Comparison of short-term visual acuity and visual disturbance phenomena and spectacle independence after implantation of three different intraocular lenses / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the short-term postoperative visual acuity, visual disturbance phenomena, and spectacle independence rate in patients who underwent monocular implantation with trifocal, multifocal, or extended range of vision intraocular lens(IOL).METHODS: A retrospective analysis was conducted on 67 cataract patients(67 eyes)who underwent phacoemulsification cataract extraction combined with IOL implantation from March 2019 to December 2022. A total of 35 cases(35 eyes)received Symfony extended range of vision IOL implantation, 21 cases(21 eyes)received AcrySof IQ ReSTOR +3D multifocal IOL, and 11 cases(11 eyes)received AcrySof IQ PanOptix trifocal IOL. The preoperative uncorrected distance visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), and uncorrected near visual acuity(UNVA)and 3 mo postoperatively were documented. Moreover, defocus curves, visual disturbance phenomena, and spectacle independence rates were recorded at 3 mo postoperatively.RESULTS: At 3 mo postoperatively, no statistically significant differences were observed in UDVA among the three groups(P>0.05). A comparison of UIVA showed superior results in the Symfony and PanOptix groups compared to the ReSTOR group(all P<0.01). The UNVA of both the ReSTOR and PanOptix groups outperformed the Symfony group(all P<0.01). The defocus curves indicated that in the intermediate vision range(-1.00 to -1.50 D), the Symfony group exhibited better performance than the ReSTOR group(P<0.05); while in the near vision range(-2.50 to -3.50 D), the ReSTOR group was superior to the Symfony group(P<0.05). The PanOptix group demonstrated superior visual acuity in the near vision range(-2.00 to -3.50 D)compared to the Symfony group(P<0.05)and was also superior in the intermediate vision range(-1.00 to -2.00 D)compared to the ReSTOR group(P<0.05). No significant differences were observed in the incidence of glare or halo and binocular interference phenomena among the three groups(P>0.05). The PanOptix and ReSTOR groups exhibited a higher spectacle independence rate compared to the Symfony group(P<0.0167).CONCLUSION: Compared to Symfony extended range of vision IOL and ReSTOR multifocal IOL, PanOptix trifocal IOL offers a balanced approach to distance, intermediate, and near visual acuity, without a high incidence of glare and halo, and with a higher spectacle independence rate. Caution is still advised when considering monocular implantation with presbyopia-correcting IOLs.

La prueba de figuras enmascaradas en la versión SaWa sobre figuras Gottschaldt ­presentación e indicadores psicométricos / The Embedded Figures Test in the SaWa Version on Gottschaldt Figures ­Presentation and Psychometric Indicators­ / O teste de figuras mascaradas na versão SaWa em figuras de Gottschaldt ­Apresentação e indicadores psicométricos­

El artículo presenta la versión de la prueba EfT desarrollada por Sawa sobre las figuras Gottschaldt, como indicador de la capacidad de reestructuración perceptual y del estilo cognitivo en la dimensión de independencia- dependencia de campo. Se examina la consistencia interna del instrumento, su validez estructural y de constructo a partir de los datos recogidos en cuatro diferentes estudios en los que ha sido aplicado (n = 6.530). Los resultados indican altos niveles de consistencia interna y adecuados niveles de validez estructural del instrumento. La validez de constructo se determina mediante el examen de los comportamientos de la prueba frente al sexo y el grado/edad. Los resultados demuestran que el instrumento se comporta de acuerdo con lo esperado en el constructo. Por último, se presentan los baremos del instrumento

This paper presents the version of the Embedded Figures Test (EfT) that Sawa developed using Gottschaldt's figures. The test indicates the perceptual restructur- ing ability and the field dependence-independence dimension of cognitive style. The instrument's internal consistency and its structural and construct validity are examined using data collected in four previous studies in which the test was administered (n = 6.530). Results show high levels of internal consistency and adequate levels of structural validity. The construct validity was determined by examining the instrument's behavior regarding sex and grade/age. Results indicate that the test behaves as expected considering the construct. Finally, the instrument's norms are presented

O artigo apresenta a versão do teste EfT, desenvol- vida por Sawa sobre as figuras de Gottchaldt, como indicador da capacidade de reestruturação perceptiva e, do estilo cognitivo na dimensão independência- -dependência do campo. A consistência interna do instrumento, sua validade estrutural e sua validade de construto são examinadas a partir dos dados co- letados em quatro diferentes estudos em que o teste foi aplicado (n = 6.530). Os resultados indicam altos níveis de consistência interna e níveis adequados de validade estrutural do instrumento. A validade de cons- truto é determinada examinando os comportamentos de teste em relação ao gênero e nível de escolaridade/ idade. Os resultados indicam que o instrumento se comporta conforme o esperado no construto. Por fim, são apresentadas as escalas do instrumento.

