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Daily Activities (daily + activity)
Kinds of Daily Activities Selected AbstractsContent validity and clinical applicability of the Irena Daily Activity assessment measuring occupational performance in adults with developmental disabilityOCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2003Irena Dychawy-Rosner MSc Abstract The purpose of this study was to investigate the validity of the Irena Daily Activity (IDA) assessment which measures occupational performance in adults with developmental disabilities. The instrument's content validity was investigated by elucidating its general appropriateness, its clinical applicability and the feasibility of the measurement procedure. Data were collected from a multidisciplinary panel of clinical experts working in day activity centres. Each expert independently judged and reviewed the IDA instrument's content validity. The results show that the content validity index (CVI) values ranged from 0.8 to 1.0 for the instrument's general appropriateness and clinical applicability, and from 0.7 to 1.0 with respect to the significance of the IDA domains' clinical applicability. The applicability of the IDA items were judged as satisfactory (CVI , 80) with respect to their importance for planning treatment and intervention. The feasibility of the measurement procedure was estimated as satisfactory in relation to the items (CVI , 0.70) and satisfactory with respect to the time needed and material used, with CVI values ranging from 0.8 to 1.0. The results of this study support the use of the IDA as a feasible and time-efficient assessment that provides insights regarding the occupational performance of adults with developmental disabilities. A limitation of this study was that it could not illuminate all-important aspects of validity. In conclusion, the IDA has the potential to become a reliable and valid clinical assessment, but additional research on psychometric properties is still needed. Copyright © 2003 Whurr Publishers Ltd. [source] Evaluation of Interventions Proposed for Altered Tissue Perfusion: Cardiopulmonary in Patients Hospitalized With Acute Myocardial InfarctionINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Ivanise Maria Gomes PURPOSE To evaluate the effectiveness and efficacy of the interventions proposed for patients with altered tissue perfusion: cardiopulmonary, according to NIC and NOC taxonomies. METHODS Prospective and descriptive study carried out in the cardiology unit of a school hospital with patients under clinical treatment followed from admission until discharge. Patient data were collected using the unit's assessment tool and nursing diagnoses were established. Daily activities were proposed for these patients based on NIC interventions "cardiac care: acute,""cardiac care," and "cardiac care: rehabilitative." Results were evaluated according to indicators selected from NOC's Tissue Perfusion: Cardiac. FINDINGS The sample comprised 25 patients (12 males, 13 females), age range 39 to 83 years. Days hospitalized averaged 3.5 in the coronary unit and 3.5 in the cardiology infirmary, for a total of 7 hospital days. The nursing diagnosis was made based on defining characteristics: enzymatic and ECG changes were found in 100% of the patients, chest pain (96%), diaphoresis (80%), and nausea (72%). The related factor in evidence for 100% of the sample was coronary arterial flow interruption. Patients were evaluated according to NOC outcomes both before starting activities and daily, with the following results: chest pain , 64% of patients initially presented pain with score 1, most (72%) presented scores 4 and 5 on day 2; on days 3, 5, 6, and 7 of hospitalization, all patients reported absence of pain (score 5). On day 4 only, 4% of patients reported pain with intensity 7 (score 2). Profuse diaphoresis was found in 80% of the sample on day 1 of hospitalization, and that disappeared in the course of the remaining days. Nausea was found in 44% of the population with score 1 on day 1 of hospitalization, and disappeared subsequently. Most the patients (84%) did not present with vomiting. Also, no evidence was found of vital sign changes in most of the sample. ECG presented score 1 in 72% of the sample on day 1, greatly decreasing from day 2. Cardiac enzymes appeared in 100% of the sample, decreasing in subsequent days. Heart ejection fraction, pulmonary artery pressure, heart rate, and myocardial scanning indicators were not measured. CONCLUSIONS Indicators evaluated achieved score 5 (no compromise) on hospital discharge in 100% of patients, which evidences effectiveness of the interventions performed. [source] Anticipatory Pleasure Skills Training: A New Intervention to Reduce Anhedonia in SchizophreniaPERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2010Jérôme Favrod RN PURPOSE., Anhedonia is a challenging symptom of schizophrenia and remains largely recalcitrant to current pharmacological treatments. The goal of this exploratory pilot study was to assess if a cognitive,sensory intervention could improve anticipatory pleasure. DESIGN AND METHODS., Five participants meeting the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) criteria for schizophrenia, presenting severe anhedonia and stabilized on atypical antipsychotic medication, received between 10 hours and 25 hours of training. FINDINGS., Results show that the patients improved on the anticipatory scale of the Temporal Experience of Pleasure Scale. Daily activities of the patients were also increased. PRACTICE IMPLICATIONS., These preliminary data need to be interpreted with caution given the small sample of the study, but they offer promising paths to develop new interventions to alleviate anhedonia in schizophrenia. [source] Development and validation of a disease-specific quality of life questionnaire for gastro-oesophageal reflux disease: the GERD-QOL questionnaireALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2010Y. CHAN Aliment Pharmacol Ther,31, 452,460 Summary Background, A simple and meaningful health-related quality of life (HRQoL) questionnaire for gastro-oesophageal reflux disease (GERD) patients is lacking. Aim, To develop and validate a disease-specific HRQoL instrument (GERD-QOL) for GERD patients. Methods, An 18-item questionnaire was generated to measure the impact of GERD on sleep, exercise, diet, need for