Journal articles on the topic 'Asthma Victoria'

Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable ifpreventive care and early disease management are applied, usually in the ambulatory setting. The Victorian ACSCs study offers a new set of indicators describing differentials and inequalities in access to the primary healthcare systemin Victoria. The study used the Victorian Admitted Episodes Dataset (1999-2000) for analysing hospital admissions for diabetes complications, asthma, vaccine preventable influenza and pneumococcal pneumonia. The analyses were performed at the level of Primary Care Partnerships (PCPs). There were 12 100 admissions for diabetes complicationsin Victoria. There was a 12-fold variation in admission rates for diabetes complications across PCPs, with 13 PCPs having significantly higher rates than the Victorian average, accounting for just over half of all admissions (6114) and39 per cent total bed days. Similar variations in admission rates across PCPs were observed for asthma, influenza and pneumococcal pneumonia. This analysis, with its acknowledged limitations, has shown the potential for using theseindicators as a planning tool for identifying opportunities for targeted public health and health services interventions in reducing demand on hospital services in Victoria.

Introduction:On November 21 and 22 of 2016, Victoria witnessed an unprecedented epidemic thunderstorm asthma emergency event in size acuity and impact. This scenario was never exercised nor contemplated. The event resulted in a 73% increase in calls to the Emergency Services Telecommunications Authority and 814 ambulance cases in the six hours from 6 pm on November 21, 2016. A 58% increase in people presented to public hospital emergency departments in Melbourne and Geelong on November 21 and 22, 2016 (based on the three-year average). 313 calls were made to the nurse on call from people with breathing, respiratory, and allergy problems (compared to an average of 63 calls for the previous month). Tragically, ten deaths are linked to this event.Methods:A substantial amount of work has been completed, much of which goes towards addressing the Inspector-General for Emergency Management recommendations following a review of the event, including: Release of an epidemic thunderstorm asthma campaign and education programs which were rolled out across Victoria for the community and health professionals from September through November 2017;Development of a new epidemic thunderstorm asthma forecasting system on 1 October 2017 and updated warning protocols during the 2017 grass pollen season;Implementation of a Real-time Health Emergency Monitoring System to alert the department of demands on public hospital emergency departments on the system; andIntroduction of a new State Health Emergency Response Plan in October 2017 to improve coordination and communications before and during a health emergency.Discussion:The presentation will concentrate on the lessons learned more than two years down the track from the event in November 2016.

Asthma is a national health priority area in Australia, and there is significant interest in capturing relevant detail about hospitalisations as a result of asthma. A public submission received by the National Centre for Classification in Health from a large teaching hospital in Victoria suggested that current classification terminology in ICD-10-AM did not adequately reflect the terms recorded in clinical inpatient records, and that patterns and severity of asthma better reflected current clinical terminology in Australian hospitals. The purpose of this study was to determine the validity of the public submission and inform future changes to ICD-10-AM. A representative sample of over 3000 asthma records across Australia and New Zealand were extracted, and the asthma terminology documented and codes assigned were recorded and analysed. The study concluded that there was little support for either pattern terminology or the current classification terminology; however, severity of asthma was commonly used in asthma documentation.

Epidemic thunderstorm asthma (ETA) is an emerging public health threat in Australia, highlighted by the 2016 event in Melbourne, Victoria, that overwhelmed health services and caused loss of life. However, there is limited understanding of the regional variations in risk. We evaluated the public health risk of ETA in the nearby state of Tasmania by quantifying the frequency of potential ETA episodes and applying a standardized natural disaster risk assessment framework. Using a case–control approach, we analyzed emergency presentations in Tasmania’s public hospitals from 2002 to 2017. Cases were defined as days when asthma presentations exceeded four standard deviations from the mean, and controls as days when asthma presentations were less than one standard deviation from the mean. Four controls were randomly selected for each case. Independently, a meteorologist identified the dates of potential high-risk thunderstorm events. No case days coincided with thunderstorms during the study period. ETA was assessed as a very low risk to the Tasmanian population, with these findings informing risk prioritization and resource allocation. This approach may be scaled and applied in other settings to determine local ETA risk. Furthermore, the identification of hazards using this method allows for critical analysis of existing public health systems.

Background: An important component of asthma care is understanding potential causes of high asthma admissions (HAADs) or readmissions (HARDs) with potential of risk mitigation. Crucial to this research is accurately distinguishing these events from background seasonal changes and time trends. To date, classification methods have been based on ad hoc and untested definitions which may hamper understanding causes of HAADs and HARDs due to misclassification. The aim of this article is to introduce an easily applied robust statistical approach, with high classification accuracy in other settings—the Seasonal Hybrid Extreme Studentized Deviate (S-H-ESD) method. Methods: We demonstrate S-H-ESD on a time series between 1996 and 2009 of all daily paediatric asthma hospital admissions in Victoria, Australia. Results: S-H-ESD clearly identified HAADs and HARDs without applying ad hoc classification definitions, while appropriately accounting for seasonality and time trend. Importantly, it was done with statistical testing, providing evidence in support of their identification. Conclusion: S-H-ESD is useful and statistically appropriate for accurate classification of HAADs and HARDS. It obviates ad hoc approaches and presents as a means of systemizing their accurate classification and detection. This will strengthen synthesis and efficacy of research toward understanding causes of HAADs and HARDs for their risk mitigation.

AbstractA major thunderstorm asthma epidemic struck Melbourne and surrounding Victoria, Australia, on 21 November 2016, which led to multiple deaths, a flood of residents seeking medical attention for respiratory problems, and an overwhelmed emergency management system. This case day had all the classic ingredients for an epidemic, including high rye grass pollen concentrations, a strong multicellular thunderstorm system moving across the region, and a large population of several million people in the vicinity of Melbourne. A particular characteristic of this event was the strong, gusty winds that likely spread the pollen grains and/or allergenic contents widely across the region to increase population exposure. This exploratory case study is the first to examine the usefulness of low-to-middle-atmospheric thermodynamic information for anticipating epidemic thunderstorm asthma outbreaks by allowing the forecast of strong downdraft winds. The authors investigated the utility of several mesoscale products derived from atmospheric soundings such as downdraft convective available potential energy (DCAPE) and indices for predicting surface wind gusts such as microburst wind speed potential index (MWPI) and a wind gust index (GUSTEX). These results indicate that DCAPE levels reached “high” to “very high” thresholds for strong downdraft winds in the lead-up to the thunderstorm, and the MWPI and GUSTEX indices accurately predicted the high maximum surface wind observations. This information may be useful for diagnostic and prognostic assessment of epidemic thunderstorm asthma and in providing an early warning to health practitioners, emergency management officials, and residents in affected areas.

Background Asthma is a chronic respiratory disorder that requires long-term pharmacotherapy and patient empowerment to manage the condition and recognize and respond to asthma exacerbations. Mobile health (mHealth) apps represent a potential medium through which patients can improve their ability to self-manage their asthma. Few studies have conducted a systematic evaluation of asthma mobile apps for quality and functionality using a validated tool. None of these reviews have systematically assessed these apps for their content and evaluated them against the available international best practice guidelines. Objective The objective of this study is to conduct a systematic search and evaluation of adult-targeted asthma mHealth apps. As part of this review, the potential of an mHealth app to improve asthma self-management and the overall quality of the app will be evaluated using the Mobile App Rating Scale framework, and the quality of the information within an app will be evaluated using the current Global Initiative for Asthma guidelines as a reference. Methods A stepwise methodological approach was taken in creating this review. First, the most recent Global Initiative for Asthma guidelines were independently reviewed by 2 authors to identify key recommendations that could be feasibly incorporated into an mHealth app. A previously developed asthma assessment framework was identified and was modified to suit our research and ensure that all of these identified recommendations were included. In total, 2 popular app stores were reviewed to identify potential mHealth apps. These apps were screened based on predefined inclusion and exclusion criteria. Suitable apps were then evaluated. Technical information was obtained from publicly available information. The next step was to perform an app quality assessment using the validated Mobile App Rating Scale framework to objectively determine the quality of an app. App functionality was assessed using the Intercontinental Medical Statistics Institute for Health Informatics Functionality Scoring System. Finally, the mHealth apps were assessed using our developed checklist. Results Funding has been received for the project from the Respiratory Department at Northern Health, Victoria. Three reviewers have been recruited to systematically evaluate the apps. The results of this study are expected in 2022. Conclusions To our knowledge, this review represents the first study to examine all mHealth apps available in Australia that are targeted to adults with asthma for their functionality, quality, and consistency with international best practice guidelines. Although this review will only be conducted on mHealth apps available in Australia, many apps are available worldwide; thus, this study should be largely generalizable to other English-speaking regions and users. The results of this review will help to fill gaps in the literature and assist clinicians in providing evidence-based advice to patients wishing to use mHealth apps as part of their asthma self-management. Trial Registration PROSPERO 269894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269894 International Registered Report Identifier (IRRID) PRR1-10.2196/33103

Abstract. We present the first representation of grass pollen in a 3-D dispersion model in Australia, tested using observations from eight counting sites in Victoria. The region's population has high rates of allergic rhinitis and asthma, and this has been linked to the high incidence of grass pollen allergy. Despite this, grass pollen dispersion in the Australian atmosphere has not been studied previously, and its source strength is untested. We describe 10 pollen emission source methodologies examining the strengths of different immediate and seasonal timing functions, and the spatial distribution of the sources. The timing function assumes a smooth seasonal term, modulated by an hourly meteorological function. A simple Gaussian representation of the pollen season worked well (average r=0.54), but lacked the spatial and temporal variation that the satellite-derived enhanced vegetation index (EVI) can provide. However, poor results were obtained using the EVI gradient (average r=0.35), which provides the timing when grass turns from maximum greenness to a drying and flowering period; this is due to noise in the spatial and temporal variability from this combined spatial and seasonal term. Better results were obtained using statistical methods that combine elements of the EVI dataset, a smooth seasonal term and instantaneous variation based on historical grass pollen observations (average r=0.69). The seasonal magnitude is inferred from the maximum winter-time EVI, whereas the timing of the season peak is based on the day of the year when the EVI falls to 0.05 below its winter maximum. Measurements are vital to monitor changes in the pollen season, and the new pollen measurement sites in the Victorian network should be maintained.

