Application of Canadian Occupational Performance Measure combined with activity analysis in clients with hand injuries / 中国康复理论与实践

ObjectiveTo explore the occupational needs of hand injury patients and the effects of activity-based analysis and occupation-based interventions. MethodsFrom January, 2021 to June, 2022, 212 patients who accepted occupational therapy for wrist-hand injury in Rehabilitation Center of the First Affiliated Hospital of Nanjing Medical University were interviewed using Canadian Occupational Performance Measure (COPM) to collect the activities that they wanted to do, needed to do, were expected to do, but unable to do. Two senior occupational therapists conducted the activity analysis of the summarized needs, identified occupational components, designed a purposeful occupation-based intervention program, and evaluated the performance and satisfaction using COPM. ResultsA cumulative total of 84 occupational needs were proposed, covering five major domains: work, basic activities of daily living, instrumental activities of daily living, leisure and sleep. The activities mostly impaired involved using computer (8.28%), using chopsticks (6.42%), wringing towels (6.25%), travelling on transport (4.90%) and lifting heavy objects (4.73%). The performance and satisfaction improved after treatment (t > 16.572, P < 0.001). ConclusionThe occupational needs are culturally specific for local hand injury patients; the use of an activity-based analysis and occupation-based intervention is effective on meeting the occupational needs.

Direct and indirect assessment of functional abilities in patients with Parkinsons disease transitioning to dementia / Avaliação direta e indireta das habilidades funcionais em pacientes com doença de parkinson em transição para demência

ABSTRACT. Cognitive impairment is common in patients with Parkinson's disease (PD), and evaluation of functional abilities is crucial for diagnosis of dementia. Objective: We evaluated differences between direct and indirect functional assessment methods to evaluate functional abilities in PD patients. Methods: We evaluated 32 patients with PD and suspected mild dementia using direct and indirect assessment methods. Results: There was a significant difference between the scores of direct and indirect methods of assessment. Patients and close informants usually overestimated their abilities in many ADL. However, all functional assessment tools used in this study had a relatively good accuracy to predict abnormal performance in a global cognitive scale. Patients with normal cognition according to scores in a global cognitive scale may have some functional impairment in ADL. Direct Assessment of Functional Ability (DAFA) scores correlated linearly with scores in global cognitive scales, and especially with scores in the domains of memory and concentration. Conclusion: Patients and close informants usually overestimate their instrumental abilities in ADL. The direct assessment of daily functioning was more reliable than indirect tools to assess functional losses in patients with PD. Finally, some patients with PD but no dementia may present functional losses in ADL.

RESUMO. O comprometimento cognitivo é comum em pacientes com doença de Parkinson (DP), e a avaliação das habilidades funcionais é crucial para o diagnóstico de demência. Objetivo: Avaliamos diferenças entre os métodos de avaliação funcional direta e indireta para avaliar habilidades funcionais em pacientes com DP. Métodos: Foram avaliados 32 pacientes com DP e suspeita de demência inicial usando métodos de avaliação direta e indireta. Resultados: Houve uma diferença significativa entre os escores dos métodos diretos e indiretos de avaliação. Pacientes e informantes geralmente superestimaram suas habilidades em muitas atividades da vida diária (AVD). No entanto, todas as ferramentas de avaliação funcional utilizadas neste estudo tiveram uma precisão relativamente boa para prever desempenho anormal em uma escala cognitiva global. Pacientes com cognição normal, de acordo com os escores em uma escala cognitiva global, podem apresentar algum comprometimento funcional nas AVD. As pontuações do Direct Assessment of Functional Ability (DAFA) correlacionaram-se linearmente com as pontuações nas escalas cognitivas globais e, especialmente, com as pontuações nos domínios da memória e concentração. Conclusão: Pacientes e informantes próximos geralmente superestimam suas habilidades instrumentais nas AVD. A avaliação direta do funcionamento diário foi mais confiável do que ferramentas indiretas para avaliar perdas funcionais em pacientes com DP. Finalmente, alguns pacientes com DP, mas sem demência, podem apresentar perdas funcionais nas AVD

Relação entre a progressão do escore do functional movement screen e lesão em atletas futebol / Relationship between progression of functional movement screen test and injury in athletes of football

