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      Revisión sistemática sobre modelos de rehabilitación con víctimas de Minas Antipersonal (MAP), en el marco de conflictos armados y el enfoque comunitario Translated title: Systematic Review on Models of Rehabilitation with Antipersonnel Landmine Victims (ALM), in the Framework of Armed Conflicts and Community Approach

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          Abstract

          Resumen El propósito del artículo consiste en identificar estrategias de rehabilitación implementadas en pacientes con amputación o lesiones asociadas a sucesos traumáticos, en el marco de conflictos armados y modelos innovadores de rehabilitación con enfoque comunitario. Se realizó un análisis bibliométrico mediante un software de vigilancia tecnológica, para luego proceder a una revisión sistemática de literatura científica. Los resultados señalan las tendencias del periodo 2000-2017, a partir de estudios de caso en diferentes contextos de guerra; por lo cual, se analizaron modelos de rehabilitación relacionados con aprendizaje pedagógico, tratamientos especializados en realidad virtual y funcionamiento en comunidad.

          Translated abstract

          Abstract The purpose of the article is to identify rehabilitation strategies implemented in patients with amputation or injuries associated with traumatic events, in the framework of armed conflicts and innovative models of rehabilitation with community approach. A bibliometric analysis was carried out by means of a technological surveillance software, and, then, a systematic review of scientific literature was conducted. The results show the trends of the 2000-2017 period, based on case studies in different war contexts. Therefore, rehabilitation models related to pedagogical learning, specialized treatments in virtual reality, and community functioning were analyzed.

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          Predictors of quality of life among individuals who have a lower limb amputation.

          The purpose of this study was to identify factors that predict an individual's subjective quality of life (QoL) after having a lower limb amputation. Cross-sectional descriptive study design. A total of 415 unilateral, above knee (27.0%) and below knee (73.0%) amputees with an average age of 61.9 years (SD = 15.7) who had lost their limb related to vascular (53.0%) or non-vascular (47.0%) etiology. Medical chart review, questionnaires (Frenchay Activities Index, Interpersonal Support Evaluation List, the Center for Epidemiology Studies - Depression scale, Prosthetic Evaluation Questionnaire mobility subscale, and the Activities-specific Balance Confidence Scale) and a QoL Visual Analogue Scale were assessed using multiple linear regression analysis. The analysis revealed seven significant factors (depression, perceived prosthetic mobility, social support, comorbidity, prosthesis problems, age and social activity participation) as predictors of subjects' perceived QoL. Depression explained 30% of the variation, while the full model explained 42% of the variation. Several modifiable characteristics influence QoL after lower limb amputation including depression and participation in daily living. This finding suggests the importance of addressing individuals' affective status to regain or maintain QoL.
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            Use and satisfaction with prosthetic devices among persons with trauma-related amputations: a long-term outcome study.

            To document and examine the use, satisfaction, and problems with prosthetic devices among persons who suffered a trauma-related lower limb amputation. Abstracted medical records and follow-up interview data were collected for a retrospective cohort of persons with a lower limb trauma-related amputation who received their acute care at the University of Maryland R. Adams Cowley Shock Trauma Center, Baltimore, MD, between 1984 and 1994. Patients with spinal cord injury, traumatic brain injury, or only toe amputations were excluded. There were 146 patients identified. Of those, 9% died during the acute admission and 3.5% died after discharge. Seventy-eight amputees were available for interview (68% response rate). The majority of those interviewed were male (87%), and two-thirds had undergone amputation before age 40 yr. Nearly 95% had a prosthesis and wore it an average of 80 hr (SD = 33) per week. Despite high use, only 43% reported being satisfied with the comfort of their prosthesis. About one-quarter of all users reported problems with wounds, skin irritation, or pain. Traumatic amputees used an average of four prostheses since injury, about one new prosthesis every 2 yr. Statistical analyses revealed that males reported higher prosthetic use (P < 0.01). Higher Injury Severity Score negatively impacted on prosthetic use (P < 0.01). Phantom pain negatively influenced reported satisfaction with the prosthesis (P < 0.03) Although almost all persons living with trauma-related amputations use prosthetic devices, the majority are not satisfied with prosthetic comfort. Phantom pain and residual limb skin problems are also common afflictions in this population.
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              Rebuilding community resilience in a post-war context: developing insight and recommendations - a qualitative study in Northern Sri Lanka

              Background Individuals, families and communities in Northern Sri Lanka have undergone three decades of war trauma, multiple displacements, and loss of family, kin, friends, homes, employment and other valued resources. The objective of the study was understanding common psychosocial problems faced by families and communities, and the associated risk and protective factors, so that practical and effective community based interventions can be recommended to rebuild strengths, adaptation, coping strategies and resilience. Methods This qualitative, ecological study is a psychosocial ethnography in post-war Northern Sri Lanka obtained through participant observation; case studies; key- informant interviews; and focus groups discussions with mental health and psychosocial community workers as well as literature survey of media and organizational reports. Qualitative analysis of the data used ethnography, case studies, phenomenology, grounded theory, hermeneutics and symbolic interactionism techniques. Quantitative data on suicide was collected for Jaffna and Killinochchi districts. Results Complex mental health and psychosocial problems at the individual, family and community levels in a post-war context were found to impair recovery. These included unresolved grief; individual and collective trauma; insecurity, self-harm and suicides; poverty and unemployment; teenage and unwanted pregnancies; alcoholism; child abuse and neglect; gender based violence and vulnerability including domestic violence, widows and female headed-household, family conflict and separation; physical injuries and handicap; problems specific for children and elderly; abuse and/or neglect of elderly and disabled; anti-social and socially irresponsible behaviour; distrust, hopelessness, and powerlessness. Protective factors included families; female leadership and engagement; cultural and traditional beliefs, practices and rituals; and creative potential in narratives, drama and other arts. Risk factors that were impeding community rehabilitation and recovery included continuing military governance, depletion of social capital particularly lack of trust, hope and socio-economic opportunity structures for development that would engender a sense of collective efficacy. Conclusions In view of the widespread trauma at the individual, family and collective levels, community based programmes to increase local awareness, knowledge and skills to deal with common mental health and psychosocial issues; and training of community level workers and others in basic mental health and psychosocial problem solving are recommended to rebuild family and community agency and resilience. The use of cultural practices and school based programmes would rekindle community processes.
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                Author and article information

                Journal
                agor
                El Ágora U.S.B.
                Ágora U.S.B.
                Universidad de San Buenaventura (Medellin, Antioquia, Colombia )
                1657-8031
                December 2021
                : 21
                : 2
                : 771-793
                Affiliations
                [1] Santander orgnameUniversidad Industrial de Santander Colombia ruzarate@ 123456uis.edu.co
                [3] Santander orgnameUniversidad Industrial de Santander Colombia catalina2168712@ 123456correo.uis.edu.co
                [2] Santander orgnameUniversidad Industrial de Santander Colombia clalogu@ 123456uis.edu.co
                Article
                S1657-80312021000200771 S1657-8031(21)02100200771
                10.21500/16578031.5882
                2b8e75d6-e5ca-4999-a531-cb812ad133fd

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : March 2021
                : November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 63, Pages: 23
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                SciELO Colombia

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Artículos derivados de investigación

                Víctimas,Victims,revisión sistemática, conflicto armado.,rehabilitación,minas antipersonales,Antipersonnel Landmines, Rehabilitation, Systematic Review, and Armed Conflict.

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