To explore the pattern and prevalence of inpatient psychiatricmorbidity and to see how it differs from the pattern of psychiatric morbidity in community. Design: The details of all inpatients from the case register developed for a health information system was included in study Setting: In Departmentof Psychiatry and Behavioral Sciences, Bahawal Victoria Hospital, Bahawalpur. Period: From 1998-2003. Results: Atotal of 5426 patients were admitted in the six year. There was a slight difference of 0.8% in total number of males andfemales cases (i.e., 2764 males Vs 2662 females). Overall difference reported in the present study, in mean ages ofmales and females was 3.45 years (i.e., males = 31.85 Vs females = 28.40). Mean stay of patients in ward is 10-12days. Most patients were admitted with Conversion disorder 24% followed by Schizophrenia 23%, Depressive disorder20%, Drug Dependence 10%, Bipolar Disorder 7%. The patients with Neurotic Disorder and Organic Disorder werebelow 5%. Conclusion: The study showed that overall general pattern of inpatient psychiatric morbidity is in line withpattern of psychiatric morbidity in community and the partial variance can be explained in terms of social variables, asthis variance exist even across studies within community samples.

Purpose: To investigate the factors associated with underperformance and the subsequent changes in training characteristics and supportive actions when returning to the world’s best cross-country skier. Methods: The participant is the most decorated winter Olympian, with 8 Olympic gold medals, 18 World Championship titles, and 114 World Cup victories. Training data were categorized by training form (endurance, strength, and speed); intensity (low, moderate, and high); and mode (running, cycling, and skiing/roller skiing). In addition, test data were retrospectively analyzed, and interviews were performed with the participant and her support team. Results: After the competitive season, the participant had 8 weeks without systematic training and an evaluation process aiming to detect the factors contributing to underperformance. Here physiological, technical, and psychological challenges were detected. As a consequence, the participant included less high-intensity training (1.2 vs 2.1 sessions/wk, P = .011); more moderate-intensity training (0.9 vs 0.4 sessions/wk, P = .016); and more low-intensity training (6.9 vs 5.9 sessions/wk, P = .036) during the general preparation phase but with similar total endurance training load as previous season. In addition, more strength training (1.6 vs 1.1 h/wk, P = .036) and new ski-specific strength exercises were included. Finally, the athlete’s autonomy when planning and adjusting training was increased, nontraining stressors were reduced, more frequent testing was included, systematic mental training was initiated, her nutritional strategy was adjusted, and her asthma treatment was optimized. Conclusions: Overall, the current case study could be used as a framework for the holistic approach to treating an overtraining condition and for generation of new hypothesis in this exiting area.

Abstract Background Asthma affects approximately 11% of Australia’s population and allergic rhinitis 19%. Grass pollen is associated with asthma and allergic rhinitis exacerbations. This study tested the hypothesis that days with extreme numbers of general practice (GP) encounters for asthma and allergic rhinitis aligned with grass pollen season. Methods The MedicineInsight GP database contains longitudinal data on persons attending a sample of Australian GPs. We created time series of daily counts of asthma and allergic rhinitis encounters by state and territory to identify extreme encounter days; days with counts above the 99th percentile. Results Of 3,036,678 attendances during the study period, 2.4% were for asthma. There were 83 extreme encounter days during April to December, across Australia. Victoria and South Australia had the highest increase in attendances on extreme days. Allergic rhinitis encounters represented 0.9% of attendances. Of the 69 extreme allergic rhinitis encounter days across Australia, Victoria and Australian Capital Territory had the highest increase in attendances. Allergic rhinitis extreme days were clustered between mid-October and early December (72%), compared to 22% of the asthma extreme days. Conclusions Extreme asthma GP encounters were not as strongly associated with grass pollen season compared to allergic rhinitis encounters. Victoria had a high number of encounters on asthma and allergic rhinitis extreme days, many associated with thunderstorm asthma. Key messages Extreme asthma encounter days can be associated with cooler months, grass pollen season and school holidays. Extremes allergic rhinitis presentation days were aligned with grass pollen season.

Abstract Background Paediatric asthma-related readmissions significantly challenge public health systems. As evidence suggests readmissions are possibly associated with ambient grass pollen levels, we sought to determine the relationship between grass pollen exposure and the risk of readmission for asthma among children in Victoria, Australia. Methods The Victorian Admitted Episodes Dataset 1st July 1997–30th June 2009 was used to identify primary admissions with a principal diagnosis of asthma for children aged 2-18 years. Total sample size was 48,068 admissions. Readmissions were defined as a subsequent admission within 28 days of index discharge. Multiple semi-parametric Poisson Generalized Additive Models were used to assess associations between the grass pollen season and daily grass pollen counts (lagged and cumulative) with repeat admissions, while controlling for meteorological factors and air pollutants. Results Readmissions totalled to 2,152 (4.47% of all admissions). Mean daily readmissions were 1.44 times higher during the grass pollen season (95%CI 1.03-2.02). Pollen season was associated with readmission only for the youngest age group (2-5), incident rate ratio 1.99 (95%CI 1.26-3.14). Daily readmission was non-linearly associated with same day pollen counts only for the 13-18-year age group. Lag 2 pollen counts were non-linearly associated with all daily readmissions for boys in gender-stratified and younger age groups (2-5, 6-12) in age-stratified analysis. Conclusions Grass pollen exposure was associated with higher readmission rates for paediatric asthma. Key messages Younger children and boys with severe or poorly controlled asthma need to be assessed for preventive therapies before the grass pollen season to reduce the repeat admissions.

The Australian Asthma Conference held this year in Melbourne, was hosted by the Asthma Foundation of Victoria. The conference attracted over 300 participants from all states and internationally, and was headed by a range of keynote speakers representing national and international leaders in the various aspects of asthma management from prevention through to clinical care. Participants included the full spectrum of health professionals, with a large number of asthma educators represented.

Objectives To demonstrate the challenges of interpreting cross-country comparisons of paediatric asthma hospital admission rates as an indicator of primary care quality. Methods We used hospital administrative data from >10 million children aged 6–15 years, resident in Austria, England, Finland, Iceland, Ontario (Canada), Sweden or Victoria (Australia) between 2008 and 2015. Asthma hospital admission and emergency department (ED) attendance rates were compared between countries using Poisson regression models, adjusted for age and sex. Results Hospital admission rates for asthma per 1000 child-years varied eight-fold across jurisdictions. Admission rates were 3.5 times higher when admissions with asthma recorded as any diagnosis were considered, compared with admissions with asthma as the primary diagnosis. Iceland had the lowest asthma admission rates; however, when ED attendance rates were considered, Sweden had the lowest rate of asthma hospital contacts. Conclusions The large variations in childhood hospital admission rates for asthma based on the whole child population reflect differing definitions, admission thresholds and underlying disease prevalence rather than primary care quality. Asthma hospital admissions among children diagnosed with asthma is a more meaningful indicator for inter-country comparisons of primary care quality.

Objectives: The main objective of the study is to clinically audit and analyse the acute asthma exacerbations in children younger than 12 years regarding management of emergency department. Methods: This clinical audit was done in Bahawal Victoria Hospital, Bahawalpur during January 2020 till June 2020. We retrospectively revised all the files of children aged 0–12 years who were visited for acute asthma in the Paediatric ED of Hospital. All the patients with a diagnosis of “acute asthma,” “wheezing bronchitis,” and “bronchospasm” were included. Results: A total of 864 patients were seen in the Emergency Department during the study. Of these, a total of 293 patients were seen for a presentation of acute asthma. As some patients had multiple visits, the 293 records represented 278 unique patients. For assessing age and gender distribution of the patients, only data from the first visit were used. Otherwise, each record was treated independently for the purpose of analyses. Conclusion: It is concluded that acute asthma management still remains an area of medical practice that continues to have long-standing difficulties.

