scholarly journals A Study Protocol for Occupational Rehabilitation in Multiple Sclerosis

Sensors ◽  
2021 ◽  
Vol 21 (24) ◽  
pp. 8436
Author(s):  
Marco Trombini ◽  
Federica Ferraro ◽  
Giulia Iaconi ◽  
Lucilla Vestito ◽  
Fabio Bandini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Study Protocol ◽  
Occupational Rehabilitation ◽  
Remote Patient Monitoring ◽  
Starting Point ◽  
Definition Of ◽  
The Individual ◽  
Remote Patient ◽  
Academic Consequences ◽  
Multiple Sclerosis Patients

Digital medical solutions can be very helpful in restorative neurology, as they allow the patients to practice their rehabilitation activities remotely. This work discloses ReMoVES, an IoMT system providing telemedicine services, in the context of Multiple Sclerosis rehabilitation, within the frame of the project STORMS. A rehabilitative protocol of exercises can be provided as ReMoVES services and integrated into the Individual Rehabilitation Project as designed by a remote multidimensional medical team. In the present manuscript, the first phase of the study is described, including the definition of the needs to be addressed, the employed technology, the design and the development of the exergames, and the possible practical/professional and academic consequences. The STORMS project has been implemented with the aim to act as a starting point for the development of digital telerehabilitation solutions that support Multiple Sclerosis patients, improving their living conditions. This paper introduces a study protocol and it addresses pre-clinical research needs, where system issues can be studied and better understood how they might be addressed. It also includes tools to favor remote patient monitoring and to support the clinical staff.

Cold-induced reactivity in multiple sclerosis patients

2017 ◽  
pp. 56-62 ◽  
Author(s):  
Л.И. Герасимова-Мейгал ◽  
И.М. Сиренев
Keyword(s):  
Multiple Sclerosis ◽  
Cold Test ◽  
Typical Feature ◽  
Humid Climate ◽  
Ssr Analysis ◽  
Epidemiological Surveys ◽  
The Central Nervous System ◽  
The Individual ◽  
Hands And Feet ◽  
Multiple Sclerosis Patients

Цель исследования - изучение особенностей восприимчивости пациентов с рассеянным склерозом (РС) к холодовому воздействию с помощью функциональных тестов, характеризующих функцию терморегуляции. Как известно, РС - хроническое прогрессирующее аутоиммунное заболевание центральной нервной системы мультифакториальной природы, более часто встречающееся в регионах с холодным и влажным климатом. Нарушения терморегуляции вследствие автономной дисфункции являются характерным признаком РС, вместе с тем участию холодового фактора в развитии заболевания не придается существенного значения. Методика. Обследовано 32 пациента (17 мужчин и 15 женщин, средний возраст 29,6 ± 4,2 года) с установленным диагнозом: РС ремиттирующе-рецидивирующая форма течения (средняя продолжительность заболевания - 4,2 ± 2,7 года) и 18 практически здоровых лиц группы сравнения. Восприятие холода оценивали с помощью визуально-аналоговой шкалы. Продолжительность холод-индуцированной вазоконстрикции после локального холодового теста изучали по данным инфракрасной термометрии. Вегетативную регуляцию вазомоторных реакций оценивали по результатам анализа вызванных кожных вегетативных потенциалов (ВКВП). Результаты. На основе анализа самооценки восприятия холода у пациентов с РС показана низкая переносимость холодового фактора. При проведении локального холодового теста отмечено замедление восстановления температуры кожи кисти, что характерно для усиления холод-индуцированной вазоконстрикции. В группе пациентов с РС выявлено снижение параметров ВКВП ладоней и стоп, свидетельствующее о дефиците нейрогенного контроля терморегуляционных сосудистых реакций. Заключение. У пациентов с РС выявлены нарушения механизмов терморегуляции при действии холода, что обусловливает высокую индивидуальную восприимчивость к холоду у данной категории лиц. Сопоставление результатов анализа механизмов индивидуальной холод-индуцированной реактивности у пациентов с РС с данными эпидемиологических исследований приводит к заключению о потенциальном модулирующем влиянии холодового фактора на течение РС. The purpose of the present study was focused on the evaluation of the sensitivity to cold in multiple sclerosis (MS) patients by means of functional thermoregulatory based tests. MS is known to be a chronic autoimmune progressive disease of the central nervous system of multifactor origin that is very common in regions with cold and humid climate. Disorder of thermoregulation caused by autonomic dysfunction is a typical feature of MS, however the role of the cold in the disease development is still underestimated. Methods. Thirty two MS patients (17 males, 15 females, mean age 29,6 ± 4,2 years) with the remittent form of the disease (mean disease duration 4,2 ± 2,7 years) and 18 age-matched healthy controls volunteered to participate in this study. Susceptibility to cold was analyzed with the use of visual-analogous scale. The duration of cold-induced vasoconstriction after local cold test was estimated using by infrared thermometry. Autonomic regulation of vasomotor reactions was investigated with the help of the skin sympathetic response (SSR) analysis. Results. The analysis of self-reported perception of the cold in MS patients showed their low tolerance to cold. Slow recovery of the skin temperature of the hand in the local cold test observed in MS patients was considered as the aggravated cold-induced vasoconstriction. The decreased SSR in the hands and feet in MS patients was found that indicates the deficit of the neurogenic control of thermoregulatory vasomotor reactions. Conclusion. The results obtained demonstrate the impairment of thermoregulation under cold in MS patients that leads to higher individual susceptibility to cold of this group. Comparing of the data found in this study on the mechanisms of the individual cold-induced reactivity in MS patients with epidemiological surveys enable to conclude that cold environment has potential modulating effect of on the course of MS.