O futebol é uma modalidade de grande exigência física com movimentos de potência e velocidade com mudança de direção. Devido à alta intensidade, ocorre uma maior predisposição às lesões. O Functional Movement Screen (FMS) é um modelo de avaliação para identificar assimetrias e desequilíbrios musculoesqueléticos. O objetivo deste trabalho foi comparar os efeitos de do is m eses de pré-temporada na progressão do escore do teste FMS e sua relação com as lesões ao longo da competição. Participaram deste estudo 28 atletas profissionais de futebol, com idade média de 25,1 ± 6,5. Foi realizado o FMS antes e após a pré-temporada e durante o período competitivo foi verificada a ocorrência de lesões. Houve uma melhora (p<0,01) dos escores do FMS da avaliação pré (15,61 ± 1,39) para a avaliação pós pré-temporada (17,29 ± 1,24) entre todo o elenco, porém, quando considerado o tamanho do efeito, os atletas que não se lesionaram tiveram um efeito maior na progressão do escore (d=1,17) do que os que se lesionaram (d=0,35). Conclui-se que os atletas que não se lesionaram durante a competição, foram os que mais progrediram no FMS durante a pré-temporada, sendo, provavelmente, a progressão do escore do s atletas mais interessante do que o atendimento ao ponto de corte sugerido pela literatura...(AU)

Football is a modality that demands high physical fitness, with intense movements and rapid direction changing. Due to the high intensity demanded, athletes are more susceptible t o in juries. The Functional Movement Screen (FMS) test it is a method to evaluate asymmetries and muscle im balance. The objective was to compared the effects of two months of preseason, on the score of the FMS t est and their relationship with the injuries resulting from the competitive period. Participated o f th is study 28 professional football players (25.1 ± 6.5 years). FMS was performed before and after the p reseason and during the competitive period the occurrence of injuries was verified. There was a significant improvement of the FMS score after the preseason (p<0.01) for the all athletes. When considering the size effect, athletes who were not injured during the competitive period had a greater effect (d=1.17) than those who injured (d=0.35). The athletes who progressed the most during the evaluation were the athletes who were exempted from injury during the competitive period. Perhaps the progression of the athlete's score was more interesting than the attendance to the cut-off point suggested by the literature...(AU)

Criterios para la construcción de un instrumento de evaluación funcional en pacientes con enfermedad cerebrovascular / Criteria for Functional Evaluation Instrument Building in Stroke Patients / Critérios para a construção de um instrumento de avaliação funcional em pacientes com enfermedad cerebrovascular

Resumen Introducción: Ninguna escala simple, por diseño, es lo suficientemente abarcadora para evaluar de forma integral la función motora de pacientes con enfermedad cerebrovascular (ECV); sin embargo, es posible la selección de una batería de ellas para controlar las distintas etapas del proceso de rehabilitación. El objetivo de este estudio fue identificar los criterios que sirven de referencia para la construcción de un instrumento de evaluación funcional en pacientes con ECV. Materiales y métodos: Se realizó una búsqueda bibliográfica en las bases de datos PubMed, Rehabilitation Measures Database, EBSCO y Medline, donde se incluyeron escalas de evaluación funcional dirigidas al control de la postura, marcha, equilibrio, tono muscular, miembros superiores e inferiores y actividades de la vida diaria. Resultados: Para la construcción de un instrumento de evaluación funcional se identificaron un total de trece criterios de referencia agrupados en: 1) criterios psicométricos y 2) criterios de diseño y aplicación. Utilizando estos criterios, se seleccionaron las escalas: Barthel Index, Action Research Arm Test, Ashworth Scale y 10 Meter Walk Test. Conclusión: Las escalas seleccionadas brindan información sobre cuatro aspectos relevantes para la evaluación funcional y la práctica terapéutica: autocuidado, función motora, tono muscular y rendimiento físico, estrechamente relacionados con las principales áreas de trabajo durante el proceso de rehabilitación en pacientes con ECV. Los recursos materiales necesarios para su aplicación son mínimos y el tiempo estimado, a partir de la integración de sus tiempos parciales, no sobrepasa los 30 minutos.

