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Tobacco consumption may pose a very serious threat to the physiological state of the body; yet, fewer records have been documented in that regard. We investigated the impact of aqueous extract of t...

Background Although cesarean delivery is one of the most commonly performed surgical procedures, robust data regarding post-cesarean pain is still lacking. Recent studies showed an association between pain upon local anesthetic (LA) injection for spinal anesthesia, or the use of a "three simple questions", and acute post-cesarean pain. Nevertheless, these assessments have yet to be validated further, despite their relative ease of use. We aimed to assess the association between pain score upon LA injection with acute post-cesarean pain after 24 hours at rest (primary outcome) and sub-acute post-cesarean pain lasting for 4 weeks or more (secondary outcome). Methods Women undergoing cesarean delivery under spinal anesthesia were given pre-operative questionnaires on pain and psychological vulnerability. We also assessed the pain score upon LA injection and mechanical temporal summation. Univariate and multivariable logistic regressions were performed. Results The incidence of moderate-to-severe acute post-cesarean pain at 24 hours was 21.0% (95% CI=16.6-27.6%) (48 of 217 patients). Pain score upon LA injection was not significantly associated with acute post-cesarean pain after 24 hours at rest (unadjusted OR=1.10, 95% CI=0.95-1.27, P=0.21). However, pain score upon LA injection was significantly associated with sub-acute post-cesarean pain (adjusted OR=1.29, 95% CI=1.07-1.55, P=0.0089) with significant covariate of increased pre-operative central sensitization inventory (CSI) scores (adjusted OR=1.05, 95% CI=1.01-1.09, P=0.0111; area under the curve (AUC)=0.691). Conclusion There was no association between increased pain score upon LA injection and acute post-cesarean pain, but it was associated with sub-acute post-cesarean pain. Further work is needed to define pain score upon LA injection as a convenient pragmatic measure of risk stratifying patients predisposed to sub-acute post-cesarean pain.

Background Robot assisted upper limb (UL) therapy has been identified as an intervention with the potential to help improve the amount of practice performed by stroke survivors. Objectives This study aimed to measure the amount of UL practice (i.e., repetitions, duration, intensity) performed by subacute stroke survivors, in particular those with severe UL impairment, pre and post implementation of robot assisted upper limb therapy (RT-UL) into an inpatient rehabilitation setting. Methods Two observational study phases (pre-RT-UL and post-RT-UL) were undertaken of occupational therapy and physiotherapy sessions performed by subacute stroke survivors. Upper limb tasks observed and recorded in therapy were classified as either impairment-related therapy or activity-related. Results In the pre-RT-UL observational phase, 7 subacute stroke survivors were observed across 11 days involving 25 therapy sessions. Post-RT-UL, 12 subacute stroke survivors were observed across 12 days involving 29 therapy sessions. There were no significant differences in characteristics of patients observed in each phase (p > .05). The mean difference (95% CI) between pre and post RT-UL for repetitions (reps) (569 (1 to 1136) and intensity (7 (4–11)) reps/min of practice increased for all patients, including those with severe UL impairment (337 (37–638)) reps and 8 (2–14) reps/minute, with the duration of therapy unchanged. Conclusions This is the first study to have observed an increase in UL practice with the inclusion of RT-UL as part of routine clinical practice. This increase in practice is considered to be due to RT-UL providing highly supportive and expeditious semi-supervised practice. Notably, RT-UL was able to be implemented within the existing organisational structures with only basic training of therapy staff. IMPLICATIONS FOR REHABILITATION Robotics presents as a viable intervention to increase the amount and intensity of upper limb practice performed by stroke survivors in routine clinical practice Robotics were able to be implemented within the existing organisational structures with only basic training of therapy staff

With the changing times, it is essential integrate behavioral health within the primary care of patients. The need is based on the research that links a number of health issues being directly to su...

Background: Intensive rehabilitation is one of the most important aspects of care for people with stroke, and there is evidence that it leads to better recovery and higher levels of independence. H...

Background: Group therapy has shown benefit in language recovery in patients with aphasia (PWA). However, many in the field question its role in improving quality of life for PWA, as well as whethe...