scholarly journals Remote patient monitoring for ED discharges in the COVID-19 pandemic

2021 ◽  
Vol 38 (3) ◽  
pp. 229-231
Author(s):  
Ahmad A Aalam ◽  
Colton Hood ◽  
Crystal Donelan ◽  
Adam Rutenberg ◽  
Erin M Kane ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Clinical Status ◽  
Remote Patient Monitoring ◽  
Hospital Capacity ◽  
Vulnerable Patients ◽  
Natural Progression ◽  
Extended Access ◽  
Discharged Patients ◽  
The Individual ◽  
Remote Patient

COVID-19 has had a significant effect on healthcare resources worldwide, with our knowledge of the natural progression of the disease evolving for the individual patient. To allow for early detection of worsening clinical status, protect hospital capacity and provide extended access for vulnerable patients, our emergency department developed a remote patient monitoring programme for discharged patients with COVID-19. The programme uses a daily emailed secure link to a survey in which patients submit biometric and symptoms data for monitoring. Patients’ meeting criteria are escalated to a physician for a phone or video visit. Here, we describe the development, implementation and preliminary analysis of utilisation of the programme.

Digital competences of the workforce – a research topic?

2017 ◽  
Vol 23 (3) ◽  
pp. 721-734 ◽  
Author(s):  
Matthias Murawski ◽  
Markus Bick
Keyword(s):  
Research Topic ◽  
Future Research ◽  
Digital Competence ◽  
Content Type ◽  
Research Activities ◽  
Starting Point ◽  
Pros And Cons ◽  
Definition Of ◽  
The Individual ◽  
Practical Implications

Purpose Considering working in the digital age, questions on the consequences for the individual workers are, so far, often neglected. The purpose of this paper is to deal with the question of whether the digital competences of the workforce is a research topic. The authors argue for the thesis that it is indeed a research topic. Design/methodology/approach In addition to a literature analysis of the top IS, HR, and learning publications, non-scientific sources, as well as the opinions of the authors, are included. The authors’ thesis is challenged through a debate of corresponding pros and cons. Findings The definition of digital competences lacks scientific depth. Focussing on the workforce is valid, as a “lifelong” perspective is not mandatory for research. Digital competence research is a multidisciplinary task to which the IS field can make a valuable contribution. Research limitations/implications Although relevant references are included, some aspects are mainly driven by the opinions of the authors. The theoretical implications encompass a call for a scientific definition of digital competences. Furthermore, scholars should focus on the competences of the workforce, including occupations, roles, or industries. The authors conclude by providing a first proposal of a research agenda. Practical implications The practical implications include the alignment of multiple stakeholders for the design of “digital” curricula and the integration by HR departments of the construct of digital competences, e.g. for compensation matters and job requirements. Originality/value This paper is one of very few contributions in the area of the digital competences of the workforce, and it presents a starting point for future research activities.