ObjectiveExplore gaps and opportunities in primary care for children following a hospital admission for asthma.DesignExploratory mixed-methods, using linked hospital and primary care administration data.SettingEligible children, aged 3–18 years, admitted to one of three hospitals in Victoria, Australia between 2017 and 2018 with a clinical diagnosis of asthma.Results767 caregivers of eligible children participated, 39 caregivers completed a semistructured interview and 277 general practitioners (GPs) caring for 360 children completed a survey. Over 90% (n=706) of caregivers reported their child had a regular GP. However, few (14.1%, n=108) attended a GP in the 24 hours prior to index admission or in the 7 days after (35.8%, n=275). Children readmitted for asthma (34.2%, n=263), compared with those not readmitted (65.8%, n=504), were less likely to have visited a GP in the non-acute phase of their asthma in the 12 months after index admission (22.1% vs 42.1%, respectively), and their GP was more likely to report not knowing the child had an asthma admission (52.8% vs 39.2%, respectively). Fewer GPs reported being extremely confident managing children with poorly controlled asthma (11.9%, n=43) or post-discharge (16.7%, n=60), compared with children with well-controlled asthma (36.4%, n=131), with no difference by child readmission status.ConclusionsGiven the exploratory design and descriptive approach, it is unknown if the differences by child readmission status have any causal relationship with readmission. Nonetheless, improving preventative patterns of primary care visits, timely communication between hospitals and primary care providers, and guideline concordant care by GPs are needed.

