Cíl: Jednou z komplikací u pacientů po amputaci končetin/y je fantomová bolest (FB) vnímaná v chybějící končetině. Zrcadlová terapie (ZT) je nefarmakologickým přístupem k FB a cílem studie je popsat a posoudit možnost využívání, efektivity, aplikovatelnosti a zahraniční zkušenosti se ZT u pacientů s FB po amputaci končetin/y. Metodika: Deskriptivní mapping study analyzující, komparující a klastrující obsahy 22 dohledaných relevantních studií. Vyhledávání v rozmezí let 2000–2017 pomocí klíčových slov a jejich kombinací bylo provedeno v databázích EBSCO, PsychINFO, PubMed, ProQuest, ScienceDirect, včetně využití metavyhledávačů. Výsledky: Specifika FB po aplikaci ZT u pacientů po amputacích se liší podle lokace amputované končetiny. ZT přináší (z)mírnění FB u pacientů po amputaci horní končetiny, dolní končetiny, stejně jako u smíšených skupin (po amputaci horní anebo dolní končetiny), a za alternativní přístup je považována ZT virtuální. ZT zůstává spíše experimentální modalitou terapie u pacientů, u kterých byly jiné postupy mírnící FB neúspěšné. Vzhledem k tomu, že dochází k modifikacím ZT a častým kombinacím s dalšími terapiemi (a u různých indikací), nelze dosud efektivitu ZT plně generalizovat. Dominantním zjištěním je doložení krátkodobého efektu ZT na snížení intenzity FB. Závěr: Přestože je oproti dalším terapiím, přístupům a intervencím ZT poměrně novým fenoménem, v zahraničí je známá a stále se rozšiřuje okruh situací pro její indikování. K jejímu obecnému rozšíření a uznání je zapotřebí dalších výzkumů a transferu poznatků do týmů poskytujících komplexní péči těmto pacientům. Výstupy mapping study mohou být využity pro rozpracování tématu v podmínkách České republiky, kde se ZT využívá ojediněle a jako experimentálně doplňková terapie (zejména v ergoterapii).
Objective: One of the complications in patients after limb amputation is phantom pain (PP) in the missing limb. Mirror therapy (MT) is a non-pharmacological approach to PP. The objective of the study is to describe and assess possible applications, effectiveness, practicability, and international experience with MT in patients with PP after limb amputation. Methods: A descriptive mapping study that analyses, compares, and clusters the content of 22 relevant studies. The search was performed between 2000 and 2017 using the keywords and their combinations in the following databases: EBSCO, PsychINFO, PubMed, ProQuest, ScienceDirect, including metasearch engines. Results: The specificities of PP after the application of MT in post amputation patients vary by the location of the amputated limb. MT alleviates PP in patients after amputation of the upper limb, lower limb, as well as in mixed groups (after amputation of the upper limb or lower limb); virtual MT is considered an alternative approach. MT remains a rather experimental therapeutic modality aimed at patients, where other attempts to alleviate PP have failed. Regarding the fact that MT is frequently modified and combined with other approaches (including various indications), the effectiveness of MT cannot be fully generalized. The main finding is the evidence of a short-term effect of MT on decreasing the intensity of PP. Conclusions: Although MT is a relatively new phenomenon compared with other therapies, approaches and interventions, it is well known in foreign countries, and the range of indication is increasing. For MT to be generally spread and acknowledged, further research is needed together with a transfer of knowledge to teams providing comprehensive care to these patients. The outcomes of the mapping study will be used for a detailed analysis of the issue in the Czech Republic, where MT is used rarely and as an experimental additional therapy (particularly in occupational therapy).
- Keywords
- mapping study,
- MeSH
- Amputation, Surgical rehabilitation MeSH
- Phantom Limb * rehabilitation MeSH
- Clinical Studies as Topic MeSH
- Humans MeSH
- Pain Management methods MeSH
- Information Storage and Retrieval methods MeSH
- Treatment Outcome MeSH
- Mirror Movement Therapy * methods MeSH
- Check Tag
- Humans MeSH
AIM: Despite the substantial progress that has been achieved in interventional cardiology and cardiac electrophysiology, endovascular intervention for the diagnosis and treatment of central nervous system (CNS) disorders such as stroke, epilepsy and CNS malignancy is still limited, particularly due to highly tortuous nature of the cerebral arterial and venous system. Existing interventional devices and techniques enable only limited and complicated access especially into intra-cerebral vessels. The aim of this study was to develop a micro-catheter magnetically-guided technology specifically designed for endovascular intervention and mapping in deep CNS vascular structures. METHODS: Mapping of electrical brain activity was performed via the venous system on an animal dog model with the support of the NIOBE II system. RESULTS: A novel micro-catheter specially designed for endovascular interventions in the CNS, with the support of the NIOBE II technology, was able to reach safely deep intra-cerebral venous structures and map the electrical activity there. Such structures are not currently accessible using standard catheters. CONCLUSION: This is the first study demonstrating successful use of a new micro-catheter in combination with NIOBE II technology for endovascular intervention in the brain.
