Suchergebnisse

Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

INTRODUCTION: Scoliosis and other spinal deformities involve 3-4% of the population during growth. Their so-called conservative treatment is in the field of competence of physical and rehabilitation medicine (PRM) physicians. This evidence based position paper represents the official position of the European Union through the European Union of Medical Specialists (UEMS) - PRM Section. The aim of the paper was to improve PRM specialists' professional practice for patients with spinal deformities during growth. EVIDENCE ACQUISITION: A systematic review of the literature and a Consensus procedure with 26 recommendations by means of a Delphi method process has been performed involving the delegates of all European countries represented in the UEMS-PRM Section. EVIDENCE SYNTHESIS: the systematic literature review is reported together with 26 recommendations coming from the Consensus Delphi procedure. CONCLUSIONS: The professional role of PRM physicians in spinal deformities during growth is to propose a complete PRM treatment for the patients considering all the concurring diseases and pathologies, impairments, activity limitations and participation restrictions. The PRM physician's role is to coordinate the individual PRM project developed in team with other health professionals and medical specialists, in agreement with the patient and his family, according to the specific medical diagnoses.

BACKGROUND: Physical and rehabilitation medicine (PRM) is well established in Europe and officially recognized by the European Union of Medical Specialists (UEMS). The European PRM Board works to promote patient safety and quality of care through the development of the highest standards of medical training and healthcare across Europe as well as the harmonization of PRM specialists' qualifications. In its Action Plan for 2014-2018, the UEMS PRM Board has included the harmonization of the PRM curriculum among the EU countries, as one of its main goals. Based on a European Directive, the Belgian Superior Council is envisaging a reform of the PRM curriculum. AIM: The aim of this paper is to present the current situation of PRM education in Europe according to the survey carried out by the Belgium Task Force. DESIGN: An online survey was posted on May 3rd 2015 to all delegates of the UEMS PRM Section and Board. Two questions were formulated: 1) What is the duration and curriculum of PRM training in your country? 2) Does a Postgraduate Rehabilitation training exist for other medical specialties? RESULTS: The majority of the PRM training programs in Europe have a duration ranging from 4 to 5 years, and are not aiming at downsizing the duration to the European minimal training period of 3 years. The vast majority (70%) of the responding countries don't offer an additional accreditation of Rehabilitation for other medical specialties CONCLUSIONS: Comparing PRM training programs in Europe can support the long-awaited reform of the PRM postgraduate curriculum in Belgium and gives perspective to agree on a transparent and comparable specialty training throughout Europe. Providing a more comparable training promotes the establishment of PRM and its rehabilitation service provisions in the world.

Since 2009 the Professional Practice Committee of the Physical and Rehabilitation Medicine (PRM) Section of the European Union (EU) of Medical Specialists (UEMS) is producing Position Papers (PPs) on the role of PRM physicians for patients with different health conditions or related topics of PRM Interest. These PPs represent the Official Position of the EU in the specific field. Until now, 16 papers have been produced, recently collected in an e-book (http://issuu.com/parisstylianides/docs/section_of_physical_and_rehabilitat/0). To proceed with the future PPs, the UEMS PRM Section defines with this paper the methodological approach to a PP, so to have a common and validated scientific structure. The final aim is to increase the quality, representativeness and visibility of this production for the benefit of all PRM specialists in (and out) of Europe. The Position Papers must be Evidence Based (EBPP). Therefore it comprises a systematic review as well as a Consensus procedure among the EU Countries delegates. All the sections of an EBPP are presented in details (Title, Authors, Abstract, Introduction, Material and Methods, Results, Discussion, Conclusion). The systematic review must focus on Cochrane reviews, Randomised Controlled Trials and Guidelines of PRM professional practice interest. The Consensus on the recommendations must be reached through a Delphi procedure, usually in four major rounds (each round can have repeated voting). The EBPP must produce Final Recommendations for Physical and Rehabilitation Medicine Professional Practice in Europe. The following overall structure for recommendations is suggested: one overall general recommendation on PRM professional practice; PRM physicians' role in Medical Diagnosis - ICD; PRM diagnosis and assessment according to ICF; PRM process (Project definition, Team, PRM interventions, Outcome criteria, Length and continuity of treatment); future research on PRM professional practice.

Refugees have high rates of mental health morbidity as a result of conflict. However, their needs for mental healthcare and psychosocial support are often unmet, despite the efforts of professional and humanitarian organisations. The war refugee crisis is a global challenge that needs a global solution. We call on all governments, regional and international organisations to take responsible humanitarian actions to intervene and support people affected by these disasters and for all humanity to unite against the forces of injustice and degradation. The thematic papers in this issue report on the Syrian crisis from a variety of perspectives.

