1.Team Rehabilitation for Spinal Cord-Injured Patients with Mental Disorders
The Japanese Journal of Rehabilitation Medicine 2007;44(2):97-106
The purpose of this study was to evaluate the effectiveness of therapeutic intervention via liaison-psychiatry by a psychiatrist to the team rehabilitation for spinal cord-injured patients with mental disorders. Out of 652 spinal cord-injured patients who underwent rehabilitation during post-acute stages in our hospital from April 2000 to March 2006, 82 patients aged from 19 to 65 with mental disorders according to the diagnostic criteria of DSM-IV-TR were selected. In order to assess the effectiveness of this comprehensive team approach, the outcomes of these 82 patients were compared with the outcomes of 82 control patients without mental disorders. As a result, there were no significant differences of the acquired BI (Barthel Index), FIM (Functional Independence Measure), and abilities of transfer between the two groups. In addition, 35 out of 82 patients went back to their home. These results demonstrate the effectiveness of liaison psychiatry in conducting the comprehensive team rehabilitation for spinal cord-injured patients with mental disorders.
4.The Effect of Comprehensive Intensive Treatment on Social Participation in Persons with Acquired Brain Injury
Yuko URAKAMI ; Yoshiko TOBIMATSU ; Fumio ETO ; Tsutomu IWAYA
The Japanese Journal of Rehabilitation Medicine 2010;47(4):232-238
The purpose of this study was to estimate the effect of our post-acute comprehensive intensive inpatient treatment (Program A) on persons with acquired brain injury in the hospital. Program A, designed for work or school, consists of daily six hours sessions for three months, personal and group sessions, and family support. It was designed to build cognitive and behavioral skills through a transdisciplinary approach and 17 patients with acquired brain injury were enrolled in the program. Seventeen program non-participants were selected as our control. Cognitive functions were measured with FIM, WAIS-III, RBMT, and TMT before and after the program. Significant cognitive improvements (especially attention) and increased societal participation were obtained for the Program A participants compared with non-participants. Considering that Program A improved both the cognitive function and level of social participation in program participants, we suggest that it is valuable to perform intensive treatment programs in an inpatient condition for acquired brain injury patients.
5.Rehabilitation of Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis with Memory Disturbance
Yuko Urakami ; Michihiko Yamasato ; Nobuko Shiraiwa ; Yoshiko Tobimatsu
The Japanese Journal of Rehabilitation Medicine 2016;53(1):75-87
Anti-N-methyl-D-aspartate(NMDA)receptor(NMDAR)encephalitis is an autoimmune disorder typically involving ovarian teratomas and a severe neuropsychiatric disorder involving prominent memory and behavioral deficits. The purpose of this study was to evaluate the clinical symptoms and outcomes of six patients(one male, five female;age:20 to 47 years)with autoantibody-associated NMDAR encephalitis, who underwent comprehensive rehabilitation in our hospital. The five female patients underwent ovarian teratoma removal. At the beginning of rehabilitation, the mean score on the Rivermead Behavioural Memory Test was 16.7, and prospective memory was preserved in two patients and was recovered in two patients. The mean Wechsler Memory Scale-Revised score of the six patients significantly increased after rehabilitation, which suggested good recovery, compared to that in the patients with herpes encephalitis. However, in the chronic state, two patients showed persistent short-term memory disturbances that required a compensatory approach and employment assistance. Four patients who were treated with convalescent cognitive rehabilitation 4.5 months after onset improved in 4 months and showed good prognoses. Three returned to work, one returned to school, and two lived independently. Patients with anti-NMDAR encephalitis respond to immunotherapy, but they exhibit persistent cognitive deficits that are related to the distribution and functional role of NMDARs in the human brain. Early intervention for the short-term memory disturbances in convalescent rehabilitation, chronic interventions for the persistent memory disturbances, and preservation of perceptive memory are important to facilitate future employment.
6.Review of Mass Vaccination Campaign after the Disaster Lessons Learned from the Vaccination Campaign in Haiti Earthquake, 2010
Sachiko Yano ; Noriko Ikeda ; Yuko Kawai ; Masaharu Nakade ; Miho Sekizuka ; Tomomi Urakami
Journal of International Health 2011;26(4):305-313
In the aftermath of disasters in areas where populations live in close proximity and where sanitation and water supplies are compromised, an environment is created which is conducive to epidemics of vaccine-preventable diseases.
A strong earthquake occurred in Haiti in January 2010, severely affecting Port au Prince, the capital of the country, and the Government was functionally damaged. Over 220,000 people lost their lives and over 300,000 were injured.
Around 1.3 million people are living in temporary shelters in the Port-au-Prince metropolitan area and over 500,000 people have left the disaster areas to seek refuge in the rest of the country.
In Haiti, one of the world's most impoverished countries, the weak routine vaccination coverage was noted and the vaccination campaign was concerned as one of the first priorities.
The Japanese Red Cross (JRC) sent a medical team, called an ERU (Emergency Response Unit) right after the earthquake and provided medical services such as clinics in affected areas.
At the same time, we were involved in the vaccination campaign as one of the key players in the International Federation of the Red Cross and Red Crescent Societies (IFRC) in responding to the mass vaccination campaign by the Ministry of Health supported by WHO (World Health Organization) and UNICEF.
More than 150,000 people were vaccinated in 1 month by all Red Cross members. 35,217 of them were by JRC and the coverage was 75.5% according to the random survey. Including all the activities, it took more than 3 months and 62% of initially estimated population was vaccinated until the end.
After disasters, people typically move to other places seeking a better environment so mass vaccination campaign has to be carried out immediately, once it is decided upon. The selection of target populations, vaccines and good cooperation with other organizations is the key to success.