subhajit's blog

Patients have the universal desire to have information regarding sexual function but at the same time reluctant of asking healthcare professionals about it (Stern et al 1991).

The aim of the piece of work is to define sexuality first. It will then appraise the different models of sexuality. The Ex PLISSIT model will be used in a case study of Lynda. And finally the discussion will focus on the advantages and the limitations of using the model.

Health Promotion Rehabilitation: an endeavour towards better health.

“Preventive measures are less expensive than the restorative measures” (Clark 1992, Friedland et al 2001, Hajnal 1997, Sheiham 1992).

Introduction
The article will define health promotion first and than will look into upstream thinking. The importance of health education in health promotion, along with different types of health promotions will be discussed. Health promotion on a wider perspective will be explored and will be related to rehabilitation. Finally the article will discuss change of health behaviour using health promotion model. The aim is to gain understanding of health promotion for the rehabilitation professional in order to incorporate them into rehabilitation practice.
An analogy of upstream thinking.
McKinlay(1979) analogy of a man standing by a fast flowing river who spent his time jumping in and pulling out people who were drowning. The task of jumping in, pulling them to the shore and applying artificial respiration was so demanding of his resources that he had no time to go upstream to prevent them falling (or being pushed in the river). The story introduced the notion of refocusing upstream and of upstream planning and action.

Allex is a 54 year old man who is currently 7 in full time employment as an IT trouble shooter. He previously participated in golf, cycling and long distances running as leisure activities and enjoyed keeping fit and active.In 2003 Allex was involved in a road traffic accident when he was knocked of his bicycle by a lorry. He incurred an injury to the cervical spine. Initially he received treatment of medications and outpatient physiotherapy; however, there was no significant relief of his pain and weakness, and in 2005 Allex received a cervical fusion at one level. Despite some improvement in strength, Allex has continued to report neck and upper back pain, headaches and decreased function. He has been referred again for outpatient rehabilitation with a diagnosis of chronic back pain. Upon presentation to you, Allex appeared to hold a negative attitude towards treatment and a sceptical view that it would help. He reported that work was difficult for him as he has to sit for extended periods, and he often experiences headaches at the end of the day. He has reluctantly given up his previous hobbies as he is not able to do them without pain.

Your intervention has been exercise based. Now at 6 weeks following initial presentation, Allex has attended only 3 of 8 scheduled visits (the first, third and seventh) and he is often late when he arrives, which causes disruption to your schedule and waits for your following clients. When he does attend, he often repeats the same information to you about the changes he has had to make in his lifestyle since his original injury, and the activities he has had to give up. He continues to complain that he is experiencing pain though he did recently attempt some running again as the weather was nice and he wanted to be outside, but this increased his pain significantly. He feels that his headaches may be slightly less frequent, though wonders if this is more related to a decreased work load stress rather than your intervention. He reports that the exercises you have prescribed are difficult to do at the suggested frequency due to his busy schedule. The referring physician has asked that you contact her to discuss Allex's progress and your recommendations at this point.
Considering the above information, what factors do you feel are influencing Allex’s engagement in the programme? How would you progress in your approach to Allex?

These days the emphasis is on Multidisciplinary/ Transdisciplinary/ Interprofessional team working in healthcare. As rehabilitation is a complex process hence more is the emphasis. In wards the OTs work with doctors/physios/ Social Worker/ Speech and Language Therapist/Healthcare assistants/ Nurses/Prosthetist & Orthotists etc..

Jackson & Davies (1995) discussed Trans-disciplinary working yet expressed uncertainty of the extent of its use. Kevin R & Feaver S (2006) reports in healthcare there is an increasing emphasis on interprofessional working- this has become a priority and is now extending to the development of interprofessional education for healthcare professionals at every level, both pre and post qualification.

The point though that I fail to understand is:
When formulating the undergraduate curriculum, does this kind of multidisciplinary teamwork happen at any level?

The molecular basis of exercise and its impact for maintaining neural function and plasticity has been found, the effect of BDNF (Brain Derieved Neutrophic Factor). BDNF seen to promote neuronal repair, learning and memory. Exercise helps to augment synaptic plasticity, promote behavioural rehabilitation and counteract deletrious effect of aging. Central nervous system has the regeneration potential. The effect of exercise go beyond simply increasing regional blood supply/ motor- sensory regions of the brain. Mailoo VJ (2006) even explored correlation of immune system and mind in Psychoneuroimmunolgical studies for different disease conditions.