986 resultados para REHABILITATION, SSCI


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Native mammal populations in Southeast Queensland are under threat from habitat loss through land development, dog attacks and motor vehicle accidents. Animals that are not killed from these impacts are sometimes rescued, rehabilitated and later released back into the wild, usually in their area of origin. Although the release of these animals is a relatively common practice, little post release monitoring has been carried out and reported to assess the success of the animals in the wild. This paper discusses the results of three recent studies which have monitored the movements and health of rehabilitated and translocated koalas (Phascolarctos ciniereus) and common brushtail possums (Trichosurus vulpecular): one conducted by Wildcare Australia in 1995- 1996, the other two in collaboration with the University of Queensland. The results indicate that the survival and health of the great majority of the released animals were good and that they were usually able to establish new home ranges during the tracking period. Such findings seem to contradict the results of studies conducted in southern Australia which have monitored the release of translocated possums and gliders, and suggest that there are some key factors which may be critical in determining the success of such releases. These factors include the age of admission and the duration of care, and in particular the selection of the release site. With both koalas and brushtail possums, the release site was found to be critical in determining both the survival and dispersal of the released animals. Consequently, while these studies confirm that the reintroduction of koalas and common brushtail possums may be a viable management strategy, the individual characteristics of the animals themselves and of their release areas must be carefully considered. It is recommended that further research of these key release factors be undertaken and that the work be extended for other species which are commonly released following rehabilitation.

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PURPOSE: To design and validate a vision-specific quality-of-life assessment tool to be used in a clinical setting to evaluate low-vision rehabilitation strategy and management. METHODS: Previous vision-related questionnaires were assessed by low-vision rehabilitation professionals and patients for relevance and coverage. The 74 items selected were pretested to ensure correct interpretation. One hundred and fifty patients with low vision completed the chosen questions on four occasions to allow the selection of the most appropriate items. The vision-specific quality of life of patients with low vision was compared with that of 70 age-matched and gender-matched patients with normal vision and before and after low-vision rehabilitation in 278 patients. RESULTS: Items that were unreliable, internally inconsistent, redundant, or not relevant were excluded, resulting in the 25-item Low Vision Quality-of-Life Questionnaire (LVQOL). Completion of the LVQOL results in a summed score between 0 (a low quality of life) and 125 (a high quality of life). The LVQOL has a high internal consistency (α = 0.88) and good reliability (0.72). The average LVQOL score for a population with low vision (60.9 ± 25.1) was significantly lower than the average score of those with normal vision (100.3 ± 20.8). Rehabilitation improved the LVQOL score of those with low vision by an average of 6.8 ± 15.6 (17%). CONCLUSIONS: The LVQOL was shown to be an internally consistent, reliable, and fast method for measuring the vision-specific quality of life of the visually impaired in a clinical setting. It is able to quantify the quality of life of those with low vision and is useful in determining the effects of low-vision rehabilitation. Copyright (C) 2000 Elsevier Science Inc.

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Four corrosion inhibitors namely sodium nitrite, sodium monofluorophosphate, ethanolamine and an alkanolamine-based mixture were studied by immersing mild steel bars for 42 days in model electrolytes of varied pH and chloride concentration which were intended to simulate the pore solution phase present within carbonated and/or chloride-contaminated concrete. Site trials were carried out on sodium monofluorophosphate and the alkanolamine-based inhibitor to study their depth of penetration into concrete. The influence of various carbonating atmospheres on the pore solution chemistry and microstructure of hydrated cement paste was investigated. Physical realkalisation of carbonated cement paste and a calcium nitrite-based corrosion rehabilitation system for chloride-contaminated cement paste were investigated by monitoring ionic transport within the pore solution phase of laboratory specimens. The main findings were as follows: 1,Sodium nitrite, sodium monofluorophosphate, ethanolamine and the alkanolamine-based mixture all behaved as passivating anodic inhibitors of steel corrosion in air-saturated aqueous solutions of varied pH and chloride concentration. 2,Sodium monofluorophosphate failed to penetrate significantly into partially carbonated site concrete when applied as recommended by the supplier. Phosphate and fluoride penetrated 5mm into partially carbonated site concrete treated with sodium monofluorophosphate. 3,The ethanolamine component of the alkanolamine-based inhibitor was found to have penetrated significant depths into partially carbonated site concrete. 4,Carbonating hydrated cement paste over saturated solutions of sodium nitrite resulted in significant concentrations of nitrite in the pore solution of the carbonated paste. Saturated solutions of sodium chloride, ammonium nitrate, magnesium nitrate and sodium dichromate were investigated and identified as alternatives for controlling the relative humidity of the carbonating environment. 5,Hardened carbonated cement paste can by physically realkalised to a limited extent due to the diffusion of hydroxyl ions under saturated conditions. A substantial proportion of the hydroxyl ions that diffused into the carbonated cement paste however, became bound into the cement matrix. Hydroxyl ion concentrations remained below 5mmol/l within the pore solution of the realkalised cement paste. 6, Nitrite ions penetrated significant distances by diffusion within the pore solution of saturated uncarbonated hydrated cement paste.

