ICF

Patient reported outcome (PRO) questionnaires are increasingly used to measure treatment effect in patients with knee pathology. PROs commonly used to assess outcome in patients with knee conditions can be generic, knee-specific, or condition-specific. Most PROs have been created based on clinician-based consensus and are not patient-centered. Items (questions plus their response options) in PROs can be generated by clinicians or through patient interviews. Items created by clinicians possess face validity. The objective of this study was to find all existing PRO items with potentially relevant content for patients with knee pathology. An exhaustive literature search was conducted for PRO questionnaires in English, German, and Scandinavian languages used to assess outcome in patients with knee pathology. The items from the collected PROs were assessed for content redundancy and item reduction was carried out to isolate items of unique content. These items were grouped into one of the components of the ICF classification system. Thirty-one PROs used for assessment of patients with knee problems were identified, yielding 539 items. Approximately 70% of these items consisted of redundant content matter. The item pool was reduced to a pool of 157 items. The search yielded 157 items of unique content. The identified items can be used to build condition-specific PRO questionnaires for patients with knee pathology.

There is little research literature on patient flow in rehabilitation. Accepted definitions of barriers to discharge and agreed performance measures are needed to support research and understanding of this topic. The potential of improved patient flow in rehabilitation to assist relieving demand pressures in acute hospitals underscores its importance. This study develops a definition of barriers to discharge from postacute care and classifies their causes using a multiphased iterative consultation and feedback process involving physiatrists, aged-care physicians, and senior nursing and allied health clinicians. Key performance indicators (KPIs) for postacute patient flow are then proposed, the development of which were informed by the available literature and a survey (nZ101) of physiatrists, aged-care physicians, and hospital managers with responsibility for patient flow who were questioned about the use of relevant KPIs in this setting. Most (>70%) respondents believed that using KPIs (eg, waiting time from acceptance by postacute care and ready for transfer until admission, percentage of postacute bed days occupied by inpatients with a discharge barrier) to measure aspects of patient flow could improve processes, but few reported collecting this information (45% admission KPIs, 19% discharge KPIs). By using the definition and classification of discharge barriers prospectively to document and address barriers, in conjunction with appropriate KPIs, postacute patient flow and the efficiency of hospital resource utilization can potentially be improved. Our commentary aims to stimulate interest among others to develop a more robust evidence base for improved flow through postacute care.

Assistive Technology (AT) is regularly provided by health and social services to many people with a wide range of needs or disabilities, to overcome barriers and difficulties in daily life. This research aims to develop a tool that may support practitioners to meet clients' individual needs when selecting AT by using a common language and structure for the process. A tool was developed incorporating the International Classification of Functioning, Disability and Health (ICF) model, collating information in a systematic order. Experts in the field of AT were consulted during the development of the tool and initial evaluation, and provided positive feedback on the research aims and approach. This paper describes the development of the tool and the potential added value of using the ICF in AT selection, with links to existing models and instruments. Plans for further development and testing of the tool are outlined.

The objective of this systematic review and content analysis was to identify and quantify the concepts contained in patient-administered health status measures in sleep medicine practice and research using the International Classification of Functioning, Disability and Health (ICF) as a reference.

2012 年我國正式實施身心障礙鑑定與需求評估制度，除了引進
世界衛生組織頒布的「國際健康功能與身心障礙分類系統」作為身心
障礙鑑定與需求評估架構外，整體服務申請流程也有變動。本文研究
目的為探究身心障礙鑑定與需求評估制度的實施經驗。本文採用焦點
團體法，針對各縣市第二鑑定人員、需求評估人員、個案管理人員、
身心障礙團體代表（服務使用者）及相關學者專家，共舉行21 場焦
點團體。本研究發現，併同辦理流程對於障礙者生活資訊蒐集有所限
制；公所人員未能發揮預期功效，進而對後續流程順暢造成影響；醫
院身心障礙者鑑定尚未參採「活動與參與」鑑定資料，障礙者表示因
進行多次到醫院鑑定造成交通往返之不便；福利服務的分流模式有修
正的必要，同時，需求評估人員與個案管理人員未來亦應加強合作機
制；專業團隊運作方面，出現審查委員訓練不足及缺乏身心障礙者參
與的情況。依據研究結果，本文針對前述議題提出若干建議，希冀藉
由研究建議的提出，增進身心障礙鑑定與需求評估制度運作順暢性。