Evaluación del nivel de independencia para la realización de actividades instrumentales de la vida diaria en una comunidad de personas vulnerables / Avaliação do nível de independência nas atividades instrumentais de vida diária numa comunidade em vulnerabilidade / Evaluation of the level of independence for the performance of instrumental activities of daily living in a community of vulnerable people

Resumen Introducción Los cambios o deficiencias estructurales y/o funcionales que presentan las personas con discapacidad pueden limitar o comprometer su interacción, para la realización o el cumplimiento de actividades personales o sociales, convirtiéndolas entonces en personas vulnerables. Para la evaluación, el terapeuta ocupacional debe valorar varios factores que pueden ser considerados como riesgo de mayor vulnerabilidad como: edad, género, nivel educacional, condiciones económicas, ocupación, condición física o mental y presencia de comorbilidades entre otras. Objetivo Evaluar nivel de independencia para la realización de actividades instrumentales de la vida diaria (AIVD) en individuos pertenecientes a una comunidad de personas vulnerables. Método Se aplicó el Índice de Lawton y Brody en adultos y adultos mayores, que tenían o referían algún tipo de discapacidad, recolectando además una serie de datos que fueron procesados y analizados en la plantilla de cálculo en Microsoft Excel 2020®. Resultados El 74,2% mostró un elevado nivel de dependencia para desarrollar las AIVD, con predominio en adultos. El 70,7% poseían carné o certificado de discapacidad, con una correlación negativa moderada entre el porcentaje de gravedad y el nivel de independencia. La artritis reumatoidea fue la enfermedad que con mayor frecuencia estuvo vinculada a la perdida de la independencia. Conclusión Resulta posible detectar tempranamente el nivel de dependencia y la presencia de discapacidad, mediante la aplicación del Índice de Lawton y Brody, determinando limitaciones funcionales para realizar AIVD en una comunidad de personas vulnerables.

Resumo Introdução As mudanças estruturais e/ou funcionais que as pessoas com deficiências apresentam podem limitar ou comprometer sua interação para o desempenho ou realização de atividades pessoais ou sociais, tornando-as assim vulneráveis. Para avaliação, o terapeuta ocupacional deve avaliar vários fatores que podem ser considerados como um risco de maior vulnerabilidade, tais como: idade, sexo, nível educacional, condições econômicas, ocupação, condição física ou mental e presença de comorbidades, entre outros. Objetivo Avaliar o nível de independência na realização de atividades instrumentais de vida diária (IADLs) em indivíduos pertencentes a uma comunidade de pessoas vulneráveis. Método O Lawton e Brody Index foi aplicado a adultos e pessoas mais velhas que tinham ou relataram algum tipo de deficiência, coletando uma série de dados que foram processados e analisados no modelo de cálculo Microsoft Excel 2020®. Resultados 74,2% mostraram um alto nível de dependência para realizar IADLs, com predomínio de adultos. 70,7% tinham um cartão ou certificado de deficiência, com uma correlação negativa moderada entre a porcentagem de gravidade e o nível de independência. A artrite reumatoide foi a doença mais frequentemente ligada à perda de independência. Conclusão É possível detectar precocemente o nível de dependência e a presença de deficiência, aplicando o Lawton e Brody Index, determinando limitações funcionais para realizar IADLs em uma comunidade de pessoas vulneráveis.

Abstract Introduction The structural and/or functional changes or impairments presented by people with disabilities can limit or compromise their interaction, for the performance or fulfillment of personal or social activities, making them then vulnerable people. For evaluation, the occupational therapist must assess several factors that can be considered as a risk of increased vulnerability such as: age, gender, educational level, economic conditions, occupation, physical or mental condition, and presence of comorbidities among others. Objective To evaluate the level of independence in the performance of instrumental activities of daily living (IADL) in individuals belonging to a community of vulnerable people. Method The Lawton and Brody Index was applied to adults and older adults who had or reported some type of disability, collecting a series of data that were processed and analyzed in the Microsoft Excel 2020® calculation template. Results 74.2% showed a high level of dependence to develop IADLs, with a predominance in adults. 70.7% had a disability card or certificate, with a moderate negative correlation between the percentage of severity and the level of independence. Rheumatoid arthritis was the disease most frequently associated with loss of independence. Conclusion It is possible to detect early the level of dependence and the presence of disability, through the application of the Lawton and Brody Index, determining functional limitations to perform IADLs in a community of vulnerable people.

Evaluación de profilaxis con factor VIII de origen plasmático en pacientes con hemofilia A severa / Evaluation of factor VIII prophylaxis of plasmatic origin in patients with severe hemophilia A / Avaliação da profilaxia do fator VIII de origem plasmática em pacientes com hemofilia A grave

Introducción: la hemofilia A severa (HAS) es una enfermedad hemorrágica hereditaria causada por un déficit de factor VIII (FVIII) menor al 1%. Se presenta principalmente con sangrados articulares, los cuales provocan una artropatía hemofílica que afecta su independencia funcional. El uso de la profilaxis terciaria con FVIII ofrece beneficios en adultos disminuyendo la tasa anual de sangrado (TAS) y mejorando la independencia funcional. Objetivo: determinar el porcentaje de pacientes que logran mantener un nivel de FVIII mayor al 1%, conocer si existe una mejora en la independencia funcional, así como una disminución en la TAS con el régimen profiláctico empleado. Métodos: estudio observacional, analítico. Se incluyó a los pacientes con HAS que se controlaron en el Hospital de Clínicas "Dr. Manuel Quintela" durante 2020 en profilaxis con FVIII durante 12 meses. Se obtuvieron tres muestras separadas en el tiempo para dosificación de FVIII y se evaluó la TAS y la independencia funcional en cada paciente. Resultados: se analizaron ocho pacientes, todos presentaron valores de FVIII superiores al 1% a la hora y 24 horas posterior a la administración de FVIII. Los episodios de sangrado se redujeron 4,76 veces con el uso de la profilaxis (p = 0,019). La independencia funcional mostró que 5/8 pacientes mejoraron al menos 1 punto del score. Conclusiones: la profilaxis terciaria en estos pacientes fue beneficioso en reducir la TAS y mejorar su capacidad funcional.