- MeSH
- Electroencephalography MeSH
- Endovascular Procedures instrumentation methods MeSH
- Catheters MeSH
- Magnets MeSH
- Brain Mapping instrumentation methods MeSH
- Cerebral Angiography MeSH
- Image Processing, Computer-Assisted MeSH
- Dogs MeSH
- Cerebrum blood supply physiology radiography MeSH
- Animals MeSH
- Check Tag
- Dogs MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Cíl: Jednou z komplikací u pacientů po amputaci končetin/y je fantomová bolest (FB) vnímaná v chybějící končetině. Zrcadlová terapie (ZT) je nefarmakologickým přístupem k FB a cílem studie je popsat a posoudit možnost využívání, efektivity, aplikovatelnosti a zahraniční zkušenosti se ZT u pacientů s FB po amputaci končetin/y. Metodika: Deskriptivní mapping study analyzující, komparující a klastrující obsahy 22 dohledaných relevantních studií. Vyhledávání v rozmezí let 2000–2017 pomocí klíčových slov a jejich kombinací bylo provedeno v databázích EBSCO, PsychINFO, PubMed, ProQuest, ScienceDirect, včetně využití metavyhledávačů. Výsledky: Specifika FB po aplikaci ZT u pacientů po amputacích se liší podle lokace amputované končetiny. ZT přináší (z)mírnění FB u pacientů po amputaci horní končetiny, dolní končetiny, stejně jako u smíšených skupin (po amputaci horní anebo dolní končetiny), a za alternativní přístup je považována ZT virtuální. ZT zůstává spíše experimentální modalitou terapie u pacientů, u kterých byly jiné postupy mírnící FB neúspěšné. Vzhledem k tomu, že dochází k modifikacím ZT a častým kombinacím s dalšími terapiemi (a u různých indikací), nelze dosud efektivitu ZT plně generalizovat. Dominantním zjištěním je doložení krátkodobého efektu ZT na snížení intenzity FB. Závěr: Přestože je oproti dalším terapiím, přístupům a intervencím ZT poměrně novým fenoménem, v zahraničí je známá a stále se rozšiřuje okruh situací pro její indikování. K jejímu obecnému rozšíření a uznání je zapotřebí dalších výzkumů a transferu poznatků do týmů poskytujících komplexní péči těmto pacientům. Výstupy mapping study mohou být využity pro rozpracování tématu v podmínkách České republiky, kde se ZT využívá ojediněle a jako experimentálně doplňková terapie (zejména v ergoterapii).
Objective: One of the complications in patients after limb amputation is phantom pain (PP) in the missing limb. Mirror therapy (MT) is a non-pharmacological approach to PP. The objective of the study is to describe and assess possible applications, effectiveness, practicability, and international experience with MT in patients with PP after limb amputation. Methods: A descriptive mapping study that analyses, compares, and clusters the content of 22 relevant studies. The search was performed between 2000 and 2017 using the keywords and their combinations in the following databases: EBSCO, PsychINFO, PubMed, ProQuest, ScienceDirect, including metasearch engines. Results: The specificities of PP after the application of MT in post amputation patients vary by the location of the amputated limb. MT alleviates PP in patients after amputation of the upper limb, lower limb, as well as in mixed groups (after amputation of the upper limb or lower limb); virtual MT is considered an alternative approach. MT remains a rather experimental therapeutic modality aimed at patients, where other attempts to alleviate PP have failed. Regarding the fact that MT is frequently modified and combined with other approaches (including various indications), the effectiveness of MT cannot be fully generalized. The main finding is the evidence of a short-term effect of MT on decreasing the intensity of PP. Conclusions: Although MT is a relatively new phenomenon compared with other therapies, approaches and interventions, it is well known in foreign countries, and the range of indication is increasing. For MT to be generally spread and acknowledged, further research is needed together with a transfer of knowledge to teams providing comprehensive care to these patients. The outcomes of the mapping study will be used for a detailed analysis of the issue in the Czech Republic, where MT is used rarely and as an experimental additional therapy (particularly in occupational therapy).