Context/objective: Information on the safety and feasibility of lower extremity powered exoskeletons for persons with acute/sub-acute spinal cord injury (SCI) is limited. Understanding the safety and feasibility of employing powered exoskeletons in acute/sub-acute (

The aim of the current study is comparison the protective effects of curcumin and nanocurcumin against lung injury induced by sub-acute exposure with paraquat (PQ) through modulation of oxidative s...

α-l-Guluronic acid (ALG; G2013) has been previously introduced as a new anti-inflammatory agent with promising therapeutic effects. Thus, in the present study, we aimed to evaluate the acute and sub-acute toxicity of ALG through intravenous (i.v.) administration in Balb/C mice. ALG was administrated i.v. to the mice with doses of 300, 600, and 1000 mg/kg of body weight to investigate acute toxicity (single dose) and with doses of 25, 50, and 100 mg/kg of body weight to sub-acute toxicity study (daily injections for a period of 28 days). The mortality rate, food and water intake, behavior, body weight, gross necropsy, hematological and biochemical parameters as well as histopathological presentations of the vital organs (kidneys, liver, lungs, spleen, and heart) were examined in treated groups and compared to the healthy controls. The results of both acute and sub-acute studies showed that i.v. administrations of ALG did not affect the investigated parameters in both sexes, indicating that the LD

Aim: This study explored the impact of a person-centered activity program for sub-acute inpatients with Behavioral and Psychological Symptoms of Dementia (BPSD). Method: A prospective observational...

This study investigated the validity of the Canadian Occupational Performance Measure (COPM) when included as one of the scales used by therapists with older adults on an inpatient sub-acute rehabilitation setting. Quantitative data from 36 participants in a sub-acute rehabilitation setting was obtained via the COPM, the Functional Independence Measure (FIM) and the Short Form 36 Health Survey (SF-36) using a pre-post methodology. Pearson's r correlations and linear regression analyses were computed. The COPM Performance admission score was significantly correlated with the FIM Total and FIM Physical admission scores (p

Numerous studies investigating dissociative posttraumatic stress disorder (D-PTSD) have emerged. However, there is a lack of studies investigating D-PTSD following a wider range of traumatic exposure. Thus, the present study investigates D-PTSD using latent class analysis (LCA) in sub-acute patients of whiplash and associated risk factors. The results of LCA showed a three-class solution primarily distributed according to posttraumatic stress disorder (PTSD) symptom severity and thus no indication of D-PTSD. Dissociative symptoms, psychological distress (i.e. anxiety/depression), and pain severity significantly predicted PTSD severity. Combined, the results support the component model of dissociation and PTSD, while still stressing the importance of dissociative symptoms when planning treatment for PTSD.

Introduction: There is growing concern that Emergency Departments (ED) are ill equipped to manage rising palliative care demand, but actual demand is unknown. The aim of this study was to estimate the annual incidence of patients with palliative care need presenting to EDs.Methods: Retrospective case review study across two New Zealand emergency departments from 1 July 2010 to 30 June 2011. We used a two-step process where (1) administrative databases were screened for patients who had presented with 12 diseases associated with palliative care need and (2) the Gold Standard Framework Prognostic Indicator Guidance (GSF PIG) criteria were applied to the clinical records of a random sample of patients meeting the disease criterion.Results: Fifty-three thousand and fifty-seven patients presented to the EDs; 4488 (8.5%) patients had diagnostic codes indicating potential palliative care need and 1024 were randomly sampled. One hundred and eighty-eight patients (18.4%, 95%CI 16.0–20.8%) from the random sample we...

Leaf and root extracts of Clerodendrum infortunatum L. have been reported to show anthelmintic efficacy on a cestode parasite Raillietina tetragona. Its leaf showed no toxicity at 1000 mg/kg body weight but root toxicity study was not known. Therefore, our study is to test both leaf and root extracts at 2000 and 3000 mg/kg body weight concentration given orally for 15 days in four groups of Swiss albino mice, keeping another set as control (without plant extract). Weight and behaviour of mice were recorded daily. Feeding, movement pattern were normal in all treatments as that of control. Though body weight increase, there was no change in the relative organ weight. Biochemical and haematological studies revealed no significant change from control and no alteration in histopathological study of liver and kidney from that of control. The plant extracts thus shown to be safe for consumption.