Introduction: The Creative Arts and Regional Well-BeingThe relationship between regionalism, well-being, and the creative arts has enjoined significant attention from community activists, commercial entrepreneurs, policy analysts, artists, and researchers over recent years (Australia Council for the Arts, “Living Culture”; Australia Council for the Arts, “The Arts in Regional Australia;” Drummond, Keane, and West; Elg; Warren, and West; Woodward, Bremner, and Cahalan). Underpinning most of the activity and research in this area is the understanding (occasionally bordering on an un-critical presumption) that the creative arts make a positive contribution to regional well-being. Commenting on the Live. Love. Life. creative-arts wellness festival in Daylesford, Victoria, Mary-Anne Thomas (Member of Parliament for the state seat of Macedon) stated that the festival will “reinforce Daylesford and the Macedon Ranges’ status as one of the nation’s leading wellness destinations” (Elg). For Thomas, it would appear that the linkage of the creative arts to regional well-being is never in doubt; which is to say, always already available for reinforcement. According to university-based researchers Margaret Woodward, Craig Bremner, and Anthony Cahalan, writing in a more scholarly and critical register, “there is a growing body of research which shows that thriving creative industries and cultural activities are crucial for the health and vitality of a region and its communities” (3). Qualifying this, they add that: “Achieving high levels of community well being through thriving creative activity is not however without its challenges in regional Australia” (3). Similarly, Rozaline Drummond, Jondi Keane, and Patrick West present their work as a test of the efficacy of the creative arts in aiding regional well-being: The opportunity to work collaboratively with a community like the one at Lake Bolac [Victoria] provided an occasion to gauge our discerning and initiating skills within creative-arts research and to test the argument that the combination of our different approaches adds to community and individual well-being. Our approach is informed by Gilles Deleuze’s ethical proposition that the health of a community is directly influenced by the richness of the composition of its parts. (n.p.)Deleuzean philosophy aside, quantitative data indicates that people in regional Australia are increasingly optimistic about the positive impact of the creative arts on their well-being. In 2016, 57% believed the arts impacted their sense of well-being and happiness, up from 52% in 2013 (Australia Council for the Arts, “The Arts in Regional Australia”). Given this article’s emphasis on place and well-being in relation to located creative-arts production, it is worth citing another dataset from the same Australia Council for the Arts publication, which details the “Location of Professional Artists”:There continues to be a concentration of artists in urban areas. Three quarters (74%) live in cities, compared to two thirds of the Australian population. This urban concentration […] may in part be related to concentration of cultural infrastructure in cities.1 in 6 Australian artists live in regional cities or towns (16%) and around 1 in 10 live in rural, remote or very remote areas (11%). (n.p.)Regional artists are a minority voice in the Australian creative arts. But the ways in which a minority voice is constructed, and the (potential) impact a minoritarian position has within the wider debate about regional well-being and the creative arts, requires careful unpacking. Ironically, creative artists themselves have been relatively neglected actors in this space. Working with Tony Birch’s short story, “The Red House”, as a neglected text of regionalism, this article exposes oversights in current understandings of the connection between well-being and regionalism. The Voice of the Regional Artist and “Resistant Speech” It is important to recognise that the “concentration of artists in urban areas” may sometimes lead to situations where non-regional artists, in the undoubtedly well-meaning pursuit of regional well-being, drown out the voices of regional artists in regional places (Australia Council for the Arts, “The Arts in Regional Australia”). Drummond, Keane, and West, all city-based artists, show sensitivity to this problem in their observation that: “It is not for the artists to presume that they can empower a [regional] community.” Certainly, regional artists and communities should take the lead in the development of regional well-being through the creative arts. The problem of (not) speaking for the other is, however, not so easily dealt with (Spivak). While urban artists might adopt the strategy of consciously allowing regional artists a voice, making such allowance could itself be viewed as a play of privilege and power by the city-based practitioner, resourced by their greater “concentration of cultural infrastructure” (Australia Council for the Arts, “The Arts in Regional Australia”). It is notoriously difficult to give the slip to the relatively invisible operations of entitlement. Furthermore, even if the regional artist is given a voice, there are many different ways of being heard or not heard. Gayatri Chakravorty Spivak’s distinction between “speaking” and “talking” is useful here. Discussing “Can the Subaltern Speak?” in an interview with Bulan Lahiri, Spivak notes that: “It was not about talking. It was about: when the subaltern speaks there is not enough infrastructure for people to recognise it as resistant speech. That’s what it means.” In this crucial move, Spivak refines understanding of the issues at stake around the minoritarian position of regional artists. It is not enough for regional artists merely to “talk”; rather, they must be heard with the full impact of “resistant speech” (Lahiri). Obviously, what Spivak means by the “infrastructure” of “resistant speech” differs from the meaning the word “infrastructure” has in the Australia Council for the Arts publication referred to above, which employs the term as part of a governmental and technocratic discourse (“The Arts in Regional Australia”). The distance separating these two usages of “infrastructure” indicates the difference between the quantitative and the qualitative. Working with Spivak, this article’s focus is on the gap or failing in the infrastructure of qualitative research that has led to the relative neglect of Tony Birch’s short story “The Red House” as a significant text of regionalism. The Australia Council for the Arts, with its quantitative and empirical methodology, would not count Birch as a regional writer (to the best of the author’s knowledge, Birch lives and works in Melbourne). Its definition of a regional artist undermines the possibilities of a qualitative research infrastructure. However, recognizing the powerful regional concerns within a text by a primarily city-based writer like Birch is a key move, not only in expanding the definition of who counts as a minoritarian regional writer, but in giving voice to the “resistant speech” of women and children, subalterns on Spivak’s terms, within the regional-urban flux (Lahiri). The aim of this article is to give voice to Tony Birch as a regional writer, at least insofar as he is the author of “The Red House”, while also addressing the issue of well-being (as linked to the curse of domestic violence), through attention to Birch’s artistic re-creation of regionalism. In this way, working with Spivak’s reference to “infrastructure,” the aim is to nurture the growth of a research infrastructure open to a more productive engagement with regionalism, which begins by nuancing the definition of regional. It is not that regional artists, defined either by their demography or (as with Birch) by their creative concerns, are not “talking” rather, what they are saying is not being recognised in Spivak’s strong sense of “speaking”. Indeed, the very fact that Birch is not a regional writer in an empirical sense, and that, as will be explored later in this article, “The Red House” is not even primarily set in a regional location, has at least one important consequence. Potentially, it increases the value of Birch’s short story to an engagement with regionalism, given that “The Red House” unfolds regionalism as a concept always already in productive dialogue with other frameworks of place (such as the urban and the international). To the extent that Birch is a city-based writer of regionalism, and thus on the (urban) margin of the (regional) margin, he enlivens an exquisite position of minoritarian power. Furthermore, “The Red House” contains a diversity of acute insights into the nexus of regionalism and well-being that, to date, critics have overlooked. “The Red House” and the Well-Being of Places Comparatively little scholarly attention has been paid to creative work that itself dramatises and interrogates the issue of regional well-being. Tony Birch’s short story “The Red House” (2006), from his collection of linked stories (which is sometimes referred to as a novel) Shadowboxing, is a particularly interesting candidate to fill this gap in the literature, given how delicately it ranges across, and problematises, the division between the urban and the regional.“The Red House” is the opening story of Shadowboxing. Covering a period of close to a decade, loosely overlapping with the 1960s, and set in different parts of Victoria and Melbourne, it is told in the voice of Michael, who recounts the story of a peripatetic family under stress and struggling to survive. The first sentence reads: “We moved to the red house in the winter after my younger sister, May, died of meningitis” (1). The first page also establishes the place-based coordinates of the story: “In the weeks following our move from Clunes back to Fitzroy, our new house was almost submerged by a rising flood” (1). Birch’s interrogation of regionalism will henceforth operate largely along the Clunes-Fitzroy axis. Fitzroy is an inner-city suburb of Melbourne while Clunes is a small regional town (present population: approximately 2000) about 140 kilometres north-west of Melbourne (Clunes). A flashback section of three pages or so, early on in the story, fills in the events leading up to the return to Melbourne after May’s death in Clunes. Apart from this, the story has a linear structure. The various spatial shifts of “The Red House”, both within Melbourne and between Clunes and Melbourne, are all triggered by threats against, or the pursuit of, multiple modes of well-being. The first move reflects the promise of a fresh romantic union: “It was only after he [Michael’s father] had met my mother and moved with her to my [maternal] grandmother’s house over in Carlton that he had left Fitzroy for the first time in his life” (4–5). This move from Fitzroy to Carlton is followed by a much bigger one: Carlton to Clunes. Implicated in this move are at least two modes of well-being: “The eventual move to the bush had come on the advice of a doctor at the public hospital. He said that the fresh air would help my dad recover from [his] asthma” (5); however, “My grandmother told me years later that the move did not really have all that much to do with his asthma. It was the drink” (5). The context is the husband’s assault of “his six months’ pregnant wife” with “a straight right on the end of her nose” (5). The decision to move to Clunes is made by Michael’s mother: “He fought with her so much that my mother eventually decided that she would have to move away from her mother’s house, for both their sakes. Clunes was a drastic move. But it worked, for a time […]. They appeared happy” (6). This part of “The Red House” unpacks the complexities of how well-being and (physical and mental) health are linked in a social matrix; a physical ailment (asthma) elides an addiction to alcohol, until a doctor’s discourse (validated by the authority of a medical establishment) is subverted by the subalternate voice of Michael’s grandmother. This passage also dramatises the abject scenario of a victim (Michael’s mother) attending to the well-being of her persecutor (Michael’s father) by moving to Clunes “for both their sakes” (6).Subsequently, May is born in Clunes, “a ‘special baby’. She was magical even…” (6). Indeed, “My father’s habit of explosive anger melted before May. He was truly besotted with her” (6). Just before what would have been her second birthday, May dies. “My father wanted to bring May back to Melbourne for burial, but my mother stood up to him and demanded that she be buried in the town where she was born” (6). This is the most powerful enduring connection of Michael’s family to regional Clunes. Significantly, well-being (in the sense of survival and the rebuilding of happiness after the tragic death of a daughter) is dispersed differently, through place, by mother and father, along gendered lines. While the mother wants her daughter’s birthplace and place of death to coincide, the father wants to possess his daughter, almost as if she were an object, by returning her to the city for burial. (Space restrictions preclude further exploration here of the many issues raised by May’s death, including those around the gendered nexus between well-being [happiness] and the proximity or otherwise to a child’s burial place.) After May’s death, Michael’s father’s behaviour deteriorates once more. The domestic violence continues: “It was difficult for my mother to find anything safe to say to him […]. She tried to talk about May with him several times, but he either responded with silence, or swore and yelled at her uncontrollably. He also found his way back to the pubs” (7). The decision to return to Melbourne is made by Michael’s father, against his wife’s wishes: And then one night after he had walked in from the pub he sat down at the table and just said to her, ‘Fuck all this fresh-air bullshit, we’re going back to Melbourne.’ She tried persuading him to stay, talked about his job and my school, but he would not listen. He got sick of her talking and slammed a fist into his heavy palm. ‘We’re fucken going. That’s it. We’re going.’ And that was it.She looked across the table that night and saw once again the man she had married six years earlier, the man who she had deceived herself had faded and eventually disappeared with the move away from the city. (7)In this passage, well-being (even if only imagined rather than real) is explicitly linked to place. Shortly afterwards, the family moves into the red house, where they will remain. The flashback section of the text has already sketched out the chain of events that leads to the return to the city, while also commenting on the agency Michael’s mother exercises in dealing with what, to her, is an unwelcome situation: “Mum […] had argued against coming back to the city. She sensed the looming danger in my father moving back both to his old streets and his old habits. But on realising that she had no real say in the matter, she was determined to ensure that she at least have some say in the house she was moving into” (4). Specifically, Michael’s mother turns her Fitzroy house into the regional house left behind in Clunes. Under her influence, “It wasn’t long before the inside of the house came to life and began to resemble the old place at Clunes” (11). Again: she brings a portrait of May, along with assorted baby belongings, into the Fitzroy house, keeping this secret from her husband. Thus, Michael’s mother infiltrates regional place into urban place as a strategy of (subalternate) well-being. In summary, “The Red House” unpacks well-being as an expansive category shaped by domestic violence, in a negative sense, but also more positively by the actuality or promise of happiness. It also interrogates the fine-grained links between well-being in its incarnations as medical and emotional health. At the same time, it maps the rise and fall of well-being against a human geography of regional and urban places, refusing any simplistic connection of place to well-being (more faintly, there is even the problematising presence of international place, in the character of the Italian landlord, Mr Carboni, and the reference to “the local Italian community [2]). Thus, the text’s regionalism suggests a strategic model, reliant on human intervention in the (re-)creation of place; this is most evident in Michael’s mother’s actions. “The Red House” rewards interpretation as a text of how regional place (Clunes) is re-made in urban place (Fitzroy) through the rehabilitation of a house in the interests of well-being. Well-Being and Domestic Violence across Places It is hard to imagine a greater threat to the well-being of women and children than domestic violence. This makes it all the more surprising that “The Red House” is one of relatively few texts (to the author’s knowledge) to offer a detailed outline of the territory of well-being, in its many forms stretching from the health-based to the emotional, while also including a direct and unflinching consideration of domestic violence. (One cognate text is Kathryn Heyman’s novel The Breaking, which merges medical disability and domestic violence within a broader consideration of regional well-being.) Even more unusual is the way Birch’s story of well-being and domestic violence is mapped in relation to regional and non-regional places. “The Red House” is rare and valuable for its triangulation of well-being, domestic violence, and place; above all, in its refusal to resort to any comforting notion that regional places have essential qualities that make them necessarily better for well-being than the experience of cities. This is perhaps the meaning of the colour of the red house, a colour Michael’s father hates. According to a local know-all, Emu Bailey, the red was originally a form of protest by Ettie Rogers, “‘some sort of communist’” (10). “‘Most everyone around here back then was DLP [Democratic Labour Party]. Still is, some of them. Ettie wasn’t in agreement with the others in the street, so she let them know all about it. Redone it every summer too, the same colour, red’” (10). When Michael’s mother responds to her husband’s injunction to re-paint the house “‘any colour but that fucken red’” (13) by preparing to re-paint it, subversively, “a deep red splash of colour” (19) it is not difficult to discern a silent protest, passed down from woman to woman, against the domestic violence suffered by Michael and his mother. Indeed, Birch comes very close to describing the red of the house as blood-like, labelling it “a rich congealed red” (2). “Congealed” is often used to describe blood. In this way, through a colour that evokes the body, a house becomes a visible and metaphorical protest against the bodily violence (but also emotional and mental torment) that is domestic violence. As Meg Mundell argues, “the body is integral to how literary sense of place is produced” (8). This bodily, coloured protest folds back into the special sort of place the Fitzroy home becomes. If Michael’s mother cannot keep living in Clunes, she can at least paint her city house red. Perhaps attesting to the success of this female protest, there is, towards the end of “The Red House”, a fascinating moment when, as if influenced by the domestic circumstances of transplanted place (from regional Clunes) created by Michael’s mother, domestic violence threatens, but is thwarted. Michael’s mother has just told her husband that she is going to have another baby: “He spun around and moved towards her. I thought that maybe he was going to hit her. But he didn’t. He stopped in front of her. They were toe to toe” (17). Place and (pregnant) body, in an intensified combination (or even, to riff on Spivak’s terminology, as an “infrastructure”), allow the subaltern to “speak” against her oppression. Conclusion: Re-Defining Regionalism through the Literary Creative Arts Tony Birch’s “The Red House” re-creates the regional as something other than a pre-determined place. Regionalism is “activated,” in a strategic mode, within the flux of the urban and the regional. This is particularly evident in the actions of Michael’s mother. She preserves her well-being (located in Clunes, as it were, where her daughter is buried) even after she is forced by her husband to return to Melbourne (the place she left to escape from his domestic violence). The picture of May acts as a talisman of well-being (aptly, given Clunes is described by Michael as “a town where old superstitions held sway over logic” [6]), which Michael’s mother smuggles from regional Clunes into her Melbourne house. “The Red House” is thus a vital literary rejoinder to the conceptualisation of well-being, and regional areas employed by government bodies and commercial entities, which instrumentalizes a binary opposition of the regional/non-regional. By extension, it contests the naïve linkage of regional place to well-being through a nuanced investigation into the complex links between place (regional, urban, even international) and multi-faceted well-being. Birch’s story is a valuable, fine-grained creative analysis of well-being (extending from happiness, comfort and security through to what might be called the “ill-being” of domestic violence), which is matched to an equally fine-grained engagement with multiple modalities of place. It challenges the reader to creatively re-think how regionalism and well-being might align. References Australia Council for the Arts. “Living Culture: First Nations Arts Participation and Wellbeing.” Sydney: Australia Council for the Arts, 2017. 10 Mar. 2019 <https://www.australiacouncil.gov.au/research/living-culture/>.———. “The Arts in Regional Australia: A Research Summary.” Sydney: Australia Council for the Arts, 2017. 10 Mar. 2019 <https://www.australiacouncil.gov.au/research/regional-arts-summary/>.Birch, Tony. “The Red House.” Shadowboxing. Melbourne: Scribe, 2006. 1–19. Clunes, Victoria. Wikipedia. <https://en.wikipedia.org/wiki/Clunes,_Victoria>.Drummond, Rozalind, Jondi Keane, and Patrick West. “Zones of Practice: Embodiment and Creative Arts Research.” M/C Journal 15.4 (2012). 1 Mar. 2019 <http://journal.media-culture.org.au/index.php/mcjournal/article/view/528>.Elg, Hayley. “New Wellness Festival for Daylesford.” The Advocate 22 Jan. 2018. 1 Mar. 2019 <https://www.hepburnadvocate.com.au/story/5182322/the-live-love-life-festival-is-coming-to-daylesford-this-november/>.Heyman, Kathryn. “When I First Wrote about Domestic Violence, No One Talked about It. Now the Shame has Lifted.” The Guardian. 21 May 2017. 10 Mar. 2019 <https://www.theguardian.com/books/2017/may/21/when-i-first-wrote-about-domestic-violence-no-one-talked-about-it-now-the-shame-has-lifted>.Lahiri, Bulan. “In Conversation: Speaking to Spivak.” The Hindu 5 Feb. 2011. 1 Mar. 2019 <https://www.thehindu.com/books/In-Conversation-Speaking-to-Spivak/article15130635.ece>.Mundell, Meg. “Crafting ‘Literary Sense of Place’: The Generative Work of Literary Place-Making.” JASAL: Journal of the Association for the Study of Australian Literature 18.1 (2018): 1–17. 10 Mar. 2019 <https://openjournals.library.sydney.edu.au/index.php/JASAL/article/view/12375>.Spivak, Gayatri Chakravorty. “Can the Subaltern Speak?” Colonial Discourse and Post-Colonial Theory: A Reader. New York: Harvester Wheatsheaf, 1993: 66–111. Warren, Brad, and Patrick West. “From Ecological Creativity to an Ecology of Well-Being: ‘Flows & Catchments’ as a Case Study of NVivo.” Landscapes: The Journal of the International Centre for Landscape and Language 5.2 (2013): 1–15. 1 Mar. 2019 <https://ro.ecu.edu.au/landscapes/vol5/iss2/21/>.Woodward, Margaret, Craig Bremner, and Anthony Cahalan. “Defining the Geography of Creativity in a Regional Australian University.” Proceedings of the 2012 Australian Council of University Art and Design Schools (ACUADS) Conference: Region and Isolation: The Changing Function of Art & Design Education within Diasporic Cultures and Borderless Communities. Australian Council of University Art and Design Schools (ACUADS) Conference 2012. Perth: Australian Council of University Art and Design Schools (ACUADS), 2012: 1–13. 1 Mar. 2019 <https://acuads.com.au/conference/article/defining-the-geography-of-creativity-in-a-regional-australian-university/>.

