INVESTIGATION OF CONSTRAINS TOWARD PARTICIPATION IN SPORTS AND LEISURE ACTIVITIES OF PEOPLE WITH DISABILITIES

The purpose of the study is to investigate the factors that deter, inhibit and/or prevent the participation of people with disabilities in athletic activities, and also the investigation of possible differentiation of reasons that inhibit exercise in people with disabilities based on gender, age, educational level, congenital or acquired disability, the participation or not in athletic activities and the frequency of participation. For the needs of this study, the “Barrier to Physical Activity Questionnaire for People with Mobility Impairments – BPAQ-MI” (Vasudevan, Rimmer, & Kviz, 2015) was used. The results showed that the main intrapersonal inhibitors are the concerns for health and the attitudes regarding physical activity. Interpersonal factors that inhibit are physical inertia, the lack of encouragement, and the non-adoption of an active lifestyle in the familial and friendly environment. The lack of accessible infrastructures and programs, the lack of appropriate equipment for adapted exercise, the lack of marketing for people with disabilities, the lack of coverage of the cost of participation from health insurance, and the high cost of participation in athletic programs constitute basic organizational barriers. The lack of accessibility of the general environment, the means of transport to the place of exercise, and safety constitute social barriers. Statistically important differences are observed between the two genders, different age groups, different levels of education, and different frequency of participation in athletic activities. The understanding of the inhibitors and obstacles, will contribute to the obviation of the reasons of distance, to the reinforcement of participation in athletic programs and recreational movement. The designers of athletic policy, the managers of athletic and recreational centers ought to improve the infrastructure, the services, according to the needs of people with disabilities, and to eliminate possible obstacles that bar participation.  Article visualizations