The evaluation and intervention of persons with dysphagia represents a significant percentage of speech-language pathologists' caseloads in medical settings. Because of its overtly medical nature, there has been considerable focus dealing with the direct physical health aspects of dysphagia management. This article argues that the use of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) by clinicians can expand and greatly enhance the outcomes for persons with dysphagia. The different components of the ICF are discussed in relation to dysphagia assessment and management. The article concludes by noting that speech-language pathologists can use the ICF framework beneficially to justify and strengthen their role in the management of dysphagia.

Objective: To describe the challenges to activity and participation faced by young people with visual impairment within the framework of the International Classification of Functioning (ICF). Methods: 14 young persons (aged 16-22 years) with visual impairment and their parents (n = 22) participated in the study. The Canadian Occupational Performance Measure (COPM) was used to describe challenges of participation as perceived by the young persons themselves. Individual interviews with the young persons and their parents were used to investigate in more depth the challenges the young persons face with regard to participation. Results: Young persons with visual impairment face challenges to participation most frequently with regard to mobility, domestic life, interpersonal interaction and relationships, major life areas, and leisure activities. The environment in which they live has a central role as a barrier or facilitator of participation. Conclusions: The challenges related to activities and participation that young persons with visual impairment face are diverse. It is important that these challenges are assessed individually and with the help of subjective measures. Serving as a broad framework for classifying the data, the ICF proved to be a useful tool, but used strictly at category level it may limit the coding of data and narrow interpretation.

Ethnopharmacological relevance: The article presents the local knowledge on medicinal plants and their relevance in managing health problems. Important ethnobotanical leads are given with priority species and disease categories, casting insight on future phytochemical and pharmacological studies. Aim of the study: The use of traditional medicinal plants has been an integral part of the traditional healthcare systems in Djibouti. However, scientific studies on the traditional herbal healing systems of the various cultural groups have never been undertaken. This study has, therefore, aimed at assessing plant-related ethnomedicinal knowledge of the people in Randa Region; prioritising the plants with respect to common disease categories and inferring about prospects of new pharmacological products. Materials and methods: Interview-based ethnobotanical field study was carried out to document the plant-based ethnomedicinal knowledge handed down to the present by the oral tradition of people living in 24 villages in Tadjourah District of Randa Region (north Djibouti). Informant Consensus Factors (ICF) and Fidelity Level (FL) values of the medicinal plants were calculated to check the level of informant agreement and the healing potentials of the species.

Whiteneck GG, Dijkers MP, Heinemann AW, Bogner JA, Bushnik T, Cicerone KD, Corrigan JD, Hart T, Malec JF, Millis SR. Development of the Participation Assessment With Recombined Tools-Objective for use after traumatic brain injury. Arch Phys Med Rehabil 2011;92:542-51. Objective: To develop a new measure, the Participation Assessment With Recombined Tools-Objective (PART-O), based on items from 3 participation instruments. Design: Instrument development based on survey research. Setting: Community. Participants: Adults (Nϭ400) with traumatic brain injury (TBI) 1 to 15 years postinjury, recruited from 8 TBI Model Systems (TBIMS). Interventions: None. Main Outcome Measure: Community Integration Questionnaire version 2; Participation Objective, Participation Subjective; Craig Handicap Assessment and Reporting Technique; PART-O.

Eyssen IC, Steultjens MP, Dekker J, Terwee CB. A systematic review of instruments assessing participation: challenges in defining participation. Arch Phys Med Rehabil 2011;92:983-97. Objectives: To evaluate: (1) whether instruments which intend to measure participation actually do and (2) how frequently specific aspects and domains of participation are addressed.

In the past decade, new models have emerged with respect to the constructs of (intellectual) disability, quality of life, and supports. These models have implications both for understanding the underlying phenomena as for validating professional practices. The authors describe the context and key components of models of human functioning (American Association on Intellectual and Development Disabilities; International Classification of Functioning, Disability, and Health), supports, and quality of life, and demonstrate how these are related by synthesizing their similarities and differences. From this they discuss the implications for professional clinical and service good practice. It is argued that these models offer relevant frames of reference for guiding and integrating activities of medical, behavioral, and social disciplines in the field of intellectual disability services. It is also argued that knowledge of these models and their relationships facilitates communication among professionals and between professionals and policy makers.

