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排序方式: 共有1260条查询结果,搜索用时 31 毫秒
51.
Lisa M. Bunn PhD Jonathan F. Marsden PhD Paola Giunti MD PhD Brian L. Day DPhil 《Movement disorders》2013,28(4):510-516
Balance impairment is a principal symptom of cerebellar disease, but is poorly understood partly because subjects with heterogenous cerebellar and extracerebellar lesions have often been studied. Spinocerebellar ataxia type 6 (SCA6) provides an opportunity to understand balance dysfunction associated with a relatively homogenous cerebellar lesion. This study investigated stance instability in SCA6 and how it is affected by varying stance width. Body sway, as well as its directional preponderance and distribution across joints, was measured three‐dimensionally in 17 SCA6 and 17 matched healthy control subjects. Subjects stood for 40 seconds on a stable surface with their eyes open and feet positioned at various stance widths (32, 16, 8, 4, and 0 cm). SCA6 subjects swayed faster than controls at every stance width. Decreasing the stance width produced a disproportionate increase in sway speed in SCA6 subjects, compared to controls. Directional preponderance of sway was dependent on stance width, but did not differ between groups. Joint instability was increased by reducing stance width in both groups, but there was greater instability of the ankle joint in the roll plane in the SCA6 group. Measures of global instability correlated strongly with disease severity measured with the Scale for the Assessment and Rating of Ataxia (r = 0.79). The sway characteristics suggest a disruption of sensorimotor processing for balance control in SCA6. The correlation with disease severity implies that balance impairment is a feature of progression of SCA6 clinical syndrome. With stance width standardized, the instability measures employed could provide sensitive, continuous outcome measures of longitudinal or therapeutic change. © 2012 Movement Disorder Society 相似文献
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Murali Mahadevan FRACS Graeme van der Meer MBChB MMed Maayan Gruber MD Peter Reed DPhil Conor Jackson FRCS Colin Brown FRACS Nikki Mills FRACS Lesley J. Salkeld FRACS FRCSC Dip ABO Michel Neeff FRACS Jan Evans MBChB Brian Anderson PhD FANZCA FJFICM Colin Barber FRACS 《The Laryngoscope》2016,126(12):E416-E420
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Cultural animation in health research: An innovative methodology for patient and public involvement and engagement
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Mihaela Kelemen BA PhD DPhil Emma Surman BSc PhD Lisa Dikomitis BA MA PhD 《Health expectations》2018,21(4):805-813
Background
A significant challenge in Patient and Public Involvement and Engagement (PPIE) in health research is to include a wide range of opinions and experiences, including from those who repeatedly find themselves at the margins of society.Objective
To contribute to the debate around PPIE by introducing a bottom‐up methodology: cultural animation (CA). Cultural Animation is an arts‐based methodology of knowledge co‐production and community engagement which employs a variety of creative and participatory exercises to help build trusting relationships between diverse participants (expert and non‐experts) and democratize the process of research.Design
Three CA full‐day workshops for the research project “A Picture of Health.”Participants
Each workshop was attended by 20‐25 participants including 4 academics, 5 retired health professionals who volunteered in the local community and 15 community members. Participants ranged in age from 25 to 75 years, and 80% of the participants were women over the age of 60.Results
The CA workshops unearthed a diversity of hidden assets, increased human connectivity, led to rethinking of and co‐creating new health indicators and enabled participants to think of community health in a positive way and to consider what can be developed.Discussion
Cultural animation encourages participants to imagine and create ideal pictures of health by experimenting with new ways of working together.Conclusion
We conclude by highlighting the main advantages to PPIE as follows: CA provides a route to co‐produce research agendas, empowers the public to engage actively with health professionals and make a positive contribution to their community. 相似文献55.
Identifying acceptable components for home‐based health promotion services for older people with mild frailty: A qualitative study
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Susan Jenkins-Clarke BSc RGN HV Cert & Roy Carr-Hill MA DPhil 《Journal of advanced nursing》2001,34(6):842-849
AIMS: The main aim of this paper is to draw attention to problems facing the primary health care workforce in terms of demand for treatment of minor illness over the next two decades. These predictions have implications for the community nursing workforce in particular and the flexibility of primary health care teams in general. BACKGROUND: Care delivered in the primary care sector influences, and is influenced by, the characteristics of the health care workforce. These characteristics fall into two main groups: firstly, the shape of the present medical and nursing workforce and manpower trends; and secondly, the changes in doctors' and nurses' workloads. DESIGN: This paper draws on two studies, both commissioned by the Department of Health; the first study focusing on skill mix and delegation in primary health care teams and the second addressing the implications of skill mix for medical workforce scenarios in the changing policy environment. FINDINGS: From the first study, general practitioners across ten general practices were prepared to delegate at least one topic from over a third of 836 consultations and a further 17% of entire consultations. This potential delegation fell mainly to practice nurses and nurse practitioners. The second study used data extracted from the National Morbidity Surveys of 1981 and 1991 predicting that minor consultations are set to increase by 11 million from the 1990s to 2020--a minimal estimate. The authors argue that many of these extra predicted consultations will find their way onto practice nurses' and nurse practitioners' caseloads. CONCLUSIONS: Workforce issues and questions of professional roles and boundaries, in the context of the "greying" community nursing workforce, demand solutions if patient/client demand is to be met over the next two decades. 相似文献
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F. Wang MClinEpid FRACS A. J. Gill MD FRACP M. Neale MM FRACS V. Puttaswamy MBBS FRACS S. Gananadha MS FRACS N. Pavlakis PhD FRACP S. Clarke MD FRACP T. J. Hugh MD FRACS J. S. Samra DPhil FRACS 《Annals of surgical oncology》2014,21(6):1937-1947