Summary: Introduction: severe hemophilia A (SAH) is an hereditary hemorrhagic disease, caused by a factor VIII (FVIII) deficiency of less than 1%. It presents with joint bleeding mainly, which causes a hemophilic arthropathy, which affects its functional independence. The use of tertiary prophylaxis with FVIII offers benefits in adults by decreasing the annual bleeding rate (ABR) and improving functional independence. Objective: to determine the percentage of patients who manage to maintain an FVIII level greater than 1%, to know if there is an improvement in functional independence, as well as a decrease in the ABR with the prophylactic regimen used. Methods: observational, analytical study. Patients with SAH who were controlled at the Hospital de Clínicas "Dr. Manuel Quintela", during the year 2020, in prophylaxis with FVIII for 12 months were included. Three samples separated in time for FVIII dosing were obtained and the ABR and functional independence were evaluated in each patient. Results: 8 patients were analyzed, all presented FVIII higher than 1% at one hour and 24 hours after the administration of FVIII. The bleeding episodes were reduced 4.76 times with the use of Prophylaxis (p = 0.019). Functional independence showed that 5/8 patients improved at least 1 point in the Score. Conclusions: tertiary prophylaxis in these patients was beneficial in reducing SAD and improving their functional capacity.

Introdução: a hemofilia A grave (HAS) é uma doença hemorrágica hereditária, causada pela deficiência do fator VIII (FVIII) inferior a 1%. Apresenta-se principalmente com sangramento articular, que causa artropatia hemofílica, que afeta sua independência funcional. O uso de profilaxia terciária com FVIII oferece benefícios em adultos, reduzindo a taxa de sangramento anual (TAS) e melhorando a independência funcional. Objetivos: determinar a porcentagem de pacientes que conseguem manter um nível de FVIII maior que 1%, identificar uma possível melhora da independência funcional, bem como uma diminuição da TAS com o esquema profilático utilizado. Métodos: estudo observacional, analítico de pacientes com HAS controlados no Hospital das Clínicas "Dr. Manuel Quintela", durante o ano de 2020, em profilaxia com FVIII durante 12 meses. Foram obtidas três amostras separadas no tempo para dosagem de FVIII e avaliação da TAS e da independência funcional de cada paciente. Resultados: foram analisados 8 pacientes, todos apresentaram FVIII maior que 1% em uma hora e 24 horas após a administração do FVIII. Os episódios de sangramento foram reduzidos 4,76 vezes com o uso da profilaxia (p = 0,019). A independência funcional mostrou que 5/8 pacientes melhoraram pelo menos 1 ponto do escore FISH. Conclusões: a profilaxia terciária nesses pacientes foi benéfica na redução da TAS e na melhora da capacidade funcional.

Dr. Francisco Domínguez Roldán. Contribución al conocimiento de su vida y obra / Francisco Domínguez Roldán, MD. Contribution to the knowledge of his life and work

Introducción: Los servicios prestados a la Patria por el Dr. Francisco Domínguez Roldán (La Habana, febrero 14, 1864-abril 25, 1942), defendiendo en la manigua la Independenciay luego en la paz, abogando por la causa de la enseñanza y la cultura, su consagración a enaltecer la memoria de Finlay como el precursor en el descubrimiento del modo de transmisión de la fiebre amarilla, por el desarrollo de la medicina en general y definitivamente por el de la Radiología en particular, son verdaderamente excepcionales. Objetivo: Describir elementos de la trayectoria multifacética del Dr. Francisco Domínguez Roldán. Material y Métodos: Se utilizaron métodos de la investigación histórica como el analítico-sintético y el deductivo-inductivo, así como los submétodos cronológico y geográfico. Desarrollo: Se rescataron y expusieron elementos de sus estudios, su notable vida científica, su profesorado en la Facultad de Medicina de La Habana, su actuación quirúrgica, sus aportes a la Radiología en Cuba, su secretaría de Instrucción Pública y Bellas Artes, su patriotismo y finlaísmo. Conclusiones: Es, sin dudas, el Dr. Domínguez Roldán, una de las más significativas figuras de la medicina en Cuba, de manera particular de su Cirugía, Radiología, Fisioterapia y Radioterapia, y uno de los pocos nombres a los que aparecen tan profundamente vinculados la historia libertadora de la Patria, la labor universitaria y académica y los progresos de la medicina cubana.