BACKGROUND: If carried out correctly and without delay, activation of emergency services by stroke bystanders could improve mortality and disability from stroke. This paper describes the development of a school-based intervention using the Intervention Mapping approach. It aims to improve the appropriate activation of emergency medical services for suspected stroke by 12-15-year-old children. METHODS: The development of the intervention was guided by Intervention Mapping approach. The logic model of the problem was created through analysis of the existing literature and semi-structured interviews with stakeholders. Based on these findings, performance objectives and their determinants were determined and matched to create a model for changing emergency medical services activation behavior. Behavior change methods and their practical applications were then determined. Based on them, intervention messages and materials were designed, the intervention was drafted, pretested, and finalized. RESULTS: It was found that the main performance objectives for the activation of emergency medical services were (1) recognizing symptoms, (2) communicating with the victim, and (3) calling an ambulance immediately. Their main determinants were knowledge, social influence, risk perception, self-efficacy, outcome expectations, and skills. Determinants were then matched with performance objectives to create the matrices of requested behavior changes. The following change methods were chosen: modeling, elaboration, belief selection, providing cues, scenario-based risk information, and cultural similarity. Methods were translated into practical applications in the form of a short educational film. The production company created, pretested, and finalized the film. As a result, a 5-minute entertainment-education video was created modeling an acute stroke with a child as the main bystander. CONCLUSION: The Intervention Mapping approach guided the development of a school-based program to improve Emergency medical services activation in stroke by 12-15 year old children. Our process and approach can serve as a model for researchers and health promotion professionals aiming to improve help-seeking behavior for stroke to improve stroke help-seeking behavior as well as other acute diseases.
- MeSH
- Stroke * therapy MeSH
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Program Development MeSH
- School Health Services MeSH
- Schools MeSH
- Emergency Medical Services * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
A method using body surface potential maps for assessment of myocardium lesions with changed repolarization is presented and suitable mapping system is introduced. Differences between normal and altered QRST integral maps together with torso volume conductor model were used to determine the equivalent dipole representing the lesion. Performance of the method was studied on simulated data. Changed repolarization was modeled by shortening of myocyte action potentials in regions typical for stenosis of the main coronary arteries. The equivalent dipole estimated the positions of small lesions with a mean error of 9+/-4 mm (17+/-14 mm for larger transmural lesions). The subepicardial or subendocardial character of the lesions was reflected in the dipole orientation. Tests of the method on patients after myocardial infarction that underwent coronary intervention on a single coronary vessel showed that in 7 of 8 successfully treated patients the dipole position matched well with the treated vessel. A small dipole moment in another patient indicated unsuccessful treatment. The method was implemented in a new 128-channel mapping system. Its active electrodes, battery powered measuring unit and optical computer interface help to minimize noise in ECG and guarantee patient's safety. The results suggest that the method and mapping system offer useful tools for noninvasive identification of local repolarization changes in the myocardium.
- MeSH
- Action Potentials MeSH
- Angioplasty, Balloon, Coronary * MeSH
- Time Factors MeSH
- Myocardial Infarction pathology physiopathology therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Body Surface Potential Mapping methods MeSH
- Models, Cardiovascular MeSH
- Myocardium pathology MeSH
- Computer Simulation MeSH
- Signal Processing, Computer-Assisted MeSH
- Heart Conduction System physiopathology MeSH
- Reproducibility of Results MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
V oblasti paliativní péče zastávají všeobecné sestry důležitou roli v péči o pacienty a jejich rodiny. Tato studie se zaměřuje na intervence všeobecných sester v konziliárním týmu paliativní péče na Klinice paliativní medicíny VFN a 1. LF UK v Praze. Pomocí deskriptivní analýzy intervencí provedených během roku 2022 mapuje činnost sester a identifikuje jejich hlavní úlohy v tomto specifickém kontextu. Výsledky ukazují, že sestry se podílely na více než polovině všech intervencí, přičemž 75 % z nich provedly sestry samostatně. Nejčastěji prováděnou intervencí byl odběr hodnotové anamnézy a screening potřeb pacientů. Hlavní role sester byla identifikována v komunikaci, koordinaci péče, advokacii a edukaci pacientů. Zjištění dokládá nutnost kontinuálního rozšiřování kompetencí sester v oblasti paliativní medicíny a zdůrazňuje důležitost specializovaného vzdělávání a tréninku, které mohou přispět ke zlepšení kvality poskytované péče v nemocnicích. Studie zároveň podtrhuje potřebu začlenění těchto dovedností do pregraduální výuky.