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This thesis examines the involvement of the French Freemason movement in the Resistance during the Occupation of France by the Germans 1939-1945, its relationship with the Vichy government and the effect the 'Nouvelle Révolution' had on the lives of individual Masons. To set the scene and to put the role of Freemasonry into perspective in the life of France and the French political system, the origins of French Freemasonry are examined and explained. The main French Masonic obediences are discussed and the differences between them emphasised. The particular attributes of a Freemason are described and the ideals and ethos of the Order is discussed. From its earliest days, Freemasonry has often been persecuted by the Roman Catholic Church or by extreme Right-wing movements. The history of this persecution is reviewed and the reasons for its persistence noted, with especial emphasis on the treatment of Freemasons under the fascist regimes of Italy and Germany. The fate of Freemasonry in countries under German control is also briefly examined. With the occupation of France by the Germans, the differences and similarities of the treatment of French and German Freemasons are discussed. The processes and legislation of this ban are closely examined and the part played by the Vichy government in the persecution of French Freemasonry is discussed. The effects of this persecution and the consequences for individuals are examined and the Freemason's role in the emerging Resistance movement is reviewed. The contribution of many lodges to the Resistance movement is examined and the sacrifice of many Freemasons for their ideals is emphasised.

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People with vision loss sometimes experience visual hallucinations associated with Charles Bonnet syndrome. The appearance of these hallucinations often causes anxiety for the sufferer and can be difficult for the attending eye care professional to manage. A review of the literature highlighted a range of visual, pharmacological and social management regimes that may alleviate these hallucinations, albeit using small samples in uncontrolled trials. Eye care practitioners should be aware of methods of rehabilitation in Charles Bonnet syndrome that may lead to resolution of the visual hallucinations.

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AIM To develop a short, enhanced functional ability Quality of Vision (faVIQ) instrument based on previous questionnaires employing comprehensive modern statistical techniques to ensure the use of an appropriate response scale, items and scoring of the visual related difficulties experienced by patients with visual impairment. METHODS Items in current quality-of-life questionnaires for the visually impaired were refined by a multi-professional group and visually impaired focus groups. The resulting 76 items were completed by 293 visually impaired patients with stable vision on two occasions separated by a month. The faVIQ scores of 75 patients with no ocular pathology were compared to 75 age and gender matched patients with visual im pairm ent. RESULTS Rasch analysis reduced the faVIQ items to 27. Correlation to standard visual metrics was moderate (r=0.32-0.46) and to the NEI-VFQ was 0.48. The faVIQ was able to clearly discriminate between age and gender matched populations with no ocular pathology and visual impairment with an index of 0.983 and 95% sensitivity and 95% specificity using a cut off of 29. CONCLUSION The faVIQ allows sensitive assessm ent of quality-of-life in the visually im paired and should support studies which evaluate the effectiveness of low vision rehabilitation services. © Copyright International Journal of Ophthalmology Press.

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Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

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Auditory Training (AT) describes a regimen of varied listening exercises designed to improve an individual’s ability to perceive speech. The theory of AT is based on brain plasticity (the capacity of neurones in the central auditory system to alter their structure and function) in response to auditory stimulation. The practice of repeatedly listening to the speech sounds included in AT exercises is believed to drive the development of more efficient neuronal pathways, thereby improving auditory processing and speech discrimination. This critical review aims to assess whether auditory training can improve speech discrimination in adults with mild-moderate SNHL. The majority of patients attending Audiology services are adults with presbyacusis and it is therefore important to evaluate evidence of any treatment effect of AT in aural rehabilitation. Ideally this review would seek to appraise evidence of neurophysiological effects of AT so as to verify whether it does induce change in the CAS. However, due to the absence of such studies on this particular patient group, the outcome measure of speech discrimination, as a behavioural indicator of treatment effect is used instead. A review of available research was used to inform an argument for or against using AT in rehabilitative clinical practice. Six studies were identified and although the preliminary evidence indicates an improvement gained from a range of AT paradigms, the treatment effect size was modest and there remains a lack of large-sample RCTs. Future investigation into the efficacy of AT needs to employ neurophysiological studies using auditory evoked potentials in hearing-impaired adults in order to explore effects of AT on the CAS.

