: The aim is to study the effect of DBM and noise on phrase perception in individuals with normal hearing, SNHL, and ANSD...
July 2017: Noise & Health
https://www.readbyqxmd.com/read/28814837/simulating-clinical-trial-visits-yields-patient-insights-into-study-design-and-recruitment
#8
S Sam Lim, Alan J Kivitz, Doug McKinnell, M Edward Pierson, Faye S O'Brien
PURPOSE: We elicited patient experiences from clinical trial simulations to aid in future trial development and to improve patient recruitment and retention. PATIENTS AND METHODS: Two simulations of draft Phase II and Phase III anifrolumab studies for systemic lupus erythematosus (SLE)/lupus nephritis (LN) were performed involving African-American patients from Grady Hospital, an indigent care hospital in Atlanta, GA, USA, and white patients from Altoona Arthritis and Osteoporosis Center in Altoona, PA, USA...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28814060/a-soft-wearable-robot-for-the-shoulder-design-characterization-and-preliminary-testing
#9
Ciaran T O'Neill, Nathan S Phipps, Leonardo Cappello, Sabrina Paganoni, Conor J Walsh
In this paper, we present a soft wearable robot for the shoulder which has the potential to assist individuals suffering from a range of neuromuscular conditions affecting the shoulder to perform activities of daily living. This wearable robot combines two types of soft textile pneumatic actuators which were custom developed for this particular application to support the upper arm through shoulder abduction and horizontal flexion/extension. The advantage of a textile-based approach is that the robot can be lightweight, low-profile, comfortable and non-restrictive to the wearer, and easy to don like an item of clothing...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814056/design-of-a-lightweight-tethered-torque-controlled-knee-exoskeleton
#10
Kirby Ann Witte, Andreas M Fatschel, Steven H Collins
Lower-limb exoskeletons show promise for improving gait rehabilitation for those with chronic gait abnormalities due to injury, stroke or other illness. We designed and built a tethered knee exoskeleton with a strong lightweight frame and comfortable, four-point contact with the leg. The device is structurally compliant in select directions, instrumented to measure joint angle and applied torque, and is lightweight (0.76 kg). The exoskeleton is actuated by two off-board motors. Closed loop torque control is achieved using classical proportional feedback control with damping injection in conjunction with iterative learning...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814025/learning-from-demonstration-teaching-a-myoelectric-prosthesis-with-an-intact-limb-via-reinforcement-learning
#11
Gautham Vasan, Patrick M Pilarski
Prosthetic arms should restore and extend the capabilities of someone with an amputation. They should move naturally and be able to perform elegant, coordinated movements that approximate those of a biological arm. Despite these objectives, the control of modern-day prostheses is often nonintuitive and taxing. Existing devices and control approaches do not yet give users the ability to effect highly synergistic movements during their daily-life control of a prosthetic device. As a step towards improving the control of prosthetic arms and hands, we introduce an intuitive approach to training a prosthetic control system that helps a user achieve hard-to-engineer control behaviours...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814019/stiffness-control-of-a-nylon-twisted-coiled-actuator-for-use-in-mechatronic-rehabilitation-devices
#12
Brandon P R Edmonds, Ana Luisa Trejos
Mechatronic rehabilitation devices, especially wearables, have been researched extensively and proven to be promising additions to physical therapy, but most designs utilize traditional actuators providing unnatural, robot-like movements. Therefore, many researchers have focused on the development of actuators that mimic biological properties to provide patients with improved results, safety, and comfort. Recently, a twisted-coiled actuator (TCA) made from nylon thread has been found to possess many of these important properties when heated, such as variable stiffness, flexibility, and high power density...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813975/a-lightweight-robotic-ankle-prosthesis-with-non-backdrivable-cam-based-transmission
#13
Tommaso Lenzi, Marco Cempini, Jeremy Newkirk, Levi J Hargrove, Todd A Kuiken
Below-knee level amputation significantly impacts the ability of an individual to ambulate. Transtibial amputees are typically prescribed energetically passive ankle-foot prostheses that behave as a spring or controlled damper, and therefore cannot fully replace the function of the missing limb. More recently, fully-powered devices have been proposed to more closely match the power generation ability of intact limbs. However, these fully-powered devices are significantly heavier than passive devices, thus increasing the stress on the socket-residual limb interface...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813884/design-parameters-and-torque-profile-modification-of-a-spring-assisted-hand-opening-exoskeleton-module
#14
Nik R Butler, Stephen A Goodwin, Joel C Perry
