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Suprascapular Nerve Block and Glenohumeral Injection in Hemiplegic Shoulder Pain: To Compare the Effectiveness on Pain and Disability  [cached]
Ay?egu?l TUBAY,Serpil BAL,Korhan Bar?? BAYRAM,Hikmet KO?YI?IT
Türkiye Fiziksel Tip ve Rehabilitasyon Dergisi , 2012,
Abstract: Objective: The aim of this study was to compare the effectiveness of glenohumeral (GH) joint injection and suprascapular nerve block (SNB) in patients with hemiplegic shoulder pain.Materials and Methods: Thirty-six patients with shoulder pain lasting for at least 3 months were randomized into two groups in which SNB was applied in the first and GH joint steroid injection in the second group. All patients were evaluated before treatment, after 30 minutes, second week and third month after the treatment. Pain at rest, with motion and nocturnal pain were determined by the visual analogue scale. Shoulder joint range of motion was recorded for all patients. Disability status was assessed using the Functional Independence Measure (FIM). Results: There was a significant decrease in VAS scores for pain at rest, night and activity immediately after, at the second week and at the third month after the treatment in both groups. Change scores were similar in both groups. Conclusion: Although, both GH joint injection and SNB reduced pain and improved functional status at upto 3 months, there was no superiority of the one over the other. Turk J Phys Med Re-hab 2012;58:299-306.
Journal of Special Education and Rehabilitation , 1997,
Abstract: The problems of mentally retarded persons which we encounter in our everyday work and several examples with drastically negative consequences of not planning the family have induced us to report our view points and suggestions about the necessity and importance of early detection of disability and necessary actions to help mentally retarded persons especially females in family planning and protection from sexual abuse.The negative consequences are reported by illustration of one case of mentally retarded mother with seven mentally retarded children and herself born illegitimately also by mentally retarded mother.
Psychometric characteristics of the Spanish version of instruments to measure neck pain disability
Francisco M Kovacs, Joan Bagó, Ana Royuela, Jesús Seco, Sergio Giménez, Alfonso Muriel, Víctor Abraira, José Martín, José Pe?a, Mario Gestoso, Nicole Mufraggi, Montserrat Nú?ez, Josep Corcoll, Ignacio Gómez-Ochoa, Ma José Ramírez, Eva Calvo, Ma Dolores Castillo, David Martí, Salvador Fuster, Carmen Fernández, Nuria Gimeno, Alejandro Carballo, álvaro Milán, Dolores Vázquez, Montserrat Ca?ellas, Ricardo Blanco, Pilar Brieva, Ma Trinidad Rueda, Luis álvarez, María del Real
BMC Musculoskeletal Disorders , 2008, DOI: 10.1186/1471-2474-9-42
Abstract: Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed.Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15.Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the lat
The development of instruments to measure the work disability assessment behaviour of insurance physicians
Romy Steenbeek, Antonius JM Schellart, Henny Mulders, Johannes R Anema, Herman Kroneman, Jan Besseling
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-1
Abstract: Based on theory and interviews with insurance physicians the questionnaire included blocks of items concerning background variables, intentions, attitudes, social norms, self-efficacy, knowledge, barriers and behaviour of the insurance physicians in relation to work disability assessment issues. The responses of 231 insurance physicians were suitable for further analysis. Factor analysis and reliability analysis were used to form scale variables and homogeneity analysis was used to form dimension variables. Thus, we included 169 of the 177 original items.Factor analysis and reliability analysis yielded 29 scales with sufficient reliability. Homogeneity analysis yielded 19 dimensions. Scales and dimensions fitted with the concepts of the ASE model. We slightly modified the ASE model by dividing behaviour into two blocks: behaviour that reflects the assessment process and behaviour that reflects assessment behaviour.The picture that emerged from the descriptive results was of a group of physicians who were motivated in their job and positive about the Dutch social security system in general. However, only half of them had a positive opinion about the Dutch Work and Income (Capacity for Work) Act (WIA). They also reported serious barriers, the most common of which was work pressure. Finally, 73% of the insurance physicians described the majority of their cases as 'difficult'.The scales and dimensions developed appear to be valid and offer a promising basis for future research. The results suggest that the underlying ASE model, in modified form, is suitable for describing the assessment behaviour of insurance physicians and the determinants of this behaviour. The next step in this line of research should be to validate the model using structural equation modelling. Finally, the predictive value should be tested in relation to outcome measurements of work disability assessments.Variation in assessments by professionals is a well-known phenomenon which occurs in cases whe
How do existing HIV-specific instruments measure up? Evaluating the ability of instruments to describe disability experienced by adults living with HIV
Kelly K O'Brien, Ahmed M Bayoumi, Carol Strike, Nancy L Young, Kenneth King, Aileen M Davis
Health and Quality of Life Outcomes , 2010, DOI: 10.1186/1477-7525-8-88