Abstract Introduction: No simple scale, by design, is comprehensive enough to comprehensively evaluate the motor function of with stroke patients; however, it is possible to select a battery of them to control the different stages of the rehabilitation process. The objective of this study was to identify the criteria that serve as a reference for the construction of a functional evaluation instrument in stroke patients. Materials and methods: A bibliographic search was conducted in the PubMed, Rehabilitation Measures Database, ebsco and Medline databases, which included functional assessment scales aimed at controlling posture, gait, balance, muscle tone, upper and lower limbs and activities daily life. Results: For construction of a functional evaluation instrument, a total of thirteen reference criteria were identified grouped into: 1) psychometric criteria and 2) design and application criteria. Using these criteria the scales were selected: Barthel Index, Action Research Arm Test, Ashworth Scale, and 10 Meter Walk Test. Conclusion: The selected scales provide information on four relevant aspects for functional evaluation and therapeutic practice: self-care, motor function, muscle tone and physical performance, closely related to main work area during the rehabilitation process in stroke patients. The material resources necessary for its application are minimal and the estimated time, from the integration of its partial times, does not exceed 30 minutes.

Resumo Introdução: Nenhuma escala simples, por concepção, é abrangente o suficiente para avaliar de forma abrangente a função motora de pacientes com doença cerebrovascular (DCV), no entanto, é possível selecionar uma bateria deles para controlar as diferentes etapas do processo de reabilitação. O objetivo deste estudo foi identificar os critérios que servem de referência para a construção de um instrumento de avaliação funcional em pacientes com DCV. Materiais e métodos: Foi realizada uma pesquisa bibliográfica nas bases de dados PubMed, Rehabilitation Measures Database, EBSCO e Medline, que incluíram escalas de avaliação funcional para controle de postura, marcha, equilíbrio, tônus muscular, membros superiores e inferiores e atividades de vida diario. Resultados: Para a construção de um instrumento de avaliação funcional, foram identificados 13 critérios de referência, agrupados em: 1) critérios psicométricos e 2) critérios de projeto e aplicação. Utilizando esses critérios, as escalas foram selecionadas: Barthel Index, Action Research Arm Test, Ashworth Scale, and 10 Meter Walk Test. Conclusão: As escalas selecionadas fornecem informações sobre quatro aspectos relevantes para avaliação funcional e prática terapêutica: autocuidado, função motora, tônus muscular e desempenho físico, intimamente relacionados à principal área de trabalho durante o processo de reabilitação em pacientes com DCV. Os recursos materiais necessários para sua aplicação são mínimos e o tempo estimado, a partir da integração de seus tempos parciais, não excede 30 minutos.

Assessment of functioning of public health facilities in a North Indian state

Background: This study was conducted to assess the current status of functioning of health facilities in Punjab.Methods: A checklist based on six building blocks of health system proposed by WHO and the IPHS was developed, validated and pretested. District hospital (DH), one sub district hospital (SDH) and two Community Health Centres or Block Primary Health Centres (CHCs/BPHCs) were randomly selected from each of 22 districts of Punjab and evaluated against checklist. Total score was thus assigned to each facility. Additionally, workload of healthcare workforce, presence of health functionaries as against total posted strength and feedback from administrators of these facilities were also recorded.Results: Health services are concentrated at the DH and SDH. Functional equipment like ECG, oxygen, mask, ambubag etc. are deficient at all levels of health facilities. Nearly 50% of expected medicines were in stock at the DH and SDH and 66% at CHC/BPHC level. Patient to doctor ratio is highest at SDH in outpatient department and CHC/BPHC in emergency section. Number of lab tests per lab technician are highest at CHC/BPHC level. Administrators express the need for reducing staff shortage, more intensive training in the financial and administrative processes and simplification of procedures for management of equipment.Conclusions: Strengthening CHC/BPHC level institutions may improve utilization of public health system and reduce referrals. Lifesaving drugs and equipment need to be available and operational at all levels of facilities. Content of training to administrators needs to be tailored to the felt needs.