Repeated back extension exercises (RBEEs) have been reported to cause changes in the distribution and intensity of radicular symptoms. Therefore, the objective of this study was to investigate the effects of RBEEs on the neurophysiology of the compromised nerve root and on standing mobility and pain intensity in patients with sub-acute and chronic lumbosacral radiculopathy (LSR).A total of 40 patients with unilateral sub-acute/chronic LSR voluntarily participated in the study; the patients performed three sets of 10 RBEEs in the prone position with 1 min of rest between the sets. The soleus H-reflex, standing mobility, and pain intensity were recorded before and after the RBEEs.The results of the study showed that the RBEEs significantly improved the H-reflex, standing mobility, and pain intensity in patients with sub-acute LSR (p .01); there was not a significant improvement in the patients with chronic LSR (p .61).RBEEs in the prone position are recommended for improving the neurophysiological function of the compromised nerve root and standing mobility in patients with sub-acute LSR.

We present a novel wheelchair posture support device (WPSD) and its clinical validation. The device was developed in order to assure correct sitting posture and to reduce the time spent by caregivers for re-positioning of hospitalized, wheelchair-bound, post-acute stroke patients.The device was validated with 16 subjects during a period of 5 days in which use of the device was compared with regular care practice.The device was used for the five consecutive days in 69% of patients, while for 6% it was not suitable; 25% did not complete the 5 days for reasons unrelated to the device. Caregivers needed to re-position the patients that used the device for the full 5 days (n = 11) on an average 52% less often when using the device, as compared to regular practice. Furthermore, the device was rated as usable and functional by the caregivers while significantly reducing perception of trunk and shoulder pain in patients during its use.The newly designed WPSD is a valuable system for the improvement of medical assistance to wheelchair-bound post-stroke patients by reducing pain and number of re-positioning manoeuvres. The WPSD might be applicable to any group of patients who need posture control in either wheelchair or common chair with arms support. IMPLICATIONS FOR REHABILITATION Advanced supports and cushions that can be shaped to individual needs, may help assure correct sitting posture in wheelchair-bound post-acute stroke patients. Advanced supports and cushions that can be shaped to individual needs, may reduce the number of times a caregiver has to re-position a hospitalized wheelchair-bound post-acute stroke patient on overall average by 52%. Advanced personalized supports and cushions may improve sitting comfort and reduce pain complaints for post-acute hospitalized stroke patients using a wheelchair.

Sub-acute residential mental health services provide care for people who are not acutely unwell but require more support than generally available when living in the community. Little is known about how these services facilitate recovery and whether these facilitators differ for clients entering from the community (step-up) or from inpatient settings (step-down).To identify features of a sub-acute residential service that have assisted step-up and step-down clients in their recovery.Semi-structured interviews were conducted with 16 step-up and 21 step-down clients. Interview transcripts were examined using an inductive, semantic content analysis approach.Themes identified included the community context, personal support, the formal program offered and assistance in personal recovery processes, with the level of support for these themes differing for step-up and step-down clients.Step-up and step-down clients have differing needs to be addressed in a sub-acute service. These services can better meet the needs of clients if they are aware of the setting the client has come from and tailor their services accordingly. Step-up clients prefer support in developing social skills and illness management techniques; step-down clients prefer a less structured environment with assistance in living skills and personal processes of recovery.

The acute and sub-acute oral toxicity of the hydroethanolic root extract of Annona stenophylla Engl. and Diels in Sprague Dawley rats was determined by administering the crude extract daily in the range 250–2000 mg/kg body weight and the animals examined for physical, histopathological and clinical biochemistry changes. There were no behavioural changes or deaths in the acute toxicity tests up to 2000 mg/kg b. wt over 14 days. There were no major changes in the clinical biochemistry parameters measured: Alanine aminotransferase (ALT), Aspartate amino transferase (AST), Alkaline phosphatase (ALP), Gamma-glutamyl transferase (GGT), glucose, creatinine and total bilirubin (p>0.05) and in the histopathological tissue sections of the pancreas and liver compared with the control rats in the sub-acute tests over 28 days. The present report supports the traditional medicinal use and relative safety of A. stenophylla in the treatment of multiple ailments including its antidiabetic potential.