scholarly journals Perceptions of Health Status in Multiple Sclerosis Patients and Their Doctors

2013 ◽  
Vol 40 (2) ◽  
pp. 210-218 ◽  
Author(s):  
Marcelo Kremenchutzky ◽  
Len Walt
Keyword(s):  
Multiple Sclerosis ◽  
Health Status ◽  
Bodily Pain ◽  
Kappa Statistic ◽  
Patient Perceptions ◽  
Mean Values ◽  
Health Domains ◽  
Important Health ◽  
Definition Of ◽  
Multiple Sclerosis Patients

Objective:To compare neurologist and patient perceptions of multiple sclerosis (MS)-related health status.Methods:MS patients (n=99) were recruited from six sites in Canada. Following a consultation with their neurologist, patients estimated their relapse frequency, rated their general health and quality of life (QoL), reviewed descriptions of eight health domains and selected the three most important, and completed a utility assessment using the standard gamble (SG). Concurrently, neurologists independently used the same instruments to rate their patients' health status. Assessments were compared on the basis of paired mean values of both groups and the degree of exact agreement quantified by intraclass coefficient (ICC) and kappa analyses, which yield values of 1.0 with 100% agreement.Results:There were significant differences (p<0.001) between patient and neurologist ratings for relapses in the last year (0.86 vs. 0.4, respectively), QoL (61.2 vs. 69.7 (maximum score = 100) and utility (0.864 vs. 0.971); ICC analysis revealed moderate to poor levels of agreement (0.56 for QoL to 0.03 for SG). There was little concordance in identification of important health domain and the only significant associations were in bodily pain and social functioning (kappa statistic = 0.24, p = 0.026 for both). Neurologists identified physical functioning domains as important, while patients placed more emphasis on mental health domains.Conclusions:Discrepancies between neurologist and patient perceptions of MS were observed. The study identifies a need to educate neurologists on the recognition of MS health domains that are important in the definition of patient QoL.

scholarly journals Bedside Tested Ocular Motor Disorders in Multiple Sclerosis Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
G. Servillo ◽  
D. Renard ◽  
G. Taieb ◽  
P. Labauge ◽  
S. Bastide ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Duration ◽  
Clinically Isolated Syndrome ◽  
Motor Disorders ◽  
Ocular Motor ◽  
Mri Findings ◽  
Substantial Impact ◽  
Ocular Motor Disorders ◽  
Definition Of ◽  
Multiple Sclerosis Patients

Background/Aims. Ocular motor disorders (OMDs) are a common feature of multiple sclerosis (MS). In clinical practice, if not reported by patients, OMDs are often underdiagnosed and their prevalence is underestimated.Methods. We studied 163 patients (125 women, 76.7%, 38 men, 23.3%; median age 45.0 years; median disease duration 10 years; median EDSS 3.5) with definite MS (n=150, 92%) or clinically isolated syndrome (n=13, 8%) who underwent a thorough clinical examination of eye movements. Data on localization of previous relapses, MS subtype, and MRI findings were collected and analyzed.Results. Overall, 111/163 (68.1%) patients showed at least one abnormality of eye movement. Most frequent OMDs were impaired smooth pursuit (42.3%), saccadic dysmetria (41.7%), unilateral internuclear ophthalmoplegia (14.7%), slowing of saccades (14.7%), skew deviation (13.5%), and gaze evoked nystagmus (13.5%). Patients with OMDs had more severe disability(P=0.0005)and showed more frequently infratentorial MRI lesions(P=0.004). Localization of previous relapses was not associated with presence of OMDs.Conclusion. OMDs are frequent in patients with stable (no relapses) MS. A precise bedside examination of eye motility can disclose abnormalities that imply the presence of subclinical MS lesions and may have a substantial impact on definition of the diagnosis and on management of MS patients.