The European Society of Physical and Rehabilitation Medicine (ESPRM), together with the European Journal of PRM and the PRM Section and Board of the European Union of Medical Specialists (UEMS), started an action to establish a relationship with Cochrane (formerly the Cochrane Collaboration). Cochrane is a global, independent network of researchers, professionals, patients, carers and people interested in health, with contributors from more than 130 countries. Its aim is to produce credible, accessible health information that is free from any conflicts of interest. Cochrane produces the Cochrane Library, an evidence-based resource that includes today more than 6300 Cochrane systematic reviews. Cochrane is made up of many different review groups and other entities (such as Centres and Branches), distributed around the world, that are mainly focused on specific healthcare problems (diseases, or organs). Inside Cochrane also Fields have been created, that focus on a dimension of health care other than a specific healthcare problem. A Cochrane Field represents a bridge between Cochrane and the stakeholders of the related healthcare area. The medical specialty of PRM is covering a broad medical domain: it deals with function, activities and participation in a large number of health conditions, mostly but not exclusively musculoskeletal, neurological and cardiorespiratory. Consequently, the currently more than 200 existing Cochrane Reviews are scattered among different groups. A PRM Field could greatly serve to the need of the specialty, spreading the actual Cochrane knowledge, focusing needs today not covered by Cochrane Reviews, facing the intrinsic methodological problems of the specialty. This paper introduces a call for the development of a PRM Cochrane Field, briefly reviewing what Cochrane is and how it is organized, defining the value and identifying a pathway toward the development of a PRM Cochrane Field, and finally shortly reviewing the Cochrane reviews of PRM interest.

2nd Congress in Preventive Psychiatry...in April 1992

Abstract: This case concerns three appeals, heard together, which resulted from actions brought by employees who had developed the mesothelioma disease as a result of being exposed at work to asbestos dust. In these actions, the claimants sought compensation against employers who had exposed them to substantial inhalation of asbestos dust or fibres. At first instance, two of the claims were dismissed on the basis that the claimants could not establish, on a balance of probabilities, which of the defendants had exposed the employee to the asbestos dust which caused the disease. In the third case the judge found that, by exposing the claimant to asbestos fibres, the defendant had materially contributed to, and thus caused, the occurrence of mesothelioma. He accordingly apportioned liability between the defendants. The claimants in the first two actions, and the defendants in the third, appealed. Before the Court of Appeal it was common ground that (a) the mechanism initiating the genetic process which culminated in mesothelioma was unknown, (b) the factor triggering off the disease might, with an equal degree of probability, be a single, a few or many fibres, and (c) the condition, once caused, was not aggravated by further exposure – however, the greater the quantity of fibres inhaled the greater the risk of developing the disease. This caused the Court of Appeal to conclude that, since mesothelioma was an indivisible disease triggered on a single unidentifiable occasion by one or more fibres on a single unidentifiable occasion, it could not be proved on a balance of probabilities which period of exposure had caused the disease. The Court accordingly held that the claimant in each case had failed to establish causation against any of the defendants. It accordingly dismissed the appeals in the first two cases and allowed the appeal in the third case. The claimants appealed to The House of Lords, which overturned these decisions. The Law Lords held that, where an employee had been exposed by different defendants, during different periods of employment, to inhalation of asbestos dust, in breach of each defendant's duty to protect him from the risk of contracting mesothelioma, and where that risk had arisen but, in current medical knowledge, the onset of the disease could not be attributed to any particular or cumulative wrongful exposure, a modified approach to proof of causation was justified. In such cases, evidence that each defendant's wrongdoing had materially increased the risk of contracting the disease was sufficient to satisfy the causal requirements for his liability. Accordingly, applying that approach and in the circumstances of each case, the claimants could prove, on a balance of probabilities, the required causal connection to establish the defendants' liability.

The following set of facts formed the basis of the decision of the Austrian OGH: The parties were land owners. Jn 1992 excavation work at the defendant's premises caused damage to the claimant's neighbouring house because inadequate precautions were taken. The amount of the damage (repair costs, reduction in value etc.) came to more than 1.85 million Austrian Schillings. The claimant did not allow the repairs until the day of the decision of the OGII, and also did not claim any advance on the costs from the defendant. He worked from October 1993 with a bank loan, that exceeded the amount of the damages, which attracted interest at a rate higher than the legal rate. In his claim, the claimant sought compensation for his aforementioned damage including the full amount of interest that had accumulated through the delay in payment. The lower courts awarded the claimant his aforementioned damage, but only allowed his claim for interest at the legal rate of 4%. In his application for Revision the claimant sought reimbursement of the sum constituting the difference between the legal rate of interest and the rate that he claimed to have paid.
According to the OGII, a claimant's claim for interest is justified in so far as he has been able to show that he has actually suffered damage in the form of interest payments of the amount claimed during the relevant time period. The issue is one of damage resulting from delay, irrespective of whether the person responsible for payment of compensation was approached for an advance of the costs involved in repairing the damage before credit was obtained or not. This head of damages — which is not limited by § 1333 AGBG — can also be claimed when the person responsible for compensation is liable to pay for the "positive damage" caused by the slight negligence of the tortfeasor. According to § 1298 AGBG it is the defendant who has the burden of pleading and proof of the absence of fault. It is irrelevant whether the claimant has incurred the amount claimed solely in repair costs. A claim is however excluded, because of the disqualification of fictitious repair costs, if it is established that no attempt to repair the damage will (or can) be made at all.
The following authors investigate the issues raised by the decision from the point of view of Austrian, German (Pahlke, Christodoulon), Belgian (Temmerman), and Greek (Christodoulou) law, as well as with reference to the Principles of European Contract Law, the CISG, the Unidroit Principles and the European Parliament and Council Regulation on the Combauing of Late Payments in Commercial Transactions of 29.6.2000.