medication, sex life, work, social activity and psychological well-being. GERD patients were invited to complete the GERD-QOL, a visual analogue scale (VAS) and a validated Chinese generic QoL (SF-36) questionnaire before and after esomeprazole treatment. Factor analysis was performed for item selection and psychometric properties were measured. An English version was developed by a forward-backward translation process. Results, A final 16-item GERD-QOL questionnaire was developed. The items were grouped into four subscales (Daily activity, Treatment effect, Diet, and Psychological well-being) after factor analysis. GERD-QOL had good item-internal consistency (Cronbach's alpha: 0.64,0.88), high test-retest reliability (intraclass correlation coefficient: 0.73,0.94, P < 0.001). Its subscale scores were correlated with SF-36 and VAS, which demonstrated high construct validity (P < 0.001). Discriminant validity was verified by correlating GERD-QOL scores with symptom severity (P < 0.001). Responsiveness after esomeprazole treatment was significant (paired- t -test P < 0.001). An English version of GERD-QOL was developed. Conclusion, The instrument, GERD-QOL, is valid and reliable. [source] Pain interference impacts response to treatment for anxiety disordersDEPRESSION AND ANXIETY, Issue 3 2009Carrie Farmer Teh PhD Abstract Background: Anxiety disorders and pain are commonly comorbid, though little is known about the effect of pain on the course and treatment of anxiety. Methods: This is a secondary analysis of a randomized controlled trial for anxiety treatment in primary care. Participants with panic disorder (PD) and/or generalized anxiety disorder (GAD) (N=191; 81% female, mean age 44) were randomized to either their primary-care physician's usual care or a 12-month course of telephone-based collaborative care. Anxiety severity, pain interference, health-related quality of life, health services use, and employment status were assessed at baseline, and at 2-, 4-, 8-, and 12-month follow-up. We defined response to anxiety treatment as a 40% or greater improvement from baseline on anxiety severity scales at 12-month follow-up. Results: The 39% who reported high pain interference at baseline had more severe anxiety (mean SIGH-A score: 21.8 versus 18.0, P<.001), greater limitations in activities of daily living, and more work days missed in the previous month (5.8 versus 4.0 days, P=.01) than those with low pain interference. At 12-month follow-up, high pain interference was associated with a lower likelihood of responding to anxiety treatment (OR=.28; 95% CI=.12,.63) and higher health services use (26.1% with ,1 hospitalization versus 12.0%, P<.001). Conclusions: Pain that interferes with daily activities is prevalent among primary care patients with PD/GAD and associated with more severe anxiety, worse daily functioning, higher health services use, and a lower likelihood of responding to treatment for PD/GAD. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] Lifestyle, participation, and health-related quality of life in adolescents and young adults with myelomeningoceleDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2009LAURIEN M BUFFART PHD This study aimed to describe participation and health-related quality of life (HRQoL) in adolescents and young adults with myelomeningocele and to explore their relationships with lifestyle-related factors. Fifty-one individuals with a mean age of 21 years 1 month (SD 4y 6mo) years participated (26 males, 25 females; 82% hydrocephalus, 55% wheelchair-dependent). Participation was assessed using the Life Habits Questionnaire, and HRQoL was assessed using the Medical Outcomes Study 36-item Short-form Health Survey. Physical activity was measured using an accelerometry-based activity monitor, fitness (peak oxygen uptake) was measured during a maximal exercise test, and the sum of four skin-folds was assessed to indicate body fat. Relationships were studied using logistic regression analyses. Of the participants, 63% had difficulties in daily activities and 59% in social roles. Participants perceived lower physical HRQoL than a Dutch reference population. Participants with higher levels of physical activity and fitness had fewer difficulties in participating in daily activities (odds ratio [OR]=8.8, p=0.02 and OR=29.7, p=0.02 respectively) and a higher physical HRQoL (OR=4.8, p=0.02 and OR=30.2, p=0.006 respectively), but not mental HRQoL. Body fat was not related to participation or HRQoL. In conclusion, a large proportion of individuals with myelomeningocele had difficulties in participation and perceived low physical HRQoL. Higher levels of physical activity and fitness were related to fewer difficulties in participation and higher physical HRQoL. [source] Weight gain in bipolar disorder: pharmacological treatment as a contributing factorACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2008C. Torrent Objective:, The aim of this paper was to review the association of most commonly used psychopharmacological drugs with weight gain in bipolar disorder. Method:, Information was retrieved from a PubMed/Medline literature search reviewing weight gain in pharmacological studies in bipolar disorder. Results:, Obesity and overweight in bipolar disorder are partly related to prescribed drugs with a strong effect of clozapine and olanzapine. Lesser but still relevant weight gain is caused by quetiapine, risperidone, lithium, valproate, gabapentin and by some antidepressants. Ziprasidone, aripiprazole, carbamazepine and lamotrigine do not seem to cause significant overweight. Conclusion:, Careful monitoring of weight changes in patients before and after drug prescription should be implemented in the clinical routine and drugs which potentially cause weight gain should be avoided in overweight patients with bipolar disorder. Furthermore, eating habits and daily activities should be targeted as they may also have a significant impact on overall health and weight-related issues. [source] Walking function, pain, and fatigue in adults with cerebral palsy: a 7-year follow-up studyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2009ARVE OPHEIM PT MSC Aim, To compare walking function, pain, and fatigue in adults with cerebral palsy (CP) 7 years after an initial survey. Method, A multidimensional questionnaire was mailed to 226 people with unilateral (hemiplegic) or bilateral (diplegic) spastic CP who had participated in a 1999 survey. People with additional diagnoses were excluded. Special emphasis was placed on participants with deterioration in walking. The questionnaire was the same as in 1999. Results, One hundred and forty-nine participants (76 males, 73 females; mean age 40y 5mo, SD 10y 7mo, range 24,76y) with a diagnosis of unilateral (n=81) or bilateral (n=68) spastic CP responded. Fifty-two per cent of all participants reported deterioration in walking function since debut of walking, compared with 39% 7 years previously. In participants with bilateral CP, 71% reported deteriorated walking, compared with 37% of participants with unilateral CP. Participants with deteriorated walking function had greater pain frequency, pain intensity, impact of pain on daily activities, and physical fatigue and reduced balance. The number of people reporting overall mobility problems was almost double compared with 7 years previously. Interpretation, The main finding was an increased prevalence of deteriorated walking, significantly associated with bilateral spastic CP, pain, fatigue, and reduced balance. Rehabilitation programmes addressing these areas are needed. [source] Minimization of socioeconomic disruption for displaced populations following disastersDISASTERS, Issue 3 2010Omar El-Anwar In the aftermath of catastrophic natural disasters such as hurricanes, tsunamis and earthquakes, emergency management agencies come under intense pressure to provide temporary housing to address the large-scale displacement of the vulnerable population. Temporary housing is essential to enable displaced families to reestablish their normal daily activities until permanent housing solutions can be provided. Temporary housing decisions, however, have often been criticized for their failure to fulfil the socioeconomic needs of the displaced families within acceptable budgets. This paper presents the development of (1) socioeconomic disruption metrics that are capable of quantifying the socioeconomic impacts of temporary housing decisions on displaced populations; and (2) a robust multi-objective optimization model for temporary housing that is capable of simultaneously minimizing socioeconomic disruptions and public expenditures in an effective and efficient manner. A large-scale application example is optimized to illustrate the use of the model and demonstrate its capabilities ingenerating optimal plans for realistic temporary housing problems. [source] Lamotrigine Therapy of Epilepsy in Tuberous SclerosisEPILEPSIA, Issue 7 2001David Neal Franz Summary: ,Purpose: Lamotrigine (LTG), a newer antiepileptic drug (AED), has activity against both partial-onset and generalized seizures. Its reported benefits for behavior, and its effectiveness in Lennox,Gastaut syndrome and other forms of refractory epilepsy, make it a logical choice for treatment of epilepsy in tuberous sclerosis complex (TSC). We present our experience with LTG therapy of epilepsy in 57 patients with TSC. Methods: Patients fulfilled the diagnostic criteria for clinically definite TSC. LTG was initiated and increased until improvement in seizure frequency was noted, intolerable side effects occurred, or maximal doses were reached. Seizure frequency and behavioral changes were recorded during LTG therapy and compared with those prior to the introduction of LTG. Results: Twenty-four (42%) were seizure free, and 21 (37%) had a >50% reduction in seizure frequency. Eighteen (32%) had subjectively improved behavior and/or alertness with daily activities. Thirty-eight (67%) had no change in this regard, whereas one (2%) became worse. Responders were more likely to not have a history of infantile spasms, and to have experienced only partial seizures (p < 0.05). Otherwise no phenotypic correlations with response were apparent. Conclusions: Among patients with TSC and epilepsy, LTG was effective and well tolerated, including as initial monotherapy. Improved alertness and behavior were apparent in many patients. The incidence of side effects is similar to that reported for other pediatric populations with symptomatic partial epilepsy. The usefulness of LTG in TSC may relate to an underlying defect of glutamatergic neurotransmission in partial epilepsy. [source] Pain and sensory complaints in multiple sclerosisEUROPEAN JOURNAL OF NEUROLOGY, Issue 7 2004A. G. Beiske Pain is a frequent and disabling symptom among multiple sclerosis (MS) patients. The importance of this problem was investigated in a hospital based MS population. A total of 142 MS patients underwent neurological examination and a structured interview for registration of pain and sensory symptoms. One-hundred and five patients reported sensory and/or pain symptoms. Pain was reported by 93 patients and was most frequently located in the limbs and lumbar region. The presence of pain was independent of gender, age at onset and examination, disability, disease course and duration. The most frequently reported characteristics of the symptoms were paresthesia, neuralgia and deep muscular aching. About 40% of the patients reported that the symptoms had important influence on daily activities. Only one-third of the patients were treated for their pain. Pain is a frequent and disabling symptom, independent of demographic and clinical variables in MS patients. The low frequency of treatment for these symptoms indicates a need for improved attention to this problem. [source] Dimensions of Ambiguous Loss in Couples Coping With Mild Cognitive Impairment,FAMILY RELATIONS, Issue 2 2007Rosemary Blieszner Abstract: We applied the theory of ambiguous loss to couples with mild cognitive impairment (MCI), an age-related decline in memory and other cognitive processes assumed not to interfere with daily activities or the maintenance of personal relationships. Face-to-face interviews with 67 older married couples revealed that lack of understanding about the behavioral manifestations of MCI resulted in much ambiguity in their lives. Fluctuations in the elders' functioning required spouses to alter their daily activities and responsibilities. As a result, couples often experienced distress that affected their emotional involvement with one another. Findings advance theoretical implications of ambiguous loss and provide educators and practitioners with suggestions for working with couples experiencing mild memory