Quality of life of patients with head and neck cancer: A mixed method study

Aim of the Study: The current research was conducted with the aim of determining the quality of life of head and neck cancer (HNC) patients using mixed method approach. Methods: A mixed method triangulation design (QUAN + QUAL) was adopted in the study. Quantitative data were collected among 54 and qualitative data were collected till data saturation using nested sampling technique. Data were collected from seven oncological wards of two tertiary care hospitals during the 4th week of radiation therapy. Quantitative data were collected through functional assessment of cancer therapy: head and neck, and a semi-structured interview schedule was adopted to elicit their experiences. Quantitative and qualitative data were compared during the analysis phase. Both qualitative and quantitative data were depicted in meta-matrices. Results: Results showed that the most affected domains were functional well-being followed by HNC subscale. Similar findings were observed in narrative description of participants. Most focused experience was pain, and difficulty in eating and swallowing was experienced due to pain. Their verbal communication was inefficacious due to loss of voice and tone. Moreover, communication was difficult owing to changes in the oral mucous membrane and pathology. Conclusion: Patients with HNC suffer from varying degrees of psychosocial problems, and it is important to identify the psychosocial adjustment of the patients since the symptoms are sufficient to lay heavy burden

Molecular and functional analysis of monoclonal antibodies in support of biologics development

Monoclonal antibody (mAb)-based therapeutics are playing an increasingly important role in the treatment or prevention of many important diseases such as cancers, autoimmune disorders, and infectious diseases. Multi-domain mAbs are far more complex than small molecule drugs with intrinsic heterogeneities. The critical quality attributes of a given mAb, including structure, post-translational modifications, and functions at biomolecular and cellular levels, need to be defined and profiled in details during the developmental phases of a biologics. These critical quality attributes, outlined in this review, serve an important database for defining the drug properties during commercial production phase as well as post licensure life cycle management. Specially, the molecular characterization, functional assessment, and effector function analysis of mAbs, are reviewed with respect to the critical parameters and the methods used for obtaining them. The three groups of analytical methods are three essential and integral facets making up the whole analytical package for a mAb-based drug. Such a package is critically important for the licensure and the post-licensure life cycle management of a therapeutic or prophylactic biologics. In addition, the basic principles on the evaluation of biosimilar mAbs were discussed briefly based on the recommendations by the World Health Organization.

Observations on the Efficacy of Sheng's Six-meridian Diagnosis and Treatment-based Acupuncture in Treating Cervical Spondylotic Arteriopathy / 上海针灸杂志

Objective To investigate the clinical efficacy of Sheng's six-meridian diagnosis and treatment-based acupuncture in treating cervical spondylotic arteriopathy.Method Seventy patients with cervical spondylotic arteriopathy were randomly allocated to treatment and control groups, 35 cases each. The treatment group received Sheng's six-meridian diagnosis and treatment-based acupuncture and the control group, conventional acupuncture. Doppler-detected vertebral artery blood flow velocity was measured, and the clinical symptom and sign score and the cervical vertigo symptom and functional assessment scale score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Result The total efficacy rate was 85.7% in the treatment group and 62.9% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in Doppler-detected vertebral artery blood flow velocity, the clinical symptom and sign score and the cervical vertigo symptom and functional assessment scale score in the two groups (P<0.01,P<0.05).Conclusion Sheng's six-meridian diagnosis and treatment-based acupuncture is an effective way to treat cervical spondylotic arteriopathy.

Study on the Utilization of the Child-Adolescent Functional Assessment Scale in Mental Health Service

OBJECTIVES: This study aims to supplement the limitations of the preliminary study and expand the use of the Child-Adolescent Functional Assessment Scale by providing standardized T-scores for measuring function in different areas, as well as guidelines for their interpretation. METHODS: The Child-Adolescent Functional Assessment Scale and Korean-Child Behavior Checklist were administered to a total of 623 individuals, including 467 parents of emotionally and behaviorally disturbed elementary school students, 45 parents of emotionally and behaviorally disturbed middle school adolescents and 111 parents of elementary school students with developmental disorders, as well as to a control group consisting of 186 parents of mainstream elementary school children in the Seoul metropolitan area. RESULTS: In contrast to the preliminary study, the emotional domain was disassociated into two factors, negative affect and emotion regulation, and the coefficient of determination for misconduct was increased significantly. Also, the overall reliability and validity of the Child-Adolescent Functional Assessment Scale were similar to those in the preliminary study, and the item structure was consistent. This study provides standardized T-scores of function in different areas based on the revised scale, and provides guidelines for their interpretation. CONCLUSION: The Child-Adolescent Functional Assessment Scale can assist the Child Global Assessment in Functioning in providing the information necessary for case management and treatment planning by comparing the impairment severity in each area of functioning, and also determining changes in behavior and function after treatment interventions. On the other hand, this scale has yet to clearly distinguish between rebellious behavior and misconduct. Further research is necessary to provide standards for more diverse age groups and for its utilization.