WebCT is an online course management system which is accessed through the portal. It has a wide range of tools which support teaching and learning and enable online delivery of lecture notes, representations, surveys and quizzes, coursework, discussion boards and much more. Evaluation of WebCT systems success or effectiveness is a fundamental challenge to education institutions. A review of previous e-learning research suggests a focused evaluation approach, thus offering limited discussion of comprehensive views of WebCT systems success or systematic and practical guidance to its evaluations. Based on a prevalent information systems success model, this paper proposes and describes a revised model for evaluating WebCT systems success in educational settings. The study findings suggest that content quality, system quality, support service quality, teaching and learning quality, self-regulated learning, intention to use/use, user satisfaction and net benefits are important factors for evaluating the success of WebCT CCMS. Implications of the proposed model for theory and practice were illustrated. In addition, future research directions that extend the reported study are also preferred.

The World Health Organization has proposed participation restriction to reflect the societal consequences of health conditions. Despite its importance, participation restriction appears to be inconsistently represented or absent from the content of many health status instruments. This paper describes the development and testing of a new self-complete measure of participation restriction from the conceptual basis of participation as an individual’s perception of their actual involvement in life situations. The psychometric properties (face, content and construct validity, responder burden, performance and repeatability) of the instrument were examined using qualitative and quantitative methods. Person-perceived participation restriction did not reflect the frequency of participation but was associated with participants’ expectations, aspirations, and needs, as well as contextual factors. We conclude that the instrument can provide estimates of person-perceived participation restriction in population surveys.

Alterations of genetic and epigenetic features can provide important insights into the natural history of breast cancer. Although DNA methylation analysis is a rapidly developing field, a reproducible epigenetic blood-based assay for diagnosis and follow-up of breast cancer has yet to be successfully developed into a routine clinical test. The aim of this study was to review multiple serum DNA methylation assays and to highlight the value of those novel biomarkers in diagnosis, prognosis and prediction of therapeutic outcome. Serum is readily accessible for molecular diagnosis in all individuals from a peripheral blood sample. The list of hypermethylated genes in breast cancer is heterogeneous and no single gene is methylated in all breast cancer types. There is increasing evidence that a panel of epigenetic markers is essential to achieve a higher sensitivity and specificity in breast cancer detection. However, the reported percentages of methylation are highly variable, which can be partly explained by the different sensitivities and the different intra-/inter-assay coefficients of variability of the analysis methods. Moreover, there is a striking lack of receiver operating characteristic (ROC) curves of the proposed biomarkers. Another point of criticism is the fact that 'normal' patterns of DNA methylation of some tumor suppressor and other cancer-related genes are influenced by several factors and are often poorly characterized. A relatively frequent methylation of those genes has been observed in high-risk asymptomatic women. Finally, there is a call for larger prospective cohort studies to determine methylation patterns during treatment and follow-up. Identification of patterns specific for a differential response to therapeutic interventions should be useful. Only in this way, it will be possible to evaluate the predictive and prognostic characteristics of those novel promising biomarkers.

Occupational therapists use a range of strategies to influence the relationship between person, environment and occupation and facilitate people's participation and inclusion in society. Technology is a fundamental environmental factor capable of enabling inclusion, and occupational therapy models articulate a role for assistive technology (AT) devices and services, but there is a gap between theory, research and practice. The context of AT provision in Australia presents systemic barriers that prevent optimal application of AT devices and services for societal health promotion and in individualised solutions. The Integrating Theory, Evidence and Action method (ITEA) was used to answer the question 'How can occupational therapy support AT provision to enable older people and people with disability?' A wide range of sources were systematically analysed to explore the complexities of AT provision in Australia. The International Classification of Functioning, Disability and...