General nurses, particularly those in palliative care, play a pivotal role in patient and family care. This study, conducted at the Department of Palliative Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, focuses on the role of general nurses within the palliative care consultation team. By conducting a descriptive analysis of the interventions performed by nurses during 2022, it maps the activities of nurses and identifies their primary roles in this specific context. The results show that nurses were involved in more than half of all interventions, and 75 % performed independently. The most common interventions were values-based history-taking and need assessment, with nurses' prominent roles including communication, care coordination, advocacy, and patient education. The results demonstrate the expansion of nurses' competencies in palliative care, underscoring the urgent need for specialized education and training. This is crucial to improve the quality of care provided in hospitals. The study also emphasizes the need to integrate these skills into undergraduate education, further highlighting the importance of this issue.
BACKGROUND: This study aims to assess which measures could improve the healthy early childhood development of children from marginalized Roma communities and to identify priority measures. METHODS: Concept mapping approach was used, using mixed methods. In total 54 professionals, including social workers, educators, health care providers, municipality representatives, and project managers participated in our study. RESULTS: Four distinct clusters of measures targeting living conditions, public resources, healthcare and community interventions, and 27 individual priority measures of highest urgency and feasibility were identified. The cluster 'Targeting living conditions', was rated as the most urgent but least feasible, whereas the cluster 'Targeting health care', was considered least urgent but most feasible. Among the 27 priority measures, 'Planning parenthood' and 'Scaling up existing projects' had the highest priority. CONCLUSION: Our results reflect the public and political discourse and indicate significant barriers to implementation. Reducing inequalities in early childhood needs to be addressed through coordinated efforts.
- MeSH
- Child MeSH
- Humans MeSH
- Delivery of Health Care MeSH
- Child, Preschool MeSH
- Roma * MeSH
- Social Workers MeSH
- Health Status MeSH
- Health Personnel MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Child, Preschool MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Half of the people living in social exclusion in the Czech Republic are of Roma origin. The worse health of Roma could be partly explained by numerous barriers to accessing health care. Therefore, our study aimed to explore the perceptions of various stakeholders and experts who may have an impact on the inclusion of Roma and/or their access to health care on how to improve health care access for Roma living in social exclusion in the Czech Republic. METHODS: We conducted a concept mapping study and obtained data from 32 participants from health and social services, policymakers and others who were involved in different study phases (brainstorming, sorting, rating, interpretation). RESULTS: Out of 64 proposed measures sorted into six distinct clusters, 20 were rated as the most urgent and the most feasible and should be implemented with a priority to improve access to health care for Roma living in social exclusion. The proposed measures covered various topics, such as education and awareness of the target group as well as education and supervision of helping professionals, strengthening capacities and streamlining the health care system, health promotion and associated services and increasing the local and financial accessibility of health care. Overall, measures concerning the education and supervision of helping professionals were rated as both the most urgent and the most feasible. Individual priority measures targeted, for example, the health needs assessment of Roma living in social exclusion to set up interventions or to include topics such as participation, empowerment, cultural competence and communication training in the curricula of health care and helping professionals in postgraduate and continuing studies. CONCLUSIONS: Stakeholders proposed a set of relevant and acceptable measures that may help improve access to health care for Roma living in social exclusion. The way they rated the proposed measures reflects both the current unfavourable mainstream and public discourse concerning Roma living in social exclusion and the most acute policy issues identified by several European and national bodies.
- MeSH
- Healthcare Disparities MeSH
- Adult MeSH
- Health Services Accessibility * MeSH
- Culturally Competent Care * MeSH
- Cultural Competency MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Delivery of Health Care * MeSH
- Spatial Analysis MeSH
- Roma * MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Social Inclusion MeSH
- Social Isolation MeSH
- Concept Formation MeSH
- Health Policy MeSH
- Health Facilities MeSH
- Vulnerable Populations MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- China MeSH