The objective of this study was to develop an ICF core set describing sub-acute spinal cord injury (SCI) specifically for Taiwanese patients.A consensus process using three rounds of Delphi technique was conducted. Twenty multidisciplinary participants from various institutions were recruited. The questionnaire used in this study comprised 118 ICF second-level categories relevant to the sub-acute stage of SCI. A five-point Likert scale was used, and participants were asked to assign weights to the effect of each category on activities of daily life after SCI. The consensus among ratings was assessed using Spearman's rho and semi-interquartile range (SIQR) indices. The core set for post-acute SCI was developed from categories that attained a mean score of ≥3.8 in the third round of the Delphi exercise.The core set for sub-acute SCI contained 58 categories. Of these, 24 comprised the component of body functions (b), 5 comprised body structures (s), 21 comprised activities and participation (d), and 8 comprised environmental factors (e).The preliminary core set for sub-acute SCI offers a comprehensive system of disability assessment and verification after people have sustained an SCI. Further validation is required. Implication for Rehabilitation The preliminary core set for sub-acute SCI offers a comprehensive system for disability assessment related to SCI among Taiwanese patients. This core set reflected problems commonly encountered by patients with SCI. This core set reflects appropriate cultural and geographic perspectives in adjustment to SCI.

Background: Patients with aphasia (PWA) are at risk of not being able to communicate effectively with health care providers. This might influence e.g. their health, healthcare and involvement in re...

The aim of the investigation was to examine the changes in phonation and related quality-of-life in the acute and sub-acute stages of recovery post-cervical spinal cord injury (CSCI). A prospective examination of phonation was conducted using perceptual and instrumental measures of respiratory and laryngeal functioning alongside a quality-of-life rating scale. Change was present across measures for both cases at each time point. Overall, a general pattern of recovery was seen, although some areas deteriorated between 6-12 months. Severity of impairments, extent of change, and impact on quality-of-life differed between the cases. Measures varied in sensitivity to change in function. Phonation can be impaired following both complete and incomplete CSCI, with type and severity of impairment/s undergoing change throughout the acute and sub-acute period post-injury. Spontaneous physiological recovery does not necessarily result in improved phonation and/ or quality-of-life. Potential exists for targeted speech-language therapy in this population, throughout recovery, to best capitalize on the physical changes that are occurring and to maximize functional application of skills to improve quality- of-life. Further research is warranted to examine this recovery period on a larger scale.

The objectives of this study were to investigate if more aspects of balance abilities could be obtained by using the Berg Balance Scale (BBS) in addition to the balance items (sitting/sitting to standing/walking) of the Motor Assessment Scale (MAS), and to examine change. Forty-four patients in a sub-acute stroke rehabilitation unit were scored on the MAS and the BBS on admission and discharge. Balance was investigated by correlation analyses. Change was explored by calculating ceiling effects at admission, number of patients changing scores and Standardized Response Means (SRMs). Spearman’s correlation coefficients between the MAS and the BBS ranged from 0.58 to 0.94, p 5 /0.01. The ceiling effects were high, range: 48/57% for the MAS items, 46/100% for the BBS items. Below ceiling, the number of patients changing scores ranged from six (26%) to 10 (45%) patients on the MAS items and from two (15%) to 10 (50%) patients on the BBS items. The SRMs ranged from /0.2 to 0.5 for the MAS items and from 0.0 to 0.5 for the BBS items. In this study, no more aspects of balance abilities were obtained by using the BBS in addition to the MAS. Change was limited on both instruments.

GIT effects of Melos Conquer Mixture were investigated - using albino wister rats. Conquer Mixture was administered orally at different concentrations whereas the control group received water. The experiment lasted from 3 to 21 days. Pathological examination was carried out on the dead animals. The animals showed (1) loss of weight and appetite (2) weakness (3) faeces was soft (4) out of 10 animals which received 1.20 ml/kg died on day 5(5) the Glt of the dead rats was virtually empty except in the colon, (6) pieces from various parts of GIT revealed evidence of acute and sub acute inflammatory cellular reactions. The results indicate that Conquer Mixture may be toxic to the gastrointestinal tract and suggest that a re-evaluation of the therapeutic usefulness of the drug in the management of malaria is warranted.

(1960). The Sub-acute and Chronic Toxicity of 1,1-Dimethylhydrazine Vapor. American Industrial Hygiene Association Journal: Vol. 21, No. 3, pp. 207-210.