OBJECTIVE: To develop a Rasch-based version of a mobility questionnaire (MobQues28) for children with cerebral palsy (CP). DESIGN: Cross-sectional study. SETTING: Private physical therapy practices and outpatient departments of hospitals and rehabilitation centers. PARTICIPANTS: Parents of 323 ambulatory children with CP (Gross Motor Function Classification System [GMFCS] level I-IV; aged, 2-13y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The mobility questionnaire measures mobility limitations in children with CP by rating the difficulty of executing 47 mobility activities, as reported by the parents. Items for the Rasch-based version were selected based on fit to the Rasch measurement (partial credit) model and invariance of item characteristics across GMFCS level, age group, or sex. RESULTS: Analysis revealed a fitting model when nonambulant and/or 2-and 3-year aged children were excluded (leaving a final sample of n=246) and answering categories were collapsed from 9 to 5. Thirteen items were removed from the questionnaire due to misfit to the model, 5 because of disordered thresholds, and 1 because of invariance across age group. Twentyeight items out of the original 47 items showed good fit to the model. CONCLUSIONS: The 28-item version of the mobility questionnaire (MobQues28) provides sound measurement properties for measuring mobility limitations in ambulant children with CP, aged 4 to 13 years, and shows promise as an instrument for research purposes.

Objective: To describe the characteristics of people with visual impairment who participated in the Visual Rehabilitation Groups, according to the ICD-10 and the International Classification of Functioning, Disability and Health  (ICF). Methods: Quantitative, cross-sectional survey, developed in a university rehabilitation research center between october and december 2012. The users from the Visual Rehabilitation Groups were invited; 13 of them agreed to participate. We performed an occupational therapy evaluation – with anamnesis, performance evaluation and functional vision assessment – an analysis of medical charts and patient description with the use of the ICF. Results: The major causes of visual impairment were diabetic retinopathy, glaucoma, optical neuritis and keratoconus. Some functions and structures of the body, performance and capabilities in activities and participation, environmental factors facilitators or limiters were highlighted in this study, allowing the description of the characteristics of each participant through the functionality and the improvement of the therapeutic planning. Assistive technologies, optical and non-optical aids used and their everyday benefits were presented. Conclusion: Visual loss, at any level, led to functional impairments, limiting and restricting the participation and performance in everyday activities, interfering with the individuals’ independence, autonomy and quality of life. However, the use of optical aids, non-optical aids and environmental adaptations proved to be beneficial for increasing the functionality, showing the influence of external factors on the performance. Knowing and recognizing the existence of diversities within the visual impairment universe allows us to understand who the treated individual is, avoiding the generalization by the visual condition. The ICF showed to have a fundamental role in this context.

Variable demand and an increasing range of electricity supply methods are such that steam plant must perform under cyclic operation. Indeed, the multiplicity of generating options means that even defining a 'typical' cycle is difficult. Quantification of the range of potential damage mechanisms is even more complex. In response to the need for greater understanding of cyclic performance issues in high energy components, in 2006 EPRI initiated a series of Annual Expert Workshops on Creep Fatigue. These discussions identified key issues and areas for development related to the design and performance under transient operation. Summary documents, produced from each of the annual meetings, have helped guide this international effort in the field of creep-fatigue. It is apparent that a coordinated effort is critical to ensuring that outcomes are meaningful and effective. Excellence in science and engineering is necessary in aiding the electricity supply industry to meet current challenges associated with safe and reliable operation of plant. The present paper documents the current state of knowledge on creep fatigue behaviour and outlines achievements from the EPRI collaborative work. The overall goal of this effort is to provide the basis of a comprehensive approach to design and life management of components that are subject to creep-fatigue conditions.

An ethnobotanical survey was carried out to collect information on the use of medicinal plants by the Zay people who live on islands as well as shore areas of Lake Ziway in the Ethiopian Rift Valley. A total of 33 medicinal plants were reported as being used locally for the treatment and/or control of human and livestock ailments. Results of the survey showed that leaf materials form the major component of plant parts harvested. The majority of the remedies are prepared in the form of juice from freshly collected plant parts. Most of the remedies are prepared from a single species, and are mainly taken orally. Most of the medicinal plants are collected from the wild. Of the total claimed medicinal plants, 10 were reported scarce locally. Environmental degradation and intense deforestation have been reported as the main causes for the depletion of medicinal plants in the area. As the Zay people are still partly dependent on medicinal plants, loss of these plants will, to a certain extent, hamper the existing health care system in the area. Measures for conservation of medicinal plants of the Zay people are urgently needed.