Introduction: The services provided by Dr. Francisco Dominguez to the homeland (Havana, February 14th, 1864 - April 25th, 1942), defending the independence in the jungle and later in peace and advocating the cause of education, along with his dedication to enhancing the memory of Finlay as the precursor of the discovery of the transmission of yellow fever, and his work for the development of medicine in general and definitively for that of Radiology in particular are truly exceptional, but little known. Objective: to describe and share features of the multifaceted career of Dr. Dominguez. Material and Methods: Historical research methods such as analytical-synthetic and inductive-deductive methods, as well as chronological and geographic sub-methods were used. Results: Elements of his studies, remarkable scientific life, his teaching at the Havana School of Medicine, surgical performance, his secretariat for Public Instruction and Fine Arts, patriotism and finlaism are collected and exposed. Conclusions: Dr. Dominguez is undoubtedly one of the most important personalities in Cuban medicine and one of the few names to which the liberating history of the Homeland, the university and academic work, and the progress of Cuban medicine appear so deeply linked.

Validación psicométrica del índice de Barthel en adultos mayores mexicanos / Psychometric validation of the Barthel index in Mexican older adults

Resumen: Objetivo: La población de adultos mayores en el mundo crece, estar al tanto de su salud ayuda a mejorar sus condiciones de vida, la independencia funcional a través de la capacidad de hacer actividades diarias básicas, es un buen indicador para conocer la salud y necesidad de atención médica. Una de las escalas más usadas para esto es el Índice de Barthel, por lo que el propósito de este trabajo fue validar esta escala psicométricamente, identificar si su estructura es la más adecuada a través de un análisis factorial confirmatorio. Materiales y métodos: Dos muestras adultos mayores de la CDMX participaron, 200 para estudiar las propiedades psicométricas y 276 para análisis factorial confirmatorio. Resultados: Se encontró una estructura con diez reactivos, adecuada confiabilidad en los coeficientes de consistencia interna pura Alpha Ordinal [Alpha=0.98, CI95% (0.96-0.98)] y Omega ordinal [Omega=0.99 CI95% (0.96-0.99)], y correcto ajuste [χ2(35) = 49.28, p=0.06, CFI=0.99, RMSEA=0.03 (IC95% 0,0.06)] Conclusiones: El índice de Barthel en autoreporte tiene propiedades psicométricas que lo hace una medida confiable y válida para el propósito de evaluar independencia funcional, en población geriátrica de la ciudad de México.

Abstract Objective: The population of older adults in the world grows and being aware of their health helps to improve their living conditions, functional independence through the ability to do basic daily activities is a good indicator to know the health and need of medical care. One of the most used scales for this is the Barthel Index, so the purpose of this work was to validate this scale psychometrically, to identify if its structure is the most appropriate through confirmatory factorial analysis. Materials and methods: Two older adult samples from CDMX participated, 200 to study psychometric properties and 276 for confirmatory factor analysis. Results: A structure with ten items, adequate reliability in the coefficients of pure internal consistency Alpha Ordinal [Alpha=0.98, CI95% (0.96- 0.98)] and Omega Ordinal [Omega=0.99 CI95% (0.96-0.99)], and correct fit [χ2(35) = 49.28, p=.06, CFI=0.99, RMSEA=0.03 (95% CI 0,.06)]. Conclusions: The Barthel index in self-report has psychometric properties that make it a reliable and valid measure for the purpose of evaluating functional independence in the geriatric population of Mexico City.

Objective Criteria for Judging Walking Independence in a Convalescent Rehabilitation Ward for Hemiparetic Stroke：A Study Using Decision Tree Analysis / The Japanese Journal of Rehabilitation Medicine

Objective：This study aimed to clarify the objective criteria for assessing walking independence using cane in patients with stroke in the convalescent rehabilitation ward.Methods：Participants were in-patients with hemiparetic stroke who could walk with a cane, and they were categorized into the independent (ID) and supervised (SV) walking groups. Stroke impairment assessment set-motor for lower extremity (SIAS-LE), trunk control test (TCT), Berg balance scale (BBS), 10-m walking speed (m/s), and functional independence measure-cognitive (FIM-C) were assessed. ID and SV used the scores at the time of independent walking and at the discharge time, respectively. Additionally, falls after independence were investigated. Statistical analysis was performed using univariate analysis and decision tree analysis.Results：In total, 148 patients (ID：n=101, 68±13 years, SV：n=47, 79±12) were included. Significant differences were observed in walking speed, TCT score, BBS score, and FIM-C score between the groups. Moreover, walking speed, FIM-C score, and BBS score were selected in the decision tree analysis in this order and divided into five groups namely：1) walking speed ≥ 0.42 and FIM-C ≥ 22 (percentage of independent patients 97％/percentage of fallers 5％), 2.) walking speed ≥ 0.42, FIM-C＜22, and BBS ≥ 50 (100％/0％), 3.) walking speed ≥ 0.42, FIM-C＜22, and BBS＜50 (52％/8％), 4.) walking speed＜0.42, and BBS ≥ 28 (49％/28％), and 5) walking speed＜0.42 and BBS＜28 (0％/0％). The overall percentage of fallers was 8.9％, with group 4 having the highest number of fallers.Conclusion：Walking speed, FIM-C, and BBS, in decreasing order, were involved in walking independence. Patients with low walking speed were more likely to fall. Therefore, careful assessment of walking independence is particularly required.