Reliability and validity of EQ-5D-3L and FACT in Beijing's patients with cancer and precancerosis / 肿瘤

Objective: Based on the Cancer Screening Program in urban districts in Beijing from 2013 to 2014, target populations included pulmonary, mammary, esophageal, colorectal, hepatic and gastric cancers and precancerosis patients. The EQ-5D-3L and Functional Assessment of Cancer Therapy (FACT) questionnaires were used to measure the patients' quality of life and the reliability and validity of EQ-5D-3L and FACT were analyzed. Methods: The EQ-5D-3L and FACT questionnaires were used to measure 1 001 patients with cancer and precancerosis. The Cronbach's α coefficient was calculated to test the consistent reliability of EQ-5D-3L and FACT. The factor analysis was used to measure the construct validity of FACT and the FACT as standard to test the convergent validity of EQ-5D-3L. Results: Cronbach's α coefficients of EQ-5D-3L for pulmonary, breast, esophageal, colorectal, hepatic and gastric cancers were 0.846, 0.805, 0.877, 0.862, 0.793 and 0.844, respectively; the Cronbach's α coefficients of FACT were 0.935, 0.916, 0.950, 0.952, 0.915 and 0.953, respectively. The cumulative explained variances of FACT were 64.28%, 65.15%, 71.43%, 67.21%, 64.76% and 70.56%, respectively. Compared with FACT, the convergent validities of EQ-5D-3L were 0.592, 0.503, 0.715, 0.672, 0.561 and 0.444, respectively. The convergent validities of EQ-Visual Analogue Scale (VAS) were 0.553, 0.606, 0.576, 0.579, 0.361 and 0.364, respectively. Conclusion: EQ-5D-3L and FACT questionnaires for pulmonary, breast, esophageal, colorectal, hepatic and gastric cancers and the precancerosis patients are verified to have good reliabilities, and the FACT questionnaires of six types of cancers are being verified to have good construct validities. The EQ-5D-3L questionnaires for esophageal, colorectal, pulmonary, hepatic and breast cancers are being verified to have good convergent validities; but for the gastric cancer and precancerosis, there are limited validities.

Content Validity of Upper Limb Functional Assessments for Children with Cerebral Palsy:Based on ICF-CY / 中国康复理论与实践

Objective To review the concepts of three common scales assessing upper limbs function of children with cerebral palsy, namely Fine Motor Function Measure (FMFM), Melbourne Assessment 2 of Unilateral Upperlimb Function (MA2) and Quality of Upper Extremity Skills Test (QUEST), from the framework of Chinese version of International Classification of Functioning, Disability and Health-Child and Youth Version (ICF-CY). Methods Concepts of each item from FMFM, MA2 and QUEST were extracted independently by a rehabilitation doctor and a therapist with professional experience more than three years, and then linked with ICF-CY category accord-ing to the linking rules. The distribution of concepts of each scale linking to ICF-CY categories was investigated. Results A total of 62 con-cepts were extracted from these three scales, and 403 linkages to various ICF-CY categories. Concepts from FMFM were the most linked with ICF-CY category among them, in which nearly two-thirds (134/204) concepts linked with the categories of Activity And Participation. Concepts from QUEST principally linked with the category of joint and arm-supporting in Body Function. Concepts from MA2 linked to category of cognition function which reflected motor accuracy 7 times and motor fluency 9 times (more than 50%of the total amount of link-ages). Conclusion FMFM mainly evaluates the activity and participation associated with upper limb function in children with cerebral palsy, and may be more applicable for younger children. MA2 mainly evaluates the accuracy and fluency of upperlimb movement. QUEST mainly evaluates body function especially the joint and supporting function of upper limbs.

Observations on the Efficacy of Sheng's Six-meridian Diagnosis and Treatment-based Acupuncture in Treating Cervical Spondylotic Arteriopathy / 上海针灸杂志

Objective To investigate the clinical efficacy of Sheng's six-meridian diagnosis and treatment-based acupuncture in treating cervical spondylotic arteriopathy.Method Seventy patients with cervical spondylotic arteriopathy were randomly allocated to treatment and control groups, 35 cases each. The treatment group received Sheng's six-meridian diagnosis and treatment-based acupuncture and the control group, conventional acupuncture. Doppler-detected vertebral artery blood flow velocity was measured, and the clinical symptom and sign score and the cervical vertigo symptom and functional assessment scale score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Result The total efficacy rate was 85.7% in the treatment group and 62.9% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in Doppler-detected vertebral artery blood flow velocity, the clinical symptom and sign score and the cervical vertigo symptom and functional assessment scale score in the two groups (P<0.01,P<0.05).Conclusion Sheng's six-meridian diagnosis and treatment-based acupuncture is an effective way to treat cervical spondylotic arteriopathy.