Background:The risk of adult onset cardiovascular and metabolic (cardiometabolic) disease accrues from early life. Infection is ubiquitous in infancy and induces inflammation, a key cardiometabolic risk factor, but the relationship between infection, inflammation, and metabolic profiles in early childhood remains unexplored. We investigated relationships between infection and plasma metabolomic and lipidomic profiles at age 6 and 12 months, and mediation of these associations by inflammation.Methods:Matched infection, metabolomics, and lipidomics data were generated from 555 infants in a pre-birth longitudinal cohort. Infection data from birth to 12 months were parent-reported (total infections at age 1, 3, 6, 9, and 12 months), inflammation markers (high-sensitivity C-reactive protein [hsCRP]; glycoprotein acetyls [GlycA]) were quantified at 12 months. Metabolic profiles were 12-month plasma nuclear magnetic resonance metabolomics (228 metabolites) and liquid chromatography/mass spectrometry lipidomics (776 lipids). Associations were evaluated with multivariable linear regression models. In secondary analyses, corresponding inflammation and metabolic data from birth (serum) and 6-month (plasma) time points were used.Results:At 12 months, more frequent infant infections were associated with adverse metabolomic (elevated inflammation markers, triglycerides and phenylalanine, and lower high-density lipoprotein [HDL] cholesterol and apolipoprotein A1) and lipidomic profiles (elevated phosphatidylethanolamines and lower trihexosylceramides, dehydrocholesteryl esters, and plasmalogens). Similar, more marked, profiles were observed with higher GlycA, but not hsCRP. GlycA mediated a substantial proportion of the relationship between infection and metabolome/lipidome, with hsCRP generally mediating a lower proportion. Analogous relationships were observed between infection and 6-month inflammation, HDL cholesterol, and apolipoprotein A1.Conclusions:Infants with a greater infection burden in the first year of life had proinflammatory and proatherogenic plasma metabolomic/lipidomic profiles at 12 months of age that in adults are indicative of heightened risk of cardiovascular disease, obesity, and type 2 diabetes. These findings suggest potentially modifiable pathways linking early life infection and inflammation with subsequent cardiometabolic risk.Funding:The establishment work and infrastructure for the BIS was provided by the Murdoch Children’s Research Institute (MCRI), Deakin University, and Barwon Health. Subsequent funding was secured from National Health and Medical Research Council of Australia (NHMRC), The Shepherd Foundation, The Jack Brockhoff Foundation, the Scobie & Claire McKinnon Trust, the Shane O’Brien Memorial Asthma Foundation, the Our Women’s Our Children’s Fund Raising Committee Barwon Health, the Rotary Club of Geelong, the Minderoo Foundation, the Ilhan Food Allergy Foundation, GMHBA, Vanguard Investments Australia Ltd, and the Percy Baxter Charitable Trust, Perpetual Trustees. In-kind support was provided by the Cotton On Foundation and CreativeForce. The study sponsors were not involved in the collection, analysis, and interpretation of data; writing of the report; or the decision to submit the report for publication. Research at MCRI is supported by the Victorian Government’s Operational Infrastructure Support Program. This work was also supported by NHMRC Senior Research Fellowships to ALP (1008396); DB (1064629); and RS (1045161) , NHMRC Investigator Grants to ALP (1110200) and DB (1175744), NHMRC-A*STAR project grant (1149047). TM is supported by an MCRI ECR Fellowship. SB is supported by the Dutch Research Council (452173113).