loss. [source] Lunar cycles and reproductive activity in reef fishes with particular attention to rabbitfishesFISH AND FISHERIES, Issue 4 2004Akihiro Takemura Abstract Cues from the moon influence synchrony in growth, feeding, migration, behaviour and reproduction of many reef fishes. Compared with comprehensive studies on the annual and daily activities of fish, few physiological studies have paid attention to the importance of lunar cues in reproductive activities. We review mutual and interesting relationships between fish reproduction and environmental changes induced by the moon, with particular emphasis on the reproductive activity of the rabbitfishes (Siganidae). Rabbitfish species exhibit, in nature, a definitive reproductive season, which differs among the tropical areas. During the reproductive season, synchronous spawning of rabbitfish is associated with a particular lunar phase. The lunar phase used by the respective species is similar in different regions on the earth. Histological observations revealed that gonads develop synchronously towards a peak around the spawning lunar phase, after which the gonads return to spent condition. Concomitant with gonadal development, sex steroid hormones were produced under the influence of gonadotropin (GtH). Injections of human chronic gonadotropin (hCG) to the fish that are undergoing active spermatogenesis accelerated testicular maturation. These results suggest that hormonal response in maturing the gonads in rabbitfish is under the regulation of GtH, and that pituitary secretion of GtH according to the lunar cycle accounts for the lunar rhythm in gonadal development. We speculate that the cues from the moon can be recognized by the higher parts of the hypothalamus,pituitary,gonadal axis. Possible relationships between exogenous environmental factors and the lunar-reproductive rhythm are also discussed. [source] A CITY IN MOTION: TIME-SPACE ACTIVITY AND MOBILITY PATTERNS OF SUBURBAN INHABITANTS AND THE STRUCTURATION OF THE SPATIAL ORGANIZATION OF THE PRAGUE METROPOLITAN AREAGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 2 2007Jakub Novák ABSTRACT. This contribution attempts to reveal the relations between new suburban areas and other parts of the Prague metropolitan area by investigating the time-space activity and mobility patterns of the inhabitants of newly built suburban districts. The focus on some aspects of the everyday life of people in new suburbs helps us to identify the impact of suburbanization on the changing geography of the metropolitan region and to better understand how the spatial organization of the Prague metropolitan area is produced, reproduced and transformed. We use several interrelated concepts, which serve the theoretical foundation of our work, namely time geography, structuration theory and the post-communist city. The empirical data utilized are primarily based on 262 diaries completed by eighty-eight individuals from thirty-eight households, accompanied by household questionnaires and interviews with the heads of households. The research confirmed the implicit, generally unspoken view that new suburbs in the Prague metropolitan region are heavily dependent on the core of the metropolitan area for the provision of jobs and services. However, newly built suburban shopping facilities to some extent disrupt this pattern, keeping some daily activities of inhabitants within the suburban zone. In addition to empirical observations, the key purpose of this contribution has been to discuss and apply time geography concepts and methods to the research of urban restructuring, and to understand the structuration of metropolitan spatial organization. [source] Clinical and radiographic scores in haemophilic arthropathies: how well do these correlate to subjective pain status and daily activities?HAEMOPHILIA, Issue 6 2002T. Wallny Summary. Haemophilic patients who reached adulthood before the establishment of prophylactic treatment frequently show multiple and substantial arthropathies. The aim of this study was to determine to what extent haemophiliac's subjective impairment due to arthropathies correlates with objective clinical and radiographic parameters. By means of a questionnaire and a visual analogue scale, we consulted 79 haemophiliacs concerning their joint-pain status, how these were treated and to what extent their daily activities had been affected. Using a scoring system suggested by the Advisory Committee of the World Federation of Haemophilia, clinical evaluation was performed. Radiographs of 60 patients were assessed by means of the Petterson scale. The results were statistically compared. We found a significant correlation between pain intensity and clinical pathology as well as between pain intensity and radiographic joint damage for both knees and for the right ankle. The number of painful joints correlated well with the number of clinically/radiographically affected joints. The more pronounced the objective damage to joints, the more frequently patients claimed to have constant pain, depressive episodes and a dependency on pain-relieving medication. The more pronounced the objectively assessed damage to the knee and ankle joint, the higher the likelihood that the patient suffers from severe joint pain and reduction of activity. Treatment of painful symptoms from arthropathies is often insufficient. Scores and questionnaires may help to define the haemophiliacs pain status more clearly, thereby offering a possibility of assessment and long-term observation. [source] Zygomaticomaxillary buttress reconstruction of midface defects with the osteocutaneous radial forearm free flapHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2008Patricio Andrades MD Abstract Background. The purpose of this study was to evaluate morbidity, functional, and aesthetic outcomes in midface zygomaticomaxillary buttress reconstruction using the osteocutaneous radial forearm free flap (OCRFFF). Methods. A retrospective review of 24 consecutive patients that underwent midface reconstruction using the OCRFFF was performed. All patients had variable extension of maxillectomy defects that requires restoration of the zygmatico-maxillary buttress. After harvest, the OCRFFF was fixed transversely with miniplates connecting the remaining zygoma to the anterior maxilla. The orbital support was given by titanium mesh when needed that was fixed to the