What is 'successful rehabilitation'? A multi-stakeholder nominal group technique study to inform rehabilitation outcome measurement

OBJECTIVE

To explore how stakeholders in rehabilitation conceptualise 'successful rehabilitation', to inform the development of a minimum dataset and core outcomes for sub-acute rehabilitation.

DESIGN

Qualitative consensus study using the nominal group technique.

SETTING

Online focus groups.

PARTICIPANTS

Consumer representatives (n = 7), clinicians (n = 15), and health service managers (n = 9) from Australia.

INTERVENTION

Participants responded to the question, 'What does successful rehabilitation look like?'. Following item generation, they prioritised their top five responses, allocating 100 points across items to denote relative importance.

MAIN MEASURES

Prioritised responses were analysed across stakeholder groups using qualitative content analysis.

RESULTS

Ten themes were identified. 'Successful rehabilitation' is: (1) person and family centred; (2) effective; (3) inter-professional; (4) accessible; (5) goal oriented with meaningful outcomes; (6) connected to the continuum of care; (7) evidence-based and supportive of innovation and research; (8) appropriately funded and skilled; (9) satisfying and engaging; and (10) safe.

CONCLUSIONS

Stakeholder-defined 'successful rehabilitation' aligned with principles of value-based care and evidence-based rehabilitation. Provision and receipt of person and family centred care was the most important indicator of successful rehabilitation. Measures of success should include indicators of structure, process, outcome, and experience, and be conducted at multiple time-points.

CircRNA_103801 accelerates proliferation of osteosarcoma cells by sponging miR-338-3p and regulating HIF-1/Rap1/PI3K-Akt pathway

This study aimed to investigate the roles of hsa_circRNA_103801 in the progression of osteosarcoma (OS) cells. Quantitative reverse transcription-polymerase chain reaction (RT-qPCR) was used to detect the expression level of circRNA_103801 in OS cells. Cell count kit-8 and Transwell migration and invasion assays were employed to detect the proliferation, migration, and invasion abilities of OS cells. The effects of circRNA_103801 on the apoptosis of OS cells were identified by flow cytometry. The binding relationship between circRNA_103801 and miR-338-3p was verified by bioinformatics analysis. MiR-338-3p level in OS cell lines was detected by RT-qPCR. Additionally, Western blotting was utilized to detect the expression levels of HIF-1, Rap1, PI3K, and Akt in OS cells. The results showed that the expression level of circRNA_103801 was significantly up-regulated in OS patients' tissues. Inhibiting the expression level of circRNA_103801 could attenuate the proliferation, migration, and invasion abilities of OS cells. In addition, the down-regulated expression level of circRNA_103801 could induce cell apoptosis. The results of the luciferase reporter assay suggested that circRNA_103801 could be combined with miR-338-3p, and the RT-qPCR revealed that the miR-338-3p level in OS cells after knockdown of circRNA_103801 was elevated compared with the control group. The results of Western blotting suggested that the expression levels of HIF-1, Rap1, PI3K, and Akt were elevated in OS cells. In conclusion, the circRNA_103801-miR-3388-3p-HIF-1/Rap1/PI3K-Akt pathway could be a therapeutic target of OS.

Development of microsatellite loci for Taxus wallichiana var. wallichiana (Taxaceae) and cross-amplification in Taxaceae

Nine polymorphic microsatellite loci were isolated and characterized in Taxus wallichiana var. wallichiana, an endangered species in China. The number of alleles per locus ranged from 2 to 20. Observed and expected heterozygosities varied from 0.0260 to 0.5325 and 0.3603 to 0.9231, respectively. Positive cross-amplification of the 9 loci was observed in 2 other varieties of T. wallichiana and 4 other Taxaceae species. These loci will be of value for studying population genetic structures and for genetic resource conservation in T. wallichiana and other Taxus species.

Local steroid injection: its effect on the recovery of nerve conduction in experimental neuropathy

This study was designed to investigate the effectiveness of local steroid injection on the recovery of nerve conduction in acute compression neuropathy. Experimental neuropathy with complete conduction block was produced by mechanical compression of the caudal nerves of 24 rats. Five days after compression, the compression site was injected with 0.2 mL Dexamethasone acetate (8 mg/mL suspension) in eight rats (group A), and 0.2 mL normal saline in another eight rats (group B). The remaining eight rats (group C) received no injection. Motor nerve conduction velocity (NCV) over the compressed segment, as well as amplitude of the evoked compound muscle action potential (CMAP) recorded from the segmental tail muscles, were measured before nerve compression and three times per week after nerve compression. The recovery rates of NCV of the caudal nerve were not significantly different among the three groups. The recovery rate of amplitude of CMAP in group A was significantly higher than that in groups B or C (p less than 0.01). However, there was no significant difference in recovery rate of the amplitude of CMAP between groups B and C. It is concluded that local steroid injection to the site of nerve compression may facilitate the recovery of nerve conduction block but not the recovery of demyelinative lesion.