ABSTRACT
Life care planning is a method of estimating future care costs for patients with catastrophic disabilities. The life care planner determines an annual budget for care, including further medical and rehabilitative interventions, durable medical goods, disposable medical goods and supplies, and recreational equipment. After determining an annual budget, the life care planner must use scientifically sound methods of determining the patient's life expectancy in order to create a lifetime budget.
Subject(s)
Costs and Cost Analysis/methods , Disability Evaluation , Forecasting/methods , Disabled Persons , Health Care Costs , Humans , Male , Middle Aged , Spinal Cord Injuries/diagnosis , Spinal Cord Injuries/economics , Spinal Cord Injuries/therapyABSTRACT
A life care plan may be useful to plan the needs of the disabled child with cerebral palsy. A cost analysis for a life care plan depends on the life expectancy of the child, and careful review of the needs of the child. A wide variety of support services may be available in the public sector. Key physical disabilities are associated with diminished life span, as are diminished cognitive abilities, even in the absence of physical impairment. The life care plan must follow the generally accepted and peer-reviewed methodology, with an appropriate foundation for each item recommended.
Subject(s)
Case Management , Cerebral Palsy/economics , Cerebral Palsy/therapy , Home Care Services , Life Expectancy , Cerebral Palsy/nursing , Child , Costs and Cost Analysis , Home Care Services/economics , Housing/economics , Humans , Needs Assessment , Pharmaceutical Preparations/economics , Self-Help Devices , Transportation/economicsSubject(s)
Consciousness , Quadriplegia/mortality , Adult , Aphasia/etiology , Female , Humans , Male , Quadriplegia/complications , Quadriplegia/psychologyABSTRACT
Many publications emphasize the theoretical relationship between impairment, disability, and the workplace. This article intended to provide the reader with some framework in this regard, but its main intent is to create a practical how-to-guide in the evaluation of impairment and disability that result from low back pain.
Subject(s)
Disability Evaluation , Disabled Persons/statistics & numerical data , Low Back Pain/classification , Physician's Role , Spinal Diseases/classification , Workers' Compensation/statistics & numerical data , Adolescent , Adult , Employment , Humans , Middle Aged , Spinal Diseases/diagnosis , United States/epidemiology , Workers' Compensation/economicsABSTRACT
OBJECTIVE: The initial purpose of this study was to establish a normal data set for median nerve studies in industrial workers using NC-stat technology. METHODS: Sixteen hundred ninety-five persons applying for employment at a single heavy industry plant without symptoms of carpal tunnel syndrome (CTS) were studied. RESULTS: Values for median distal motor latency (DML), amplitude, and F-waves were recorded in the dominant limbs. The DML was 3.81 +/- 0.57 milliseconds, with a 95% cut-off value of 4.75 milliseconds. Amplitude of the compound muscle action potential was 0.95 +/- 0.46 mV, reflecting the use of volume conduction by this technology. Most of the workers who were characterized as having borderline, prolonged, or very prolonged distal motor latencies according to NeuroMetrix automated report actually fell below the 95% cut-off of this independent data analysis. CONCLUSION: NC-stat technology using DML appears to be no more sensitive or specific than a traditionally performed DML for the diagnosis of CTS. Until recently promoted sensory studies using NC-stat technology are better defined, this technology cannot be recommended for screening or diagnosis of CTS in an industrial population.
Subject(s)
Carpal Tunnel Syndrome/diagnosis , Diagnostic Techniques, Neurological/instrumentation , Mass Screening/instrumentation , Occupational Diseases/diagnosis , Occupational Medicine/instrumentation , Age Factors , Body Size , Carpal Tunnel Syndrome/physiopathology , Electrophysiology , Female , Humans , Male , Mass Screening/methods , Median Nerve/physiopathology , Neural Conduction , Occupational Diseases/physiopathology , Occupational Medicine/methods , Reference Values , Regression Analysis , Sensitivity and Specificity , Sex FactorsSubject(s)
Consciousness Disorders/mortality , Quadriplegia/mortality , Humans , Longevity , SyndromeSubject(s)
Analgesics, Opioid/administration & dosage , Opioid-Related Disorders/prevention & control , Oxycodone/administration & dosage , Pain, Postoperative/drug therapy , Pain/drug therapy , Patient Participation , Administration, Oral , Adult , Arthroplasty, Replacement, Hip , Drug Administration Schedule , Female , Humans , Neoplasms/complications , Neoplasms/surgery , Pain/etiologyABSTRACT
OBJECTIVES: Physicians may be asked by attorneys or other patient advocates to help plan for the long-term needs of children with cerebral palsy (CP) and developmental disability (DD). The first step in such planning is to thoroughly examine the literature dealing with life expectancy in these populations. This review paper comprehensively reviews the literature relating to survival in children with cerebral palsy and developmental disability. STUDY SELECTION: A Medline data search was completed using the terms cerebral palsy, life expectancy, survival, as well as other pertinent terms. Further articles were gleaned from bibliographies of pertinent literature. DATA SYNTHESIS: Certain key disabilities can be used to accurately predict life expectancy in children with cerebral palsy and mental retardation. These include: (1) presence and severity of mental retardation, (2) inability to speak intelligible words, (3) inability to recognize voices, (4) inability to interact with peers, (4) severity of physical disability, (5) use of tube feeding, (6) incontinence, and (7) presence and severity of seizures. CONCLUSIONS: Literature review definitively shows that children with CP and DD have a diminished life expectancy, which can be assessed based on simple clinical examination findings.
Subject(s)
Cerebral Palsy/mortality , Intellectual Disability/mortality , Life Expectancy , Long-Term Care , Cerebral Palsy/complications , Child , Humans , Intellectual Disability/complications , Survival AnalysisABSTRACT
Physicians may be asked to help plan long-term needs of patients with catastrophic injury. It is crucial to know the life expectancy and be intimately familiar with the needs of the disabled person for whom one is planning. This article uses two diagnostic groups as models to illustrate the process: one a spinal cord injured adult and the other a child with cerebral palsy and mental retardation. We provide examples of some of the specific types of needs for these two groups of individuals.
Subject(s)
Disabled Persons , Long-Term Care , Patient Care Planning , Case Management , Catastrophic Illness/economics , Cerebral Palsy/economics , Humans , Intellectual Disability/economics , Long-Term Care/economics , Needs Assessment , Spinal Cord Injuries/economicsABSTRACT
We review in this article the most recent edition of the American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guides) from a physiatric perspective. Important general changes within the framework from the 4th to the 5th edition are highlighted. Those sections of the AMA Guides most often consulted by physiatrists are examined in critical detail, including sections dealing with the spine, upper and lower extremities, neurologic impairments, and impairments due to pain.
Subject(s)
Disability Evaluation , Practice Guidelines as Topic/standards , American Medical Association , Humans , Manuals as Topic , Pain Measurement , Range of Motion, Articular , United StatesABSTRACT
Estuda-se a hipertonia espástica post ictus considerando as intervençöes farmacológicas e cirúrgicas para o seu tratamento