radial forearm bone anteriorly and placed on the remaining orbital floor posteriorly. The skin paddle was used for intraoral lining, external skin coverage, or both. The main outcome measures were flap success, donor-site morbidity, orbital, and oral complications. Facial contour, speech understandability, swallowing, oronasal separation, and socialization were also analyzed. Results. There were 6 women and 18 men, with an average age of 66 years old (range, 34,87). The resulting defects after maxillectomy were (according to the Cordeiro classification; Disa et al, Ann Plast Surg 2001;47:612,619; Santamaria and Cordeiro, J Surg Oncol 2006;94:522,531): type I (8.3%), type II (33.3%), type III (45.8%), and type IV (12.5%). There were no flap losses. Donor-site complications included partial loss of the split thickness skin graft (25%) and 1 radial bone fracture. The most significant recipient-site complications were severe ectropion (24%), dystopia (8%), and oronasal fistula (12%). All the complications occurred in patients with defects that required orbital floor reconstruction and/or cheek skin coverage. The average follow-up was 11.5 months, and over 80% of the patients had adequate swallowing, speech, and reincorporation to normal daily activities. Conclusions. The OCRFFF is an excellent alternative for midface reconstruction of the zygomaticomaxillary buttress. Complications were more common in patients who underwent resection of the orbital rim and floor (type III and IV defects) or external cheek skin. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [source] Botulinum Toxin Type-A (BOTOX®) in the Treatment of Occipital Neuralgia: A Pilot StudyHEADACHE, Issue 10 2008Martin Taylor DO Objective., To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia. Background., Occipital neuralgia is a unilateral or bilateral radiating pain with paresthesias commonly manifesting as paroxysmal episodes and involving the occipital and parietal regions. Common causes of occipital neuralgia include irritation or injury to the divisions of the occipital nerve, myofascial spasm, and focal entrapment of the occipital nerve. Treatment options include medication therapy, occipital nerve blocks, and surgical techniques. BTX-A, which has shown promise in relief of other headache types, may prove a viable therapeutic option for occipital neuralgia pain. Methods., Botulinum toxin type-A (reconstituted in 3 cc of saline) was injected into regions traversed by the greater and lesser occipital nerve in 6 subjects diagnosed with occipital neuralgia. Subjects were instructed to report their daily pain level (on a visual analog pain scale), their ability to perform daily activities (on several quality of life instruments) and their daily pain medication usage (based on a self-reported log), 2 weeks prior to the injection therapy and 12 weeks following injection therapy. Data were analyzed for significant variation from baseline values. Results., The dull/aching and pin/needles types of pain reported by the subjects did not show a statistically significant improvement during the trial period. The sharp/shooting type of pain, however, showed improvement during most of the trial period except weeks 3-4 and 5-6. The quality of life measures exhibited some improvement. The headache-specific quality of life measure showed significant improvement by 6 weeks which continued through week 12. The general health- and depression-related measures showed no statistical improvement. No significant reduction in pain medication usage was demonstrated. Conclusions., Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain. [source] Neuromodulators for Migraine PreventionHEADACHE, Issue 4 2008Robert Kaniecki MD Migraine is a debilitating condition characterized by a cycle of painful headaches and headache-related symptoms interspersed with periods of worry, distress, and apprehension. The negative impact of migraine on patient functioning, workplace productivity, and other daily activities has been demonstrated through the use of a variety of clinician- and patient-reported assessment tools, including the Migraine-Specific Questionnaire and the Migraine Disability Assessment questionnaire. In addition to considering the frequency and severity of migraine, clinicians need to encourage more open dialogue with their patients about the impact of this disorder on daily activities and productivity. Only then can the most appropriate course of treatment be determined. Appropriately prescribed acute and preventive therapies should break the cycle of migraine and improve the daily activities of patients with this chronic condition. Divalproex sodium and topiramate are neuromodulators that are approved by the US Food and Drug Administration (FDA) for the prophylaxis (prevention) of migraine headache in adults. Non-FDA-approved neuromodulators sometimes used in the management of migraine headache include gabapentin, lamotrigine, levetiracetam, and zonisamide. All medications need to be titrated, and treatment-related adverse events need to be managed appropriately. Preventive medications should be taken for at least 2-3 months to ascertain their therapeutic effect. [source] Epidemiology and Symptomatology of Migraine Among School Children: Denizli Urban Area in TurkeyHEADACHE, Issue 8 2004Mehmet Zencir MD Objective.,This study was aimed at finding the prevalence, associated factors, and symptomatology of migraine among 5 to 8 grades of secondary and 9 to 11 grades of high school children (age range between 11 and 18 years old) in the Denizli urban area in the western part of Turkey. Background.,Data from the developed countries indicate that migraine is the most common cause of recurrent headaches in children. Also, childhood migraine is sufficiently severe to prevent the half of the suffering children from carrying on their usual daily activities. Methods.,A cross-sectional school-based study was conducted between May 2000 and June 2000. There were 2,490 participants selected by a multistage stratified clustered sampling procedure. A validated self-administered questionnaire designed according to the International Headache Society criteria was given to the school children of age between 11 and 18 years. Results.,Overall migraine prevalence was 8.8%; it was 6.7% in boys and 11.0% in girls (OR: 1.7; 95% CI: 1.3 to 2.3). Among girls, the highest prevalence (17.7%) occurred