Scientific Program Oral Presentations Authors Title Abstract CONSTANTIN MUNTEANU, Mihail HOTETEU, Diana MUNTEANU, Gabriela DOGARU - 12 minutes PERSPECTIVES OF BALNEOLOGY - INTERNATIONAL DATA INPUTS, NATIONAL OUTPUTS Link L1 UMBERTO SOLIMENE - 14 minutes CLIMATE AND HEALTH: A NEW CHALLENGE FOR AN OLD SCIENCE Link L2 Zeki KARAGÜLLE - 14 minutes BALNEOLOGICAL TREATMENTS WITH NATURAL HYDROGEN SULFIDE (H2S) Waters Link L3 Constantin Florin Dragan, Liliana Padure, Gelu Onose - 12 minutes SPECIFIC ADVANCED QUANTIFICATIONS ON THE RELATIONSHIP BETWEEN THE ANGULATION OF THE MAIN SCOLIOTIC CURVE AND LEG SWING IN THE GAIT PHASES, IN CHILDREN AND ADOLESCENTS WITH AND WITHOUT POSTURAL TREATMENT Link L4 Irina ALBADI, Camelia CIOBOTARU, Andreea-Alexandra LUPU, Ionela BALASA, Claudiu FATU, Enghin SACHIR, Gelu ONOSE - 12 minutes A MULTIMODAL APPROACHES TO MANAGE REHABILITATION THERAPY OF DISFUNCTIONALS ASPECTS TO A PACIENT WITH GOUT, MIELLITUS DIABETES, ATRIAL FIBRILATION AND MIDDLE CEREBRAL ARTERY STROKE Link L5 ELENA RAEVSCHI - 12 minutes PREVENTION CONSIDERATIONS IN Cardiovascular Diseases regarding the premature mortality reduction Link L6 ANIȘOARA CIMIL - 12 minutes THE EFFECTIVENESS OF THE REHABILITATION PROGRAMME ACCORDING TO THE ETIOPATHOGENESIS OF PROSTHETIC JOINT PATHOLOGY Link L7 TRAIAN -VIRGILIU SURDU, Monica SURDU, Olga SURDU - 10 minutes FOURTH INDUSTRIAL REVOLUTION (INDUSTRY 4.0) AND MODERN THERMAL MEDICINE (THERME 4.0) IN XXIST CENTURY Link L8 Gabriela DOGARU, Akos MOLNAR, Marieta MOTRICALA - 10 minutes EFFECTS OF CARBONATED MINERAL WATER AND MOFETTE IN BĂILE TUŞNAD IN EXPERIMENTALLY INDUCED ISCHEMIC HEART DISEASE Link L9 Q & A – 12 minutes Authors Title Abstract Aurelian Anghelescu, Valentin Deaconu, Catalina Axente,Elena Constantin, Gelu Onose - 12 minutes THERAPEUTIC DIFFICULTIES IN A YOUNG PATIENT WITH MULTIDRUG RESISTANT EPILEPSY (NEEDING VAGAL NERVE ELECTROSTIMULATION), SEQUELAE AFTER CONGENITAL VASCULAR CEREBRAL MALFORMATION, WITH CHRONIC GAIT IMPAIRMENTS AND RECENT TRAUMATIC BRAIN COMPLICATION Link L10 Luminița NIRLU, Alexandru G. STAVRICĂ, Laura Georgiana Popescu, Ana Carmen Albeșteanu, Ali-Osman Saglam, Gelu Onose - 12 minutes DIAGNOSTIC PARTICULARITIES AND MULTIMODAL THERAPEUTIC AND REHABILITATION APPROACHES TO A COMPLEX CASE OF POST ISCHEMIC STROKE WITH DYSPHAGIA AND DYSPHONIA, ASSOCIATING MILLARD-GUBLER AND WALLENBERG SYNDROMES - CASE REPORT Link L11 Cristina Octaviana DAIA, Croitoru Stefana, Mariana Axente, Gelu ONOSE - 14 minutes IONTOPHORESIS AND LASER APPLICATIONS IN FACIAL NERVE PALSY Link L12 Doina Maria MOLDOVAN, Gabriela DOGARU - 12 minutes SPLINTING VERSUS SURGICAL TREATMENT IN MALLET FINGER Link L13 Doina Maria MOLDOVAN, Gabriela DOGARU - 12 minutes EARLY REHABILITATION IN PATIENT AFTER TREATMENT FOR DISTAL RADIUS FRACTURE Link L14 Liliana PADURE, Raluca PETCU, Anca Irina GRIGORIU - 12 minutes THE IMPACT OF MULTIFACTORIAL GAIT ANALYSIS ON THE DIAGNOSIS AND REHABILITATION OF CHILDREN WITH WALKING DISORDERS Link L15 Valerica Creanga-Zarnescu, Ana-Maria Fatu, Mihaela Lungu, Violeta Sapira, Anamaria Ciubara - 12 minutes REHABILITATION POSSIBILITIES OF APHASIC PATIENT Link L16 Cristina DAIA, Simona SCHEK, Stefana CROITORU, Alina GHERGHICEANU, Gelu ONOSE - 12 minutes FAVORABLE REHABILITATION RESULTS ON A PATIENT WITH SEVERE LEFT HEMIPLEGIA AFTER AN INTRAPARENCHYMAL HEMATOMA Link L17 Elena VIZITIU, Mihai CONSTANTINESCU, Sînziana Călina SILIȘTEANU - 12 minutes THE ROLE OF THERAPEUTIC SWIMMING IN THE PROPHYLAXIS OF SCOLIOSIS IN THE "C" LEFT IN CHILDREN DURING THE PREPUBERTAL PERIOD Link L18 Q & A – 12 minutes Authors Title Abstract Alexandru G. STAVRICĂ, Luminiţa Nirlu, Laura Georgiana Popescu, Ana Carmen Albeşteanu, Gelu ONOSE - 12 minutes DIAGNOSTIC AND THERAPEUTIC APPROACHES IN REHABILITATION CORRELATED TO A CASE OF TETRAPARESIS (WITH PREDOMINANCE OF PARAPARESIS) AFTER SEVERE CCT - BIFRONTO - BASAL AND BITEMPORAL CONTUSION. Link L19 Ana Maria Bumbea, Otilia Rogoveanu, Carmen,Albu Rodica Traistaru, Catalin,Bostina, Bogdan Stefan Bumbea, Roxana Dumitrascu, Borcan Madalina MANAGEMENT OF SPASTICITY IN NEUROLOGICAL PATIENTS Link L20 Laura Georgiana Popescu, Luminița Nirlu, Ana Carmen Albeșteanu, Ali Osman Saglam, Gelu Onose - 12 minutes PARTICULARITIES OF COMPLEX THERAPEUTICALLY-REHABILITATIVE MANAGEMENT, STEPWISE, IN A PATIENT WITH POST-CCT PSYCHO-COGNITIVE IMPAIRMENT IN A LARGE POLYTRAMATIC CONTEXT - CASE REPORT Link L21 Adrian MELNIC, Oleg PASCAL - 12 minutes DEVELOPING STRATEGIES TO ADDRESS COMORBIDITY IN STROKE REHABILITATION. Link L22 Dorin-Gheorghe TRIFF, Simona POP - 12 minutes MONOGENIC DISEASES WITH MUSCULO ARTICULAR LAXITY. DIAGNOSTIC CRITERIA AND PRINCIPLES OF RECOVERY THERAPY Link L23 Catalin Ionite, Dragos Arotaritei, Mihai Ilea, Mariana Rotariu - 12 minutes THE USE OF ELASTIC BANDS IN THE RECOVERY OF ANKLE SPRAINS Link L24 Mariana Rotariu, Marius Turnea, Calin Corciova, Catalin Ionite - 12 minutes THE EFFECTS OF CUBE THERAPY IN THE RECOVERY OF THE ARTHROSIS HAND IN GERIATRICS Link L25 Cristian Ştefan LIUŞNEA - 12 minutes FITNESS AND WELLNESS. CONCEPTUAL DELIMITATIONS Link L26 Adriana LUPU - 12 minutes NSAID THERAPY OF MUSCULOSKELETAL PAINS AND ITS PARTICULARITIES IN THE PATIENTS SUFFERING FROM CARDIOVASCULAR DISORDERS Link L27 Q & A – 12 minutes Authors Title Abstract Mihaela MANDU, Cristinel Dumitru BADIU, Raluca PETCU, Cosmin OPREA, Gelu ONOSE - 12 minutes CLINICAL-EVOLUTIVE PARTICULARITIES AND A MULTIMODAL THERAPEUTIC-REHABILITATIVE, AS WELL AS THROUGH CONNECTED CARES, APPROACH, IN A CASE OF HEMIPLEGIA AFTER ISCHEMIC CARDIO-EMBOLIC STROKE WITHIN A POLYPATHOLOGICAL CONTEXT Link L28 Ana Carmen Albesteanu, Laura Georgiana Popescu, Luminița Nirlu, Ali Osman Saglam, Gelu Onose - 12 minutes MULTIMODAL - REHABILITATIVE THERAPEUTICAL APPROACHES IN A COMPLEX OF PATHOLOGY INCLUDING POSSIBLY EVOLVING DISCARIOTIC TYPE - CASE REPORT Link L29 Liliana PADURE, Cristian Adam, Laura Fierbinteanu - 12 minutes ATTACHMENT - PROGNOSTIC FACTOR IN MEDICAL RECOVERY Link L30 Prof. Alexandru Vlad Ciurea - 20 minutes MOTILITY OR MORBIDITY IN NEUROSURGERY Link L31 Valerica CREANGA-ZARNESCU, Ana-Maria FATU, Anamaria CIUBARA, Violeta SAPIRA,Aurelia ROMILA, Mihaela LUNGU - 12 minutes EXERCISES PROGRAM AND REHABILITATION IN PARKINSON’S DISEASE Link L32 Irina VERINCEANU,Alice MUNTEANU, Andreea STOICA, Stefan ISPAS - 12 minutes THE CARDIAC REHABILITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION Link L33 Marius Turnea, Catalin Ionite, Mihai Ilea, Dragos Arotaritei - 12 minutes STATISTICAL ANALYSIS OF PHYSIOTHERAPEUTIC MEANS USED IN THE RECOVERY OF MUSCLE INJURIES IN ATHLETES Link L34 Mihaiela CHICU, Eugen BITERE - 10 minutes THE ROLE OF IL1β IN CARTILAGINOUS DISTRUCTION IN RHEUMATOID ARTHRITIS Link L35 Mihaiela CHICU, Eugen BITERE - 10 minutes THE ROLE OF THE INFLAMMASOMS IN THE PATHOGENESIS OF INFLAMMATORY REACTION Link L36 Q & A – 8 minutes Authors Title Abstract