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To support and facilitate the rehabilitation of patients with physical limitations and aid the therapist, several robotic structures are being studied. Among the structures, the cable-driven robots stand out. The cable-driven robots are structures actuated by cables and have the advantages of being flexible and reconfigurable for each patient. The objective of this paper is to develop a theoretical model for knee flexion/extension force and moment using a cable-driven robot. The proposed model is necessary for elaborating a referential to which diagnosis can be made and the improvement of the patient evaluated. The presented theoretical model was validated through experiments with twelve sedentary and healthy volunteers. The first procedure tested ten subjects in three thigh angles for knee flexion motion; the second procedure tested two subjects in flexion and extension for the same thigh angle. The results show the validity of the model for 88.58% of the tests in an ANOVA analysis with a 99% confidence interval. The similarity of data for different gender, ages, and intrinsic factors was noted, implying that the model is representative and independent of the subject’s individuality. Differences between flexion and extension values were observed, which need to be studied in the future.
Full ‘rehabilitation’ of sick and injured wild animals should include restoration to the wild. Few attempts have been made to discover the fate of released ‘rehabilitated’ animals, a significant omission in terms of animal welfare. They may die, unable to find adequate food or nest sites in unfamiliar places. They may be ostracized or even attacked by wild resident conspecifics.
Eight ‘rehabilitated’ hedgehogs (Erinaceus europaeus) were released into farmland and radio-tracked to monitor their movements and nesting; they were also weighed frequently. Three wild hedgehogs caught on site were studied in parallel.
Only one animal remained close to the release site throughout the eight week study. The rest scattered, perhaps seeking more familiar terrain. One animal died, possibly not having fully recovered from its original disorder. Of the seven others, three survived at least seven weeks, but two then met with accidental deaths (drowning and road kill). Contact was lost with four animals, but circumstances suggested that they were probably still alive at least five weeks after release. There was no evidence of negative interaction with local wild hedgehogs nor any indication of difficulty with foraging, nesting or finding their nests again. Body-weights were generally maintained or increased. It is concluded that rehabilitated adult hedgehogs can probably cope well with release.
The post-release survival of hand-reared tawny owls (Strix aluco) was measured using radio-tracking and leg-band return data. Of 16 birds fitted with 2.4 g radiotelemetry tags, two shed their tags after four and nine days, respectively and one bird was recovered and the tag removed. The remaining 13 birds were tracked for between 16 and 84 days (median 38). Of these, two were found dead (one emaciated and one predated) and one was recovered alive but emaciated and was subsequently euthanased. Thirty-seven percent were radio-tracked for more than six weeks, thought to be the critical period beyond which raptors will mostly survive. Of 112 birds banded between 1995 and 2005, 18 were recovered (seven live and 11 dead). Of the seven live recoveries, three were involved in road traffic collisions. Of the dead recoveries for which the cause of death was known (n = 4), all had been involved in road traffic collisions. The time elapsed between release and recovery ranged from 1–2,246 days (median 123 days). Over 65% survived for more than six weeks. The distance travelled between release and recovery ranged between 0 and 6 km (median 0). Further work is required on the effects of hand rearing on post-release survival of rehabilitated wildlife.
Many juvenile hedgehogs (Erinaceus europaeus) are ‘rehabilitated’ with little or no previous experience of life in the wild. A study is described in which twelve such animals were monitored after release in Devon. They quickly learned their way about, built nests and found them again, and interacted normally with each other and with wild conspecifics. While several showed significant weight loss, this represented only the excess accumulated in captivity. Deaths caused by a predator (badger) and motor cars suggest that captives destinedfor release should not be allowed to become tame and unwary. However, deaths are to be expected in natural circumstances and at least one third of these animals survived beyond the nine-week study, despite having no previous experience of life in the wild. This supports the belief that, although deaths are to be expected, rehabilitating hedgehogs (even naïve juveniles) is possible and worthwhile.
Environmental conditions during the early life stages of birds can have significant effects on the quality of sexual signals in adulthood, especially song, and these ultimately have consequences for breeding success and fitness. This has wide-ranging implications for the rehabilitation protocols undertaken in wildlife hospitals which aim to return captive-reared animals to their natural habitat. Here we review the current literature on bird song development and learning in order to determine the potential impact that the rearing of juvenile songbirds in captivity can have on rehabilitation success. We quantify the effects of reduced learning on song structure and relate this to the possible effects on an individual's ability to defend a territory or attract a mate. We show the importance of providing a conspecific auditory model for birds to learn from in the early stages post-fledging, either via live- or tape-tutoring and provide suggestions for tutoring regimes. We also highlight the historical focus on learning in a few model species that has left an information gap in our knowledge for most species reared at wildlife hospitals.