Effects of Exclusion Items in Outcome Assessment on the KRW Achievement Index in Convalescent Rehabilitation Wards / The Japanese Journal of Rehabilitation Medicine

Objective：To clarify the effect of exclusion items on the KRW achievement index (KRW-AI) in the outcome evaluation of a convalescent rehabilitation ward.Methods：The subjects were 812 inpatients in a convalescent rehabilitation ward. The objective variable was the KRW-AI of 40 or less, and the explanatory variables were the items excluded from the KRW-AI and their combination for a total of eight categories, such as (1) low motor FIM, (2) high motor FIM, (3) low cognitive FIM, (4) elderly, (5) (1)＋(3), (6) (1)＋(4), (7) (3)＋(4), (8) (1)＋(3)＋(4). The adjusted variables were sex, rehabilitation calculation category, and time from onset to admission to the ward. Poisson regression analysis was performed. The Incidence Rate Ratio (IRR) and 95％ confidence interval (CI) were calculated.Results：Five of the eight exclusion categories were significantly associated with low-KRW-AI scores. The highest IRR was 2.29 (95％ CI：1.41-3.69, p＜0.001) for (2).Conclusion：High motor FIM are associated with a higher relative risk of falling below the KRW-AI of 40. Conversely, being older and the presence of cognitive disorder did not interfere with low-KRW-AI scores.

Effects of Exclusion Items in Outcome Assessment on the KRW Achievement Index in Convalescent Rehabilitation Wards / The Japanese Journal of Rehabilitation Medicine

Objective：To clarify the effect of exclusion items on the KRW achievement index (KRW-AI) in the outcome evaluation of a convalescent rehabilitation ward.Methods：The subjects were 812 inpatients in a convalescent rehabilitation ward. The objective variable was the KRW-AI of 40 or less, and the explanatory variables were the items excluded from the KRW-AI and their combination for a total of eight categories, such as (1) low motor FIM, (2) high motor FIM, (3) low cognitive FIM, (4) elderly, (5) (1)＋(3), (6) (1)＋(4), (7) (3)＋(4), (8) (1)＋(3)＋(4). The adjusted variables were sex, rehabilitation calculation category, and time from onset to admission to the ward. Poisson regression analysis was performed. The Incidence Rate Ratio (IRR) and 95％ confidence interval (CI) were calculated.Results：Five of the eight exclusion categories were significantly associated with low-KRW-AI scores. The highest IRR was 2.29 (95％ CI：1.41-3.69, p＜0.001) for (2).Conclusion：High motor FIM are associated with a higher relative risk of falling below the KRW-AI of 40. Conversely, being older and the presence of cognitive disorder did not interfere with low-KRW-AI scores.

Functional independence analysis in persons with spinal cord injury / Análise da independência funcional em indivíduos com lesão da medula espinal

Abstract Introduction Spinal cord injury (SCI) radically changes a person's life because of alterations in body dynamics, leading to disabilities and reduced functionality. Objective To analyze the functional independence of individuals with spinal cord injury and compare the groups. Methods Individuals with SCI were interviewed about their functional independence using the Brazilian version of the Spinal Cord Independence Measure - Self-Reported Version (brSCIM-SR) and later their respective domains and subdomains were compared between diagnostic groups, time since injury and sex. Results The sample consisted of fifty individuals aged 40.92 ± 13.93 years, predominantly men and diagnosed with paraplegia. In most brSCIM-SR domains, all respondents achieved good independence in self-care, respiration and sphincter management, and in the total brSCIM-SR, except for mobility. In paraplegia, chronic SCIs and both sexes achieved excellent independence in most subdomains and in the total. Significantly low values were found for tetraplegia and recent SCI in the self-care subdomain. In most subdomains, tetraplegia reached significantly lower values. In the subdomains of respiration and sphincter management, the participants were independent in the breathing function, but in tetraplegia, they showed significant dependence on transfer to the toilet. In terms of mobility, there was great dependence on the items going up and down stairs and transfer from the floor to the wheelchair. Conclusion The brSCIM-SR measures the degree of functionality, allowing health professionals and the patient to quantify and locate the items that indicate their deficits or gains during the rehabilitation process. Here, individuals with SCI showed good functional independence, with worse performance in the tetraplegia and recent injury groups: however, mobility showed partial dependence in the participants.

Resumo Introdução A lesão da medula espinal (LME) muda radicalmente a vida da pessoa devido às alterações na dinâmica corporal, levando à incapacidades e redução da funcionalidade. Objetivo Analisar a independência funcional de indivíduos com LME e comparar os grupos. Métodos Indivíduos com LME foram entrevistados sobre sua independência funcional por meio da versão brasileira do Spinal Cord Independence Measure - Self-Reported Version (brSCIM-SR) e posteriormente seus respectivos domínios e subdomínios foram comparados entre os grupos diagnósticos, tempo de lesão e gênero. Resultados A amostra foi composta por 50 indivíduos com idade de 40,92 ± 13,93 anos, prevalecendo homens e diagnóstico de paraplegia. Na maioria dos domínios do brSCIM-SR todos os entrevistados atingiram boa independência no autocuidado, na respiração e controle esfincteriano e no total do brSCIM-SR, exceto na mobilidade. Na paraplegia, as LMEs crônicas e ambos os sexos alcançaram excelente independência na maioria dos subdomínios e no total do instrumento. Valores significantemente baixos foram encontrados na tetraplegia e nas LMEs recentes no subdomínio autocuidado. Na maioria dos subdomínios, a tetraplegia atingiu valores significativamente inferiores. Nos subdomínios da respiração e controle esfincteriano, os participantes eram independentes na função respiração, mas nas tetraplegias apresentaram significativa depen-dência nas transferências para o vaso sanitário. Na mobilidade houve grande dependência nos itens subir e descer escadas e transferir-se do chão para a cadeira de rodas. Conclusão Os indivíduos com LME demonstra-ram boa independência funcional, com pior desempenho na tetraplegia e lesões recentes, mas a mobilidade apresentou parcial dependência nos participantes.