at 15 years of age, but among boys, the highest prevalence (11.9%) occurred at 16 years of age. Of children with migraine, 56.5% had a positive family history, and only 29.1% visited a doctor for headache. Conclusion.,Migraine is a common health problem among school children in Denizli urban area and it often goes underdiagnosed. [source] Use of the Migraine Disability Assessment Questionnaire in Children and Adolescents With Headache: An Italian Pilot StudyHEADACHE, Issue 7 2003D. D'Amico MD Objectives.,To determine the suitability of the Migraine Disability Assessment (MIDAS) Questionnaire for assessing disability in children and adolescents with headache and to obtain preliminary information about disability in different primary headaches. Background.,During the last decade, researchers have begun to employ standardized methodologies to investigate the global impact of primary headaches. Disease-specific instruments have been developed to measure headache-related disability. The MIDAS Questionnaire, which is the most extensively studied of these instruments, was designed to assess the overall impact of headaches over the 3 months before compilation. The MIDAS Questionnaire is an optimal tool to assess headache-related disability in adults. Methods.,Ninety-five patients aged 7 to 17 years with tension-type headache, migraine, or both completed the validated Italian form of the MIDAS questionnaire on 2 occasions. Test-retest reliability was assessed by the Spearman rank correlation test. The Cronbach , assessed internal consistency. The patients answered questions about the adequacy of the questionnaire. Results.,The Cronbach , was .8. Correlation coefficients were generally high for the overall MIDAS score and for the items investigating disability in school and in family/leisure activities; they were lower for the items about housework. Most patients thought that the MIDAS Questionnaire was useful (98.9%) and that it captured the impact of their headaches (58.9%); 41% thought that questions about disability in housework were useless, 44.2% suggested adding questions regarding inability to do homework. All primary headaches had a considerable impact on daily activities, but patients with migraine tended to have lower headache frequencies and lower total disability time; those with tension-type headache suffered more days in which activities, although performed, were substantially impaired. Conclusions.,The MIDAS Questionnaire is useful for assessing disability in children and adolescents with different primary headaches. Minimal changes in the phrasing and content of the items would be sufficient to render the MIDAS specific for the younger population with headache. [source] Patient preferences for managing asthma: results from a discrete choice experimentHEALTH ECONOMICS, Issue 7 2007Madeleine T. King Abstract Effective control of asthma requires regular preventive medication. Poor medication adherence suggests that patient preferences for medications may differ from the concerns of the prescribing clinicians. This study investigated patient preferences for preventive medications across symptom control, daily activities, medication side-effects, convenience and costs, using a discrete choice experiment embedded in a randomized clinical trial involving patients with mild,moderate persistent asthma. The present data were collected after patients had received 6 weeks' treatment with one of two drugs. Three choice options were presented, to continue with the current drug, to change to an alternative, hypothetical drug, or to take no preventive medication. Analysis used random parameter multinomial logit. Most respondents chose to continue with their current drug in most choice situations but this tendency differed depending on which medication they had been allocated. Respondents valued their ability to participate in usual daily activities and sport, preferred minimal symptoms, and were less likely to choose drugs with side-effects. Cost was also significant, but other convenience attributes were not. Demographic characteristics did not improve the model fit. This study illustrates how discrete choice experiments may be embedded in a clinical trial to provide insights into patient preferences. Copyright © 2007 John Wiley & Sons, Ltd. [source] Increasing intra-abdominal pressure increases pressure, volume, and wall tension in esophageal varicesHEPATOLOGY, Issue 4 2002Angels Escorsell Many daily activities cause acute elevations of intra-abdominal pressure (IAP). In portal hypertensive cirrhotic patients, increased IAP increases absolute portal pressure and azygos blood flow, suggesting that it may have detrimental consequences at the esophageal varices. The aim of this study was to investigate the effects of increased IAP on variceal pressure, size, and wall tension. Endosonography and a noninvasive endoscopic pressure gauge were used to measure variceal pressure, radius, wall tension, and volume in baseline conditions and after increasing IAP by 10 mm Hg using an inflatable girdle in 14 patients with cirrhosis and esophageal varices. Increasing IAP markedly increased variceal pressure (from 13.3 ± 4.2 to 17.4 ± 4.6 mm Hg; P = .0001) and radius (from 2.9 ± 1.0 to 3.9 ± 1.1 mm; P = .0001). Consequently, wall tension dramatically increased (from 38.7 ± 13.6 to 65.9 ± 23.8 mm Hg · mm, +78%; P = .0001). Variceal volume increased significantly from 1,264 ± 759 to 2,025 ± 1,129 mm3 (P = .0001). In conclusion, in portal hypertensive cirrhotic patients, increases in IAP have deleterious effects on variceal hemodynamics, markedly increasing the volume, pressure, and wall tension of the varices. Increases in IAP may contribute to the progressive dilatation that precedes the rupture of the varices in portal hypertension. [source] Neural correlates of consolidation in working memoryHUMAN BRAIN MAPPING, Issue 3 2007Nelly Mainy Abstract Many of our daily activities rely on a brain system called working memory, which implements our ability to encode information for short-term maintenance, possible manipulation, and retrieval. A recent intracranial study of patients performing a paradigmatic working memory task revealed that the maintenance of information involves a distributed network of oscillations in the gamma band (>40 Hz). Using a similar task, we focused on the encoding stage and targeted a process referred to as short-term