One commonly used method of managing confiscated wild primates in Latin American countries is to release rehabilitated individuals back to their natural habitats. However, little information has been collected from confiscated animal releases, so no clear guidelines have been developed to measure the success of this type of procedure. In most countries, the collection of critical post-release data is too costly and time-consuming for it to be incorporated into the routine procedures of institutions managing confiscated fauna. Therefore, this project was carried out in conditions similar to those of other Colombian and Latin American rehabilitation centres. A group of eight confiscated and rehabilitated brown capuchin monkeys (Cebus apella) was released in Los Llanos Orientales in Colombia, and monitored for 6.5 months to determine their adaptation and survival after release. Results were analysed according to how the animals adapted to their new environment in terms of foraging, feeding, locomotion, sleeping, social interactions between the group and with other animals and species, prédation, orientation, and establishment of a territory. The results show that the short-term adaptation and survival of the group 6.5 months after release was successful. Five of the eight animals remained together, two separated, and only one was lost during the first month. Implications for animal well-being are discussed.
There is growing interest in and support for the development of disease prevention measures in free-living wildlife and for the rescue, treatment and rehabilitation of wild animals that are sick and injured. In some cases these endeavours may be of importance to the conservation of populations but frequently they are undertaken for welfare rather than conservation reasons. There are circumstances in which wildlife welfare can be improved by therapeutic intervention but the difficulties, and their potentially harmful consequences, should not be underestimated. Interventions for the welfare of free-living wild animals whose fate we control or influence and which are therefore, to some extent, under our stewardship, are consistent with the tradition of humanity for and stewardship of domesticated or captive animals. However, it is suggested here that the decision to treat sick or injured free-living wild animals should not be based on welfare grounds alone.
The fate of rescued hedgehogs (Erinaceus europaeus) released back to the wild has now been the subject of several follow-up studies. Although subject to various hazards, released hedgehogs have clearly shown essential ‘life-skills’. However, all previous studies have involved releases into hedgehog-rich areas and the observed long-range (> 500m) dispersal movements shown by some subjects, of up to 5km, may be a consequence of local intraspecific competition. This study has reduced a number of potentially confounding subject variables and provides follow-up data on 12 age-matched female hedgehogs with similar histories. A main group (n = 10) was released into a rural woodland area (Surrey, UK) of low natural hedgehog density, and radio-tracked for up to 108 days. A pilot release of two animals in an urban area with an established hedgehog population also took place (tracked for 109 and 131 days respectively). Most of the main group dispersed (up to 3km) from the release site; the two animals in the urban site did not. These data, taken with those from previous studies, suggest that dispersal is not specifically the result of intraspecific competition. Overall survival at week 8 was 42per cent (5 hedgehogs) plus two lost animals. This is comparable with previous studies. However, survival fell to 25 per cent (3 animals) plus two lost animals by week 15. Of seven recorded deaths, only one was the result of a failure to thrive and all other mortalities were accidental: four road deaths, one drowned in a pond and one predation. The study concludes that the hazards of the human environment were the principal threat to the welfare and survival of released hedgehogs in the area.
In Britain large numbers of animals are taken into captivity for treatment or care and then subsequently returned to the wild, but there are few data on the effectiveness of these rehabilitation programmes. In this study, over a period of four years 251 fox cubs that had been captive-reared were tagged and released; 90 were recovered. Survival rates were low, and road traffic accidents were found to be a major cause of mortality immediately following release. Recovery distances were lower than expected. The stress associated with captive-rearing meant that released foxes weighed less than wild-reared foxes, and they suffered further weight loss in the period immediately following release, even though an analysis of the stomach contents of animals recovered dead showed that released foxes rapidly learnt to hunt successfully.
It was concluded that captive-rearing is a problematic process for foxes, and contrary to predictions they face severe problems in adapting following release. Suggestions are made for the improvement of fox captive-rearing and release programmes, and the need for similar studies on other species is highlighted.
Of the wildlife casualties admitted to rehabilitation centres in England, less than half are subsequently released back into the wild. If the factors associated with survival within rehabilitation centres can be determined, they may be used to focus efforts on individuals with high chances of successful recovery, and thus improve welfare by devoting resources to those animals that are more likely to benefit. We analysed the medical record cards of eight species admitted to four wildlife rehabilitation centres run by the Royal Society for the Prevention of Cruelty to Animals between 2000-2004 to determine those factors that affected the chance of survival in care until release, and whether trends in predictive factors occurred across taxonomic groups. We found that the most important predictive factor, across all species, was the severity of the symptoms of injury or illness. Factors commonly used as important indicators of rehabilitation success in published practice guidelines, such as mass and age, were not found to affect survival significantly. Our results highlight the importance of triage based on clinical diagnosis as soon as a wildlife casualty is admitted, and indicate that although the ethos of many rehabilitation centres is to attempt the treatment of all wildlife casualties, the attempted treatment of those with severe injuries may be adversely affecting welfare by prolonging suffering.