Abstract: We searched databases from 1980 to 2006 for English language, HIV-specific, self-reported questionnaires consisting of at least two items that were tested for reliability and validity. We then conducted a content analysis to assess how well existing questionnaires describe disability as defined by the Episodic Disability Framework, a framework that conceptualizes this experience from the perspective of adults living with HIV. We matched items of the instruments with categories of the framework to evaluate the extent to which the instruments capture major dimensions of disability in the framework.We reviewed 4274 abstracts, of which 30 instruments met the inclusion criteria and were retrieved. Of the four major dimensions of disability, symptoms/impairments were included in all 30 instruments, difficulties with day-to-day activities in 16, challenges to social inclusion in 16, and uncertainty in 9. Seven instruments contained at least 1 item from all 4 dimensions of disability (breadth) however, the comprehensiveness with which the dimensions were represented (depth) varied among the instruments.In general, symptoms/impairments and difficulties carrying out day-to-day activities were the disability dimensions characterized in greatest depth while uncertainty and challenges to social inclusion were less well represented. Although none of the instruments described the full breadth and depth of disability as conceptualized by the Episodic Disability Framework, they provide a foundation from which to build a measure of disability for adults living with HIV.With longer survival, HIV-positive individuals are facing an increasing variety of health-related consequences and symptoms related to HIV infection, associated treatment, and concurrent health conditions [1-11]. Together, these experiences may be conceptualized as disability. We developed a conceptual framework of disability from the perspective of adults living with HIV. In the Episodic Disability Framework, adults l
Estimating and validating disability-adjusted life years at the global level: a methodological framework for cancer  [cached]
Soerjomataram Isabelle,Lortet-Tieulent Joannie,Ferlay Jacques,Forman David
BMC Medical Research Methodology , 2012, DOI: 10.1186/1471-2288-12-125
Abstract: Background Disability-adjusted life years (DALYs) link data on disease occurrence to health outcomes, and they are a useful aid in establishing country-specific agendas regarding cancer control. The variables required to compute DALYs are however multiple and not readily available in many countries. We propose a methodology that derives global DALYs and validate variables and DALYs based on data from various cancer registries. Methods We estimated DALYs for four countries (Norway, Bulgaria, India and Uganda) within each category of the human development index (HDI). The following sources (indicators) were used: Globocan2008 (incidence and mortality), various cancer registries (proportion cured, proportion treated and duration of disease), treatment guidelines (duration of treatment), specific burden of disease studies (sequelae and disability weights), alongside expert opinion. We obtained country-specific population estimates and identified resource levels using the HDI, DALYs are computed as the sum of years of life lost and years lived with disabilities. Results Using mortality:incidence ratios to estimate country-specific survival, and by applying the human development index we derived country-specific estimates of the proportion cured and the proportion treated. The fit between the estimates and observed data from the cancer registries was relatively good. The final DALY estimates were similar to those computed using observed values in Norway, and in WHO’s earlier global burden of disease study. Marked cross-country differences in the patterns of DALYs by cancer sites were observed. In Norway and Bulgaria, breast, colorectal, prostate and lung cancer were the main contributors to DALYs, representing 54% and 45%, respectively, of the totals. These cancers contributed only 27% and 18%, respectively, of total DALYs in India and Uganda. Conclusions Our approach resulted in a series of variables that can be used to estimate country-specific DALYs, enabling global estimates of DALYs and international comparisons that support priorities in cancer control.
A study to measure the impact of customer perception, quality, environment concern and satisfaction on green customer loyalty
Hamid Reza Saeednia,Saeeid Khodaei Valahzaghard
Management Science Letters , 2012,
Abstract: Green product management plays an important role in today's economy and people are increasing becoming more interested in green products. In this paper, we present an empirical study to measure the impact of customer perception, quality, environment concern and satisfaction on green customer loyalty. The study proposes two hypotheses, where the first hypothesis studies whether the quality of green product has direct impact on customer satisfaction and the second hypothesis examines whether quality of green product has direct impact on customer loyalty. The population of this paper includes all people who use paper-based drinking glass, napkin and packaging products and live in city of Tehran, Iran. Since not all people are involved in all parts of the city in such product, we have decided to select only those who are involved in using these kinds of products including hospitals, universities, etc. The sampling technique has distributed 300 questionnaires and gathered 283 good quality ones for analysis. The questionnaire consists of 19 questions in five different perspectives. The proposed study uses sequential equation modeling and the results have confirmed both hypotheses.