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

Φυσικοθεραπευτικές προσεγγίσεις σε γυναίκες που έχουν υποβληθεί σε μαστεκτομή

Ο καρκίνος του μαστού αποτελεί τον πιο κοινό καρκίνο στις γυναίκες στις ανεπτυγμένες χώρες. Η θεραπεία περιλαμβάνει χειρουργική επέμβαση, χημειοθεραπεία, ακτινοθεραπεία και ανοσοθεραπεία/ορμονοθεραπεία, που αναπτύσσονται συνεχώς και αυξάνουν ολοένα και περισσότερο την επιβίωση των ασθενών με διάγνωση καρκίνου. Μετά τη διάγνωση και τη θεραπεία, ένας σημαντικός αριθμός γυναικών αναπτύσσει επιπλοκές που σχετίζονται με τη θεραπεία και επηρεάζουν τη λειτουργία και την ποιότητα ζωής. Οι επιπλοκές δεν εντοπίζονται πάντα στον ιστό του μαστού, καθώς πολλές από τις θεραπείες εκτός από τοπικές έχουν και περιφερικές και συστηματικές επιδράσεις στις δομές και τη λειτουργία του σώματος (όπως πόνος και κόπωση), συμπεριλαμβανομένων των ψυχοκοινωνικών προβλημάτων (κατάθλιψη, άγχος), των μυοσκελετικών επιπλοκών (εύρος κίνησης/προβλήματα στον ώμο, αλλαγές στην εμβιομηχανική και τη στάση του σώματος) και των σχετικών με την κίνηση, καθώς και την καρδιαγγειακή, αιματολογική και ανοσολογική λειτουργία (ανάπτυξη λεμφοιδήματος). Οι υπηρεσίες αποκατάστασης μέσω διεπιστημονικής ομάδας έχουν αναγνωριστεί από καιρό ως αναπόσπαστο συστατικό της ολοκληρωμένης φροντίδας του καρκίνου. Η παρούσα εργασία επικεντρώνεται στη φυσικοθεραπεία η οποία διαδραματίζει κύριο ρόλο στο να ανακτήσουν οι ασθενείς τη δύναμη και τη φυσική τους λειτουργία και να βελτιώσουν την ποιότητα ζωής και την ανεξαρτησία τους στις καθημερινές δραστηριότητες. Οι φυσικοθεραπευτικές προσεγγίσεις περιλαμβάνουν φυσικά μέσα (κρυοθεραπεία, λέιζερ, υδροθεραπεία κ.α.), προγράμματα θεραπευτικής άσκησης (ασκήσεις ενδυνάμωσης, αερόβια άσκηση, ασκήσεις εύρους κίνησης, ευλυγισίας, συντονισμού και εκπαίδευσης ισορροπίας), τεχνικές αντιμετώπισης του λεμφοιδήματος ενώ γίνεται αναφορά και στις εναλλακτικές θεραπείες (μάλαξη, βελονισμός, γιόγκα, Pilates κ.α.). Μέσω της παρούσας μελέτης γίνεται εμφανές ότι για την πληρότητα και την αποτελεσματικότητα της μετεγχειρητικής αποκατάστασης του καρκίνου του μαστού πρέπει να εξεταστούν πληθώρα προσεγγίσεων διαχείρισης των ασθενών και επανασχεδιασμός του τρόπου ζωής τους με ενσωμάτωση πτυχών προώθησης της υγείας (π.χ. συστηματική σωματική δραστηριότητα).Breast cancer is the most common cancer in women in developed countries. Treatment includes surgery, chemotherapy, radiotherapy and immunotherapy / hormone therapy, which are constantly evolving and increasing the survival of patients diagnosed with cancer. After diagnosis and treatment, a significant number of women develop treatment-related complications that affect function and quality of life. Complications are not always found in the breast tissue, as many of the treatments, in addition to local, have peripheral and systemic effects on the structures and function of the body, including psychosocial problems (pain, fatigue, depression, anxiety), musculoskeletal complications (range of motion / shoulder problems, biomechanical and postural changes) and movement-related, as well as cardiovascular, hematological and immune function (development of lymphedema). Rehabilitation services through a multidisciplinary team have long been recognized as an integral part of integrated cancer care. This review focuses on physiotherapy which helps patients regain strength and physical function and improve their quality of life and independence in daily activities. Physiotherapy approaches include natural remedies (cryotherapy, laser, hydrotherapy, etc.), therapeutic exercise programs (strengthening exercises, aerobic exercise, range of motion exercises, flexibility, coordination and balance training), coping techniques and treatments (massage, acupuncture, yoga, Pilates etc.). Through the present study it becomes clear that for the completeness and effectiveness of postoperative breast cancer rehabilitation a variety of patient management approaches and redesign of their lifestyle with integration of health promotion aspects (eg systematic physical activity) should be considered

Lymphocyte apoptosis after major abdominal surgery is not influenced by anesthetic technique: a comparative study of general anesthesia versus combined general and epidural analgesia

Study Objective: To examine the influence of abdominal colectomy with combined general anesthesia and epidural analgesia versus general anesthesia on apoptosis of circulating lymphocytes. Design: Prospective, randomized, clinical comparison study. Setting: Tertiary-care general hospital. Patients: 40 ASA physical status I and II patients undergoing elective open colectomy for nonmetastatic colon carcinoma. Interventions: Patients were randomly allocated to two groups to receiver either general anesthesia alone (Group G) or general anesthesia combined with epidural analgesia (Group Q. Group C comprised 21 patients while 19 patients constituted Group G. All patients underwent median longitudinal laparotomy. Measurements: Blood samples were collected preoperatively and 24 hours postoperatively for measurement of lymphocyte apoptosis, serum cortisol, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Main Results: There were no differences between the two groups in age, weight, or duration of surgery. No significant alterations in total lymphocyte counts, as well as in lymphocyte subpopulations (early apoptotic, late apoptotic, viable, and necrotic), were observed between the general and combined anesthesia groups. Cortisol, ESR, and CRP were significantly increased postoperatively in both groups. Group C presented with lower serum cortisol levels postoperatively than Group G (b = -5.38, C195%: -8.72 to -2.05, P = 0.002). Conclusions: Epidural block could not suppress postoperative lymphocyte apoptosis, increases in cortisol, CRP, or ESR compared with general anesthesia. (C) 2009 Elsevier Inc. All rights reserved