The International Classification of Functioning, Disability, and Health (ICF) consists of 34 codes per person at the one digit level and, at more detailed levels, the number of codes can reach 1,424 items. This degree of complexity has led research groups to develop core sets of ICF codes for specific health conditions and Ageing Int (2012) 37:414-440 disabilities. The ICF core sets typically include the least number of domains to be practical, but as many as required to sufficiently characterize a specific condition. The purpose of this article is to present an ICF core set addressed to older adults with dementia in the process of receiving Assistive Technology (AT) for their functioning and well-being. The ICF Core Set development involved a formal decision-making and consensus process, integrating evidence gathered from preliminary studies that included focus groups of health professionals, a systematic review of the literature, and empirical data collected from patients and caregivers. In the ICF core set for older adults with dementia in an AT selection process, the body functions and structures codes are decreased but those related to activities and participation and personal and environmental factors are increased. To further achieve a biopsychosocial and user-driven Core Set that can be applied internationally, ICF categories have been supplemented with items in a measure of AT predisposition and use that is used in many countries. The combination is named the ICF core set for Matching Older Adult with Dementia and Technology (MOADT).

...ogni possibile rapporto tra l’uomo e le cose o tra l’uomo e gli altri uomini è filtrato dal concetto bisogno, il quale implica la dipendenza dell’essere umano da tali rapporti.
Il concetto di bisogno, si vuole intendere, non rimanda ad uno stato provvisorio di privazione rispetto ad un qualunque bene percepito come necessario, bensì ad una condizione permanente di dipendenza che può caratterizzare l’uomo sia in senso positivo sia negativo...

Selective laser melting is an additive manufacturing technology where metal powder is melted by a laser source layer-wise, forming a solid, dense metallic component. With the selective laser meting process, near net shape components can be manufactured directly from a 3D-model. The model is sliced into thin layers and a powder is spread onto a build platform. In the next step, the powder is fused by a laser as dictated by the model. The laser energy is intense enough to permit full melting (welding) of the particles to form solid metal. The process is repeated layer by layer until the part is complete. A number of materials are available, including steel, aluminium, titanium and, in recent time, also superalloys. The material investigated in the current project is a nickel base superalloy composition-wise equivalent to Hastelloy X, a solution strengthened superalloy typically used in large welded components exposed to high temperatures in oxidizing as well as reducing environments.

The purpose of the research presented in this thesis is to enhance the field of accessibility to include a multitude of perspectives. Based on cultural-historical activity theory (CHAT), it analyzes how human, artifactual and natural factors impact an individual’s possibilities to act in concrete situations that are part of a systemic whole. The thesis presents two main results: An enhanced accessibility encompassing: Epiaccessibility, accessibility’s spirit of the times, stands for how experiences of activities alter accessibility capacities, learning, expectations, attitudes, trust, demands and denials of the individual and her human, artifactual and natural environments. Lived accessibility, which includes the anticipations and the experienced conditions of a person to be able to do what she wants in a concrete situation. Planned accessibility, which consists of all the accessibility factors that can be created beforehand based on plans, guidelines and principles. The Activity Di...

Purpose: Exploring which variables are related to work status in patients with chronic low back pain (CLBP), classified according to the International Classification of Functioning, Disability and Health (ICF). Method: Ninety-two patients with CLBP filled out questionnaires inquiring after health status, impairments in body functions/ structures, limitations in activities of daily living (ADL), participation in work, environmental and personal factors. Additionally, patients performed tests to measure physical fitness and performance of work-related activities. Univariate analyses were performed to investigate whether differences exist between working and non-working patients. Logistic linear regression analysis was performed to explain work status from the variables of functioning. Results: Non-working patients had a lower self-reported physical and mental health, lower physical fitness, more self-reported limitations in ADL, lower education, more depressive symptoms and higher psycho neuroticism than working patients. Self-reported physical and mental health and educational level correctly classified 84.5% of the patients as working or non-working. Performance of work-related activities was not significantly related with work status. Conclusions: The relation between work status and CLBP is multidimensional, as was illustrated by using the bio-psychosocial model of the ICF. Patients with a low educational level, a low self-reported physical or mental health were more likely to be non-working. Self-reported limitations and physical and mental health are more important in explaining work status than objective measurements of performance.