Family-centered task-oriented training can significantly improve the functional independence and life quality of children with spastic cerebral palsy / 中华物理医学与康复杂志

Objective:To observe the effect of a family-centered task-oriented training (TOT) program on the functional independence and life quality of children with spastic cerebral palsy.Methods:A total of 62 children with spastic cerebral palsy were randomly divided into a control group ( n=31) and a TOT group ( n=31). The children in the control group were given family rehabilitation training according to the discharge instruction manual, while the children in the TOT group received family-centered TOT. Both groups trained for 1 hour once a day, 5 days a week for 6 months. The mobility, functional independence and life quality of the two groups were evaluated with the pediatric evaluation of disability inventory (PEDI), functional independence measures for Chinese children (WeeFIM) and a pediatric quality of life inventory (PedsQL) before and after 3 and 6 months of treatment. Results:After 6 months there was significant improvement in the average mobility, WeeFIM and PedsQL scores of both groups. The average mobility, WeeFIM and PedsQL scores of the TOT group were then significantly better than those of the control group.Conclusion:Family-centered TOT training can significantly improve the functional independence and life quality of children with spastic cerebral palsy.

Desde la periferia: la noción de espacio social en la movilización sociopolítica de la juventud / From the periphery: The notion of social space in the socio-political mobilization of youth / Da partir da periferia: A noção de espaço social na mobilização sócio-política da juventude

Resumen (analítico) Este artículo pone de manifiesto la existencia de un elemento transversal en la relación de la juventud con la esfera pública, que contribuye a comprender mejor la naturaleza de sus expresiones políticas: la asimilación de una cierta posición periférica impuesta dentro del espacio social. La idea de espacio social, y en particular la de periferia, contribuyen a dar coherencia a determinados fenómenos y tendencias de la movilización sociopolítica de la juventud en su conjunto. Para ello, se analizan tres movimientos juveniles surgidos en Barcelona durante el año 2019, en los que la juventud tuvo especial protagonismo. Las diferencias y similitudes entre los tres movimientos muestran la versatilidad de la noción de periferia, que sirve para visualizar la precariedad vital que identifica a toda una generación, más allá de sus diferencias.

Abstract (analytical) This article highlights the existence of a transversal element in the relationship of youth with the public sphere, which contributes to a better understanding of the nature of their political expressions: the internalization of a certain imposed peripheral position within the social space. The idea of social space, and in particular the idea of periphery, contributes to give coherence to some phenomena and trends on the sociopolitical mobilization of youth as a whole. To do this, three youth movements emerged in Barcelona during 2019 are analyzed, in which the youth played a special role. The differences and similarities between the three movements show the versatility of the notion of periphery, which serves to visualize the vital precariousness that identifies an entire generation, beyond their internal differences.

Resumo (analítico) Este artigo tem como objetivo destacar a existência de um elemento transversal na relação dos jovens com a esfera pública, o que contribui para a melhor compreensão da natureza de suas expressões políticas: a assimilação de uma determinada posição periférica imposta dentro do espaço social. A ideia de espaço social e, em particular, de periferia, contribui para dar coerência a certos fenômenos e tendências na mobilização sócio-política da juventude como um todo. Para isso, são analisados três movimentos juvenis surgidos em Barcelona em 2019, nos quais os jovens tiveram protagonismo especial. As diferenças e semelhanças entre os três movimentos mostram a versatilidade da noção de periferia, que serve para visualizar a precariedade vital que identifica uma geração inteira, além de suas diferenças internas.

A Nationwide Assessment of Psychosocial Adjustment and Its Associated Factors in People With Spinal Cord Injury and Disorders (PA-SCID): The Study Protocol

@#Introduction: This article aims to describe the study protocol of a nationwide survey on psychosocial adjustment of people with spinal cord injury or disorders (SCID) and its associated factors. SCID is a complex clinical condition and debilitating public health issues to families and societies. Psychosocial adjustment is represented in this study as health-related quality of life, perceived social support, coping, independence, and spiritual well-being. This study aims to determine the psychosocial adjustment of people with SCID in Malaysia. Methods: This is a study protocol for a nationwide cross-sectional postal and online survey of people with SCID. Cross-cultural adaptation and hypothesis-validity testing will be conducted for independence and spiritual well-being measures. A total of 786 eligible participants will be recruited from eight public hospitals in the Peninsular, Sabah, and Sarawak. The questionnaires include the World Health Organization Quality of Life-Brief (WHOQOL-BREF), Spinal Cord Independence Measure – Self-report (SCIM-SR), Brief Coping Orientation to Problems Experienced (Brief COPE), Medical Outcome Survey – Social Support (MOS-SSS) and Functional Assessment of Chronic Illness Therapy – Spiritual Well-being Short Version (FACIT-Sp-12). HRQoL measured by WHOQOL-BREF is the main primary outcome of this study. Independent association between the sociodemographic and clinical characteristics with the outcome variables will be determined separately using multiple linear regression. Discussion: The findings of the study will be informative regarding the causes of SCID and factors associated with psychosocial adjustment in Malaysia. It will benefit future medical and public health initiatives to improve on the existing rehabilitation programs and social services to people with SCID.