The Reliability of Functional Mobility Assessment Tools Among the Elderly in Malaysia / Jurnal Sains Kesihatan Malaysia

Functional mobility among the older population is an important element for a meaningful quality of life. The implementation of functional mobility assessments among the older people is vital to ensure appropriate steps can be taken in order to detect changes in functional mobility. There are varieties of functional mobility assessments available however most of the reliability test are based on Western countries. Therefore this study was to determine the reliability of three types of functional mobility status assessment of physical activity, especially among the older person. Sixty older respondents with the average age of 76.32 years and standard deviation of 8.66 participated in this study performed three types of functional assessments; Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Sit-to-Stand Test (STS). Two measurements were carried out with a week gap from the first measurement. Intraclass Correlation (ICC), Limits of Agreement (LOA) and Standard Error of Measurement (SEM) statistical tests followed by the combination of the three statistical analysis measurements were used for data analysis. The results showed all functional measurement tools using ICC, LOA, SEM and combination of three types analysis were highy reliable. The ICC value was exceeded 0.90 (ICC=0.94-0.99). The LOA graph for all activity measurement tools showed some degree of reliability while the SEM percentage recorded a value of less than 10% (SEM%=0.95%-9.95%). In conclusion, all three functional measurement tools are highly reliable and can be used as one of the functional test among the older people in Malaysia.

Vision Status: Presbyopic Patient Undergone Corneal Inlay Procedure / Jurnal Sains Kesihatan Malaysia

This study reports the vision status of a presbyopic patient who has undergone a corneal inlay procedure. The study hopes to provide optometrists more insight on the procedure and the co-management involved in such a patient. The patient, a 48 years-old Chinese woman with presbyopia underwent the corneal inlay procedure three years ago. She had the inlay implanted in the non-dominant eye to aid near vision i.e. her left eye. The pre and post-operative evaluations include distance and near visual acuity, fundoscopy, tonometry, Schirmer’s test, slit lamp evaluation, corneal topography and corneal pachymetry. Near visual acuity for the left eye improved from N14 to N5 immediately after the procedure. Even after 3 years of post-operative followup, the patient was still able to maintain her near vision. In conclusion, the corneal inlay procedure helped to improve near vision of this presbyopic patient. Optometrist plays a very important role in the co-management of such patients alongside with the ophthalmologist in terms of visual functional assessments pre and post-surgery, counseling of the procedure and managing patients’ expectations.

O questionário de atividades funcionais de Pfeffer: revisão integrativa da literatura brasileira / Pfeffer’s functional activities questionnaire: an integrative review of the brazilian literature

O Questionário de Atividades Funcionais (Functional Activities Questionnaire – FAQ) tem grande importância clínica em razão da sua capacidade de identificar perdas funcionais em indivíduos com suspeita de demência. O presente estudo tem o objetivo de: 1) Identificar os grupos clínicos com os quais o instrumento é utilizado no Brasil; 2) Identificar qual versão do questionário é usada nos estudos brasileiros; 3) Avaliar o instrumento quanto ao estágio de validação, à confiabilidade e à adaptação para o contexto brasileiro, identificando as lacunas existentes e as necessidades de aprimoramento; e 4) Identificar o método de administração e o ponto de corte mais formal desse instrumento no Brasil. Realizou-se uma revisão integrativa da literatura a partir de busca nas bases de dados Lilacs, SCIELO Brasil e PUBMED, sendo que 45 estudos compuseram a amostra. Constatou-se que diferentes versões baseadas no FAQ são usadas no Brasil, não sendo possível concluir se a versão original é a mais utilizada. Esses questionários são amplamente empregados em idosos com alterações cognitivas. Foram encontrados 18 estudos de validade de construto, 15 de validade de critério e um de confiabilidade. Não foram encontrados estudos sobre a validade ecológica do FAQ. O ponto de corte utilizado com maior frequência como indicador de incapacidade funcional é o de 5 pontos. A entrevista com informante é a forma de aplicação mais utilizada. Em razão da diversidade de versões do FAQ no contexto nacional, é fundamental que o profissional tenha clareza sobre as evidências de validade da versão que utiliza para a prática clínica e de pesquisa.