consolidation, which corresponds to the encoding of novel items in working memory. The paradigm was designed to manipulate the subjects' intention to encode: series of 10 letters were presented, among which only five had to be remembered, as indicated by visual cues preceding or following each letter. During this task we recorded the intracerebral EEG of nine epileptic patients implanted in mesiotemporal structures, perisylvian regions, and prefrontal areas and used time,frequency analysis to search for neural activities simultaneous with the encoding of the letters into working memory. We found such activities in the form of increases of gamma band activity in a set of regions associated with the phonological loop, including the Broca area and the auditory cortex, and in the prefrontal cortex, the pre- and postcentral gyri, the hippocampus, and the fusiform gyrus. Hum Brain Mapp, 2007. © 2006 Wiley-Liss, Inc. [source] Population-based controlled study of social support, self-perceived stress, activity and work issues, and access to health care in inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 4 2008Linda Rogala RN Abstract Background: The Manitoba IBD Cohort Study is a longitudinal, population-based study of multiple determinants of health outcomes in persons with inflammatory bowel disease (IBD) diagnosed within 7 years at enrollment. In this cross-sectional substudy we compared IBD participants' levels of social support, self-perceived stress, disability, and access to healthcare with those of a matched community sample. Methods: IBD participants (n = 388) were interviewed using the Canadian Community Health Surveys (CCHS) 1.1 and 1.2 to assess psychosocial variables. The national CCHS data were accessed to extract a community comparison group, matched on age, sex, and geographic residence. Results: Compared to the community sample, IBD participants received more tangible, affective, or emotional support in the past year and were more likely to have experienced a positive social interaction. Those with IBD were as likely to be employed as those in the community sample, although they reported greater rates of reduced activity and days missed. Work was not identified as a significant source of stress, but physical health was more likely to be identified as a main stressor by those with active IBD compared to the non-IBD sample. Individuals with IBD were twice as likely to report unmet healthcare needs than the community sample; however, there was agreement across both groups regarding common barriers, including long waits and availability. Conclusions: While the disease may contribute to greater interference with work quality and daily activities, IBD patients have similar levels of stress and appear to have enhanced social supports relative to those in the community without IBD. (Inflamm Bowel Dis 2008) [source] Impact of COPD severity on physical disability and daily living activities: EDIP-EPOC I and EDIP-EPOC II studiesINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2009J. M. Rodriguez Gonzalez-Moro Summary Aims:, The severity of chronic obstructive pulmonary disease (COPD) is associated to patients' health-related quality of life (HRQL). Physical impairment increasingly affects daily activities creating economic, social and personal burden for patients and their families. This burden should be considered in the management of COPD patients; therefore, we intended to assess the impact of the disease severity on physical disability and daily activities. Methods:, Two epidemiological observational cross-sectional descriptive studies were carried out in 1596 patients with moderate COPD and 2012 patients with severe or very severe COPD in the routine clinical practice. Demographic and basic clinical-epidemiological data were collected and patients completed questionnaires to assess their physical disability because of COPD [Medical Research Council (MRC)], COPD repercussion on daily activities [London Chest Activity of Daily Living (LCADL)], job, economy and family habits and their health status [EQ-5D visual analogue scale (VAS)]. Results:, In all, 37% of severe/very severe COPD patients and 10% of moderate (p < 0.0001) had MRC grades 4 and 5. Mean global LCADL was significantly higher in severe/very severe than in moderate patients [29.6 (CI 95%: 28.91,30.25) vs. 21.4 (CI 95%: 20.8,21.9); p < 0.0001]. COPD job impact and economic and family habits repercussions were significantly higher and health status significantly worse in severe/very severe cases than in patients with moderate COPD. Conclusions:, COPD severity is highly associated with physical disability by MRC grading, with functionality on daily activities and with impairment of other social and clinical activities. Moderate COPD patients show already a significant degree of impairment in all these parameters. [source] Exploratory analysis of Chinese-American family caregivers' needs and instructional video on dressing stroke survivorsINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 5 2010Shu-Hwa LinArticle first published online: 18 AUG 2010 Abstract The aims of this project were to explore the needs of family caregivers in the Chinese-American community and to develop training videos for caregivers on dressing stroke survivors. In-depth, semi-structured, open-ended interviews were used to explore the problems of caregivers of stroke survivors. Forty participants were recruited from Chinese-American communities. Verbatim interview transcripts were coded and analyzed. Four main concerns emerged: the impact and adjustment in lifestyle for family caregivers; lack of social activities and failure to seek community support; physical and mental stress and methods to alleviate stress, such as instruction in heavy lifting and guidance for daily activities, which include dressing. An 18-min video was produced to provide instruction on dressing stroke survivors for those who need this information. Also, this article addresses the lack of social activities and information about community or public services. [source] Pre-school staffs' attitudes toward foods in relation to the pedagogic mealINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 2 2006Hanna Sepp Abstract The aim of this study, with the pedagogic meal in focus, was to identify pre-school staff members' attitudes to the role of food and meals as part of daily activities at