Prof. Dr. Gelu Onose, (Keynote Speaker) Vlad Ciobanu, Corina Sporea - 20 minutes A TOPICAL SYSTEMATIC LITERATURE REVIEW AND REAPPRAISAL ON ESSAYS TOWARDS SYSTEMATIZING CLINICAL ASSESSMENT INSTRUMENTS USED TO EVALUATE NEURO-functional deficits after spinal cord injuries, mainly in adults, including through the ICF(-DH) conceptual framework Link L37 Diana-Elena SERBAN, Aurelian ANGHELESCU, Elena CONSTANTIN, Gelu ONOSE - 12 minutes THE ACQUISITION OF SELF-DEFENSE TECHNIQUES AND PROCEDURES AGAINST THE ACT OF AGGRESSION IN THE PACIENT WITH PARAPLEGIA, WHEEL-CHAIR INDEPENDENT Link L38 Aurelian Anghelescu, Elena Constantin, Anca Sanda Mihaescu, Gelu Onose - 12 minutes “PREVENTION IS CURE, EDUCATION IS ESSENTIAL” - RESPONSIBLE IMPLICATION OF YOUNG PEOPLE IN EDUCATIONAL AND PROPHYLACTIC ACTIONS AGAINST ACCIDENTAL CERVICAL SPINAL CORD INJURY AND SEVERE DISABILITIES BY DIVING IN UNVERIFIED WATERS. Link L39 Alexandra SPORICI, Irina ANGHEL, Lapadat MAGDALENA, Gelu ONOSE - 12 minutes RECOVERABLE RESULTS AT A PATIENT WITH AIS/FRANKEL D INCOMPLETE TETRAPLEGIA / POST SPINAL CORD INJURY BY FALLING FROM A HEIGHT, ON AN ANKYLOSING SPONDYLITIS BACKGROUND Link L40 Ioana ANDONE, Carmen CHIPĂRUȘ, Andreea FRUNZA, Aura SPÎNU, Simona STOICA, Liliana ONOSE, George PATRASCU, Gelu ONOSE -12 minutes CLINICAL, PARACLINICAL ASPECTS AND COMPLEX THERAPEUTICAL APPROACHES IN A PATIENT WITH INCOMPLETE PARAPLEGIA, POST THORACIC MENIGIOMA SURGICALLY TREATED, IN NEUROFIBROMATOSIS CONTEXT Link L41 Cristina Octaviana DAIA, Alina-Elena Gherghiceanu, Helene Ivan, Gelu ONOSE - 12 minutes RESEARCH ON NEUROREHABILITATION RESULTS IN VERTEBRO-MEDULLARY POST-TRAUMATIC CONDITIONS ASSOCIATING FRACTURES, IN A POLITRAMATIC CONTEXT Link L42 Ali-Osman Saglam, Alexandru G. Stavrica, Ana Carmen Albeşteanu, Laura Georgiana Popescu, Luminita Nirlu, Gelu Onose - 12 minutes MEDICAL-REHABILITATION ENDEAVORS, CARE INTERVENTIONS AND CONNOTATIONS OF A MEDICO-SOCIAL TYPE, IN A COMPLEX POLYPATHOLOGICAL CASE: PARAPLEGIA, SPONDYLODISCITIS, KIDNEY FAILURE IN THE HAEMODIALYSIS STAGE AND BILATERAL NEPHROSTOMIES AFTER SURGICALY TREATTED BLADDER NEOPLASM. Link L43 Sorina Petrușan-Dunca, Liviu Lazăr, Tiberiu-Dorin Corha - 12 minutes INDICATIONS AND LIMITIS OF REHABILITATION TREATMENT FOR LUMBAR DISCOPATHY IN PREGNACY Link L44 Q & A – 8 minutes Authors Title Abstract Elena Silvia SHELBY, Mihaela AXENTE, Liliana PĂDURE - 12 minutes CHARCOT MARIE TOOTH DISEASE. CASE PRESENTATION. GENETIC DISEASES WHICH REQUIRE physical rehabilitation Link L45 Link L46 Simona Carniciu - 12 minutes Influence of nutrition and exercise on the use of different energy substrates in the prevention of metabolic diseases Link L81 Simona-Isabelle STOICA, Carmen Elena CHIPĂRUȘ, Magdalena Vasilica LAPADAT, George PĂTRAȘCU, Gelu ONOSE - 12 minutes CLINICAL-THERAPEUTIC AND RECUPERATORY FEATURES IN A PATIENT WITH PLURIPATOLOGY: ISCHEMIC STROKE, ISCHEMIC HEART DISEASE (SECHELAR MYOCARDIAL INFARCTION), CHRONIC KIDNEY DISEASE AND MONSTROUS GOUT- CASE PRESENTATION Link L47 Eugen BITERE, Mihaiela CHICU - 12 minutes PATHOPHYSIOLOGY OF ATHEROGENESIS AND CARDIOVASCULAR RISK IN CHRONIC INFLAMMATORY DISEASES Link L48 Victoria CHIHAI, Alisa TĂBÎRȚĂ, Anastasia ROTĂREANU, Vladlena MIHAILOV, Mihail CÎRÎM - 12 minutes THE IMPACT OF ACTIVE KINETIC PROGRAMS ON CLINICAL AND FUNCTIONAL STATUS ADRESSED TO PEOPLE WITH DIABETIC ANGIOPATHY Link L49 Ana-Maria Fătu, Ana Maria Pâslaru, Valerica Creangă-Zărnescu, Alexandru Nechifor, Mădălina Verenca, Mihaela Lungu, Anamaria Ciubară - 12 minutes THE IMPACT OF COGNITIVE DECLINE ON STROKE REHABILITATION Link L50 Alisa TĂBÎRŢĂ, Victoria CHIHAI - 12 minutes THE USE OF TRINITY AMPUTATION AND PROSTHESIS EXPERIENCE SCALES IN THE COMPLEX REHABILITATION OF PERSONS WITH LOWER LIBM AMPUTATION Link L51 Ilie ONU, Mariana ROTARIU, Elvina MIHALAȘ, Călin CORCIOVĂ - 12 minutes STUDY ON EFFICIENCY OF ELECTROTHERAPY AND PHYSIOTHERAPY MANAGEMENT ON HERNIATED LUMBAR DISC Link L52 María G. Souto Figueroa, Antonio Freire Magariños RESEARCH - SURVEY TO 142 THERMALIST WHO HAVE PERFORMED A THERMAL CURE AT THE BATHS OF BAÑOS DE MOLGAS (OURENSE) AND AUGAS SANTAS (LUGO) - GALICIA – SPAIN Link L53 Q & A – 12 minutes Authors Title Abstract Irina Ionica - 12 minutes ACUPUNCTURE IN REHABILITATION - A GENERAL VIEW Link L54 Denisa COAJĂ, Gabriela DOGARU - 12 minutes THE HEALTH BENEFITS OF FINNISH SAUNA BATHING Link L55 Otilia ROGOVEANU, Florin GHERGHINA , Rodica TRAISTARU - 12 minutes SPINA BIFIDA – FUNCTIONAL REHABILITATION METHODS IN CHILDREN Link L56 Mihaela DUTESCU, Raluca OLTEAN, Petru NENADICI - 12 minutes GEOAGIU BAI RESORT - OUR EXPERIENCE OF MEDICAL REHABILITATION TREATMENT Link L57 Dumitru MIHĂILĂ, SILISTEANU Sinziana Calina, ȚICULEANU Mihaela (Ciurlică) - 12 minutes THE METEOROLOGICAL COMPLEX AND THE HUMAN PATHOLOGY. CASE STUDY – SUCEAVA COUNTY Link L58 Mariana VARODI, Gabriela DOGARU - 12 minutes EFFICACY OF NATURAL THERAPEUTIC FACTORS FROM OCNA SIBIULUI SPA RESORT IN GONARTHROSIS Link L59 Boróka-Panna GÁSPÁR, Gabriela DOGARU - 12 minutes BONE HYDRATION AND MINERAL WATERS Link L60 CALIN BOCHIS, LIVIU LAZAR, HORAȚIU URECHESCU, CARMEN NISTOR-CSEPPENTO, FELICIA CIOARA, NICOLETA PASCALAU, ALIN BOCHIS , DIANA IOVANOVICI - 12 minutes CORRELATION OF VAS PAIN SCORE WITH FUNCTION AT THE PACIENTS WITH TEMPOROMANDIBULAR OSTEOARTHRITIS Link L61 Marian Romeo CALIN, Ileana RADULESCU, Mihaela Antonina CALIN, Elena Roxana ALMASAN - 12 minutes RADIOMETRIC ASSESSMENT OF PELOID AND SALT WATER USED FOR THERAPY AND BALNEARY TRATAMENT FROM TECHIRGHIOL LAKE, ROMANIA Link L62 Q & A – 12 minutes Authors Title Abstract Cristina PETRESCU - 12 minutes EFFICACY NATURAL THERAPEUTIC FACTORS FROM BAILE GOVORA IN BRONCHIAL ASTHMA Link L63 PARASCHIVA POSTOLACHE - 12 minutes PULMONARY REHABILITATION SAVES LIVES AND IMPROVES LIFE Link L64 DOINA-CLEMENTINA COJOCARU, PARASCHIVA POSTOLACHE - 12 minutes ASSESSMENT OF DYSPNEA IN PULMONARY REHABILITATION PRACTICE Link L65 PARASCHIVA POSTOLACHE, CRISTINA LACATUSI - 12 minutes HELIOTHERAPY, CLIMATOTHERAPY AND PATIENTS WITH RESPIRATORY DISEASES Link L66 CONSTANTIN MUNTEANU, DIANA MUNTEANU, MIHAIL HOTETEU - 12 minutes BIOLOGICAL INSIGHTS OF SPELEOTHERAPY Link L67 PARASCHIVA POSTOLACHE, CRISTINA LACATUSI, DOINA-CLEMENTINA COJOCARU - 12 minutes AEROSOLS AND BREATHING Link L68 PARASCHIVA POSTOLACHE, MADALINA ZEBEGA - 12 minutes RESPIRATORY MUSCLE TRAINING AND RESPIRATORY REHABILITATION Link L69 CRISTI FRENȚ, GEORGETA MAIORESCU - 12 minutes DEVELOPMENTS AND INVOLUTIONS OF TOURISM IN THE SPA RESORTS IN ROMANIA AND THE CASE STUDY FOR LACUL SĂRAT RESORT Link L70 Dragos Arotaritei, Andrei Gheorghita, Mariana Rotariu, Marius Turnea - 12 minutes MATHEMATICAL MODEL OF SULPHUR ABSORPTION PROCESS, A POSSIBLE APPLICATION IN CURE WITH SULPHUROUS MINERAL WATER Link L71 Q & A – 12 minutes Authors Title Abstract Mihai Ciocanu, Anișoara Cimil - 12 minutes THE EFFICIENCY OF THE REHABILITATION