scholarly journals Concept and system of criminal and legal consequences of crime commission

2021 ◽  
Vol 2021 (1) ◽  
pp. 126-136
Author(s):  
Yuriy Pudovochkin
Keyword(s):  
Criminal Law ◽  
Legal Status ◽  
Criminal Liability ◽  
Crime Commission ◽  
Starting Point ◽  
Definition Of ◽  
The Individual ◽  
Fundamental Categories ◽  
Almost All ◽  
Legal Consequences

A significant problem of modern criminal law science is the definition of its fundamental categories to which the “criminal and legal consequences” category belongs. The theme of criminal and legal consequences of committing a crime is still weakly developed. Nevertheless, the content of almost all theoretical constructions associated with criminal and legal measures, criminal punishment and criminal liability depends on its solution. The author suggests his idea of the system of criminal and legal consequences based on the system interpretation of law and formal and logical analysis of criminal law norms. The system comprises: a) consequences of commission of a crime such as discharges and implementation of criminal liability; consequences of commission of other criminal and related acts and appearing of criminal and relevant events that influence correction of the legal status of the individual having committed a crime. The starting point in the development of the system appeared to be understanding of the terms «crime» and «consequence» in the context of criminal and legal relations theory and legal factors of criminal law. It is also noted that the system of criminal and legal consequences of crime commission can be viewed as a part of the consequence crime commission system which includes both actually legal and extra-legal consequences.

Human Security

2017 ◽  
Author(s):  
Edward Newman
Keyword(s):  
Security Policy ◽  
Security Analysis ◽  
Human Security ◽  
Security Studies ◽  
Ethical Orientation ◽  
Critical Security Studies ◽  
Starting Point ◽  
Negative Rights ◽  
Definition Of ◽  
The Individual

Human security suggests that security policy and security analysis, if they are to be effective and legitimate, must focus on the individual as the referent and primary beneficiary. In broad terms, human security is “freedom from want” and “freedom from fear:” positive and negative rights as they relate to threats to core individual needs. Human security is normative; it argues that there is an ethical responsibility to (re)orient security around the individual in line with internationally recognized standards of human rights and governance. Much human security scholarship is therefore explicitly or implicitly underpinned by a solidarist commitment to moral obligation, and some are cosmopolitan in ethical orientation. However, there is no uncontested definition of, or approach to, human security, though theorists generally start with human security challenges to orthodox neorealist conceptions of international security. Nontraditional and critical security studies (which are distinct from human security scholarship) also challenges the neorealist orthodoxy as a starting point, although generally from a more sophisticated theoretical standpoint than found in the human security literature. Critical security studies can be conceived broadly to embrace a number of different nontraditional approaches which challenge conventional (military, state-centric) approaches to security studies and security policy. Human security has generally not been treated seriously within these academic security studies debates, and it has not contributed much either.

Psychological Violence

2020 ◽  
pp. 42-59
Author(s):  
Maria Gabriella Cairo
Keyword(s):  
Similar Pattern ◽  
General Definition ◽  
Psychological Violence ◽  
Starting Point ◽  
Definition Of ◽  
The Individual

This chapter deals with psychological violence in its most recurrent forms. The author uses the general definition of psychological violence as a starting point to then analyze its manifestations in two different contexts: the professional and private environment. This way, the author wishes to demonstrate that psychological violence is associated with the establishment of a hold, a conditioning, which makes the individual who is subjected to it incapable of recognizing it. It is a process which is developed through typical schemes and which follows a similar pattern in different contexts. The consequences for the victims are numerous. The author analyzes them through a psychosomatic approach which explains why certain diseases develop when individuals are subjected to such pressures. The author also shares the results obtained in her practise of accompanying victims.

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