pre-school. Interviews were carried out at 12 pre-schools and a total of 34 pre-school staff participated. The staff revealed strong opinions as well as ambivalence towards how food and meals should best be integrated into their daily work and pedagogic activities. The pre-school staffs' lack of or insufficient education and knowledge regarding food and nutrition resulted in an ambivalent and uncertain situation with respect to how they should see themselves as teachers in the meal situation. Nevertheless, most of the staff had a clear perception of what it meant to practice a pedagogic meal. It meant helping and encouraging the children to help themselves and serving as an adult model for the children at table, though this pedagogic activity was uncommon. While the staff were satisfied with the pre-schools' role of catering for the children, they expressed concern about or even mistrust towards the children's parents. Despite, or perhaps due to, their inadequate knowledge about food and nutrition and the lack of specific aims for the pedagogic meal, they assumed that the public sector was a better educational institution regarding foods and a better guarantor for children's food habits and dietary intake. As the teachers' identities have changed over the past years they have not yet found a solid ground for determining how food and meals could be integrated into their everyday work as pre-school teachers and childminders. [source] Formable acrylic treatment for ingrowing nail with gutter splint and sculptured nailINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2004Hiroko Arai MD Background, The treatment of choice for an ingrowing nail has been surgical rather than nonsurgical. Yet, surgical treatments are far from successful, cause pain and patient apprehension, and leave disfigurement. Further, there is misunderstanding about the disease pathophysiology. Objective, To demonstrate the benefits of a noninvasive method of treatment for an ingrowing nail using gutter splint and formable acrylics and to present a current understanding of the disease pathophysiology. Methods, From a total of 541 cases of ingrowing nails treated, full follow-up data were obtained between January 1979 and March 2002. Formable acrylic treatments were carried out in 106 cases treated with acrylic-affixed gutter splint, 17 cases with sculptured nails, and 28 cases in which the two treatments were combined. These were then compared with 233 cases treated with adhesive tape-attached gutter splint and the remainder with other conservative modalities. Results, Acrylic treatment with gutter splint and sculptured nail was found to be vastly superior to the other methods described, especially in the ability to firmly affix the gutter splint and sculptured nail for the extended period required for treatment. The treatment leads to a complete remission with almost instant alleviation of pain, with no disfigurement, while allowing for the resumption of daily activities. Conclusion, Conservative methods utilizing formable acrylics are highly beneficial in the treatment of an ingrowing nail and should be viewed as the first treatment option. [source] An examination of willingness to self-disclose in women with bulimic symptoms considering the context of disclosure and negative affect levelsINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2002Lynette Evans Abstract Objective This study explored the relationship between bulimic symptoms and self-disclosure. It examined whether women who reported greater bulimic symptomatology were generally less willing to self-disclose in intimate relationships or whether reluctance to disclose was confined to eating and weight concerns. Method Women with high and low scores on the Bulimia Test Revised (BULIT-R) were compared on self-disclosure about three topics (daily activities, eating, and weight) and sexual and relationship issues to three targets (mother, friend, and partner). Results There were significant main and interaction effects for BULIT-R score, target, and topic of self-disclosure. When depression was controlled for, it partially explained the association between bulimic behavior and self-disclosure. Discussion Results supported a contextual model of self-disclosure. Compared with nonbulimic women, women with bulimic symptoms were less willing to self-disclose certain topics to particular targets. Levels of depression explained low willingness to disclose on topics unrelated to eating and weight to some targets. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 31: 344,348, 2002; DOI 10.1002/eat.10020 [source] Symptom management for HIV-positive persons in NorwayINTERNATIONAL NURSING REVIEW, Issue 3 2004E. H. Bunch rn Abstract Purpose:, To record symptoms experienced by people with HIV/AIDS, and describe useful self-care strategies and how symptoms impact on daily life. Method:, A questionnaire was used with self-reported answers and descriptions of how symptoms impact on daily activities and suggestions for useful self-care strategies. Four hundred and twenty-two (n = 422) HIV-positive persons from seven sites in the USA and one site in Norway (n = 20) answered the questionnaire. Results:, In this article subjective symptom descriptions from the Norwegian sample are presented along with self-care strategies and their effectiveness. Findings revealed the Norwegian sample to be a little older, maybe less anxious and depressed, than participants in the larger study. This difference might be explained by the structure of the national social and health care system in Norway, where treatments, medications and social services are available to all citizens without cost. Respondents described a number of related symptoms as well as their subjective explanations of what triggered the symptoms. Most of the self-care strategies were learnt by trial and error. Recommendations:, Community health providers, nurses and physicians should become more knowledgeable about the symptoms that infected persons struggle with, as well as the impact these symptoms have on routine daily self-care activities and a person's quality of life. There is need for more research about helpful self-care strategies to assist HIV-positive persons to manage their symptoms and to disseminate these to community health providers and support groups for HIV infected persons. [source] | |||||||||||||||||||||||||||||||||||||||||||