To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected. A literature search was conducted using medical and health science electronic databases (PubMed, Medline, EMBASE, CINAHL, Cochrane Library) up to September 2014. Two independent reviewers selected studies reporting outcomes for natural disaster survivors following medical rehabilitation that addressed functional restoration and participation. Two reviewers independently extracted data and assessed the methodological quality of the studies using Critical Appraisal Skills Program's (CASP) appraisal tools. A meta-analysis was not possible due to heterogeneity amongst included trials, therefore a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomised controlled trials, 8 observational studies) investigated a variety of medical rehabilitation interventions for natural disaster survivors to eval...

"Questo documento è stato realizzato nell'ambito del progetto ANDIW, iniziato nel mese di ottobre 2009 e concluso nel mese di settembre 2011. Durante il primo anno abbiamo intervistato alcune funzionarie dei servizi del pubblico Impiego e cinque aziende che assolvono l'obbligo di assunzione di categorie protette o offrono la possibilità di svolgere al loro interno dei tirocini pur non rientrando nelle categorie obbligate ad assumere persone con disabilità.
A questa fase è seguito un confronto con i partner e la stesura di un capitolo che fa parte di un corso di formazione a distanza per datori di lavoro e consulenti di servizi per il pubblico impiego.
La seconda fase di lavoro ci ha permesso di riflettere su quanto avevamo raccolto nel primo anno e di valutare la significatività di ciò che ci era stato descritto.
Abbiamo pertanto deciso di pubblicare degli estratti del lavoro svolto, nella consapevolezza che non si tratta di discorsi rivolti a lettori specializzati ma piuttosto a chiunque desideri comprendere meglio come funzionano oggi i servizi di inserimento professionale e quale é l'approccio che guida l'organizzazione di questi servizi.
Ci sembra che i risultati siano significativi sia dal punto di vista numerico, vista la quantità di avviamenti al lavoro che vengono effettuati, sia dal punto di vista qualitativo, vista l'attenzione e la cura posta nella formazione del personale, nella fase di orientamento e poi in quella di collocamento.
Riteniamo che oggi, nel 2011, vi sia ancora una grande confusione quando si parla di “persone con disabilità e avviamento al lavoro”.
I servizi del pubblico impiego non si rivolgono in generale a chiunque viva con una qualche forma di disabilità. La percentuale di disabilità riconosciuta dalle commissioni mediche, il desiderio e la motivazione della persona ad entrare in un circuito che richiede un impegno e una disponibilità prolungati, il fatto di vivere in contesti in cui vi é una cultura capace di leggere in modo corretto concetti come inclusione e funzionamento, l’evoluzione della situazione individuale ma anche di quella sociale, sono solo i principali aspetti che circoscrivono il numero di persone di cui si parla quando si parla di collocamento mirato.
Ci sembra pertanto importante aver cercato di illustrare le caratteristiche dell'utenza, che comprendono spesso una o più delle seguenti situazioni:
• disabilità multiple,
• un insieme di problemi di natura più strettamente sanitaria e di problemi sociali e culturali,
• uno svantaggio sociale che, partendo da un livello educativo basso, porta ad avere più facilmente una disabilità se si sono svolti lavori usuranti per buona parte della vita lavorativa.
Sono tutti aspetti che é importante tenere presenti quando si affronta il tema dell'inserimento lavorativo mirato.
Nel confronto con i partner stranieri abbiamo potuto constatare come l'approccio che prevede di non concentrarsi su una diagnosi, anzi, di non conoscerla affatto, sia estremamente positivo. Le conseguenze più immediate di questo rispetto della privacy della persona sono la possibilità di essere vista per quello che può e sa fare, non per quello che noi attribuiamo a nomi e concetti astratti e generici.
Siamo certi che la stessa diagnosi accomuni due persone molto marginalmente, e che qualificarsi o riqualificarsi, ricercare una lavoro, sperimentarlo, mantenerlo, richiedano un insieme che comprende dei saperi, ma anche saper fare e saper essere. In tutto questo, le capacità fisiche, mentali, sensoriali delle persone costituiscono solo una minima parte.
Presentiamo quindi questo lavoro che cerca di raccontare un percorso complesso e che include anche contraddizioni, con parole semplici augurandoci che la lettura stimoli ad approfondire il tema e, soprattutto, come dicono le funzionarie intervistate, contribuisca a “fare cultura”.
Ringraziamo la Provincia di Genova per la collaborazione che ci ha offerto, e rimaniamo ovviamente responsabili di qualsiasi imprecisione contenuta nel testo."