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This dissertation identifies, examines, and assesses the relative influence of identified empirically and conceptually relevant variables on incarcerated substance abusers' expectations of postrelease adjustment. A purposive sampling procedure was used to recruit 101 male and female substance-abusing offenders participating in prison- and jail-based drug treatment programs in south Florida. A 92-item survey questionnaire was used to collect basic demographic data; measure inmate preincarceration characteristics, social support, and rehabilitation program participation; and record archival data. Regression equations were developed utilizing ten different measures of the participants' expectations of their postrelease adjustment. Two equations yielded statistically significant F ratios; maintaining a stable living and maintaining abstinence. Twenty-two percent of the variance in respondents' expectations of maintaining a stable living was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 1.89; df = 13,87; p $<$.05). The only significant predictor variable was perception of social support (b = $-$.05; t = $-$3.6; p $<$.001). Twenty-three percent of the variance in respondents' expectations of maintaining abstinence from substances was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 2; df = 13,87; p $<$.05). Once again, the only significant predictor variable was perception of social support. The results of the analyses indicate that social support was the only important variable for understanding these respondents' efficacy expectations of postrelease abstinence and stable living. The results of this investigation demonstrate the complexity of the social support variable for prisoners, and identify social support as a potential rehabilitative resource for substance-abusing inmates. The results of this investigation underscore the importance of continued, detailed empirical study in order to understand and clarify how social support, efficacy expectations, and actual postrelease performance interrelate for this population of offenders.

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The major barrier to practical optimization of pavement preservation programming has always been that for formulations where the identity of individual projects is preserved, the solution space grows exponentially with the problem size to an extent where it can become unmanageable by the traditional analytical optimization techniques within reasonable limit. This has been attributed to the problem of combinatorial explosion that is, exponential growth of the number of combinations. The relatively large number of constraints often presents in a real-life pavement preservation programming problems and the trade-off considerations required between preventive maintenance, rehabilitation and reconstruction, present yet another factor that contributes to the solution complexity. In this research study, a new integrated multi-year optimization procedure was developed to solve network level pavement preservation programming problems, through cost-effectiveness based evolutionary programming analysis, using the Shuffled Complex Evolution (SCE) algorithm.^ A case study problem was analyzed to illustrate the robustness and consistency of the SCE technique in solving network level pavement preservation problems. The output from this program is a list of maintenance and rehabilitation treatment (M&R) strategies for each identified segment of the network in each programming year, and the impact on the overall performance of the network, in terms of the performance levels of the recommended optimal M&R strategy. ^ The results show that the SCE is very efficient and consistent in the simultaneous consideration of the trade-off between various pavement preservation strategies, while preserving the identity of the individual network segments. The flexibility of the technique is also demonstrated, in the sense that, by suitably coding the problem parameters, it can be used to solve several forms of pavement management programming problems. It is recommended that for large networks, some sort of decomposition technique should be applied to aggregate sections, which exhibit similar performance characteristics into links, such that whatever M&R alternative is recommended for a link can be applied to all the sections connected to it. In this way the problem size, and hence the solution time, can be greatly reduced to a more manageable solution space. ^ The study concludes that the robust search characteristics of SCE are well suited for solving the combinatorial problems in long-term network level pavement M&R programming and provides a rich area for future research. ^

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Greater inclusion of individuals with disabilities into mainstream society is an important goal for society. One of the best ways to include individuals is to actively promote and encourage their participation in the labor force. Of all disabilities, it is feasible to assume that individual with spinal cord injuries can be among the most easily mainstreamed into the labor force. However, less that fifty percent of individuals with spinal cord injuries work. ^ This study focuses on how disability benefit programs, such as Social Security Disability Insurance, and Worker's Compensation, the Americans with Disabilities Act and rehabilitation programs affect employment decisions. The questions were modeled using utility theory with an augmented expenditure function and indifference theory. Statically, Probit, Logit, predicted probability, and linear regressions were used to analyze these questions. Statistical analysis was done on the probability of working, ever attempting to work after injury, and on the number of years after injury that work was first attempted and the number of hours worked per week. The data utilized were from the National Spinal Cord Injury Database and the Spinal Cord Injuries and Labor Database. The Spinal Cord Injuries and Labor Database was created specifically for this study by the author. Receiving disability benefits decreased the probability of working, of ever attempting to work, increased the number of years after injury before the first work attempt was made, and decreased the number of hours worked per week for those individuals working. These results were all statistically significant. The Americans with Disabilities Act decrease the number of years before an individual made a work attempt. The decrease is statistically significant. The amount of rehabilitation had a significant positive effect for male individuals with low paraplegia, and significant negative effect for individuals with high tetraplegia. For women, there were significant negative effects for high tetraplegia and high paraplegia. ^ This study finds that the financial disincentives of receiving benefits are the major determinants of whether an individual with a spinal cord injury returns to the labor force. Policies are recommended that would decrease the disincentive. ^