SERVICE IN HOSPITAL CONDITIONS Link L72 Sinziana Calina SILIȘTEANU, Andrei Emanuel SILIȘTEANU - 12 minutes TRIAL ON THE WATER CONSUMPTION BY THE PERSONS IN THE GROUP AGED 19-30 YEARS Link L73 Liviu Lazăr, Florin Marcu, Felicia Cioară, Carmen Nistor Csepentö - 12 minutes MANAGEMENT OF SPECIAL ARTERIAL DISEASES Link L74 Mihaela-Carmen SUCEVEANU, Paul-Nicolae SUCEVEANU - 12 minutes EVOLUTION OF CARDIOVASCULAR RISK FACTORS AFTER MORE THAN 2 PERIODIC HOSPITALIZATIONS IN THE COVASNA HOSPITAL FOR CARDIOVASCULAR REHABILITATION Link L75 Mihaela DUTESCU, Adina TRAILA, Margit SERBAN, Emilia URSU, Dorina MIU, Ioana MALITA, Bianca CIRESAN - 12 minutes THE EFFICIENCY OF MEDICAL REHABILITATION TREATMENT IN PATIENTS WITH HEMOPHILIA AFTER SURGICAL ORTHOPEDIC INTERVENTIONS - THE EXPERIENCE OF "CRISTIAN SERBAN" BUZIAS CENTER Link L76 Dorin-Gheorghe TRIFF, Simona POP - 12 minutes PRECURSORS OF BALENOLOGY EDUCATION IN ROMANIA Link L77 Dr. Eugenia Dumitrescu, Dr. Carmen Enescu - 12 minutes ANTIALLERGIC PROCEDURES MOST COMMONLY USED IN PHYSICAL RECOVERY MEDICINE AND BALNEOLOGY Link L78 Mihail HOTETEU, Constantin MUNTEANU, Diana MUNTEANU, Gabriela DOGARU - 12 minutes PELOIDS - PERSPECTIVES ON RESEARCH AND FUTURE PLANS Link L79 Liliana Stanciu, Daniela Profir, Viorica Marin, Doinița Oprea, Elena Ionescu, Elena Almășan, Carmen Oprea - 12 minutes THE SCIENCE OF AGING WELL Link L80 Q & A – 12 minutes POSTER SESSION Authors Title Abstract Andra Pintilie, Liliana Pădure, Andrada Mirea, Corina Sporea Proprioceptive Functional Vibration Stimulation as therapeutic tool in spasticity management of jump gait pattern of spastic diplegic children with cerebral palsy Poster 1 Andra Pintilie, Liliana Pădure, Andrada Mirea, Corina Sporea Modern computerized techniques for gait’s functional evaluation through a specialized wireless inertial sensor – premise for orthopedic corrective shoes wear in children with gait disorders secondary to Cerebral Palsy Poster 2 Ana Maria PÂSLARU, Ana Maria FĂTU, Anamaria CIUBARĂ The role of medical recovery in oncology Poster 3 Maria Veronica MORCOV, Liliana PADURE, Cristian Gabriel MORCOV, Gelu ONOSE Exercises availed by sensor-based computer advanced devices: part of the interactive cognitive recovery – adjuvant of the therapy applied in the Centrul National Clinic de Recuperare Neuropsihomotorie Copii “Dr. N. Robanescu” Poster 4 Avram Mihai, Liliana Padure, Gelu Onose Theoretical fundamentals and conceptual premise for advanced proprioceptive and sensory stimulus apparatus, with sequential evaluation for the treatment of the recuperator in the equilibrium disorder, from Cerebral Palsy (PC) casuistry. Poster 5 Andrada MIREA, Gelu ONOSE, Madalina LEANCA, Florin-Petru GRIGORAS, Mihaela AXENTE, Liliana PADURE, Corina SPOREA Respiratory management in patients with rare progressive neuromuscular diseases Poster 6 Mihaela MANDU, Elena CONSTANTIN, Cristinel Dumitru BADIU, Cosmin Daniel OPREA, Cristina DAIA, Gelu ONOSE Presentation od the Fugl Meyer Assesment scale and related suggesttion in order to enhance its level of implementation in inner neurorehabilitation units Poster 7 ALEXANDRU BOGDAN-CĂTĂLIN, ALINA SIMONA ȘOVREA, ANNE-MARIE CONSTANTIN, ADINA BIANCA BOȘCA, CARMEN GEORGIU, MONICA POPA Complex oral rehabilitation in an elderly patient with periodontal disease who exercises regularly Poster 8 Dorin-Gheorghe TRIFF, Simona POP MORBIDITY BY OSTEO-MUSCULO-ARTICULAR DISEASES IN THE OCCUPATIONAL ENVIRONMENT IN MARAMURES COUNTY. THE IMPORTANCE OF MEDICAL RECOVERY AND RECORDS THROUGH ELECTRONIC DATA MANAGEMENT SYSTEMS Poster 9 Authors Title Abstract Mihaela Antonina CALIN, Marian Romeo CALIN, Constantin Munteanu New evidence on the effects of pelotherapy on local microcirculation Poster 10 Izabela Lazar, Gabriela Dogaru The effectiveness of balnear treatment in the management of psoriasis Poster 11 Dorin-Gheorghe TRIFF, Mușata Dacia BOCOȘ CORRELATIONS OF OSTEOMUSCULO-ARTICULAR DISEASES WITH WORK ABILITY, PERCEIVED SELF EFFICACY AND OCCUPATIONAL STRESSORS AT A REGULAR MEDICAL CHECK-UP IN PRE-UNIVERSITY EDUCATION UNITS Poster 12 Doroteea Teoibas-Serban, Valentin Stan, Dan Blendea PREVENTION OF LUMBAR DISC HERNIATION IN YOUNG ADULT POPULATION: A PRACTICAL APPROACH Poster 13 Călin Corciovă, Cătălina Luca, Robert Fuior, Flavia Corciovă Development a Monitoring Device for Arm Rehabilitation Poster 14 Simona Daniela Zavalichi, Marius Andrei Zavalichi, Sorin Stratulat, Florin Mitu Cardiovascular rehabilitation: challenges in a case of acute myocardial infarction and familial hypercholesterolemia Poster 15 Simona-Isabelle STOICA, Ioana TANASE, Gelu ONOSE Influences and consequences resulting in addictions in general and to chronic alcoholism, especially for patients with spinal cord injury Poster 16 Roxana Dumitrascu, Ana Maria Bumbea, Carmen Albu, Otilia Rogoveanu, Catalin Bostina, Rodica Traistaru, Borcan Madalina BIOMECHANICAL DYSFUNCTIONS OF THE FOOT – MAJOR IMPACT ON THE KINETIC CHAIN Poster 17 Otilia Rogoveanu, Gherghina Florin, Caimac Dan, Trifu Ramona, Cruceru Andra, Beldie C Medical rehabilitation in post-stroke spastic hemiparesis in young patients Poster 18 Ana Maria Bumbea, Otilia Rogoveanu, Roxana Dumitrascu, Bogdan Stefan Bumbea, Catalin Bostina, Albu Carmen, Borcan Madalina PERIPHERAL MAGNETIC STIMULATION - A CHALLENGE IN VERTEBRAL POSTTRAUMATIC RECOVERY Poster 19 Authors Title Abstract Dănuţ PĂCURAR, Mihaela Ramona PĂCURAR KNEE ARTHROPLASTY RECOVERY OF AN CANCER PATIENT Poster 20 Dănuţ PĂCURAR, Mihaela Ramona PĂCURAR THE IMPACT OF OSTEOARTICULAR PATHOLOGY IN POSTSTROKE RECOVERY Poster 21 Borcan Madalina, Bumbea Ana Maria, Bostina Catalin, Radoi Georgeta, Bumbea Bogdan EFFICIENT REHABILITATION TREATMENT IN A CASE WITH MAV-RUPTA MALFORMATION Poster 22 Demirgian Sibel, Nan Simona, Lulea Adela, Lascu Ioana, Marin Viorica Is possible the management of synovial chondromatosis of the hip by arthroscopy or complex balneal treament? Poster 23 Mădălina Codruța Verenca, Sorina Mierlan, Claudiu Elisei Tanase The Efficiency of Medical Treatment of Scoliosis – Paediatrics Poster 24 Florentina NASTASE¹, Alin Laurentiu TATU², Madalina Codruta VERENCA¹ Orthopaedic manifestations of Neurofibromatosis type 1 – case report Poster 25 Simona CARNICIU, Anatolie BACIU, Vasile FEDAS The attenuation of energy metabolic misbalance by means of aerobic, hypoxic, hypothermal adaptation and environment optimization at recreation resort center Poster 26 Irina Anghel, Alexandra Sporici, Magdalena Lapadat, Gelu Onose Complex clinical and therapeutic rehabilitation approach of a patient with Complete AIS/Frankel A quadriplegia post cervical spinal cord injury after accidental fall off a trailer and multiple complications occurring during disease progression - case study Poster 27 Ana-Maria Pelin , Monica Georgescu , Cristina Stefanescu , Costinela Georgescu Molecular treatment strategies in osteoporosis Poster 28