The release of animals from captivity frequently leads to a period of erratic movement behaviour which is thought to expose the animal to a high risk of mortality. Twenty-six foxes which had been reared at a wildlife hospital or captive-bred, were radio-collared when nearly full-grown and released without site acclimation. Immediately after release there was an erratic phase of behaviour, during which the foxes travelled widely and movement parameters were markedly elevated. For those foxes which survived, a second phase was entered after an average of 17.2 days, during which one small area only was used, and movement parameters were much reduced. In a second study, nine foxes were released following site acclimation in a pre-release pen; this process postponed but did not eliminate the phase of high movement activity.
This pattern of movement was compared with the dispersal behaviour of wild-reared foxes. It was concluded that released foxes, despite being proficient in other aspects of behaviour, were moving and behaving in a markedly abnormal manner and this resulted in a high death rate. The results are used to discuss methods of improving rehabilitation techniques.
If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on “common mental disorders” and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment.
Methods
The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued.
Results
A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant (p = 0.14). Intervention patients returned to their workplace earlier than patients in the control group (p = 0.040).
Conclusions
The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement.
This study explored non-specialist audiological clinical practice in the context of traumatic brain injury (TBI), and whether such practices incorporated considerations of TBI-related complexities pertaining to identification, diagnosis and management of associated auditory and vestibular disturbances.
Design:
A cross-sectional online survey exploring clinical practice, TBI-related training and information provision was distributed to audiologists across Australia via Audiology Australia and social media. Fifty audiologists, 80% female and 20% male, participated in this study. Years of professional practice ranged from new graduate to more than 20 years of experience.
Results:
Clear gaps of accuracy in knowledge and practice across all survey domains relating to the identification, diagnosis and management of patients with auditory and/or vestibular deficits following TBI were evident. Further, of the surveyed audiologists working in auditory and vestibular settings, 91% and 86%, respectively, reported not receiving professional development for the diagnosis and management of post-traumatic audio-vestibular deficits.
Conclusion:
Inadequate resources, equipment availability and TBI-related training may have contributed to the gaps in service provision, influencing audiological management of patients with TBI. A tailored TBI approach to identification, diagnosis and management of post-traumatic auditory and vestibular disturbances is needed.
Asiatic black bears (Ursus thibetanus) face chronic stress in bile farms. In this study, we investigated whether bile-farmed bears show significantly high levels of stress at rescue and whether stress levels reduce over time in a bear sanctuary where the bears are supported with environmental enrichment and veterinary care to improve animal welfare. We measured stress hormone levels using faecal cortisol metabolites (FCM) in 16 Asiatic black bears freshly rescued from bile farms in Vietnam. Fresh faeces were collected from each bear on the rescue truck and on a weekly basis for a 22-week study period at a bear sanctuary in Vietnam. Results showed that for all 16 rescued bears (with one exception) individual FCM levels from truck samples were above mean baseline FCMs of bears previously rehabilitated to a bear sanctuary. This suggested the majority of the rescued bears were still capable of showing a stress endocrine response during the rescue operation despite being exposed to conditions causing chronic stress in bears on bile farms. Results showed that mean FCM levels of the rescued bears differed significantly between time-periods (higher at the rescue [on truck samples] compared to week 22 samples) and mean FCM levels showed an overall decline over the first 22 weeks after they arrived at the bear sanctuary. The bears also demonstrated acute FCM stress responses to management interventions at the sanctuary, such as veterinary health checks and transportation. In conclusion, rescued bears tend to modulate their stress endocrine response after rehoming at the bear sanctuary. This is an important result, indicating that the rescue effort and rehabilitation of bile-farm bears is effective. Whether this also coincides with behavioural adjustments in rehabilitating bears (eg lessening of stereotypic behaviour) warrants further investigation.