An ethnobotanical study was conducted from October 2005 to June 2006 to investigate the uses of medicinal plants by people in Zegie Peninsula, northwestern Ethiopia. Information was gathered from 200 people: 70 female and 130 males, using semistructured questionnaire. Of which, six were male local healers. The informants, except the healers, were selected randomly and no appointment was made prior to the visits. Informant consensus factor (ICF) for category of aliments and the fidelity level (FL) of the medicinal plants were determined. Sixty-seven medicinal plants used as a cure for 52 aliments were documented. They are distributed across 42 families and 64 genera. The most frequently utilized plant part was the underground part (root/rhizome/bulb) (42%). The largest number of remedies was used to treat gastrointestinal disorder and parasites infections (22.8%) followed by external injuries and parasites infections (22.1%). The administration routes are oral (51.4%), external (38.6%), nasal (7.9%), and ear (2.1%). The medicinal plants that were presumed to be effective in treating a certain category of disease, such as 'mich' and febrile diseases (0.80) had higher ICF values. This probably indicates a high incidence of these types of diseases in the region, possibly due to the poor socio-economic and sanitary conditions of this people. The medicinal plants that are widely used by the local people or used as a remedy for a specific aliment have higher FL values (Carissa spinarum, Clausena anisata, Acokanthera schimperi, Calpurnia aurea, Ficus thonningii, and Cyphostemma junceum) than those that are less popular or used to treat more than one type of aliments (Plumbago zeylanicum, Dorstenia barnimiana).

Objective: To examine the hypothesis that the influence of physical activity capacity on participation is mediated through activity performance. Design: Secondary analysis of a prospective cross-sectional study sample. Setting: Regional pediatric specialty care hospital. Participants: Children (NZ128; 59% boys; age range, 2e9y) with cerebral palsy with Gross Motor Function Classification System levels I to III; 49% had hemiplegia, and 72% had spasticity. Interventions: Not applicable. Main Outcome Measures: Activity capacity was measured with the Gross Motor Function Measure-66, performance was measured with the Activities Scale for Kids, and participation was measured with the Assessment of Life Habits. Children's Assessment of Participation and Enjoyment and the Assessment of Preschool Children's Participation assessed diversity participation. Regression equations and Sobel z test were used to examine the mediated effect via performance. Results: Physical activity performance mediates 74.9% (bZ.83, P<.001) of the effect of activity capacity on total participation levels and 52.8% (bZ.47, PZ.001) of the effect of capacity on diversity participation. Conclusions: The relation between what an ambulatory child with cerebral palsy is able to perform in a clinical setting and their participation in life is significantly mediated by what they actually do motorically in day-to-day life. Results suggest that interventions focusing on improving what they actually do every day, regardless of their capacity to perform (what they can do when tested), may positively influence participation.

Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique that activates neurons via generation of brief pulses of high-intensity magnetic field. If these pulses are applied in a repetitive fashion (rTMS), persistent modulation of neural excitability can be achieved. The technique has proved beneficial in the treatment of a number of neurological and psychiatric conditions. However, the effect of rTMS on excitability and the other performance indicators shows a considerable degree of variability across different sessions and subjects. The frequency of stimulation has always been considered as the main determinant of the direction of excitability modulation. However, interactions exist between frequency and several other stimulation parameters that also influence the degree of modulation. In addition, the spatial interaction of the transient electric field induced by the TMS pulse with the cortical neurons is another contributor to variability. Considerati...

ID: 329 Fachbereich: Prävention sozial und nachhaltig gestalten Themenbereich: Sozialepidemiologie/ Psychosoziale Einflüsse auf Gesundheit Beitragsart: Beitrag zu organisierter Veranstaltung Psychosocial stress as an indicator for disease severity, mental health and health care utilization in IBD patients. Evaluation of a short scale of perceived stress in chronic diseases J Hardt, S Conrad, C Muche-Borowski, H Raspe