Among the different assessment tools employed to measure functional capacity, the Functional Activities Questionnaire (FAQ) stands out due to its capacity for identifying functional damages in individuals with suspected dementia. The aims of the present study were: 1) identify clinical groups for which the FAQ is used in Brazil; 2) identify what version of the questionnaire is used in Brazilian studies; 3) evaluate the FAQ with regard to the stage of validation, reliability and adaptation to Brazilian culture; and 4) identify the most frequent administration method and cutoff point used for the FAQ in Brazil. An integrative review of the literature was performed based on a search of the Lilacs, SCIELO Brazil and PUBMED databases. Forty-five studies were selected to compose the sample. Different versions of the FAQ are used in Brazil and it was not possible to conclude whether the original version is the most employed. These questionnaires are widely used for older adults with cognitive impairment. Eighteen studies on construct validity, 15 on criterion validity and one on reliability were found. No study was found addressing the ecological validity of the FAQ. The most frequent cutoff point used as an indicator of functional disability was 5 points. An interview with the informant was the most frequent form of administering the questionnaire. Considering the diversity of versions of the FAQ in the national context, it is essential that the professional has clarity about the evidence of validity of the version which uses for clinical practice and research.

Validación del índice Duruõz en una población argentina con esclerodermia / Reliability and validity of the Duruoz Hand Index in an argentinian population with scleroderma

Objetivo: el objetivo de nuestro estudio fue adaptar y validar el Indice Duruõz (ID) en una población argentina con esclerodermia. Métodos: Para la validación, reumatólogos tradujeron al español la versión original en francés. Para evaluar la validez constructiva se utilizó la escala global visual análoga del paciente (EVA), EVA para cada una de las preguntas de la misma actividad, el cuestionario de evaluación de salud (HAQ) y el Score modificado de Rodnan para evaluar la piel. Resultados: Se incluyeron 45 pacientes con diagnóstico de esclerodermia. La correlación entre la puntuación total de ID y el EVA global del paciente fue de 0,58, con el HAQ fue 0,63 y con el Rodnan fue 0,08. El coeficiente de correlación entre el EVA y cada grupo de preguntas para la misma actividad en el ID, indicó buena correlación para las preguntas que se refieren a las actividades de cocina, así como para vestirse, de higiene, y para las preguntas de oficina. Se encontró excelente nivel de correlación con los ítems relacionados con las actividades de motricidad fina. La reproducibilidad fue de 0,88 y la confiabilidad de 0,98. Conclusión: Los resultados mostraron que el ID es un cuestionario confiable y válido para esta población argentina con esclerodermia.

Objective: the aim of our study was to adapt and to validate theDHI questionnaire in an argentinian population with scleroderma. Methods:  For validation, rheumatologists translated to Spanish the original version in French. To evaluate the construct validity, we used thepatient global visual analogue scale (VAS), VAS for questions for the sameactivity, the health assessment questionnaire (HAQ) and the Rodnan. Results: a total of 45 patients with scleroderma were includedin the study. The correlation between the total score of DHI and thepatient global VAS was 0.58, with the HAQ was 0.63 and with Rodnan0.08. The correlation coefficient between the VAS and each group of questions for the same activity in the DHI questionnaire, indicatedgood correlation for the questions that refer to activities of kitchen, aswell as for dressing, for hygiene, and for the office questions. Therewas excellent level of correlation with those related to  fine motoractivities. The reproducibility was 0.88 and the reliability was 0.98. Conclusion: The results from this study show the DHI to be a reliableand valid test for this argentinian population with scleroderma.

Information and rehabilitation needs of Indian breast cancer patients: Report of a cross-sectional study.