Each year, worldwide, large numbers of wild animals are taken to rehabilitation centres for treatment, care and release. Although analysis of intake records may provide valuable insight into the threats and impacts to wildlife, there are few such published reports. Four years of intake records from a large urban rehabilitation centre in South Africa were examined for trends. Animal intake rate was high (2,701 [± 94] per annum). Most of the intake (90%) was birds, with few mammals (8%) and reptiles (2%), and most of these were of locally common species (eg doves, pigeons). This reflects the findings of other studies, namely that species living in close association with humans are the most frequently admitted to rehabilitation centres. In total, most of the animals admitted (43%) were juveniles, which were assumed to be abandoned or orphaned. The implications of then rehabilitating these juveniles, which were largely uninjured, are three-fold: should humans be interfering with nature if the cause was not human-related, can each juvenile (especially in these large numbers) be adequately prepared to survive and thrive when released into the wild, and is there space in the environment for them, without causing harm to others already in the environment. This study suggests that the large numbers of animals currently being admitted to the centre may be reduced, possibly through increased public education; in particular to leave uninjured juveniles in the wild. Furthermore, improvements in the centre's recording system may allow for use in funding requests and various research opportunities.
Although bats are frequently admitted to rescue centres — mainly as orphans — very little information is available on their survival after release. Our study answered the following questions: i) do hand-reared bats survive over a short time; ii) which activities and habitat selection do they exhibit; iii) are bats loyal to the release area; and iv) are they able to join local colonies? We radio-tracked 21 hand-reared Pipistrellus kuhlii over a two-year period released on a site that differed from that where they were rescued. At the study site they were provided with the same bat boxes used in the rehabilitation room. Nineteen bats were confirmed to survive, stay in the area and actively forage over 4-14 days. Fourteen day roosts in buildings (nine of which hosted a local colony) were used by 12 subjects. Bats travelled less than 5 km in total each night; their most frequent activity was night roosting, followed by foraging and commuting. We recorded typical foraging behaviour, including hunting around street lamps at sites exploited by many conspecifics. A comparison of habitats available within individual home ranges with those within the study area showed that urban areas, riparian vegetation and farmland were equally important and preferred to woodland. When the foraging time spent in each habitat was compared with habitat composition within individual home ranges or within the study area, urban sites were preferred for foraging over all other habitats, followed by farmland and woodland and finally riparian vegetation. Overall, we showed that hand-raised orphaned P. kuhlii may readily adapt to environments they are not familiar with, exhibit a high short-term survival and select key resources in the release area, provided appropriate rehabilitation and training techniques are adopted.
This study evaluates the methods utilised to release and monitor three troops of rehabilitated vervet monkeys (Chlorocebus aethiops) in South Africa. In all cases, monitoring was poor and conducted over a short time-frame disallowing release outcomes to be fully assessed. Wild troops were present at two of the three locations, casting doubt upon sightings of released monkeys and indicating that the release sites chosen were unsuitable and presented disease risks to the wild vervets. Eighty-three percent of monkeys were unaccounted for at the end of monitoring. Any future releases should make use of radio or GPS collars to track the monkeys, have a planned monitoring schedule covering a period of at least one year, collect detailed data on behaviour, demographics and ecology and should follow the IUCN Guidelines for Non-Human Primate Re-introductions.
The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients’ ability to participate in work and social life and improving collaborative patient-clinician relationships.
Method:
The self- and observer ratings of capacity limitations in a sample of N = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S).
Results:
Paired-samples t-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions adherence to regulations, planning and structuring of tasks, professional competency and endurance as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of contact with others and self-care were only marginally higher than the observer ratings.
Conclusions:
The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.
Chapter 1 examines the construction of large-scale national systems for rehabilitating the war disabled, which began in the final months of 1914, with the establishment of the first wartime institutions for vocational re-education, and grew, over the course of the conflict, to include administrative bodies, organisational structures, and legal frameworks for the provisioning of care. They were constantly retooled and restructured in order to make them more efficient and more responsive to the needs of nations at war. By 1918, they had become remarkably sophisticated and, moreover, strikingly similar to one another – the result of a dedicated transnational movement of people and ideas and of a shared aim. This unity of purpose, however, did not exclude revisionist interpretations of rehabilitation programmes that overstressed their dissimilarities and imagined such systems – and the men they served – as nationally or ethnically particular nor did it resolve tensions between competing ideas about care, philanthropy, and the state.
Chapter 2 investigates the development of a transnational Allied culture of rehabilitation that underwrote local and national efforts to rehabilitate the war disabled. Military and government officials, social reformers, philanthropists, and medical authorities contributed, throughout the war, to a robust, multi-directional campaign that championed the virtues of rehabilitation and solicited support for programmes that aimed to fit the war disabled into post-war society. Such literature became, itself, a way to imagine the contours of the post-war world with respect to hierarchies of gender and class and the roles of religion, science, rights, and internationalism. The co-constructed nature of the wartime culture of rehabilitation, in which images and rhetoric were frequently borrowed and re-circulated amongst nations, served to harmonise – though not entirely homogenise – Allied visions for rehabilitation and for social rights and welfare, more broadly.