How to use χ2 test correctly—— χ2 tests for the data collected from the three kinds of two dimensional contingency tables without ordinal variables in two directions / 四川精神卫生

The purpose of this article was to introduce the χ2 test and SAS and R software implementation of three kinds of two-way unordered two-dimensional contingency table data except the four-fold table data. The three kinds of the tables referred to the two-way unordered “R×2”“2×C” and “R×C” （both R and C were greater than 2） contingency tables. Generally speaking， the purpose of analyzing them was to test whether the two attribute variables in the contingency table were independent. When certain prerequisites were met， the simple statistical analysis method that could be used was the χ2 test， when the specific prerequisites were not met， the Fisher’s exact test， which required the large amount of calculation， should be selected.

How to use χ2 test correctly——the independence test for the data of the person-time / 四川精神卫生

The purpose of this paper was to introduce the independence test and the SAS implementation for the "unstratified person-time data" and the "stratified person-time data". In "person-time data"， the sample size in each level of the treatment factor was expressed as "person-years". Furthermore， it was necessary to use the "incidence density" to replace the "incidence rate" in the usual qualitative data analysis. The paper introduced the concrete approaches of comparing the "incidence density" of the "unstratified person-time data" and the "stratified person-time data" in detail， and demonstrated the whole process of using SAS software to realize the calculation through two examples， including the SAS program code， the SAS output results， the results explanation and the conclusion statement.

How to use χ2 test correctly——the independence test for the data of a multiway table / 四川精神卫生

The purpose of this article was to introduce the methods for the independence test of a special high-dimensional table （ie g×2×2 table） and its SAS implementation. There were three approaches， in the SAS software and the statistical textbooks， which could be used to perform the independence test for the data of a multiway table. The three kinds of methods were the generalized CMH χ2 test （for short， approach-1）， the weighted χ2 test with the weighted coefficients in its formula （for short， approach-2）， and the weighted χ2 test without the weighted coefficients in its formula （for short， approach-3）， respectively. This article revealed that the “approach-2” and “approach-3” were the same weighted χ2 test essentially， but with different manifestations. It also revealed that the weighted χ2 test statistic estimation was approximately equal to the CMH χ2 test statistic estimation in the “approach-1”. Based on an example and the SAS software， the article introduced the concrete approaches for the independence test of the g×2×2 table data， explained the output results， and made the statistical and professional conclusions.

Effect of Proximal Muscle Strengthening on Distal Muscle Facilitation in Guillain Barre Syndrome

In Guillain Barre Syndrome (GBS), there is symmetrical muscle weakness which ranges from mild weakness to severe palsy of all limbs. The motor symptoms start distally and move proximally. Proximal muscle weakness is primary and common factor in GBS. To overcome the weakness, one has to strengthen the muscle. Muscle activity of proximal segment is necessary for activation of distal segment. In fact, stable activity of distal parts needs controlling of the proximal parts. As distal muscle weakness is a major problem in post GBS individuals, they need to be facilitated with the help of proximal muscle strengthening. MethodsAfter obtaining the ethical committee clearance an experimental study was conducted among a total of 30 GBS subjects selected through convenience sampling. OPD subjects were given proximal muscle strengthening for 6 weeks. Each subject was examined by modified sphygmomanometer test (MST) and functional independence measure scale (FIMS) before and after the study. ResultsResult was calculated by using MST and FIMS. Exercises showed extremely significant difference on MST [p = 0.0001, t = 11.924] on handgrip strength, [p value = 0.0001) t = 12.334] on plantar flexion, [p value = 0.0001, t = 9.558] on dorsiflexion. FIMS [p value = 0.0001, t = 25.699] extremely significant difference was seen. ConclusionsProximal muscle strengthening is found to be effective for distal muscle facilitation in Guillain Barre Syndrome.

Applying the functional independence measure to the assessment of patients with mucopolysaccharidosis / Test de medida de independencia funcional en la evaluación de pacientes con mucopolisacaridosis

Abstract Objective: To assess the functional independence of a group of patients with mucopolysaccharidosis using the Functional Independence Measure as a tool that accomplishes this purpose. Methods: This is a cross-sectional study of patients with mucopolysaccharidosis. Our data was collected between June 2015 and July 2016. In addition to history of present illness and physical examination each study participant was asked to answer a questionnaire to specifically evaluate their functional independence using the functional independence measure. the internal consistency of the functional independence measure was assessed using Cronbach's alpha coefficient. Results: We collected data on 20 patients with mucopolysaccharidosis. The average age was 10.8 (8.67-13.03) years, the average weight was 23.6 (19.91-27.37) kg and the average height was 1 (0.83-1.17) m. The most prevalent type of mucopolysaccharidosis in the study was type VI (n= 14). The average total functional independence measure score was 104.4 (97.61-111.19), the average for the mobility domain was 73.50 (68.22-78.78) and the average for the cognitive function domain was 30.90 (28.68-33.13). The internal consistency of the entire questionnaire was 0.859, with values of 0.966 for the mobility domain and 0.624 for the cognitive function domain. Conclusion: The lowest functional independence measure scores were obtained in the following sub-domains: self-care, locomotion and cognitive function. The functional independence measure questionnaire demonstrated internal consistency for the evaluation of functional independence in patients with mucopolysaccharidosis, being able to value all the affected sub-domains separately.