There is a growing demand for functional rehabilitation orthotics that can effectively assist in patient recovery from motor impairments after stroke. The hand in particular is a complex system that has proven difficult to mimic with current exoskeleton technologies. This paper presents data-driven design parameters to increase the functionality and improve the assistance profile of the ArmAssist-2.0 hand module. Improvements from the previous model include adjustable linkages to fulfill the largest population of users, new joint locations to more accurately represent biomechanics of the hand, and a more impairment-appropriate torque profile to assist in hand opening, adjustable through interchangeable springs...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813872/mit-skywalker-evaluating-comfort-of-bicycle-saddle-seat
#15
Rogerio S Goncalves, Taya Hamilton, Ali R Daher, Hiroaki Hirai, Hermano I Krebs
The MIT-Skywalker is a robotic device developed for the rehabilitation of gait and balance after a neurological injury. This device has been designed based on the concept of a passive walker and provides three distinct training modes: discrete movement, rhythmic movement, and balance training. In this paper, we present our efforts to evaluate the comfort of a bicycle/saddle seat design for the system's novel actuated body weight support device. We employed different bicycle and saddle seats and evaluated comfort using objective and subjective measures...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813853/towards-human-knee-orthosis-interaction-based-on-adaptive-impedance-control-through-stiffness-adjustment
#16
Joana Figueiredo, Paulo Felix, Cristina P Santos, Juan C Moreno
Rehabilitation interventions involving powered, wearable lower limb orthoses that can provide high-challenging locomotor tasks for repetitive training sessions, mainly when assist-as-needed strategies, such as adaptive impedance control, are designed. In this study, the adaptive behavior was ensured by software control of the robotic stiffness involved in the human-knee orthosis interaction in function of the gait cycle and speed. To estimate the stiffness, we analyzed the interaction torque-angle characteristics with experimental data...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813851/lokomat-therapy-in-colombia-current-state-and-cognitive-aspects
#17
Marcela Munera, Alexandra Marroquin, Laura Jimenez, Juan S Lara, Catalina Gomez, Sandra Rodriguez, Luis E Rodriguez, Carlos A Cifuentes
Neurological disorders frequently affect walking function which is one of the most fundamental skills to improve quality of life and autonomy, and Lokomat has been a key piece for gait's rehabilitation. In this study, a diagnosis about the development of the Robot-assisted therapy rehabilitation with Lokomat in Colombia is made. The study was performed by collecting some anthropometric and demographic data of the patients that use Lokomat, followed by a survey of cognitive aspects. With the purpose to compare the current state of the robotic therapies it was found that in Colombia the benefits of this treatment have not being fully exploited...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813837/walking-speed-intention-model-using-soleus-electromyogram-signal-of-nondisabled-and-post-stroke-hemiparetic-patients
#18
Sang Hun Chung, Taejin Choi, Yoha Hwang, Hyungmin Kim, Seung-Jong Kim, Min Ho Chun, Jong Min Lee
It is well known that the activation of plantar flexors have a strong influence on the walking speed. If the gait speed can be predicted using this relationship, a post-stroke hemiparetic patient could control a gait rehabilitation robot according to his or her gait intention, and the robotic gait rehabilitation effect could be further improved. To find out this relationship, 9 nondisabled subjects and 4 chronic post-stroke hemiparetic subjects performed overground level walking at a comfortable pace, a slow pace, a fast pace, and an increasing pace with electromyogram sensors attached on plantar flexors...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813828/active-lower-limb-orthosis-with-one-degree-of-freedom-for-people-with-paraplegia
#19
Michal Gloger, Goro Obinata, Eiichi Genda, Jan Babjak, Yanling Pei
The main challenges of designing devices for paraplegic walking can be summarized into three groups, stability and comfort, high efficiency or low energy consumption, dimensions and weight. A new economical device for people with paraplegia which tackles all problems of the three groups is introduced in this paper. The main idea of this device is based on HALO mechanism. HALO is compact passive medial hip joint orthosis with contralateral hip and ankle linkage, which keeps the feet always parallel to the ground and assists swinging the leg...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813813/therapeutic-effects-of-an-anti-gravity-treadmill-alterg-training-on-gait-and-lower-limbs-kinematics-and-kinetics-in-children-with-cerebral-palsy
#20
M Lotfian, M R Kharazi, A Mirbagheri, F Dadashi, R Nourian, M M Mirbagheri
We aimed to investigate the effects of the lower body weight support treadmill (AlterG) training on kinetics and kinematics of the lower extremities in children with cerebral palsy (CP). We provided a 45-minute training program, 3 times a week for 8 weeks. AlterG can support the subject's weight up to 70% so that the subject will be able to walk more comfortably to reach a more correct walking pattern. The kinematics and kinetics were evaluated using an isokinetic dynamometer. The locomotion parameters were assessed in the gait laboratory...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
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