Background: Breast cancer causes significant disruption to the quality of life (QOL) of its patients, which is compounded further by lack of information and adequate facilities for rehabilitation. Materials and Methods: This descriptive cross-sectional study was conducted in women who had completed their Primary treatment of breast cancer. The QOL was assessed by Functional assessment of cancer therapy-breast (FACT-B) version 4, and information and rehabilitation needs were enquired about in a semi-structured interview. Results: A total of 154 patients were enrolled and divided into three groups according to the time elapsed after initial treatment; Group I: 1-2 years, Group II: 2-5 years, Group III: >5 years The FACT-B mean scores were; Group I (n = 64): 79.06 ± 14.60; Group II (n = 48): 85.75 ± 20.15; and Group III (n = 42): 89.83 ± 12.80. Patients in Group I scored lowest on physical well-being subscale, Group II on breast specific subscale and Group III on Social well-being subscale. Pain, lack of energy, inability to meet the needs of the family, fear that the condition will get worse and loss of body image were significant factors contributing to poor QOL. Analysis of interviewshowed many unmet information needs. Main rehabilitation needs were effective treatment of physical symptoms and counselling about body image issues and sexual dysfunctions. Easy availability of clinical and social support services were major felt needs in the long-term follow-up. Conclusions: Targeted Interventions are needed to address issues relating to QOL and rehabilitation needs of breast cancer patients.

Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people

Objective: To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs) based on the Katz and Lawton indices for Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods: In this study, 85 patients with MCI and 93 with AD, stratified by age (≤ 74 years, > 74 years), completed the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis), reliability (internal consistency), and criterion-related validity (receiver operating characteristic analysis and logistic regression) were assessed. Results: Three factors of ADL (self-care, domestic activities, and complex activities) were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL). The components showed good internal consistency (> 0.800) and moderate (younger participants) or high (older participants) accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. Conclusion: The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD. .

A Preliminary Study for Developing a Child and Adolescent Functional Assessment Scale in the Mental Health Service

OBJECTIVES: The aim of this study was to develop an assessment tool for measurement of children's functioning in the mental health service. We conducted a preliminary study to develop a sensitive and inclusive scale focused on the functional changes of children rather than just focusing on their symptoms or screening. METHODS: The Child and Adolescent Functional Assessment Scale and the Korean-Child Behavior Checklist (K-CBCL) were both administered to 134 parents of children with emotional or behavioral problems who participated in the Aizone program and also to 186 parents of elementary school children in the Seoul metropolitan area as a control group. SPSS version 12.0 was used for statistical analysis. RESULTS: Most of the reliability coefficients were over 0.70 except those of the conduct behavior items, which showed relatively high internal consistency. The corrected item-total correlations ranged from .411 to .758, except those of conduct behavior items and special measure items. In a concurrent validity test with K-CBCL, the total behavior problem score of K-CBCL was highly correlated with the total score of the Child and Adolescent Functional Assesment Scale (r=.610). For the construct validity, confirmatory factor analysis was performed for each of four areas, including behavior (at home/school), achievement, peer relationship, and emotion. CONCLUSION: The results showed that the scale was statistically reliable and valid, except for conduct behavior items. This study was conducted only for parents with elementary children. An adolescents group should be included in future studies.

Quality of life in children with psychiatric disorders at the Philippine Children's Medical Center (PCMC): Child, parent and clinician report

OBJECTIVES: This study aims to determine the quality of life (QoL) of children and adolescents with psychiatric disorders at PCMC using child, parent and clinician reports.METHODOLOGY: Consecutive referrals of 125 children and adolescents and their parents assessed QoL using the Pediatric Quality of life Inventory (PedsQL) and the Child and Adolescent Functional Assessment Scale (CAFAS) for clinicians.RESULTS: Eight diagnostic categories were identified: attention deficit hyperactivity disorder (ADHD), anxiety disorder, disruptive behavior disorders, mood disorder, no axis I diagnosis, psychotic disorder, parent-child relational problem, and others. From the children's report , no significant difference was noted in the QoL among diagnostic categories. From the parent's report, children with disruptive behavior disorders had the poorest psychosocial health. From the clinician's report, children with psychotic and mood disorders had the poorest QoL. Specific functional domains were affected per diagnostic category: for children with ADHD, school functioning; for children with disruptive behavior disorder, home, community domains and social and school functioning; for children with mood disorders, home, community and self-harm domain; for children with psychotic disorder, behavior toward others, mood, thinking, and social domains.CONCLUSION: Multi-rater assessment of QoL of children and adolescents varied. Domains of functioning must be targeted to improve overall QoL.