Resumen Objetivo: Evaluar la independencia funcional de un grupo de pacientes con mucopolisacaridosis utilizando la Medida de Independencia Funcional como herramienta para lograr este propósito. Métodos: Este es un estudio transversal de pacientes con mucopolisacaridosis. Nuestros datos se recopilaron entre junio de 2015 y julio de 2016. Además de la historia de la enfermedad actual y el examen físico, se pidió a cada participante del estudio que respondiera un cuestionario para evaluar específicamente su independencia funcional utilizando la Medida de Independencia Funcional. la consistencia interna de la Medida de Independencia Funcional se evaluó mediante el coeficiente alfa de Cronbach. Resultados: Recopilamos datos de 20 pacientes con mucopolisacaridosis. La edad promedio fue de 10.8 (8.67-13.03) años, el peso promedio fue de 23.6 (19.91-27.37) kg y la altura promedio fue de 1 m (0.83-1.17). El tipo de mucopolisacaridosis más prevalente en el estudio fue el tipo VI (n= 14). El puntaje promedio de la medida de independencia funcional total fue 104.4 (97.61-111.19), el promedio para el dominio de movilidad fue 73.50 (68.22-78.78) y el promedio para el dominio de función cognitiva fue 30.90 (28.68-33.13). La consistencia interna de todo el cuestionario fue de 0.859, con valores de 0.966 para el dominio de movilidad y 0.624 para el dominio de función cognitiva. Conclusión: Las puntuaciones más bajas de la medida de independencia funcional se obtuvieron en los siguientes subdominios: autocuidado, locomoción y función cognitiva. El cuestionario de medida de independencia funcional demostró consistencia interna para la evaluación de la independencia funcional en pacientes con mucopolisacaridosis, pudiendo valorar todos los subdominios afectados por separado.

Impact of Pressure Ulcers on Therapeutic Outcomes in Inpatient Physiotherapy Services.

Pressure ulcers have been associated with an extended length of hospitalization, sepsis and mortality. Over the last few decades, little has been written about the impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. It is obvious that critically ill patients, who are sedated, ventilated, patients with chronic neurological, musculoskeletal and cardio-respiratory disorders who are bed ridden for prolonged period of time are particularly at risk of developing skin breakdown. This will help in identifying barriers to patient participation and develop strategies to pressure ulcer prevention. We wanted to determine the impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. MethodsThe study was conducted from June 2015 to January 2016. The impact of pressure ulcer on inpatient physiotherapy services was determined by detailed physical assessment, evaluation with Functional Independence Measure score (FIM) and Braden Q Scale. A total 96 subjects were assessed during this time. ResultsThere was statistically significant impact of pressure ulcers on therapeutic outcomes in inpatient physiotherapy services. The FIM takes into consideration self-care, sphincter control, transfers, locomotion, communication social cognition. A poor score denotes poor outcome at discharge. Tissue level assessment was carried out by using Braden Q Scale, a poor score of which again denotes very poor outcome in mobility, activity, sensory perception, moisture, friction – shear, nutrition, tissue perfusion and oxygenation. ConclusionsPressure ulcer is one of the preventable problems; but in majority of cases it becomes the main reason for poor therapeutic outcome.

Evaluation of growth factor independence 1 expression in patients with de novo acute myeloid leukemia

Objective: Growth factor independence 1 (GFI1), a transcriptional repressor, is required for hematopoietic stem cell maintenance and self-renewal in addition to controlling differentiation and proliferation of myeloid cells. As murine studies have demonstrated that this transcription factor has a notable role in the initiation and progression of acute myeloid leukemia (AML) disease, the aim of the current study was to investigate and review the influence of GFI1 in human AML cells. Methods: GFI1 expression levels were measured by means of real-time polymerase chain reaction in 96 primary AML samples which were then compared to gene expression levels observed in 18 healthy subjects. Moreover, GFI1 expression patterns were analyzed based on specific AML subtypes including acute promyelocytic leukemia (APL). Finally, leukemic cells were stained to measure levels of myeloperoxidase (MPO) activity. Results: This study reports that AML patients have significantly higher GFI1 mRNA levels in comparison to healthy subjects and that, when considering AML subtypes, patients with APL have higher GFI1 expression than non-APL patients. Conclusion: It is also concluded that GFI1 overexpression in patients with high MPO levels, such as those of the APL subtype, is correlated with favorable disease prognosis as supported by other studies which demonstrate that increased peroxide activity and GFI1 are independently correlated with a favorable prognosis