The AMC Linear Disability Score (ALDS): a cross-sectional study with a new generic instrument to measure disability applied to patients with peripheral arterial disease
Rosemarie Met, Jim A Reekers, Mark JW Koelemay, Dink A Legemate, Rob J de Haan
Health and Quality of Life Outcomes , 2009, DOI: 10.1186/1477-7525-7-88
Abstract: Patients with intermittent claudication (IC) and critical limb ischemia (CLI) presenting from January 2007 through November 2007 were included. Risk factors for atherosclerosis, ankle/brachial index and toe pressure, the Vascular Quality of Life Questionnaire (VascuQol), and the ALDS were recorded. To compare ALDS and VascuQol scores between the two patient groups, an unpaired t-test was used. Correlations were determined between VascuQol, ALDS and pressure measurements.Sixty-two patients were included (44 male, mean ± sd age was 68 ± 11 years) with IC (n = 26) and CLI (n = 36). The average ALDS was significantly higher in patients with IC (80, ± 10) compared to patients with CLI (64, ± 18). Internal reliability consistency of the ALDS expressed as Cronbach's α coefficient was excellent (α > 0.90). There was a strong convergent correlation between the ALDS and the disability related Activity domain of the VascuQol (r = 0.64).The ALDS is a promising clinimetric instrument to measure disability in patients with various stages of peripheral arterial disease.The impact of a disease on a patient's quality of life and level of activities of daily life (ADL) is an important outcome measure in clinical studies [1]. It is well known that perceived quality of life and ADL are significantly impaired in individuals with peripheral arterial disease (PAD) [2-5].There are several instruments available to measure quality of life in patients with PAD. Both generic instruments, such as the Short-Form 36 (SF36), the Sickness Impact Profile, and the Nottingham Health Profile [6], and disease-specific instruments like the Vascular Quality of Life Questionnaire (VascuQol) and the Claudication Scale (CLAU-S) are frequently used [7,8]. A limitation of these instruments is that they do not focus on level of ADL in terms of self-care, dressing, indoors and outdoors activities, and housekeeping management. Measuring this level of disability is useful, since it is more closely related to impai
Measuring upper limb disability in non-specific neck pain: A clinical performance measure
Sionnadh McLean,Jason Taylor,Toulassidharane Balassoubramanien,Manik Kulkarni
International Journal of Physiotherapy and Rehabilitation , 2010,
Abstract: Clinically it is common for patients with non-specific neck pain to report problems with upper limb function. Yet the extent of upper limb deficits in patients with neck pain is not well known and there are few measures available to clinicians to help quantify upper limb capacity in patients with neck pain. This paper synthesises and presents the findings of several studies which attempt to quantify the extent of upper limb disability in patients with non-specific neck pain and describes the development, validation and limitations of the Single Arm Military Press (SAMP) test. The SAMP test is an easy to conduct, brief, economical, performance based measure of upper limb disability which may prove beneficial for use in clinical practice in different cultural or socioeconomic communities, though further validation is required to confirm this.
Validated instruments used to measure attitudes of healthcare students and professionals towards patients with physical disability: a systematic review
Wai Lam, Sameer K Gunukula, Denise McGuigan, New Isaiah, Andrew B Symons, Elie A Akl
Journal of NeuroEngineering and Rehabilitation , 2010, DOI: 10.1186/1743-0003-7-55
Abstract: We electronically searched Medline, EMBASE, PsycINFO, Health and Psychosocial Instruments. We included papers reporting on the development and/or validation of survey instruments to measure attitudes of healthcare students and professionals towards patients with physical disability. We excluded papers in which the attitudes were not measured in a provider-patient context. Two reviewers carried out titles and abstracts screening, full texts screening, and data abstraction in a duplicate and independent manner using standardized and pilot tested forms.We identified seven validated survey instruments used for healthcare students and professionals. These instruments were originally developed for the following target populations: general population (n = 4); dental students (n = 1); nursing students (n = 1); and rehabilitation professionals (n = 1). The types of validity reported for these instruments were content validity (n = 3), criterion-related validity (n = 1), construct validity (n = 2), face validity (n = 1), discriminant validity (n = 1), and responsiveness (n = 1). The most widely validated and used tool (ATDP) was developed in the late 1960s while the most recent instrument was developed in the early 1990s.Of the seven identified validated instruments, less than half were specifically designed for healthcare students and professionals and none for medical students. There is a need to develop and validate a contemporary instrument specifically for medical students.Three main issues have been identified in addressing the problem of health care providers and their approach to people with disabilities: lack of disability-specific knowledge; discomfort with working with people with disabilities; and attitudes and misperceptions about disability. People with disabilities have cited negative attitudes and behaviors of health care providers as the most formidable barriers to accessing health care services[1-5].Negative attitudes held by health care providers about pati
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